AzTrials
AzTrials

Spinal CordNEUROMOFYNCT05544175

NEUROMOdulation Pain Therapy in Combination With Intensive Physiotherapy

A study testing NEUROMOdulation pain therapy in combination with intensive physiotherapy in people with Spinal Cord, run by Charles University, Czech Republic at 1 site in Czechia.

Not yet recruiting

Opening soon. The study is approved but enrolment has not started yet. Sites may already take enquiries.

Sites and contacts
Official record
Search all trials

Trial summary

In this project, the aim is to verify that neuromodulation therapy (spinal cord stimulation) in combination with intensive physiotherapy on a neurophysiological basis will lead to the restoration of mobility of lower limbs. Read more about this study

Who is it for?
Ages 18 to 60 years
Conditions the study is for
Spinal Cord
What is being tested?
NEUROMOdulation pain therapy in combination with intensive physiotherapy
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
10 participants
Where
1 siteCzechia
Study dates
1 Oct 2024to 22 Dec 2026
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 60 years
  • All sexes
  • No healthy volunteers
  • Adult

Who may be able to join

  • spinal cord lesion

Who cannot join

  • other neurological conditions

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Kamila Řasová, assoc. prof. contact

+420604511416

kamila.rasova@lf3.cuni.cz

Czechia1 site
  • Departmet of revmatology and rehabilitation, Faculty Thomayer Hospital

    Prague

    Tom Philipp, Ph.D., +420737273589, tom.philipp@ftn.cz

Other trials in Czechia

About this study

Official title: NEUROMOdulation Pain Therapy in Combination With Intensive Physiotherapy on a Neurophysiological Basis Improves Not Only Pain But Also Mobility in Spastic Paraparesis

In this project, the aim is to verify that neuromodulation therapy (spinal cord stimulation) in combination with intensive physiotherapy on a neurophysiological basis will lead to the restoration of mobility of lower limbs.

Read the detailed description

So far, posterior spinal cord neurostimulation (NM SCS) has been applied as a standard in patients with the most severe forms of pharmacoresistant neuropathic pain. The most recent research of the last 1-2 years brings clinical findings that, in a mode and modified arrangement, it could even induce rhythmic muscle activity of the lower limbs and help in verticalization and assisted bipedal locomotion.

In this project, the aim is to verify that neuromodulation therapy SCS (spinal cord stimulation) in combination with intensive physiotherapy on a neurophysiological basis will lead to the restoration of mobility of lower limbs.

In the therapy, the neuronal circuits of the lumbosacral region, where the so-called central pattern generators for locomotion are located will be targeted. Neurostimulation of this area will generate motor movement patterns corresponding to the previous mapping of the corresponding muscle groups. These will be supported by intensive physiotherapy on a neurophysiological basis - thanks to it and the facilitation of movement by neurostimulation, global motor patterns will be triggered, and motor programs stored at the subcortical level will be activated. Their memorization and subsequent spontaneous retrieval will facilitate sensorimotor learning techniques.

Current research further shows that neurostimulation stimulates neurons in Rexed laminae 3-5, specifically a group of neurons designated as SC VSX2 and subsequently proprioceptive fibres. Physiotherapy will enhance the effect of neuromodulation by stimulating proprioceptors using soft and neurophysiologically based techniques. Proprioceptive fibres make connections to motoneurons and also ascend through the spinal cord to the brain, and thus reflex motor movements can be triggered. Information about them is carried to the brain by ascending pathways, and thus a free awareness of the movement facilitated by the neurostimulator occurs. All these mechanisms should potentiate plasticity (and lead to the restoration of locomotion.

Conditions
Spinal Cord
Being tested
NEUROMOdulation pain therapy in combination with intensive physiotherapy
Keywords
spinal cord stimulation, physiotherapy

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • NEUROMOdulation pain therapy in combination with intensive physiotherapyProcedure or surgery

    Neuromodulation: Spinal cord stimulation affects nerve tissues with a defined electrical current. We will use low-voltage electrical stimulation of the posterior roots of the spinal cord in the MRI region of the localized conus medullaris. Electrodes are inserted epidurally from a laminotomy in the lumbosacral region.

    Physiotherapy will be based on recommendations for spinal patients.

Study groups in NCT05544175
Study groupRoleWhat they receive
NEUROMOdulation pain therapy in combination with intensive physiotherapyExperimentalNeuromodulation therapy (low-voltage electrical stimulation of the posterior roots of the spinal cord) by electrodes inserted epidurally from a laminotomy in the lumbosacral region. Intensive, four hour per day, individual physiotherapy (soft techniques, methods based on neurophysiology, so-called neuroproprioceptive "facilitation, inhibition" (Vojta's reflex method, Motor programs activating therapy, Proprioceptive neuromuscular stimulation, Bobath concept) will be combined with methods of acquiring motor skills (individualized therapy using the knowledge of sensorimotor learning) will take minimally one month.
Receives: Procedure: NEUROMOdulation pain therapy in combination with intensive physiotherapy

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change in Muscle strength at 2 weeks, 6 weeks, 6 and 12 months

    Hip flexion, abduction and extension, knee flexion and extension, plantar flexion and dorsiflexion using a microFET2 digital dynamometer. The higher value, the better function (higher strength).

