Stroke Clinical Trial
Official title:
35 Hz Versus 50 Hz Frequency Stimulation Effects on Motor Recovery in Older Adults After Stroke. A Randomized Clinical Trial
NCT number | NCT03913624 |
Other study ID # | 43/09 |
Secondary ID | |
Status | Completed |
Phase | N/A |
First received | |
Last updated | |
Start date | July 2009 |
Est. completion date | September 2014 |
Verified date | April 2019 |
Source | University of Valencia |
Contact | n/a |
Is FDA regulated | No |
Health authority | |
Study type | Interventional |
A Randomized Clinical Trial (RCT) was conducted to determine the effects of two neuromuscular electrical stimulation protocols with different stimulation frequencies on motor recovery in older adults with spastic hemiparesis after a stroke.
Status | Completed |
Enrollment | 69 |
Est. completion date | September 2014 |
Est. primary completion date | September 2014 |
Accepts healthy volunteers | No |
Gender | All |
Age group | 60 Years and older |
Eligibility |
Inclusion Criteria: - Age = 60 years - Post-stroke spastic hemiparesis - Mild-moderate hand impairment - A score = 3 on the modified Ashworth scale for wrist and finger flexors - Active wrist extension = 5º from the resting position - Wrist extension response to stimulation - Post-stroke period < 18 months - Clinical stability - Mini-Mental State Examination score = 23 Exclusion Criteria: - Previous hemiparesis due to stroke - Dermatological reactions with the application of stimulation - Significant sensory deficits in the affected arm - Previous musculoskeletal problems of the hand - Treatment with the botulin toxin - Anti-spastic medication usage - Cardiac pacemaker, implanted electronic device, or metal implants in the affected arm - Complex regional pain syndrome - Severe aphasia, history of epileptic seizures, psychiatric disorder or important alterations of behavior - Severe visual impairment - Any comorbid neurological disease - Important deformity or obesity that affects the application of the NMES - Potentially fatal cardiac arrhythmia or another decompensated heart disease - Systemic infectious process, cancer or another terminal disease |
Country | Name | City | State |
---|---|---|---|
Spain | Doctor Peset University Hospital | Valencia |
Lead Sponsor | Collaborator |
---|---|
University of Valencia |
Spain,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Other | Intervention costs | Intervention costs related to staff, consumables, and capital for intervention were calculated. | Intervention costs were recorded from the baseline to 12 weeks. | |
Primary | Change in range of motion | A universal goniometer was used to measure the resting angle, active extension and passive extension of the wrist. A special JAMAR finger goniometer was used to evaluate the resting angle and active extension of the metacarpophalangeal joints of the fingers. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Primary | Change in dynamometric strength | The grip strength was assessed by means of a JAMAR hydraulic hand dynamometer and the pinch strength using the JAMAR hydraulic pinch gauge. Unit of measurement was kgf. Three repetitions were done in both evaluations, taking the highest value and leaving a resting period of 1 minute between them. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Primary | Change in muscle tone | Hypertonia of the finger and wrist flexors was measured using the modified Ashworth scale (MAS). MAS was used to categorize the severity of muscle tone by judging resistance to passive movement. It is a 6-point scale (0, 1, 1+ 2, 3, and 4) that ranges from 1 (=no increase in tone) to 4 (=limb rigid in flexion or extension). The assessment was started 5 minutes after laying the subject down in the supine position and using a single passive movement to evaluate each muscle group. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Primary | Change in functional motor ability | Manual dexterity was assessed by Box and block test. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in the mean electromyographic (EMG) amplitude | The Muscle Trainer model METR-0 (Mega Electronics Ltd, Kuopio, Finland) surface electromyograph was used. Circular adhesive surface bipolar electrodes (Ambú® Blue Sensor) were used and placed parallel to the muscle fibers. The mean amplitude of the EMG signal (in µV) of the muscle was recorded in the radial extensor and the radial flexor of the carpus. The patient was asked to perform maximum voluntary isometric contractions of both the flexors and extensors of the wrist for five seconds against manual resistance and the electrical activity of both the agonist and antagonist muscles was recorded simultaneously. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in the peak EMG amplitude | The Muscle Trainer model METR-0 (Mega Electronics Ltd, Kuopio, Finland) surface electromyograph was used. Circular adhesive surface bipolar electrodes (Ambú® Blue Sensor) were used and placed parallel to the muscle fibers. The peak amplitude of the EMG signal (in µV) of the muscle was recorded in the radial extensor and the radial flexor of the carpus. The patient was asked to perform maximum voluntary isometric contractions of both the flexors and extensors of the wrist for five seconds against manual resistance and the electrical activity of both the agonist and antagonist muscles was recorded simultaneously. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in the antagonist co-activation ratio | The Muscle Trainer model METR-0 (Mega Electronics Ltd, Kuopio, Finland) surface electromyograph was used. The antagonist co-activation ratio, both for the flexors and extensors of the wrist, was calculated using the following formula (antagonist activity/ [agonist activity + antagonist activity] x100%) (Reference: J Electromyogr Kinesiol. 2014;24:731-738) which provides an estimate of the relative activation of the agonist-antagonist muscle pair and also of the magnitude of the co-activation of the antagonist. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in kinaesthetic sensation | Hand kinaesthesia was assessed by the Revised Nottingham Sensory Assessment (RNSA) subscale. The RNSA includes three subscales: tactile sensation, kinesthetic sensation, and stereognosis. For kinesthetic sensation, all three aspects of the movement were tested: appreciation of movement, its direction, and accurate joint position sense. The limb on the affected side of the body was supported and moved by the examiner in various directions but the movement is only at one joint at a time. The patients were asked to mirror the change of movement with the other limb. This subscale ranges from 0 to 3. Higher scores indicate better kinaesthetic sensation. | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in activities of daily living | A score of the Barthel Index ranging from 0 to 100 was collected where 0 is the minimum (worst outcome) and 100 is the maximum (best outcome). | The groups were assessed at baseline and 12 weeks post-intervention. | |
Secondary | Change in health-related quality of life | COOP/WONCA charts were used. This instrument is a generic health status questionnaire which comprises nine single-item scales: physical fitness, feelings (mental well-being), daily activities, social activities, change in health and overall health, pain, social support, and quality of life. Each chart is rated on a five-point Likert scale with accompanying pictorial representations. Lower scores indicate better health-related quality of life. | The groups were assessed at baseline and 12 weeks post-intervention. |
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