RECRUITING

rTMS Plus CCFES-mediated Functional Task Practice for Severe Stroke

Study Overview

This clinical trial focuses on testing the efficacy of different digital interventions to promote re-engagement in cancer-related long-term follow-up care for adolescent and young adult (AYA) survivors of childhood cancer.

Description

This study is a necessary and important step in the development of a new therapy for upper limb functional recovery in patients with severe motor impairment. It is the first clinical trial of non-invasive brain stimulation (repetitive transcranial magnetic stimulation or rTMS) delivered to excite the undamaged hemisphere (specifically the contralesional higher motor cortices or cHMC) in stroke. Therefore, this study will determine whether the positive results obtained in our short-term pilot study can be made to last longer and produce functional benefits in severe patients with the application of brain stimulation in combination with long-term rehabilitation therapy. Rehabilitation therapy administered is called contralaterally controlled functional electrical stimulation (CCFES). Determining whether combining rTMS facilitating the cHMC with CCFES produces synergistic gains in functional abilities in severe patients is necessary for acceptance by the clinical community and to move this technology toward commercialization and widespread dissemination. The proposed study will determine whether the combination of rTMS facilitating the cHMC with CCFES produces greater improvements in upper extremity function in severe participants who are ≥6 months from stroke onset than the combination of rTMS facilitating the damaged hemisphere (specifically the ipsilesional primary motor cortex, iM1) and CCFES or the combination of sham rTMS and CCFES. The secondary purposes are to define which patients benefit most from the treatments, which may inform future device and treatment development and clinical translation, and to explore what distinct effects the three treatments have on the brain. To accomplish these purposes, we are conducting a clinical trial that enrolls severe stroke patients.

Official Title

Contralaterally Controlled FES Combined With Brain Stimulation for Severe Upper Limb Hemiplegia

Quick Facts

Study Start:2019-05-14
Study Completion:2025-04-30
Study Type:Not specified
Phase:Not Applicable
Enrollment:Not specified
Status:RECRUITING

Study ID

NCT03870672

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Ages Eligible for Study:18 Years to 90 Years
Sexes Eligible for Study:ALL
Accepts Healthy Volunteers:No
Standard Ages:ADULT, OLDER_ADULT
Inclusion CriteriaExclusion Criteria
  1. * age 18 to 90 years old at time of randomization
  2. * greater than 6 months since a first clinical cortical or subcortical, ischemic or hemorrhagic stroke
  3. * severe upper limb hemiparesis defined as less than 10° active wrist extension or less than 10° active thumb abduction/extension or less than 10° active extension in at least two additional digits (i.e., will not meet minimum CIMT criteria)
  4. * ability to follow 3-stage commands and can remember 2 items from a list of 3 items after 3 minutes
  5. * adequate active movement of shoulder and elbow to position the paretic hand on one's lap for performance of functional task practice and CCFES-assisted hand opening exercises
  6. * skin intact on hemiparetic arm
  7. * surface electrical stimulation of the paretic finger and thumb extensors produces functional hand opening without pain
  8. * able to hear and respond to cues from stimulator
  9. * completed occupational therapy at least 2 months prior to enrollment (no concomitant OT)
  10. * full volitional hand opening/closing of the non-paretic hand
  11. * ability to follow instructions for putting on and operating the CCFES stimulator or a caregiver available to provide assistance
  1. * metal implant in the head
  2. * history of seizures as an adult
  3. * history of alcohol or substance abuse less than 10yrs prior to enrollment
  4. * intake of anticonvulsants or anti-depressants contraindicated with TMS
  5. * cardiac pacemaker or other programmable implant

Contacts and Locations

Study Contact

Kyle J. O'Laughlin, MS
CONTACT
866-449-1394
olaughk@ccf.org
Ela B. Plow, PhD PT
CONTACT
216-445-4589
plowe2@ccf.oeg

Principal Investigator

Ela B Plow, PhD PT
PRINCIPAL_INVESTIGATOR
Lerner Research Institute; Cleveland Clinic Foundation

Study Locations (Sites)

Lerner Research Institute; Cleveland Clinic Foundation
Cleveland, Ohio, 44195
United States

Collaborators and Investigators

Sponsor: The Cleveland Clinic

  • Ela B Plow, PhD PT, PRINCIPAL_INVESTIGATOR, Lerner Research Institute; Cleveland Clinic Foundation

Study Record Dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Registration Dates

Study Start Date2019-05-14
Study Completion Date2025-04-30

Study Record Updates

Study Start Date2019-05-14
Study Completion Date2025-04-30

Terms related to this study

Keywords Provided by Researchers

  • Upper limb
  • Stroke
  • CVA
  • Rehabilitation
  • Brain Stimulation
  • CCFES
  • Motor Cortex
  • TMS
  • Motor Recovery

Additional Relevant MeSH Terms

  • Stroke
  • Hemiplegia
  • Cerebrovascular Accident (CVA)
  • Hemiparesis