Neuropathic Pain Clinical Trial
Official title:
The Clinical Feasibility of Combining Cranial Electrotherapy Stimulation (CES Alpha-Stim) and Non-invasive Interactive Neurostimulation (InterX) for Optimized Rehabilitation Following Extremity Immobilization
This study will be aimed at assessing the feasibility of a dual-device treatment prior to a rehabilitation session for an orthopaedic injury requiring immobilization, and its impact on improving outcomes and decreasing the risk for development of neuropathic pain. The investigators will evaluate the clinical feasibility and effectiveness of incorporating the Alpha-Stim and Inter-X treatment into a standard rehabilitation protocol to address risk factors associated with the development of neuropathic pain (i.e., pain, range of motion, and skin temperature) as well as its impact on reduced pain medication.
Once patients provide consent and we have determined that they meet inclusion criteria the
process will occur as follows:
1. Participants will be administered baseline demographic and standard medical history
questionnaires, including information about prescription medication use. In addition,
participants will fill out baseline self-report outcomes and be administered the (LANSS)
Pain Scale. Range of motion and temperature will also be assessed during the initial
session. Some of these measurements are standard of care and would be filled out by the
participant even if the participant were not participating in the study.
Usual CARE The usual care aspect of this study is the delivery of the pain treatment (NIN and
CES) as is commonly used at the Center for the Intrepid. The experimental aspect is the
combined delivery of the treatment, and the use of sham treatment as a control. The treatment
(NIN and CES) will be delivered in a pragmatic fashion, with treatment delivered in
conjunction with rehab visits and lasting approximately 4-weeks total. Each session will last
approximately 20-40 minutes long, and will most often be delivered in conjunction with their
rehab visit (physical therapy or occupational therapy) that occurs anywhere from 1 to 3 times
each week.
STRICTLY RESEARCH The experimental aspect of the study will be the comparison of combined
treatment (NIN + CES), standard NIN with sham CES, to standard care alone. Before initiation
of treatment participants will be randomized to either NIN + CES, NIN + Sham CES, or standard
care only immediately after the immobilization device (cast, brace, etc) has been removed.
Randomization with be performed with a random number gerator. All groups will continue with
their own rehabilitation as indicated throughout the entire course of the study treatment,
and beyond as indicated by their therapist. The investigators will keep track of rehab
appointments and visits, but not control for them.
3. At the 1-month follow-up, all participants will fill out the same self-report outcome
measures from baseline, to include prescription pain medication and be administered the LANSS
pain scale. Range of motion and temperature will also be assessed.
4. At the 2 and 4-month follow-up the same assessments will again be administered. If the
participant has completed formal therapy prior to the 2 and 4 month follow-up time points the
participant will be asked to return to the clinic to complete these assessments. Participants
may be contacted by telephone or email, if agreeable, to provide a reminder for the return
appointment(s).
5. Outcomes will be compared between the three groups at each time point (i.e., initial, one
month, two months, four months).
6. All participants will be followed out to 4 months.
Although every attempt will be made to collect data at these specific times, due to the
variability of participant and clinic schedules, the actual timing of collection may vary
(+/- 1 week) and some of the proposed measures may not be collected at all time points.
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