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MyndMove Therapy for Severe Hemiparesis of the Upper Limb Following Stroke

Primary Purpose

Stroke

Status
Unknown status
Phase
Not Applicable
Locations
Canada
Study Type
Interventional
Intervention
MyndMove
Sponsored by
University Health Network, Toronto
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Stroke focused on measuring Stroke, Cerebrovascular accident, Upper extremity, Cerebral Infarction, Brain Infarction, Brain Ischemia, Cerebrovascular Disorders, Cardiovascular Diseases, Nervous System Diseases, Central Nervous System Diseases

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Ischemic or hemorrhagic stroke confirmed by MRI or CT scan
  2. Sub-acute subjects at least 10 days post stroke. Chronic subjects at least 6 months post stroke
  3. Chedoke-McMaster Stroke Assessment Stage 1-2 (arm and hand)
  4. Severe hemiplegia of the upper extremity defined as UE-FMA score of less than or equal to 19
  5. Subject is able to follow instructions
  6. Subject is able to sit and participate in one hour of upper limb therapy
  7. Anticipated to be discharged home or already at home following conventional inpatient rehabilitation
  8. Willing to attend outpatient therapy if chronic or late sub-acute
  9. Subject is able and willing to give written informed consent
  10. Men and women aged 18 or older

Exclusion Criteria:

  1. Global Aphasia
  2. Previous history of clinical stroke either ischemic infarct, hemorrhagic and subarachnoid bleeding
  3. Upper extremity injury or condition prior to stroke that limits the function of the hand or arm
  4. Life expectancy of less than 12 months due to other illness
  5. Subject has malignant skin lesion on the affected upper extremity
  6. Subject has history of seizure disorder and on seizure medications
  7. Subject has existing electrical stimulation devices (ICD, Pacemaker, Spinal Stimulation)
  8. Neurologic condition that may affect motor response (e.g. Parkinson's, ALS, MS)
  9. Subject has rash or open wound at any potential electrode site
  10. In the judgment of the medical provider, subject has medical complications that may interfere with the execution of the study
  11. Botulinum toxin (Botox) injection into affected upper extremity at least 3 months before the study or during the study
  12. Currently enrolled in another upper limb study
  13. Enrolled in the past six months in a clinical study involving drugs or biologics

Sites / Locations

  • Toronto Rehab Inst, UHN

Arms of the Study

Arm 1

Arm Type

Experimental

Arm Label

MyndMove

Arm Description

The MyndMove system is a neuromodulation device that delivers short electrical pulses to stimulate muscle contractions and enhance motor recovery following Stroke or Spinal Cord Injury. MyndMove delivers therapeutic stimulation sequences called protocols, which are coded therapeutic algorithms which assist muscle movement allowing the brain and central nervous system to be retrained restoring voluntary reaching and grasping functions lost following neurological injury. The MyndMove system comprises the hardware device, stimulation electrodes and cables, hand and foot switches, and integrated software.

Outcomes

Primary Outcome Measures

Upper Extremity Fugl-Meyer Assessment (UE-FMA)
The Upper Extremity Fugl-Meyer Assessment (UE-FMA) is a standardized scale used for the evaluation of physical performance in the post-stroke hemiplegic patient. The upper extremity (UE) evaluates the function of the upper extremity motor function in four components: Shoulder/Elbow and Forearm, Wrist, Hand and Coordination and Speed in a series of performed tasks. The maximum score associated with the UE-FMA is 66 points. Each of the 33 specific tasks is scored as either 0 or an absence of function to a maximum score of 2 for the tasks being fully completed. Partial function can be scored as 1 for selected tasks. This evaluation will be completed by a trained physiotherapist or occupational therapist. Upper extremity assessment for stroke patients. Clinically Significant change is >6 points

Secondary Outcome Measures

FIM and Self - Care FIM
To measure the degree of disability the Functional Independence Measure will be completed. The FIM consists of 18 items of which 13 are motor related tasks and 5 are cognitive related items. The measure is broken down into 6 classifications of self-care, sphincter control, mobility, locomotion, communication and social cognition. The self-care consists of 6 items: eating, grooming, bathing, dressing-upper body, dressing-lower body, toileting. Each item is rated using a 7-point scale indicating the level of functioning from total assistance with a score of 1 to complete independence with a score of 7.

