Neuromodulation Combined With Dual FES Cycling and Cognitive Training After Stroke
Exploratory Evaluation of Neuromodulation Combined With Dual Functional Electrical Stimulation Cycling and Cognitive Task Training on Cognitive-Motor Performance in Individuals After Stroke
This study will evaluate the effects of functional electrical stimulation (FES) cycling, cognitive task training, and non-invasive photobiomodulation on cognitive and upper-limb motor performance in adults after stroke. The study includes three stages to identify favorable FES cycling and neuromodulation approaches and to evaluate their combined effects. Participants will complete 10 intervention sessions over 2 weeks. Cognitive and motor outcomes will be assessed before treatment, immediately after treatment, and at 3-month follow-up. Feasibility, tolerance, and adverse events will also be evaluated.
연구 개요
상태
상태
정황
정황
개입 / 치료
개입 / 치료
- 장치: Functional Electrical Stimulation Cycling
- 행동: Cognitive Task Training
- 장치: Sham Functional Electrical Stimulation Cycling
- 장치: Transcutaneous Auricular Photobiomodulation
- 장치: Transcutaneous Forehead Photobiomodulation
- 장치: Sham Photobiomodulation
- 다른: Optimal FES Cycling Protocol
- 장치: Optimal Neuromodulation Protocol
상세 설명
This is a three-stage, randomized, sham-controlled study in individuals after stroke. Stage 1 will compare FES cycling alone, FES cycling combined with cognitive task training, and sham FES cycling. Stage 2 will compare photobiomodulation applied to the ear, forehead, and sham stimulation. Stage 3 will evaluate the selected FES cycling and neuromodulation approaches alone and in combination. Participants will complete 10 sessions over 2 weeks. Cognitive, upper-extremity motor, functional, participation, and quality-of-life outcomes will be assessed at baseline, immediately after treatment, and at 3-month follow-up. Feasibility, adherence, tolerance, and adverse events will also be monitored.
연구 유형
연구 유형
등록 (추정된)
등록
단계
단계
- 해당 없음
연락처 및 위치
연구 연락처
연구 연락처
- 이름: Chia-Ling Chen
- 전화번호: 8148 +883-3-3281200
- 이메일: clingchen@gmail.com
참여기준
자격 기준
자격 기준
공부할 수 있는 나이
건강한 자원 봉사자를 받아들입니다
연구 대상 성별
설명
Inclusion Criteria:
- Adults aged 20 to 80 years.
- First-ever ischemic or hemorrhagic stroke with unilateral impairment in hand or arm strength or motor function.
- Medically stable and able to participate safely in the training program.
- Able to understand the study procedures and sign the informed consent form.
- Able to follow verbal instructions, comply with study procedures, and complete all assessments.
- Able to maintain a seated position and participate in each training session (approximately 40-60 minutes).
Exclusion Criteria:
- Stroke involving the brainstem or cerebellum.
- History of epilepsy, photosensitive epilepsy, or a tendency to faint.
- Presence of implanted electronic devices, such as pacemakers, implantable cardioverter-defibrillators (ICD), or other electronic medical implants (e.g., artificial heart, infusion pumps, cochlear implants).
- Wounds, infections, or significant skin problems at potential stimulation sites (ear or scalp).
- Presence of major psychiatric disorders or inability to understand or cooperate with testing.
- Cardiovascular or vascular-related conditions, including severe heart disease, uncontrolled arrhythmia, or medical advice against exercise; use of anticoagulant medication that makes laser stimulation inappropriate.
- Acute illness, such as fever or active infection.
- Botulinum toxin injections or relevant surgeries within the past six months.
- Photosensitive disorders (e.g., lupus, porphyria) or current use of photosensitizing medications.
- Inability to safely perform cycling training (e.g., recent fractures, severe spasticity, difficulty maintaining seated posture).
- Pregnant or breastfeeding individuals.
- Any other condition deemed unsuitable by the study physician (e.g., severe claustrophobia).
공부 계획
연구는 어떻게 설계됩니까?
