Effects of Individualized iTBS on Upper Limb Function After Stroke
试验速览
- 阶段
- 不适用
- 状态
- 尚未招募
- 入组人数
- 159
- 试验地点
- 1
- 主要终点
- Fugl-Meyer Assessment-upper extremity
研究概览
简要总结
The primary objective of this clinical study is to assess the comparative efficacy of individualized intermittent theta burst stimulation (iTBS) in contrast to standard iTBS for individuals post-stroke experiencing upper limb impairment. The key inquiries addressed in this study encompass:
Enhancement of Upper Limb Function: The primary investigation seeks to determine whether individualized iTBS yields superior improvements in upper limb functionality compared to standard iTBS.
Long-Term Effects: This study endeavors to explore the sustained effects of both individualized and standard iTBS on upper limb function over an extended duration.
Neural Mechanisms Investigation: Functional near-infrared spectroscopy (fNIRS) will be employed to elucidate the neural mechanisms underlying the impact of iTBS on the enhancement of upper limb function.
Post-stroke individuals with upper limb impairment will undergo pre-treatment assessments, including motor function evaluations and fNIRS tests. Subsequently, they will be randomized into three groups: individualized iTBS, standard iTBS, and sham stimulation. Participants will undergo post-treatment assessments and follow-up evaluations.
The research team aims to discern disparities in the efficacy of different iTBS modalities. The central hypothesis posits that individualized iTBS will demonstrate superior efficacy in enhancing post-stroke upper limb function, with sustained effects persisting for a minimum of one month.
详细描述
This research constitutes a single-center, double-blind, randomized controlled study. Upon enrollment, baseline information is established through the assessment of upper limb function using the Fugl Meyer Assessment (FMA), the modified Rankin Scale, the Action Research Arm Test (ARAT), and a handgrip test. Additionally, functional near-infrared spectroscopy (fNIRS) is employed to assess brain function, providing insights into the patient's motor network.
Participants in the study are randomly assigned to one of three groups: individualized iTBS, standard iTBS, and sham stimulation. All participants undergo physical therapy and occupational therapy tailored to their functional evaluation. After three weeks of treatment, participants are required to complete the aforementioned assessments, with a follow-up evaluation scheduled one month post-treatment.
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
- Triple (Participant, Care Provider, Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •aging from 18-80
- •diagnosed as first-happened stroke,duration of the disease ranged from 1-3 months
- •upper extremity impairment
- •with mini-mental state examination>15
- •agree to participate in this study and sigh the informed consent
排除标准
- •with stroke history
- •have metal device within the body
- •with history of upper extremity trauma,fracture, and/or burn
- •serious conditions and can not finish the examination and treatment
研究组 & 干预措施
indvidualized iTBS
In this arm of the study, participants undergo individualized intermittent theta burst stimulation (iTBS) subsequent to encephalography (EEG) testing. Three electrodes are strategically positioned on the first dorsal interosseous (FDI) hotspot to record the resting theta frequency, which is subsequently utilized as the theta frequency for theta burst stimulation (TBS). The participants receive this treatment regimen once daily, five times a week, over a total duration of three weeks.
干预措施: individualized intermittent theta burst sitmulation (iTBS) (Device)
standard iTBS
In this particular arm of the study, participants also undergo an initial electroencephalography (EEG) procedure. Subsequently, intermittent theta burst stimulation (iTBS) is administered using the standard theta burst stimulation frequency of 5Hz. The participants receive this treatment once daily, five times a week, over a total duration of three weeks.
干预措施: standard iTBS (Device)
sham iTBS
In this arm, the treatment procedure is similar to the standard iTBS unless the coil is perpendicular to the scalp.
干预措施: sham stimulation (Device)
结局指标
主要结局
Fugl-Meyer Assessment-upper extremity
时间窗: Befor and after the treatment, and 1 month after the treatment.
Fugl-Meyer Assessment (FMA) scale is an index to assess the sensorimotor impairment in individuals who have had stroke. The FMA motor assessments for the upper fucntion with maximum score 66 points, including relflex activity, flexor synergy, extensor synergy, movement combining synergies, movement out of synergy,normal reflex, wrist function, hand function and coordination/speed, and sensory assessment.
次要结局
- modified Rankin Scale(Befor and after the treatment, and 1 month after the treatment.)
- handrip test(Befor and after the treatment, and 1 month after the treatment.)
- Action Research Arm Test(Befor and after the treatment, and 1 month after the treatment.)
- functional nearinfrared spectroscopy(Befor and after the treatment, and 1 month after the treatment.)