Full Information

First Posted
October 24, 2017
Last Updated
October 24, 2017
Sponsor
University Health Network, Toronto
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1. Study Identification

Unique Protocol Identification Number
NCT03323632
Brief Title
MyndMove Therapy for Severe Hemiparesis of the Upper Limb Following Stroke
Official Title
Clinical Feasibility and Usability of MyndMove Therapy for FES Facilitated Treatment of Subacute and Chronic Severe Hemiparesis of the Upper Limb Following Stroke
Study Type
Interventional

2. Study Status

Record Verification Date
August 2014
Overall Recruitment Status
Unknown status
Study Start Date
August 2014 (undefined)
Primary Completion Date
September 30, 2018 (Anticipated)
Study Completion Date
December 31, 2018 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University Health Network, Toronto

4. Oversight

Data Monitoring Committee
No

5. Study Description

Brief Summary
The purpose of this study is to examine the efficacy of MyndMove therapy in the early sub-acute, late sub-acute and chronic post-stroke patients. Other objectives include assessing the required doses of electrical current amplitudes, the usability of the device, and examining the overall safety.
Detailed Description
The purpose of this study is to examine the efficacy of MyndMove therapy in the early sub-acute, late sub-acute and chronic post-stroke patients. Other objectives include assessing the required doses of electrical current amplitudes, the usability of the device, and examining the overall safety. Many individuals experience weakness or paralysis of their arms and hands following a stroke. As a result, they are often unable to grasp and reach objects voluntarily and have difficulty performing basic activities of daily living (ADLs) such as dressing, feeding, bathing and grooming. Despite extensive rehabilitation programs, many of these individuals remain dependent on others for assistance with ADLs. This unmet medical need remains the focus of a wide range of research efforts. MyndMove is a newly developed Functional Electrical Stimulation based treatment designed to recover voluntary movement in severely paralyzed upper limbs following stroke and spinal cord injury. This study will enroll stroke patients that have severe hemiparesis of an upper limb (as defined by 1) an UE-FMA score of less than or equal to 19 and 2) a Chedoke McMaster Stage of 1-2 for the arm and hand). Three cohorts of patients enrolled in the study will include: Early sub-acute stroke patients (less than 2 months post stroke) receiving therapy during inpatient rehabilitation; Late sub-acute stroke patients (post-discharge from inpatient rehab and less than 6 months post stroke) receiving therapy in outpatient clinic settings; and Chronic stroke patients (greater than 6 months post stroke) receiving therapy in outpatient clinic settings

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Stroke
Keywords
Stroke, Cerebrovascular accident, Upper extremity, Cerebral Infarction, Brain Infarction, Brain Ischemia, Cerebrovascular Disorders, Cardiovascular Diseases, Nervous System Diseases, Central Nervous System Diseases

