[Kokeilu laitteelle, jota ei ole hyväksynyt tai hyväksynyt Yhdysvaltain FDA] (ESWT/BSI)
The goal of this clinical trial is to evaluate the clinical safety and efficacy of Extracorporeal Shockwave Therapy (ESWT) for the management of high-grade Bone Stress Injuries (BSIs) in collegiate and recreational athletes compared to a control group receiving standard of care with sham ESWT.
The primary and secondary endpoints of the study are to evaluate the safety and feasibility of extracorporeal shockwave therapy for the treatment of pelvic and lower limb extremity fracture or BSI.
Researchers will compare the ESWT group to the sham ESWT group to see if ESWT results in better safety and efficacy outcomes for treating high-grade BSIs.
Participants will:
- Undergo a screening period to determine eligibility.
- Receive up to 4 treatment sessions of ESWT, with the frequency of sessions being approximately every 5 days (within a range of every 3-10 days).
- Be monitored for up to 6 months for research follow-up, with further questionnaires and check-ins during the standard of care follow-up period until they are able to return to sport activity level.
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
Extracorporeal shockwave treatment (ESWT) administered using the SANUWAVE Profile ESWT device is an established therapeutic modality that uses focused shockwaves through an electrohydraulic process that uses higher energy per unit area.
Each subject will receive treatment: the goal for each participant is to receive a total of 4 treatment sessions, with the frequency of treatment being one treatment on average every 5 days (permitted frequency every 3-10 days).
The treatment and care of bone stress injuries will depend on the injury site identified for the subject as noted in Table 1 of the protocol. The initial treatment will be set at lower energy settings and will increase using standard language delivered to the patient for Treatment Sessions 2-4.
Subjects will be monitored for a period of up to 6 months for research follow-up. Standard of care follow-up period begins in which subjects will receive questionnaires and check-ins to monitor for adverse events until the subject is determined to be able to return to sport activity level. If subjects have serious questions, they will be advised to speak with their treating physician.
In total, subjects are to participate for a duration of 8 months. The total study duration for recruitment, enrollment, and study completion of all subjects will last up to 3 years.
UCLA will serve as the IRB of record for all sites, and all sites will conduct the study as described in this application.
Opintotyyppi
Ilmoittautuminen (Arvioitu)
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskeluyhteys
- Nimi: Perion L Smith
- Puhelinnumero: 310-592-0008
- Sähköposti: PerionSmith@mednet.ucla.edu
Tutki yhteystietojen varmuuskopiointi
- Nimi: Bailey J Maslyar
- Puhelinnumero: 310-210-6829
- Sähköposti: bmaslyar@mednet.ucla.edu
Opiskelupaikat
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California
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Los Angeles, California, Yhdysvallat, 91803
- Rekrytointi
- UCLA Ronald Reagan Medical Center
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Ottaa yhteyttä:
- Azraa Adamjee
- Puhelinnumero: 424-467-6746
- Sähköposti: AAdamjee@mednet.ucla.edu
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Päätutkija:
- Kristofer Jones, Medical Degree
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Päätutkija:
- Aurelia Nattiv, Medical Degree
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Ottaa yhteyttä:
- Bailey Maslyar
- Puhelinnumero: 310-869-5653
- Sähköposti: BMaslyar@mednet.ucla.edu
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Redwood City, California, Yhdysvallat, 94063
- Rekrytointi
- Stanford Physical Medicine and Rehabilitation in Redwood City
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Päätutkija:
- Michael Fredericson, MD
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Ottaa yhteyttä:
- Mikkael Lamoca
- Puhelinnumero: 650-721-7613
- Sähköposti: mlamoca@stanford.edu
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Massachusetts
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Cambridge, Massachusetts, Yhdysvallat, 02138
- Rekrytointi
- Harvard - Spaulding Rehabilitation Hospital
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Ottaa yhteyttä:
- Michael Cheung
- Puhelinnumero: 617-573-6981
- Sähköposti: MCHEUNG0@MEEI.HARVARD.EDU
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Päätutkija:
- Adam Tenforde, Medical Degree
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New York
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New York, New York, Yhdysvallat, 10021
- Ei vielä rekrytointia
- Hospital of Special Surgery (HSS) in NY
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Ottaa yhteyttä:
- Olivia Lynch
- Puhelinnumero: 646-714-6435
- Sähköposti: lyncho@hss.edu
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Päätutkija:
- Marci Goolsby, Medical Degree
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Male or female 18 - 50 years of age who engage in greater than or equal to 2.5 hours a week of physical activity (in any sport, with the primary aim to maintain health and fitness), at screening.
- Documentation of pelvic or lower extremity BSI diagnosis as evidenced by one or more clinical features consistent with the high-grade BSI by MRI grading (stress reactions of MRI grade 3 or stress fracture, grade 4 by Fredericson MRI Grading) with specific stress injury sites to be included: pelvis (including pubic ramus and sacrum), compression-sided femoral neck with fracture line less than 50% diameter if grade 4, femoral shaft, posteromedial tibia, calcaneus, metatarsal (2nd-4th, excluding proximal 2nd), and fibula.
