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Trial registered on ANZCTR
Registration number
ACTRN12612001030864
Ethics application status
Approved
Date submitted
21/09/2012
Date registered
25/09/2012
Date last updated
25/09/2012
Type of registration
Prospectively registered
Titles & IDs
Public title
Grasp rehabilitation with motor imagery after spinal cord injury
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Scientific title
In quadriplegic patients with chronic non-evolutive motor impairments does motor rehabilitation including mental training with motor imagery improve residual upper limb motor functions through the induction of cerebral reorganizations potentially reflected during motor imagery?
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Secondary ID [1]
281257
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Nil
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Universal Trial Number (UTN)
U1111-1134-6932
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Spinal cord injuries
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Condition category
Condition code
Physical Medicine / Rehabilitation
287790
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0
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Physiotherapy
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Injuries and Accidents
287820
287820
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0
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Other injuries and accidents
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Neurological
287829
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Mental practice with motor imagery, whereby participants visualise themselves grasping objects. Different motor imagery modalities are used (e.g. visual, kinesthetic, etc.) focusing various tenodesis grasping skills (e.g. different seizes of objects, contralateral and ipsilateral tenodesis grasping actions.. etc.). Administration mode: one-on-one supervision by a physiotherapist. Frequency and duration of mental practice sessions: SCI patients underwent 3×30 minutes sessions per week for 5 weeks.
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Intervention code [1]
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Rehabilitation
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Intervention code [2]
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Treatment: Other
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Comparator / control treatment
Posttest level is compared with the baseline pretests level (i.e. before rehabiltiative interventions with mental training) in spinal cord injured patients. Age and sex-matched healthy control participants follow similar a repeated pretests and posttest assessments procedure. They do not recieve rehabilitative interventions but a control task (i.e. playing cards with a physiotherapist 3×30 minutes per week for 5 weeks).
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Control group
Active
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Outcomes
Primary outcome [1]
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Kinematic analysis of tenodesis grasp actions
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Assessment method [1]
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Timepoint [1]
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At weeks 1, 3 and 5 following inclusion and at weeks 1 and 8 following intervention. Experimental intervention is administered during weeks 6 to 10 relative to patient's inclusion.
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Primary outcome [2]
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Magnetoencephalographic cerebral activity during imagined and executed tenodesis grasp actions
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Assessment method [2]
288026
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Timepoint [2]
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At weeks 1, 3 and 5 following inclusion and at weeks 1 and 8 following intervention. Experimental intervention is administered during weeks 6 to 10 relative to inclusion.
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Primary outcome [3]
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Autonomic nervous system (i.e. heart rate and electrodermal activity) activity during imagined and executed tenodesis grasp actions. We used an autonomic nervous system acquisition device (E-MOTION) and recorded the electrocardiogram. We also recorded skin resistance responses, using two 50 mm2 unpolarizable Ag/AgCl electrodes (Clark Electromedical Instruments, Ref. E243) placed on upper limb regions correponding where sympathetic innervation was spared by the neurological lesion. Isotonic conductive paste was used to improve skin/electrode contact. Skin resistance was recorded with 15 uA current (current density=0.5 uA/mm2).
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Assessment method [3]
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Timepoint [3]
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At weeks 1, 3 and 5 following inclusion and at weeks 1 and 8 following intervention
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Secondary outcome [1]
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Motor imagery ability assessment with mental chronometry
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Assessment method [1]
299299
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Timepoint [1]
299299
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At weeks 1, 3 and 5 following inclusion and at weeks 1 and 8 after experimental intervention. Experimental intervention is administered during weeks 6 to 10 relative to inclusion.
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Secondary outcome [2]
299301
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Motor imagery ability assessment with the Kinesthetic and Visual Imagery Questionnaire
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Assessment method [2]
299301
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Timepoint [2]
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At week 1 following inclusion, before the first kinematic analysis and magnetoencephalographic recording.
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Secondary outcome [3]
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Physiotherapy and occupational therapy functional motor assessments
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Assessment method [3]
299303
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Timepoint [3]
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At weeks 1, 3 and 5 following inclusion and at weeks 1 and 8 after experimental intervention. Experimental intervention is administered during weeks 6 to 10 relative to inclusion.
