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The goal of this clinical trial is to demonstrate the improvement of motor functions related symptoms in patients with stroke and spasticity using Exopulse Mollii suit stimulation.
The main questions it aims to answer are:
to evaluate the short-term impact of EXOPULSE Mollii suit on balance in adult patients with stroke and suffering from spasticity.
to assess the effects of Exopulse Mollii suit on spasticity, mobility, pain, fatigue and QoL.
.
Participants will participate in:
One baseline visit for inclusion during which the patient will undergo the first session (active or sham) along with evaluations (before and after the session) One visit after two weeks during which the patient will undergo the second session (active or sham) along with evaluations (before and after the session) One visit after two weeks of the second stimulation condition; the patients will undergo a third evaluation and receive the EXOPULSE Mollii Suit for the four-week open label phase and will use the suit at home for an active stimulation session every other day for four weeks.
One visit at the end of the open label phase to perform the fourth and last evaluation and return the EXOPULSE Mollii suit.
Researchers will compare both Active and Sham groups to demonstrate the improvement of motor functions related symptoms in patients with stroke and spasticity using Exopulse Mollii suit.
The study is a randomized crossover, sham-controlled, double-blind trial to demonstrate the improvement of motor functions and stroke related symptoms following a single session of "active" versus "sham" EXOPULSE Mollii suit. A 2-week washout period should be enough to prevent a potential carry over effect. Two weeks after the end of this phase (phase 1), a second phase of this trial, an open label phase, will be proposed for all patients to understand the effects of EXOPULSE Mollii suit employed over 4 weeks (a session every other day for a total of 14 sessions) on stroke related symptoms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| EXOPULSE Mollii Suit Stimulation Active | Active Comparator | This will be the EXOPULSE Mollii Suit Active Stimulation. Stimulation will go on for 60 minutes while control unit is on for 60 minutes |
|
| EXOPULSE Mollii Suit Stimulation Sham | Sham Comparator | This will be the EXOPULSE Mollii Suit Sham Stimulation. Stimulation will go on for 1 minute then it turns off while the control unit will remain on for total of 60 minutes. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| EXOPULSE Mollii Suit Stimulation | Device | We designed a randomized crossover, sham-controlled, double-blind trial to demonstrate the improvement of motor functions and stroke related symptoms following a single session of "active" versus "sham" EXOPULSE Mollii suit stimulation. in phase 1, the patient will receive two stimulations separated by a two-week washout period. The patients will be randomized to receive either active/sham or sham/active and both patients and investigators will be blinded to the order in which the stimulation will be given. A 2-week washout period should be enough to prevent a potential carry over effect. Two weeks after the end of phase 1, a second open label phase (phase 2) of this trial will be proposed to all patients where they will receive active stimulation every other day at home over four weeks (for a total of 14 sessions). This will help understand the long term effects of EXOPULSE Mollii suit stimulation on stroke related symptoms. |
| Measure | Description | Time Frame |
|---|---|---|
| Balance using Berg Balance Scale (BBS) | Balance will be assessed using the 14-item Berg Balance Scale (BBS) which has good psychometric properties in patients with stroke (concurrent validity, interrater reliability). The scale rates the balance using 56 points, with higher scores indicating better balance abilities. A score equal to or below 45 is commonly associated with risk of fall across the literature. | To be assessed at baseline. |
| Balance using Berg Balance Scale (BBS) | Balance will be assessed using the 14-item Berg Balance Scale (BBS) which has good psychometric properties in patients with stroke (concurrent validity, interrater reliability). The scale rates the balance using 56 points, with higher scores indicating better balance abilities. A score equal to or below 45 is commonly associated with risk of fall across the literature. | To be assessed at week 2. |
| Balance using Berg Balance Scale (BBS) | Balance will be assessed using the 14-item Berg Balance Scale (BBS) which has good psychometric properties in patients with stroke (concurrent validity, interrater reliability). The scale rates the balance using 56 points, with higher scores indicating better balance abilities. A score equal to or below 45 is commonly associated with risk of fall across the literature. | To be assessed at week 4. |
