- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04229329
Effects of Intensive Training on Reocvery of Fingers Dexterity Following Stroke
September 17, 2022 updated by: Nachum Soroker, MD, Loewenstein Hospital
The Effect of Intensive Training on Recovery of Fingers Dexterity Following Stroke: Behavioral, Physiological and Anatomical Predictors
The investigators aim to test whether intensive training of finger individuation during the sensitive window of the subacute phases can lead to a clinically-meaningful recovery of dexterous movement in stroke patients.
Study Overview
Status
Recruiting
Conditions
Study Type
Interventional
Enrollment (Anticipated)
70
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Contact
- Name: Shay Ofir-Geva, M.D.
- Phone Number: 972-522204842
- Email: shinofir@gmail.com
Study Contact Backup
- Name: Silvi Frenkel-Toledo, Ph.D.
- Phone Number: 972-545509413
- Email: silvft@ariel.ac.il
Study Locations
-
-
-
Raanana, Israel, 43100
- Recruiting
- Loewenstein Rehabilitation Center
-
Contact:
- shay ofir
- Phone Number: 972-522204842
- Email: shinofir@gmail.com
-
-
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 83 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- First symptomatic ischemic or hemorrhagic stroke
- Clinically evident upper-limb motor deficit
- Understand the study aim, is able to cooperate with the task for the specified time
- Clinically stable
Exclusion Criteria:
- Other neurological or psychiatric illness which affects upper-limb motor function
- An orthopedic or rheumatologic disease that affects the ability to undergo a robotic hand therapy.
- Sensory problems that prevent the patient from reporting pain during the robotic hand therapy
- Skin breakdown or wounds located in places where the hand contacts the robot.
- Patients with C/I to TMS (history of seizures, the existence of cardiac pacer, VP shunt, spinal stimulator or any other hardware that may malfunction at the presence of strong magnetic fields) will no undergo TMS but may participate in the study
- Participation in another interventional study for upper limb rehabilitation
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: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Intervention
The patient hand will be restrained to a robotic arm AMADEO(TM) which enables the measurement and manipulation of forces at each finger individually.
After appropriate calibration, the force measurements obtained from the robot will be used to move a cursor on the screen.
The patient will be rewarded visually and auditory when a higher degree of finger individuation will be measured.
Specifically, when the applied force of the instructed fingers hit the predefined force target and at the same, the force in the non-instructed fingers stay as low as possible
|
Interactive robot-mediated treatment aimed at increased individuation done repeatedly for at least1 hour per day for 2 weeks (5 training days a week).
|
Sham Comparator: Control
The patient hand will be restrained to a robotic arm AMADEO(TM) which enables the measurement and manipulation of forces at each finger individually.
After appropriate calibration, the force measurements obtained from the robot will be used to move a cursor on the screen.
The patient will be rewarded in a way that is unrelated to the degree of individuation.
In other words, a successful trial considered when the applied force of the instructed fingers hits the predefined force target regardless of the force exerted in the non-instructed fingers.
|
Interactive robot-mediated treatment not aimed specifically at increased individuation done repeatedly for at least 1 hour per day for 2 weeks (5 training days per week)
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Fugl-Meyer Assessment Score for Upper Extremity at the immediate post-intervention time
Time Frame: Change from Baseline Score at 1-3 days post-intervention
|
A Likert-scale that quantifies movement quality, sensation, range of motion and pain in the upper limb following stroke.
Range: 0 - 66. Higher values correlate with better motor control.
|
Change from Baseline Score at 1-3 days post-intervention
|
Change in Fugl-Meyer Assessment Score for Upper Extermity at 1-month post-intervention
Time Frame: Change from Baseline Score at 1 month post-intervention
|
A Likert-scale that quantifies movement quality, sensation, range of motion and pain in the upper limb following stroke.
Range: 0 - 66. Higher values correlate with better motor control.
|
Change from Baseline Score at 1 month post-intervention
|
Change in Fugl-Meyer Assessment Score for Upper Extermity at 3-month post-intervention
Time Frame: Change from Baseline Score at 3 month post-intervention
|
A Likert-scale that quantifies movement quality, sensation, range of motion and pain in the upper limb following stroke.
Range: 0 - 66. Higher values correlate with better motor control.
|
Change from Baseline Score at 3 month post-intervention
|
Change in Individuation Index at the immediate post-intervention time
Time Frame: Change from Baseline Score at 1-3 days post-intervention
|
The relationship between forces (in Newton) in the active vs. passive fingers during a set of isolated finger movements.
Higher numbers correlate with better finger-joint individuation, thus better dexterity.
|
Change from Baseline Score at 1-3 days post-intervention
|
Change in Individuation Index at 1-month post-intervention
Time Frame: Change from Baseline Score at 1-month post-intervention
|
The relationship between forces (in Newton) in the active vs. passive fingers during a set of isolated finger movements.
Higher numbers correlate with better finger-joint individuation, thus better dexterity.
|
Change from Baseline Score at 1-month post-intervention
|
Change in Individuation Index at 3-month post-intervention
Time Frame: Change from Baseline Score at 3-month post-intervention
|
The relationship between forces (in Newton) in the active vs. passive fingers during a set of isolated finger movements.
Higher numbers correlate with better finger-joint individuation, thus better dexterity.
|
Change from Baseline Score at 3-month post-intervention
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Arm Research Action Test (ARAT) Score at the immediate post-intervention time
Time Frame: Change from Baseline Score at 1-3 days post-intervention
|
Time and quality of performance of 19 items mimicking activity of daily living, are measured.
