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The Therapeutic Effects of Peroneal Nerve Functional Electrical Stimulation for Lower Extremity in Patients With Sub-acute Post-stroke Hemiplegia (RALLY)

16 juin 2020 mis à jour par: Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan

The Therapeutic Effects of Peroneal Nerve Functional Electrical Stimulation for Lower Extremity in Patients With Sub-acute Post-stroke Hemiplegia A Randomized Controlled Study

Among the sequelae of stroke, gait disorder is directly linked to the degree of autonomy in the daily life of patients. It is considered significant effects on their Quality of Life(QOL).

Further methods of rehabilitation are required for convalescent patients to recover their function soon and better, due to a multitudes of recovery patient with troubles such as gait problem.

This trial is studying to investigate the effects of gait training with a functional electrical stimulation (FES) 'WalkAide[R](WA)' to improve the lower-limb function and ambulation in convalescent stroke patients.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Description détaillée

This study is targeting convalescent patients within 6 months after the onset of initial stroke (cerebral infarction or cerebral hemorrhage) and also observing the foot drop during walking.

Some study for the patients after the onset of stroke (over several months) are reported that a case of the efficacy by the treatment using the FES, and another case of using FES indicated the equal efficacy and the higher QOL compared to using ankle-foot orthosis(AFO).

However, these are clinical research results overseas and there are not so many studies targeting only for convalescent stroke patients.

FES which recover the lost function by paralysis using electrical stimulation is recommended as convalescent rehabilitation by Japanese Guidelines for the Management of Stroke 2015 etc..

The purpose of FES treatment is the electrical stimulation to peroneal nerve of patients with foot drop and equinus foot due to central nervous system damage and the objective efficacy is following:

  • To improve the walking by dorsiflexing the foot during swing phase
  • To prevention and suppression of disuse atrophy
  • To increase local blood flow
  • To re-educate muscle
  • To maintain or increase the range of joint motion

Type d'étude

Interventionnel

Inscription (Réel)

202

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Japon
    • Chiba-prefecture
      • Yachiyo-city, Chiba-prefecture, Japon, 276-0015
        • Shinyachiyo Hospital
    • Ehime-prefecture
      • Matsuyama-city, Ehime-prefecture, Japon, 791-1111
        • Matsuyama Rehabilitation Hospital
    • Fukuoka-prefecture
      • Kurume-city, Fukuoka-prefecture, Japon, 830-0047
        • St.Mary's Hospital Healthcare Center
      • Yame-city, Fukuoka-prefecture, Japon, 834-0006
        • Yame Rehabilitation Hospital
    • Hokkaido-prefecture
      • Kitami-city, Hokkaido-prefecture, Japon, 090-0837
        • Hokusei Memorial Hospital
      • Muroran-city, Hokkaido-prefecture, Japon, 050-0082
        • Ohkawara Neurosurgical Hospital
      • Obihiro-city, Hokkaido-prefecture, Japon, 080-0833
        • Tokachi Rehabilitation Center
      • Sapporo-city, Hokkaido-prefecture, Japon, 003-0026
        • Sapporo Shiroishi Memorial Hospital
      • Sapporo-city, Hokkaido-prefecture, Japon, 060-0031
        • Tokeidai Memorial Hospital
      • Sapporo-city, Hokkaido-prefecture, Japon, 060-0010
        • Sapporo Keijinkai Rehabilitation Hospital
    • Hyogo-prefecture
      • Kobe-city, Hyogo-prefecture, Japon, 652-0803
        • Yoshida Hospital, Cerebrovascular Research Institute
    • Kagoshima-prefecture
      • Aira-city, Kagoshima-prefecture, Japon, 899-5241
        • Kajikionsen Hospital
      • Kagoshima-city, Kagoshima-prefecture, Japon, 890-0031
        • Acras Central Hospital
      • Kagoshima-city, Kagoshima-prefecture, Japon, 890-8520
        • Department of Rehabilitation and Physical Medicine, Graduate School of Medical and Dental Sciences, Kagoshima University
      • Kanoya-city, Kagoshima-prefecture, Japon, 893-0023
        • Kohshinkai Ogura Hospital
      • Tarumi-city, Kagoshima-prefecture, Japon, 891-2124
        • Tarumi City Medical Center Tarumi Central Hospital
    • Kumamoto-prefecture
      • Kumamoto-city, Kumamoto-prefecture, Japon, 861-4173
        • Sakura Jyuji Hospital
      • Kumamoto-city, Kumamoto-prefecture, Japon, 862-0924
        • Kumamoto Takumadai Rehabilitation Hospital
    • Miyazaki-prefecture
      • Miyakonojo-city, Miyazaki-prefecture, Japon, 885-0072
        • Fujimotokanmachi Hospital
      • Miyazaki-city, Miyazaki-prefecture, Japon, 880-2112
        • Junwakai Memorial Hospital
      • Nichinan-city, Miyazaki-prefecture, Japon, 889-3141
        • Nichinan Municipal Chubu Hospital
    • Nagasaki-prefecture
      • Sasebo-city, Nagasaki-prefecture, Japon, 857-0022
        • Yohkoh Rehabilitation Hospital
      • Togitsu-cho, Nishisonogi-gun, Nagasaki-prefecture, Japon, 851-2103
        • Nagasakikita Hospital
    • Okinawa-prefecture
      • Okinawa-city, Okinawa-prefecture, Japon, 904-2151
        • Chuzan Hospital
      • Okinawa-city, Okinawa-prefecture, Japon, 904-2173
        • Okinawa Rehabilitation Center Hospital
      • Shimajiri-gun, Okinawa-prefecture, Japon, 901-0493
        • Nanbu-Tokushukai Hospital
    • Osaka-prefecture
      • Toyonaka-city, Osaka-prefecture, Japon, 560-0054
        • Kansai Rehabilitation Hospital
    • Saitama-prefecture
      • Misato-city, Saitama-prefecture, Japon, 341-0034
        • Saitama Misato Sogo Rehabilitation Hospital
    • Shizuoka-prefecture
      • Hamamatsu-city, Shizuoka-prefecture, Japon, 433-8511
        • Seirei Hamamatsu City Rehabilitaion Hospital
    • Tokyo
      • Adachi-ku, Tokyo, Japon, 123-0864
        • Hakujikai Memorial Hospital
      • Itabashi-ku, Tokyo, Japon, 174-0051
        • IMS Itabashi Rehabilitation Hospital

