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Treadmill, Stretching and Proprioceptive Exercise (TreSPE) Rehabilitation Program for Charcot−Marie−Tooth Neuropathy Type 1A (CMT1A)

The recruitment status of this study is unknown because the information has not been verified recently.
Verified October 2010 by University of Genova.
Recruitment status was  Not yet recruiting
Sponsor:
Information provided by:
University of Genova
ClinicalTrials.gov Identifier:
NCT01289704
First received: January 24, 2011
Last updated: February 3, 2011
Last verified: October 2010
  Purpose

Charcot−Marie−Tooth neuropathy type 1A (CMT1A) is one of the most common inherited neurological disorders. The study will evaluate the efficacy and safety of an innovative rehabilitation protocol constituted by exercises at the treadmill and by a stretching and proprioceptive approach. A total of 92 patients will be enrolled in the study and treated in a controlled, randomized, single blind, way. To recruit a high number of patients with CMT1A the study will be multicentric and will comprehend four of the most active clinical centers in the field of CMT, in Italy. People with CMT1A are very motivated in entering rehabilitation protocols because to date there is no effective therapy for this disease. Therefore, the investigators expect a high compliance by the patients. With the present project the investigators plan to clarify several unanswered questions: 1) the efficacy and safety of treadmill over a more conventional protocol; 2) the duration and frequency of any rehabilitation treatment; 3) the most sensitive outcome measures to evaluate the efficacy of rehabilitation approach in patients with CMT.


Condition Intervention Phase
Charcot-Marie-Tooth Disease
Charcot-Marie-Tooth Disease Type 1A
Other: TreSPE
Other: SPE
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Safety/Efficacy Study
Intervention Model: Parallel Assignment
Masking: Single Blind (Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Multicenter Study to Evaluate the Effects on Charcot−Marie−Tooth Neuropathy Type 1A of a Composite Treadmill, Stretching and Proprioceptive Exercise (TreSPE) Rehabilitation Program.

Resource links provided by NLM:


Further study details as provided by University of Genova:

Primary Outcome Measures:
  • Walking ability of patients will be evaluated as the time needed to walk for 10 meters at normal speed for the patients [ Time Frame: Baseline: 1 day before the rehabilitative protocol starts (T1) ] [ Designated as safety issue: No ]
    The walking ability of patients will be evaluated through the "10 meters timed walk test" which will be performed at baseline (T1 or day-1), at the end of the three months of treatment (T2 or day90) and at the end of the three months of follow up (T3 or day180).

  • Walking ability of patients will be evaluated after finishing the treatment as the time needed to walk for 10 meters at normal speed for the patients [ Time Frame: at the end of treatment: day 90 (T2) ] [ Designated as safety issue: No ]
    The walking ability of patients will be evaluated through the "10 meters timed walk test" which will be performed at baseline (T1 or day-1), at the end of the three months of treatment (T2 or day90) and at the end of the three months of follow up (T3 or day180).

  • Walking ability of patients will be evaluated after finishing the treatment as the time needed to walk for 10 meters at normal speed for the patients [ Time Frame: at the end of follow up: day 180 (T3) ] [ Designated as safety issue: No ]
    The walking ability of patients will be evaluated through the "10 meters timed walk test" which will be performed at baseline (T1 or day-1), at the end of the three months of treatment (T2 or day90) and at the end of the three months of follow up (T3 or day180).


Secondary Outcome Measures:
  • Balance will be evaluated through the Berg Scale [ Time Frame: Baseline: 1 day before the rehabilitative protocol starts ] [ Designated as safety issue: No ]
    The Berg scale is a tool to evaluate balance and ranges from 0 to 36 points being 36 normal

  • Balance will be evaluated through the Berg Scale [ Time Frame: at the end of treatment: day 90 (T2) ] [ Designated as safety issue: No ]
    The Berg scale is a tool to evaluate balance and ranges from 0 to 36 points being 36 normal

  • balance will be evaluted through the Berg scale [ Time Frame: at the end of follow up: day 180 (T3) ] [ Designated as safety issue: No ]
    The Berg scale is a tool to evaluate balance and ranges from 0 to 36 points being 36 normal

  • Quality of life will be evaluated through the SF - 36 questionnaire [ Time Frame: Baseline: 1 day before the rehabilitative protocol starts (T1) ] [ Designated as safety issue: No ]
    The SF-36 is a multi-purpose, short-form health survey with only 36 questions. It yields an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index.

