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Demonstrate safety and efficacy of TAPS delivered by a Cala device as a treatment for action tremor in subjects with Parkinson's disease hand tremor
40 patients with PD with at least mild postural tremor were enrolled in a four-week, prospective, single-arm, open-label study of twice daily TAPS therapy. Due to the COVID-19 pandemic, TAPS devices were shipped to patients to run the study remotely. Unsupervised motion assessments were captured at home, and at the beginning and end of the four weeks by telemedicine.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| TAPS delivered by Cala device | Experimental | Two 40-minute TAPS sessions daily for 28 days, recommended as once in the morning and once in the evening. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Cala Device | Device | transcutaneous afferent patterned stimulation (TAPS) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Tremor Power | Pre-specified effectiveness endpoints included improvements in (1) objective postural tremor power (primary outcome; assessed using an accelerometer on the device under standard of care medication state at home). | 4 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) | Improvement of clinician-ratings of Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) Part III [Goetz, C.G. et al. Wiley Intersci. 2008] (co-secondary; in medication-off state). Clinician rated patients' tremor pre and post therapy on a scale of 0-4. 0=Normal (no tremor), 4=Severe. | 4 weeks |
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Inclusion Criteria:
Must be ≥22 years of age
Competent and willing to provide written, informed consent to participate in the study
Clinically significant postural tremor as defined by:
Stable dose of Parkinson's disease medications, if applicable, for 30 days prior to study entry
Willing to comply with study protocol requirements including:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Cala Clinic | Burlingame | California | 94010 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | TAPS Delivered by Cala Device | Two 40-minute TAPS sessions daily for 28 days, recommended as once in the morning and once in the evening. Cala Device: transcutaneous afferent patterned stimulation (TAPS) |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
40 enrolled subjects with PD
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| ID | Title | Description |
|---|---|---|
| BG000 | TAPS Delivered by Cala Device | Two 40-minute TAPS sessions daily for 28 days, recommended as once in the morning and once in the evening. Cala Device: transcutaneous afferent patterned stimulation (TAPS) |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Tremor Power | Pre-specified effectiveness endpoints included improvements in (1) objective postural tremor power (primary outcome; assessed using an accelerometer on the device under standard of care medication state at home). | Posted | Median | Inter-Quartile Range | Percentage of tremor power reduction | 4 weeks |
|
|
4 weeks
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | TAPS Delivered by Cala Device | Two 40-minute TAPS sessions daily for 28 days, recommended as once in the morning and once in the evening. Cala Device: transcutaneous afferent patterned stimulation (TAPS) |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Unsteady gait | General disorders | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Alex Kent | Cala Health | 267-973-4180 | alex.kent@calahealth.com |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot | Yes | No | No | Study Protocol | Oct 1, 2020 | Nov 2, 2023 | Prot_000.pdf |
| SAP | No | Yes | No | Statistical Analysis Plan | Mar 25, 2021 | Nov 1, 2023 | SAP_001.pdf |
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| ID | Term |
|---|---|
| D010300 | Parkinson Disease |
| ID | Term |
|---|---|
| D020734 | Parkinsonian Disorders |
| D001480 | Basal Ganglia Diseases |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
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| Bain and Findley Activities of Daily Living (BF-ADL) | Improvement of patient-ratings of the Bain and Findley Activities of Daily Living (BF-ADL) [Bain PG, et al. Journal of Neurol, Neuros & Psych 1993] (co-secondary; in medication-off state). Patients' rated ability to perform specific activities pre and post therapy on a scale from 1-4. 1=Able to do the activity without difficulty, 4=Cannot do the activity by yourself. | 4 weeks |
| Percentage of Patients With Clinician and Patient Global Impressions of Improvement Rated < 4 (CGI-I, PGI-I) | Clinician and Patient global impressions of improvement (CGI-I, PGI-I; exploratory) post therapy. This is a rated scale from 1-7, with 1=Very Much Improved to 7=Very Much Worse. Percentage of patients with ratings < 4 (including very much improved, much improved and improved) were computed respectively for CGI-I and PGI-I. | 4 weeks |
| years |
|
| Sex: Female, Male | Count of Participants | Participants | No |
|
| Race/Ethnicity, Customized | Count of Participants | Participants |
|
|
|
| Secondary | Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) | Improvement of clinician-ratings of Movement Disorder Society Unified PD Rating Scale (MDS-UPDRS) Part III [Goetz, C.G. et al. Wiley Intersci. 2008] (co-secondary; in medication-off state). Clinician rated patients' tremor pre and post therapy on a scale of 0-4. 0=Normal (no tremor), 4=Severe. | Posted | Mean | Standard Deviation | units on a scale | 4 weeks |
|
|
|
| Secondary | Bain and Findley Activities of Daily Living (BF-ADL) | Improvement of patient-ratings of the Bain and Findley Activities of Daily Living (BF-ADL) [Bain PG, et al. Journal of Neurol, Neuros & Psych 1993] (co-secondary; in medication-off state). Patients' rated ability to perform specific activities pre and post therapy on a scale from 1-4. 1=Able to do the activity without difficulty, 4=Cannot do the activity by yourself. | Posted | Mean | Standard Deviation | units on a scale | 4 weeks |
|
|
|
| Secondary | Percentage of Patients With Clinician and Patient Global Impressions of Improvement Rated < 4 (CGI-I, PGI-I) | Clinician and Patient global impressions of improvement (CGI-I, PGI-I; exploratory) post therapy. This is a rated scale from 1-7, with 1=Very Much Improved to 7=Very Much Worse. Percentage of patients with ratings < 4 (including very much improved, much improved and improved) were computed respectively for CGI-I and PGI-I. | Posted | Number | percentage of patients with improvement | 4 weeks |
|
|
|
| 0 |
| 40 |
| 0 |
| 40 |
| 8 |
| 40 |
| sore/lesion | Skin and subcutaneous tissue disorders | Systematic Assessment | sore/lesion observed in 2 subjects, on the dominant wrist |
|
| significant and persistent skin irritation | Skin and subcutaneous tissue disorders | Systematic Assessment |
|
| persistent pain from stimulation | Musculoskeletal and connective tissue disorders | Systematic Assessment | pain felt in thumb of treatment hand |
|
| significant discomfort with stimulation | General disorders | Systematic Assessment |
|
| twitching of ring finger | Musculoskeletal and connective tissue disorders | Systematic Assessment | ring finger on treatment hand |
|
| anxiety/insomnia/worsening of tremor at night | General disorders | Systematic Assessment |
|
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| D009422 | Nervous System Diseases |
| D009069 | Movement Disorders |
| D000080874 | Synucleinopathies |
| D019636 | Neurodegenerative Diseases |