Tange: 0 - 57.
Higher values correlate with better motor control.
|
Change from Baseline Score at 1-3 days post-intervention
|
Arm Research Action Test (ARAT) Score at at 1-month post-intervention
Time Frame: Change from Baseline Score at 1-month post-intervention
|
Time and quality of performance of 19 items mimicking activity of daily living, are measured.
Range: 0 - 57.
Higher values correlate with better motor control.
|
Change from Baseline Score at 1-month post-intervention
|
Arm Research Action Test (ARAT) Score at at 3-month post-intervention
Time Frame: Change from Baseline Score at 3-month post-intervention
|
Time and quality of performance of 19 items mimicking activity of daily living, are measured.
Range: 0 - 57.
Higher values correlate with better motor control.
|
Change from Baseline Score at 3-month post-intervention
|
Change in M1 MEP (motor evoked potentials) amplitude at immediate post-intervention time
Time Frame: Change from Baseline Score at 1-3 days post-intervention
|
Stimulation of the ipsilesional M1 will be done (using either figure-of-eight, H- or dual-H rotational field coil) connected to TMS to elicit motor-evoked potential (MEP) of the first dorsal interosseous (FDI) muscle of the right hand, recorded with an EMG electrode.
The peak-to-peak time will be computed off-line using MATLAB software.
Higher MEP amplitudes correlate with higher cortico-spinal integrity.
|
Change from Baseline Score at 1-3 days post-intervention
|
Change in M1 MEP (motor evoked potentials) amplitude at 1-month post-intervention
Time Frame: Change from Baseline Score at 1-month post-intervention
|
Stimulation of the ipsilesional M1 will be done (using either figure-of-eight, H- or dual-H rotational field coil) connected to TMS to elicit motor-evoked potential (MEP) of the first dorsal interosseous (FDI) muscle of the right hand, recorded with an EMG electrode.
The peak-to-peak time will be computed off-line using MATLAB software.
Higher MEP amplitudes correlate with higher cortico-spinal integrity.
|
Change from Baseline Score at 1-month post-intervention
|
Change in MEP (motor evoked potentials) amplitude at 3-months post-intervention
Time Frame: Change from Baseline Score at 3-months post-intervention
|
Stimulation of the ipsilesional M1 will be done (using either figure-of-eight, H- or dual-H rotational field coil) connected to TMS to elicit motor-evoked potential (MEP) of the first dorsal interosseous (FDI) muscle of the right hand, recorded with an EMG electrode.
The peak-to-peak time will be computed off-line using MATLAB software.
Higher MEP amplitudes correlate with higher cortico-spinal integrity.
|
Change from Baseline Score at 3-months post-intervention
|
Change in extent of SICI (short-interval cortical inhibition) at the immediate post-intervention time
Time Frame: Change from Baseline Score at 1-3 days post-intervention
|
Single test pulses, conditioning pulses (five of each) and paired pulses (five pairs) at an inter-stimuli-interval (ISI) of 2 ms will be delivered to the motor cortex of both hemispheres.
The intensity of the conditioning stimulus will be set at 80% of the subject's resting motor threshold (MT).
The intensity of the test pulse will be 110% of the resting MT.
The SICI will be measured as the reduction in conditioned MEPs relative to baseline MEPs.
Higher SICI correlates with increased inhibitory activity of the motor cortex.
|
Change from Baseline Score at 1-3 days post-intervention
|
Change in extent of SICI (short-interval cortical inhibition) at 1-month post-intervention
Time Frame: Change from Baseline Score at 1-month post-intervention
|
Single test pulses, conditioning pulses (five of each) and paired pulses (five pairs) at an inter-stimuli-interval (ISI) of 2 ms will be delivered to the motor cortex of both hemispheres.
The intensity of the conditioning stimulus will be set at 80% of the subject's resting motor threshold (MT).
The intensity of the test pulse will be 110% of the resting MT.
The SICI will be measured as the reduction in conditioned MEPs relative to baseline MEPs.
Higher SICI correlates with increased inhibitory activity of the motor cortex.
|
Change from Baseline Score at 1-month post-intervention
|
Change in extent of SICI (short-interval cortical inhibition) at 3-months post-intervention
Time Frame: Change from Baseline Score at 3-months post-intervention
|
Single test pulses, conditioning pulses (five of each) and paired pulses (five pairs) at an inter-stimuli-interval (ISI) of 2 ms will be delivered to the motor cortex of both hemispheres.
The intensity of the conditioning stimulus will be set at 80% of the subject's resting motor threshold (MT).
The intensity of the test pulse will be 110% of the resting MT.
The SICI will be measured as the reduction in conditioned MEPs relative to baseline MEPs.
Higher SICI correlates with increased inhibitory activity of the motor cortex.
|
Change from Baseline Score at 3-months post-intervention
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Sponsor
Collaborators
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)
May 1, 2021
Primary Completion (Anticipated)
May 1, 2024
Study Completion (Anticipated)
March 1, 2026
Study Registration Dates
First Submitted
December 31, 2019
First Submitted That Met QC Criteria
January 12, 2020
First Posted (Actual)
January 18, 2020
Study Record Updates
Last Update Posted (Actual)
September 21, 2022
Last Update Submitted That Met QC Criteria
September 17, 2022
Last Verified
September 1, 2022
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- LOE-19-19
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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