Exploration of the Effectiveness and Mechanism of Personalized Epidural Electrical Stimulation in Improving Upper Limb Function in Participants With Spinal Cord Injury
Studieoversigt
Status
Status
Betingelser
Betingelser
Intervention / Behandling
Intervention / Behandling
Detaljeret beskrivelse
Undersøgelsestype
Undersøgelsestype
Tilmelding (Anslået)
Tilmelding
Fase
Fase
- Ikke anvendelig
Kontakter og lokationer
Studiekontakt
Studiekontakt
- Navn: Yu-Chen Chen, M.D., Ph.D.
- Telefonnummer: 13054 +886-3-856-1825
- E-mail: spring810569@gmail.com
Undersøgelse Kontakt Backup
- Navn: Sheng-Tzung Tsai, M.D., Ph.D
- Telefonnummer: 13054 +886-3-856-1825
- E-mail: flydream.tsai@gmail.com
Studiesteder
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Hualien City, Taiwan
- Rekruttering
- Buddhist Tzu Chi Medical Foundation Hualien Tzu Chi Hospital
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Kontakt:
- Sheng-Tzung Tsai, M.D., Ph.D
- Telefonnummer: 13054 +886-3-856-1825
- E-mail: flydream.tsai@gmail.com
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-
Deltagelseskriterier
Berettigelseskriterier
Berettigelseskriterier
Aldre berettiget til at studere
- Voksen
- Ældre voksen
Tager imod sunde frivillige
Beskrivelse
Inclusion Criteria:
- Age between 18 and 70 years.
- Duration since spinal cord injury ranging from 1 to 10 years.
- Spinal cord injury level at or above T4.
- MRI and/or CT imaging confirms adequate spinal cord decompression and spinal stability.
- Stable vital signs and no dependence on mechanical ventilation.
- Stable neurological and psychological status, with no history of neurological deterioration within the past 6 months (e.g., acute worsening of motor or sensory function, new-onset seizures, acute changes in muscle tone, or other neurological symptoms). Participants must be conscious, able to understand, and comply with study instructions. Clinical neurological examinations and imaging findings (MRI or CT) should demonstrate no new abnormalities.
- Willingness to participate in and comply with rehabilitation programs.
- Participants who have completed spinal cord electrical stimulation implantation surgery and/or are currently undergoing conventional rehabilitation therapy.
Exclusion Criteria:
- Patients with untreated fractures of the upper extremities.
- Patients with severe skin lesions or wounds that interfere with EMG electrode placement or the surgical sites for electrical stimulation implantation (e.g., chest/back, upper extremities, posterior cervical region, or subclavicular area).
- Patients with a history of other neurological diseases.
- Patients with known allergy or hypersensitivity to silver (Ag).
Studieplan
Hvordan er undersøgelsen tilrettelagt?
Design detaljer
- Primært formål: Behandling
- Tildeling: N/A
- Interventionel model: Enkelt gruppeopgave
- Maskning: Ingen (Åben etiket)
Antal våben
Våben og indgreb
Deltagergruppe / ArmDeltagergruppe / Arm |
Intervention / BehandlingIntervention / Behandling |
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Eksperimentel: Epidural electrical stimulation (EES)
Participants will undergo implantation of a 16-electrode epidural spinal cord array.
Following surgery, they will participate in a structured program of physical rehabilitation combined with epidural electrical stimulation.
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Forsøgspersonerne vil gennemgå en kirurgisk procedure for at implantere et system, der giver epidural elektrisk stimulation (EES) af den cervikale rygmarv.
Efter operationen vil forsøgspersonerne gennemgå et struktureret fysisk rehabiliteringsprogram og elektrisk stimulering.
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Hvad måler undersøgelsen?
Primære resultatmål
Primære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Change dexterity of the upper limb as measured by the Action Research Arm Test (ARAT)
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Use the Action Research Arm Test (ARAT) assessment to quantify functional hand and arm dexterity.
The score ranges from 0 to 57, with a higher value indicating better function.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Change in hand dexterity as measured by the Box and Block Test (BBT).
