Mirror Therapy Integrated with Electrical Stimulation for Cortical Modulations

NCT ID: NCT06209801

Last Updated: 2025-02-07

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

RECRUITING

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-01

Study Completion Date

2027-12-31

Brief Summary

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Peripheral nerve injury is common and can result in loss of sensation and motor function, reduced quality of life, and prolonged time to return to work. Maladaptive cortical reorganization occurs after nerve injury or immobilization and can further impair the recovery process. To improve the sensorimotor prognosis of people with peripheral nerve injury, methods such as mirror therapy, motor imagery, and electrical stimulation have been used in addition to usual care. However, no studies have shown the effect of integrating mirror therapy, motor imagery, and electrical stimulation in these individuals. Furthermore, the real-time effect of mirror therapy on cortical activation in this population remains unexplored. This study aims to determine the real-time cortical modulation effects of mirror therapy combined with electrical stimulation in individuals with peripheral nerve injury.

Detailed Description

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Two groups of subjects (a group of peripheral nerve injury group and a group of healthy adults) will perform hand exercises in three randomized conditions: (1) mirror therapy with electrical stimulation and motor imagery, (2) electrical stimulation and motor imagery, and (3) motor imagery. Each participant performs specific sets of two exercises based on the type of nerve injury: (1) Median nerve injury: Picking up and putting down a pen using the thumb and index finger, and picking up and putting down a marble using the thumb and little finger. (2) Ulnar nerve injury: Picking up and putting down a card using the thumb and index finger, and picking up and putting down a marble using the thumb and little finger.(3) Brachial plexus injury: Picking up and putting down an empty cup, and picking up and putting down a pair of pliers. For combined median nerve and ulnar nerve injuries and healthy adult groups, movements corresponding to median nerve injuries are performed. Each experimental condition consists of 20 repetitions, lasting 60 seconds, followed by a 30-second rest between conditions. Relative alpha and beta band power in the sensorimotor cortex will be recorded and analyzed.

Conditions

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Peripheral Nerve Injuries

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Experimental group

Individuals with peripheral nerve injuries

Group Type EXPERIMENTAL

Mirror therapy

Intervention Type BEHAVIORAL

60 seconds of intervention

Neuromuscular electrical stimulation

Intervention Type DEVICE

60 seconds of intervention

Motor imagery

Intervention Type BEHAVIORAL

60 seconds of intervention

Control group

Healthy individuals

Group Type ACTIVE_COMPARATOR

Mirror therapy

Intervention Type BEHAVIORAL

60 seconds of intervention

Neuromuscular electrical stimulation

Intervention Type DEVICE

60 seconds of intervention

Motor imagery

Intervention Type BEHAVIORAL

60 seconds of intervention

Interventions

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Mirror therapy

60 seconds of intervention

Intervention Type BEHAVIORAL

Neuromuscular electrical stimulation

60 seconds of intervention

Intervention Type DEVICE

Motor imagery

60 seconds of intervention

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* newly diagnosed median or ulnar nerve transection injury of the forearm in the past 6 months
* sufficient communication in the Chinese language
* being able to follow instructions
* muscle atrophy or lack of voluntary contraction over the injured hand, with maximum voluntary isometric contraction (MVIC) recorded with surface electromyography (EMG) less than 10% compared to the non-affected hand
* achieve an average score of 2 or above in the Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10) for kinesthetic imagery

Exclusion Criteria

* had central nervous disease
* had a recent (1 year) history of nerve entrapment syndrome
* had a history of latent neuropathy, such as diabetes or dialysis
Minimum Eligible Age

20 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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National Taiwan University

OTHER

Sponsor Role collaborator

Chang Gung Memorial Hospital

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Yueh-Hsia Chen, PhD

Role: PRINCIPAL_INVESTIGATOR

National Taiwan University, School of Medicine

Locations

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National Taiwain Univeristy, Colledge of Medicine, School and Graduate Institude of Physicl Therapy

Taipei, , Taiwan

Site Status RECRUITING

Chang Gung Memorial Hospital

Taoyuan District, , Taiwan

Site Status RECRUITING

Countries

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Taiwan

Central Contacts

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Yueh-Hsia Chen, PhD

Role: CONTACT

+886-3366-8133

Cheng-Tong Lam, BS

Role: CONTACT

Facility Contacts

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Yueh-Hsia Chen, PhD

Role: primary

Yueh-Hsia Chen, PhD

Role: primary

References

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Rizzo M, Petrini L, Del Percio C, Lopez S, Arendt-Nielsen L, Babiloni C. Mirror visual feedback during unilateral finger movements is related to the desynchronization of cortical electroencephalographic somatomotor alpha rhythms. Psychophysiology. 2022 Dec;59(12):e14116. doi: 10.1111/psyp.14116. Epub 2022 Jun 3.

