- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT05859178
Exercise Training for Brachial Plexus Injury Following Nerve Transfer
Exercise Training to Improve Nerve Regeneration and Function in Patients With Brachial Plexus Injury Following Nerve Transfer - a Randomized Controlled Clinical Trial
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Peripheral nerve injury is common, affecting 3% of patients with limb trauma seen in the emergency department. Of those, young males who are active in the work force are most frequently inflicted. The functional loss does not only carry a huge personal burden but is also associated with substantial healthcare and socioeconomic costs. Indeed, based on data from the National Inpatient Sample in the US, estimated direct healthcare costs for patients who sustained upper limb nerve injury is over $1.2B per year. Although in previous studies the investigators found that conditioning electrical stimulation, a form of activity dependent therapy, enhances nerve regeneration following injury, it did not improve bone density. Therefore, alternative treatments capable of promoting bone formation, restoring muscle bulk and increasing nerve regeneration are needed.
Based on recent discoveries in animal studies, the goal of this randomized controlled clinical trial is to test the hypothesis that exercise training can accelerate nerve regeneration and significantly increase muscle bulk and bone density compared to surgery alone in patients with brachial plexus injury.
To test this hypothesis, patients with brachial plexus injury involving the musculocutaneous nerve will be randomized to the exercise or control group following nerve transfer surgery. This will be done using a redundant branch of the ulnar nerve to reinnervate the biceps muscle. To evaluate the treatment efficacy, compound muscle action potential of the biceps muscle will be used as the primary outcome measure to quantify reinnervation. The following anatomic and functional measures will be used as secondary outcome measures: i) muscle bulk of the biceps using MRI; ii) bone density of the humerus using dual-energy x-ray absorptiometry (DEXA) imaging; iii) quantitative force measurement for elbow flexion; iv) the Disability of Arm, Shoulder and Hand (DASH) instrument to assess disability, and v) the Canadian Occupational Performance Measure for limitations in participation.
Study Type
Enrollment (Estimated)
Phase
- Phase 2
Contacts and Locations
Study Contact
- Name: Ming Chan
- Phone Number: 780-492-9343
- Email: ming.chan@ualberta.ca
Study Locations
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Alberta
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Edmonton, Alberta, Canada, T6G 2C9
- University of Alberta
-
Contact:
- Ming Chan
- Phone Number: 780-492-9343
- Email: ming.chan@ualberta.ca
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- adults age 18-60
- electrodiagnostically confirmed brachial plexus injury affecting the musculocutaneous nerve
- able to consent for participation.
Exclusion Criteria:
• individuals with additional neurological or musculoskeletal conditions that would affect elbow and hand function
Study Plan
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: Exercise group
Each participant in the exercise group will undergo hand grip exercise for 30 minutes a day, 5 days a week for a total of 12 weeks.
To activate the ulnar nerve innervated muscles, the exercise will be done using an electronic hand grip device with adjustable resistance individualized to the strength of each participant.
|
Along with nerve transfer surgery, individuals in the exercise group will undergo handgrip exercise for 30 minutes a day, 5 days a week for a total of 12 weeks.
|
Experimental: Control group
Participants will carry out a stretch exercise routine that is not known to have any effect on nerve regeneration.
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Along with nerve transfer surgery, individuals in the exercise group will undergo handgrip exercise for 30 minutes a day, 5 days a week for a total of 12 weeks.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Motor nerve conduction study
Time Frame: Baseline, 3, 6 and 9 months post surgery
|
compound muscle action potential of the biceps muscle.
Range: 0-7 mV.
Higher scores signify better nerve regeneration
|
Baseline, 3, 6 and 9 months post surgery
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
magnetic resonance imaging (MRI)
Time Frame: Baseline, 3, 6 and 9 months post surgery
|
muscle bulk of the biceps.
Measure in cubic cm.
Higher score signifies better nerve regeneration.
|
Baseline, 3, 6 and 9 months post surgery
|
dual energy x-rays absorptiometry (DEXA)
Time Frame: Baseline, 3, 6 and 9 months post surgery
|
bone density - humerus (g/sq.
m).
Higher scores denote better outcome
|
Baseline, 3, 6 and 9 months post surgery
|
quantitative force measurement for elbow flexion using dynamometer DASH Questionnaire
Time Frame: Baseline, 3, 6 and 9 months post surgery
|
to assess impairment (N).
Higher scores denote better outcome
|
Baseline, 3, 6 and 9 months post surgery
|
Canadian Occupational Performance Measure (COPM)
Time Frame: Baseline, 3, 6 and 9 months post surgery
|
to assess handicap and participation (Range 1-5).
Higher scores denote better outcome
|
Baseline, 3, 6 and 9 months post surgery
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
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
Other Study ID Numbers
- Pro00128785
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
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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