Pilot study to investigate the effectiveness of combining physiotherapy and electrical stimulation to improve mobility in recently discharged stroke patients
ISRCTN | ISRCTN91639560 |
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DOI | https://doi.org/10.1186/ISRCTN91639560 |
Secondary identifying numbers | Version 1 |
- Submission date
- 09/03/2007
- Registration date
- 16/07/2007
- Last edited
- 18/04/2016
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Plain English summary of protocol
Not provided at time of registration
Contact information
Dr Paul Taylor
Scientific
Scientific
The National Clinical Functional Electrical Stimulation Systems Centre
Salisbury NHS Foundation Trust
Salisbury District Hospital
Salisbury
SP2 8BJ
United Kingdom
Phone | +44 (0)1722 429119 |
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p.taylor@salisburyfes.com |
Study information
Study design | Randomised controlled pilot study. |
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Primary study design | Interventional |
Secondary study design | Randomised controlled trial |
Study setting(s) | Other |
Study type | Treatment |
Participant information sheet | Patient information can be found at: http://www.salisburyfes.com/index2.htmReferral criteria and treatment protocol on: http://www.salisburyfes.com/pdfs/referral.PDF |
Scientific title | Pilot study to investigate the effectiveness of combining physiotherapy and electrical stimulation to improve mobility in recently discharged stroke patients |
Study acronym | EPIC - Electrical stimulation as Part of Integrated Physiotherapy |
Study objectives | Electrical stimulation improves mobility, when delivered as an integrated part of outpatient physiotherapy for people less than 6 months post stroke. This pilot study will investigate the use of electrical stimulation integrated into physiotherapy to improve gait in early stroke rehabilitation. The study will take place in a realistic clinical setting using techniques appropriate to a typical outpatient physiotherapy department. Stimulation will be applied to improve gait directly during walking. By using electrical stimulation in gait it is hoped to facilitate a more normal muscle activation pattern. It will also be used on various lower limb muscle groups as exercise to promote muscle strength, reduce antagonist spasticity and improve range of movement. During exercise and walking multiple muscle groups could be stimulated guided by the patient's particular problems. |
Ethics approval(s) | Approved by Wiltshire Ethics Committee (ref: 07/Q2004/19) |
Health condition(s) or problem(s) studied | Cerebral vascular accident/stroke |
Intervention | A randomised controlled pilot study model will be used. 30 people who have had a stroke less than 6 months previously with a Rivermead Mobility Index score between 6 and 10 will be randomly assigned to a treatment or control group. The control group will receive physiotherapy appropriate to their needs while the treatment group will receive physiotherapy with the addition of electrical stimulation. All subjects will receive 2 physiotherapy sessions of duration 1 hour a week for 6 weeks. Subjects will be instructed in exercises to perform at home, which will include electrical stimulation in the treatment group. |
Intervention type | Other |
Primary outcome measure | Walking speed over 10 m assessed at Week 1, Week 8 and Week 20. This has been shown to correlate well with more sophisticated measures of gait and is used routinely in the Salisbury Functional Electrical Stimulation Systems (FES) Clinic for comparison and audit purposes. |
Secondary outcome measures | The following will be assessed at Week 1, Week 8 and Week 20: Walking: 1. Effort as measured by Physiological Cost Index over 10 m. Polar heart rate monitor is used for non-invasive estimation of effort during the walking tests. 2. Visual gait analysis from video by blinded assessor using Rivermead Visual Gait Assessment from video when participants are able to walk sufficient distances. This measure should reflect changes in gait quality. Function: 3. Six-minute walk. This simple test is suggested as way of quantifying change in walking ability with less floor or ceiling effects than walking tests over shorter distances. Six and 12 minute walks have been shown to be responsive to change and useful in documenting gait outcome over an inpatient stay. Participation: 4. Canadian Occupational Performance Measure. This measures change in activities of daily living and assesses self-perceived satisfaction and performance. This outcome measure allows trial participants to focus on relevant personal problems and concerns. 5. Hospital Anxiety and Depression Scale, a widely used indicator of mood. 6. Rivermead Mobility Index to measure changes in mobility and to inform one of the selection criteria. |
Overall study start date | 15/04/2007 |
Completion date | 15/04/2009 |
Eligibility
Participant type(s) | Patient |
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Age group | Adult |
Lower age limit | 18 Years |
Sex | Both |
Target number of participants | 30 |
Key inclusion criteria | 1. Participants will be over 18 years 2. Participants will be medically fit enough to undertake physiotherapy (consultant and GP approval will be sought prior to starting the trial) 3. Current inpatient stay will be for rehabilitation following first stroke 4. During the inpatient period participants will have demonstrated they have sufficient motivation, memory and cognitive ability to participate in treatment within physiotherapy and practice outside of treatment sessions 5. Patients will be able to understand spoken instructions 6. Participants' goals must include improving gait 7. Suitable patients will be returning home after hospital discharge with a Rivermead Mobility Index of between 6 and 10 8. Participants will be able to attend the hospital for twice weekly physiotherapy i.e. will have suitable transport and live within 25 miles of the hospital |
Key exclusion criteria | 1. Unable to tolerate sensation of stimulation (assessed prior to acceptance onto the trial) 2. Poor skin condition making stimulation unsuitable 3. Previous neurological conditions likely to influence response to treatment 4. Orthopaedic/other health problems limiting ability to participate or use stimulation/physiotherapy 5. Score of 25 or under on Mini Mental Test 6. Pacemaker and other active implant users 7. Poorly controlled epileptics 8. Pregnancy |
Date of first enrolment | 15/04/2007 |
Date of final enrolment | 15/04/2009 |
Locations
Countries of recruitment
- England
- United Kingdom
Study participating centre
The National Clinical Functional Electrical Stimulation Systems Centre
Salisbury
SP2 8BJ
United Kingdom
SP2 8BJ
United Kingdom
Sponsor information
Salisbury NHS Foundation Trust (UK)
Hospital/treatment centre
Hospital/treatment centre
Salisbury NHS Foundation Trust
Salisbury District Hospital
Wiltshire
Salisbury
SP2 8BJ
England
United Kingdom
Phone | + 44 (0)1722 425027 |
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Stef.Scott@salisbury.nhs.uk | |
https://ror.org/00ja2ye75 |
Funders
Funder type
Charity
Stroke Association (ref: TSA 2006/2007) (UK)
Private sector organisation / Associations and societies (private and public)
Private sector organisation / Associations and societies (private and public)
- Location
- United Kingdom
Results and Publications
Intention to publish date | |
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Individual participant data (IPD) Intention to share | No |
IPD sharing plan summary | Not provided at time of registration |
Publication and dissemination plan | Not provided at time of registration |
IPD sharing plan |
Study outputs
Output type | Details | Date created | Date added | Peer reviewed? | Patient-facing? |
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Results article | results | 01/11/2015 | Yes | No |
Editorial Notes
18/04/2016: Publication reference added