- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT03859960
The Effects of Spasticity on Glucose Metabolism in Individuals With Spinal Cord Injury
August 19, 2020 updated by: Arzu Atici, Fatih Sultan Mehmet Training and Research Hospital
The Effects of Spasticity on Glucose Metabolism and Soft Tissue Body Composition in Individuals With Motor Complete and Motor Incomplete Spinal Cord Injury
Muscle atrophy may occur in individuals with spinal cord injury (SCI) as a result of diminished physical activity and alterations in glucose metabolism and body composition may be seen.
In a few studies, it has been suggested that spasticity may have a positive impact on glucose metabolism by preventing muscle atrophy and alterations in body composition in individuals with motor complete SCI.
Investigators aimed to assess the effects of spasticity on glucose metabolism and body composition in participants with complete and incomplete SCI.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
Investigators plan a prospective clinical trial.
Participants with SCI were included to study if times from injury were at least one year.
Participants had an AIS grades of A-D with spasticity.
We evaluated that participants with AIS A and B SCI were motor complete group, AIS C and D SCI were motor incomplete group.
Spasticity was assessed with Modified Ashworth Scale (MAS) and spasms were assessed with Penn Spasm Frequency Scale (PSFS).
Hip adductor and extensor spasticity, knee extensor and flexor spasticity and ankle plantar flexor spasticity were assessed by using MAS.
Body composition was measured by dual-energy x-ray absorptiometry.
All participants underwent a 75 gram (g) oral glucose tolerance test (OGTT).
Insulin sensitivity was assessed by calculating Matsuda index and HOMA-IR.
Investigators assessed the effects of spasticity on glucose metabolism and body composition in participants with SCI.
Study Type
Observational
Enrollment (Actual)
33
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 65 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Sampling Method
Probability Sample
Study Population
Individuals with SCI were included to study if they were 18-65 years old and times from injury were at least one year.
Description
Inclusion Criteria:
• Spinal cord injury AIS A,B,C,D
Exclusion Criteria:
- Other central nervous system diseases
- Significant complications that affect spasticity
- Joint contracture
- Diabetes mellitus
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
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Correlation Between Knee Flexor Muscle Modified Ashworth Scale and Insulin Resistance
Time Frame: One day
|
Modified Ashworth Scale is used to assess muscle spasticity on a 6-point scale.
0: No increase in muscle tone 4: Affected part(s) is (are) rigid in flexion or extension.
Higher scores mean a worse outcome.
HOMA index was used to evaluate insulin resistance.
HOMA index is a simple, and inexpensive method used for evaluating insulin sensitivity.
In most of the studies, values >2.7 were accepted as insulin resistance.
HOMA-IR was calculated by using fasting plasma glucose (mg/dL) X fasting insulin (uIU/mL) /405 formula.
Pearson correlation was used to calculate the correlation coefficient (r).
|
One day
|
|
Correlation Between Knee Flexor Muscle Modified Ashworth Scale and Insulin Sensitivity
Time Frame: One day
|
We used the Matsuda index to assess insulin sensitivity.
Matsuda index was calculated 10.000/square root (Fasting plasma glucose x fasting plasma insulin) x (mean OGTT glucose concentration X mean OGTT insulin concentration) formula.
Higher scores mean better.
Modified Ashworth Scale is used to assess muscle spasticity on a 6-point scale.
0: No increase in muscle tone 4: Affected part(s) is (are) rigid in flexion or extension.
Higher scores mean a worse outcome.
Pearson correlation was used to calculate the correlation coefficient (r).
|
One day
|
|
Correlation Between Penn Spasm Frequency Scale and Insulin Resistance
Time Frame: One day
|
Penn Spasm Frequency Scale is used to assess spasms.
This scale is a 5-point scale.
Higher scores mean a worse outcome.
HOMA index is a simple, and inexpensive method used for evaluating insulin sensitivity.
In most of the studies, values >2.7 were accepted as insulin resistance.
HOMA-IR was calculated by using fasting plasma glucose (mg/dL) X fasting insulin (uIU/mL) /405 formula.
Pearson correlation was used to calculate the correlation coefficient (r).
|
One day
|
|
Correlation Between Penn Spasm Frequency Scale and Insulin Sensitivity
Time Frame: One day
|
We used the Matsuda index to assess insulin sensitivity.