  • Quality of life will be evaluated through the SF - 36 questionnaire [ Time Frame: at the end of treatment: day 90 (T2) ] [ Designated as safety issue: No ]
    The SF-36 is a multi-purpose, short-form health survey with only 36 questions. It yields an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index.

  • Quality of life will be evaluated through the SF - 36 questionnaire [ Time Frame: at the end of follow up: day 180 (T3) ] [ Designated as safety issue: No ]
    The SF-36 is a multi-purpose, short-form health survey with only 36 questions. It yields an 8-scale profile of functional health and well-being scores as well as psychometrically-based physical and mental health summary measures and a preference-based health utility index.


Estimated Enrollment: 92
Study Start Date: February 2011
Estimated Study Completion Date: January 2012
Estimated Primary Completion Date: October 2011 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: TreSPE
Treatment with treadmill, proprioceptive and stretching exercises
Other: TreSPE
  1. treadmill: 5'warm up, 20'aerobic exercise (gradually incremented to 30', from session to session, if possible), 5'warm down, controlling hearth rate, blood pressure and SaO2.
  2. Respiratory Physiotherapy: positive Expiratory Pressure (PEP) bottle for 10' (in various postures), and postural training, for the other 10'.
  3. Stretching for 20', of the triceps surae, tibialis posterior, extensor and flexors digitorum longus and brevis, both at the bed and in a static position.
  4. Proprioceptive and postural kinesitherapy according to the Perfetti method.
  5. Balance Exercising consists of exercises carried on by basculating bars with improving difficulties in the instruments utilized and in the tasks with therapist supervision and near a handbar preventing falls.
Other Names:
  • TreSPE
  • SPE
Active Comparator: SPE
Proprioceptive and stretching exercises
Other: TreSPE
  1. treadmill: 5'warm up, 20'aerobic exercise (gradually incremented to 30', from session to session, if possible), 5'warm down, controlling hearth rate, blood pressure and SaO2.
  2. Respiratory Physiotherapy: positive Expiratory Pressure (PEP) bottle for 10' (in various postures), and postural training, for the other 10'.
  3. Stretching for 20', of the triceps surae, tibialis posterior, extensor and flexors digitorum longus and brevis, both at the bed and in a static position.
  4. Proprioceptive and postural kinesitherapy according to the Perfetti method.
  5. Balance Exercising consists of exercises carried on by basculating bars with improving difficulties in the instruments utilized and in the tasks with therapist supervision and near a handbar preventing falls.
Other Names:
  • TreSPE
  • SPE
Other: SPE
  1. Respiratory Physiotherapy for 20', consisting of Positive Expiratory Pressure (PEP) bottle for 10' (in various postures), and postural training according to the Mèzières technique, for the other 10'.
  2. Stretching for 20', of the triceps surae, tibialis posterior, extensor and flexors longus and brevis, both at the bed and in a static position.
  3. Proprioceptive and postural kinesitherapy according to the neurocognitive method.
  4. Balance Exercising consists of exercises carried on by moving bars with improving difficulties in the instruments utilized and in the tasks with therapist supervision and near a handlebar preventing falls.
Other Name: SPE

Detailed Description:

A multicentre, prospective, randomised, controlled, single blind study to evaluate the impact of aerobic exercise, based on a tightly controlled program at the treadmill, on the rehabilitation therapy of CMT 1A neuropathy.