디자인 세부사항
- 주 목적: 치료
- 할당: 무작위
- 중재 모델: 병렬 할당
- 마스킹: 더블
팔의 수
무기와 개입
참가자 그룹 / 팔참가자 그룹 / 팔 |
개입 / 치료개입 / 치료 |
|---|---|
|
실험적: Stage 1: FES Cycling Alone
Participants receive FES-assisted arm cycling. |
FES-assisted arm cycling is provided for approximately 40 minutes per session, 5 sessions per week for 2 weeks. |
|
실험적: Stage 1: Dual-Task FES Cycling
Participants receive FES-assisted arm cycling combined with cognitive task training. |
FES-assisted arm cycling is provided for approximately 40 minutes per session, 5 sessions per week for 2 weeks. Cognitive tasks are performed during FES cycling and progressively target attention, working memory, and executive control. |
|
위약 비교기: Stage 1: Sham FES Cycling
Participants receive sham FES cycling. |
Participants receive the sham FES cycling control condition. |
|
실험적: Stage 2: Auricular Photobiomodulation
Participants receive transcutaneous auricular photobiomodulation (taPBM). |
Photobiomodulation is applied to the outer ear for approximately 20 to 30 minutes. |
|
실험적: Stage 2: Forehead Photobiomodulation
Participants receive transcutaneous forehead photobiomodulation (tfPBM). |
Photobiomodulation is applied to the forehead for approximately 20 to 30 minutes. |
|
위약 비교기: Stage 2: Sham Photobiomodulation
Participants receive sham photobiomodulation. |
Participants receive the sham photobiomodulation control condition. |
|
실험적: Stage 3: Optimal FES Cycling + Sham Neuromodulation
Participants receive the optimal FES cycling protocol identified in Stage 1 combined with sham neuromodulation. |
Participants receive the sham photobiomodulation control condition. The FES cycling condition associated with the most favorable cognitive-motor performance pattern in Stage 1 will be selected for use in Stage 3. The selected protocol will consist of either FES cycling alone or FES cycling combined with cognitive task training. |
|
실험적: Stage 3: Optimal Neuromodulation + Sham FES Cycling
Participants receive the optimal neuromodulation protocol identified in Stage 2 combined with sham FES cycling. |
Participants receive the sham FES cycling control condition. The photobiomodulation condition associated with the most favorable cognitive-motor performance pattern in Stage 2 will be selected for use in Stage 3. The selected protocol will consist of either transcutaneous auricular photobiomodulation (taPBM) or transcutaneous forehead photobiomodulation (tfPBM). |
|
실험적: Stage 3: Optimal FES Cycling + Optimal Neuromodulation
Participants receive the optimal FES cycling protocol combined with the optimal neuromodulation protocol. |
The FES cycling condition associated with the most favorable cognitive-motor performance pattern in Stage 1 will be selected for use in Stage 3. The selected protocol will consist of either FES cycling alone or FES cycling combined with cognitive task training. The photobiomodulation condition associated with the most favorable cognitive-motor performance pattern in Stage 2 will be selected for use in Stage 3. The selected protocol will consist of either transcutaneous auricular photobiomodulation (taPBM) or transcutaneous forehead photobiomodulation (tfPBM). |
|
위약 비교기: Stage 3: Sham FES Cycling + Sham Neuromodulation
Participants receive sham FES cycling combined with sham neuromodulation. |
Participants receive the sham FES cycling control condition. Participants receive the sham photobiomodulation control condition. |
연구는 무엇을 측정합니까?
