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Combined Behavioral Approaches With Functional Electrical Therapy in Stroke Rehabilitation

10. februar 2015 opdateret af: Chang Gung Memorial Hospital

Combined Behavioral Approaches With Functional Electrical Therapy in Stroke Rehabilitation: Effects on Motor Control, Motor Impairment, Daily Function and Community Reintegration

This project attempts to perform a randomized controlled trial to verify the efficacy and motor control mechanism of the proposed combined functional electrical therapy with distributed constraint-induced therapy or with robot-assisted Bilateral training.

Studieoversigt

Status

Trukket tilbage

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Two theory-based, task-oriented approaches are distributed CIT (dCIT) and robot-assisted Bilateral training(BAT). CIT/dCIT involves massed practice of the affected arm and restraint of the unaffected arm. BAT involves repetitive practice of symmetrical bilateral movements on robot. Both are evident to improve motor performance, motor control or daily function in high functioning patients. These dCIT and BAT have their own limitations for motor-deficit rehabilitation after stroke, i.e. only appropriate for high-functioning or mildly motor impaired patients. Functional electrical therapy, an innovative technology, is proposed as an adjunct to these behavioral approaches to assist in movement execution. Functional electrical therapy is used to increase the electric activity of muscles for movement and the active range of motion in low functioning patients. Combining functional electrical therapy into CIT or BAT may extend the utility of these two behavioral approaches beyond patients with mild motor deficits and could expedite the progress of motor recovery. This project attempts to perform a randomized controlled trial to verify the efficacy and motor control mechanism of the proposed combined functional electrical therapy with dCIT or with BAT.

Undersøgelsestype

Interventionel

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Taiwan
      • Taoyuan County, Taiwan
        • Chang Gung Memorial Hospital

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år og ældre (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • The onset duration more than 6 months
  • An initial upper extremity subsection of the Fugl-Meyer Assessment score of 33 to 52 indicating moderate or moderate-to-mild movement impairment
  • No serious cognitive deficits (a score of more than 24 on the Mini Mental State Exam)
  • The availability of caregiver for assistance during the 6-hour restraint time of unaffected extremity per day
  • No balance problems sufficient to compromise safety when wearing the project's constraint device with the assistance of the caregiver
  • Considerable nonuse of the affected upper extremity (an AOU score < 2.5 of Motor Activity Log)

Exclusion Criteria:

  • Exhibit physician determined major medical problems or poor physical conditions that would interfere with participation
  • Excessive pain in any joint that might limit participation

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: Faktoriel opgave
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Combined dCIT with FET
Combined distributed constraint induced therapy with functional electrical therapy
Adfærdsmæssigt: dCIT
This dCIT group focuses on restriction on movement of the unaffected hand by placement of the hand in a mitt for 6 hours/day and intensive training of the affected upper extremity in functional tasks 1.5 hours/weekday, for 4 weeks. The level of challenge will be adapted based on patient ability and improvement during training. Patients will be encouraged to initiate the designed therapeutic functional activities.
Andre navne:
  • distributed constraint induced therapy
Adfærdsmæssigt: Functional electrical stimulation
Andre navne:
  • FES
Eksperimentel: Combined BAT with FET
Combined bilateral arm treatment with functional electrical therapy
Adfærdsmæssigt: Functional electrical stimulation
Andre navne:
  • FES
Adfærdsmæssigt: BAT
The BAT group concentrates on the simultaneous movements of both the affected and unaffected upper extremity on robot for 1.5 hours/day, 5 days/week for 4 weeks.
Andre navne:
  • bilateral arm training
Aktiv komparator: Control intervention group
Control intervention
Adfærdsmæssigt: Control intervention group
The conventional intervention group is designed to control for the duration and intensity of patient-therapist interactions and therapeutic activities (1.5 hours/day, 5 days/week, for 4 weeks). Therapy in the control intervention group will involve training for coordination, balance, and movements of the affected upper extremity, as well as compensatory practice on functional tasks with the unaffected upper extremity or both upper extremities.
Andre navne:
  • Kontrolindgreb
Eksperimentel: dCIT
distributed constraint induced therapy
Adfærdsmæssigt: dCIT
This dCIT group focuses on restriction on movement of the unaffected hand by placement of the hand in a mitt for 6 hours/day and intensive training of the affected upper extremity in functional tasks 1.5 hours/weekday, for 4 weeks. The level of challenge will be adapted based on patient ability and improvement during training. Patients will be encouraged to initiate the designed therapeutic functional activities.
Andre navne:
  • distributed constraint induced therapy
Eksperimentel: BAT
bilateral arm treatment
Adfærdsmæssigt: BAT
The BAT group concentrates on the simultaneous movements of both the affected and unaffected upper extremity on robot for 1.5 hours/day, 5 days/week for 4 weeks.
Andre navne:
  • bilateral arm training

