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NuroSleeve Powered Brace & Stimulation System to Restore Arm Function

Primary Purpose

Neurologic Diseases, Hemiparesis, Quadriplegia

Status
Recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Neurosleeve
Sponsored by
Thomas Jefferson University
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional supportive care trial for Neurologic Diseases focused on measuring Arm weakness, paralysis, orthosis, functional electrical stimulation, brace

Eligibility Criteria

4 Years - undefined (Child, Adult, Older Adult)All SexesAccepts Healthy Volunteers

Inclusion Criteria:• Must be 4 years or older

  • Must have weakness in one or both arms such that flexion or extension of the wrist, elbow or shoulder are 3/5 or less on the Manual Muscle Testing Scale
  • The etiology of weakness is due to a neurological disease or injury or orthopedic condition that occurred 6 or more months ago
  • Participant is willing to comply with trial instructions
  • Adult participant is able to provide informed consent prior to enrollment in the study, and for children, child is able to provide assent and designated caregiver (parent or guardian) is able to provide informed consent
  • The participant is fluent in English and, if the participant were a child, at least one parent/guardian were fluent in English
  • Medically stable and living at home in the community.
  • No joint contracture, spasticity or other limitations to range of motion in the affected lower limb(s) precluding the operation of a wearable, powered orthotic device on the arm
  • Sufficient sitting balance to sit in a chair
  • No condition (e.g., severe arthritis, central pain) that would interfere with movement of the legs, ability to understand verbal commands and cooperate with test procedures.
  • No condition that would pose a risk to the application of electrical current to the body (e.g., skin conditions or skin breakdown)

Exclusion Criteria:• Visual impairment such that following visually-guided instructions would be challenging even with ordinary corrective lenses

  • Orthopedic conditions of either arm that would affect performance on study
  • Untreated psychiatric or neurologic disturbances that would affect motivation and trial participation
  • Excessive pain in one or both of the arms (> 5 on a 10-point visual analog scale)
  • Excessive spasticity at one or both arms, as defined as a score of > 2 on the Modified Ashworth Spasticity Scale
  • Advice from any of the participant's health providers that upper extremity powered orthotics or electrical stimulation were contra-indicated
  • Presence of an implanted medical device in the body (such as cardiac pacemaker, implanted defibrillator, metallic device)
  • Metal implants or exposed metal in the weak or paralyzed arm
  • Lack of access to internet or wireless coverage to enable telemedicine-guided sessions
  • Any history of seizure or epilepsy (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation)
  • Currently taking the medication bupropion (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation)
  • Any history of prior neurosurgical procedure (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation)
  • Known or suspected skull defect (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation)
  • Any history of alcohol or other substance use
  • Other conditions or circumstances that, in the opinion of the investigators, would preclude safe and/or effective participation, including severe skin conditions, and/or other sequelae that may be contraindicated for using a powered orthotic or using electrical stimulation, as well as personal circumstances

Sites / Locations

  • Nemours Children's HospitalRecruiting
  • Thomas Jefferson UniversityRecruiting

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

Treatment Arm

Arm Description

Participants will received a customized NuroSleeve and undergo 8 weeks of occupational therapy using the NuroSleeve (135 minutes per week for 8 weeks: this can be done as 45 minutes three times per week, 68 minute sessions twice per week, or one 135 minute once per week).

Outcomes

Primary Outcome Measures

Change in Canadian Occupational Performance Measure score at 8 weeks
The Canadian Occupational Performance Measure (COPM) is an individualized measure designed for use by occupational therapists to detect self-perceived change in occupational performance problems over time. From Law et al., 2000.

Secondary Outcome Measures

Change from Baseline Action Research Arm Test (ARAT) score at 8 weeks
The Action Research Arm Test (ARAT) measures specific changes in the arm function in people who sustained cerebral damage resulting in arm weakness. The ARAT consists of 19 items grouped into four subscales: grasp, grip, pinch and gross movements. Each sub scale has items ordered according to ascending difficulty: 0- can not perform any part of the test, 1- performs the test partialy, 2- completes the test, but takes abnormally long time, 3- performs the test normally. The sum of all subscales are added to compute the total score. The total score ranges between 0 to 57. The higher score is considered to be better outcome. From: Yozbatiran et al. A standardized approach to performing the action research arm test. Neurorehabil. Neural Repair, 2008.

