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Radial Shock Waves for Functional Disability in Stroke

Not Applicable
Completed
Conditions
Ischemic Stroke
Interventions
Device: Active Radial Shockwave
Device: Sham Radial Shockwave
Registration Number
NCT02924168
Lead Sponsor
Marta Imamura
Brief Summary

This is a double blind randomized clinical trial to evaluate the effect of radial shock waves on functional recovery of the upper limb of patients with sequelae of ischemic strokes in the territory of the middle cerebral artery. A total of 20 patients will be enrolled and will undergo motor, functional and cortical excitability evaluations before and after four weekly sessions of radial shockwaves. 5,000 pulses with a frequency of 15 Hz and 3.5 to 4 bar of air pressure will be applied to the active group, resulting in an energy flux density (EFD) of approximately 0.07 mJ/mm2. The sham group will receive identical treatment, except for the fact that no energy flux will be applied.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
22
Inclusion Criteria
  • Clinical and radiological diagnosis: Magnetic Resonance Imaging (MRI) or Computed Tomography (CT) scan indicating Stroke in the territory of the middle cerebral artery;
  • 6 to 24 months after stroke date;
  • Stability observed in clinical medical evaluation
  • Granting of written informed consent to participate in the study
Exclusion Criteria
  • Individuals with a score lower than 24 on the Mini-mental test;
  • Previously documented strokes
  • Pregnancy
  • Patients treated with botulinum toxin, phenol, alcohol or previous surgeries six months before entering the study
  • Bone diseases, pre-existing joint damage, and deformities affecting the patient in a way to interfere with implementation of the proposed therapy
  • Psycho-affective disorder that prevents adherence
  • Joint pain that occurs within the movement range of therapies

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Active Radial ShockwaveActive Radial ShockwaveEvery patient will receive 5,000 continuous pulses per treatment session, at 3.5 to 4 bar air pressure (resulting in an energy flux density \[EFD\] of approximately 0.07 mJ/mm2) and at 15Hz frequency. A total of 4 sessions will be performed.
Sham Radial ShockwaveSham Radial ShockwaveEvery patient will receive 5,000 continuous pulses per treatment session, without air pressure (resulting in no EFD) and at 15Hz frequency. A total of 4 sessions will be performed.
Primary Outcome Measures
NameTimeMethod
Fugl-Meyer Assessment (FMA)Change from baseline to 8 weeks

Mean change in Fugl Meyer Assessment score after four sessions of Radial Shockwave Therapy (RSWT) as compared to baseline.

Secondary Outcome Measures
NameTimeMethod
Corticospinal excitability measures with transcranial magnetic stimulation (TMS)Baseline, one and two months

Multiple changes in Corticospinal excitability

Jebsen-Taylor Hand Function Test (JTHFT)Baseline, one and two months

Multiple changes in JTHFT

Change in fine motor function measured with Finger Tapping (FT)Baseline, one and two months

Multiple changes in FT

Purdue Pegboard Test (PPBT)Baseline, one and two months

Multiple changes in PPBT

Medical Research Council scale (MRC)Baseline, one and two months

Multiple changes in MRC scale

Robotic kinematic evaluation (RKE)Baseline, one and two months

Multiple changes in RKE

Pinch strength testingBaseline, one and two months

Pinch strength testing

Visual Analogue Scale (VAS)Baseline, one and two months

Multiple changes in VAS

Esthesiometry - Von Frey ScaleBaseline, one and two months

Multiple changes in Von Frey Scale

Fugl-Meyer AssessmentBaseline and two months

Changes in Fugl-Meyer Assessment compared to baseline

Hand gripBaseline, one and two months

Multiple changes in Hand grip

Upper Limb Modified Ashworth Scale (MAS)Baseline, one week, two weeks, three weeks, four weeks and two months

Multiple changes in MAS

Trial Locations

Locations (1)

Instituto de Medicina Fisica e Reabilitacao HCFMUSP

🇧🇷

Sao Paulo, Brazil

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