Trial Outcomes & Findings for Electrical Stimulation for Recovery of Ankle Dorsiflexion in Chronic Stroke Survivors (NCT NCT01029912)

NCT ID: NCT01029912

Last Updated: 2017-12-07

Results Overview

The Lower Extremity Fugl-Meyer (LEFM) Assessment is a measure of lower limb motor impairment. Participants are asked to attempt to perform a list of isolated and simultaneous movements of the hip, knee, and ankle that take into account synergy patterns, isolated strength, coordination, and hypertonia. Each movement attempt is graded on a 3-point ordinal scale (0, cannot perform; 1, perform partially; and 2, perform fully) and these subscores are summed to provide a maximum score of 34, minimum score of 0. Higher scores are considered to be a better outcome. For each individual, the score prior to treatment was subtracted from the score at end of the 6-week treatment. Then for each treatment group, these change scores were averaged.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

26 participants

Primary outcome timeframe

2 timepoints: Prior to treatment, and End of treatment at 6 weeks.

Results posted on

2017-12-07

Participant Flow

Participant milestones

Participant milestones
Measure
CCNMES
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) CCFES Electrical Stimulator: 6-week intervention Home: Self-administered active repetitive CCNMES-mediated ankle dorsiflexion exercise performed ten 51-minute sessions (three 15-min sets separated by 3-min rest) per week at home. Lab: 15 minutes of therapist-guided CCFES-mediated ankle exercise + 30 minutes of gait training in the laboratory twice a week.
Cyclic NMES
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Cyclic NMES Electrical Stimulator: 6-week intervention Home: Self-administered active repetitive Cyclic NMES-mediated ankle dorsiflexion exercise performed ten 51-minute sessions (three 15-min sets separated by 3-min rest) per week at home. Lab: 15 minutes of therapist-guided Cyclic NMES-mediated ankle exercise + 30 minutes of gait training in the laboratory twice a week.
Overall Study
STARTED
14
12
Overall Study
COMPLETED
12
12
Overall Study
NOT COMPLETED
2
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Electrical Stimulation for Recovery of Ankle Dorsiflexion in Chronic Stroke Survivors

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CCNMES
n=12 Participants
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Cyclic NMES
n=12 Participants
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Total
n=24 Participants
Total of all reporting groups
Age, Continuous
56.7 years
STANDARD_DEVIATION 13.7 • n=5 Participants
59.3 years
STANDARD_DEVIATION 9.1 • n=7 Participants
58.0 years
STANDARD_DEVIATION 11.4 • n=5 Participants
Sex: Female, Male
Female
4 Participants
n=5 Participants
6 Participants
n=7 Participants
10 Participants
n=5 Participants
Sex: Female, Male
Male
8 Participants
n=5 Participants
6 Participants
n=7 Participants
14 Participants
n=5 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Asian
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Black or African American
6 Participants
n=5 Participants
5 Participants
n=7 Participants
11 Participants
n=5 Participants
Race (NIH/OMB)
White
6 Participants
n=5 Participants
7 Participants
n=7 Participants
13 Participants
n=5 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=5 Participants
0 Participants
n=7 Participants
0 Participants
n=5 Participants
Years Since Stroke
2.7 years
STANDARD_DEVIATION 1.8 • n=5 Participants
3.6 years
STANDARD_DEVIATION 3.9 • n=7 Participants
3.1 years
STANDARD_DEVIATION 3.0 • n=5 Participants
Lower Extremity Fugl-Meyer Score
19.1 units on a scale
STANDARD_DEVIATION 6.8 • n=5 Participants
18.9 units on a scale
STANDARD_DEVIATION 7.0 • n=7 Participants
19.0 units on a scale
STANDARD_DEVIATION 6.8 • n=5 Participants
Time to complete Modified Emory Functional Ambulation Profile (MEFAP) in seconds
120.7 seconds
STANDARD_DEVIATION 86.3 • n=5 Participants
118.6 seconds
STANDARD_DEVIATION 86.5 • n=7 Participants
119.7 seconds
STANDARD_DEVIATION 84.5 • n=5 Participants
Gait velocity (cm/sec)
39.9 cm/sec
STANDARD_DEVIATION 22.3 • n=5 Participants
38.3 cm/sec
STANDARD_DEVIATION 19.1 • n=7 Participants
39.1 cm/sec
STANDARD_DEVIATION 20.4 • n=5 Participants

PRIMARY outcome

Timeframe: 2 timepoints: Prior to treatment, and End of treatment at 6 weeks.