| Balance using Berg Balance Scale (BBS) | Balance will be assessed using the 14-item Berg Balance Scale (BBS) which has good psychometric properties in patients with stroke (concurrent validity, interrater reliability). The scale rates the balance using 56 points, with higher scores indicating better balance abilities. A score equal to or below 45 is commonly associated with risk of fall across the literature. | To be assessed at week 8. |
| Measure | Description | Time Frame |
|---|---|---|
| Visual Analog Score for spasticity. | Spasticity will be measured using a visual analog score from 0 to 10, 0 being no spasticity and 10 being the worst possible spasticity. | This to be assessed at baseline, then at week 2, week 4 and week 8. |
| Visual Analog Score for pain. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Naji J Riachi, MD | Contact | +97123144444 | 2979 | nriachi@ssmc.ae |
| Hasan M Jaber, Bsc | Contact | +97123144444 | 3869 | hasjaber@ssmc.ae |
| Name | Affiliation | Role |
|---|---|---|
| Naji J Riachi, MD | SSMC | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| SSMC | Recruiting | Abu Dhabi | United Arab Emirates |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30796921 | Background | Andringa A, van de Port I, van Wegen E, Ket J, Meskers C, Kwakkel G. Effectiveness of Botulinum Toxin Treatment for Upper Limb Spasticity Poststroke Over Different ICF Domains: A Systematic Review and Meta-Analysis. Arch Phys Med Rehabil. 2019 Sep;100(9):1703-1725. doi: 10.1016/j.apmr.2019.01.016. Epub 2019 Feb 21. | |
| 29722625 | Background |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| D009128 | Muscle Spasticity |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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|
Pain will be measured using a visual analog score from 0 to 10, 0 being no pain, to 10 being the worst possible pain. |
| This to be assessed at baseline, then at week 2, week 4 and week 8. |
| EQ-5D-5L: EuroQol 5 Dimensions 5 Levels Quality of Life Questionnaire | Two weeks after the second stimulation and 4 weeks later at the end of phase 2. |
| Overall Clinical improvement | Evaluation of overall Clinical improvement will be done using the 7-point Clinical Global Impression (CGI). Patient will fill a questionnaire that will address their clinical situation as follows: Very much improved. Much improved. Slightly improved. No change. Slightly worse. Much worse. Very much worse. The score will range from 1-7, 1 being the best clinical outcome and 7 the worst. | This to be assessed at baseline, then at week 2, and week 8. |
| Blinding Questionnaire | Evaluation of patient's blinding to the type of stimulation in the crossover trial periods using a dedicated questionnaire. Patients will be asked whether they think they received the sham or active stimulation. No scale will be used for this measure. | This to be assessed at baseline, then at week 2. |
| Visual Analog Score for fatigue | Fatigue will be measured using a visual analog score from 0 to 10, 0 being no fatigue, to 10 being the worst possible fatigue. | This to be assessed at baseline, then at week 2, week 4 and week 8. |
| Muscle tone. | Muscle tone will be evaluated by the Modified Ashworth Scale (MAS). Scores will range from 0 to 4, 0 being no increase or normal muscle tone, to 4 being rigidity in flexion or extension of muscles. | This to be assessed at baseline, then at week 2, week 4 and week 8. |
| Fall Risk | Fall risk will be assessed using the Falls Efficacy Scale-International scale. It is a 16-item scale, including a range of functional activities, that assesses the perceived risk of falling, using a score that will range from 1 to 4, 1 being not at all concerned to 4 being very concerned. Items are summed to a total score that will range from a minimum of 16 (no concern about falling) to a maximum of 64 (severe concern about falling). | Two weeks after the second stimulation and 4 weeks later at the end of phase 2. |
| Weight | The patient weight will be measured and recorded in kilograms. | Baseline. |
| Height | The patient height will be measured and recorded in centimeters. | Baseline |
| Time Up and Go (TUG) | Patients have to stand up from a chair when they hear the verbal instruction "go", walk a distance of 3 meters, turn around, walk back to the chair and sit down. Timing starts with the verbal instruction "go' and stops when the patients return to the seated position. The score consists of the time taken to complete the test activity, measured in seconds. | This to be assessed at baseline, then at week 2, week 4 and week 8. |
| Body Mass Index (BMI) | The weight and height will be combined to report BMI in kg/m^2. BMI of 35 kg/m^2 or more will be used as an exclusion criterion for the study. | Baseline |
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| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D009135 | Muscular Diseases |
| D009140 | Musculoskeletal Diseases |
| D009122 | Muscle Hypertonia |
| D020879 | Neuromuscular Manifestations |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |