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Trial registered on ANZCTR
Registration number
ACTRN12617000717358
Ethics application status
Approved
Date submitted
12/04/2017
Date registered
17/05/2017
Date last updated
17/05/2017
Type of registration
Retrospectively registered
Titles & IDs
Public title
Effects of combining repetitive transcranial magnetic stimulation with treadmill training on gait performance in individuals with chronic stroke
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Scientific title
Effects of combining repetitive transcranial magnetic stimulation with treadmill training on gait performance in individuals with chronic stroke
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Secondary ID [1]
291662
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none
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Universal Trial Number (UTN)
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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:
stroke
302820
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Condition category
Condition code
Stroke
302312
302312
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0
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Haemorrhagic
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Stroke
302313
302313
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0
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Ischaemic
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Fourteen participants with chronic stroke were randomly assigned to experimental (n=8) or control group (n=6). Participants in both groups received treadmill training for 30 minitues, 3 times a week for 3 weeks. The treadmill training started with a 5 minutes warm up session walking at half of participant’s preferred speed. After warm up, the treadmill speed would be increased gradually until the maximum tolerable and safe speed of the participant has been reached. While training, a suspension system was used to ensure the safety of the participants, and a physiotherapist would be standing aside to ensure that the participants walked with good posture and appropriate weight transfer using verbal cues.
Prior to each treadmill training session, the participants in the experimental group received real repetitive transcranial magnetic stimulation (rTMS) with 5Hz, 10s, 18 trains with total 900 pulses at 90% resting motor threshold for 15 minutes to the ipsilesional primary motor cortex of tibialis anterior (TA) muscle, and the control group received sham rTMS.
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Intervention code [1]
297750
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Rehabilitation
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Intervention code [2]
298033
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Treatment: Other
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Comparator / control treatment
the control group received sham rTMS plus same treadmill training as experimental group
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Control group
Active
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Outcomes
Primary outcome [1]
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gait velocity obtained from the GAITRite system,
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Assessment method [1]
301719
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Timepoint [1]
301719
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pre-training, post-training, and 4 weeks follow-up
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Secondary outcome [1]
333681
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gait asymmetry index using formulas proposed by O'Sullivan et al, 2007 and Hsu et al., 2003
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Assessment method [1]
333681
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Timepoint [1]
333681
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pre-training, post-training, and 4 weeks follow-up
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Secondary outcome [2]
333682
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electromyography (EMG) of TA during walking
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Assessment method [2]
333682
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Timepoint [2]
333682
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pre-training, post-training, and 4 weeks follow-up
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Secondary outcome [3]
333683
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lower extremity motor score of Fugl-Meyer Assessment
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Assessment method [3]
333683
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Timepoint [3]
333683
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pre-training, post-training, and 4 weeks follow-up
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Secondary outcome [4]
333684
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brain motor evoked potential (MEP) asymmetry calculated by using amplitude of MEP of both hemispheres obtained from MagStim 200 and the formula built by Brouwer et al., 2006.
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Assessment method [4]
333684
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Timepoint [4]
333684
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pre-training, post-training, and 4 weeks follow-up
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Secondary outcome [5]
334657
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electromyography (EMG) of rectus femoris (RF) during walking
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Assessment method [5]
334657
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Timepoint [5]
334657
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pre-training, post-training, and 4 weeks follow-up
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Eligibility
Key inclusion criteria
(1) hemiparesis from a single stroke, (2) after stroke period more than 6 month. (3)able to walk independently for 10 meters with or without an assistive device. (4) Stable medical condition to allow participation in the testing protocol
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Minimum age
20
Years
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Maximum age
80
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
(1) subjects have contraindications of TMS, such as: intracranial metal implants, history of epilepsy or severe heart disease; (2) other non-stroke-related neurological diseases, Such as: cerebellum or vestibular system disease; (3) cognitive dysfunction; (4) muscular system diseases of lower limbs and interfere the walking function.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Stopped early
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Data analysis
Data collected is being analysed
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Reason for early stopping/withdrawal
Participant recruitment difficulties
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Date of first participant enrolment
Anticipated
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Actual
22/12/2010
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Date of last participant enrolment
Anticipated
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Actual
17/05/2011
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Date of last data collection
Anticipated
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Actual
5/07/2011
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Sample size
Target
30
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Accrual to date
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Final
14
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Recruitment outside Australia
Country [1]
8788
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Taiwan, Province Of China
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State/province [1]
8788
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Funding & Sponsors
Funding source category [1]
296162
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Government body
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Name [1]
296162
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Ministry of Science and Technology
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Address [1]
296162
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106, Sec. 2, Heping E. Rd., Taipei 10622, Taiwan, R.O.C
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Country [1]
296162
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Taiwan, Province Of China
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Primary sponsor type
Individual
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Name
Ray-yau, Wang
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Address
Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 112. No. 155, Sec 2, Li Nong St., Shih-Pai, Taipei, Taiwan
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Country
Taiwan, Province Of China
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Secondary sponsor category [1]
295065
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None
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Name [1]
295065
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Address [1]
295065
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Country [1]
295065
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
297408
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Institutional Review Board, Taipei Veterans General Hospital
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Ethics committee address [1]
297408
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No.201, Sec. 2, Shipai Rd., Beitou District, Taipei City, Taiwan 11217, R.O.C.
