- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04908423
Xeomin® and Gait Related Mobility After Stroke
Upper Extremity Injection of Xeomin® and Changes in Gait Related Mobility in Adults After Stroke
Study Overview
Detailed Description
For this pilot study, the investigators hypothesize that there will be durational improvements in gait related mobility on the instrumented TUG and 10-meter walk tests 4-6-weeks post upper extremity Xeomin® injection. Physical function will be quantified as time to complete the instrumented TUG.
A one-group pretest-post-test experimental design will be used. Participants will be tested on the primary and secondary outcome measures before upper extremity injection with Xeomin® and 4 to 6 weeks thereafter. Additionally, participants will be contacted for an end of study visit via telephone approximately 12-weeks post Xeomin® injection to obtain information regarding any adverse events and gain insight into the therapeutic duration of the Xeomin®. The proposed duration of the study is 2 years to allow adequate time for screening, recruitment and follow-up.
Study Type
Enrollment (Estimated)
Phase
- Phase 4
Contacts and Locations
Study Contact
- Name: Mark A Hirsch, PhD
- Phone Number: 704-355-7673
- Email: Mark.Hirsch@atriumhealth.org
Study Contact Backup
- Name: Christine Patino, RN, BSN
- Phone Number: 704-355-9368
- Email: Christine.Patino@atriumhealth.org
Study Locations
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North Carolina
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Charlotte, North Carolina, United States, 28203
- Recruiting
- Carolinas Rehabilitation
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Contact:
- Mark A Hirsch, PhD
- Phone Number: 704-355-7673
- Email: Mark.Hirsch@atriumhealth.org
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Principal Investigator:
- Mark A Hirsch, PhD
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Sub-Investigator:
- Vu QC Nguyen, MD, MBA
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Sub-Investigator:
- Nahir Habet, MS
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Sub-Investigator:
- Mark A Newman, PhD
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Contact:
- Christine Patino, RN, BSN
- Phone Number: 704-355-9368
- Email: Christine.Patino@atriumhealth.org
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Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Diagnosis of hemiparesis and spasticity secondary to stroke with upper and lower limb spasticity and unilateral motor and/or sensory deficit
- No prior surgery to the lower limb
- Able to walk at least 10 meters without physical assistance from another person and without an assistive device
- Toe- ground clearance during swing phase without assistive device or orthoses
- No treatment with botulinum toxin within the past 4 months
Exclusion Criteria:
- Passive range of motion at either the ankle, knee, or elbow joint less than 30 degrees
- Participants with uncorrected hearing impairment
- Weight bearing restrictions due to concurrent orthopedic injuries that would make ambulating with or without an assistive device unsafe
- Speech language expression deficit (e.g., aphasia)
- Absence of proprioception upon neurologic examination
- Presence of fixed contractures in the upper or lower extremities not correctable to neutral
- Other confounding neurological diagnoses or active acute illness (cancer, Parkinson's disease, multiple sclerosis)
Study Plan
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: Xeomin®
Participants will be injected via electromyographic guidance with a total of 200 units of Xeomin® into the pectoralis major, biceps brachii, brachioradialis, and latissimus dorsi muscles of the hemiparetic side using a standardized injection protocol (16).
An additional 100 units of Xeomin® will be available at the discretion of the investigator for injection into additional affected upper extremity muscles
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To discover whether injection into the upper extremity with Xeomin® triggers improvements in gait-related mobility and quality of life in adults with hemiparesis secondary to stroke.
Other Names:
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Instrumented Timed Up and Go test time
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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Subjects arise from a chair, walk at their normal speed, turn around right after passing the tape at the end of the pathway, return to the chair, turn around and sit down.
Subjects will be fitted with a , single Attitude and heading reference system (AHRS) sensor fixed on the manubrium inferior to the interclavicular notch in a chest-mounted pack.
The AHRS is a wireless-telemetry, 10-parameter unit which includes a tri-axial accelerometer, a tri-axial gyroscope, a tri-axial magnetometer and an onboard temperature sensor.
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Baseline and 4-6 weeks after Xeomin injection
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in Ten-meter walk test time
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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Subjects walk 10-meters at self-selected pace
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Baseline and 4-6 weeks after Xeomin injection
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Change in Mini-Mental State Examination score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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Quantitative assessment of cognitive impairment.
Scores range from 0-30, higher scores represent less cognitive impairment.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Quality of Life in Neurological Disorders (Neuro-QoL) Depression - Short Form score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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Eight-item assessment of loss and feelings of hopelessness, negative mood, decrease in positive affect, information-processing deficits, negative views of the self, and negative social cognition in patients with neurological disorders.
Scores range from 8-40, higher scores represent greater depressive symptoms.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Patient-Reported Outcomes Measurement Information System (PROMIS) General Life Satisfaction - Short Form 5a score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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This form consists of 5-items and assesses the participant's cognitive evaluation of life experiences and whether that participant is content with their life.
Scores range from 5-35, higher scores represent increased life satisfaction.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Brief Pain Inventory (BPI) - Short Form score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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The BPI is a self-report measure that assesses severity of pain, impact of pain on daily function, location of pain, pain medications and amount of pain relief in the past 24 hours.
For the pain intensity portion of the assessment, scores range from 0-40, higher scores represent increased pain intensity.
For the pain interference portion of the scale, scores range from 0-70, higher scores represent increased pain interference.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Neuro-QoL Satisfaction with Social Roles and Activities - Short Form score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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A reliable and valid 8-item measure of involvement in social roles, activities and responsibilities.
Scores for the social roles portion of the assessment range from 4-20, higher scores represent increased satisfaction with social roles.
Scores for the activities portion of the assessment range from 4-20, higher scores represent increased activity satisfaction.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Modified Ashworth Scale (MAS) score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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The MAS will be used as a measure of spasticity.
Scores range from 0-4 for each muscle tested, higher scores represent increased spasticity.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Berg Balance Scale (BBS) score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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The BBS is a 14-item objective tool that assesses static balance and fall risk in adults' post-stroke.
Scores range from 0-56, higher scores indicate increased functional balance.
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Baseline and 4-6 weeks after Xeomin injection
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Change in Activities-Specific Balance (ABC) Scale score
Time Frame: Baseline and 4-6 weeks after Xeomin injection
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The ABC scale is a 16-item self-report measure of balance confidence in performing various activities without losing balance or experiencing a sense of unsteadiness.
Scores range from 0-100, higher scores indicate increased self-confidence with balance.
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Baseline and 4-6 weeks after Xeomin injection
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Collaborators and Investigators
Collaborators
Investigators
- Principal Investigator: Mark A Hirsch, PhD, Wake Forest University Health Sciences
Study record dates
Study Major Dates
Study Start (Actual)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Cardiovascular Diseases
- Vascular Diseases
- Cerebrovascular Disorders
- Brain Diseases
- Central Nervous System Diseases
- Nervous System Diseases
- Stroke
- Physiological Effects of Drugs
- Neurotransmitter Agents
- Molecular Mechanisms of Pharmacological Action
- Peripheral Nervous System Agents
- Cholinergic Agents
- Membrane Transport Modulators
- Acetylcholine Release Inhibitors
- Neuromuscular Agents
- incobotulinumtoxinA
Other Study ID Numbers
- IRB00082738
- BTX1.0 (Other Identifier: Atrium Health)
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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