- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04387162
Prism Adaptation in Left Brain Stroke
One Treatment, Multiple Targets: Prism Adaptation and Left Brain Stroke Rehabilitation
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
The functional disability experienced by Veterans after stroke, and the limited rehabilitation resources available, highlight the importance of identifying feasible treatments acting on more than one recovery target. Currently, there are separate and modality-specific treatment pathways for cognitive and motor impairments. These modality-specific treatment pathways lead to fragmentation of care, and under-identification and under-treatment of invisible disabilities, such as spatial neglect, aphasia and pain. The result is longer hospital stays, greater risk of falls, and poor functional outcomes. Employing a treatment that simultaneously addresses multiple targets will ensure that the investigators provide the needed care for >50% of post-stroke Veterans who have both visible and invisible disabilities, during the critical post-acute period of recovery.
Prism adaptation treatment (PAT) is a 10-day regimen reported to be inexpensive, replicable and effective for treatment of spatial neglect, and studies have demonstrated that it also enhances everyday activities and motor recovery and reduces chronic post-stroke pain in patients with right brain stroke. Additionally, brain mapping methods have shown that in patients with right brain stroke, those with frontal lesions respond optimally to PAT. No studies have investigated PAT in left-brain stroke patients with language and cognitive impairment. To address this research gap, the investigators will address the following aims:
Aim 1: To demonstrate the feasibility of adapted PAT procedures in patients with aphasia and memory impairment. .
Aim 2: To demonstrate the feasibility of adapted methods for assessing spatial and motor function and pain in patients with aphasia and memory impairment.
Aim 3: To demonstrate the feasibility of using information about lesion location from the radiology report to classify frontal vs. nonfrontal lesions.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
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Georgia
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Decatur, Georgia, United States, 30033-4004
- Atlanta VA Medical and Rehab Center, Decatur, GA
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- 1-3 months post-stroke, entering outpatient treatment
- proficient English speakers
- experiencing moderate functional disability as measured by Functional Independence Measure (FIM), observational or telephone-administered FONE-FIM
- experiencing aphasia as determined by a Western Aphasia Battery Aphasia Quotient and memory impairment as determined by the Brief Visuospatial Memory Test- Revised, the Hopkins Verbal Learning Test- Revised or digit span forward and backward
- able to provide informed consent to participate, using aphasia-accessible process, as needed.
Exclusion Criteria:
- History of brain conditions other than left brain stroke, including clinical right brain pathology.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Immediate
Participants will enter treatment after one week baseline
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Spatial retraining treatment
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Experimental: Delayed
Participants will enter treatment after two week baseline
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Spatial retraining treatment
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Client Satisfaction Questionnaire
Time Frame: Immediately following the two-week treatment (study week 3 in immediate group, study week 5 in delayed group)
|
Assessment of satisfaction and perceived value of Prism Adaptation Treatment; scores range from 8-32, with higher scores indicating greater satisfaction
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Immediately following the two-week treatment (study week 3 in immediate group, study week 5 in delayed group)
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Credibility/Expectancy Questionnaire
Time Frame: Immediately following the two-week treatment (study week 3 in immediate group, study week 5 in delayed group)
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Assessment of whether Prism Adaptation Treatment is believable, convincing and logical (credibility) and the expectations for treatment-induced improvement (expectancy); two rating scales with one scale ranging from 1-9 and from 0%-100%, with higher scores indicating greater credibility and expectancy.
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Immediately following the two-week treatment (study week 3 in immediate group, study week 5 in delayed group)
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Barthel Index
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Assessment of functional disability by activities of daily living; scores range from 0-100, with higher score indicating greater independence and less functional disability
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Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
|
Functional Independence Measure
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Assessment of cognitive and motor function; scores range from 18-126, with a higher score indicating greater functional independence
|
Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
|
Behavioral Inattention Test- Conventional Subtest
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Assessment of spatial neglect; severity scores range from 1-6, with higher scores indicating more severe spatial neglect
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Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
|
Catherine Bergego Scale via the Kessler Foundation Neglect Assessment Process
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
|
Assessment of spatial neglect; scores range from 0-30, with higher scores indicating more severe spatial neglect
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Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
|
Wolf Motor Function Test
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Assessment of motor function; scores range from 0-75, with higher scores indicating less impairment in motor function
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Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Defense and Veterans Pain Rating Scale
Time Frame: Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Assessment of pain; scores range from 0-10, with higher scores indicating more severe pain
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Weekly from baseline to follow-up (study week 7); CHANGE from baseline to immediate post-treatment (study week 3 in immediate group, study week 5 in delayed group), CHANGE from baseline to two weeks post-treatment (study week 7)
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Classification of lesion location
Time Frame: Baseline
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Assessment of whether lesion is "frontal" or "nonfrontal"
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Baseline
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Collaborators and Investigators
Investigators
- Principal Investigator: Amy D. Rodriguez, PhD, Atlanta VA Medical and Rehab Center, Decatur, GA
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Actual)
Study Completion (Actual)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Estimated)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- B3474-P
- RX003474-01 (Other Grant/Funding Number: VAORD)
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
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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