Rehabilitation Protocol for Disorders on Hand Sensitivity in Multiple Sclerosis Patients. (FINGER)
Sensory disorders in patients with multiple sclerosis are among the most common symptoms encountered.
A functional impairment based on sensory disorders of the hand. The hand is a sensory organ that transmits the cerebral cortex protopathic sensitive information, proprioceptive or epicritiques. The view-hand association plays an important role in the understanding of the environment. Its exploratory use remains an essential and voluntary basis. The process of recognition of the object passes through manipulation, but operates instantaneously. The brain is able to do a quick summary of the information it receives to determine the nature of the manipulated object. The exploration takes a posteriori, the brain can then determine the details component object (texture, shape, composition, temperature and weight).
Neurophysiological mechanisms that would explain the analgesic effects of transcutaneous electrical nerve stimulation (TENS) are not fully understood. Several theories underlying its use as a neuromodulator of pain. The gate control theory has led to the development of TENS devices. Recruitment of myelinated, large caliber, by the TENS electrodes afferent fibers increases the control exerted on spinal level, thereby inhibiting the action of afferent fibers of small caliber related to nociception. This stimulation strengthens the blocking of "gate" at the corresponding cell bodies of spinothalamic tract and reduces the transmission of nociceptive impulses to the spinal cord dorsal horn. This is segmental presynaptic inhibition depends on the area and stimulated.
The objective of this study is to improve the quality of life through improved sensitivity disorders of the hand in patients with MS, thanks to reeducation of the hand.
研究概览
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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Nice、法国、06000
- Hôpital Pasteur
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
描述
Inclusion Criteria:
- Patients with relapsing remitting MS defined according to Poser criteria [9] and McDonald [5].
- Age ≥ 18 years, male or female sex
- Patients with sensory disorders interesting hands, evidenced by clinical examination objective.
- Patients with an EDSS between 2 and 4 with functional sensitivity parameter ≥ 2.
- Patients affiliated to a social security scheme.
- Patients signed informed consent for the study.
Exclusion Criteria:
- Patients with other central or peripheral disorders may affect the sensitivity of the hand.
- Patients with allodynia in the study area
- Patients with a motor and / or deficit cerebellar ataxia of the upper limbs.
- Patients treated with psychotropic or antiepileptic drugs.
- Patients for whom a flare occurred affecting the sensitivity of the hand, within 30 days before enrollment.
- Patients holders of an active implantable medical device.
- Pregnant women and vulnerable patient population.
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
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实验性的:A group enjoying a corrective touch
At first, the patient is asked to gradually define the different types of touch that is applied to the hyposensitive area (fixed or mobile touches) with different textures and then compare them with the healthy side. In a second step, the patient is asked to associate multiple items sensation shape and texture, shape and weight. In a third step is used everyday objects. Desensitisation techniques find their interest mainly when symptoms or dysesthetic hyperesthésique. The objective is to increase the threshold of sensitivity to textures and particles eventually reduce dysaesthetic sensations. The patient class in order of increasing tolerance 10 textures. Dysesthetic area is stimulated 5 to 10 minutes by the first texture to numb the area by saturation of the action potential. This helps promote functional work and recognition of objects. As soon as the texture causes more trouble we go to the next texture by applying the same job. |
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实验性的:A group receiving TENS (TENS)
Well known in the management of neuropathic pain based on the gate control theory, the application of TENS in the rehabilitation of touch remains to be demonstrated.
A recent study applied to the September highlighted the long-term interest of the transcutaneous electrical nerve stimulation (TENS) to improve sensitivity tact arguing possible action on brain plasticity.
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无干预:A control group
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Compare quality of life between baseline and procedure
大体时间:frist day, 1 month and 3 month
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Improve the quality of life through improved sensitivity disorders of the hand in patients with MS, thanks to reeducation of the hand. Unit of mesure: scale MusiQoL |
frist day, 1 month and 3 month
|
次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Compare the performance during functional tests between baseline and procedure
大体时间:first day, 1 month and 3 month
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Improve performance of MS patients during functional tests in patients undergoing rehabilitation treatment compared to the control group. Using picking up test and thr Nine Hole Peg Test |
first day, 1 month and 3 month
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Compare the improvement clinically sensitive target from baseline procedure
大体时间:first day, 1 month and 3 month
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Improve clinically sensitive target of MS patients through a rehabilitation treatment compared to the control group. Using the Threshold pressure, the Threshold to the vibration and the Weber test. |
first day, 1 month and 3 month
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合作者和调查者
调查人员
- 研究主任:Mikael COHEN, Medical Doctor、Centre Hospitalier Universitaire de Nice
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (估计)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
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