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Transcranial Alternating Current Stimulation in Cerebral Palsy (BOOSTTACS) 44 无创 随机化 儿科 青少年

尚未招募
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临床试验NCT06372041 (BOOSTTACS)是一项针对脑瘫干预性研究试验,当前状态为尚未招募试验尚未开始,计划于2024年4月15日开始,预计招募44名患者。该研究由IRCCS Eugenio Medea主导,计划于2026年5月14日完成。试验数据来源于ClinicalTrials.gov,最后更新时间为2024年4月17日
简要概括
The present study aims to assess, through a randomized controlled trial (RCT), the efficacy of transcranial alternating current stimulation (tACS) in enhancing the functional changes due to an intensive motor training in children and adolescents with Cerebral Palsy (CP). Particularly, in two different groups active or sham tACS will be paired with the Hand-Arm Bimanual Intensive Therapy Including Lower Extremities (H...显示更多
详细描述
This represents one of the two RCTs of the project "Bottom-up and tOp-down neuromOdulation of motor plaSTicity in cerebral palsy" (BOOST; FRRB 3438840).The study will be a randomized, sham controlled, pre-test/post-test study involving 44 children and adolescents with CP. Patients will be treated in pairs, with a matching of motor deficit severity, IQ, or age. Each pair will be randomly assigned to the active or to t...显示更多
官方标题

tACS-combined Motor Training for the Rehabilitation of the Upper Limb in Children and Young People With Cerebral Palsy: a Randomized, Sham-controlled Trial