- Written informed consent obtained from subject or subject's legal representative and ability for subject to comply with the requirements of the study.
- If on NSAIDs, willing to refrain from use during the study.
- If female of child-bearing potential, both of the following must be met at screening:
- Practices one of the following methods of contraception and continues through the duration of the study: abstinence, hormonal contraceptives, IUD, spermicide and barrier or implantable device, and
- Has a negative urine qualitative beta-HCG pregnancy test.
- If female and post-menopausal one of the following must be met at screening:
- Has had a complete hysterectomy, bilateral salpingo-oophorectomy or tubal ligation or otherwise be incapable of pregnancy, or
- Is postmenopausal for at least one year.
Exclusion Criteria:
- Pregnant, breastfeeding, plans to become pregnant during the study, or unwilling to practice birth control during participation in the study.
- Unsuitable candidate for the study, based on the opinion of the investigator (e.g. cognitive impairment), such that participation might create undue risk to the subject or interfere with the subject's ability to comply with the protocol requirements or complete the study.
- Subjects who, at entry, are known to have alternative treatment (e.g. surgery) planned within the next 8 weeks.
- History of severe osteoporosis (prior DXA scan with Z-score of -3.0 or T-score less than or equal to -2.5 and prior fracture history) or other underlying bone disease/disorder.
- Chronic rheumatologic condition and/or history of chronic oral steroid use.
- Type II diabetes, other chronic underlying disease.
- Morbid obesity (Body Mass Index greater than or equal to 35) at screening.
- Has clinically significant renal disease defined as having an estimated creatinine clearance of greater than or equal to 40mL/min at screening.
- History of osteomyelitis in the injured area on which the treatment is to be administered at screening.
- Has a current history of substance abuse (current is defined as within 120 days of screening).
- Has evidence of a prior fracture or BSI within the last 6 months in the same area as the current injury.
- Has active cellulitis or wound either at the injury site, or in the surrounding area at screening.
- Has an injury requiring surgical intervention at screening.
- Current/active DSM-V eating disorder diagnosis.
- History of vascular insufficiency.
- History of neurologic insufficiency.
- History of coagulopathy, including previous deep vein thrombosis within six months of Visit 1; and/or therapy with anticoagulation medication (e.g. warfarin).
- Radiation treatment within 120 days of Visit 1.
- Presence of malignant disease with or without metastases.
- Has a life expectancy of less than or equal to 2 years.
- History of sickle cell anemia.
- Has a known immunodeficiency disorder to include, but not be limited to: AIDS, HIV, etc.
- Has participated in another investigation within 30 days of Visit 1.
- Has previously received extracorporeal shockwave therapy (ESWT) with a SANUWAVE device.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Kaksinkertainen
Aseet ja interventiot
Osallistujaryhmä / Arm |
Interventio / Hoito |
|---|---|
|
Kokeellinen: Standard of Care + ESWT
Participants in this arm will be receiving Extracorporeal shockwave treatment, supplementing their standard of care.
|
Extracorporeal shockwave treatment is a therapeutic modality that uses focused shockwaves through an electrohydraulic process that uses higher energy per unit area.
|
|
Placebo Comparator: Standard of Care + Sham Device
Participants in this arm will be receiving the sham device mimicking extracorporeal shockwave treatment, supplementing their standard of care.
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The sham device (placebo) will be used in correlation with the standard of care procedures.
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Primary Outcome
Aikaikkuna: From baseline to the end of treatment at up to 8 months
|
Incidence of adverse events as a measure of ESWT safety.
|
From baseline to the end of treatment at up to 8 months
|
Toissijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
Secondary Outcome
Aikaikkuna: From baseline to the end of treatment at up to 8 months
|
Radiographic healing of participants as defined by percentage of healing measured at different timepoints in the study. Radiographic healing at 8 weeks and 12 weeks compared to baseline will be defined as mild (0-30%), moderate (30-60%) or significant (greater than 60%) radiographic healing by MRI and mild (0-30%), moderate (30-60%) or significant (greater than 60%) radiographic healing as demonstrated by bone bridging by CT. The investigators expect to see about 48% "healed" in the control group by 8 weeks. The investigators would compare the control group to the ESWT group. If ESWT speeds healing by 2 weeks in MRI grade 3 and 4 BSI, this would increase the percent healed to 69% in the treated group. If ESWT speeds healing by 3 weeks in MRI grade 3 and 4 BSI, this would increase the percent healed to 79%. |
From baseline to the end of treatment at up to 8 months
|
Yhteistyökumppanit ja tutkijat
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Arvioitu)
Opintojen valmistuminen (Arvioitu)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
Muut tutkimustunnusnumerot
- ESWT4
- MTEC2306-USAMRDCMultiTopic-094 (Muu apuraha/rahoitusnumero: Department of Defense - MTEC)
Yksittäisten osallistujien tietojen suunnitelma (IPD)
Aiotko jakaa yksittäisten osallistujien tietoja (IPD)?
Lääke- ja laitetiedot, tutkimusasiakirjat
Tutkii yhdysvaltalaista FDA sääntelemää lääkevalmistetta
Tutkii yhdysvaltalaista FDA sääntelemää laitetuotetta
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