The Application of Thermal Stimulation on Functional Recovery of Stroke Patients

April 6, 2015 updated by: Jau-Hong Lin, Professor, Kaohsiung Medical University Chung-Ho Memorial Hospital
In literature review, thermal stimulation (TS) intervention is effective in facilitating upper extremity functional recovery in stroke patients. In addition, several functional MRI studies have indicated that thermal stimuli promoted activation in the premotor and motor cortices of healthy participants. These imply the possibility of TS in cortical reorganization. However, there were no studies exploring the relationship of the TS intervention and cortical reorganization. By the functional recovery of stroke patients, findings of brain image and brain mapping, it could enhance the understanding the TS influences on brain reorganization. Regarding with clinical application of the TS intervention for improving functional performance of upper extremity in participants with stroke, the best parameters of TS intervention in clinical practice have not been decided. Therefore, this five-year study recruited three groups of stroke patients (acute, sub-acute, chronic) undergoing TS intervention with different parameters. Functional scales, kinematic data, brain image were taken in several timelines as outcome measures.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The thermal stimulation (TS) intervention uses the heat and cold apply alternately (~30minutes), and this kind temperature application is common in clinical neuromuscular or sports rehabilitation. Moreover, some studies have proved efficacy of the TS on stroke. However, the best parameters and application on different-stage stroke groups have not been clearly explored. Moreover, in order to discover the TS intervention influences on neuroplasticity, the brain images and the brain mapping are taken in the group A (explained in the below). In addition, the kinematic data was also collected in group A. However, the above-mentioned three examination are optional. Finally, functional recovery measurements (clinical scales) are measured in the three groups.

There are three groups (90 participants in each group) and their respective TS intervention design. In other word, three sub-studies (A, B, C) are under this project. Group A recruited 90 acute stroke (~ 30 days) and the independent variable is temperature of TS intervention. Group B is with sub-acute stroke (3-12 months), undergoing different frequency of TS intervention. Group C targets on participants with chronic stroke (> 1 y/o) and this variation in TS is intensity of TS application (30 mins vs 60 mins/each session).

Study Type

Interventional

Enrollment (Actual)

220

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Taiwan
      • Kaohsiung city, Taiwan, 807
        • Kaohsiung Medical University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 80 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion Criteria:

  1. first-ever ischemic stroke;
  2. no severe cognitive impairments and able to follow instructions;
  3. sit on a chair for more than 30 minutes independently.

Exclusion Criteria:

  1. musculoskeletal or cardiac disorders that potentially interferes with experimental tests;
  2. diabetic or sensory impairment that attributable to peripheral vascular disease or neuropathy;
  3. speech disorder or global aphasia;
  4. skin problems at the sites of stimulation;

6.contraindications of heat or ice application.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Factorial Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Noxious TS in study A
Other: Noxious TS
hot, cold alternately, noxious TS in study A
Active Comparator: Innocuous TS
Innocuous TS in study A
Other: Innocuous TS
warm, cool alternately, Innocuious TS in study A
Experimental: High Frequency of Noxious TS
High Frequency of Noxious TS in study B
Other: High Frequency of Noxious TS
High Frequency of Noxious TS in study B
Active Comparator: Low Frequency of Noxious TS
Low Frequency of Noxious TS in study B
Other: Low Frequency of Noxious TS
Low Frequency of Noxious TS in study B
Experimental: High Intensity of Noxious TS
High Intensity of Noxious TS in study C
Other: High Intensity of Noxious TS
High Intensity of Noxious TS in study C
Active Comparator: Low Intensity of Noxious TS
Low Intensity of Noxious TS in study C
Other: Low Intensity of Noxious TS
Low Intensity of Noxious TS in study C

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Movement performance assessment
Time Frame: baseline, half time-line of whole intervention period, post-intervention, 1 month follow-up, 6 month follow-up
  • Movement performance assessment by clinical motor assessment scales in upper extremity
  • executed by qualified physiotherapy
  • in study A, B, C
baseline, half time-line of whole intervention period, post-intervention, 1 month follow-up, 6 month follow-up
Brain images
Time Frame: immediate effects in 3 timeline
  • "intermediate effect of TS" means: pretest of the single TS, then application of this single TS, finally post-test of this TS in the session in the same day
  • immediate effects of intervention in the 1st day and 24th of intervention, six-month follow-up
  • this examination is optional
  • in study A.
  • use regular scan examination of hospital and operated by trained qualified professionals, the attending is consulted
  • This examination can be stopped at any time if participants do not want to perform or feeling unwell
immediate effects in 3 timeline
Mapping of brain cortex
Time Frame: immediate effect in four timeline
  • "intermediate effect of TS" means: pretest of the single TS, then application of this single TS, finally post-test of this TS in the session in the same day
  • immediate effects of intervention in the 1st day and 24th of intervention, one-month follow-up, six-month follow-up
  • in study A.
  • this examination is optional
  • use equipment of brain mapping and operated under trained staff, the attending is consulted This examination can be stopped at any time if participants do not want to perform or feeling unwell
immediate effect in four timeline
Kinematics measure of upper extremity movement
Time Frame: four timeline
  • 1st day and 24th of intervention, one-month follow-up, six-month follow-up (This examination is optional)
  • signal emission marks are sticked on surface skin during motion tests

  • this examination is optional

    --in study A.

  • executed by trained qualified physiotherapy
four timeline

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Quality of life
Time Frame: baseline, post-intervention, 6 month follow-up
  • Quality of life by subjective questionnaires
  • executed by qualified physiotherapy --in study A, B, C.
baseline, post-intervention, 6 month follow-up

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Kaohsiung Medical University Chung-Ho Memorial Hospital

Collaborators

E-DA Hospital
Kaohsiung Municipal Hsiaokang Hospital

Investigators

  • Principal Investigator: Jau-Hong Lin, Professor, Kaohsiung Medical University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start

January 1, 2010

Primary Completion (Actual)

June 1, 2014

Study Completion (Actual)

December 1, 2014

Study Registration Dates

First Submitted

June 26, 2011

First Submitted That Met QC Criteria

August 16, 2011

First Posted (Estimate)

August 17, 2011

Study Record Updates

Last Update Posted (Estimate)

April 8, 2015

Last Update Submitted That Met QC Criteria

April 6, 2015

Last Verified

April 1, 2015

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • NHRI-EX99-9907PI

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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