- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04680533
Wireless TENS for Peripheral Edema (Lower Limb Swelling)
August 8, 2023 updated by: Jennifer Gewandter, University of Rochester
Transcutaneous Electrical Nerve Stimulation for Peripheral Edema: A Single Arm Clinical Trial
This study is single center, subject will receive a wireless TENS device.
All subjects will be allowed to keep the commercially-available device for use after the study.
The primary goal is to test the feasibility of the study design and secondary is to test the preliminary efficacy of the TENS.
Study Overview
Status
Active, not recruiting
Conditions
Intervention / Treatment
Detailed Description
This study is single center, subject will receive a wireless TENS device.
The coordinator will introduce the study device, be available to answer questions about the device, and assess adverse events.
Subjects will be told that we are testing whether TENS, which has shown promise in some patients but needs to be tested formally, has an effects on lower limb swelling .
The treatment period will be 3 weeks in duration.
After the treatment period, all subjects will be asked to complete the Treatment-period Endpoint-Qualitative interview.
All subjects will be allowed to keep the commercially-available device for use after the study.
Study Type
Interventional
Enrollment (Estimated)
52
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: Rachel De Guzman
- Phone Number: (585) 275-9361
- Email: TENS.edema.study@urmc.rochester.edu
Study Contact Backup
- Name: Jennifer Gewandter
- Phone Number: 585-276-5661
- Email: TENS.edema.study@urmc.rochester.edu
Study Locations
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New York
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Rochester, New York, United States, 14642
- University of Rochester Medical Center
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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
16 years and older (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion criteria (subjects must…)
- Have had lower extremity edema for at least 3 months.
- Currently have edema of at least 2+ (i.e., 3-4mm depression rebounds within a few seconds, but not immediately) on the pitting scale. 21 Pitting will have been assessed by a Clinician, the clinician Co-I within 6 weeks of the screening visit or at the screening visit by the research staff.
- Willing to not start or change the dosages of any medications that could affect edema for 2 weeks prior to enrollment, and throughout the duration of the study.
- Not currently using diuretics to control their edema.
- Not currently using and willing to not start using occupational therapy, physical therapy, or lymphatic massage (at home or by PT) 2 weeks prior to and throughout the duration of the study.
- Not currently using compression stockings or Velcro or bandage wraps at least 2 weeks prior to enrollment in the study or based on shared decision making of the potential subjects' clinician or the clinician co-investigator are receiving sufficiently little benefit from these therapies to warrant stopping their use for the duration of the study.
- Have access to a smart phone or device with an Apple or Android operating system with iOS 10 or later, or Android 6 or later. iOS and Android devices must have Bluetooth Low Energy (LE, also called Bluetooth Smart) compatibility. The smart phone or device must have the ability to access the TENS device's Quell App, Zoom App or software and, the ability to connect to the cellular data or Wi-Fi on a daily basis during the trial.
- Have an active and accessible email.
- Be willing and able to regularly check the email provided throughout the study.
- Be able to read English (i.e., is literate, can speak English, and is not blind) because patient-reported outcomes and consent form are only available in English.
- Be at least 18 years of age.
- Be able to provide informed consent.
Exclusion criteria (subjects must not…)
- Be currently using a TENS device for any reason.
- Have an acute and symptomatic lower extremity DVT (i.e., the diagnosis of DVT is less than 3 months prior to study enrollment).
- Have started anticoagulants within the past 3 months.
- Have lower extremity wounds or ulcers.
- Have a cardiac pace maker or defibrillator.
- Have epilepsy.
- Have a leg that is too small or too large for the TENS device to fit securely.
- Have cellulitis or fibrosis.
- Have any skin condition at the site where the electrode pads adhere such that the PI/Co-I think the device will not be safe for the subject.
- Have congestive heart failure.
- Have chronic kidney disease of stage 3 or greater.
- Have cirrhosis of the liver.
- Have previous surgery that removed lymphatic lower leg tissue.
- Have a diagnosis of lower limb lymphedema.
- Be pregnant or planning to become pregnant.
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: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: TENS device
The device is worn on the upper calf right below the knee and secured by an elastic band.
The device is controlled by an App and alternates between treatment periods and rest periods.
Participants will be asked to wear the device 7-8 hours per day alternating legs.
|
Quell TENS device.
The device is worn on the upper calf right below the knee and secured by an elastic band.
The device is controlled by an App and alternates between treatment periods and rest periods.
Participants will be asked to wear the device 7-8 hours per day alternating legs.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Water volume displacement
Time Frame: day 28
|
The volume of water displaced by the combination of the foot and ankle, and the entire lower limb below the knee of the most affected limb at baseline will be measured using a Volumeter, which is a water displacement measurement device.
The volumes will be recorded in Volumeter Measurements form.
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day 28
|
Edema Symptom Diary score
Time Frame: day 0 to day 28
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Swelling and symptoms associated with edema will be recorded in the Edema Symptom Diary using a verbal rating scale of swelling in the lower limbs and feet using the anchors "none", "a little bit", "quite a bit" "a lot", or "very much", which converts to a 1 to 5 measurable scale, with [1 = none, 5 = very much].
