- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT01933438
Sup-ER Protocol RCT
Does Early Supination and External Rotation Repositioning in Children With Birth Related Brachial Plexus Injury Have Benefit? A Randomized Controlled Trial of the Sup-ER Protocol.
Study Overview
Status
Intervention / Treatment
Detailed Description
The brachial plexus is a group of 5 nerves from the spinal cord that provide the movement and sensation of an upper extremity. In some difficult deliveries, traction on the shoulder may lead to damage to the brachial plexus and will result in an arm that is paralyzed. This is called 'birth related brachial plexus injury' (BRBPI). This may occur in up to 1/1000 births and the nerves may be injured minimally to severely. About 2/3 of children with this injury will recover to quite functional levels simply by maintaining looseness of joints while their nerves slowly heal. Some children have nerve injuries severe enough that they require surgical reconstruction with nerve grafts and nerve transfers to achieve even adequate function. Even in children with otherwise "good" recovery, the motions of external rotation of the shoulder and supination of the forearm are weaker, later to recover, and often incomplete. More importantly, lack of full motion leads to long term changes in the structure, growth, and posture of the shoulder requiring further musculoskeletal surgery, or a child with permanent deformity or disability.
Any gains in active and passive range of motion during the first year of life may improve these long-term shoulder outcomes. The investigators have instituted a program of early passive repositioning mostly using a custom Sup-ER (Supination and External Rotation) splint during early growth and development to improve arm position and range of motion where ER and Sup are weak. In compliant patients in a pilot study, the speed and strength of recovery of ER and Supination are improved compared to historical controls. It is a novel splint and protocol designed by the investigators. This study is a randomized controlled trial to evaluate the use of the Sup-ER protocol in multiple centres over a two year period by assessing the arm function at common time points in recovery. The subjects are randomized to the Sup-ER protocol or the currently accepted standard treatment.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
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British Columbia
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Vancouver, British Columbia, Canada, V6H 3V4
- BC Children's Hospital
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Diagnosis of brachial plexus injury at birth.
- Significant deficit in external rotation and/or supination of the affected limb based on clinical assessment using the Toronto Active Movement Scale at 6 weeks of age (External Rotation ≤ 2 and/or Supination ≤ 2)
- Tightness in Passive Range of Motion of external rotation: any angle of less than 180°.
- Age 6-8 weeks
Exclusion Criteria:
- Neuromuscular disorder
- Unwillingness or inability to comply with the requirements of the study protocol.
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: Control
Standard treatment
|
Standard treatment
|
Experimental: Sup-ER protocol
Early shoulder repositioning (Sup-ER Splint)
|
Early shoulder repositioning (Sup-ER Splint)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Time Frame |
---|---|
Toronto Active Movement Scale
Time Frame: 1 year of age
|
1 year of age
|
Collaborators and Investigators
Sponsor
Collaborators
Investigators
- Principal Investigator: Cynthia Verchere, MD FRCSC, University of British Columbia
Publications and helpful links
Helpful Links
Study record dates
Study Major Dates
Study Start
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Estimate)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- H13-00751
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.
Clinical Trials on Birth Related Brachial Plexus Injury
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University of British ColumbiaChildren's & Women's Health Centre of British ColumbiaWithdrawnBirth Related Brachial Plexus Injury | Obstetrical Brachial Plexus Palsy
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All India Institute of Medical Sciences, New DelhiCompletedBrachial Plexus InjuryIndia
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Ataturk UniversityNot yet recruitingBrachial Plexus Injury | Elasticity Imaging Techniques
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Centre Hospitalier Universitaire VaudoisWithdrawnBrachial Plexus InjurySwitzerland
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Assiut UniversityNot yet recruiting
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Siriraj HospitalLerdsin General HospitalCompleted
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University of AlbertaRoyal Alexandra Hospital; Glenrose FoundationNot yet recruiting
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Carilion ClinicEunice Kennedy Shriver National Institute of Child Health and Human Development... and other collaboratorsRecruitingBrachial Plexus InjuryUnited States
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Leiden University Medical CenterZonMw: The Netherlands Organisation for Health Research and DevelopmentUnknownBrachial Plexus InjuryNetherlands
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Emine AtıcıCompletedObstetric Brachial Plexus InjuryTurkey
Clinical Trials on Sup-ER Protocol
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University of British ColumbiaChildren's & Women's Health Centre of British ColumbiaWithdrawnBirth Related Brachial Plexus Injury | Obstetrical Brachial Plexus Palsy
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Fifth Affiliated Hospital, Sun Yat-Sen UniversityRecruitingThyroid Cancer | Lymph Node Metastases | Positron-Emission TomographyChina
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Istituti Clinici Scientifici Maugeri SpAActive, not recruiting
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University of PittsburghCompleted
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Hospices Civils de LyonRecruitingHealthy | Visual ImpairmentFrance
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Aalborg University HospitalDanish Heart FoundationCompletedIschemic Stroke | Peripheral Artery Disease | Acute Myocardial Infarction
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Institut de Recherche pour le DeveloppementUnited Nations World Food Programme (WFP); UNICEF; Sidaction; Global FundCompletedHIV/AIDS | Malnutrition
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SIGA TechnologiesUnited States Department of DefenseCompletedSmallpoxUnited States
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RVL Pharmaceuticals, Inc.Osmotica Pharmaceutical US LLCWithdrawnMultiple Sclerosis | SpermUnited States
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Chinese University of Hong KongRecruiting