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临床试验/NCT02797886
NCT02797886Unknown不适用

Pairing Functional Electrical Stimulation (FES) and Volitional Effort Training Promotes Neuroplasticity and Motor Gain

Kessler Foundation0 个研究点目标入组 45 人开始时间: 2016年6月1日最近更新:
适应症

试验速览

阶段
不适用
发起方
入组人数
45
主要终点
Center of Pressure of Plantar Loading During Walking Trial

研究概览

简要总结

The goal of the study is to explore the effect of combined training involving functional electrical stimulation (FES) of the ankle dorsal flexor with simultaneous maximal-effort voluntary contraction of the same muscle to correct or improve foot drop in chronic stroke patients. Participants will be assessed for functional motor ability and neurological function during their first visit and then again after five and then ten weeks of training. Functional motor ability is broken down into dorsiflexion strength and general gait analysis. Dorsiflexion strength is measured by use of a dynamometer. Gait is assessed via recordings of electromyography, pedobarography, kinematic, and various functional variables during 10 walking trials. The neurological assessment will include electroencephalographic (EEG) analysis of movement-related cortical potentials (MRCP), somatosensory evoked potentials (SSEP), and M-wave response to stimulation. Participants will be randomly assigned to one of three groups: 1) FES + volitional movement (VOL), 2) FES alone, and 3) VOL alone, which will determine their training regimen. The training sessions involve roughly 20 minutes of repeated muscle contractions (with appropriate breaks to avoid fatigue). The participants assigned to the FES+VOL group will receive electrical stimulation to the peroneal nerve in concert with volitional dorsiflexion, whereas the other groups will either dorsiflex voluntarily with no stimulation or receive stimulation while being asked to do nothing.

研究设计

研究类型
Interventional
分配方式
Randomized
干预模型
Parallel
主要目的
Treatment
盲法
None

入排标准

年龄范围
10 Years 至 90 Years(Child, Adult, Older Adult)
性别
All
接受健康志愿者

入选标准

  • Must be hemiplegic secondary to stroke and exhibit foot drop (as diagnosed by the participant's treating physician)
  • Between the ages of 10 and
  • Must have sustained a stroke at least 6 months prior to enrollment.
  • Uninvolved lower limb must have no history of injury or pathology within the last 90 days.
  • Must be able to walk independently for 10 meters.
  • Must have inadequate dorsiflexion during the swing phase of gait resulting in inadequate limb clearance
  • Medically stable for three months prior to the most recent episode of stroke resulting in hemiplegia or hemiparesis with foot drop
  • Adequate cognitive function to give informed consent, understand instructions, and give adequate feedback.

排除标准

  • Individuals with additional orthopedic, neuromuscular, or neurological pathologies that would interfere with their ability to walk
  • Individuals with previous use of FES for community ambulation (neuroprosthesis) or clinical treatment <1 year will be excluded from participation due to possible confounding effects
  • Severe cardiac disease such as myocardial infarction, or congestive heart failure
  • Fixed ankle contractures of ten degrees of plantarflexion with knee extended
  • Pre-existing pathology resulting in a significant disruption in alignment or function of the lower extremity
  • Excessive dysesthetic pain secondary to neurological involvement
  • Severe hypertonicity resulting in the need for more involved rehabilitation strategies
  • Participants will not be excluded due to gender or ethnicity.

结局指标

主要结局

Center of Pressure of Plantar Loading During Walking Trial

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Joint Angles During Walking Trial

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Sagittal (flexion and extension), frontal (abduction and adduction) and transverse (internal and external rotation) plane angles of the ankle, knee, and hip.

Amplitude of the Major Components of Somatosensory Evoked Potentials

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Amplitude of the N1, N2, P1, and P2 components of artifact free epochs

Amplitude of the P40-N50 Complex During Movement Related Cortical Potentials

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Amplitude and Latency of M-Wave Component of EMG During Maximal Voluntary Contraction

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Force Produced by Voluntary Dorsiflexion

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

Time to Complete 10 Meter Walk

时间窗: Change from baseline to 0 weeks post-intervention and from baseline to 5 weeks post-intervention

次要结局

未报告次要终点

研究者

发起方
Kessler Foundation
申办方类型
Other
责任方
Sponsor

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