Clinical Trial Details
— Status: Withdrawn
Administrative data
NCT number |
NCT04241588 |
Other study ID # |
0589-19-FB |
Secondary ID |
|
Status |
Withdrawn |
Phase |
|
First received |
|
Last updated |
|
Start date |
November 2022 |
Est. completion date |
November 22, 2022 |
Study information
Verified date |
August 2023 |
Source |
University of Nebraska |
Contact |
n/a |
Is FDA regulated |
No |
Health authority |
|
Study type |
Observational
|
Clinical Trial Summary
The neural basis underlying motor performance in children using a prosthesis has been
severely understudied resulting in minimal empirical evidence. With the use of low-cost 3D
printed prosthetics, the purpose of this study is to examine the assessment of primary motor
cortex activation and the representation of gray and white matter in a child with congenital
limb loss. This will be accomplished by cross-examining results from fNIR and Anatomical
Magnetic Resonance Imaging (MRI). The proposed research uses anatomical MRI to test if
children with unilateral congenital partial hand reductions demonstrate less gray and white
matter in the motor representation zones. Moreover, the proposed research will focus on an
assessment of motor performance using continuous and discrete tasks with a robotic
manipulandum. Assessment of motor performance and neural networking are critical to
increasing our limited knowledge of how the child increases the number of motor repertoires.
Description:
The investigators anticipate enrolling a total of 40children between 3 and 18 years of age.
Specifically, two groups of children will be recruited; children with unilateral congenital
upper-limb reductions (n=20) and age and sex-matched control group of typically developing
children (n=20). Considering the effect size from preliminary data and to account for a 10%
drop-out rate, a total sample of 40 subjects will provide 80% power to detect a true
standardized effect size.
All subjects including controls will attend four data collection sessions that will include:
one fitting session, second to obtain a baseline, the third visit will be one month after
baseline, and the final visit will be four months after baseline. Participants will attend an
initial measurement session to take a 3D scan of the affected and nonaffected upper limbs as
well as several anthropometric measurements. During this session, three pictures of the upper
limbs will be taken which will also be used to verify the fit the prostheses in a process
previously validated by our research team. The subjects will then perform an anatomical MRI
scan. The MRI scan is not a clinical scan intended for diagnostic or therapeutic purposes.
The research participants will then be asked to come for two testing visits. During the first
testing visit (visit 1), participants will be fitted with the prosthesis and required
adjustments to improve comfort and avoid pressure point will be performed. After fitting the
prosthesis, participants will be given 15 minutes to explore the prosthesis and adjust the
tensioner dial to regulate the opening of the fingers to perform the Box and Block Test.
After the training and accommodation period, participants will be asked to perform 3 trials
of flexion and extension of each wrist with and without the prosthesis and 3 different trials
of the Box and Blocks Test for each hand while monitoring neural activity of the primary
motor cortex using a fNIRS device. After a brief period of rest and encouragement, the
subject will be asked to perform eight trials of discrete (four trials) and continuous (four
trials) tasks using a robotic manipulandum (InMotion Arm Robot, Interactive Motion
Technologies, Inc., Cambridge, MA, USA). These tasks have been previously used for the
assessment of changes in upper-limb performance and the effect of different treatments in the
recovering of motor function of children with acquired or congenital hemiparesis, ataxia, and
hemiparesis. This data collection performed at baseline will be performed again one and four
months after baseline. Eight weeks after the baseline measurements, participants will be
asked to visit our laboratory for a second time and perform the same assessments. Between the
testing visits, participants will be encouraged to use the prosthesis for a minimum of 2
hours a day.