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  2. Change in Spasticity at 2 weeks, 6 weeks, 6 and 12 months

    Hip flexors, knee flexors and extensors, dorsal and plantar flexors using the Modified Ashworth scale. The higher value, the worse function (higher spasticity).

    Measured: Post-assessment 1 (immediately after the end of two weeks hospitalisation)

  3. Change from Baseline Timed Up And Go at 2 weeks, 6 weeks, 6 and 12 months

    The subject stands up from a chair, walks 3m, turns back, and sits down again as quickly and safely as possible while being timed. Higher times reflect worse mobility.

    Measured: Post-assessment 1 (immediately after the end of two weeks hospitalisation)

  4. Change from Baseline Berg Balance Scale at 2 weeks, 6 weeks, 6 and 12 months

    The subject stands up from a chair, walks 3m, turns back, and sits down again as quickly and safely as possible while being timed. Higher times reflect worse mobility.

    Measured: Post-assessment 1 (immediately after the end of two weeks hospitalisation)

  5. Change from Baseline The 10 Metre Walk Test at 2 weeks, 6 weeks, 6 and 12 months

    A performance measure used to assess walking speed in meters per second over 10 meters. Shorter times reflect better mobility.

    Measured: Post-assessment 1 (immediately after the end of two weeks hospitalisation)

  6. Change from Baseline The 6 Minute Walk Test at 2 weeks, 6 weeks, 6 and 12 months

    A long walking capacity test recording the maximal distance a subject walks at the fastest speed possible in 6 minutes. The more distance covered, the better the walking performance is.

    Measured: Post-assessment 1 (immediately after the end of two weeks hospitalisation)

  7. Change in Walking Index for Spinal Cord Injury at 2 weeks, 6 weeks, 6 and 12 months

    questionnaire from 0 to 20. Higher number means better function.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

Secondary outcomes (8)
  1. Change in Visual Analogue Scale for pain at 2 weeks, 6 weeks, 6 and 12 months

    scale from 0 to 10. Higher number means worse function (higher subjective feeling of pain)

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  2. Change in The Fatigue Scale for Motor and Cognitive Functions at 2 weeks, 6 weeks, 6 and 12 months

    Questionnaire with 20 questions on fatigue. Higher number, worse fatigue.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  3. Change in SYMBOL DIGIT MODALITIES TEST at 2 weeks, 6 weeks, 6 and 12 months

    Cognitive testing (putting right symbols in 90 seconds). Higher number, better function.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  4. Change in European Health Questionnaire at 2 weeks, 6 weeks, 6 and 12 months

    questionnaire on Quality of Life. Higher value, better quality of life.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  5. Change from Baseline World Health Organisation Disability Assessment Schedule 2.0 at 2 weeks, 6 weeks, 6 and 12 months

    the 36-item questionnaire, higher score means higher disability

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  6. Change in the 36-Item Short Form Survey Instrument at 2 weeks, 6 weeks, 6 and 12 months

    36 item questionnaire. Higher number, worse quality of life.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  7. Change from Baseline Goal Attainment scale at 2 weeks, 6 weeks, 6 and 12 months

    Each goal is rated on 5-point scale (-2 much less than expected, 0 achieved the expected level, 2 much more than expected). Higher score means a better outcome.

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

  8. Change in the Spinal Cord Independence Measure at 2 weeks, 6 weeks, 6 and 12 months

    17 item questionnaire. Higher number, better function (lower independence).

    Measured: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted16 Sep 2022
  2. Study start1 Oct 2024 (estimated)
  3. Primary completion30 Sep 2025 (estimated)
  4. Study completion22 Dec 2026 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrolment
10 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05544175
Sponsor's protocol ID
092022
Acronym
NEUROMOFY
Status last verified
Feb 2024
First submitted
14 Sep 2022
Last updated
6 Feb 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: All data sharing terms and conditions and the nature of the relationship between the study and new user will be contained in a Data-sharing Agreement that will be issued and sighed before any data are handed out. The de-identification process for each patient is to ensure anonymization of individual patient's data, in order to be able to share IPD within the terms of participant's consent and ethics committee approval. The study policy on sharing defines the terms of privileged use by the study team. The research team requires to be appropriately notified and acknowledged in publications and other outputs of the transferred data (or analyses conducted by the study on the new users' behalf). The Data-sharing agreement will comprehend arrangements for data destruction or secure archiving. It is planned that the data will be placed into an online repository (to be specified later).

Questions about this trial

What is this clinical trial studying?

A study testing NEUROMOdulation pain therapy in combination with intensive physiotherapy in people with Spinal Cord, run by Charles University, Czech Republic at 1 site in Czechia.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 1 inclusion and 1 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: opening soon, as of the sponsor's last update on 6 Feb 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Czechia. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Kamila Řasová, assoc. prof. (+420604511416, kamila.rasova@lf3.cuni.cz), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change in Muscle strength at 2 weeks, 6 weeks, 6 and 12 months (time frame: Pre-assessment (baseline testing), Post-assessment 1 (immediately after the end of two weeks hospitalisation), Post-assessment 2 (immediately after the end of one month hospitalisation), Follow up (6 and 12 month after beginning of the study).). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 6 Feb 2024.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in