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Neuroplasticity After Proprioceptive Rehabiliation

Recruiting
Conditions
Traumatic Brain Injury
Stroke
Hemiparesis
Registration Number
NCT05277519
Lead Sponsor
Institut National de la Santé Et de la Recherche Médicale, France
Brief Summary

Sequences of muscle tendon vibrations allow to reproduce the sensory feedback during movement like locomotion and kinaesthesia. It is known that such a treatment promotes motor recovery after stroke assuming that it enhances neuroplasticity. The aim of the research is to study the activity in cerebrospinal circuitry to evaluate the neuroplastic changes during and after instrumented proprioceptive rehabilitation relying on sequences of muscle vibration in subacute stroke stages.

Detailed Description

Randomized control trial : 28 patients with active vibrations vs. 28 patients with sham stimulation Subacute phase : D15 to 6 months after stroke or patients with traumatic brain injury with similar semiology as stroke (hemiparesis) Measure at baseline : Electrophysiological investigations (EMG,EEG, MRI, clinical evaluation) Treatment of 5 weeks with 3 sessions of vibrations or sham a week Evaluation at mid time (electrophysiology and clinical examinations) Final examination (electrophysiology, MRI and clinical examination)

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
56
Inclusion Criteria
  • hemiparesis at least transient in lower limb following an acquired brain injury (stroke or traumatic brain injury)
  • French spoken
  • Affiliated to a French social insurance
  • No previous traumatic, vascular or neurodegenerative injuries
  • Having presented during the acute phase or presenting a motor deficit of one of the lower limbs
  • Presenting an absence of autonomy of walking at the entrance of the rehabilitation department
  • In the sub-acute phase, i.e. from 15 days to 6 months after the accident
  • Presenting moderate cognitive disorders allowing them to understand instructions and give their consent
Exclusion Criteria
  • strong cognitive disorders
  • maintenance of justice, tutelage, legal guardianship
  • Pregnancy and breastfeeding
  • Outpatients who do not have weekly follow-up in the rehabilitation department

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
Baseline EMGEvaluation at baseline (4 days before treatment)

H-reflex and reciprocal inhibition

EMG change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

H-reflex and reciprocal inhibition

EEG change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

SEP and resting state activity

EMG change after the 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

H-reflex and reciprocal inhibition

Baseline EEGEvaluation at baseline (4 days before treatment)

SEP and resting state activity

EEG change after the 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

SEP and resting state activity

Secondary Outcome Measures
NameTimeMethod
Baseline Muscle StrengthEvaluation at baseline (4 days before treatment)

score to Medical Research Council scale

Walking from baseline after 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

score to 10-m walking test

Change in MDEvaluation 4 days after the end of the 5-week treatment

Evaluation of white matter integrity along the corticospinal tract by calculating the mean diffusivity (MD) evaluated from diffusion MRI

Sensorimotor function change from baseline after 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

subscore for lower limbs to Fugl meyer assessment

Spasticity change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

score to Modified Ashworth scale

Baseline BalanceEvaluation at baseline (4 days before treatment)

Score to Berg balance scale

Baseline walkingEvaluation at baseline (4 days before treatment)

score to 10-m walking test

Change in FAEvaluation 4 days after the end of the 5-week treatment

Evaluation of white matter integrity along the corticospinal tract by calculating the fraction of anisotropy (FA) evaluated from diffusion MRI

Baseline MDEvaluation at baseline (4 days before treatment)

Evaluation of white matter integrity along the corticospinal tract by calculating the mean diffusivity (MD) evaluated from diffusion MRI

Baseline FAEvaluation at baseline (4 days before treatment)

Evaluation of white matter integrity along the corticospinal tract by calculating the fraction of anisotropy (FA) evaluated from diffusion MRI

Muscle Strength change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

score to Medical Research Council scale

Muscle Strength change from baseline after 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

score to Medical Research Council scale

Baseline SpasticityEvaluation at baseline (4 days before treatment)

score to Modified Ashworth scale

Spasticity change from baseline after 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

score to Modified Ashworth scale

Baseline sensorimotor functionEvaluation at baseline (4 days before treatment)

subscore for lower limbs to Fugl meyer assessment

Sensorimotor function change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

subscore for lower limbs to Fugl meyer assessment

Balance change from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

Score to Berg balance scale

Balance change from baseline after 5-week treatmentEvaluation 4 days after the end of the 5-week treatment

Score to Berg balance scale

Walking from baseline after 2-week treatmentEvaluation during the 3rd week of treatment

score to 10-m walking test

Trial Locations

Locations (1)

Pitié-Salpêtrière Hospital

🇫🇷

Paris, France

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