Sub-Acute Stroke Rehabilitation With AMES

This study is ongoing, but not recruiting participants.
Sponsor:
Collaborators:
NW Medical Rehabilitation
Emory University
University of California, San Francisco
Rehabilitation Institute of Chicago
Eisenhower Medical Center
Information provided by (Responsible Party):
AMES Technology
ClinicalTrials.gov Identifier:
NCT00609115
First received: December 27, 2007
Last updated: January 16, 2014
Last verified: January 2014
  Purpose

The AMES device is designed to produce functional cortical changes by:(1) assisting the subject as he/she attempts to move the limb (assisted movement) and (2) enhancing movement sensation by vibrating the muscles during movement (enhanced sensation). The primary hypothesis is that the combination of assisted movement and enhanced sensation from muscle vibration can increase the amount of motor recovery in individuals disabled by a stroke.


Condition Intervention Phase
Cerebrovascular Stroke
Device: AMES device
Device: AMES device (sham)
Phase 2
Phase 3

Study Type: Interventional
Study Design: Allocation: Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Crossover Assignment
Masking: Double Blind (Subject, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: Sub-Acute Stroke Rehabilitation With Assisted Movement With Enhanced Sensation

Resource links provided by NLM:


Further study details as provided by AMES Technology:

Primary Outcome Measures:
  • Fugl-Meyer Assessment [ Time Frame: Pre-treament, post-treatment, post crossover treatment ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Stroke Impact Scale [ Time Frame: Pre-treatment, post-treatment, post crossover treatment ] [ Designated as safety issue: No ]
  • Gait test [ Time Frame: Pre-treatment, post-treatment, post crossover treatment ] [ Designated as safety issue: No ]
  • Rancho Los Amigos Functional Test [ Time Frame: Pre-treatment, post-treatment, post-crossover treatment ] [ Designated as safety issue: No ]
  • Spasticity (Modified Ashworth) Scale [ Time Frame: Pre-treatment, post-treatment, post crossover treatment ] [ Designated as safety issue: No ]
  • Passive Motion Test [ Time Frame: Prior to each treatment session ] [ Designated as safety issue: No ]
  • Joint Position Test [ Time Frame: Prior to each treatment session ] [ Designated as safety issue: No ]
  • Strength Test [ Time Frame: Prior to each treatment session ] [ Designated as safety issue: No ]

Estimated Enrollment: 132
Study Start Date: September 2007
Estimated Study Completion Date: December 2014
Estimated Primary Completion Date: June 2014 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
Experimental: T
The Test Group will have 18 half hour AMES (Assisted Movement with Enhanced Sensation) treatments per qualified subject limb with the AMES device. Sessions to be scheduled preferably 2 to 3 times per week, with the 18 sessions to be completed within the 6 month anniversary date of the subject's stroke.
Device: AMES device
Eighteen treatment sessions for each qualifying subject limb using the AMES device. Each treatment session being 30 minutes long. Sessions to be scheduled preferable 2 to 3 times per week, with the 18 sessions to be completed within the 6 month anniversary date of the subject's stroke.
Sham Comparator: C-1
Eighteen treatment sessions for each qualifying subject limb using the AMES device programed to provide placebo therapy. Each treatment session consisting of 30 minutes of placebo therapy. Sessions to be scheduled preferably 2 to 3 times per week, with the 18 sessions to be completed within the 6 month anniversary date of the subject's stroke.
Device: AMES device (sham)
Eighteen treatment sessions for each qualifying subject limb using the AMES device. Each treatment session to provide thirty minutes of the placebo form of AMES therapy.
Active Comparator: C-2
Crossover treatment of subjects who received placebo treatment during Phase 1 of the study to provide 18 regular (i.e., non-placebo) AMES (Assisted Movement with Enhanced Sensation) treatment sessions. Sessions to be scheduled preferably 2 to 3 times per week with each session one-half hour in length.
Device: AMES device
Eighteen treatment sessions for each qualifying subject limb using the AMES device. Each treatment session being 30 minutes long. Sessions to be scheduled preferable 2 to 3 times per week, with the 18 sessions to be completed as soon as possible after the completion of Arm C-1 Sham Comparator.

Detailed Description:

Approximately 700,000 U.S. citizens have a stroke each year with about half ending up with significant motor disabilities. There are an estimated 5 million stroke survivors in the U.S., making strokes the leading cause of long-term disability in the U.S.. Existing rehabilitation therapies have not been effective in returning all stroke survivors to full motor recovery.

