Brain Injury Clinical Trial
Official title:
Assessment and Rehabilitation of Central Sensory Impairments for Balance in mTBI
Verified date | March 2021 |
Source | Oregon Health and Science University |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
Our central hypothesis is that chronic balance deficits after mild traumatic brain injury (mTBI) result from impairments in central sensorimotor integration (CSMI) that may be helped by rehabilitation. There are two objectives of this proposal; the first objective is to characterize balance deficits in people with mTBI. The second objective is to use a novel auditory bio-feedback (ABF) device to improve measures central sensorimotor integration and balance control.
Status | Completed |
Enrollment | 132 |
Est. completion date | June 24, 2019 |
Est. primary completion date | April 11, 2019 |
Accepts healthy volunteers | Accepts Healthy Volunteers |
Gender | All |
Age group | 18 Years to 60 Years |
Eligibility | Inclusion Criteria: - have a diagnosis of mTBI based upon Veterans Health Administration (VHA)/Department of Defense (DoD) criteria with persisting symptoms >3 months post injury - have minimal cognitive impairment; a score between 0 and 8 on the Short Blessed test for cognitive function - may have or not had a loss of consciousness (LOC) with their initial injury -OR- - have no recent history of mTBI or brain injury and related complaints Exclusion Criteria: - have had or currently have any other injury, medical, substance or neurological illness that could potentially explain balance deficits (e.g., Central Nervous System disease, stroke, moderate TBI, lower extremity amputation) - meet criteria for moderate to severe substance use disorder within the past month, as defined by Diagnostic and Statistical Manual (DSM-V) - display behavior that would significantly interfere with validity of data collection or safety during study - be in significant pain during the evaluation (5/10 by patient subjective report) - be a pregnant female (balance considerations) - have past history of peripheral vestibular pathology or ocular motor deficits - have significant hearing loss that would interfere with the use of an auditory biofeedback device; hearing loss no worse than 30 decibel (dB) HL (PTA 0.5-3 kHz), in better ear, with the difference in ears being less than 15 dB PTA - be unable to abstain for 24 hours in advance of testing in the use medications that might impair their balance (meclizine, scopolamine, benzodiazepines such as Valium, sedatives such as Ambien, narcotic pain medications, and antihistamines) |
Country | Name | City | State |
---|---|---|---|
United States | Oregon Health and Science University | Portland | Oregon |
Lead Sponsor | Collaborator |
---|---|
Oregon Health and Science University | Portland VA Medical Center |
United States,
Fino PC, Parrington L, Walls M, Sippel E, Hullar TE, Chesnutt JC, King LA. Abnormal Turning and Its Association with Self-Reported Symptoms in Chronic Mild Traumatic Brain Injury. J Neurotrauma. 2018 May 15;35(10):1167-1177. doi: 10.1089/neu.2017.5231. Epub 2018 Mar 23. — View Citation
Fino PC, Peterka RJ, Hullar TE, Murchison C, Horak FB, Chesnutt JC, King LA. Assessment and rehabilitation of central sensory impairments for balance in mTBI using auditory biofeedback: a randomized clinical trial. BMC Neurol. 2017 Feb 23;17(1):41. doi: 10.1186/s12883-017-0812-7. — View Citation
Fino PC, Raffegeau TE, Parrington L, Peterka RJ, King LA. Head stabilization during standing in people with persisting symptoms after mild traumatic brain injury. J Biomech. 2020 Nov 9;112:110045. doi: 10.1016/j.jbiomech.2020.110045. Epub 2020 Sep 17. — View Citation
Fino PC, Wilhelm J, Parrington L, Stuart S, Chesnutt JC, King LA. Inertial Sensors Reveal Subtle Motor Deficits When Walking With Horizontal Head Turns After Concussion. J Head Trauma Rehabil. 2019 Mar/Apr;34(2):E74-E81. doi: 10.1097/HTR.0000000000000418. — View Citation
Martini DN, Parrington L, Stuart S, Fino PC, King LA. Gait Performance in People with Symptomatic, Chronic Mild Traumatic Brain Injury. J Neurotrauma. 2021 Jan 15;38(2):218-224. doi: 10.1089/neu.2020.6986. Epub 2020 Aug 10. — View Citation
Peterka RJ, Murchison CF, Parrington L, Fino PC, King LA. Implementation of a Central Sensorimotor Integration Test for Characterization of Human Balance Control During Stance. Front Neurol. 2018 Dec 13;9:1045. doi: 10.3389/fneur.2018.01045. eCollection 2018. — View Citation