疾病
脑瘫
出版物
关于此临床试验发表的科学文章和研究论文:
其他研究标识符
  • BOOSTTACS
  • 944/B
NCT编号
实际开始日期
2024-04-15
最近更新发布
2024-04-17
预计完成日期
2026-05-14
计划入组人数
44
研究类型
干预性研究
试验分期 (阶段)
不适用
试验状态
尚未招募
关键词
transcranial Alternating Current Stimulation
intensive bimanual training
neurorehabilitation
non invasive brain stimulation
upper limb motor deficit
主要目的
治疗方法
分配方式
随机
干预模型
平行
盲法
三盲
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Active tACS combined with the training
The tACS will be applied for the first 20 minutes of the training, every day of the treatment. Before and the after of the stimulation, SpO2 and HR will be checked. After the stimulation participants will be asked to rate the sensations and possible side effects occurring during tACS. The intensive bimanual training will be administered by following the procedure described in the Detailed Description session, as for ...显示更多
transcranial Alternating Current Stimulation
tACS will be performed by using a Conformite Europeenne (CE) marked stimulator device (Starstim ®, Neuroelectrics, Barcelona, Spain). By applying alternating current at the gamma frequency band (range 30-80), known to be associated to motor performance, tACS can entrain or synchronize neural oscillations in the targeted brain regions. By modulating cortical excitability of the cerebellum, a region strongly involved i...显示更多
模拟对照Sham tACS combined with the training
The sham-tACS will be applied for the first 20 minutes of the training, every day of the treatment. However, in this condition, after the initial 30 seconds of ramp-up phase of the current, the stimulation will be switched off. This procedure allows participants to feel the characteristic tingling sensations in the vicinity of the electrodes for a brief period of time, which enhanced the plausibility of the sham cond...显示更多
transcranial Alternating Current Stimulation
tACS will be performed by using a Conformite Europeenne (CE) marked stimulator device (Starstim ®, Neuroelectrics, Barcelona, Spain). By applying alternating current at the gamma frequency band (range 30-80), known to be associated to motor performance, tACS can entrain or synchronize neural oscillations in the targeted brain regions. By modulating cortical excitability of the cerebellum, a region strongly involved i...显示更多
主要终点
结果指标度量标准描述时间框架
Assisting Hand Assessment (AHA)
This scale enables to quantify the assistance provided by the more affected hand to the less affected hand during bimanual activities. This observation-based, criterion-referenced assessment highlights a person's typical performance, emphasizing practical functionality over maximal capacity, and serves as a reliable measure of change over time. The scale comprised 20 items, scored on a 4-point Likert scale, from 1 to 4. The total score indicates how well the more affected hand is used as an assisting hand. A score of 20 means poor performance (the hand is not used as an assisting hand); a score of 80 means that the hand is used effectively. The results are converted for each of the three scales to logits by a Rasch analysis, on a 0-to-100 scale (with higher scores suggesting better use).
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Box and Block Test (BBT)
This test is designed to measure manual dexterity. It is quick, simple, and cost- effective. It involves a box with a partition in the middle placed on a table, with a total of 150 blocks on one side of the partition. The score of the test is given by the number of blocks transported within a minute. Higher values suggest better performance. The BBT provides a reliable and objective measurement of manual dexterity, making it valuable for evaluating functional outcomes and monitoring progress in rehabilitation programs over a short period of time.
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Visuomotor task
The visuomotor task is an ad hoc computer based task. It involves a mouse click- and-drag operation where an object appears at the center of the screen. The objective is to drag and drop the object to the location indicated by a previously presented arrow, pointing towards a target object within a configuration of objects. Participants are required to focus on the arrow's direction, swiftly and accurately moving the central object to its designated target location. This task enables the measurement of movement time (in milliseconds; consisting in the time necessary to move the object in the target position); precision error (calculated as the distance, in pixels, between the drop position of the object and the actual target position); the proportion of overtime errors (the percentage of trials in which responses are too slow). Smaller values of Movement time, Precision error and overtime errors will suggest better performance.
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
次要终点
结果指标度量标准描述时间框架
Canadian Occupational Performance Measure (COPM)
This is a client-centered, semi-structured interview used in occupational therapy to identify the problems experienced by the patients. This interview engages the patient in recognizing daily occupations of importance that he/she want to do, need to do, or are expected to do but is unable to accomplish. Upon the identification of the problems experienced in patient's everyday-life activities the patient is asked to rate the importance of each activity in his/her life though a 10-points rating scale and then, to select up to five problems to be addressed during the intervention. Lastly, the patient is asked to rate on a 10 points scale his/her own level of performance and satisfaction in performing that activity for each of the five problems (from 0, low performance or low satisfaction to 10, high performance or high satisfaction).
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Children's Hand-Use Experience Questionnaire (CHEQ)
The questionnaire includes 27 bimanual activities. Each activity is rated on three scales measuring: i) the perceived efficacy of the activity ("How do you think the child's hand works?") from 1 (Bad / not used hand) to 4 (Good efficacy); ii) the amount of assistance and the time needed to perform the activity ("How much time does your child need to do the whole task, compared to peers?) from 1 (Considerably longer) to 4 (Equally long time compared to other peers); and iii) the child's satisfaction with their performance ("Is your child bothered by his/her reduced hand/arm function during this activity?") from 1 ("It bothers him/her a lot") to 4 ( "It does not bother him/her at all"). The questionnaire provides a result corresponding to the summary of the ratings. The results are converted for each of the three scales to logits by a Rasch analysis, on a 0-to-100 scale (with higher scores suggesting better performance/satisfaction).
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Melbourne Assessment 2 (MA2)
This scale allows evaluating the unimanual performance of both the more and less affected hand. It measures four elements of upper limb movement quality: movement range, accuracy, dexterity and fluency. It consists of 14 test items that require children to interact (by reaching, grasping, releasing and manipulating) with simple objects. Movement elements are scored on a 3-, 4-, or -5 point scale according to specific criteria. Scores are arranged into the 4 sub-scales (movement range, accuracy, dexterity and fluency) according to the element of movement being rated. A child's total raw score for each sub-scale is converted to a percentage of the maximum possible score for that sub-scale, with higher scores indicating better performance.
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Gross Motor Function Measure (GMFM-66)
It is a standardized observational tool used by healthcare professionals to evaluate and quantify the gross motor abilities and limitations of children with CP. It assesses 66 motor skills across five dimensions: lying and rolling, sitting, crawling and kneeling, standing, and walking, running, and jumping. Each skill is scored on a 4-point scale, ranging from 0 (does not initiate) to 3 (performs fully).
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
Vineland Adaptive Behavior Scale Version 2 (VABS II)
This is a tool designed to assess adaptive behavior in individuals from birth to age 90. It assesses 11 subdomains of adaptive behavior grouped into four domains; sums of these scores are standardized into Communication, Daily Living Skills, Socialization and Motor Skills domain standard scores. Sums of the domain standard scores are then standardized into the Adaptive Behavior Composite score ranging from 20 to 160 (mean=100; standard deviation= 15).
1-2 days before the start of training (t0), three months after the end of the training (t2)
Pediatric quality of life inventory PedsQL(cerebral palsy module), (PEDS-QL)
This is a widely employed, brief, and standardized self-reporting tool for assessing health-related quality of life in children and young individuals. The measure can be completed by parents (the Proxy Report) as well as children and young people (the Self-Report) with versions available for children and young people aged 5-7, 8-12, and 13-18. Parent-rated versions are available for children aged 2-4, 5-7, 8-12, and 13-18. The versions from 5 to 18 years comprise 35 items comprising 7 dimensions: Daily Activities; School Activities; Movement and Balance; Pain and Hurt; Fatigue; Eating Activities; Speech and Communication. For each item, consisting in everyday life action, it is required to indicate how much of a problem each item has been in the past month with response options from 0 (never a problem) to 4 (almost always a problem). The items are reverse scored and transformed to a 0-100 scale, with higher scores indicating better health related quality of life.
1-2 days before the start of training (t0), three months after the end of the training (t2)
Cortical rhythms at rest and during the Visuomotor task
Cortical rhythms will be recorded using EEG electrodes placed over the fronto-central regions to investigate potential changes in EEG power in gamma (30- 100 Hz) bands. We will investigate the event-related synchronization/desynchronization (ERS/ERD) of this frequency, reflecting an increase or decrease in power within the EEG signal during the visuomotor task compared to the resting state condition. This analysis will focus on regions associated with cognitive and motor control, aiming to detect any changes indicative of treatment effects.
1-2 days before the start of training (t0), 1-2 days after the end of the training (t1), three months after the end of the training (t2)
参与助手
资格标准