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Movement time (MT)
Tidsramme: Baseline and change from baseline in MT at 4 weeks
The movement time is collected by a 7-camera motion analysis system (VICON MX 3-D, Oxford Metrics Inc., Oxford, UK) from unilateral and bilateral reaching tasks of pressing the desk bell. MT is the interval between movement onset and offset.
Baseline and change from baseline in MT at 4 weeks
Total displacement (TD)
Tidsramme: Baseline and change from baseline in TD at 4 weeks
The movement time is collected by a 7-camera motion analysis system (VICON MX 3-D, Oxford Metrics Inc., Oxford, UK) from unilateral and bilateral reaching tasks of pressing the desk bell. TD refers to the path of a hand in three-dimensional space and is a measure of trajectory smoothness.
Baseline and change from baseline in TD at 4 weeks
Percentage of peak velocity (PPV)
Tidsramme: Baseline and change from baseline in PPV at 4 weeks
The movement time is collected by a 7-camera motion analysis system (VICON MX 3-D, Oxford Metrics Inc., Oxford, UK) from unilateral and bilateral reaching tasks of pressing the desk bell. The PPV reflects the duration of the acceleration phase relative to the deceleration phase and indicates the type of movement strategy selected for a motor action.
Baseline and change from baseline in PPV at 4 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Fugl-Meyer Assessment (FMA)
Tidsramme: Baseline, ændring fra baseline i FMA efter 2 uger og ændring fra baseline i FMA efter 4 uger
UE-underskalaen af ​​FMA (maks. score 66) bruger en 3-punkts ordinalskala til at vurdere motorisk svækkelse.
Baseline, ændring fra baseline i FMA efter 2 uger og ændring fra baseline i FMA efter 4 uger
Motoraktivitetslog (MAL)
Tidsramme: Baseline, ændring af MAL efter 2 uger og ændring af MAL efter 4 uger
MAL er et semistruktureret interview af patienter for at vurdere mængden af ​​brug (AOU) og bevægelseskvalitet (QOM) af den berørte øvre ekstremitet i 30 vigtige daglige aktiviteter ved hjælp af en 6-punkts ordinær skala. Højere score indikerer bedre præstation.
Baseline, ændring af MAL efter 2 uger og ændring af MAL efter 4 uger
ABILHAND spørgeskema
Tidsramme: Baseline, ændring af ABILHAND spørgeskema efter 2 uger og ændring af ABILHAND spørgeskema efter 4 uger
ABILHAND spørgeskema er en opgørelse over 56 manuelle aktiviteter, der bruger en 3-punkts ordinær skala til at måle subjektivt opfattet vanskelighed ved at udføre daglige bimanuelle aktiviteter.
Baseline, ændring af ABILHAND spørgeskema efter 2 uger og ændring af ABILHAND spørgeskema efter 4 uger
Medical Research Council scale (MRC)
Tidsramme: Baseline, change from baseline in MRC at 2 weeks, and change from baseline in MRC at 4 weeks
The MRC scale examines the muscle strength of the affected arm and is reliable measurement with score ranged from 0 (no contraction) to 5 (normal power).
Baseline, change from baseline in MRC at 2 weeks, and change from baseline in MRC at 4 weeks
Modified Ashworth Scale (MAS)
Tidsramme: Baseline, change from baseline in MAS at 2 weeks, and change from baseline in MAS at 4 weeks
The MAS scale is an ordinal scale (0-5 points) assessing spasticity of skeletal muscle in UE. A higher score indicating more spasticity.
Baseline, change from baseline in MAS at 2 weeks, and change from baseline in MAS at 4 weeks
MYOTON-3
Tidsramme: Baseline, change from baseline in MYOTON-3 at two weeks, and change from baseline in MYOTON-3 at 4 weeks
Assessment of the functional state of skeletal muscle was carried out using myometric measurements with the MYOTON-3 device.
Baseline, change from baseline in MYOTON-3 at two weeks, and change from baseline in MYOTON-3 at 4 weeks
Reintegration of Normal Living Index (RNL)
Tidsramme: Baseline, change of RNL at 2 weeks, and change of RNL at 4 weeks
The RNL is used to measure the satisfaction with community reintegration. It scores on a 4-point ordinal scale, with higher scores indicating a higher level of satisfaction.
Baseline, change of RNL at 2 weeks, and change of RNL at 4 weeks

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Chang Gung Memorial Hospital

Samarbejdspartnere

National Science Council, Taiwan
National Health Research Institutes, Taiwan

Efterforskere

  • Ledende efterforsker: Ching-yi Wu, ScD, Chang Gung University

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart

1. januar 2012

Primær færdiggørelse (Faktiske)

1. marts 2013

Studieafslutning (Faktiske)

1. marts 2013

Datoer for studieregistrering

Først indsendt

30. januar 2012

Først indsendt, der opfyldte QC-kriterier

30. januar 2012

Først opslået (Skøn)

1. februar 2012

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

11. februar 2015

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

10. februar 2015

Sidst verificeret

1. september 2014

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • NSC 99-2314-B-182-014-MY3
  • 98-3827B (Anden identifikator: Chang Gung Memorial Hospital)

Disse oplysninger blev hentet direkte fra webstedet clinicaltrials.gov uden ændringer. Hvis du har nogen anmodninger om at ændre, fjerne eller opdatere dine undersøgelsesoplysninger, bedes du kontakte register@clinicaltrials.gov. Så snart en ændring er implementeret på clinicaltrials.gov, vil denne også blive opdateret automatisk på vores hjemmeside .

Kliniske forsøg med Cerebrovaskulær ulykke

Kliniske forsøg med dCIT

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Sponsorer og samarbejdspartnere

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Narkotikainterventioner

CROs by country

CROs in China

Betingelser

Sjældne sygdomme

Narkotikainterventioner

Kosttilskud

Sponsor / samarbejdspartnere

Placeringer

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