RECRUITING

An Early Feasibility Study of the ReHAB System

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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

The purpose of this research study is to examine the feasibility of a system that involves implanting small electrodes in the parts of the brain that control movement and sensation, and combining that with electrodes in the upper arm and shoulder to activate paralyzed muscles of the arm and hand. This system is intended for people with extensive paralysis in their arms. The small electrodes in the brain will be used to attempt to measure intended movements, and the muscles in the arm and hand will be stimulated to attempt to follow those intentions. The study is a prospective, non-randomized, open-label, exploratory safety/feasibility trial of up to 12 subjects. The Primary Endpoint will be evaluation over the first 13 months after implantation, after which the subjects will have the option of removal of the device or continued participation in a long-term study.

Official Title

An Early Feasibility Study to Assess the Effects of the "Reconnecting the Hand and Arm to the Brain (ReHAB)" System

Quick Facts

Study Start:2019-04-09

Study Completion:2026-03-01

Study Type:Not specified

Phase:Not Applicable

Enrollment:Not specified

Status:RECRUITING

Study ID

NCT03898804

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:22 Years to 65 Years

Sexes Eligible for Study:ALL

Accepts Healthy Volunteers:No

Standard Ages:ADULT, OLDER_ADULT

Inclusion Criteria	Exclusion Criteria
1. Age between 22 and 65 years of age. 2. Tetraplegia due to a static identified disease process (spinal cord injury or stroke) that prevents functional activity of the upper extremity. 3. Onset of tetraplegia at least 12 months prior to enrollment, with stability of weakness for at least 3 months. 4. Must have sufficiently intact cortical motor structures and stable medical prognoses to be able to perform the BCI control tasks for at least one year. . 5. Ability to speak understandably or, if unable to speak understandably, a reliable means of yes/no communication. 6. Life expectancy greater than 13 months. 7. Chronic care environment within a three-hour drive of the study site or the ability to temporarily relocate to a residence within a three-hour drive of the study site. 8. Willingness to remain available (geographically stable) for at least 13 months after enrollment, including maintenance of the evaluation schedule, frequent visits to the Investigator's office, and visits of Sponsor personnel to the subject's chronic care environment. 9. Willingness to allow videotape recordings to be made of the surgical procedure (for training purposes) and portions of the Feasibility Evaluations. 10. A stable psychosocial support system. 11. Scalp devoid of any lesions or skin breakdown precluding surgery. 12. Ability to provide voluntarily informed consent in accordance with Site institutional policies and willingness to release of Personal Health Information from the date of the injury or disease onset through the completion of the clinical Study. 13. Availability of caregivers capable of providing the necessary daily care of the subject's skin and electrode externalization sites.	1. Presence of an implanted stimulator such as a pacemaker, spinal cord stimulator, cochlear implant, deep brain stimulator, vagus nerve stimulator, or defibrillator. (Implanted intrathecal pumps for pain or spasticity, cough implants, or diaphragmatic pacers are not excluded.) 2. Any active infection(s) or unexplained fever. 3. Active cancer within the one year prior to enrollment (other than adequately treated basal or squamous cell skin cancer). 4. Uncontrolled insulin-dependent diabetes mellitus. 5. Hydrocephalus requiring diversion of cerebrospinal fluid. 6. Autonomic dysreflexia within three months prior to enrollment that required urgent evaluation and pharmacologic intervention prescribed by a physician. 7. Seizure within 3 months prior to enrollment. 8. Any medical condition expected to require routine MRI imaging or subjects with contraindication(s) to MRI. 9. History of osteomyelitis or skin disorder that causes excessive skin sloughing, lesions or breakdown of the scalp. 10. Chronic use of medications such as sedatives that may significantly retard motor coordination and cognitive ability. 11. Chronic use of anticoagulant medications. (Subjects receiving prophylactic anticoagulation solely for the prevention of deep venous thrombosis are not excluded, but must be able to have their prophylactic anticoagulation suspended temporarily for the surgical procedure and immediate post-operative period.) 12. Chronic use of steroids or immunosuppressant therapy. 13. Active treatment for another serious medical, neurological or psychiatric disease or disorder that could seriously affect the subject's ability to undergo surgical implantation of the electrodes or participate in the testing sessions. 14. Pregnant, lactating, or of childbearing age and not using adequate birth control. 15. Active consumption of more than 1 alcoholic beverage per day. 16. Suicide attempt within 12 months prior to enrollment. 17. History of myocardial infarction or unstable cardiac arrhythmia. 18. Enrollment in any other investigational study that may interfere with the time commitments required of this study. 19. Subjects who are immunocompromised. 20. Subjects who require ongoing diathermy or ultrasound treatments. 21. Subjects with severe upper extremity joint contractures or Ashworth spasticity scores of 4 that would limit functional movements. 22. Subjects who have contraindication(s) to CT. 23. Subjects who are ventilator dependent. Subjects who are sometimes ventilator-assisted (for example, while sleeping) are not excluded.