Reference Type BACKGROUND
PMID: 35657095 (View on PubMed)

Bello UM, Kranz GS, Winser SJ, Chan CCH. Neural Processes Underlying Mirror-Induced Visual Illusion: An Activation Likelihood Estimation Meta-Analysis. Front Hum Neurosci. 2020 Jul 31;14:276. doi: 10.3389/fnhum.2020.00276. eCollection 2020.

Reference Type BACKGROUND
PMID: 32848663 (View on PubMed)

Binder E, Dovern A, Hesse MD, Ebke M, Karbe H, Saliger J, Fink GR, Weiss PH. Lesion evidence for a human mirror neuron system. Cortex. 2017 May;90:125-137. doi: 10.1016/j.cortex.2017.02.008. Epub 2017 Feb 24.

Reference Type BACKGROUND
PMID: 28391066 (View on PubMed)

Cengiz B, Vuralli D, Zinnuroglu M, Bayer G, Golmohammadzadeh H, Gunendi Z, Turgut AE, Irfanoglu B, Arikan KB. Analysis of mirror neuron system activation during action observation alone and action observation with motor imagery tasks. Exp Brain Res. 2018 Feb;236(2):497-503. doi: 10.1007/s00221-017-5147-5. Epub 2017 Dec 11.

Reference Type BACKGROUND
PMID: 29230518 (View on PubMed)

Scott M, Taylor S, Chesterton P, Vogt S, Eaves DL. Motor imagery during action observation increases eccentric hamstring force: an acute non-physical intervention. Disabil Rehabil. 2018 Jun;40(12):1443-1451. doi: 10.1080/09638288.2017.1300333. Epub 2017 Mar 21.

Reference Type BACKGROUND
PMID: 28322596 (View on PubMed)

Zhang JJQ, Fong KNK, Welage N, Liu KPY. The Activation of the Mirror Neuron System during Action Observation and Action Execution with Mirror Visual Feedback in Stroke: A Systematic Review. Neural Plast. 2018 Apr 24;2018:2321045. doi: 10.1155/2018/2321045. eCollection 2018.

Reference Type BACKGROUND
PMID: 29853839 (View on PubMed)

Bello UM, Winser SJ, Chan CCH. Role of kinaesthetic motor imagery in mirror-induced visual illusion as intervention in post-stroke rehabilitation. Rev Neurosci. 2020 Aug 27;31(6):659-674. doi: 10.1515/revneuro-2019-0106.

Reference Type BACKGROUND
PMID: 32229682 (View on PubMed)

Wang J, Fritzsch C, Bernarding J, Holtze S, Mauritz KH, Brunetti M, Dohle C. A comparison of neural mechanisms in mirror therapy and movement observation therapy. J Rehabil Med. 2013 Apr;45(4):410-3. doi: 10.2340/16501977-1127.

Reference Type BACKGROUND
PMID: 23474778 (View on PubMed)

Yang YJ, Jeon EJ, Kim JS, Chung CK. Characterization of kinesthetic motor imagery compared with visual motor imageries. Sci Rep. 2021 Feb 12;11(1):3751. doi: 10.1038/s41598-021-82241-0.

Reference Type BACKGROUND
PMID: 33580093 (View on PubMed)

Chen YH, Siow TY, Wang JY, Lin SY, Chao YH. Greater Cortical Activation and Motor Recovery Following Mirror Therapy Immediately after Peripheral Nerve Repair of the Forearm. Neuroscience. 2022 Jan 15;481:123-133. doi: 10.1016/j.neuroscience.2021.11.048. Epub 2021 Dec 5.

Reference Type BACKGROUND
PMID: 34875363 (View on PubMed)

Lu Y, Liu H, Hua X, Xu JG, Gu YD, Shen Y. Attenuation of brain grey matter volume in brachial plexus injury patients. Neurol Sci. 2016 Jan;37(1):51-56. doi: 10.1007/s10072-015-2356-1. Epub 2015 Aug 9.

Reference Type BACKGROUND
PMID: 26255300 (View on PubMed)

Saavedra-Garcia A, Moral-Munoz JA, Lucena-Anton D. Mirror therapy simultaneously combined with electrical stimulation for upper limb motor function recovery after stroke: a systematic review and meta-analysis of randomized controlled trials. Clin Rehabil. 2021 Jan;35(1):39-50. doi: 10.1177/0269215520951935. Epub 2020 Aug 24.

Reference Type BACKGROUND
PMID: 32830512 (View on PubMed)

Other Identifiers

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202301500A3

Identifier Type: -

Identifier Source: org_study_id

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