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Effects of Upper Limb Motor and Robotic Training Over Neuroplasticity and Function Capacity (NARLE1)

1. mars 2016 oppdatert av: University of Sao Paulo General Hospital

Effects of Upper Limb Motor Training and Upper Limb Robotic Training Over Neuroplasticity and Function Capacity: A Single-blind Randomized Clinical Trial With Patients With Stroke Sequelae

The purpose of this study is to evaluate and compare the effects of upper limb training with Induced Constraint Therapy (ICT) or robotic therapy. No placebo therapy is used. Motor function, neurological evaluations and quality of life are assessed for the comparison of the therapies.

Studieoversikt

Status

Ukjent

Forhold

Intervensjon / Behandling

Detaljert beskrivelse

The trial is being carried out in the Institute of Physical Medicine and Rehabilitation of the University of São Paulo since February 2012. The investigators are including patients with clinical diagnosis of Ischemic or hemorrhagic stroke.

The patients are being randomized in blocks of four, six and eight, in two arms: ICT: patients are undergoing 60 minutes physiotherapy and occupational therapy twice a week for ten consecutive weeks. Other therapeutic services as phonoaudiology, psychology, nutrition, physical conditioning are prescribed upon the patients' medical demands. After the 10 weeks, the patients are undergoing two whole weeks of daily ICT as to reach 90% of the time under constraint, including weekends. During this last period, no other therapeutic service is offered, but the occupational therapy under ICT. Patients are not allowed to undergo robotic therapy.

Robotic therapy: patients are undergoing robotic occupational therapy for 60 minutes, three times a week for twelve consecutive weeks. All other therapeutic services are prescribed upon the patients' medical demands. Patients are not allowed to undergo ICT.

The investigator and the raters are blind to treatment.

The evaluations are done prior to the beginning of the treatment and at the end of it. The follow up assessments are done at 3 and 12 months after the end of the treatment.

The sample size was estimated to be 62 patients in each arm, a total size of 124 patients

Studietype

Intervensjonell

Registrering (Faktiske)

51

Fase

  • Fase 2

Kontakter og plasseringer

Denne delen inneholder kontaktinformasjon for de som utfører studien, og informasjon om hvor denne studien blir utført.

Studiesteder

  • Brasil
      • Sao Paulo, Brasil, 04116-040
        • Centro de Pesquisa Clínica do Instituto de Medicina Física e Reabilitação do HCFMUSP

Deltakelseskriterier

Forskere ser etter personer som passer til en bestemt beskrivelse, kalt kvalifikasjonskriterier. Noen eksempler på disse kriteriene er en persons generelle helsetilstand eller tidligere behandlinger.

Kvalifikasjonskriterier

Alder som er kvalifisert for studier

18 år og eldre (Voksen, Eldre voksen)

Tar imot friske frivillige

Nei

Kjønn som er kvalifisert for studier

Alle

Beskrivelse

Inclusion Criteria:

  • Clinical diagnosis of stroke;
  • Patients from 6 months after stroke up to 36 months after stroke;
  • Clinically stable;
  • Upper limb Brunnstrom scale III or IV;
  • Brunnstrom scale above V if clinician supports patients will benefit from treatment;
  • Minimum wrist extension of 20°, and minimum of 10° of metacarpophalangeal active extension.
  • Signed Informed Consent Form;

Exclusion Criteria:

  • Mini-Mental score lower than 20 points;
  • Previous multiple strokes;
  • Bone diseases and articulation injuries ;
  • Presence of psychological disturbances capable of diminishing adherence;
  • Articulation pain within the range of motion proposed by the therapies;
  • Participation in another study protocol for upper limbs therapies.
  • Previous treatment with robotic assisted therapies.

Studieplan

Denne delen gir detaljer om studieplanen, inkludert hvordan studien er utformet og hva studien måler.

Hvordan er studiet utformet?

