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rTMS Study to Improve Functional Performance for Patients With Stroke

10 december 2015 uppdaterad av: Yen-Nung Lin, Taipei Medical University WanFang Hospital

The Potential Benefit of 1-Hz rTMS to Improve Gross Motor Function After Stroke: A Randomized Controlled Trial.

To use repetitive transcranial magnetic stimulation (rTMS) to treat stroke patients is getting a popular idea. Previous studies seemed to support its effects on facilitating motor recovery after stroke. This study focuses on the motor recovery of lower extremities. Investigators conducted the study to evaluate the treatment effect of rTMS on the functional performance of lower extremities in terms of postural control, balance, and mobility in stroke patients. Investigators hypothesized that these performances could be improved through the better motor control of lower extremities caused by rTMS.

Studieöversikt

Status

Avslutad

Betingelser

Intervention / Behandling

Detaljerad beskrivning

Protocol:

  1. Setting: inpatient rehabilitation department of Shuang-Ho Hospital.
  2. Study population: Patients received inpatient treatment or rehabilitation for stroke in Shuang-Ho Hospital (SHH).
  3. Eligibility. Screening for eligibility was done by the 2 physiatrists from rehabilitation department of SHH.
  4. Study design: controlled trial with stratified randomization

  5. Blinding

    1. The patients were blinded by the real or sham coil of rTMS
    2. The assessors who performed the outcome measurements were blinded to the assignment of treatment.

  6. Measurements.

    1. Baseline demographic records. The stroke severity was measured by National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS), Brunnstrum stage, and Manual muscle test (MMT) before intervention.

    2. Clinical assessments.

      • Postural control was assessed by Postural Assessment Scale for Stroke Patients (PASS)
      • The motor recovery of lower extremities was assessed by the lower extremity subscale of Fugl-Meyer Assessment (FMA-LE)
      • The balance and gait subscales of Tinetti Performance Oriented Mobility Assessment (POMA-b and POMA-g)
      • Timed Up and Go (TUG) test was used to assess the gross mobility.
      • Barthel Index (BI) for the ADL independence
      • modified Rankin Scale (MRS) for disability classification were also collected.
    3. These measurements (including the clinical and corticomotor excitability assessments) are performed by one researcher who are responsible for the measurements.
  7. Compliance and side effect. The compliance of interventions were investigated. The attendance of treatments (including rTMS sessions and physical therapy sessions) and possible side effect/discomfort were recorded during the interventions by a researcher. He also tries to understand the reason of drop-out from the study.

Studietyp

Interventionell

Inskrivning (Faktisk)

60

Fas

  • Fas 3

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

  • Taiwan
      • New Taipei City, Taiwan
        • Shuang Ho Hospital

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:

  • unilateral hemiplegia caused by the stroke,
  • first ever stroke,
  • time since stroke: 10-90 days,
  • age: 18-80 y/o,
  • Functional ambulation classification (FAC): 0-2,

Exclusion Criteria:

  • contraindication to TMS (eg, pacemaker, seizure history, pregnancy),
  • cranial metal implants
  • intracranial hemorrhage associated with tumor or arteriovenous malformation, craniotomy
  • able to complete Timed Up and Go (TUG) test within 2 minutes
  • unable to walk normally before the stroke
  • those whose motor evoked potentials (MEP) of M1-UH were absent in the pretest

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: Trippel

Vapen och interventioner

Deltagargrupp / Arm
Intervention / Behandling
Experimentell: real rTMS
Experimental included the a daily real rTMS session for 15 mins followed by a physical therapy for 45 mins.
Enhet: rTMS
Interventions started on the next weekday after pretest and were performed once a day for 15 consecutive weekdays. Participants in the E and C groups received rTMS (either real or sham, 1 Hz, 15 minutes), followed by a session of physical therapy for 45 minutes.
Andra namn:
  • Magstim Rapid2
Sham Comparator: sham rTMS
the control interventions included a daily sham rTMS session for 15 minutes followed by a physical therapy for 45 minutes.
Enhet: rTMS
Interventions started on the next weekday after pretest and were performed once a day for 15 consecutive weekdays. Participants in the E and C groups received rTMS (either real or sham, 1 Hz, 15 minutes), followed by a session of physical therapy for 45 minutes.
Andra namn:
  • Magstim Rapid2

Vad mäter studien?

Primära resultatmått

Resultatmått
Tidsram
Timed Up and Go (TUG)
Tidsram: Up to 3 months after interventions completed
Up to 3 months after interventions completed

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
the lower extremity subscale of Fugl-Meyer Assessment (FMA-LE)
Tidsram: up to 3 months after the intervention completed
up to 3 months after the intervention completed
The balance and gait subscales of Tinetti Performance Oriented Mobility Assessment (POMA-b and POMA-g)
Tidsram: up to 3 months after the interventions completed
up to 3 months after the interventions completed
Barthel Index (BI)
Tidsram: Up to 3 months after interventions completed
Up to 3 months after interventions completed
Postural control was assessed by Postural Assessment Scale for Stroke (PASS)
Tidsram: up to 3 months after the intervention completed
PASS which examines the patient's ability to maintain or change a given posture and is applicable to patients with very poor postural performance. This instrument has been reported to have a good validity and reliability at different recovery stages after stroke, minimal floor and ceiling effect, and be sensitive to changes in severe stroke patients at early stage after stroke.
up to 3 months after the intervention completed
modified Rankin Scale (MRS)
Tidsram: Up to 3 months after interventions completed
Up to 3 months after interventions completed

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Sponsor

Taipei Medical University WanFang Hospital

Utredare

  • Huvudutredare: Yen-Nung Lin, MD, MS, Department of Physical Medicine and Rehabilitation, Wan Fang Hospital, Taipei Medical University

Publikationer och användbara länkar

Den som ansvarar för att lägga in information om studien tillhandahåller frivilligt dessa publikationer. Dessa kan handla om allt som har med studien att göra.

Allmänna publikationer

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 2013

Primärt slutförande (Faktisk)

1 december 2015

Avslutad studie (Faktisk)

1 december 2015

Studieregistreringsdatum

Först inskickad

4 december 2013

Först inskickad som uppfyllde QC-kriterierna

4 december 2013

Första postat (Uppskatta)

10 december 2013

Uppdateringar av studier

Senaste uppdatering publicerad (Uppskatta)

11 december 2015

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

10 december 2015

Senast verifierad

1 december 2015

Mer information

Termer relaterade till denna studie

Nyckelord

Ytterligare relevanta MeSH-villkor

Andra studie-ID-nummer

  • 102-wf-eva-04

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