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
MyndMove
Arm Type
Experimental
Arm Description
The MyndMove system is a neuromodulation device that delivers short electrical pulses to stimulate muscle contractions and enhance motor recovery following Stroke or Spinal Cord Injury. MyndMove delivers therapeutic stimulation sequences called protocols, which are coded therapeutic algorithms which assist muscle movement allowing the brain and central nervous system to be retrained restoring voluntary reaching and grasping functions lost following neurological injury. The MyndMove system comprises the hardware device, stimulation electrodes and cables, hand and foot switches, and integrated software.
Intervention Type
Device
Intervention Name(s)
MyndMove
Intervention Description
During a MyndMove therapy session, the patient is instructed to attempt to execute a task voluntarily. As the patient is attempting to perform the designated task, specific muscles in the arm are stimulated to generate contractions that produce the desired movement. After a brief interval of the patient attempting to initiate a movement the therapist activates the MyndMove stimulation protocol, which generates bursts of short electrical pulses, using surface electrodes, to produce muscle contractions enabling the patient to complete the desired/instructed task. Proper sequencing of the muscle contractions as per the MyndMove protocols are tailored to achieve a wide range of reaching and grasping functions. The technique stimulates non-damaged pathways of the central nervous system.
Primary Outcome Measure Information:
Title
Upper Extremity Fugl-Meyer Assessment (UE-FMA)
Description
The Upper Extremity Fugl-Meyer Assessment (UE-FMA) is a standardized scale used for the evaluation of physical performance in the post-stroke hemiplegic patient. The upper extremity (UE) evaluates the function of the upper extremity motor function in four components: Shoulder/Elbow and Forearm, Wrist, Hand and Coordination and Speed in a series of performed tasks. The maximum score associated with the UE-FMA is 66 points. Each of the 33 specific tasks is scored as either 0 or an absence of function to a maximum score of 2 for the tasks being fully completed. Partial function can be scored as 1 for selected tasks. This evaluation will be completed by a trained physiotherapist or occupational therapist. Upper extremity assessment for stroke patients. Clinically Significant change is >6 points
Time Frame
baseline to 6 weeks
Secondary Outcome Measure Information:
Title
FIM and Self - Care FIM
Description
To measure the degree of disability the Functional Independence Measure will be completed. The FIM consists of 18 items of which 13 are motor related tasks and 5 are cognitive related items. The measure is broken down into 6 classifications of self-care, sphincter control, mobility, locomotion, communication and social cognition. The self-care consists of 6 items: eating, grooming, bathing, dressing-upper body, dressing-lower body, toileting. Each item is rated using a 7-point scale indicating the level of functioning from total assistance with a score of 1 to complete independence with a score of 7.
Time Frame
Baseline - 6 weeks

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Ischemic or hemorrhagic stroke confirmed by MRI or CT scan Sub-acute subjects at least 10 days post stroke. Chronic subjects at least 6 months post stroke Chedoke-McMaster Stroke Assessment Stage 1-2 (arm and hand) Severe hemiplegia of the upper extremity defined as UE-FMA score of less than or equal to 19 Subject is able to follow instructions Subject is able to sit and participate in one hour of upper limb therapy Anticipated to be discharged home or already at home following conventional inpatient rehabilitation Willing to attend outpatient therapy if chronic or late sub-acute Subject is able and willing to give written informed consent Men and women aged 18 or older Exclusion Criteria: Global Aphasia Previous history of clinical stroke either ischemic infarct, hemorrhagic and subarachnoid bleeding Upper extremity injury or condition prior to stroke that limits the function of the hand or arm Life expectancy of less than 12 months due to other illness Subject has malignant skin lesion on the affected upper extremity Subject has history of seizure disorder and on seizure medications Subject has existing electrical stimulation devices (ICD, Pacemaker, Spinal Stimulation) Neurologic condition that may affect motor response (e.g. Parkinson's, ALS, MS) Subject has rash or open wound at any potential electrode site In the judgment of the medical provider, subject has medical complications that may interfere with the execution of the study Botulinum toxin (Botox) injection into affected upper extremity at least 3 months before the study or during the study Currently enrolled in another upper limb study Enrolled in the past six months in a clinical study involving drugs or biologics
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Debbie A Hebert, MSc(Kin)
Organizational Affiliation
University Health Network, Toronto
Official's Role
Principal Investigator
Facility Information:
Facility Name
Toronto Rehab Inst, UHN
City
Toronto
State/Province
Ontario
ZIP/Postal Code
M5G2A2
Country
Canada

12. IPD Sharing Statement

Citations:
Citation
Hebert, D, Bowen, J. M., Ho, C. Antunes, I, O'Reilly, D. J. and Bayley, M. (2017) Examining a new functional electrical stimulation therapy with people with sever upper extremity hemiparesis and chronic stroke: A feasibility study. British Journal of Occupational Therapy. 0/0: 1 - 10.
Results Reference
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MyndMove Therapy for Severe Hemiparesis of the Upper Limb Following Stroke

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