The Lower Extremity Fugl-Meyer (LEFM) Assessment is a measure of lower limb motor impairment. Participants are asked to attempt to perform a list of isolated and simultaneous movements of the hip, knee, and ankle that take into account synergy patterns, isolated strength, coordination, and hypertonia. Each movement attempt is graded on a 3-point ordinal scale (0, cannot perform; 1, perform partially; and 2, perform fully) and these subscores are summed to provide a maximum score of 34, minimum score of 0. Higher scores are considered to be a better outcome. For each individual, the score prior to treatment was subtracted from the score at end of the 6-week treatment. Then for each treatment group, these change scores were averaged.

Outcome measures

Outcome measures
Measure
CCNMES
n=12 Participants
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Cyclic NMES
n=12 Participants
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Change in Lower Extremity Fugl-Meyer Score at End of Treatment
0.93 units on a scale
Standard Error 0.65
1.8 units on a scale
Standard Error 0.77

PRIMARY outcome

Timeframe: 2 timepoints: Prior to treatment, and End of treatment at 6 weeks.

Gait velocity was assessed using a motion capture and analysis system which collected spatio-temporal data as the participant walked 5-meters 10 times at a self-selected comfortable speed within the field of view of the motion capture system. A higher gait velocity is considered to be a better outcome. For each individual, the gait velocity prior to treatment was subtracted from the gait velocity at end of the 6-week treatment. Then for each treatment group, these change values were averaged.

Outcome measures

Outcome measures
Measure
CCNMES
n=12 Participants
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Cyclic NMES
n=12 Participants
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Change in Gait Velocity (cm/Sec) at End of Treatment
3.0 cm/sec
Standard Error 2.1
1.2 cm/sec
Standard Error 2.6

PRIMARY outcome

Timeframe: 2 timepoints: Prior to treatment, and End of treatment at 6 weeks.

The MEFAP is a measure of functional ambulation, measuring the time to ambulate through 5 common environmental terrains: 1) 5-meter walk on a hard floor, 2) 5-meter walk on a carpeted floor, 3) rise from a chair, 3-meter walk, return to seated position, 4) standardized obstacle course (bricks to step over), 5) stair ascent and descent. The five times subscores were added to derive a total time. Lower times are considered to be a better outcome. For each individual, the MEFAP completion time prior to treatment was subtracted from the MEFAP completion time at end of the 6-week treatment. Then for each treatment group, these change values were averaged.

Outcome measures

Outcome measures
Measure
CCNMES
n=12 Participants
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Cyclic NMES
n=12 Participants
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Change in Time (Sec) to Complete the Modified Emory Functional Ambulation Profile (MEFAP).
-9.6 seconds
Standard Error 2.6
-3.2 seconds
Standard Error 4.1

Adverse Events

CCNMES

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Cyclic NMES

Serious events: 0 serious events
Other events: 1 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
CCNMES
n=12 participants at risk
Contralaterally Controlled Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Cyclic NMES
n=12 participants at risk
Cyclic Neuromuscular Electrical Stimulation (Electrical Stimulator) Electrical stimulator: 6-week intervention 15 minutes of therapist-guided stimulated ankle exercise + 30 minutes of physical therapy in the laboratory twice a week. Self-administered active repetitive ankle dorsiflexion exercise performed twice a day, 6 days a week at home using the device.
Musculoskeletal and connective tissue disorders
Discomfort from stimulation
8.3%
1/12 • Number of events 1
8.3%
1/12 • Number of events 1

Additional Information

Dr. Jayme Knutson

MetroHealth Medical Center

Phone: 2167787342

Results disclosure agreements

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