- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01716871
The Using of NEurocryostimulation in Military Ankle Sprains (TUNEMAS)
COMPARAISON D'EFFICACITÉ ENTRE LA CRYOTHÉRAPIE GAZEUSE HYPERBARE ET LA CRYOTHÉRAPIE CONVENTIONNELLE DANS LE TRAITEMENT DES ENTORSES EXTERNES DE LA CHEVILLE Étude randomisée auprès d'Une Population de Militaires
Introduction: The military population is at high-risk for injury with by painful sprains, especially of the ankle. The referenced treatment method for pain is the cryotherapy, consisting in applying cold-packs to the injured ankle several times a day. However, another pain treatment has been developed and is commonly used by high-level sports teams and rheumatologists but its efficacy has never been assessed within a military population, i.e. the hyperbaric CO2 cryotherapy, also called the neurocryostimulation.
Research design: This study was carried out on a French multicenter basis, the study consisting in a randomized controlled superiority trial and open-label prospective analysis in the treatment of 40-year-old military patients or younger suffering from acute ankle sprains. Two groups were made: patients were treated either by neurocryostimulation or by the referenced cryotherapy (cold-packs). The care protocol for both groups consisted in six supervised 30 minute-sessions within a period of three consecutive days.
Hypothesis: Neurocryostimulation is more effective in the treatment of pain severity resulting from an ankle sprain than the referenced treatment by cold-packs. Moreover, we theorized that the total consumption of paracetamol and the number of days of temporary inaptitude and of work exemption were lower in patients treated by neurocryostimulation.
Outcomes:
For each session, pain severity is assessed on a 100-mm Visual Analog Scale at the beginning and at the end of session 20 minutes later after a four-step walk.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
In France, there is one ankle sprain per 10,000 person/day mainly as a result of athletic practice. The military population is one of the most physically active populations due to taking part in sports exercise, scheduled sports periods and leisure sports , or required military exercise which increase the soldiers' risk for injury to the lower extremity, especially the ankle. The incidence rate for ankle sprain injuries among all -active-duty US service members was 34.95 per 1000 person/year , thus more than 5 times greater than previously reported in civilian studies reported in the literature. These are among the two first leading causes of sports and physical training related hospitalizations among the U.S. Army population.
Sprains can lead to numerous consequences in the long-term in physical restrictions such as, ankle instability, risk of recurrence, but also absenteeism from work and/or participation in sports and chronic pain. A more efficient treatment seems to be necessary in preventing such troubles.
The usual care protocol for ankle sprains (RICE protocol) involve the cryotherapy (usually a cold-pack (R) applied directly to the injury several times a day with no existing undesirable effects).
An innovative treatment method, the neurocryostimulation, developed by Cluzeau and a French Company in 1993, gained rapid and wide-spread use among physiotherapists, rheumatologists, and athletes.It would provide a powerfull anti-inflammatory, myorelaxant and analgesic effect but contradictory results are shown in literature. Demoulin et al. aimed to assess the efficacy of neurocryostimulation following total knee arthroplasty compared to routinely used strategies for applying cold therapy, but didn't show significant differences regarding pain severity, mobility and perimetric measures. However, a pilot study led in Switzerland, comparing the pain reported by patients after an acute post-operative knee arthroscopy, has shown a pain differential higher in the neurocryostimulation than in the referenced cryotherapy (2.2 versus 0.5). And, Chatap et al. showed in a prospective study that pain scores decreased significantly after four sessions in elderly patients with acute or chronic pain.
At this day, No study has proved the efficacy of neurocryostimulation versus cold packs in pain resulting from an ankle sprain . A better treatment of the ankle sprain could reduce pain and , in the same time, also reduce the consumption of analgesics, the time of temporary inaptitudes and of work exemptions.
