tDCS and Robotic Therapy in Stroke
After stroke a limited motor recovery in the paretic upper limb accounts for a large proportion of the disabling sequelae. Only about 15% of those with initial complete upper limb paralysis after stroke recover functional use of their impaired arm in daily life.
The aim of this study is to test the effects of tDCS combined with upper extremity robot-assisted therapy on stroke survivors.
Studieöversikt
Status
Betingelser
Intervention / Behandling
Studietyp
Inskrivning (Faktisk)
Fas
- Fas 2
Kontakter och platser
Studieorter
-
-
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Ferrara, Italien
- Ferrara University Hospital
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Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
Tar emot friska volontärer
Kön som är behöriga för studier
Beskrivning
Inclusion Criteria:
- Males and females subjects. Age > 18 years.
- Diagnosis of first ischemic stroke
- Impairment of the upper limb
- Trunk control defined in the Trunk-Control Test (TCT), with a score > 50.
Exclusion Criteria:
- anyone who does not have adequate understanding of verbal or written information in Italian sufficient to complete any test
- Impaired cognitive functioning: score less than 24 on the Mini Mental Status Examination (MMSE)
- contraindications to single-pulse transcranial magnetic stimulation (TMS)(TMS will be used to measure cortical excitability): presence of a history of epilepsy, frequent headaches or neck pain, implantable devices (ventriculoperitoneal shunts, pacemakers, intrathecal pumps, intracranial metal implants)
- Contraindications to tDCS: intracranial metal implants that can be stimulated, incorrectly positioned or over-heated by the electric current
- Neurological or psychiatric pathology
- severe cardio-pulmonary, renal, hepatic diseases
- Pregnancy
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Trippel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
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Sham Comparator: sham-tDCS + UE robot-assisted therapy
This group will receive the same robot-assisted therapy of the intervention group, in association of sham-tDCS.
This consists in a 30 seconds stimulation, with the same instrumentation and electrodes placement.
This method of sham stimulation was previously validated.
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Experimentell: real-tDCS + UE robot-assisted therapy
This group will receive continuous stimulation lasting 30 minutes during the session of robot-assisted therapy. The training session, which includes multiplanar, repetitive and target reaching movements, will be given 5 times a week for 2 weeks(REO Therapy System; Motorika, Medical LTD, Israel). Each session will last about 30 minutes. Transcranial direct current stimulation (tDCS) will be administered as follows. The anode will be placed on the primary motor cortex (M1) of the affected hemisphere and the cathode on the contralateral M1 area. The direct current is transmitted through a pair of sponge electrodes, with a surface of 35 cm2 (7x5), soaked in saline solution and, it is generated by a constant current stimulator, with rechargeable batteries (Brainstim, EMS, Italy). This continuous stimulation lasted 30 minutes, with an intensity of 1mA. |
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Fugl-Meyer Upper Extremity
Tidsram: A week prior to treatment beginning
|
Measure of upper extremity motor impairment.
The upper extremity score ranges from 0-66.
|
A week prior to treatment beginning
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Box and Block Test
Tidsram: A week prior to treatment beginning
|
Test for gross motor function.
It counts the number of blocks that can be transported from one compartment of a box to another compartment within 1 minute.
|
A week prior to treatment beginning
|
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Ashworth Modified Scale
Tidsram: A week prior to treatment beginning
|
a 6 point measure of spasticity.
We will assess the spasticity at the shoulder, elbow and, wrist
|
A week prior to treatment beginning
|
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Motor Activity Log (MAL)
Tidsram: A week prior to treatment beginning
|
Assessment of the change in real-world arm use in activities of daily living.
Subjects are asked to score the quality of movement as well as amount of use of the affected arm in a number of common daily activities.
|
A week prior to treatment beginning
|
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Assessment of cortical excitability (TMS)
Tidsram: A week prior to treatment beginning
|
MEP of upper limb muscles (first dorsal interosseous) will be recorded with surface EMG electrodes. neurophysiological parameters analyzed:
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A week prior to treatment beginning
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Samarbetspartners och utredare
Sponsor
Publikationer och användbara länkar
Studieavstämningsdatum
Studera stora datum
Studiestart
Primärt slutförande (Faktisk)
Avslutad studie (Faktisk)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Uppskatta)
Uppdateringar av studier
Senaste uppdatering publicerad (Uppskatta)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- Stroke_tDCS
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