Designdetaljer

  • Primært formål: Behandling
  • Tildeling: Randomisert
  • Intervensjonsmodell: Parallell tildeling
  • Masking: Enkelt

Våpen og intervensjoner

Deltakergruppe / Arm
Intervensjon / Behandling
Eksperimentell: Induced Constraint Therapy - ICT
Physical rehabilitation with Induced Constraint Therapy as part of the occupational therapy. Standard Occupational Therapy two times a week for ten weeks, followed by two whole weeks of Induced Constraint Therapy.
Fremgangsmåte: Induced Constraint Therapy - ICT
Standard Occupational Therapy two times a week for ten weeks, followed by two whole weeks of Induced Constraint Therapy.
Andre navn:
  • IKT
Eksperimentell: Robotic occupational therapy
Physical rehabilitation with Robotic occupational therapy. Robotic Occupational Therapy three times a week for twelve weeks.
Fremgangsmåte: Robotic occupational therapy
Robotic Occupational Therapy three times a week for twelve weeks.
Andre navn:
  • Robotic therapy

Hva måler studien?

Primære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change on Motor Function assessed by Wolf Motor Function scale
Tidsramme: Baseline and 12 weeks
Change from baseline in Wolf Motor Function scale.
Baseline and 12 weeks
Change on Motor Function assessed by Fugl Meyer scale
Tidsramme: Baseline and 12 weeks
Change from baseline in Fugl Meyer scale.
Baseline and 12 weeks

Sekundære resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Change on Motor Function assessed by Wolf Motor Function scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in Wolf Motor Function scale.
Baseline, 3 months and 12 months
Change on Motor Function assessed by Fugl Meyer scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in Fugl Meyer scale.
Baseline, 3 months and 12 months
Change on Motor Function assessed by Robotic scale
Tidsramme: Baseline, 3 months and 12 months
Multiple changes from baseline in robotic scale.
Baseline, 3 months and 12 months
Change on Function ability and quality of movement assessed by Arm Motor Ability Test (AMAT)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in AMAT scale.
Baseline, 12 weeks, 3 months and 12 months
Change on Functional Independence Measure (FIM) as assessed by FIM scale
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in FIM scale.
Baseline, 12 weeks, 3 months and 12 months
Change on Quality of life assessed by Stroke Impact Scale (SIS)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in SIS.
Baseline, 12 weeks, 3 months and 12 months
Change on Kinematic variables assessed by InMotion robots
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple motion changes from baseline in the Kinematic variables assessed by InMotion robots.
Baseline, 12 weeks, 3 months and 12 months

Andre resultatmål

Resultatmål
Tiltaksbeskrivelse
Tidsramme
Psychological Evaluation assessed by Perceived Stress Scale (PSS-10)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in PSS-10.
Baseline, 12 weeks, 3 months and 12 months
Neuroplasticity as assessed by Brain Derived Neurotrophic Factor (BDNF)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in BDNF.
Baseline, 12 weeks, 3 months and 12 months
Corticospinal excitability as assessed by transcranial magnetic stimulation (TMS)
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in TMS.
Baseline, 12 weeks, 3 months and 12 months
Neurologic evaluation as assessed by electroencephalography
Tidsramme: Baseline, 12 weeks, 3 months and 12 months
Multiple changes from baseline in electroencephalography.
Baseline, 12 weeks, 3 months and 12 months

Samarbeidspartnere og etterforskere

Det er her du vil finne personer og organisasjoner som er involvert i denne studien.

Sponsor

University of Sao Paulo General Hospital

Etterforskere

  • Hovedetterforsker: Linamara Rizzo Battistella, Md PhD, University of Sao Paulo

Publikasjoner og nyttige lenker

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Generelle publikasjoner

Studierekorddatoer

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Studer hoveddatoer

Studiestart

1. februar 2012

Primær fullføring (Forventet)

1. april 2016

Studiet fullført (Forventet)

1. februar 2017

Datoer for studieregistrering

Først innsendt

24. november 2015

Først innsendt som oppfylte QC-kriteriene

1. mars 2016

Først lagt ut (Anslag)

7. mars 2016

Oppdateringer av studieposter

Sist oppdatering lagt ut (Anslag)

7. mars 2016

Siste oppdatering sendt inn som oppfylte QC-kriteriene

1. mars 2016

Sist bekreftet

1. august 2015

Mer informasjon

Begreper knyttet til denne studien

Nøkkelord

Ytterligere relevante MeSH-vilkår

Andre studie-ID-numre

  • 0910.0.015.000-11

Plan for individuelle deltakerdata (IPD)

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NEI

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