Study Type
Enrollment (Anticipated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: CREDORC
- Phone Number: +33387562427
- Email: credorc@hia-legouest.fr
Study Locations
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Paris, France, 75000
- Recruiting
- DCSSA
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Contact:
- courtiere Alain, PHD
- Phone Number: 0169237174
- Email: acourtiere@imassa.fr
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
age equal or less than 40 years-old, military subject, acute ankle injury, To have completed and signed the informed consent.
Exclusion Criteria:
contraindications to cryotherapy ( cold allergy, cryoglobulinemia, Raynaud's phenomenon, cutaneous sensory abnormalities, and diabetes mellitus), paracetamol allergy, 4th grade sprains according to the Trevino Classification (with bone wrenching), to take analgesic or anti-inflammatory treatment other than paracetamol.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Active Comparator: cryotherapy using Cold pack®
patients with lateral ankle sprain who have been randomized in the "cold packs®" group. Application of cryotherapy with Cold pack® or ice-cubes pack in the sprained ankle during 20 minutes 4 times a day, 3 days long. |
Patients receive 2 controlled applications a day (one in the morning and one in the evening) of cryotherapy with Cold pack® or ice-cubes pack (with average dimensions of 5 cm by 8 cm) to the injury site for a duration of 20 minutes. Furthermore, the patients are instructed to do 2 more applications of the ice-pack during the daytime to follow the usual recommendations. The first and last sessions of each day must be supervised by the medical care Unit to insure standardized data collection for each group. |
Active Comparator: cryotherapy using Neurocryostimulation
Patient with lateral ankle sprain randomized in the "neurocryostimulation" group. Application of neurocryostimulation with Duo-cryo® device during 1 minute on the sprained ankle, 2 times a day, 3 days long |
organized in the morning and in the evening during 3days.
The gaz is sprayed with Duo-cryo® device on dry skin over the ankle using a slow, regular, sweeping movement.
The tip of the nozzle is kept 15 to 20 cm away from the skin.
Neurocryostimulation is applied to patients for a duration of one minute by a trained staff
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Evolution of pain assassed by Visual analogic scale of pain
Time Frame: 2 times in the morning, 2 times in the evening, 3 days long
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pain is assessed with Visual analogic scale of pain just before the application of cryotherapy (T0) and 20 minutes after the application of cold(T20) right after the patient has taken four-step walk.
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2 times in the morning, 2 times in the evening, 3 days long
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Daily consumption of paracetamol
Time Frame: every day during 3 days
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The daily analgesic consumption (grams of paracetamol) is also reported in medical records every evening by means of doctor-patient interrogation.
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every day during 3 days
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Other Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
number of days of temporary incapacity of work
Time Frame: participants will be followed for the duration of the symptoms (pain, oedema), an expected average of 4 weeks
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The patient must visit the investigator of his center every week, who judges the patient's aptitude to go back to work without any restriction.
The investigator will report the total number of days of all temporary inaptitude related to the ankle sprain.
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participants will be followed for the duration of the symptoms (pain, oedema), an expected average of 4 weeks
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number of days of work exemption
Time Frame: participants will be followed for the duration of the symptoms (pain, oedema), an expected average of 2 weeks
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The investigator will report,if any, the total number of days of work exempt consecutive to the ankle sprain.
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participants will be followed for the duration of the symptoms (pain, oedema), an expected average of 2 weeks
|
Collaborators and Investigators
Investigators
- Principal Investigator: Nicolas VERTU, Interne, Direction Centrale du Service de Santé des Armées
- Study Director: Denis LAGAUCHE, Dr, Direction Centrale du Service de Santé des Armées
- Study Chair: Alain COURTIERE, Pharmacien, Direction Centrale du Service de Santé des Armées
Study record dates
Study Major Dates
Study Start
Primary Completion (Anticipated)
Study Completion (Anticipated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Estimate)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- Lagauche 2011-RC-11
- 2011-A00111-40 (Other Identifier: French ANSM)
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
product manufactured in and exported from the U.S.
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