适龄参与研究
儿童
最低年龄要求
6 Years
适龄性别
全部
  • clinical signs of unilateral or bilateral upper limb deficits (with a difference at least of 25% between more affected and less affected hand at Box and Block test);
  • Magnetic Resonance Imaging (MRI) confirmed diagnosis according to Surveillance of Cerebral Palsy (SCPE) criteria;
  • Manual Ability Classification System (MACS) level I,II,III;
  • Gross Motor Function Classification System (GMFCS) level I,II,III;
  • Visual Function Classification System (VFCS) I-II-III;
  • Intelligence quotient (IQ) > 50.

  • presence of cochlear implant, cardiac pacemaker, ventriculoperitoneal shunt, neuro-stimulators, clips, fragments or metal splinters in the brain or skull except for titanium;
  • treatments for spasticity or functional surgery of the upper limb in the previous 6 months or planned during the duration of the study;
  • uncontrolled epileptic seizure in the last 2 years.
IRCCS Eugenio Medea logoIRCCS Eugenio Medea
  • IRCCS National Neurological Institute "C. Mondino" Foundation logoIRCCS National Neurological Institute "C. Mondino" Foundation
  • Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia logoAzienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia
没有联系数据。
1 位于 1 个国家/地区的研究中心

Lecco

Scientific Institute, IRCCS E. Medea, Bosisio Parini, Lecco, 23842, Italy
Alessandra Finisguerra, 联系人, +39031877652, [email protected]
Cosimo Urgesi, 联系人, +39031877652, [email protected]
Viola Oldrati, 分研究者