Nutrition, Neuromuscular Electrical Stimulation (NMES) and Secondary Progressive Multiple Sclerosis (SPMS)

NCT ID: NCT01381354

Last Updated: 2018-06-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE1

Total Enrollment

38 participants

Study Classification

INTERVENTIONAL

Study Start Date

2010-10-31

Study Completion Date

2016-05-31

Brief Summary

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The study will use a multimodal therapeutic lifestyle intervention consisting of a study diet, stressing more vegetables and fruit, elimination of foods at greatest risk for food allergy, meditation, self massage, progressive exercise and neuromuscular electrical stimulation for rehabilitation of gait and fatigue disability in the setting of secondary and primary progressive multiple sclerosis with gait disability.

Detailed Description

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Restoration of function is very rare in individuals with MS who have experienced gradual worsening in the absence of acute MS symptoms (relapses) and partial or complete recovery of those acute symptoms (remissions).

A recent case report of a patient with secondary progressive MS documented a transition from scooter dependence to mild gait disability following the initiation of electrotherapy in the form of neuromuscular electrical stimulation and nutritional interventions aimed increasing the nutrient density and decreasing the risk of food sensitivity and food allergies. Multiple studies of neuromuscular electrical stimulation in athletes, cerebral palsy and stroke patients have demonstrated gains in strength and coordination. Multiple authors have reported that antioxidants, essential amino acids and micronutrient rich diets are neuroprotective. It is likely that the combination of the intensive nutrition and the electrotherapy contributed to the marked gains in improvement. However in the absence of an additional case report the strength of the association remains unknown.

The intent of this study is to replicate the interventions from the case report as closely as possible.

Our primary objective is to measure how many and how completely subjects implement 1) the nutritional interventions, 2) the home exercise program intervention, and 3) the electrotherapy intervention and if the improve improved nutrition and exercise are associated with improved function. To assess improvements in function will measure 1) the change in nutritional status as reported in food frequency surveys, 24 hr dietary recalls, 2) change in neurocognitive testing and behaviors, 3) change in self-reported function and disability scales, 4) change in gait and 5) change in medications doses or classes for MS related symptoms.

Subjects will be followed for three years. After the first year, subjects will not receive intensive support from the study team. The subjects return at months 18, 24 and 36 to assess adherence with study interventions, function and quality of life. Nutrition intake is assessed again at 24 and 36 months.

To assess for safety we will assess safety labs (kidney and liver function tests) and changes in weight, and self reported side effects questionnaire.

Conditions

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Multiple Sclerosis

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Combined intervention

Combination intervention consisting of the following: structured modified paleolithic diet, Progressive Exercise, Neuromuscular Electrical Stimulation designed to facilitate the adoption of multiple therapeutic lifestyle behaviors associated with superior health outcomes.

Group Type EXPERIMENTAL

Progressive exercise

Intervention Type OTHER

Progressive strengthening exercises designed to improve core muscles and muscles of ambulation.

Neuromuscular electrical stimulation delivered using the electrical therapy device EMPI 300 PV

Intervention Type DEVICE

Neuromuscular electrical stimulation to train core muscles and ambulation muscles. Device is Empi 300 manufactured by DJO Inc.

Modified paleolithic diet

Intervention Type OTHER

Diet based upon a Paleolithic diet and structured to increase the consumption of greens, sulfur rich vegetables, bright colors, seaweed and omega 3 fatty acid rich foods.

Omega 3 fatty acids

Intervention Type DIETARY_SUPPLEMENT

4 grams daily by mouth.

Full Spectrum vitamin

Intervention Type DIETARY_SUPPLEMENT

Two capsules daily.

Essential - hydroxytyrosol

Intervention Type DIETARY_SUPPLEMENT

Two capsules twice daily.

Maltodextrin fiber supplement

Intervention Type DIETARY_SUPPLEMENT

One scoop daily.

Mineral boost (magnesium)

Intervention Type DIETARY_SUPPLEMENT

Two capsules daily

Niacinamide

Intervention Type DIETARY_SUPPLEMENT

500 mg daily

Methyl B12

Intervention Type DIETARY_SUPPLEMENT

Methyl B12 1000 mcg daily

Taurine

Intervention Type DIETARY_SUPPLEMENT

one gram daily

creatine

Intervention Type DIETARY_SUPPLEMENT

one teaspoon daily

thiamine

Intervention Type DIETARY_SUPPLEMENT

100 mg daily

riboflavin

Intervention Type DIETARY_SUPPLEMENT

200 mg daily

N acetylcysteine

Intervention Type DIETARY_SUPPLEMENT

1 gram daily

alpha lipoic acid

Intervention Type DIETARY_SUPPLEMENT

300 mg twice daily

L acetyl carnitine

Intervention Type DIETARY_SUPPLEMENT

500 mg twice daily

methyl folate

Intervention Type DIETARY_SUPPLEMENT

1000 mcg one pill four times a week

coenzyme Q

Intervention Type DIETARY_SUPPLEMENT

100 mg daily

meditation

Intervention Type BEHAVIORAL

meditation 15 minutes daily

self massage

Intervention Type BEHAVIORAL

self massage of hands, feet, ears 15 minutes daily

learning

Intervention Type BEHAVIORAL

completing puzzles or learning 15 minutes daily

Coconut oil

Intervention Type DIETARY_SUPPLEMENT

If excessive weight loss occurs, the subject will add 1-2 tablespoons of coconut oil daily to smoothies or foods eaten.