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

20 ans à 85 ans (Adulte, Adulte plus âgé)

Accepte les volontaires sains

Non

Sexes éligibles pour l'étude

Tout

La description

Inclusion Criteria:

  • 1) Patients who agree to participate in this study and provide their informed consent
  • 2) Patients from 20 to 85 years old at the time of consent
  • 3) Patients of convalescent stoke (within 6 months of onset)
  • 4) Patients with a first episode of stroke, which type limited intracranial hemorrhage or ischemic stroke (excluding subarachnoid hemorrhage)
  • 5) Patients inpatients for the rehabilitation therapy
  • 6) Patients diagnosed 3 or 4 on Functional Ambulation Classification (FAC)
  • 7) Patients stable general condition(blood pressure, pulse, blood glucose level etc.)
  • 8) Patients with drop foot in walking

Exclusion Criteria:

  • 1) Patients due to severe heart disease
  • 2) Patients with previous gait disability, such as neurological disease
  • 3) Patients with previous orthopedic disease, such as knee osteoarthritis
  • 4) Patients with severe hepatic or renal dysfunction
  • 5) Patients with severe sensory disturbance or severe ataxia or severe higher brain dysfunction
  • 6) Patients correspond to contraindicated for the electrical stimulation (e.g. patients with a medical implant or implantable medical electrical equipment such as a cardiac pacemaker)
  • 7) Patients with severe skin disease
  • 8) Patients with any dose adjustment of antispasticity drugs (tizanidine hydrochloride, eperisone hydrochloride, baclofen, etc.) within 1month
  • 9) Patients whose impairment severities changed during the study period
  • 10) Patients taking the botulinum toxin formulation injection or the nerve block injection with phenol within 6months
  • 11) Patients with any lower limb treatment using FES or the robot suit within 1month
  • 12) Patients diagnosed not to use during the the WA trial operation period
  • 13) Patients who do not complete the WA trial operation for 7 days
  • 14) Patients joining any other clinical trials or studies with intervention

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Traitement
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Aucun (étiquette ouverte)

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Comparateur actif: Contrôler
Autre: Control
Conventional rehabilitation therapy and gait training without WA.
Expérimental: WA
Dispositif: WA group
Conventional rehabilitation therapy and gait training with WAIntervention with WA is scheduled 40min/day, five times a week, for 8 weeks.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
maximum walking distance of 6 Minute Walk Test (bare feet)
Délai: 8weeks
Measuring maximum walking distance of 6 Minute Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values. Targeting for all patients.
8weeks

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
maximum walking distance of 6 Minute Walk Test (with WA)
Délai: 8weeks

Measuring maximum walking distance of 6 Minute Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values.

