Mindful SensoriMotor Therapy With Brain Modulation in Highly Impaired Extremities

March 8, 2022 updated by: Max Ortiz Catalan, Chalmers University of Technology

Mindful SensoriMotor Therapy With Brain Modulation for the Treatment of Pain in Individuals With Disarticulation or Nerve Injuries: A Single Arm Clinical Trial

Brief summary: This single-arm, pilot clinical investigation aims to evaluate Mindful SensoriMotor Therapy (MSMT) enhanced with brain modulation as a treatment of pain due to sensorimotor impairment, such as Phantom Limb Pain (PLP). MSMT consists of consciously retraining the motor and sensory networks used by the missing limb via myoelectric pattern recognition and haptic feedback. In this trial, we further enhance the effect of MSMT by brain modulation, transcranial Direct Current Stimulation (tDCS).

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

People with upper or lower limb disarticulation (amputation at joint level) or nerve injury will participate in this study. It is a single-arm study in which all participants receive the same intervention. Each participant attends a screening visit, up to 5 baseline assessments, 15 interventions, and 3 follow-ups at 1, 3, and 6 months after the last intervention. Brain imaging will be performed pre- and post-treatment.

Study Type

Interventional

Enrollment (Anticipated)

8

Phase

  • Not Applicable

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

Study Locations

  • Sweden
    • Västra Götaland
      • Mölndal, Västra Götaland, Sweden, 431 80
        • Center for Bionics and Pain Research, CBPR
        • Contact:
          • Max Ortiz Catalan, PhD
        • Principal Investigator:
          • Max Ortiz Catalan, PhD

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 and older (Adult, Older Adult)

Accepts Healthy Volunteers

No

Genders Eligible for Study

All

Description

Inclusion criteria

  • The participant has given written informed consent to participate.
  • The participant must have chronic neuropathic pain due to sensorimotor impairment (example PLP).
  • At least six months should be passed since the date of injury (acute pain cases should not be included in the study).
  • If the participant is under pharmacological treatments, there must be no variations on the medication dosages (steady consumption) for at least 1 month before the screening visit.
  • If the participant has previously been treated for neuropathic pain, the last session of that treatment(s) must be at least 3 months before the screening visit.
  • Any pain reduction potentially correlated to previous neuropathic pain treatments must have been observed at least 3 months prior to the screening visit, as reported by the participant.
  • In the case of having a prosthesis, the participant must be in a stable prosthetic situation (i.e. satisfied with the fitting of the prosthesis or not using a prosthesis).
  • Participants must have enough contact surface at the site of the amputation or the injured nerves for the system to work, in the researcher's opinion.
  • Participants must be able to perceive the haptic stimulation at the time of the screening visit.
  • Participants must not experience painful sensations from haptic stimulation in the stump (i.e. allodynia).
  • The participant has a sufficient understanding of both Swedish and English to be able to participate in all study assessments, in the researcher's opinion.
  • Participants should not have any other condition or symptoms that can prevent them from participating in the study, in the researcher's opinion.
  • No mental inability, reluctance, or language difficulties that result in difficulty understanding the meaning of study participation, in the researcher's opinion.
  • The participant should not have any condition associated with the risk of poor protocol compliance, in the researcher's opinion.

Exclusion criteria

- The potential participant will be excluded from the study if the person does not meet at least one of the inclusion criteria.

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: Mindful SensoriMotor Therapy Enhanced with Brain Modulation

The participant can choose between one, two, or five interventions per week depending on their availability.

Steps of each intervention:

  1. Pain Evaluation: Numeric Rating Scale (NRS)
  2. Functional Assessments (1st, 5th, 10th, and last sessions)

  3. Preparation:

    1. Locate participant in a comfortable position for training (comfortable chair, about a meter distance to the screen, pleasant arm position)
    2. Placement of the surface electrodes
    3. Positioning of the feedback wearable device over the affected body part
    4. Placement of the brain modulation cap

  4. Treatment modalities:

    1. Motor training
    2. Sensory training
    3. Sensorimotor training
  5. Assessments

Step 4 is repeated for different phantom movements, initially one at a time, progressing to several joints simultaneously. A treatment session lasts 2 hours.
Device: Mindful SensoriMotor Therapy Enhanced with Brain Modulation

Hardware and software for myoelectric pattern recognition and sensory training developed at the Center for Bionics and Pain Research.

tES by Neuroelectrics

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The change in Pain Rating Index (PRI) over the treatment duration
Time Frame: Pain Rating Index registered at the beginning and at the end of the treatment. [ Time Frame: 28-40 weeks, depending on the frequency of the sessions.]
The Pain Rating Index (PRI) is calculated as the sum of 15 descriptors presented to the participant at the end of each intervention session. Descriptors are rated from 0 (no pain) to 3 (maximum pain) and therefore, the PRI is a number between 0 and 45. The higher PRI number, the greater pain the person feels
Pain Rating Index registered at the beginning and at the end of the treatment. [ Time Frame: 28-40 weeks, depending on the frequency of the sessions.]

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The change in Pain Disability Index (PDI) between the first and the last treatment session.
Time Frame: PDI assessed at the beginning the end of the treatment. [ Time Frame: 28-40 weeks, depending on the frequency of the sessions.]
The Pain Disability Index (PDI) measures the impact of the pain on the ability of a person to participate in essential life activities. The PDI is the sum of 7 categories and each of the category rates between 0 and 10. Therefore, the index is comprised between 0 and 70. The higher the index the greater the person's disability due to pain is.
PDI assessed at the beginning the end of the treatment. [ Time Frame: 28-40 weeks, depending on the frequency of the sessions.]

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Chalmers University of Technology

Collaborators

Sahlgrenska University Hospital, Sweden

Investigators

  • Principal Investigator: Max Ortiz Catalan, PhD, Associate professor

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

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 (Anticipated)

June 1, 2022

Primary Completion (Anticipated)

August 1, 2023

Study Completion (Anticipated)

August 1, 2023

Study Registration Dates

First Submitted

May 18, 2021

First Submitted That Met QC Criteria

May 18, 2021

First Posted (Actual)

May 21, 2021

Study Record Updates

Last Update Posted (Actual)

March 9, 2022

Last Update Submitted That Met QC Criteria

March 8, 2022

Last Verified

March 1, 2022

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2020-07147

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

The study protocol article will be published in a scientific journal.

IPD Sharing Time Frame

The study protocol is estimated to be available from November 2021.

IPD Sharing Access Criteria

open access

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL

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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