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Effects of Upper Limb Motor and Robotic Training Over Neuroplasticity and Function Capacity (NARLE1)

1. marts 2016 opdateret af: University of Sao Paulo General Hospital

Effects of Upper Limb Motor Training and Upper Limb Robotic Training Over Neuroplasticity and Function Capacity: A Single-blind Randomized Clinical Trial With Patients With Stroke Sequelae

The purpose of this study is to evaluate and compare the effects of upper limb training with Induced Constraint Therapy (ICT) or robotic therapy. No placebo therapy is used. Motor function, neurological evaluations and quality of life are assessed for the comparison of the therapies.

Studieoversigt

Status

Ukendt

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

The trial is being carried out in the Institute of Physical Medicine and Rehabilitation of the University of São Paulo since February 2012. The investigators are including patients with clinical diagnosis of Ischemic or hemorrhagic stroke.

The patients are being randomized in blocks of four, six and eight, in two arms: ICT: patients are undergoing 60 minutes physiotherapy and occupational therapy twice a week for ten consecutive weeks. Other therapeutic services as phonoaudiology, psychology, nutrition, physical conditioning are prescribed upon the patients' medical demands. After the 10 weeks, the patients are undergoing two whole weeks of daily ICT as to reach 90% of the time under constraint, including weekends. During this last period, no other therapeutic service is offered, but the occupational therapy under ICT. Patients are not allowed to undergo robotic therapy.

Robotic therapy: patients are undergoing robotic occupational therapy for 60 minutes, three times a week for twelve consecutive weeks. All other therapeutic services are prescribed upon the patients' medical demands. Patients are not allowed to undergo ICT.

The investigator and the raters are blind to treatment.

The evaluations are done prior to the beginning of the treatment and at the end of it. The follow up assessments are done at 3 and 12 months after the end of the treatment.

The sample size was estimated to be 62 patients in each arm, a total size of 124 patients

Undersøgelsestype

Interventionel

Tilmelding (Faktiske)

51

Fase

  • Fase 2

Kontakter og lokationer

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

Studiesteder

  • Brasilien
      • Sao Paulo, Brasilien, 04116-040
        • Centro de Pesquisa Clínica do Instituto de Medicina Física e Reabilitação do HCFMUSP

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:

  • Clinical diagnosis of stroke;
  • Patients from 6 months after stroke up to 36 months after stroke;
  • Clinically stable;
  • Upper limb Brunnstrom scale III or IV;
  • Brunnstrom scale above V if clinician supports patients will benefit from treatment;
  • Minimum wrist extension of 20°, and minimum of 10° of metacarpophalangeal active extension.
  • Signed Informed Consent Form;

Exclusion Criteria:

  • Mini-Mental score lower than 20 points;
  • Previous multiple strokes;
  • Bone diseases and articulation injuries ;
  • Presence of psychological disturbances capable of diminishing adherence;
  • Articulation pain within the range of motion proposed by the therapies;
  • Participation in another study protocol for upper limbs therapies.
  • Previous treatment with robotic assisted therapies.

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: Induced Constraint Therapy - ICT
Physical rehabilitation with Induced Constraint Therapy as part of the occupational therapy. Standard Occupational Therapy two times a week for ten weeks, followed by two whole weeks of Induced Constraint Therapy.
Procedure: Induced Constraint Therapy - ICT
Standard Occupational Therapy two times a week for ten weeks, followed by two whole weeks of Induced Constraint Therapy.
Andre navne:
  • IKT
Eksperimentel: Robotic occupational therapy
Physical rehabilitation with Robotic occupational therapy. Robotic Occupational Therapy three times a week for twelve weeks.
Procedure: Robotic occupational therapy
Robotic Occupational Therapy three times a week for twelve weeks.
Andre navne:
  • Robotic therapy

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change on Motor Function assessed by Wolf Motor Function scale
Tidsramme: Baseline and 12 weeks
Change from baseline in Wolf Motor Function scale.
Baseline and 12 weeks
Change on Motor Function assessed by Fugl Meyer scale
Tidsramme: Baseline and 12 weeks
Change from baseline in Fugl Meyer scale.
Baseline and 12 weeks

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Change on Motor Function assessed by Wolf Motor Function scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in Wolf Motor Function scale.
Baseline, 3 months and 12 months
Change on Motor Function assessed by Fugl Meyer scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in Fugl Meyer scale.
Baseline, 3 months and 12 months
Change on Motor Function assessed by Robotic scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in robotic scale.
Baseline, 3 months and 12 months
Change on Function ability and quality of movement assessed by Arm Motor Ability Test (AMAT)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in AMAT scale.
Baseline, 12 weeks, 3 months and 12 months
Change on Functional Independence Measure (FIM) as assessed by FIM scale
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in FIM scale.
Baseline, 12 weeks, 3 months and 12 months
Change on Quality of life assessed by Stroke Impact Scale (SIS)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in SIS.
Baseline, 12 weeks, 3 months and 12 months
Change on Kinematic variables assessed by InMotion robots
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple motion changes from baseline in the Kinematic variables assessed by InMotion robots.
Baseline, 12 weeks, 3 months and 12 months

Andre resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Psychological Evaluation assessed by Perceived Stress Scale (PSS-10)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in PSS-10.
Baseline, 12 weeks, 3 months and 12 months
Neuroplasticity as assessed by Brain Derived Neurotrophic Factor (BDNF)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in BDNF.
Baseline, 12 weeks, 3 months and 12 months
Corticospinal excitability as assessed by transcranial magnetic stimulation (TMS)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in TMS.
Baseline, 12 weeks, 3 months and 12 months
Neurologic evaluation as assessed by electroencephalography
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in electroencephalography.
Baseline, 12 weeks, 3 months and 12 months

Samarbejdspartnere og efterforskere

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

Sponsor

University of Sao Paulo General Hospital

Efterforskere

  • Ledende efterforsker: Linamara Rizzo Battistella, Md PhD, University of Sao Paulo

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

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. februar 2012

Primær færdiggørelse (Forventet)

1. april 2016

Studieafslutning (Forventet)

1. februar 2017

Datoer for studieregistrering

Først indsendt

24. november 2015

Først indsendt, der opfyldte QC-kriterier

1. marts 2016

Først opslået (Skøn)

7. marts 2016

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Skøn)

7. marts 2016

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

1. marts 2016

Sidst verificeret

1. august 2015

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • 0910.0.015.000-11

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

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