Targeting only for WA group.
8weeks
maximum walking distance of 6 Minute Walk Test (with AFO)
Délai: 8weeks

Measuring maximum walking distance of 6 Minute Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values.

Targeting only for patients using AFO before starting this study.
8weeks
walking speed of 10 Meter Walk Test (bare feet)
Délai: 8weeks
Measuring maximum walking speed of 10 Meter Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values. Targeting for all patients.
8weeks
walking speed of 10 Meter Walk Test (with WA)
Délai: 8weeks
Measuring maximum walking speed of 10 Meter Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values. Targeting only for WA group.
8weeks
walking speed of 10 Meter Walk Test (with AFO)
Délai: 8weeks
Measuring maximum walking speed of 10 Meter Walk Test at baseline and after 8-weeks intervention. Calculating difference of those measured values. Targeting only for patients using AFO before starting this study.
8weeks
Fugl-Meyer assessment (FMA)
Délai: 8weeks
Calculating difference of the total score of lower extremity subscale of the Fugl-Meyer Assessment (perfect score: 34 points) at baseline and after 8-weeks intervention.
8weeks
modified Ashworth scale (MAS)
Délai: 8weeks
Calculating difference of the muscle tone six levels ( 0 , 1 , 1+ , 2 , 3 , 4 ) at baseline and after 8-weeks intervention.
8weeks
range of motion
Délai: 8weeks
Calculating difference of the angle of the ankle succumbed back (5 ° increments) at baseline and after 8-weeks intervention.
8weeks
Timed up and go test (bere feet)
Délai: 8weeks

Measuring the time that patients take to rise from a chair, walk three metres, turn around, walk back to the chair, and sit down .

Calculating difference of those measured values between at baseline and after 8-weeks intervention. Targeting for all patients.
8weeks
Timed up and go test (with AFO)
Délai: 8weeks

Measuring the time that patients take to rise from a chair, walk three metres, turn around, walk back to the chair, and sit down .

Calculating difference of those measured values between at baseline and after 8-weeks intervention. Targeting only for patients using AFO before starting this study.
8weeks
Timed up and go test (with WA)
Délai: 8weeks

Measuring the time that patients take to rise from a chair, walk three metres, turn around, walk back to the chair, and sit down .

Calculating difference of those measured values between at baseline and after 8-weeks intervention. Targeting only for WA group.
8weeks
Stroke Impact Scale (SIS)
Délai: 8weeks
An evaluation of summation score of the total score and physical domain (sixth domain) score. Calculating difference of those measured values between at baseline and after 8-weeks intervention.
8weeks
Patient reported outcome measure (PRO)
Délai: 8weeks
Evaluation gait analysis using visual analogue scale(VAS scale) by Patient's own. Calculating the difference of these VAS scale between at baseline and after 8-weeks intervention.
8weeks
gait analysis by medical staff
Délai: 8weeks
Evaluation using total score of gait analysis by medical staff (-48~48).Calculating difference of these score between at baseline and after 8-weeks intervention.
8weeks
Adverse event assessment
Délai: 8weeks

A frequency counting of the adverse events. LLT code will be assigned to the reported adverse event using the MedDRA dictionary.

The origin date of the term until adverse events define the start date of the treatment program(0 week).

Also doing a frequency counting of adverse events observed during the the WA trial operation period, but not included in the safety evaluation of the treatment program.
8weeks

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Translational Research Center for Medical Innovation, Kobe, Hyogo, Japan

Collaborateurs

Kagoshima University
Nippon Medical School

Les enquêteurs

  • Chaise d'étude: Shuji Matsumoto, MD, Ph.D, Nippon Medical School

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

1 mai 2016

Achèvement primaire (Réel)

24 avril 2019

Achèvement de l'étude (Réel)

29 novembre 2019

Dates d'inscription aux études

Première soumission

7 septembre 2016

Première soumission répondant aux critères de contrôle qualité

7 septembre 2016

Première publication (Estimation)

13 septembre 2016

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

17 juin 2020

Dernière mise à jour soumise répondant aux critères de contrôle qualité

16 juin 2020

Dernière vérification

1 juin 2020

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • TRIORTHO1524
  • UMIN-CTR (Autre identifiant: UMIN000020604)

Ces informations ont été extraites directement du site Web clinicaltrials.gov sans aucune modification. Si vous avez des demandes de modification, de suppression ou de mise à jour des détails de votre étude, veuillez contacter register@clinicaltrials.gov. Dès qu'un changement est mis en œuvre sur clinicaltrials.gov, il sera également mis à jour automatiquement sur notre site Web .

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