The AMES device was designed to be able to provide therapy for the ankle joint and the hand (fingers/wrist). Subjects may qualify for one or two limbs. In this 18 treatment sessions, double-blinded, control study, AMES therapy will be provided in addition to the usual physician-ordered rehabilitation during the sub-acute period following a stroke. Those control subject who complete the Phase 1 placebo sessions will have the opportunity to cross-over to participate in a AMES treatment group for a Phase 2.

  Eligibility

Ages Eligible for Study:   18 Years to 80 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Hemispheric stroke (ischemic or hemorrhagic), cortical or sub-cortical, documented by either a CT or MRI scan and associated with residual weakness in the arm and/or leg.
  • First time ever stroke or previous stroke with complete resolution of motor deficit, occurring ≤4 months prior to subject enrollment.
  • Age 18-80 years old.
  • Moderate to severe lower-extremity paresis (defined as a leg motor Fugl-Meyer score of ≥6 and ≤22 out of a possible 34.
  • Moderate to severe upper-extremity paresis (defined as an arm motor Fugl-Meyer score of ≥6 and ≤43 out of a possible 66.
  • Visible voluntary movement of the ankle in at least one direction: dorsiflexion or plantarflexion for the ankle and flexion or extension for the hand.
  • At least partially functioning proprioception from the paretic arm or leg—capable of correctly identifying, ≥70% of the time, the direction of passive joint rotation (i.e., flexion-extension) with eyes closed.
  • Physically and cognitively capable of consenting to and complying with the protocol.
  • Score of <19 out of 63 on the 21-question version of the Beck Depression Inventory.
  • Subject or legally authorized representative must be capable of providing informed consent.-

Exclusion Criteria:

  • Complete flaccidity of the hand, wrist, and ankle.
  • Pathological neurological/physical conditions, other than stroke, impairing the function of the impaired arm or leg or resulting in pain in either the arm or leg.
  • Spinal cord injury, arthritis, or fractures of affected limbs that have resulted in loss of range of motion.
  • Peripheral nerve injury or neuropathy resulting in significant motor or sensory loss in the limb being considered for testing.
  • Cardiopulmonary compromise including but not limited to uncontrolled hypertension or angina, deep vein thrombosis, decompensated congestive heart failure, myocardial infarction, heart irregularities, or exercise intolerance.
  • Major active psychiatric disorder.
  • Severe apraxia; inability to understand verbal (English) directions; or inability to communicate adequately with study personnel.
  • Size of arm or leg incompatible with the AMES device.
  • Severe contractures or decreased range of motion that would prohibit comfortable positioning or tolerance of the device
  • Skin condition not able to tolerate use of the AMES device.
  • Any progressive neurodegenerative disorder affecting the motor system.
  • Uncontrolled seizure disorder.
  • Current abuse of alcohol or drugs.
  • Terminal illness with anticipated survival of <12 months.
  • Current or planned concurrent participation in another study or clinical trial.
  • NIH Stroke Scale, following scores: Item 1a > 0; Item 1c > 0; Item 2 > 0; Item 3 > 0; Item 9 > 2; Item 10 > 1; Item 11 > 1 (based on exam by Study Physician).
  • Intent to receive Botox injections, initiation of antispasmodic medication, or use any other robotic (e.g., MANUS, Locomat) or stimulation device (e.g., Bioness) while participating in the AMES trial.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT00609115

Locations
United States, California
Eisenhower Medical Center
Rancho Mirage, California, United States, 92270
UCSF School of Medicine- Physical Therapy and Rehabilitation
San Francisco, California, United States, 94123
United States, Georgia
Emory University Dept of Rehabilitation Medicine/School of Medicine
Atlanta, Georgia, United States, 30322
United States, Illinois
Rehabilitation Institute of Chicago
Chicago, Illinois, United States, 60611
United States, Washington
NW Medical Rehabilitation
Spokane, Washington, United States, 99202
Sponsors and Collaborators
AMES Technology
NW Medical Rehabilitation
Emory University
University of California, San Francisco
Rehabilitation Institute of Chicago
Eisenhower Medical Center
Investigators
Study Director: Paul J. Cordo, PhD AMES Technology Inc./ Oregon Health and Science University
  More Information

Additional Information:
No publications provided

Responsible Party: AMES Technology
ClinicalTrials.gov Identifier: NCT00609115     History of Changes
Other Study ID Numbers: CT001
Study First Received: December 27, 2007
Last Updated: January 16, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by AMES Technology:
Sub-acute care
Robotics

Additional relevant MeSH terms:
Stroke
Cerebral Infarction
Cerebrovascular Disorders
Brain Diseases
Central Nervous System Diseases
Nervous System Diseases
Vascular Diseases
Cardiovascular Diseases
Brain Infarction
Brain Ischemia

ClinicalTrials.gov processed this record on July 23, 2014