NCT02645344

Brief Summary

The objective was to compare the effects of repetitive Transcranial Magnetic Stimulation (rTMS) combined with sensory cueing (SC), rTMS alone, and conventional rehabilitation on reducing unilateral neglect (UN) and improving hemiplegic arm functions and performance of activities of daily living (ADL). Sixty subacute patients with left UN after right-hemispheric stroke were randomly assigned to three groups; rTMS combined with SC, rTMS alone, and conventional rehabilitation. rTMS at 1 Hz was applied over P5 of the contralesional hemisphere while vibration cueing was emitted using a wristwatch device on the hemiplegic arm, five days per week for two weeks. The first two groups received the same dosage of conventional rehabilitation on top of their experimental interventions. Blinded assessments were administered at baseline, 2 weeks postintervention, and four-week follow-up upon completion of training.

Trial Health

100
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
60

participants targeted

Target at P50-P75 for not_applicable stroke

Timeline
Completed

Started Jun 2013

Typical duration for not_applicable stroke

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

Study Start

First participant enrolled

June 1, 2013

Completed
1.9 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2015

Completed
3 months until next milestone

Study Completion

Last participant's last visit for all outcomes

August 1, 2015

Completed
5 months until next milestone

First Submitted

Initial submission to the registry

December 23, 2015

Completed
9 days until next milestone

First Posted

Study publicly available on registry

January 1, 2016

Completed
Last Updated

January 5, 2016

Status Verified

January 1, 2016

Enrollment Period

1.9 years

First QC Date

December 23, 2015

Last Update Submit

January 3, 2016

Conditions

Keywords

Unilateral neglectRight hemiplegia

Outcome Measures

Primary Outcomes (2)

  • Behavior Inattention Test (BIT)

    Change from baseline in 4 weeks (baseline, 2-week and 2-week after training)

  • Catherine Bergego Scale (CBS)

    Change from baseline in 4 weeks (baseline, 2-week and 2-week after training)

Secondary Outcomes (3)

  • Fugl-Meyer Assessment (FMA)

    Change from baseline in 4 weeks (baseline, 2-week and 2-week after training)

  • Action Research Arm Test (ARAT)

    Change from baseline in 4 weeks (baseline, 2-week and 2-week after training)

  • Modified Barthel index (MBI)

    Change from baseline in 4 weeks (baseline, 2-week and 2-week after training)

Study Arms (3)

Repetitive Transcranial Magnetic Stimulation (rTMS)

EXPERIMENTAL

Low frequency rTMS at 1 Hz was applied over P5 of the contralesional hemisphere in addition to conventional rehabilitation

Device: Repetitive Transcranial Magnetic Stimulation (rTMS)Behavioral: Conventional Rehabilitation

rTMS combined with sensory cueing (SC)

EXPERIMENTAL

Vibration cueing was emitted using a wristwatch device on the hemiplegic arm combined with low frequency rTMS in addition to conventional rehabilitation

Device: Repetitive Transcranial Magnetic Stimulation (rTMS)Behavioral: Sensory Cueing (SC)Behavioral: Conventional Rehabilitation

Conventional rehabilitation

ACTIVE COMPARATOR

Physical therapy and occupational therapy

Behavioral: Conventional Rehabilitation

Interventions

Repetitive Transcranial Magnetic Stimulation (rTMS)rTMS combined with sensory cueing (SC)
rTMS combined with sensory cueing (SC)
Conventional rehabilitationRepetitive Transcranial Magnetic Stimulation (rTMS)rTMS combined with sensory cueing (SC)

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Diagnosis of right-hemispheric stroke
  • Duration since onset of more than one week
  • Presenting with unilateral neglect, confirmed by the conventional subtests of the BIT with cutoff scores of 129
  • First-ever stroke, or unilateral neglect as the consequence of the last stroke
  • Being aged 18 or over
  • Mini Mental State Examination score of ≥17
  • Giving written consent to participate.

You may not qualify if:

  • Duration since onset of stroke of more than six months
  • Medically unstable
  • Epileptic seizures, unconsciousness, or intracranial hypertension
  • Serious heart disease
  • Gravid
  • Severe aphasia so as to have difficulty understanding the therapists' instructions
  • Metal implants in vivo

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Related Publications (2)

  • Fong KN, Lo PC, Yu YS, Cheuk CK, Tsang TH, Po AS, Chan CC. Effects of sensory cueing on voluntary arm use for patients with chronic stroke: a preliminary study. Arch Phys Med Rehabil. 2011 Jan;92(1):15-23. doi: 10.1016/j.apmr.2010.09.014.

    PMID: 21187201BACKGROUND
  • Fong KN, Yang NY, Chan MK, Chan DY, Lau AF, Chan DY, Cheung JT, Cheung HK, Chung RC, Chan CC. Combined effects of sensory cueing and limb activation on unilateral neglect in subacute left hemiplegic stroke patients: a randomized controlled pilot study. Clin Rehabil. 2013 Jul;27(7):628-37. doi: 10.1177/0269215512471959. Epub 2013 Feb 12.

    PMID: 23405025BACKGROUND

MeSH Terms

Conditions

Stroke

Interventions

Transcranial Magnetic Stimulation

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Intervention Hierarchy (Ancestors)

Magnetic Field TherapyTherapeutics

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
SINGLE
Who Masked
OUTCOMES ASSESSOR
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Associate Professor

Study Record Dates

First Submitted

December 23, 2015

First Posted

January 1, 2016

Study Start

June 1, 2013

Primary Completion

May 1, 2015

Study Completion

August 1, 2015

Last Updated

January 5, 2016

Record last verified: 2016-01

Data Sharing

IPD Sharing
Will not share