Hand Rehabilitation Using Botulinum Toxin and Functional Electrical Stimulation-pilot Study
Primary Purpose
Stroke, Spastic Hemiparesis, Spasticity as Sequela of Stroke
Status
Completed
Phase
Phase 4
Locations
Study Type
Interventional
Intervention
Botulinum Toxin Type A 100 unit/Vial (Product)
Sponsored by
About this trial
This is an interventional treatment trial for Stroke focused on measuring stroke, hand, botulinum toxin, functional electrical stimulation
Eligibility Criteria
Inclusion Criteria:
- age over 18 years
- hemiplegic upper limb spasticity secondary to a unilateral ischemic or hemorrhagic stroke
- fingers and wrist flexor spasticity graded at least 1+ on the Modified Ashworth Scale
- at least 6 months since stroke
Exclusion Criteria:
- fixed contracture
- previous treatment of the upper limb spasticity with neurolytic or surgical procedure
- treatment with botulinum toxin type A in the previous 4 months
- any active device implant
- any neurological disorder, other than stroke causing motor deficits or spasticity
- inability to attend to and/or to cooperate with all outcome measure-related task secondary to cognitive impairment or aphasia
- pregnancy, planned pregnancy, or lactation
- contraindication to botulinum toxin type A
Sites / Locations
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Botulinum toxin type A injection
Arm Description
Botulinum toxin type A injection followed by functional electrical stimulation
Outcomes
Primary Outcome Measures
Change in Box and Block test
number of box moved by affected upper extremity
Change of Action Research Arm Test
Score of Action Research Arm Test
Secondary Outcome Measures
Muscle strength of finger extensor
Medical research council grading of muscle strength
Spasticity of finger extensor
Modified ashworth scale of finger flexor
active range of motion of wrist joint
active range of motion of wrist joint
Brunnstrom stage of stroke recovery of distal upper extremity
Brunnstrom stage of stroke recovery of distal upper extremity. By observing the pattern of participants posture, the stage was scored. The stage ranges from 1 to 6. Higher is better.
Distance from middle finger tip to mid-palmar crease
Distance from middle finger tip to mid-palmar crease
Repeated number of finger extension and flexion
Repeated number of finger extension and flexion
Quick Disabilities of Arm, Shoulder & Hand
Quick Disabilities of Arm, Shoulder & Hand is questionnaire about patients' symptoms as well as ability to perform certain activities in the last week.
Total score is obtained by summing the each question, and ranges from 0 (no disability) to 100 (most severe disability).
Grading of active thumb opposition
Grading of active thumb opposition. It is measured by observing the pattern of thumb opposition.
Grip strength
measured by Jamar dynamometer
Active finger extension
Active finger extension. It is graded by observation of voluntary finger extension.
Full Information
NCT ID
NCT03549975
First Posted
May 16, 2018
Last Updated
May 25, 2018
Sponsor
National Rehabilitation Center, Seoul, Korea
1. Study Identification
Unique Protocol Identification Number
NCT03549975
Brief Title
Hand Rehabilitation Using Botulinum Toxin and Functional Electrical Stimulation-pilot Study
Official Title
Hand Rehabilitation Using Botulinum Toxin and Functional Electrical Stimulation Among Stroke Patients With Limitation of Finger Extension Due to Spasticity- Pilot Study
Study Type
Interventional
2. Study Status
Record Verification Date
May 2018
Overall Recruitment Status
Completed
Study Start Date
May 18, 2016 (Actual)
Primary Completion Date
August 18, 2017 (Actual)
Study Completion Date
August 18, 2017 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Principal Investigator
Name of the Sponsor
National Rehabilitation Center, Seoul, Korea
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
The investigator tried to find out possibility of functional improvement using botulinum toxin injection targeting finger flexor spasticity with functional electrical stimulation among chronic stroke patients who did not show any improvement in hand function.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke, Spastic Hemiparesis, Spasticity as Sequela of Stroke
Keywords
stroke, hand, botulinum toxin, functional electrical stimulation
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
20 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Botulinum toxin type A injection
Arm Type
Experimental
Arm Description
Botulinum toxin type A injection followed by functional electrical stimulation
Intervention Type
Drug
Intervention Name(s)
Botulinum Toxin Type A 100 unit/Vial (Product)
Other Intervention Name(s)
functional electrical stimulation
Intervention Description
Botulinum toxin type A injection followed by functional electrical stimulation
Primary Outcome Measure Information:
Title
Change in Box and Block test
Description
number of box moved by affected upper extremity
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Change of Action Research Arm Test
Description
Score of Action Research Arm Test
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Secondary Outcome Measure Information:
Title
Muscle strength of finger extensor
Description
Medical research council grading of muscle strength
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Spasticity of finger extensor
Description
Modified ashworth scale of finger flexor
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
active range of motion of wrist joint
Description
active range of motion of wrist joint
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Brunnstrom stage of stroke recovery of distal upper extremity
Description
Brunnstrom stage of stroke recovery of distal upper extremity. By observing the pattern of participants posture, the stage was scored. The stage ranges from 1 to 6. Higher is better.
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Distance from middle finger tip to mid-palmar crease
Description
Distance from middle finger tip to mid-palmar crease
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Repeated number of finger extension and flexion
Description
Repeated number of finger extension and flexion
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Quick Disabilities of Arm, Shoulder & Hand
Description
Quick Disabilities of Arm, Shoulder & Hand is questionnaire about patients' symptoms as well as ability to perform certain activities in the last week.
Total score is obtained by summing the each question, and ranges from 0 (no disability) to 100 (most severe disability).
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Grading of active thumb opposition
Description
Grading of active thumb opposition. It is measured by observing the pattern of thumb opposition.
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Grip strength
Description
measured by Jamar dynamometer
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
Title
Active finger extension
Description
Active finger extension. It is graded by observation of voluntary finger extension.
Time Frame
baseline, 2 weeks after baseline, 6 weeks after baseline, 10 weeks after baseline
10. Eligibility
Sex
All
Minimum Age & Unit of Time
19 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
age over 18 years
hemiplegic upper limb spasticity secondary to a unilateral ischemic or hemorrhagic stroke
fingers and wrist flexor spasticity graded at least 1+ on the Modified Ashworth Scale
at least 6 months since stroke
Exclusion Criteria:
fixed contracture
previous treatment of the upper limb spasticity with neurolytic or surgical procedure
treatment with botulinum toxin type A in the previous 4 months
any active device implant
any neurological disorder, other than stroke causing motor deficits or spasticity
inability to attend to and/or to cooperate with all outcome measure-related task secondary to cognitive impairment or aphasia
pregnancy, planned pregnancy, or lactation
contraindication to botulinum toxin type A
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Joon-Ho Shin, MS
Organizational Affiliation
National Rehabilitation Center of Korea
Official's Role
Principal Investigator
12. IPD Sharing Statement
Learn more about this trial
Hand Rehabilitation Using Botulinum Toxin and Functional Electrical Stimulation-pilot Study
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