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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The Box and Block Test (BBT) assesses manual dexterity and upper extremity function by measuring the number of blocks transferred within 60 seconds.
Higher scores indicate better hand function and coordination.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Change in functional independence as measured by the Spinal Cord Independence Measure III (SCIM-III)
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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The Spinal Cord Independence Measure III (SCIM-III) is a standardized functional assessment tool specifically designed for individuals with spinal cord injury.
It evaluates independence in daily activities, including self-care, respiration and sphincter management, and mobility, to quantify the impact of spinal cord injury on functional ability.
The SCIM-III consists of 19 items, Each item is typically scored on a scale ranging from 0 (completely dependent) to 3 (completely independent).with
higher scores indicating greater independence in activities of daily living.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Change in ASIA Impairment Scale (AIS) grade assessed using the International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI).
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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The International Standards for Neurological Classification of Spinal Cord Injury (ISNCSCI) is a standardized assessment of motor and sensory function following spinal cord injury.
Neurological impairment is classified using the American Spinal Injury Association (ASIA) Impairment Scale (AIS), which ranges from Grade A (complete injury) to Grade E (normal motor and sensory function).
Higher AIS grades indicate better neurological function and less severe neurological impairment.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Sekundære resultatmål
Sekundære resultatmål
Resultatmål |
Foranstaltningsbeskrivelse |
Tidsramme |
|---|---|---|
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Ændring i livskvalitet (QOL) målt af World Health Organization Quality of Life (WHOQOL-BREF)
Tidsramme: Baseline; 1 - 4 - 7 - 13 - 19 - 25 måneder efter implantation
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WHOQOL-BREF er et selvadministreret spørgeskema, der omfatter 26 spørgsmål om individets opfattelse af deres helbred og velvære i løbet af de foregående to uger.
Svar på spørgsmål er på en Likert-skala fra 1-5, hvor 1 repræsenterer "uenig" eller "slet ikke" og 5 repræsenterer "helt enig" eller "ekstremt".
, Jo højere score, jo bedre livskvalitet
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Baseline; 1 - 4 - 7 - 13 - 19 - 25 måneder efter implantation
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Change in spasticity as measured by the Modified Ashworth Scale (MAS)
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Quantify spasticity scores using the Modified Ashworth Scale (MAS) for the shoulder, elbow, and wrist.
The muscle tension is divided into 0-4 grades.
The lower the score, the closer to normal.
The higher the score, the more severe the spasticity.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Change in activities of daily living as measured by the Barthel Index (BI).
Tidsramme: Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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The Barthel Index (BI) assesses functional independence in activities of daily living across 10 domains, including self-care, mobility, and continence.
Scores range from 0 to 100, with higher scores indicating greater independence.
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Baseline; at 1 - 4 - 7 - 13 - 19 - 25 months after the implantation
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Samarbejdspartnere og efterforskere
Sponsor
Sponsor
Efterforskere
Efterforskere
- Ledende efterforsker: Sheng-Tzung Tsai, M.D., Ph.D, Hualien Tzu Chi General Hospital
Datoer for undersøgelser
Studer store datoer
Studiestart (Faktiske)
Studiestart
Primær færdiggørelse (Anslået)
Primær færdiggørelse
Studieafslutning (Anslået)
Studieafslutning
Datoer for studieregistrering
Først indsendt
Først indsendt
Først indsendt, der opfyldte QC-kriterier
Først indsendt, der opfyldte QC-kriterier
Først opslået (Faktiske)
Først opslået
Opdateringer af undersøgelsesjournaler
Sidste opdatering sendt (Faktiske)
Sidste opdatering sendt
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier
Sidst verificeret
Sidst verificeret
Mere information
Begreber relateret til denne undersøgelse
Yderligere relevante MeSH-vilkår
Andre undersøgelses-id-numre
Andre undersøgelses-id-numre
- IRB114-101-A
- NSTC 114-2314-B-303-011 (Andet bevillings-/finansieringsnummer: National Science and Technology Council, R.O.C)
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