NCT04752982

Brief Summary

Spatial neglect is a common post-stroke condition in which people may not be aware of anything on one side of the world (usually the same side they lost their movement). Currently, there is no effective treatment for spatial neglect. A therapy called SIGHT (Spatial Inattention Grasping Home-based Therapy) has shown early evidence of improving stroke survivors' spatial neglect (Rossit et al., 2019). SIGHT involves individuals picking-up and balance wooden rods with their less affected hand, independently, without the need for a therapist present at all times. Working with stroke survivors, carers and clinicians we have developed of a computerized version of SIGHT (c-SIGHT; Morse et al., in press). The present trial aims to: 1) investigate the feasibility of a blinded randomized controlled trial of c-SIGHT (active intervention) vs. an attentional control training version of c-SIGHT (sham intervention) in the homes of stroke survivors with spatial neglect; 2) Explore participant's experience using c-SIGHT independently at home; and 3) Explore the potential effects and effect size of c-SIGHT active intervention compared to the attentional control training to inform a future Phase II trial.

Trial Health

43
At Risk

Trial Health Score

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

Trial has exceeded expected completion date
Enrollment
46

participants targeted

Target at P50-P75 for not_applicable stroke

Timeline
Completed

Started Feb 2021

Geographic Reach
1 country

4 active sites

Status
unknown

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

First Submitted

Initial submission to the registry

February 7, 2021

Completed
5 days until next milestone

First Posted

Study publicly available on registry

February 12, 2021

Completed
13 days until next milestone

Study Start

First participant enrolled

February 25, 2021

Completed
1.6 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

September 30, 2022

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

September 30, 2022

Completed
Last Updated

July 12, 2021

Status Verified

July 1, 2021

Enrollment Period

1.6 years

First QC Date

February 7, 2021

Last Update Submit

July 9, 2021

Conditions

Keywords

StrokeSpatial Neglectc-SIGHTFeasibility TrialTelerehabilitionHome-based therapyAttention

Outcome Measures

Primary Outcomes (8)

  • Recruitment rate

    Rate of participants recruited into the trial amongst all participants screened

    Through study completion, approximately 2 years

  • Exclusion rate

    Rate of participants excluded from participating amongst all participants screened

    Through study completion, approximately 2 years

  • Attrition rate

    Rate of participants and data lost

    Through study completion, approximately 2 years

  • Follow-up rate

    Rate of participants included at follow-up

    Through study completion, approximately 2 years

  • Time required to collect and analyze data

    Time required for data collection and analysis will be computed per participant.

    Through study completion, approximately 2 years

  • c-SIGHT compliance

    Measured using short videos of participants carrying out first and final session of c-SIGHT. Following the participant's completion of the trial, videos will be reviewed by the research team to monitor whether participants and therapists deviated from instructions. Photo of set-up of first and last day of the training phase will also be checked to confirm set-up of equipment was correct and constant throughout the training phase.

    10 days

  • Blinding and allocation success

    Evaluated by the frequency of unblinding occurred among stroke survivors, carers and outcome assessors and clinical care team. Success of allocation method using minimisation will be evaluated by measuring homogeneity of the two groups on co-variates such as age, time since stroke, hemisphere damage and neglect severity.

    Through study completion, approximately 2 years

  • Adherence to c-SIGHT protocol

    The number of trials performed and length will be computed per session via a motion-tracking sensor.

    Through study completion, approximately 2 years

Secondary Outcomes (15)

  • Star cancellation test

    Baseline (T0, before intervention), post-training (T1, after 10 days of intervention) and at follow-up (T2, after 1 month post-training)

  • Line bisection test

    Baseline (T0, before intervention), post-training (T1, after 10 days of intervention) and at follow-up (T2, after 1 month post-training)

  • Computerised Extrapersonal Neglect Test (CENT)

    Baseline (T0, before intervention), post-training (T1, after 10 days of intervention) and at follow-up (T2, after 1 month post-training)

  • Oxford Cognitive Screen

    Baseline (T0, before intervention)

  • Broken Hearts test

    Baseline (T0, before intervention), post-training (T1, after 10 days of intervention) and at follow-up (T2, after 1 month post-training)

  • +10 more secondary outcomes

Study Arms (2)

c-SIGHT intervention

ACTIVE COMPARATOR

Grasp, lift and balance three wooden rods of different lengths.

Behavioral: c-SIGHT intervention

c-SIGHT attentional control

SHAM COMPARATOR

Grasp and lift three wooden rods of different lengths from one end only (no attempt to balance rods).

