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临床试验 NCT04997109 (APPLES-TELE) 针对脑瘫目前招募中。请查看临床试验雷达卡片视图和 AI 发现工具了解所有详情,或在此提出任何问题。 | ||
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Telemedicine in Early Childhood Constraint Therapy in Cerebral Palsy (APPLES-TELE) 267
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临床试验NCT04997109 (APPLES-TELE)是一项针对脑瘫的干预性研究试验,目前试验状态为招募中。试验始于2022年2月23日,计划招募267名患者。该研究由埃默里大学主导,预计于2027年2月28日完成。试验数据来源于ClinicalTrials.gov,最后更新时间为2025年10月14日。
简要概括
This study assesses two active treatments in different sequences and a standard of care group among infants with cerebral palsy.
详细描述
Cerebral palsy (CP) is a disorder characterized by impairments of sensorimotor function resulting from neural insults in the perinatal period. Every year almost 10,000 children are born with CP in the US. CP incidence ranges from 2 to 3 per 1000 in North America, Australia, and Europe and is difficult to estimate in the developing world. Intervention strategies to promote function of children with CP must be adaptabl...显示更多
官方标题
Telemedicine in Early Childhood Constraint Therapy in Cerebral Palsy
疾病
脑瘫其他研究标识符
- APPLES-TELE
- STUDY00003197
- 2R01HD081120 (美国 NIH 拨款/合同)
NCT编号
实际开始日期
2022-02-23
最近更新发布
2025-10-14
预计完成日期
2027-02-28
计划入组人数
267
研究类型
干预性研究
试验分期 (阶段)
不适用
试验状态
招募中
主要目的
支持治疗
分配方式
随机
干预模型
交叉设计
盲法
单盲
试验组/干预措施
| 参与者组/试验组 | 干预措施/治疗方法 |
|---|---|
实验性APPLES-tele first, then PCA Participants receiving the APPLES-tele intervention for 6 weeks followed by the PCA intervention for 6 weeks. | APPLES-tele The APPLES-tele intervention is 5 weekly telehealth sessions of therapist-demonstrated tasks, delivered over a 6 week period. Infant participants wear a soft-constraint harness (C-Mitt) on their less affected arm for 6 hours per day, while their parent encourages them to use their more affected arm to complete play-based activities as instructed by the study therapist. As the infant experiences success, heavier objec...显示更多 Parent-centered Approach (PCA) Support Intervention The PCA support intervention is 5 weekly telehealth sessions delivered over a 6 week period. The PCA curriculum includes 5 basic principles of positive parenting from Triple P: ensuring a safe engaging environment, creating a positive learning environment, using assertive discipline, having reasonable expectations, and looking after yourself as a parent. All of these elements, when taught to parents in an individuali...显示更多 |
实验性PCA first, then APPLES-tele Participants receiving the PCA intervention for 6 weeks followed by the APPLES-tele intervention for 6 weeks. | APPLES-tele The APPLES-tele intervention is 5 weekly telehealth sessions of therapist-demonstrated tasks, delivered over a 6 week period. Infant participants wear a soft-constraint harness (C-Mitt) on their less affected arm for 6 hours per day, while their parent encourages them to use their more affected arm to complete play-based activities as instructed by the study therapist. As the infant experiences success, heavier objec...显示更多 Parent-centered Approach (PCA) Support Intervention The PCA support intervention is 5 weekly telehealth sessions delivered over a 6 week period. The PCA curriculum includes 5 basic principles of positive parenting from Triple P: ensuring a safe engaging environment, creating a positive learning environment, using assertive discipline, having reasonable expectations, and looking after yourself as a parent. All of these elements, when taught to parents in an individuali...显示更多 |
阳性对照Standard of Care Control Arm Participants receiving the standard of care for 6 weeks. | 标准护理 Participants will receive the usual care from being followed in high-risk infant follow-up (HRIF) programs in the Early Detection and Intervention (EDI) Network. |
主要终点
次要终点
| 结果指标 | 度量标准描述 | 时间框架 |
|---|---|---|
Change in Bayley Scales of Infant and Toddler Development (Bayley-3) More Affected Arm Motor Function Score | The Bayley-3 instrument is a norm-referenced test assessing developmental delays in early childhood. The fine motor function of the more affected upper extremity is assessed using the 54 unimanual items of the Bayley-3 instrument. Responses are provided on a 3-point scale where 0 = the skill is not present, 1 = the skill is emerging, and 2 = the skill is mastered. Total unimanual fine motor raw scores for the more affected arm range from 0 to 108 where higher scores indicate greater fine motor function. | Baseline, Week 6 (after the first intervention), Week 12 (after the second intervention) |
Change in Parenting Styles and Dimensions Questionnaire (PSDQ) Authoritative Scale Score | The Authoritative Parenting Style scale of the Parenting Styles and Dimensions Questionnaire (PSDQ) - short version, includes 15 items that are rated on a 5-point scale where 1 = never and 5 = always. The raw score ranges from 15 to 75 and higher scores indicate a more expression of the authoritative parenting style. | Baseline, Week 6 (after the first intervention), Week 12 (after the second intervention) |