Full Information

First Posted
March 10, 2021
Last Updated
April 11, 2023
Sponsor
Thomas Jefferson University
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1. Study Identification

Unique Protocol Identification Number
NCT04798378
Brief Title
NuroSleeve Powered Brace & Stimulation System to Restore Arm Function
Official Title
Myoelectric Devices for Restoration of Independent Arm Function in Children and Adults With Neurological Disease and Injury
Study Type
Interventional

2. Study Status

Record Verification Date
April 2023
Overall Recruitment Status
Recruiting
Study Start Date
April 16, 2020 (Actual)
Primary Completion Date
December 2025 (Anticipated)
Study Completion Date
December 2025 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
Thomas Jefferson University

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
Yes
Product Manufactured in and Exported from the U.S.
Yes

5. Study Description

Brief Summary
The purpose of this study is to investigate if a person with weakness or paralysis in one or both arms, can use the NuroSleeve combined powered arm brace (orthosis) and muscle stimulation system to help restore movement in one arm sufficient to perform daily activities. This study could lead to the development of a product that could allow people with arm weakness or arm paralysis to use the NuroSleeve and similar devices to improve arm health and independent function.
Detailed Description
People can develop arm weakness due to stroke and other neurological conditions. Portable powered braces and functional electrical stimulation can help restore functional arm movement in these individuals. Powered braces and muscle stimulation may be triggered by detecting movement or electrical activity of proximal muscles that the person still can control. The overall objective of this study is to establish that children and adults with chronic, stable neurological motor impairment can achieve voluntary control over the NuroSleeve upper extremity orthosis and functional electrical stimulation system, and that they can use this voluntary control to perform functionally beneficial tasks to enhance independence, mental and physical health. While myoelectric prostheses have been studied for decades in children with limb loss, it is necessary to gather pilot data on the use of orthoses with optional electrical stimulation in people with intact yet paralyzed limbs. These adults and children have persistent motor deficits even after intensive physical and occupational therapy. The NuroSleeve and similar devices could help all people who have arm weakness.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Neurologic Diseases, Hemiparesis, Quadriplegia, Muscular Dystrophies, Arthrogryposis, Spinal Cord Injuries, Charcot-Marie-Tooth, Stroke, Weakness of Extremities as Sequela of Stroke, Weakness Due to Upper Motor Neuron Dysfunction, Amyotrophic Lateral Sclerosis, Spinal Muscular Atrophy, Arm Paralysis, Cerebral Palsy
Keywords
Arm weakness, paralysis, orthosis, functional electrical stimulation, brace

