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FR-taVNS Tinnitus Tria

23. juli 2026 opdateret af: Chun Hou Huang, Tzu Chi University

Efficacy of Foot Reflexology and Transcutaneous Auricular Vagus Nerve Stimulation on Tinnitus in Non-Cancer Adult Populations

Tinnitus is a common neurosensory symptom affecting 12-30% of adults and is closely associated with anxiety, sleep disturbance, and autonomic dysregulation. Current pharmacologic treatments offer limited efficacy and notable side effects, prompting interest in non-pharmacological approaches. This randomized, single-blind, sham-controlled trial evaluates whether foot reflexology (FR), transcutaneous auricular vagus nerve stimulation (ta-VNS), and auricular acupressure (AA) improve tinnitus severity, psychological distress, sleep quality, and autonomic indicators (heart rate variability and salivary cortisol) in non-cancer adults with tinnitus, compared with usual care. Participants are randomized to a foot reflexology group, an auricular vagus nerve stimulation group (each with true and sham subgroups), or a usual-care control group, and are followed at baseline and weeks 2, 4, and 8.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a three-arm parallel, repeated-measures randomized controlled trial conducted in the otolaryngology outpatient and inpatient settings of Hualien Tzu Chi Hospital. Eligible non-cancer adults with tinnitus as the sole chief complaint and normal pure-tone thresholds are stratified by age and sex, then randomized by computer-generated random number tables to the FR group, the ta-VNS group, or the usual-care control group; the FR and ta-VNS groups are further randomized to true or sham subgroups. The foot reflexology intervention is delivered once weekly for 20 minutes over four sessions (one month) and comprises a relaxation phase, an inner-ear/autonomic regulation phase, and a circulation/detoxification phase; the sham condition applies light, non-specific touch. The ta-VNS intervention stimulates the left tragus, cymba conchae, and cavum conchae (pulse width 250 µs, 25 Hz, 0.5-5 mA individualized to a tingling sensation, 30 s on/off) once weekly for 20 minutes over four weeks; the sham condition stimulates the left earlobe at 0.5 mA. Auricular acupressure with magnetic beads is self-administered three times daily. Outcomes are assessed at T0 (baseline), T1 (week 2), T2 (week 4), and T3 (week 8). Data are analyzed with generalized estimating equation (GEE) models.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

180

Fase

  • Ikke anvendelig

Kontakter og lokationer

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Studiekontakt

Undersøgelse Kontakt Backup

Studiesteder

      • Hualien City, Taiwan, 970
        • Rekruttering
        • Hualien Tzu Chi Hospital, Department of Otorhinolaryngology
        • Kontakt:

Deltagelseskriterier

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Beskrivelse

Inclusion Criteria:

  • Age 18-75 years, conscious, able to communicate and comprehend, and able to complete questionnaires and comply with study procedures
  • Tinnitus as the sole chief complaint, with pure-tone thresholds ≤25 dB HL bilaterally at 500, 1000, 2000, and 4000 Hz

Exclusion Criteria:

  • Objective tinnitus, peripheral vestibular disease, central nervous or cardiovascular causes, or other organic ear pathology
  • Open wounds or skin lesions of the foot or ear, lower-limb edema, history of deep vein thrombosis, or diabetes with most recent HbA1c >7.5%
  • Cardiac pacemaker or other implanted electronic device, or other severe cardiovascular disease
  • Foot reflexology or vagus nerve stimulation within the past 3 months
  • Pregnant or breastfeeding women
  • History of epilepsy or seizures
  • Physically frail condition

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Arm A: Foot Reflexology - True (n=36)
Procedure: True Foot Reflexology
Once weekly, 20 min, 4 sessions over 1 month. Three phases: relaxation (diaphragm, brain, spine reflex zones, 3 min); inner-ear and autonomic regulation (inner ear, hypothalamus, cerebellum, brainstem, thyroid, adrenal zones, 10 min); circulation/detoxification (kidney, lymphatic zones, 7 min).
Sham-komparator: Arm B: Foot Reflexology - Sham (n=36)
Procedure: Sham Foot Reflexology
Light touch on non-specific foot areas (dorsum, anterior ankle, foot margins) without effective pressure.
Eksperimentel: Arm C: ta-VNS - True (n=36)
Device: True ta-VNS + Procedure: Auricular Acupressure
Left tragus, cymba conchae, cavum conchae; 250 µs, 25 Hz, 0.5-5 mA individualized to tingling, 30 s on/off; once weekly, 20 min, 4 weeks. Device: Hong-Tai mid-frequency electrotherapy stimulator, model HT66B (TFDA license no. 000637), used off-label for auricular vagus nerve stimulation.
Magnetic beads (1-2 mm) at left tragus, cymba conchae, cavum conchae; pressed 3×/day, ~30 s per point; changed every 2-3 days.
Sham-komparator: Arm D: ta-VNS - Sham (n=36)
Device: Sham ta-VNS + Procedure: Sham Auricular Acupressure
Left earlobe, 0.5 mA, otherwise identical parameters (250 µs, 25 Hz, 30 s on/off).
Beads at left earlobe (non-vagal regions), same frequency/duration.
Aktiv komparator: Arm E: Usual Care (n=36)
Other: Usual Care
Standard tinnitus clinical care (pharmacologic and supportive); no study intervention.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Tinnitus Handicap Inventory (THI) score
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
25-item scale across functional, emotional, and catastrophic subscales; total 0-100, higher = greater handicap.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Tinnitus Functional Index (TFI) score
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
25-item scale; total 0-100, higher = greater impact.
T0 baseline, T1 week 2, T2 week 4, T3 week 8

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change in Distress Thermometer (DT)
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
0-10 single-item rating; >=4 indicates clinically significant distress.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Pittsburgh Sleep Quality Index (PSQI)
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
19-item; total 0-21, >5 indicates poor sleep.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in Heart Rate Variability (HRV)
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
TS-0411 wrist device (HRV Master, TFDA license no. 001525), after 10-min rest, ~5-min wrist recording.
T0 baseline, T1 week 2, T2 week 4, T3 week 8
Change in salivary cortisol concentration
Tidsramme: T0 baseline, T1 week 2, T2 week 4, T3 week 8
1 cc saliva, ELISA.
T0 baseline, T1 week 2, T2 week 4, T3 week 8

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Publikationer og nyttige links

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Datoer for undersøgelser

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Studer store datoer

Studiestart (Faktiske)

28. april 2026

Primær færdiggørelse (Anslået)

31. december 2028

Studieafslutning (Anslået)

31. december 2028

Datoer for studieregistrering

Først indsendt

13. juli 2026

Først indsendt, der opfyldte QC-kriterier

13. juli 2026

Først opslået (Faktiske)

17. juli 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

24. juli 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. juli 2026

Sidst verificeret

1. juli 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • Tzu Chi University

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