Interventions

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Progressive exercise

Progressive strengthening exercises designed to improve core muscles and muscles of ambulation.

Intervention Type OTHER

Neuromuscular electrical stimulation delivered using the electrical therapy device EMPI 300 PV

Neuromuscular electrical stimulation to train core muscles and ambulation muscles. Device is Empi 300 manufactured by DJO Inc.

Intervention Type DEVICE

Modified paleolithic diet

Diet based upon a Paleolithic diet and structured to increase the consumption of greens, sulfur rich vegetables, bright colors, seaweed and omega 3 fatty acid rich foods.

Intervention Type OTHER

Omega 3 fatty acids

4 grams daily by mouth.

Intervention Type DIETARY_SUPPLEMENT

Full Spectrum vitamin

Two capsules daily.

Intervention Type DIETARY_SUPPLEMENT

Essential - hydroxytyrosol

Two capsules twice daily.

Intervention Type DIETARY_SUPPLEMENT

Maltodextrin fiber supplement

One scoop daily.

Intervention Type DIETARY_SUPPLEMENT

Mineral boost (magnesium)

Two capsules daily

Intervention Type DIETARY_SUPPLEMENT

Niacinamide

500 mg daily

Intervention Type DIETARY_SUPPLEMENT

Methyl B12

Methyl B12 1000 mcg daily

Intervention Type DIETARY_SUPPLEMENT

Taurine

one gram daily

Intervention Type DIETARY_SUPPLEMENT

creatine

one teaspoon daily

Intervention Type DIETARY_SUPPLEMENT

thiamine

100 mg daily

Intervention Type DIETARY_SUPPLEMENT

riboflavin

200 mg daily

Intervention Type DIETARY_SUPPLEMENT

N acetylcysteine

1 gram daily

Intervention Type DIETARY_SUPPLEMENT

alpha lipoic acid

300 mg twice daily

Intervention Type DIETARY_SUPPLEMENT

L acetyl carnitine

500 mg twice daily

Intervention Type DIETARY_SUPPLEMENT

methyl folate

1000 mcg one pill four times a week

Intervention Type DIETARY_SUPPLEMENT

coenzyme Q

100 mg daily

Intervention Type DIETARY_SUPPLEMENT

meditation

meditation 15 minutes daily

Intervention Type BEHAVIORAL

self massage

self massage of hands, feet, ears 15 minutes daily

Intervention Type BEHAVIORAL

learning

completing puzzles or learning 15 minutes daily

Intervention Type BEHAVIORAL

Coconut oil

If excessive weight loss occurs, the subject will add 1-2 tablespoons of coconut oil daily to smoothies or foods eaten.

Intervention Type DIETARY_SUPPLEMENT

Other Intervention Names

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NMES, electrical therapy Wahls Diet, Paleolithic Diet, Gluten-free, Dairy-free. Pinnaclife Omega 3 fatty acids Pinnaclife Pinnaclife Essential Pinnaclife Cleanse Pinnaclife Mineral Boost. Extra virgin cold press coconut oil

Eligibility Criteria

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Inclusion Criteria

* Secondary or primary progressive multiple sclerosis
* Some level of gait disability
* Tolerance for test electrical therapy session
* Successful completion of two week Run-IN phase completing the daily logs -
* Demonstrating \> 80% compliance with dietary and behavioral interventions

Exclusion Criteria

* Antiplatelet or blood thinning medication
* Cognitive disability or psychiatric disorder making compliance with study interventions difficult
* Implanted electronic medical device
* Change in medication in the prior three months
Minimum Eligible Age

18 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Direct MS Canada

UNKNOWN

Sponsor Role collaborator

DJO Incorporated

INDUSTRY

Sponsor Role collaborator

Pinnaclife Inc.

INDUSTRY

Sponsor Role collaborator

TZ Press, LLC

UNKNOWN

Sponsor Role collaborator

University of Iowa

OTHER

Sponsor Role lead

Responsible Party

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Terry L. Wahls

Clinical Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Univeristy of Iowa/ VA Iowa City VA Medical Center

Iowa City, Iowa, United States

Site Status

Countries

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United States

References

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Wahls TL, Reese D, Kaplan D, Darling WG. Rehabilitation with neuromuscular electrical stimulation leads to functional gains in ambulation in patients with secondary progressive and primary progressive multiple sclerosis: a case series report. J Altern Complement Med. 2010 Dec;16(12):1343-9. doi: 10.1089/acm.2010.0080.

Reference Type BACKGROUND
PMID: 21138391 (View on PubMed)

Reese D, Shivapour ET, Wahls TL, Dudley-Javoroski SD, Shields R. Neuromuscular electrical stimulation and dietary interventions to reduce oxidative stress in a secondary progressive multiple sclerosis patient leads to marked gains in function: a case report. Cases J. 2009 Aug 10;2:7601. doi: 10.4076/1757-1626-2-7601.

Reference Type BACKGROUND
PMID: 19918474 (View on PubMed)

Other Identifiers

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200911781

Identifier Type: -

Identifier Source: org_study_id

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