- ICH GCP
- Amerikanska kliniska prövningsregistret
- Klinisk prövning NCT07631078
kTMP-Enhanced Motor Rehabilitation for Chronic Stroke Recovery (KULMINATE) Pilot
kTMP-Enhanced Motor Rehabilitation for Chronic Stroke Recovery
Studieöversikt
Status
Intervention / Behandling
Detaljerad beskrivning
The goal of this pilot clinical trial is to assess the feasibility and preliminary efficacy of kTMP on upper limb motor recovery in chronic stroke compared to sham. We will conduct a 6-week double-blind, randomized, sham-controlled pilot study to test the beneficial influence of kTMP combined with simple motor tasks on kinematic outcomes such as range of motion of the upper arm, hand and fingers.
After baseline assessments, participants will be randomly allocated to either the kTMP group or the Control group. Participants, experimentalists, and outcome assessors will be blinded to group allocation. kTMP will begin within 1 week following randomization and will be delivered three times a week for 6 weeks. The primary endpoint will be assessed at the end of treatment, with follow-up assessments occurring 1 month, 3 months and 6 months following treatment completion. There is one assessment 4 weeks into the treatment phase to assess if patients continue to improve from 4 to 6 weeks of treatment.
Studietyp
Inskrivning (Beräknad)
Fas
- Inte tillämpbar
Kontakter och platser
Studiekontakt
- Namn: Ludovica Labruna, PhD
- Telefonnummer: 5104237125
- E-post: participate@magnetictides.com
Studieorter
-
-
California
-
San Francisco, California, Förenta staterna, 94158
- Rekrytering
- UCSF Mission Bay- Sandler Neurosciences Center
-
Kontakt:
- Christina Merrick
- Telefonnummer: 510-423-7125
- E-post: participate@magnetictides.com
-
Huvudutredare:
- Ludovica Labruna, PhD
-
Huvudutredare:
- Richard Ivry, PhD
-
Huvudutredare:
- Karunesh Ganguly, MD
-
-
Deltagandekriterier
Urvalskriterier
Åldrar som är berättigade till studier
- Vuxen
- Äldre vuxen
Tar emot friska volontärer
Beskrivning
Inclusion criteria:
- Adults aged 18-80 years who have a history of an ischemic or hemorrhagic stroke ≥ 12 m prior to enrollment.
- Fugl-Meyer Assessment: Upper Extremity (FMA UE) score 20-50.
- Ability to communicate, understand, and give appropriate consent. Participants can follow two-step commands.
- Motor evoked potentials in a hand muscle when stimulating ipsilesional cortex with suprathreshold single-pulse TMS (MEP positive).
Exclusion criteria:
- Participants with moderate or severe cognitive impairment (MoCA < 18).
- Participants with sensory deficits FMA-S < 6/12 (with proprioception < 4/8).
- Participants with severe apraxia (TULIA < 5).
- Language impairment or behavioral disorder that interferes with their ability to adhere to the protocol or to provide informed consent.
- Individuals who have a serious uncontrolled medical condition, including but not limited to severe cardiovascular and cardiopulmonary disease.
- Pregnancy or plans to become pregnant during the study period.
- Botulinum toxin injections of the affected upper extremity within 3 months prior to onset of study.
- Severe spasticity of the affected upper limb (Modified Ashworth ≥ 4).
- Absolute contraindications related to non-invasive brain stimulation, including:
9a) History of seizures in the last 12 months while taking anti-epilepsy medication 9b) Presence of any metal implants in the head (excluding the mouth), such as cortical stimulators and DBS, clips, coils, shunts, stents or skull plates, cochlear implants 9c) Permanent eye liner or head tattoos 9d) Implanted electronics such as pacemakers, defibrillators, intrathecal baclofen pumps or vagus nerve stimulator 9e) History of experiencing a serious adverse event during a previous transcranial magnetic stimulation (TMS) session
Studieplan
Hur är studien utformad?
Designdetaljer
- Primärt syfte: Behandling
- Tilldelning: Randomiserad
- Interventionsmodell: Parallellt uppdrag
- Maskning: Trippel
Vapen och interventioner
Deltagargrupp / Arm |
Intervention / Behandling |
|---|---|
|
Experimentell: Aktiv KTMP
Deltagarna fick 8 V/m aktiv stimulering
|
Ett nytt icke-invasivt verktyg för hjärnstimulering
|
|
Sham Comparator: Sham kTMP
Participants receive sham stimulation (0.0 V/m electric field)
|
Ett nytt icke-invasivt verktyg för hjärnstimulering med skeninställning vald
|
Vad mäter studien?
Primära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Range of Joint Motion (ROM)
Tidsram: 6 weeks
|
defined as the standard deviation of the joint angle time series for a given trial.
The median ROM will be calculated for eleven degrees of freedom and then averaged.
If there are joints which appear to be compensatory, they will be removed from the analysis
|
6 weeks
|
Sekundära resultatmått
Resultatmått |
Åtgärdsbeskrivning |
Tidsram |
|---|---|---|
|
Fugl- Meyer Assessment (Upper Extremity)
Tidsram: 6 weeks
|
A comprehensive clinical examination that has been widely used to evaluate stroke-related motor impairment.
It is graded from 0 (hemiplegia) to 66 for the Upper extremity.
Higher scores signifies better motor control, and hence a better outcome.
|
6 weeks
|
|
Modified Ashworth Scale (MAS)
Tidsram: 6 weeks
|
Used to measure spasticity in wrist and hand flexors and extensors.
It assigns a grade of spasticity from 0-4.
Lower scores represent normal muscle tone and higher scores represent spasticity.
Hence lower scores are associated with better outcomes.
|
6 weeks
|
|
Transport Time
Tidsram: 6 weeks
|
Calculated for each of three epochs, pre, during and post
|
6 weeks
|
|
Trial to Trial Variability (T2TV)
Tidsram: 6 weeks
|
Defined as the mean-squared error between the joint angle time-series for a given trial and the median joint angle timeseries.
The median T2TV will be calculated for eleven degrees of freedom.
|
6 weeks
|
|
Grasp to Lift Time
Tidsram: 6 weeks
|
Calculated for each of three epochs, pre, during and post
|
6 weeks
|
Samarbetspartners och utredare
Studieavstämningsdatum
Studera stora datum
Studiestart (Beräknad)
Primärt slutförande (Beräknad)
Avslutad studie (Beräknad)
Studieregistreringsdatum
Först inskickad
Först inskickad som uppfyllde QC-kriterierna
Första postat (Faktisk)
Uppdateringar av studier
Senaste uppdatering publicerad (Faktisk)
Senaste inskickade uppdateringen som uppfyllde QC-kriterierna
Senast verifierad
Mer information
Termer relaterade till denna studie
Nyckelord
- Stroke
- Transkraniell magnetisk stimulering
- Ischemisk stroke
- Icke-invasiv hjärnstimulering
- Kortikal excitabilitet
- Kronisk stroke
- Formbarhet
- Cerebrovaskulära störningar
- Hjärnstörningar
- Störningar i centrala nervsystemet
- Hemorragisk stroke
- Kardiovaskulära sjukdomar
- kTMP
- kilohertz transkraniell magnetisk störning
Ytterligare relevanta MeSH-villkor
Andra studie-ID-nummer
- kTMPstrokePilot
Plan för individuella deltagardata (IPD)
Planerar du att dela individuella deltagardata (IPD)?
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