A Study of Neurostyle Brain Exercise Therapy Towards Enhanced Recovery (nBETTER) for Stroke (nBETTER)
A Pilot Feasibility Clinical Trial of Neurostyle Brain Exercise Therapy Towards Enhanced Recovery (nBETTER) for postStroke Arm Paresis
調査の概要
詳細な説明
Stroke remains the 4th cause of death in Singapore and despite advances in neuro-medical care and rehabilitation, 40-50% of stroke survivors are left with permanent neuro-disability and a reduced quality of life. The previous 2 decades has seen exponential leaps in the development of rehabilitation technologies which enhance neuroplasticity and rehabilitation outcome. One of these potentially useful technologies is nBETTER System, was developed by Institute for Infocomm Research, Agency for Science, Technology and Research (A*STAR). nBETTER is a portable, internet-connected device that detects the imagination of movement of stroke-affected limb using a Electroencephalography (EEG)-based Brain-Computer Interface (BCI) thus delivering visually engaging feedback for directed neurofeedback aimed at improving upper limb recovery for subacute to chronic stroke patients. The pilot study aims to recruit 13 patients using a multi centre trial design to investigate nBETTER system feasibility and safety for rehabilitation of subacute to chronic stroke patients with upper limb motor impairment and to determine clinical efficacy, safety and feasibility of such a system when it is delivered with standard occupational therapy.
The investigators primary hypothesis is that nBETTER is a feasible and safe prototype in stroke survivors (> 3 months) with moderate to severe arm impairment (FMMA 10-50). The primary outcome is a gain of 15% in Fugl-Meyer motor scores at 6 weeks after 18 sessions (total of 27 hours) of supervised training by occupational therapists and bioengineers.
研究の種類
入学 (実際)
段階
- 適用できない
連絡先と場所
研究場所
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-
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Singapore、シンガポール、308433
- Tan Tock Seng Hospital
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参加基準
適格基準
就学可能な年齢
健康ボランティアの受け入れ
受講資格のある性別
説明
Inclusion Criteria:
- Aged 21-80 years with first-ever clinical stroke diagnosed on CT or MRI brain imaging.
- Stroke duration of 3-24 months.
- Stroke type: ischemic or haemorrhagic
- Fugl-Meyer motor score of the upper limb range from 10-50
- Ability to pay attention and maintain supported sitting for 1.5 hours continuously
- Able to give own consent and understand simple instructions
- Fulfils BCI resting brain states on initial screening.
Exclusion Criteria:
- Recurrent clinical stroke
- Functional status: severe aphasia or inattention, unstable medical conditions which may affect participation (e.g. unresolved sepsis, postural hypotension, end stage renal failure) or anticipated life expectancy of <1 year due to malignancy or neurodegenerative disorder)
- Hemispatial neglect (visual or sensory) or severe visual impairment despite visual aids
- History of epilepsy, severe depression or active psychiatric disorder
- Skull defect or previous cranial surgery as this would affect physical fit of EEG cap interface
- Local arm factors: severe spasticity Modified Ashworth scale >2 in any region, visual analogue scale (VAS score) >4/10, fixed joint contractures or joint replacements, patients with poor skin conditions which would contraindicate repetitive arm training.
- TMS contraindications: females with reproductive potential not on reliable contraception; pregnancy; cardiac pacemakers; orthodontics (braces); metal implants.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：デバイスの実現可能性
- 割り当て：なし
- 介入モデル：単一グループの割り当て
- マスキング：なし（オープンラベル）
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：nBETTER and Conventional Therapy
Intervention: nBetter therapy
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60 minutes of nBETTER training followed by 30 minutes of conventional therapy occupational therapy.
Total of 18 sessions over 6 weeks.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Upper extremity Fugl-Meyer motor score post training
時間枠：Baseline and week 6
|
As above
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Baseline and week 6
|
二次結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
|
Change in Transcranial Magnetic Stimulation Assessment (TMS)
時間枠：Baseline and week 6
|
As above
|
Baseline and week 6
|
|
Change in Grip Strength
時間枠：Baseline and week 6
|
Grip Strength measures hand force in kgf
|
Baseline and week 6
|
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Change in Frenchay Arm Test of Function (FAT)
時間枠：Baseline and week 6
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Frenchay Arm Test of Function (FAT) measures 5 tasks:
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Baseline and week 6
|
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Change in Modified Ashworth Scale score (MAS)
時間枠：Baseline and week 6
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Modified Ashworth Scale score (MAS) measure spasticity of wrist and hand finger flexors on a scale from 0 to 4
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Baseline and week 6
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Change in Visual Analogue Scale (VAS)
時間枠：Baseline and week 6
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Visual Analogue Scale (VAS) measures pain on a scale from 0 to 10
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Baseline and week 6
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協力者と研究者
スポンサー
捜査官
- 主任研究者：Karen S Chua, MBBS, FRCP、Tan Tock Seng Hospital
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (実際)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (見積もり)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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