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- Essai clinique NCT07643337
Impact of VNS With Rehab on Gait Post-Stroke
The Impact of Vagus Nerve Stimulation Paired With Rehabilitation on Lower Limb and Gait Functions After Ischemic Stroke
Aperçu de l'étude
Statut
Les conditions
Intervention / Traitement
Description détaillée
Stroke is a major cause of disability worldwide and currently there is a lack of effective treatments to improve functional capacity of patients with long-term disability. Vagus Nerve Stimulation (VNS) is FDA-approved for rehabilitation of upper limb deficits in patient with stroke. The device (including Vagus nerve electrodes and chest generator) is permanently implanted prior to the beginning of rehabilitation as standard of care. It is activated by patients and physical therapists during a period of 4.5 months of in-clinic and home therapy. However, so far there have been no approved neuromodulation treatments to improve lower limb functions and gait, which are key for patients' quality of life and their ability to integrate with work and social cycles.
This project will evaluate the impact of VNS on lower limb functions as measured by clinical and laboratory-based analyses of gait in stroke survivors. Patients with both upper and lower limb deficits will be included in this project. After the completion of the standard upper limb VNS-rehabilitation protocol, patients will be double-blindly randomized into 2 groups: a) lower limbs and gait rehabilitation with VNS ON for the duration of therapy; b) lower limbs and gait rehabilitation with VNS OFF.
Based on prior experience with upper limb deficits, we hypothesize that rehabilitation therapy coupled with VNS neuromodulation will elicit functional improvements in lower limb deficits and gait.
Type d'étude
Inscription (Estimé)
Phase
- N'est pas applicable
Contacts et emplacements
Coordonnées de l'étude
- Nom: Ellen M Carl, PhD, CCRP
- Numéro de téléphone: 7260 716-218-1000
- E-mail: ecarl@ubns.com
Sauvegarde des contacts de l'étude
- Nom: Amylynn M Liskiewicz, MA, CCRP
- Numéro de téléphone: 716-218-1000
- E-mail: aliskiewicz@ubns.com
Lieux d'étude
-
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New York
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Buffalo, New York, États-Unis, 14203
- Recrutement
- University at Buffalo Neurosurgery
-
Contact:
- Ellen M Carl, PhD, CCRP
- Numéro de téléphone: 7260 716-218-1000
- E-mail: ecarl@ubns.com
-
Contact:
- Amylynn M Liskiewicz, MA, CCRP
- Numéro de téléphone: 716-218-1000
- E-mail: aliskiewicz@ubns.com
-
Chercheur principal:
- Assaf Berger, MD
-
Sous-enquêteur:
- Jonathan Riley, MD
-
Sous-enquêteur:
- Sue Ann Sisto, MD
-
-
Critères de participation
Critère d'éligibilité
Âges éligibles pour étudier
- Adulte
- Adulte plus âgé
Accepte les volontaires sains
La description
Inclusion Criteria:
- Approved for Vagus Nerve Stimulation (VNS) and rehabilitation therapy
- ≥22 years and ≤ 80 years
- Only patients who elect to undergo VNS therapy for stroke-related upper limb deficits
- Residual active movement in the affected limb's thumb and other 2 fingers
- Stroke-related deficits in the lower limbs and gait with a Functional Ambulation Category (FAC) ≥3
- Able to follow simple instructions and independently walk short distances with or without external support or leg orthoses, but without manual contact with another person
Exclusion Criteria:
- Intact lower limb functions (Fugl-Meyer score=34)
- Not a candidate for VNS therapy according to FDA guidelines
- Pregnant patients
Plan d'étude
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Double
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
|
Expérimental: VNS ON
Receives active stimulation during therapy
|
Implanted vagus nerve stimulation (VNS) therapy for post-stroke recovery (Vivistim System, MicroTransponder, Austin, TX, USA)
|
|
Comparateur factice: VNS OFF
No stimulation during therapy
|
Implanted vagus nerve stimulation (VNS) therapy for post-stroke recovery (Vivistim System, MicroTransponder, Austin, TX, USA)
|
Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Absolute Change in Functional Assessment - Fugl-Meyer Lower Extremity (FMA-LE) scale
Délai: 90 days post-operation
|
Absolute change in FMA-LE from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - Fugl-Meyer Lower Extremity (FMA-LE) scale
Délai: 90 days post-operation
|
Percent change in FMA-LE from baseline to 90 days
|
90 days post-operation
|
Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
|
Absolute Change in Functional Assessment - 10-meter walk
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the timed 10-meter walk from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - 10-meter walk
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the timed 10-meter walk from baseline to 90 days
|
90 days post-operation
|
|
Absolute Change in Functional Assessment - 6-minute walk
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the 6-minute walk from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - 6-minute walk
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the 6-minute walk from baseline to 90 days
|
90 days post-operation
|
|
Absolute Change in Functional Assessment - Berg Balance Scale
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the Berg Balance Scale from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - Berg Balance Scale
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the Berg Balance Scale from baseline to 90 days
|
90 days post-operation
|
|
Absolute Change in Functional Assessment - Five Times Sit-to-Stand Test
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the Five Times Sit-to-Stand test from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - Five Times Sit-to-Stand Test
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the Five Times Sit-to-Stand test from baseline to 90 days
|
90 days post-operation
|
|
Absolute Change in Functional Assessment - Stroke Impact Scale
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the Stroke Impact Scale from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - Stroke Impact Scale
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the Stroke Impact Scale from baseline to 90 days
|
90 days post-operation
|
|
Absolute Change in Functional Assessment - 3D Motion Analysis of Gait
Délai: 90 days post-operation
|
Absolute change in gait function as assessed by the 3D Motion Analysis of Gait from baseline to 90 days
|
90 days post-operation
|
|
Percent Change in Functional Assessment - 3D Motion Analysis of Gait
Délai: 90 days post-operation
|
Percent change in gait function as assessed by the 3D Motion Analysis of Gait from baseline to 90 days
|
90 days post-operation
|
Collaborateurs et enquêteurs
Parrainer
Les enquêteurs
- Chercheur principal: Assaf Berger, MD, University at Buffalo
Dates d'enregistrement des études
Dates principales de l'étude
Début de l'étude (Estimé)
Achèvement primaire (Estimé)
Achèvement de l'étude (Estimé)
Dates d'inscription aux études
Première soumission
Première soumission répondant aux critères de contrôle qualité
Première publication (Réel)
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
Dernière mise à jour soumise répondant aux critères de contrôle qualité
Dernière vérification
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- STUDY00008984
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