NCT04562415

Brief Summary

This study is aimed to investigate the effect of continuous theta burst stimulation (cTBS) and low frequency repetitive transcranial magnetic stimulation (rTMS) on upper extremity spasticity and functional recovery in patients with chronic ischemic stroke.

Trial Health

87
On Track

Trial Health Score

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

Enrollment
20

participants targeted

Target at below P25 for not_applicable stroke

Timeline
Completed

Started Oct 2018

Shorter than P25 for not_applicable stroke

Geographic Reach
1 country

1 active site

Status
completed

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

Trial Relationships

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Study Timeline

Key milestones and dates

Study Start

First participant enrolled

October 1, 2018

Completed
7 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2019

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2019

Completed
1.4 years until next milestone

First Submitted

Initial submission to the registry

September 19, 2020

Completed
5 days until next milestone

First Posted

Study publicly available on registry

September 24, 2020

Completed
Last Updated

September 28, 2020

Status Verified

September 1, 2020

Enrollment Period

7 months

First QC Date

September 19, 2020

Last Update Submit

September 24, 2020

Conditions

Keywords

StrokeRepetitive Transcranial Magnetic StimulationContinuous Theta Burst StimulationFunctional RecoverySpasticity

Outcome Measures

Primary Outcomes (2)

  • Upper Extremity Fugl-Meyer Motor Function Scale

    Scale measures level of upper extremity motor functions (min-max: 18-126 points). Higher values represent a better outcome.

    up to 6 weeks

  • Modified Ashworth Scale

    Scale measures muscle tone (spasticity) (min-max:0-4). Higher values represent a worse outcome.

    up to 6 weeks

Secondary Outcomes (3)

  • Functional Independence Measure

    up to 6 weeks

  • Motor Activity Log-28

    up to 6 weeks

  • Brunnstrom Motor Recovery Scale

    up to 6 weeks

Study Arms (3)

Active rTMS group

ACTIVE COMPARATOR

chronic ischemic stroke patients receiving active low frequency repetitive transcranial magnetic stimulation therapy and physical therapy

Device: Active Repetitive Transcranial Magnetic Stimulation Therapy

Active cTBS group

ACTIVE COMPARATOR

chronic ischemic stroke patients receiving active continuous theta burst stimulation therapy and physical therapy

Device: Active Continuous Theta Burst Stimulation Therapy

Sham cTBS group

SHAM COMPARATOR

chronic ischemic stroke patients receiving sham continuous theta burst stimulation therapy and physical therapy

Device: Sham Continuous Theta Burst Stimulation Therapy

Interventions

10 sessions of intact hemispheric upper extremity motor area (M1) were targeted and inhibitor rTMS was applied with a frequency of 1 Hz consisting of 1200 pulses for 20 minutes. In addition, within 30 minutes after TMS sessions, all patients underwent 10 sessions of joint range of motion, stretching, strengthening, balance and coordination exercises, hand rehabilitation and daily living activities.

Also known as: Rehabilitation Program
Active rTMS group

10 sessions of intact hemispheric upper extremity motor area (M1) were targeted and cTBS was administered for a total of 600 pulses consisting of 3 burst stimulations of 50 Hz repeated every 200 milliseconds for 40 seconds. In addition, within 30 minutes after TMS sessions, all patients underwent 10 sessions of joint range of motion, stretching, strengthening, balance and coordination exercises, hand rehabilitation and daily living activities.

Also known as: Rehabilitation Program
Active cTBS group

10 sessions of intact hemispheric upper extremity motor area (M1) were targeted and sham cTBS was administered for a total of 600 pulses consisting of 3 burst stimulations of 50 Hz repeated every 200 milliseconds for 40 seconds. In addition, within 30 minutes after TMS sessions, all patients underwent 10 sessions of joint range of motion, stretching, strengthening, balance and coordination exercises, hand rehabilitation and daily living activities.

Also known as: Rehabilitation Program
Sham cTBS group

Eligibility Criteria

Age18 Years - 80 Years
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • ischemic stroke with a disease interval of 6 months to 2 years
  • aged between 18-80 years
  • Mini mental test score ≥ 24
  • upper limb Brunnstrom recovery stage 3 to 5
  • upper extremity (elbow, wrist and finger) spasticity level Modified Ashworth Scale (MAS) 1+ to 3

You may not qualify if:

  • hemorrhagic stroke
  • history of epilepsy
  • a cardiac pacemaker
  • pregnancy
  • history of previous stroke or ischemic attack
  • neurological diseases other than stroke
  • metallic implant in brain or scalp (including cochlear implant)
  • previous brain surgery
  • orthopedic disease that prevents upper extremity movements
  • poor general health (due to heart failure, chronic obstructive pulmonary disease, severe infection, etc.)
  • diagnosis of malignancy
  • injections of botulinum toxin in the last 6 months for the affected upper extremity
  • drug or dosage changes of anti-spasticity medications in the last 1 month period

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Gaziler PMR, Training and Research Hospital, Department of PMR

Ankara, Çankaya, 06100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

StrokeMuscle Spasticity

Interventions

Rehabilitation

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular DiseasesMuscular DiseasesMusculoskeletal DiseasesMuscle HypertoniaNeuromuscular ManifestationsNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and Symptoms

Intervention Hierarchy (Ancestors)

AftercareContinuity of Patient CarePatient CareTherapeuticsHealth ServicesHealth Care Facilities Workforce and Services

Study Officials

  • Bilge Yılmaz, Professor,MD

    Gaziler PMR, Training and Research Hospital, Department of PMR

    STUDY DIRECTOR
  • Ömer Kuzu, MD

    Gaziler PMR, Training and Research Hospital, Department of PMR

    PRINCIPAL INVESTIGATOR

Study Design

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

Study Record Dates

First Submitted

September 19, 2020

First Posted

September 24, 2020

Study Start

October 1, 2018

Primary Completion

May 1, 2019

Study Completion

May 1, 2019

Last Updated

September 28, 2020

Record last verified: 2020-09

Data Sharing

IPD Sharing
Will not share

Locations