주요 결과 측정
주요 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Trail Making Test-Part B (TMT-B)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The TMT-B assesses executive function and cognitive flexibility. Longer completion times indicate poorer executive function and cognitive flexibility. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Intra-Extra Dimensional Shift (IED)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The IED assesses set-shifting ability and cognitive flexibility. Fewer errors indicate better performance. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Rapid Visual Information Processing (RVP)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The RVP assesses sustained attention. Higher accuracy indicates better sustained attention. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Digit Span Test
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The Digit Span Test assesses working memory and sustained attention. Higher span scores indicate stronger working memory and sustained attention. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Fugl-Meyer Assessment-Upper Extremity (FMA-UE)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The FMA-UE assesses upper-extremity motor control. Scores range from 0 to 66, with higher scores indicating better motor control. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Action Research Arm Test (ARAT)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The ARAT assesses upper-limb functional performance. Scores range from 0 to 57, with higher scores indicating better upper-limb function. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
2차 결과 측정
2차 결과 측정
결과 측정 |
측정값 설명 |
기간 |
|---|---|---|
|
Montreal Cognitive Assessment (MoCA)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The MoCA assesses cognitive functioning across domains including attention, executive function, memory, and visuospatial skills. Scores range from 0 to 30, with higher scores indicating better cognitive functioning. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Trail Making Test-Part A (TMT-A)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The TMT-A assesses processing speed and attention. Longer completion times indicate poorer processing speed and attention. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Symbol Digit Modalities Test (SDMT)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The SDMT assesses processing speed. More correct responses indicate better processing speed. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Spatial Working Memory (SWM)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The SWM assesses working memory. Fewer errors indicate better working memory performance. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Paired Associates Learning (PAL)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The PAL assesses visual learning. Fewer errors indicate better visual learning performance. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Modified Ashworth Scale (MAS)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The MAS assesses muscle spasticity. Scores range from 0 to 4, with higher scores indicating greater spasticity. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Grip and Pinch Dynamometry
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
Grip and pinch dynamometry measures upper-extremity muscle strength. Higher force output indicates greater muscle strength. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Box and Block Test (BBT)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The BBT assesses gross manual dexterity. More blocks transferred indicate better gross manual dexterity. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Nine-Hole Peg Test (9HPT)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The 9HPT assesses fine motor coordination. Shorter completion times indicate better fine motor coordination. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Motor Activity Log (MAL)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The MAL assesses use of the affected arm in daily activities and perceived quality of movement. Scores range from 0 to 5, with higher ratings indicating greater daily arm use and better movement quality. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
ABILHAND Questionnaire
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The ABILHAND Questionnaire assesses perceived manual ability in daily activities. Higher logit scores indicate better perceived manual ability. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Functional Independence Measure (FIM)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The FIM assesses functional independence. Scores range from 18 to 126, with higher scores indicating greater functional independence. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Stroke Impact Scale (SIS)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The SIS assesses the impact of stroke on functional recovery. Domain scores range from 0 to 100, with higher scores indicating better functional recovery. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
|
Stroke-Specific Quality of Life Scale (SS-QOL)
기간: Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
The SS-QOL assesses stroke-specific health-related quality of life. Higher scores indicate better health-related quality of life. |
Baseline (T0), immediately after the 2-week intervention (T1), and 3-month follow-up (T2).
|
공동 작업자 및 조사자
수사관
수사관
- 연구 책임자: Chia-Ling Chen, Chang Gung Memorial Hospital
연구 기록 날짜
연구 주요 날짜
연구 시작 (추정된)
연구 시작
기본 완료 (추정된)
기본 완료
연구 완료 (추정된)
연구 완료
연구 등록 날짜
최초 제출
최초 제출
QC 기준을 충족하는 최초 제출
QC 기준을 충족하는 최초 제출
처음 게시됨 (실제)
처음 게시됨
연구 기록 업데이트
마지막 업데이트 게시됨 (실제)
마지막 업데이트 게시됨
QC 기준을 충족하는 마지막 업데이트 제출
QC 기준을 충족하는 마지막 업데이트 제출
마지막으로 확인됨
마지막으로 확인됨
추가 정보
이 연구와 관련된 용어
키워드
기타 연구 ID 번호
기타 연구 ID 번호
- 202502050A3
약물 및 장치 정보, 연구 문서
미국 FDA 규제 의약품 연구
미국 FDA 규제 기기 제품 연구
이 정보는 변경 없이 clinicaltrials.gov 웹사이트에서 직접 가져온 것입니다. 귀하의 연구 세부 정보를 변경, 제거 또는 업데이트하도록 요청하는 경우 register@clinicaltrials.gov. 문의하십시오. 변경 사항이 clinicaltrials.gov에 구현되는 즉시 저희 웹사이트에도 자동으로 업데이트됩니다. .