AMES + Brain Stimulation
This study is ongoing, but not recruiting participants.
Sponsor:
AMES Technology
Collaborator:
Information provided by (Responsible Party):
AMES Technology
ClinicalTrials.gov Identifier:
NCT01169181
First received: July 22, 2010
Last updated: May 17, 2013
Last verified: May 2013
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Purpose
The procedure involves: (1) assisted hand movement by a mechanical device, (2) mechanical vibration applied to the surface of the forearm, and (3) stimulation of the brain with either transcranial magnetic stimulation (TMS) or transcortical direct current stimulation (DCS). These 3 components of the procedure are carried out simultaneously. Each subject will be evaluated pre- and post-treatment with several clinical tests of functional movement. The hypotheses of this project are that the AMES+rTMS and AMES+tDCS procedures are safe and will enable most of the stroke patients to recover finger extension.
| Condition | Intervention | Phase |
|---|---|---|
|
Stroke Cerebrovascular Accident Plegia |
Device: AMES + brain stimulation |
Phase 1 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Safety/Efficacy Study Intervention Model: Single Group Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | AMES + Brain Stimulation: Treatment for Profound Plegia in Stroke |
Resource links provided by NLM:
Further study details as provided by AMES Technology:
Primary Outcome Measures:
- Maximum volitional EMG in the extensor digitorum and the finger flexors [ Time Frame: Following each treatment with the AMES device ] [ Designated as safety issue: No ]EMG intensity will be measured during maximal efforts at hand opening and closing at the end of each treatment session. The averages of 3 attempted openings and 3 closings will be determined and recorded.
Secondary Outcome Measures:
- Chedoke-McMaster Stroke Assessment [ Time Frame: Before the first treatment session, and again after the last treatment session. ] [ Designated as safety issue: No ]A validated assessment tool for evaluating the severity of physical impairment in adult stroke survivors.
| Estimated Enrollment: | 6 |
| Study Start Date: | July 2010 |
| Estimated Study Completion Date: | December 2013 |
| Estimated Primary Completion Date: | December 2013 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
|
Active Comparator: AMES therapy with rTMS
Each subject will participate in 30 therapy sessions over a 10- to 15-week period. A session will last 90 to 120 minutes, which includes 20 minutes of AMES+rTMS, followed by an EMG test. During the hand-opening phase of the AMES therapy, the subjects assigned to the AMES+rTMS treatment group will be subjected to trains of TMS pulses.
|
Device: AMES + brain stimulation
Stroke survivors with plegia of affected upper extremity receive either AMES + rTMS or AMES + tDCS.
|
|
Active Comparator: AMES therapy with tDCS
Each subject will participate in 30 therapy sessions over a 10- to 15-week period. A session will last 90 to 120 minutes, which includes 20 minutes of AMES+tDCS, followed by an EMG test. A constant current will be applied throughout the entire 20-minute therapy session with the AMES device.
|
Device: AMES + brain stimulation
Stroke survivors with plegia of affected upper extremity receive either AMES + rTMS or AMES + tDCS.
|
Detailed Description:
This protocol is designed to investigate the safety and efficacy of a procedure for treating chronic (>1 year post) stroke patients who still cannot move the hand affected by the stroke. The treatment involves: (1) assisted hand movement by a mechanical device, (2) mechanical vibration applied to the surface of the forearm, and (3) stimulation of the brain with either transcranial magnetic stimulation (TMS) or transcortical direct current stimulation (DCS). Subjects receiving TMS during treatment are expected to respond more fully (i.e., increased volitional EMG) in the treated hand compared to those receiving DCS.
Eligibility| Ages Eligible for Study: | 18 Years to 75 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Criteria
Inclusion Criteria:
- Stroke occurring ≥12 months before enrollment
- Hemispheric stroke (ischemic or hemorrhagic), cortical or subcortical
- Residual upper-extremity weakness without the ability to activate volitionally extensor digitorum (no volitional EMG in the long finger extensor muscle)independently
- Age 18-75 years old
Exclusion Criteria:
- Significant upper-extremity proprioceptive deficit (<70% correct detection of the direction of passive finger movement, with eyes closed)
- Cortical stroke involving the primary motor cortex
- Epilepsy not controlled by medication
- Botox injections 5 months before or during enrollment; use of intrathecal Baclofen
- Residual pain in the tested arm
- Significant neglect involving the affected limb (NIHSS 2 on the extinction and attention items)
- Exercise intolerant
- Uncontrolled hypertension or angina
- Cognitive or behavioral inability to follow instructions
- Current abuse of alcohol or drugs
- Terminal illness with anticipated survival of <12 months
- Severe apraxia; inability to understand oral directions in English; or inability to communicate adequately with study personnel
- Circumference of arm incompatible with the AMES device (checked by placing the limb in the device)
- Contractures, decreased range of motion, or skin condition preventing tolerance of the AMES muscle vibrators
- Spinal cord injury, arthritis, or fractures of affected limbs resulting in loss of range of motion
- In the tested arm, peripheral nerve injury or neuropathy resulting in significant motor or sensory loss
- Pathological neurological/physical condition other than stroke that impairs the function of the impaired arm or that produces pain in the impaired arm
- Implanted device (e.g., cardiac pacemaker, Baclofen pump) the operation of which might be adversely affected by the brain stimulation
- Previous vascular surgery on the blood vessels of the brain or heart or heart valve surgery
- Female and pregnant
Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT01169181
Locations
| United States, Oregon | |
| Oregon Health and Science University | |
| Portland, Oregon, United States, 97239 | |
Sponsors and Collaborators
AMES Technology
Investigators
| Principal Investigator: | Jau-Shin Lou, MD PhD | Oregon Health and Science University |
| Principal Investigator: | Paul J. Cordo, PHD | Oregon Health and Science University |
More Information
No publications provided
| Responsible Party: | AMES Technology |
| ClinicalTrials.gov Identifier: | NCT01169181 History of Changes |
| Other Study ID Numbers: | 6237, 1R43NS067694-01A1 |
| Study First Received: | July 22, 2010 |
| Last Updated: | May 17, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by AMES Technology:
|
Stroke Cerebrovascular Accident Plegia |
Upper Extremity rTMS tDCS |
Additional relevant MeSH terms:
|
Cerebral Infarction Stroke Paralysis Brain Infarction Brain Ischemia Cerebrovascular Disorders Brain Diseases |
Central Nervous System Diseases Nervous System Diseases Vascular Diseases Cardiovascular Diseases Neurologic Manifestations Signs and Symptoms |
ClinicalTrials.gov processed this record on June 18, 2013