7. Study Design

Primary Purpose
Supportive Care
Study Phase
Not Applicable
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Treatment Arm
Arm Type
Experimental
Arm Description
Participants will received a customized NuroSleeve and undergo 8 weeks of occupational therapy using the NuroSleeve (135 minutes per week for 8 weeks: this can be done as 45 minutes three times per week, 68 minute sessions twice per week, or one 135 minute once per week).
Intervention Type
Device
Intervention Name(s)
Neurosleeve
Intervention Description
Myoelectric devices for restoration of independent arm function
Primary Outcome Measure Information:
Title
Change in Canadian Occupational Performance Measure score at 8 weeks
Description
The Canadian Occupational Performance Measure (COPM) is an individualized measure designed for use by occupational therapists to detect self-perceived change in occupational performance problems over time. From Law et al., 2000.
Time Frame
8 weeks
Secondary Outcome Measure Information:
Title
Change from Baseline Action Research Arm Test (ARAT) score at 8 weeks
Description
The Action Research Arm Test (ARAT) measures specific changes in the arm function in people who sustained cerebral damage resulting in arm weakness. The ARAT consists of 19 items grouped into four subscales: grasp, grip, pinch and gross movements. Each sub scale has items ordered according to ascending difficulty: 0- can not perform any part of the test, 1- performs the test partialy, 2- completes the test, but takes abnormally long time, 3- performs the test normally. The sum of all subscales are added to compute the total score. The total score ranges between 0 to 57. The higher score is considered to be better outcome. From: Yozbatiran et al. A standardized approach to performing the action research arm test. Neurorehabil. Neural Repair, 2008.
Time Frame
8 Weeks
Other Pre-specified Outcome Measures:
Title
Change from Baseline Motricity Index score at 8 weeks
Description
The Motricity Index measures strength in the arms and legs after stroke. The weighted score is based on the ordinal 6 point scale of Medical Research Council to measure maximal isometric muscle strength. From: Collin and Wade. Assessing motor impairment after stroke: A pilot reliability study. J. Neurol. Neurosurg. Psychiatry, 1990.
Time Frame
8 weeks
Title
Change in ABILHAND-Kids questionnaire score at 8 weeks (for participants aged < 18)
Description
The ABILHAND-Kids questionnaire was developed as a measure of manual ability and explores the most representative inventory of manual activities. The 21 items of ABILHAND-Kids defined a valid and reliable manual ability scale.
Time Frame
8 weeks
Title
Change in Box and Blocks score at 8 weeks
Description
The experimented counts how many uniformly sized cubes that can be moved from one half of an opened wooden box, over a partition to the other half of the opened box the participant can move in one minute, This measure reflects dexterity, grasp strength, ability to release, and speed of movement and will be performed while the participant is using the NuroSleeve. From Mathiowetz et al, 1985.
Time Frame
8 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
4 Years
Accepts Healthy Volunteers
Accepts Healthy Volunteers
Eligibility Criteria
Inclusion Criteria:• Must be 4 years or older Must have weakness in one or both arms such that flexion or extension of the wrist, elbow or shoulder are 3/5 or less on the Manual Muscle Testing Scale The etiology of weakness is due to a neurological disease or injury or orthopedic condition that occurred 6 or more months ago Participant is willing to comply with trial instructions Adult participant is able to provide informed consent prior to enrollment in the study, and for children, child is able to provide assent and designated caregiver (parent or guardian) is able to provide informed consent The participant is fluent in English and, if the participant were a child, at least one parent/guardian were fluent in English Medically stable and living at home in the community. No joint contracture, spasticity or other limitations to range of motion in the affected lower limb(s) precluding the operation of a wearable, powered orthotic device on the arm Sufficient sitting balance to sit in a chair No condition (e.g., severe arthritis, central pain) that would interfere with movement of the legs, ability to understand verbal commands and cooperate with test procedures. No condition that would pose a risk to the application of electrical current to the body (e.g., skin conditions or skin breakdown) Exclusion Criteria:• Visual impairment such that following visually-guided instructions would be challenging even with ordinary corrective lenses Orthopedic conditions of either arm that would affect performance on study Untreated psychiatric or neurologic disturbances that would affect motivation and trial participation Excessive pain in one or both of the arms (> 5 on a 10-point visual analog scale) Excessive spasticity at one or both arms, as defined as a score of > 2 on the Modified Ashworth Spasticity Scale Advice from any of the participant's health providers that upper extremity powered orthotics or electrical stimulation were contra-indicated Presence of an implanted medical device in the body (such as cardiac pacemaker, implanted defibrillator, metallic device) Metal implants or exposed metal in the weak or paralyzed arm Lack of access to internet or wireless coverage to enable telemedicine-guided sessions Any history of seizure or epilepsy (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation) Currently taking the medication bupropion (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation) Any history of prior neurosurgical procedure (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation) Known or suspected skull defect (only an exclusion criterion for those seeking to undergo optional transcranial magnetic stimulation) Any history of alcohol or other substance use Other conditions or circumstances that, in the opinion of the investigators, would preclude safe and/or effective participation, including severe skin conditions, and/or other sequelae that may be contraindicated for using a powered orthotic or using electrical stimulation, as well as personal circumstances
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Erica Jones
Phone
215-503-4042
Email
CenterNR@jefferson.edu
Facility Information:
Facility Name
Nemours Children's Hospital
City
Wilmington
State/Province
Delaware
ZIP/Postal Code
19803
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erica Jones, BA
Phone
215-503-4042
Email
CenterNR@jefferson.edu
First Name & Middle Initial & Last Name & Degree
Mena Scavina, DO
Email
Mena.Scavina@nemours.org
First Name & Middle Initial & Last Name & Degree
Mena Scavina, DO
Facility Name
Thomas Jefferson University
City
Philadelphia
State/Province
Pennsylvania
ZIP/Postal Code
19107
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Erica Jones
Phone
215-503-4042
Email
CenterNR@jefferson.edu
First Name & Middle Initial & Last Name & Degree
Mijail Serruya, MD, PhD

12. IPD Sharing Statement

Links:
URL
https://research.jefferson.edu/labs/researcher/serruya-research.html
Description
Neurorestoration laboratory web page

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NuroSleeve Powered Brace & Stimulation System to Restore Arm Function

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