Inclusion Criteria

Exclusion Criteria

1. Age between 22 and 65 years of age.
2. Tetraplegia due to a static identified disease process (spinal cord injury or stroke) that prevents functional activity of the upper extremity.
3. Onset of tetraplegia at least 12 months prior to enrollment, with stability of weakness for at least 3 months.
4. Must have sufficiently intact cortical motor structures and stable medical prognoses to be able to perform the BCI control tasks for at least one year. .
5. Ability to speak understandably or, if unable to speak understandably, a reliable means of yes/no communication.
6. Life expectancy greater than 13 months.
7. Chronic care environment within a three-hour drive of the study site or the ability to temporarily relocate to a residence within a three-hour drive of the study site.
8. Willingness to remain available (geographically stable) for at least 13 months after enrollment, including maintenance of the evaluation schedule, frequent visits to the Investigator's office, and visits of Sponsor personnel to the subject's chronic care environment.
9. Willingness to allow videotape recordings to be made of the surgical procedure (for training purposes) and portions of the Feasibility Evaluations.
10. A stable psychosocial support system.
11. Scalp devoid of any lesions or skin breakdown precluding surgery.
12. Ability to provide voluntarily informed consent in accordance with Site institutional policies and willingness to release of Personal Health Information from the date of the injury or disease onset through the completion of the clinical Study.
13. Availability of caregivers capable of providing the necessary daily care of the subject's skin and electrode externalization sites.

1. Presence of an implanted stimulator such as a pacemaker, spinal cord stimulator, cochlear implant, deep brain stimulator, vagus nerve stimulator, or defibrillator. (Implanted intrathecal pumps for pain or spasticity, cough implants, or diaphragmatic pacers are not excluded.)
2. Any active infection(s) or unexplained fever.
3. Active cancer within the one year prior to enrollment (other than adequately treated basal or squamous cell skin cancer).
4. Uncontrolled insulin-dependent diabetes mellitus.
5. Hydrocephalus requiring diversion of cerebrospinal fluid.
6. Autonomic dysreflexia within three months prior to enrollment that required urgent evaluation and pharmacologic intervention prescribed by a physician.
7. Seizure within 3 months prior to enrollment.
8. Any medical condition expected to require routine MRI imaging or subjects with contraindication(s) to MRI.
9. History of osteomyelitis or skin disorder that causes excessive skin sloughing, lesions or breakdown of the scalp.
10. Chronic use of medications such as sedatives that may significantly retard motor coordination and cognitive ability.
11. Chronic use of anticoagulant medications. (Subjects receiving prophylactic anticoagulation solely for the prevention of deep venous thrombosis are not excluded, but must be able to have their prophylactic anticoagulation suspended temporarily for the surgical procedure and immediate post-operative period.)
12. Chronic use of steroids or immunosuppressant therapy.
13. Active treatment for another serious medical, neurological or psychiatric disease or disorder that could seriously affect the subject's ability to undergo surgical implantation of the electrodes or participate in the testing sessions.
14. Pregnant, lactating, or of childbearing age and not using adequate birth control.
15. Active consumption of more than 1 alcoholic beverage per day.
16. Suicide attempt within 12 months prior to enrollment.
17. History of myocardial infarction or unstable cardiac arrhythmia.
18. Enrollment in any other investigational study that may interfere with the time commitments required of this study.
19. Subjects who are immunocompromised.
20. Subjects who require ongoing diathermy or ultrasound treatments.
21. Subjects with severe upper extremity joint contractures or Ashworth spasticity scores of 4 that would limit functional movements.
22. Subjects who have contraindication(s) to CT.
23. Subjects who are ventilator dependent. Subjects who are sometimes ventilator-assisted (for example, while sleeping) are not excluded.

Contacts and Locations

Study Contact

Jonathan Miller

CONTACT

(216)844-3470

jonathan.miller@uhhospitals.org

Mario Beccera, RN

CONTACT

2168441734

Mario.Becerra@UHhospitals.org

Principal Investigator

Jonathan Miller

PRINCIPAL_INVESTIGATOR

University Hospitals Cleveland Medical Center

Study Locations (Sites)

University Hospitals Cleveland Medical Center

Cleveland, Ohio, 44106

United States

Collaborators and Investigators

Sponsor: Jennifer Sweet, MD

Jonathan Miller, PRINCIPAL_INVESTIGATOR, University Hospitals Cleveland Medical Center

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 Date2019-04-09

Study Completion Date2026-03-01

Study Record Updates

Study Start Date2019-04-09

Study Completion Date2026-03-01

Terms related to this study

Additional Relevant MeSH Terms

Tetraplegia