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Repetitive Transcranial Magnetic Stimulation for Lower Limb Spasticity in Multiple Sclerosis Patients

Not Applicable
Suspended
Conditions
Multiple Sclerosis
Interventions
Other: Conventional exercise
Device: Transcranial magnetic stimulation
Registration Number
NCT02747914
Lead Sponsor
University of Belgrade
Brief Summary

Leg spasticity is common problem encountered with a large proportion of patients suffering with multiple sclerosis (MS) with an increasing severity as the disease progresses. It mostly affects the antigravity muscles that significantly complicates transfer, increases fatigue and makes walking more difficult. Hence, leg spasticity often interferes with patients' mobility and significantly influences their quality of life. A great number of multidisciplinary rehabilitation studies has shown a significant effect of numerous specific functional changes in patients with secondary (SP) and primary progressive (PP) MS but there are no reviews related to spasticity. The positive therapeutic effect of modulating Transcranial Magnetic Stimulation ( TMS) methods on spasticity is shown in only two studies, in patients with relapse remitting clinical form in the remission phase of the disease. The effect of TMS on clinical measures of lower limb spasticity, functional inability and the quality of life in patients with SPMS and PPMS will be examined in this study. The objective to this study are to to explore whether rTMS boosted exercise therapy (ET) treatment can bring more improvement in lower limb spasticity than ET treatment alone in these patients.

Detailed Description

Not available

Recruitment & Eligibility

Status
SUSPENDED
Sex
All
Target Recruitment
40
Inclusion Criteria
  • Confirmed clinical form of SPMS and PPMS (established on the basis of the revised McDonald criteria)
  • EDDS score 2-6.5
  • lower limb spasticity caused by MS
  • 18 years ≥age of the patient ≤ 65. years
Exclusion Criteria
  • clinical worsening of the disease over the past 30 days,
  • the presence of pregnancy, dementia, alcoholism, history of loss of consciousness, epilepsy, metal objects in the head, pacemakers and other electronic devices in the body at a distance of 20cm from the top of the patients head, serious associate diseases (malignancy, heart disease).

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional exercise treatmentConventional exerciseGroup of patients treated with conventional exercise
Transcranial magnetic stimulation therapyTranscranial magnetic stimulationGroup of patients treated with rTMS low than 5Hz
Primary Outcome Measures
NameTimeMethod
muscle tone measured by Modified Ashworth Scale (MAS)3 weeks
Secondary Outcome Measures
NameTimeMethod
impact of leg spasticity on daily activities measured by Multiple Sclerosis Spasticity Scale 88 (MSSS-88)3 weeks
Activities of daily living measured by Barthel Index3 weeks
Quality of life measured by Multiple Sclerosis Quality of Life 54 (MSQoL54).3 weeks
Walking mobility measured by Timed 25 Foot Walk test3 weeks

Trial Locations

Locations (1)

Clinic for rehabilitation dr Miroslav Zotovic Faculty of Medicine University of Belgrade

🇷🇸

Belgrade, Serbia

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