Matsuda index was calculated 10.000/square root (Fasting plasma glucose x fasting plasma insulin) x (mean OGTT glucose concentration X mean OGTT insulin concentration) formula.
Higher scores mean better.
Penn Spasm Frequency Scale is used to assess spasms.
This scale is a 5-point scale.
Higher scores mean a worse outcome.
Pearson correlation was used to calculate the correlation coefficient (r).
|
One day
|
|
Correlation Between Knee Flexor Muscle Modified Ashworth Scale and Total Body Fat-Free Mass%
Time Frame: One day
|
The body composition of the individuals was measured by dual-energy absorptiometry (DXA) device.
Modified Ashworth Scale is used to assess muscle spasticity on a 6-point scale.
0: No increase in muscle tone 4: Affected part(s) is (are) rigid in flexion or extension.
Higher scores mean a worse outcome.
Pearson correlation was used to calculate correlation coefficient.
|
One day
|
|
Correlation Between Penn Spasm Frequency Scale and Total Body Fat-Free Mass%
Time Frame: One day
|
The body composition of the individuals was measured by dual-energy absorptiometry (DXA) device.
Penn Spasm Frequency Scale is used to assess spasms.
This scale is a 5-point scale.
Higher scores mean a worse outcome.
Pearson correlation was used to calculate the correlation coefficient (r).
|
One day
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Arzu Atici, Fatih Sultan Mehmet Training and Research Hospital
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
- Skold C, Levi R, Seiger A. Spasticity after traumatic spinal cord injury: nature, severity, and location. Arch Phys Med Rehabil. 1999 Dec;80(12):1548-57. doi: 10.1016/s0003-9993(99)90329-5.
- Gorgey AS, Dudley GA. Spasticity may defend skeletal muscle size and composition after incomplete spinal cord injury. Spinal Cord. 2008 Feb;46(2):96-102. doi: 10.1038/sj.sc.3102087. Epub 2007 Jul 17. Erratum In: Spinal Cord. 2008 Dec;46(12):825.
- Gorgey AS, Dolbow DR, Dolbow JD, Khalil RK, Castillo C, Gater DR. Effects of spinal cord injury on body composition and metabolic profile - part I. J Spinal Cord Med. 2014 Nov;37(6):693-702. doi: 10.1179/2045772314Y.0000000245. Epub 2014 Jul 7.
- Gorgey AS, Dudley GA. Skeletal muscle atrophy and increased intramuscular fat after incomplete spinal cord injury. Spinal Cord. 2007 Apr;45(4):304-9. doi: 10.1038/sj.sc.3101968. Epub 2006 Aug 29.
- Gorgey AS, Chiodo AE, Zemper ED, Hornyak JE, Rodriguez GM, Gater DR. Relationship of spasticity to soft tissue body composition and the metabolic profile in persons with chronic motor complete spinal cord injury. J Spinal Cord Med. 2010;33(1):6-15. doi: 10.1080/10790268.2010.11689669.
- Jung IY, Kim HR, Chun SM, Leigh JH, Shin HI. Severe spasticity in lower extremities is associated with reduced adiposity and lower fasting plasma glucose level in persons with spinal cord injury. Spinal Cord. 2017 Apr;55(4):378-382. doi: 10.1038/sc.2016.132. Epub 2016 Sep 13.
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 (Actual)
September 21, 2014
Primary Completion (Actual)
May 10, 2018
Study Completion (Actual)
August 8, 2018
Study Registration Dates
First Submitted
February 26, 2019
First Submitted That Met QC Criteria
February 27, 2019
First Posted (Actual)
March 1, 2019
Study Record Updates
Last Update Posted (Actual)
September 4, 2020
Last Update Submitted That Met QC Criteria
August 19, 2020
Last Verified
August 1, 2020
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Central Nervous System Diseases
- Nervous System Diseases
- Neurologic Manifestations
- Musculoskeletal Diseases
- Muscular Diseases
- Neuromuscular Manifestations
- Trauma, Nervous System
- Spinal Cord Diseases
- Muscle Hypertonia
- Wounds and Injuries
- Spinal Cord Injuries
- Muscle Spasticity
- Hypoglycemic Agents
- Physiological Effects of Drugs
- Insulin
- Insulin, Globin Zinc
Other Study ID Numbers
- 2013/22
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
No
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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