Stuart S, Parrington L, Martini DN, Kreter N, Chesnutt JC, Fino PC, King LA. Analysis of Free-Living Mobility in People with Mild Traumatic Brain Injury and Healthy Controls: Quality over Quantity. J Neurotrauma. 2020 Jan 1;37(1):139-145. doi: 10.1089/neu.2019.6450. Epub 2019 Aug 26. — View Citation
Stuart S, Parrington L, Morris R, Martini DN, Fino PC, King LA. Gait measurement in chronic mild traumatic brain injury: A model approach. Hum Mov Sci. 2020 Feb;69:102557. doi: 10.1016/j.humov.2019.102557. Epub 2019 Nov 26. — View Citation
Theodoroff SM, Papesh M, Duffield T, Novak M, Gallun F, King L, Chesnutt J, Rockwood R, Palandri M, Hullar T. Concussion Management Guidelines Neglect Auditory Symptoms. Clin J Sport Med. 2020 Sep 15. doi: 10.1097/JSM.0000000000000874. [Epub ahead of print] — View Citation
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Change in gait activity in the home as measured using an inertial sensor continuously in the home for a week before and after intervention. | An APDM movement monitor will be worn around the waist to gather information on local activity during the day. | before and after 6 weeks of intervention | |
Secondary | Change in Sensory Orientation Test (SOT) Composite Score | We will compare baseline SOT composite score with the post rehabilitation scores looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Change in Modified Balance Error Scoring System (mBESS) instrumented and non-instrumented scores | We will compare baseline mBESS measures using inertial sensors and the clinical scoring method looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Change in dynamic gait coordination | We will compare baseline gait measures using inertial sensors looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Change in Sport Concussion Assessment Tool - 3rd edition (SCAT-3) symptoms questionnaire | We will compare subjects symptoms using the SCAT-3 symptom log looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Automated Neuropsychological Assessment Metrics (ANAM) | We will use this test to determine if it is a good predictor for rehabilitation outcomes | baseline | |
Secondary | Dizziness Handicap Index (DHI) | This questionnaire takes approximately 10 minutes and asks if you become dizzy while performing various tasks. | baseline | |
Secondary | PTSD Checklist | This questionnaire takes approximately 10 minutes and is a list of problems and complaints some people have in response to stressful life experiences. | baseline | |
Secondary | Pain Location Inventory | This questionnaire takes approximately 5 minutes and asks if you have pain and where that pain is located. | baseline | |
Secondary | SIQR symptom Questionnaire | This questionnaire asks you to rate different symptoms on a sliding scale. | baseline | |
Secondary | Sports Concussion Assessment Tool - 3 (SCAT-3) symptom questionnaire | This questionnaire takes approximately 5 minutes and asks you to rate 22 different symptoms on a scale between zero and six. | Every session | |
Secondary | Becks Depression Inventory (BDI) | This questionnaire takes approximately 5 minutes and will ask questions regarding depression and personal emotions. | baseline | |
Secondary | Short Form - 36 | This questionnaire will take approximately 10 minutes and covers 36 questions about daily living and how your symptoms have or have not changed over certain time periods. | baseline | |
Secondary | Neurobehavioral Symptom Inventory | This questionnaire takes approximately 10 minutes and goes through commons symptoms after traumatic brain injury (such as nausea and blurred vision) and asks you to rate your symptoms. | baseline | |
Secondary | Change in Central Sensorimotor Integration (CSMI) Weighting Scores; vision | We will compare baseline CSMI scores (Wvis) with post rehabilitation scores looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Change in Central Sensorimotor Integration (CSMI) Weighting Scores; vestibular | We will compare baseline CSMI scores (Wvest) with post rehabilitation scores looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes | |
Secondary | Change in Central Sensorimotor Integration (CSMI) Weighting Scores; proprioception | We will compare baseline CSMI scores (Wprop) with post rehabilitation scores looking for a difference between the standard of care and audio biofeedback rehabilitation groups. | Subjects will be tested before and after a 6-week intervention period and again 6 weeks later to determine long-term changes |
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