Comparing aerobic training at the treadmill combined with respiratory physiotherapy, stretching and proprioceptive exercises (TreSPE- treated group) with a more conventional treatment only composed by respiratory physiotherapy, stretching and proprioceptive exercises (SPE- control group) will provide information on the impact of Treadmill in CMT1A.

92 patients (23 per centre) will be enrolled and randomly assigned to TreSPE (n = 46) or to SPE (n = 46). Both groups will be treated for three months and followed up for six months.

No serious side effects are expected with TreSPE, as also suggested by our preliminary results. For safety reasons blood pressure (BP), heart rate (HR) and an electrocardiogram will be recorded during the rehabilitation treatment when the treating physician considers it necessary. The patients will be allowed, if needed, to hold at the parallel bars of the treadmill during exercise. According to the American Thoracic Society (ATS) guidelines the cardiopulmonary exercise test will be interrupted if BP raises at 240/120 and/or HR to 220−patients age.

  Eligibility

Ages Eligible for Study:   18 Years to 70 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Clinical diagnosis of CMT1A
  • Genetic confirmation (17p112 chromosome duplication)
  • Age 18 - 70 years old
  • Ability to accomplish the primary outcome measure (10 meter walking test) without support, with or without ankle foot orthoses (AFO)
  • Ability to walk on a treadmill on a horizontal plane for 20 minutes at a speed of 1.5 km/h with or without support at the bars
  • Score at the Mobility Scale between 2 and 11
  • Signed written informed consent to participate

Exclusion Criteria:

  • Diagnosis of Hereditary Neuropathy with Liability to Pressure Palsies (HNPP) or any other type of CMT
  • Other associated causes of neuropathy
  • Vestibular affections, psychiatric, cardiovascular and lung disorders or severe arthropathic changes in the lower limbs
  • Non ambulating patients or patients always requiring even monolateral support to walk
  • Other neurological disorders
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01289704

Contacts
Contact: Margherita A Monti Bragadin, MD 0039-010-3537040 margherita.montibragadin@gmail.com

Locations
Italy
University of Genoa Not yet recruiting
Genoa, Italy, 16132
Contact: Angelo Schenone, Professor    +39 010 353 7040    aschenone@neurologia.unige.it   
I.R.C.C.S. Foundation, Besta Institute Not yet recruiting
Milan, Italy, 20133
Contact: Davide Pareyson, MD    +39 02 23943001    dpareyson@istituto-besta.it   
Don Carlo Gnocchi Foundation Not yet recruiting
Rome, Italy, 00194
Contact: Luca Padua, MD    +39 06 33086231    lpadua@rm.unicatt.it   
Departement of Neurological and Visual Sciences, University of Verona Not yet recruiting
Verona, Italy, 37134
Contact: Gian Maria Fabrizi, MD    +39 045 8124461    gianmaria.fabrizi@univr.it   
Sponsors and Collaborators
University of Genova
Investigators
Principal Investigator: Angelo E Schenone, MD University of Genova
  More Information

Additional Information:
Publications:

Responsible Party: Gianluigi Mancardi, Neuroscience, Ophtalmology and Genetic Departement
ClinicalTrials.gov Identifier: NCT01289704     History of Changes
Other Study ID Numbers: GUP09013
Study First Received: January 24, 2011
Last Updated: February 3, 2011
Health Authority: Italy: Ethics Committee

Keywords provided by University of Genova:
Charcot−Marie−Tooth disease,
CMT1A,
rehabilitation,
treadmill,
stretching,
proprioception,
Randomised Controlled Trial.

Additional relevant MeSH terms:
Charcot-Marie-Tooth Disease
Hereditary Sensory and Motor Neuropathy
Nerve Compression Syndromes
Tooth Diseases
Congenital Abnormalities
Genetic Diseases, Inborn
Heredodegenerative Disorders, Nervous System
Nervous System Diseases
Nervous System Malformations
Neurodegenerative Diseases
Neuromuscular Diseases
Peripheral Nervous System Diseases
Polyneuropathies
Stomatognathic Diseases

ClinicalTrials.gov processed this record on November 20, 2014