Trial Outcomes & Findings for Combined Neural and Behavioral Therapies to Enhance Stroke Recovery (NCT NCT00929656)

NCT ID: NCT00929656

Last Updated: 2017-08-21

Results Overview

Change, in seconds, between Pre-intervention and post-intervention (4 wks following pre-intervention). The time to complete 15 separate upper extremity functional tasks are recorded. These 15 separate timed events are averaged to provide one time, in seconds. This is considered an Activity Measure on the WHO ICF model.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

22 participants

Primary outcome timeframe

Change between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Results posted on

2017-08-21

Participant Flow

Participants were recruited from the Malcom Randall VA Brain Rehabilitation Research Center database from 2/1/13-9/30/15

Participant milestones

Participant milestones
Measure
Unimanual UE Training + Real rTMS
Unimanual Upper Extremity (UE) training + repetitive Transcranial Magnetic Stimulation (rTMS) Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
Unimanual Upper Extremity (UE) training + sham repetitive Transcranial Magnetic Stimulation (rTMS) Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Overall Study
STARTED
13
9
Overall Study
COMPLETED
13
8
Overall Study
NOT COMPLETED
0
1

Reasons for withdrawal

Reasons for withdrawal
Measure
Unimanual UE Training + Real rTMS
Unimanual Upper Extremity (UE) training + repetitive Transcranial Magnetic Stimulation (rTMS) Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
Unimanual Upper Extremity (UE) training + sham repetitive Transcranial Magnetic Stimulation (rTMS) Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Overall Study
Lost to Follow-up
0
1

Baseline Characteristics

Combined Neural and Behavioral Therapies to Enhance Stroke Recovery

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Participants randomized to the Experimental Arm received real rTMS (1000 pulses) to their ipsilesional hemisphere followed by two hours of paretic arm functional task practice administered/supervised by a physical therapist.
Unimanual UE Training + Sham rTMS
n=9 Participants
Participants randomized to the Placebo Arm received sham rTMS to their ipsilesional hemisphere followed by two hours of paretic arm functional task practice administered/supervised by a physical therapist.
Total
n=22 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Age, Categorical
Between 18 and 65 years
9 Participants
n=93 Participants
6 Participants
n=4 Participants
15 Participants
n=27 Participants
Age, Categorical
>=65 years
4 Participants
n=93 Participants
3 Participants
n=4 Participants
7 Participants
n=27 Participants
Age, Continuous
61.3 years
STANDARD_DEVIATION 10.0 • n=93 Participants
59.4 years
STANDARD_DEVIATION 8.2 • n=4 Participants
60.5 years
STANDARD_DEVIATION 9.1 • n=27 Participants
Sex: Female, Male
Female
1 Participants
n=93 Participants
4 Participants
n=4 Participants
5 Participants
n=27 Participants
Sex: Female, Male
Male
12 Participants
n=93 Participants
5 Participants
n=4 Participants
17 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
2 Participants
n=93 Participants
4 Participants
n=4 Participants
6 Participants
n=27 Participants
Race (NIH/OMB)
White
11 Participants
n=93 Participants
5 Participants
n=4 Participants
16 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Region of Enrollment
United States
13 Participants
n=93 Participants
9 Participants
n=4 Participants
22 Participants
n=27 Participants
Time Post-Stroke
44.0 months
STANDARD_DEVIATION 95.6 • n=93 Participants
33.3 months
STANDARD_DEVIATION 25.9 • n=4 Participants
39.6 months
STANDARD_DEVIATION 74.2 • n=27 Participants

PRIMARY outcome

Timeframe: Change between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Change, in seconds, between Pre-intervention and post-intervention (4 wks following pre-intervention). The time to complete 15 separate upper extremity functional tasks are recorded. These 15 separate timed events are averaged to provide one time, in seconds. This is considered an Activity Measure on the WHO ICF model.

Outcome measures

Outcome measures
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Unimanual UE training + rTMS Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
n=9 Participants
Unimanual UE training + sham rTMS Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Wolf Motor Function Test Change
1.6 seconds
Standard Error 1.1
1.8 seconds
Standard Error 1.2

SECONDARY outcome

Timeframe: Change Between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Change in Score from Pre-intervention to Post-Intervention. This outcome measures arm motor control; the ability to move outside of pathologic synergistic patterns. It is a measure of impairment in Body Structure/Function. Total score ranges from 0-66, with 0 indicative of no movement and 66 considered normal motor control.

Outcome measures

Outcome measures
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Unimanual UE training + rTMS Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
n=9 Participants
Unimanual UE training + sham rTMS Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Upper Extremity Fugl-Meyer Motor Assessment Change
5.8 units on a scale
Standard Error 1.4
5.8 units on a scale
Standard Error 1.1

SECONDARY outcome

Timeframe: Change between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Change in Paretic hand grip strength from pre- to post-intervention. Grip strength measured by hand-held dynamometer. An average of 3 5-second trials was used for analysis.

Outcome measures

Outcome measures
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Unimanual UE training + rTMS Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
n=9 Participants
Unimanual UE training + sham rTMS Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Grip Strength Change
1.1 kilograms
Standard Error 2.0
1.3 kilograms
Standard Error 2.4

SECONDARY outcome

Timeframe: Change Between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Self-Report Amount of Use of Paretic UE to complete 30 functional tasks. Each task is reported on a 0-5 scale with "0" representing "did not use my paretic hand at all for that task" and "5" representing "I used my paretic hand as much as before the stroke to complete that task." A "5" on each task would be considered "normal."

Outcome measures

Outcome measures
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Unimanual UE training + rTMS Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
n=9 Participants
Unimanual UE training + sham rTMS Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Motor Activity Log - Amount of Use Change
1.3 Units on a scale
Standard Error 0.3
1.2 Units on a scale
Standard Error 0.3

SECONDARY outcome

Timeframe: Change between Pre-intervention (baseline) to Post-intervention (4 wks following pre-intervention)

Self-Report of How Well paretic UE performed completing 30 functional tasks. Each task is reported on a 0-5 scale with "0" representing "Unable to use my paretic hand to perform that task" and "5" representing "My paretic hand performs that task as well as it did before the stroke." A "5" on each task would be considered "normal."

Outcome measures

Outcome measures
Measure
Unimanual UE Training + Real rTMS
n=13 Participants
Unimanual UE training + rTMS Unimanual UE training + rTMS: rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Unimanual UE Training + Sham rTMS
n=9 Participants
Unimanual UE training + sham rTMS Unimanual UE training + sham rTMS: sham rTMS application to lesioned hemisphere followed by unimanual (paretic) UE functional task practice (2 hours) for 16 sessions (4 sessions/week for 4 weeks)
Motor Activity Log - How Well Change
1.1 Units on a scale
Standard Error 0.3
1.2 Units on a scale
Standard Error 0.4

Adverse Events

Unimanual UE Training + Real rTMS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Unimanual UE Training + Sham rTMS

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Dr. Dorian Rose, Research Health Scientist

Malcom Randall VAMC

Phone: 352-376-1611

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place