| 结果指标 | 度量标准描述 | 时间框架 |
|---|---|---|
Change in Infant Motor Activity Log (IMAL) How Often Score | Parent perception of hand performance is assessed with the IMAL. The IMAL includes 20 items asking caregivers how often and how well the infant uses their less preferred hand. Responses are given on a 5-point Likert scale where 0 = not used and 5 = normal use. Raw scores on how often the infant uses their less preferred hand range from 0 to 100, with higher scores indicating more normal hand usage. | Baseline, Week 6 (after the first intervention), Week 12 (after the second intervention) |
Change in Hand Assessment in Infants (HAI) Score | The HAI is an assessment evaluating quality and frequency of hand abilities in infants 3 to 12 months corrected age using a semi-structured 12-15 min videotaped play session that is scored by a certified therapist. There are 12 unimanual and 5 bimanual items, each is scored on a 3-point rating scale, of 0, 1, or 2 points. Each hand receives a raw score based upon performance on the unimanual items. The raw score for the more affected hand will be reported as a continuous variable. Total raw scores for the unimanual items range from 0 to 24 and higher scores indicate greater ability. | Baseline, Week 6 (after the first intervention) |
Change in Bayley Scales of Infant and Toddler Development (Bayley-3) Global Fine Motor Function Score | The Bayley-3 instrument is a norm-referenced test assessing developmental delays in early childhood. The fine motor function scale of the Bayley-3 instrument includes 66 items, and responses are provided on a 3-point scale where 0 = the skill is not present, 1 = the skill is emerging, and 2 = the skill is mastered. Total fine motor raw scores range from 0 to 132 where higher scores indicate greater fine motor function. | Baseline, Week 6 (after the first intervention) |
Change in Welch Emotional Connection Screen (WECS) Score | The WECS assesses parent-infant connection by examining four emotional connection dimensions of behavior: attraction, vocal communication, facial communication, and sensitivity. Items are rated on a 3-point scale where 1 = low and 3 = high. A WECS Mother (WECS-M) score is created by summing the four items for maternal connection while the four items for infant connection create a WECS Infant (WECS-I) score. Total WECS-M or WECS-I scores range from 4 to 12 where higher scores indicate greater connection. | Baseline, Week 6 (after the first intervention) |
Change in Maternal Confidence Questionnaire (MCQ) Score | The MCQ assesses parent knowledge and confidence in caring for and understanding their infant. The MCQ has 14 items which are scored on a 5-point scale where 1 = never and 5 = a great deal. Scores are reversed for some items and total scores range from 14 to 70. Higher scores indicate greater maternal confidence. | Baseline, Week 6 (after the first intervention) |
参与助手
资格标准
适龄参与研究
儿童
最低年龄要求
4 Months
适龄性别
全部
- Aged 4 to 13 months, corrected age
- Diagnosis of CP or classification of high-risk for CP as determined by published guidelines (>95% risk of later CP)
- Hammersmith Infant Neurological Exam (HINE) arm asymmetry score of greater than or equal to 2 and/or neuroimaging consistent with perinatal involvement
- Hand Assessment for Infants (HAI) difference between hands ≥2, with an observable and relative difference in quality or amount of movement between hands, as determined by HAI-certified study therapists and/or a unimanual Bayley score difference between hands >1
- Parent/legal guardian is able to provide informed consent
- Congenital malformation of the brain or musculoskeletal system (MSK)
- Receipt of botulinum toxin to the affected extremity within 3 months of study entry
- Any prior long-term hard constraint programs
研究责任方
Nathalie Maitre, 主要研究者, Professor, Emory University
研究中心联系人
联系人: Nathalie Maitre, MD, PhD, (678) 476-5332, [email protected]
4 位于 1 个国家/地区的研究中心
Georgia
Emory University, Atlanta, Georgia, 30322, United States
Nathalie Maitre, MD, PhD, 联系人, (678) 476-5332, [email protected]
Nathalie Maitre, MD, PhD, 主要研究者
招募中
Maryland
Kennedy Krieger Institute, Baltimore, Maryland, 21205, United States
Vera Joanna Burton, MD, PhD, 联系人, [email protected]
Vera Joanna Burton, MD, PhD, 主要研究者
招募中
Pennsylvania
Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, 19104, United States
Andrea F Duncan, MD, MS, 联系人, [email protected]
Andrea F Duncan, MD, MS, 主要研究者
招募中
Utah
The University of Utah, Salt Lake City, Utah, 84112, United States
Betsy Ostrander, MD, 联系人, [email protected]
Betsy Ostrander, MD, 主要研究者
招募中