About this trial
kTMP, kilohertz transcutaneous magnetic perturbations, is a low intensity transcranial magnetic stimulation technique that will be used in this study to promote arm/hand rehabilitation in patients who have been disabled by stroke.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Adults aged 18-80 years who have a history of an ischemic or hemorrhagic stroke ≥ 12 m prior to enrollment.
Fugl-Meyer Assessment: Upper Extremity (FMA UE) score 20-50.
Ability to communicate, understand, and give appropriate consent. Participants can follow two-step commands.
Motor evoked potentials in a hand muscle when stimulating ipsilesional cortex with suprathreshold single-pulse TMS (MEP positive).
Disqualifiers
Participants with moderate or severe cognitive impairment (MoCA < 18).
Participants with sensory deficits FMA-S < 6/12 (with proprioception < 4/8).
Participants with severe apraxia (TULIA < 5).
Language impairment or behavioral disorder that interferes with their ability to adhere to the protocol or to provide informed consent.
Trial design
Parallel
Treatments tested in this trial
kTMP
DeviceA new non-invasive brain stimulation tool
Sham kTMP
DeviceA new non-invasive brain stimulation tool with sham setting selected
Treatment groups
Trial outcomes
Primary outcomes
Range of Joint Motion (ROM)
defined as the standard deviation of the joint angle time series for a given trial. The median ROM will be calculated for eleven degrees of freedom and then averaged. If there are joints which appear to be compensatory, they will be removed from the analysis
Secondary outcomes
Fugl- Meyer Assessment (Upper Extremity)
A comprehensive clinical examination that has been widely used to evaluate stroke-related motor impairment. It is graded from 0 (hemiplegia) to 66 for the Upper extremity. Higher scores signifies better motor control, and hence a better outcome.
Modified Ashworth Scale (MAS)
Used to measure spasticity in wrist and hand flexors and extensors. It assigns a grade of spasticity from 0-4. Lower scores represent normal muscle tone and higher scores represent spasticity. Hence lower scores are associated with better outcomes.
Transport Time
Calculated for each of three epochs, pre, during and post
Trial to Trial Variability (T2TV)
Defined as the mean-squared error between the joint angle time-series for a given trial and the median joint angle timeseries. The median T2TV will be calculated for eleven degrees of freedom.
Sponsors and contacts
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Magnetic Tides
Lead sponsor
University of California, San Francisco
Collaborator
National Institute of Neurological Disorders and Stroke (NINDS)
Collaborator