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Ethics committee country [1]
297408
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Taiwan, Province Of China
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Date submitted for ethics approval [1]
297408
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Approval date [1]
297408
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15/11/2010
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Ethics approval number [1]
297408
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Summary
Brief summary
Background and purpose: Decreased gait performance is one of the functional limitations after stroke. It’s important to establish effective rehabilitation strategies to restore walking function. Repetitive transcranial magnetic stimulation (rTMS) can modulate the excitability of the motor cortex. Some studies showed that combining rTMS with motor training resulted in better improvements in hand function than motor training alone. However, such effects on lower extremity have not been established. The purpose of this study was to investigate effects of combining rTMS with treadmill training on gait performance in chronic stroke patients. Methods: This is a double-blinded randomized control trial. Fourteen participants with chronic stroke were randomly assigned to experimental (n=8) or control group (n=6). Participants in both groups received treadmill training for 30 minitues, 3 times a week for 3 weeks. Before treadmill training, the participants in the experimental group received real rTMS with 5Hz, 10s, 18 trains with total 900 pulses at 90% resting motor threshold for 15 minutes to the ipsilesional primary motor cortex of tibialis anterior (TA) muscle, and the control group received sham rTMS. The outcome measures were collected at pre-training, post-training, and 4 weeks follow-up, including gait velocity, spatial and temporal gait asymmetry index, and electromyography (EMG) of TA and rectus femoris (RF) during walking, lower extremity motor score of Fugl-Meyer Assessment , amplitude of motor evoked potential (MEP)for both hemispheres and brain MEP asymmetry. Friedman test was used to exam within-group improvement at different time points, Mann-Whitney U test was used to exam the differences between groups, and the significant level was set at a=0.05.
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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
73942
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Prof Ray-yau, Wang
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Address
73942
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Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 112. No. 155, Sec 2, Li Nong St., Shih-Pai, Taipei, Taiwan
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Country
73942
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Taiwan, Province Of China
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Phone
73942
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+886928231905
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Fax
73942
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Email
73942
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[email protected]
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Contact person for public queries
Name
73943
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Ray-yau, Wang
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Address
73943
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Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 112. No. 155, Sec 2, Li Nong St., Shih-Pai, Taipei, Taiwan
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Country
73943
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Taiwan, Province Of China
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Phone
73943
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+886928231905
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Fax
73943
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Email
73943
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[email protected]
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Contact person for scientific queries
Name
73944
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Ray-yau, Wang
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Address
73944
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Department of Physical Therapy and Assistive Technology, National Yang-Ming University, 112. No. 155, Sec 2, Li Nong St., Shih-Pai, Taipei, Taiwan
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Country
73944
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Taiwan, Province Of China
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Phone
73944
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+886928231905
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Fax
73944
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Email
73944
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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
Source
Title
Year of Publication
DOI
Embase
High-frequency repetitive transcranial magnetic stimulation enhanced treadmill training effects on gait performance in individuals with chronic stroke: A double-blinded randomized controlled pilot trial.
2019
https://dx.doi.org/10.1016/j.gaitpost.2018.12.023
N.B. These documents automatically identified may not have been verified by the study sponsor.
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