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Eligibility
Key inclusion criteria
(i) Quadriplegia elicited by traumatic SCI at the C6/C7 level
(ii) Complete infra-lesional motor deficit (score < 20/100 on the ASIA impairment scale) (iii) Time post-injury superior or equal to 6 months, with non-evolutive general, motor and sensory deficit
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Minimum age
18
Years
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Maximum age
55
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
(i) Non-stabilized HTN or pathological autonomous nervous system dysfunction (e.g. orthostatic hypotension) (ii) Cerebral damage and/or cognitive deficit (iii) Elbow or shoulder joint amplitude restriction, upper limb para osteo-arthropathy (iv)Presence of metallic objects within the body (e.g. pacemaker, auditory device) incompatible with neuroimaging recordings (v) Participation to another research program
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Patients were hospitalized after traumatic cervical spinal cord injury. The head medical doctor responsible for patient's hospitalization and medical care delivery checked that participants met the inclusion criteria, and informed of the possibility to participate in a rehabilitation research program. Participants provided written informed consent according to the statements and principles of the Declaration of Helsinki.
Healthy control participants matched according to genre and age to the patients also participated in the trial.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
SCI patients were systematically allocated to the treatment group. Healthy control participants matched according to genre and age to the patients were assigned to the control group.
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
Due to ethical reasons, we could not deprive voluntarily SCI patients from the treatment condition so as to constitute a patient control group. Indeed, there is a rich scientific background supporting the therapeutical relevance of motor imagery interventions in the management of motor rehabilitation in neurological populations.
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Phase
Not Applicable
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2012
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
8
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Accrual to date
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Final
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Recruitment outside Australia
Country [1]
4564
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France
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State/province [1]
4564
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Rhone Alpes
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Hospices Civils de Lyon
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Address [1]
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5 place d'Arsonval
69437 Lyon cedex 03
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Country [1]
286047
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France
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Primary sponsor type
University
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Name
Universite Claude Bernard Lyon 1 - CRIS EA 647
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Address
27-29 Boulevard du 11 Novembre 1918
69622 Villeurbanne Cedex
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Country
France
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Secondary sponsor category [1]
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Hospital
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Name [1]
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Hopital Henri Gabrielle (Neurological Rehabilitation)
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Address [1]
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20 Route de Vourles
69230, Saint Genis Laval
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Country [1]
284860
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France
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Secondary sponsor category [2]
284861
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Other Collaborative groups
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Name [2]
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CERMEP Imagerie du vivant - Departement MEG
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Address [2]
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Centre Hospitalier Le Vinatier
95 Boulevard Pinel
69500 Bron
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Country [2]
284861
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France
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Comite de Protection des Personnes Sud-Est II
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Ethics committee address [1]
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Hopital Hotel-Dieu, place de l'Hopital, porte 16 69288 Lyon Cedex 02
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Ethics committee country [1]
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France
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Date submitted for ethics approval [1]
288097
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Approval date [1]
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01/04/2012
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Ethics approval number [1]
288097
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Summary
Brief summary
Grasp function is severely impaired after quadriplegia elicited by traumatic spinal cord injury. Patients can learn a modified type of grasp called tenodesis, where pinch grip is generated by active wrist extension (a movement spared by the lesion below the C6-C7 level). We investigate whether mental training with motor imagery can improve tenodesis grasp function in quadriplegic patients. Using magnetoencephalography, we seek to delineate whether mental training can induce cerebral reorganizations enabling functional motor recovery. We also investigate whether the neural networks mediating motor imagery are reorganized due to motor rehabilitation with mental training.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
34731
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Address
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Country
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Phone
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Fax
34731
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Email
34731
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Contact person for public queries
Name
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Di Rienzo Franck
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Address
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27-29 Boulevard du 11 Novembre
69622 Villeurbanne Cedex
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Country
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France
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Phone
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+33 4 72432734
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Fax
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Email
17978
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[email protected]
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Contact person for scientific queries
Name
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Di Rienzo Franck
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Address
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27-29 Boulevard du 11 Novembre
69622 Villeurbanne Cedex
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Country
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France
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Phone
8906
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+33 4 72432734
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Fax
8906
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Email
8906
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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