NMES Efficacy on Patients With NBPP

NCT ID: NCT01999465

Last Updated: 2018-12-14

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

20 participants

Study Classification

INTERVENTIONAL

Study Start Date

2013-11-30

Study Completion Date

2018-01-31

Brief Summary

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Neonatal Brachial Plexus Palsy (NBPP), characterized by weakness and sensory loss in the affected arm, results from damage in the prenatal period to the nerves extending from the spine to the arm. Proper stretching and exercise of the joints and affected arm from the time of diagnosis can greatly assist in the development of healthy movement of the limb. Additionally, neuromuscular electrical stimulation has been shown to be an effective treatment in other neural disorders and therefore its effectiveness in NBPP is worth studying.

In the case of NBPP patients, the loss in normal arm function can be observed very early. Young patients will often neglect using the affected arm or modify motions to avoid the use of the biceps muscle, specifically in hand to mouth actions such as gripping a bottle or placing toys or other objects in the mouth. A goal of this study is to test the effectiveness of NMES on improving the biceps muscle Medical Research Council (MRC) strength and active range of motion (AROM).

The subjects of this study are newborns between the ages of 3-9 months who are already a part of the University of Michigan Brachial Plexus program. Parents of the children will be trained to perform the neuromuscular electrical stimulation therapy at home using the EMPI Continuum unit for 30 minutes each day and monthly follow up appointments will be performed be the research occupational therapists throughout three month study period.

Parents of the participants will complete a questionnaire before and during the study period to help analyze for confounders and gather data regarding parent compliance and NMES effectiveness. To detect the effectiveness of NMES, two cohort groups using standard units and sham units will be recruited and compare with data analysis.

The investigators predict that the NMES will effectively improve the ability of the neonate to increase use of the affected arm, specifically in muscle strength biceps MRC score and AROM.

Detailed Description

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The purpose of this study is to investigate whether the use of Neuromuscular Electrical Stimulation (NMES), via the Empi® Continuum unit, will improve the ability with which children with Neonatal Brachial Plexus Palsy (NBPP) are able to use their biceps muscle in activities of daily living. We will examine the British Medical Research Council (MRC) muscle strength and participants' ability to perform active range of motion (AROM) movements. Patients will be divided into two groups with one group receiving NMES and the other receiving sham NMES. We plan to analyze the effects of this one treatment intervention of NMES to determine if the device improves the function of the biceps muscle strength and motion.

Conditions

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Neonatal Brachial Plexus Palsy

Keywords

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Brachial plexus injury Brachial plexus palsy Neonate

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

TRIPLE

Participants Caregivers Outcome Assessors

Study Groups

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Standard NMES cohort

Patients who will apply standard NMES device.

Group Type ACTIVE_COMPARATOR

Standard NMES device

Intervention Type DEVICE

Blinded parents will follow the NMES parent instructions and place the NMES on the biceps muscle of their child for 30 minutes every day for three months.

* Rate(35 Hz)
* Width (300 us)
* Ch1 Ramp+ (2 seconds)
* On Time 1 (10 seconds)
* Ch1 Ramp - (2 seconds)

Sham NMES cohort

Patients who will apply sham NMES device.

Group Type SHAM_COMPARATOR

Sham NMES device

Intervention Type DEVICE

Blinded parents will follow the NMES parent instructions and place the NMES on the biceps muscle of their child for 30 minutes every day for three months.

* Rate(35 Hz)
* Width (48 us)
* Ch1 Ramp+ (0 seconds)
* On Time 1 (0 seconds)
* Ch1 Ramp - (0 seconds)

Interventions

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Standard NMES device

Blinded parents will follow the NMES parent instructions and place the NMES on the biceps muscle of their child for 30 minutes every day for three months.

* Rate(35 Hz)
* Width (300 us)
* Ch1 Ramp+ (2 seconds)
* On Time 1 (10 seconds)
* Ch1 Ramp - (2 seconds)

Intervention Type DEVICE

Sham NMES device

Blinded parents will follow the NMES parent instructions and place the NMES on the biceps muscle of their child for 30 minutes every day for three months.

* Rate(35 Hz)
* Width (48 us)
* Ch1 Ramp+ (0 seconds)
* On Time 1 (0 seconds)
* Ch1 Ramp - (0 seconds)

Intervention Type DEVICE

Other Intervention Names

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Neuromuscular electrical stimulation (NMES)

Eligibility Criteria

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Inclusion Criteria

* Children ages 3-9 months at time of enrollment
* NBPP patients who receive care from University Of Michigan Brachial Plexus Palsy clinic
* All gender/race/financial backgrounds
* active range of motion (AROM) elbow flexion \<150°
* All Narakas grades
* British Medical Research Council (MRC) grade 2- or 4 for biceps brachii

Exclusion Criteria

* Brachial Plexus patients require needing surgical repair
* Patients with any existing secondary medical conditions
* Patients with elbow contracture greater than 5°
* British Medical Research Council (MRC) grade 5 for biceps brachii
* active range of motion (AROM) elbow flexion =150°
* Non-English speaking families
* Children already using NMES unit
Minimum Eligible Age

3 Months

Maximum Eligible Age

9 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Spring Arbor University

UNKNOWN

Sponsor Role collaborator

University of Michigan

OTHER

Sponsor Role lead

Responsible Party

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Lynda Yang

MD, PhD

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lynda Yang, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

Neurosurgery Department, University of Michigan Health System

Locations

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University of Michigan

Ann Arbor, Michigan, United States

Site Status

Countries

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United States

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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MedSAU-NMES

Identifier Type: -

Identifier Source: org_study_id