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The Application of Thermal Stimulation on Functional Recovery of Stroke Patients

6 april 2015 uppdaterad av: Jau-Hong Lin, Professor, Kaohsiung Medical University Chung-Ho Memorial Hospital
In literature review, thermal stimulation (TS) intervention is effective in facilitating upper extremity functional recovery in stroke patients. In addition, several functional MRI studies have indicated that thermal stimuli promoted activation in the premotor and motor cortices of healthy participants. These imply the possibility of TS in cortical reorganization. However, there were no studies exploring the relationship of the TS intervention and cortical reorganization. By the functional recovery of stroke patients, findings of brain image and brain mapping, it could enhance the understanding the TS influences on brain reorganization. Regarding with clinical application of the TS intervention for improving functional performance of upper extremity in participants with stroke, the best parameters of TS intervention in clinical practice have not been decided. Therefore, this five-year study recruited three groups of stroke patients (acute, sub-acute, chronic) undergoing TS intervention with different parameters. Functional scales, kinematic data, brain image were taken in several timelines as outcome measures.

Studieöversikt

Detaljerad beskrivning

The thermal stimulation (TS) intervention uses the heat and cold apply alternately (~30minutes), and this kind temperature application is common in clinical neuromuscular or sports rehabilitation. Moreover, some studies have proved efficacy of the TS on stroke. However, the best parameters and application on different-stage stroke groups have not been clearly explored. Moreover, in order to discover the TS intervention influences on neuroplasticity, the brain images and the brain mapping are taken in the group A (explained in the below). In addition, the kinematic data was also collected in group A. However, the above-mentioned three examination are optional. Finally, functional recovery measurements (clinical scales) are measured in the three groups.

There are three groups (90 participants in each group) and their respective TS intervention design. In other word, three sub-studies (A, B, C) are under this project. Group A recruited 90 acute stroke (~ 30 days) and the independent variable is temperature of TS intervention. Group B is with sub-acute stroke (3-12 months), undergoing different frequency of TS intervention. Group C targets on participants with chronic stroke (> 1 y/o) and this variation in TS is intensity of TS application (30 mins vs 60 mins/each session).

Studietyp

Interventionell

Inskrivning (Faktisk)

220

Fas

  • Inte tillämpbar

Kontakter och platser

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Studieorter

      • Kaohsiung city, Taiwan, 807
        • Kaohsiung Medical University

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

18 år till 80 år (Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Beskrivning

Inclusion Criteria:

  1. first-ever ischemic stroke;
  2. no severe cognitive impairments and able to follow instructions;
  3. sit on a chair for more than 30 minutes independently.

Exclusion Criteria:

  1. musculoskeletal or cardiac disorders that potentially interferes with experimental tests;
  2. diabetic or sensory impairment that attributable to peripheral vascular disease or neuropathy;
  3. speech disorder or global aphasia;
  4. skin problems at the sites of stimulation;

6.contraindications of heat or ice application.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Primärt syfte: Behandling
  • Tilldelning: Randomiserad
  • Interventionsmodell: Faktoriell uppgift
  • Maskning: Enda

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: Noxious TS in study A
hot, cold alternately, noxious TS in study A
Aktiv komparator: Innocuous TS
Innocuous TS in study A
warm, cool alternately, Innocuious TS in study A
Experimentell: High Frequency of Noxious TS
High Frequency of Noxious TS in study B
High Frequency of Noxious TS in study B
Aktiv komparator: Low Frequency of Noxious TS
Low Frequency of Noxious TS in study B
Low Frequency of Noxious TS in study B
Experimentell: High Intensity of Noxious TS
High Intensity of Noxious TS in study C
High Intensity of Noxious TS in study C
Aktiv komparator: Low Intensity of Noxious TS
Low Intensity of Noxious TS in study C
Low Intensity of Noxious TS in study C

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Movement performance assessment
Tidsram: baseline, half time-line of whole intervention period, post-intervention, 1 month follow-up, 6 month follow-up
  • Movement performance assessment by clinical motor assessment scales in upper extremity
  • executed by qualified physiotherapy
  • in study A, B, C
baseline, half time-line of whole intervention period, post-intervention, 1 month follow-up, 6 month follow-up
Brain images
Tidsram: immediate effects in 3 timeline
  • "intermediate effect of TS" means: pretest of the single TS, then application of this single TS, finally post-test of this TS in the session in the same day
  • immediate effects of intervention in the 1st day and 24th of intervention, six-month follow-up
  • this examination is optional
  • in study A.
  • use regular scan examination of hospital and operated by trained qualified professionals, the attending is consulted
  • This examination can be stopped at any time if participants do not want to perform or feeling unwell
immediate effects in 3 timeline
Mapping of brain cortex
Tidsram: immediate effect in four timeline
  • "intermediate effect of TS" means: pretest of the single TS, then application of this single TS, finally post-test of this TS in the session in the same day
  • immediate effects of intervention in the 1st day and 24th of intervention, one-month follow-up, six-month follow-up
  • in study A.
  • this examination is optional
  • use equipment of brain mapping and operated under trained staff, the attending is consulted This examination can be stopped at any time if participants do not want to perform or feeling unwell
immediate effect in four timeline
Kinematics measure of upper extremity movement
Tidsram: four timeline
  • 1st day and 24th of intervention, one-month follow-up, six-month follow-up (This examination is optional)
  • signal emission marks are sticked on surface skin during motion tests
  • this examination is optional

    --in study A.

  • executed by trained qualified physiotherapy
four timeline

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Quality of life
Tidsram: baseline, post-intervention, 6 month follow-up
  • Quality of life by subjective questionnaires
  • executed by qualified physiotherapy --in study A, B, C.
baseline, post-intervention, 6 month follow-up

Samarbetspartners och utredare

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Utredare

  • Huvudutredare: Jau-Hong Lin, Professor, Kaohsiung Medical University

Publikationer och användbara länkar

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Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart

1 januari 2010

Primärt slutförande (Faktisk)

1 juni 2014

Avslutad studie (Faktisk)

1 december 2014

Studieregistreringsdatum

Först inskickad

26 juni 2011

Först inskickad som uppfyllde QC-kriterierna

16 augusti 2011

Första postat (Uppskatta)

17 augusti 2011

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

8 april 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

6 april 2015

Senast verifierad

1 april 2015

Mer information

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