The scores per each symptom per day will be summed and averaged over 7 days.
The higher the score the worse the health outcome.
The range of scores the participant can achieve per day is between 6 - 30.
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day 0 to day 28
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Screening failure
Time Frame: Entire recruitment period, up to 6 months
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The rate at which participants who are approached and screened for the study but are ineligible will be assessed using study records.
The rate recorded will be the total percentage of screening failures during the total recruitment period of the study.
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Entire recruitment period, up to 6 months
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Patient Refusal
Time Frame: Entire recruitment period, up to 2 years
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The rate at which participants who are approached and screened for the study but choose to not participate in the study will be assessed using study records.
The rate recorded will be the total percentage of patient refusals during the total recruitment period of the study.
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Entire recruitment period, up to 2 years
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Outcome Measure completion
Time Frame: day -7 to day 28
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The rate of outcome measure completion by participants over course of enrollment in the study will be assessed using the study dispositions records in REDCap.
The rate recorded will be the total percentage of completed outcome measures during the period of enrollment in the study.
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day -7 to day 28
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Mean Treatment Adherence On skin time
Time Frame: day 0 to day 28
|
Treatment adherence will be evaluated using data from the TENS device's App to review the time that the device was in contact with the skin per day.
The Quell Health account for each subject will be set up at the baseline visit using a de-identified, unique dummy email address created for the study to protect subjects' privacy.
|
day 0 to day 28
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Mean Treatment Adherence Sessions
Time Frame: day 0 to day 28
|
Treatment adherence will be evaluated using data from the TENS device's App to review the number of treatment sessions/day.
The Quell Health account for each subject will be set up at the baseline visit using a de-identified, unique dummy email address created for the study to protect subjects' privacy.
|
day 0 to day 28
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Mean Treatment Adherence stimulations time
Time Frame: day 0 to day 28
|
Treatment adherence will be evaluated using data from the TENS device's App to review the amount of time the participant received stimulation per day.
The Quell Health account for each subject will be set up at the baseline visit using a de-identified, unique dummy email address created for the study to protect subjects' privacy.
|
day 0 to day 28
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Mean Treatment Adherence Frequency type
Time Frame: day 0 to day 28
|
Treatment adherence will be evaluated using data from the TENS device's App to review the type of frequency stimulation the participant receives per day.
The Quell Health account for each subject will be set up at the baseline visit using a de-identified, unique dummy email address created for the study to protect subjects' privacy.
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day 0 to day 28
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Coordinator tape measurements of the lower limb
Time Frame: day 28
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The blinded coordinator will use a tape measure at the arch of the foot, 1/2 and the distance between the middle of the kneecap and the ankle, and at the knee crease of both limbs regardless of which is more affected.
Measurements will be recorded in the Coordinator Lower Limb Swelling form.
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day 28
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Mean Change in monofilament threshold
Time Frame: day 0 to day 28
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Measuring the lightest touch that the participant can feel on their big toe using a monofilament.
Recording the threshold once the participant guesses the touches in the trial pair correctly 7 or 8 times.
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day 0 to day 28
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Impression of Change in Edema Symptoms
Time Frame: day 28
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Impression of change in edema symptoms is measured from baseline to first endpoint and first endpoint to second endpoint.
The form uses a 1 - 7 scale, with anchors "very much improved", "much improved", "minimally improved", "not changed", "minimally worse", "much worse", or "very much worse", with [1 = very much improved, 7 = very much worse].
The range of scores the participant can achieve 0 - 105.
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day 28
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Lymphoedema Quality of Life
Time Frame: day 28
|
Quality of life is measure over the course of the study using a 1 - 4 scale, with anchors "not at all", "a little bit", "quite a bit", or "very much", with [0 = not at all, 4 = very much].
If the question is not applicable the scale value is 0. Overall quality of life (Q22) is measure using a 0 - 10 NRS scores [0 = poor, 10 = excellent].
Each answer's score is summed by domain, Function 1-3; Appearance 4-9; Symptoms 10-15; and Mood 16-21.
Each domain score is by the total number of questions answered in the domain.
If fewer than 50% of the items were answered, the whole domain is scored as 0. The higher the LYMQOL (Lymphoedema Quality of Life) domain scores the more severe the edema.
The 5th domain, Overall quality of life 22, is measure using a 0 - 10 numerical rating scale (NRS) scores, with [0 = poor, 10 = excellent].
The range of scores the participant can achieve per domain is: Function 0 - 32; Appearance 0 - 24; Symptoms 0 - 24; Mood 0 - 24; and Overall quality of life 0 - 10.
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day 28
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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)
June 28, 2021
Primary Completion (Estimated)
May 28, 2025
Study Completion (Estimated)
September 1, 2025
Study Registration Dates
First Submitted
December 10, 2020
First Submitted That Met QC Criteria
December 17, 2020
First Posted (Actual)
December 23, 2020
Study Record Updates
Last Update Posted (Actual)
August 9, 2023
Last Update Submitted That Met QC Criteria
August 8, 2023
Last Verified
August 1, 2023
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- STUDY00005655
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
Yes
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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