Behavioral: c-SIGHT attentional control

Interventions

The c-SIGHT active intervention involves grasping, lifting and balancing wooden rods using the unaffected hand. C-SIGHT uses a training mat, three wooden rods of different lengths, a laptop (to run the computer program) and a small motion tracking sensor which records the user's session length and trials completed. The participant's existing television is used to present the program (connected to the laptop).

c-SIGHT intervention

The c-SIGHT attentional control exercises involves grasping and lifting wooden rods from one end using the unaffected hand. Identical to the intervention group, the c-SIGHT attentional control version uses a training mat, three wooden rods of different lengths, a laptop (to run the computer program) and a small motion tracking sensor which records the user's session length and trials completed. The participant's existing television is used to present the program (connected to the laptop).

c-SIGHT attentional control

Eligibility Criteria

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

You may not qualify if:

  • years and older
  • At least one-week post-stroke
  • Stroke confirmed using clinical neuroimaging (head CT or MRI)
  • Medically stable (as confirmed by the stroke service medical team responsible for the individual's stroke care)
  • Capacity to give informed consent (as confirmed by the stroke service medical team responsible for the individual's stroke care and/or PI)
  • Able to follow and execute a two-step command (e.g. "lift and balance this pen/pencil")
  • Live within 70 miles of the University of East Anglia
  • Signs of spatial neglect either via clinical assessment (e.g. star cancellation test; BIT) or observation
  • History of other neurological conditions (e.g. dementia, brain tumour, Parkinson's disease, previous strokes)
  • Bilateral impairment in arms (unable to move both arms)
  • Taking part in a stroke rehabilitation research trial (which includes an intervention)
  • years and older
  • Capacity to give informed consent
  • Carer of stroke survivor in trial
  • Live within 70 miles of the University of East Anglia

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (4)

Cambridge University Hospital

Cambridge, United Kingdom

RECRUITING

Cambridgeshire and Peterborough NHS Foundation Trust

Cambridge, United Kingdom

ACTIVE NOT RECRUITING

Norfolk & Norwich University Hospital NHS Foundation Trust

Norwich, United Kingdom

RECRUITING

Norfolk Community Health and Care NHS Trust

Norwich, United Kingdom

RECRUITING

Related Publications (2)

  • Rossit S, Benwell CSY, Szymanek L, Learmonth G, McKernan-Ward L, Corrigan E, Muir K, Reeves I, Duncan G, Birschel P, Roberts M, Livingstone K, Jackson H, Castle P, Harvey M. Efficacy of home-based visuomotor feedback training in stroke patients with chronic hemispatial neglect. Neuropsychol Rehabil. 2019 Mar;29(2):251-272. doi: 10.1080/09602011.2016.1273119. Epub 2017 Jan 24.

    PMID: 28116988BACKGROUND
  • Morse H, Biggart L, Pomeroy V, Rossit S. Exploring perspectives from stroke survivors, carers and clinicians on virtual reality as a precursor to using telerehabilitation for spatial neglect post-stroke. Neuropsychol Rehabil. 2022 Jun;32(5):707-731. doi: 10.1080/09602011.2020.1819827. Epub 2020 Sep 18.

    PMID: 32942950BACKGROUND

Related Links

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular DisordersBrain DiseasesCentral Nervous System DiseasesNervous System DiseasesVascular DiseasesCardiovascular Diseases

Study Officials

  • Stephanie Rossit, Ph.D

    University of East Anglia

    PRINCIPAL INVESTIGATOR

Central Study Contacts

Stephanie Rossit, PhD

CONTACT

Helen Morse

CONTACT

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
QUADRUPLE
Who Masked
PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
Masking Details
The outcome assessor, stroke survivor, carer, research team and clinical care staff (e.g. GP) will be blinded to group allocation. Participants will not be told if they are in the active or attentional control c-SIGHT group. The set-up and equipment is the same between the two arms and only the instructions differ.
Purpose
TREATMENT
Intervention Model
PARALLEL
Model Details: Participants are randomly allocated (using minimisation) to either the active intervention or attentional control group. Minimisation will use the following parameters: age, days since stroke, side of hemisphere damaged, and neglect severity (measured using the star cancellation test).
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
Lecturer

Study Record Dates

First Submitted

February 7, 2021

First Posted

February 12, 2021

Study Start

February 25, 2021

Primary Completion

September 30, 2022

Study Completion

September 30, 2022

Last Updated

July 12, 2021

Record last verified: 2021-07

Data Sharing

IPD Sharing
Will share

The final anonymised data set will be shared with other researchers through an open repository.

Shared Documents
STUDY PROTOCOL
Time Frame
Study protocol will be published before or soon after recruitment has begun. The final, anonymised data set will be shared on an open repository (e.g., Open Science Framework) after the study has ended.
More information

Locations