Harnessing Neuroplasticity to Enhance Functional Recovery During Chronic Recovery From Upper Extremity Nerve Repair
Hand Transplantation, Peripheral Nerve Injuries, Neurologic Rehabilitation
About this trial
This is an interventional treatment trial for Hand Transplantation focused on measuring Rehabilitation Neuroscience, Transcranial Direct Current Stimulation, Rehabilitation Therapy, Neuroplasticity, Transplantation, Hand Therapy, Constraint Induced Movement Therapy, Peripheral Nerve Injuries, tDCS, CIMT
Eligibility Criteria
Inclusion Criteria:
- Individuals whom have received a unilateral allogeneic transplantation proximal to the wrist and are at the chronic stage of recovery (approx. 12 - 18 months following surgery, when Tinel's sign reaches the distal fingertips).
- Individuals whom have undergone a complete amputation the hand between the wrist and elbow followed by successful re-attachment and are at the chronic stage of recovery (approx. 12 - 18 months following surgery, when Tinel's sign reaches the distal fingertips).
- Individuals whom have undergone repairs of the median, ulnar, or other related or nearby nerve(s) following complex volar forearm lacerations or other injuries between the distal wrist crease and the flexor musculotendinous junctions. Individuals must be at the chronic stage of recovery (approx. 12 - 18 months following surgery, when Tinel's sign reaches the distal fingertips).
Exclusion Criteria:
- Individuals with significant/severe brain trauma
- Serious psychiatric conditions
- Chronic or severe neurological conditions.
- Current pregnancy
- History of seizures or unexplained loss of consciousness
- Metallic implants above the chest
- Certain implanted medical devices.
Sites / Locations
- Christine Kleinert Institute for Hand & MicrosurgeryRecruiting
- University of MissouriRecruiting
- Washington University School of MedicineRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Active Comparator
Active Comparator
No Intervention
Transplantation/Replantation Patients
Nerve Injury Patients active
Actigraphy Testing
Can plateaued hand function in hand transplantation patients/hand replantation patients in the chronic stage of recovery be facilitated by use of bi-hemispheric transcranial direct current stimulation (tDCS) combined with modified Constraint Induced Movement Therapy (CIMT)?
Can plateaued hand function in peripheral nervous system injuries in the chronic stage of recovery be facilitated by use of bi-hemispheric transcranial direct current stimulation (tDCS) combined with modified Constraint Induced Movement Therapy (CIMT)?
We will acquire a set of actigraphy data from a group of hand transplant/replant patients and unilateral, adult amputees in order to evaluate typical patterns of limb use prior to hand transplantation and to investigate prosthesis utilization.