Triple therapy to boost stroke recovery in Azerbaijan: combining brain stimulation, medication, and physiotherapy

ISRCTN ISRCTN45191532
DOI https://doi.org/10.1186/ISRCTN45191532
Submission date
30/01/2025
Registration date
13/02/2025
Last edited
12/02/2025
Recruitment status
Recruiting
Overall study status
Ongoing
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data
Record updated in last year

Plain English summary of protocol

Background and study aims
This research will study the effectiveness of cerebrolysin in combination with physical methods of treatment, including transcranial direct current stimulation (tDCS), kinesitherapy, and massage, in the rehabilitation of patients with cerebral stroke.

Who can participate?
Patients aged between 18 and 85 years old with acute ischemic stroke in the early recovery period (90-180 days) and late (from 6 months to a year)

What does the study involve?
The investigators hypothesize that the triple therapy concept in this study (cerebrolysin plus tDCS plus standardized physiotherapy) will be superior in improving the patient's motor skills and quality of life after stroke compared to traditional physiotherapy plus tDCS alone.

What are the possible benefits and risks of participating?
Benefits and risks not provided at registration

Where is the study run from?
The Azerbaijan Scientific Research Institute of Medical Rehabilitation

When is the study starting and how long is it expected to run for?
March 2024 to March 2026

Who is funding the study?
The Azerbaijan Scientific Research Institute of Medical Rehabilitation

Who is the main contact?
Mrs Sadagat Huseynova, hsadagat@gmail.com, huseynova-sadagat@rambler.ru

Contact information

Mrs Sadagat Huseynova
Public, Scientific, Principal Investigator

Azerbaijan Scientific Research Institute of Medical Rehabilitation
Khatai Avenue, 9
Baku, Narimanov
AZ1008
Azerbaijan

Phone +994 12 496-07-06, +994 12 496-07-47, +994 12 496-07-48
Email hsadagat@gmail.com

Study information

Study designSingle-centre interventional randomized open-label study
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)University/medical school/dental school
Study typeSafety, Efficacy
Participant information sheet Not available in web format, please use the contact details to request a participant information sheet
Scientific titleCINEMA study - cerebrolysin neuro modulation Azerbaijan
Study acronymCINEMA
Study objectivesThe investigators hypothesize that the innovative triple therapy concept in this study (cerebrolysin plus transcranial direct current stimulation [tDCS] plus standardized physiotherapy) will be superior in improving the patient's motor skills and quality of life after stroke compared to traditional physiotherapy plus tDCS alone.
Ethics approval(s)

Approved 23/09/2024, Ethics Committee of Azerbaijan Medical University (Samad Vurghun, Baku, AZ1022, Azerbaijan; +994125973898; info@amu.edu.az), ref: 35

Health condition(s) or problem(s) studiedTo study the effectiveness of the use of cerebrolysin in combination with physical methods of treatment (direct current stimulation, kinesitherapy, massage) in the rehabilitation of patients with cerebral stroke.
InterventionThis is a single-centre interventional randomised open-label study design:
The study will involve 60 patients with cerebral stroke (CS) in the early (from 3 to 6 months) and late (from 6 months to a year) recovery periods of the disease. Patients will be divided into 2 groups.
1. Patients in group I (main) will receive injections of cerebrolysin - 30 ml diluted in 100 ml of NaCl solution, intravenously, by drop infusion (14 days). On the same day, patients will receive transcranial direct current stimulation (tDCS) kinesiotherapy (proprioceptive neuromuscular facilitation (PNF), constraint-induced movement (Ci) therapy) and massage.
2. Patients of group II (control, comparison group) will receive only tDCS kinesiotherapy and massage.

Methods of kinesitherapy (task-oriented approach):
1. Treatment by constraint-induced movement, Ci-therapy.
2. Method of proprioceptive muscle facilitation - PNF.
Intervention typeMixed
Primary outcome measureFunctional activity of the upper limbs is measured using the Action Research Arm Test (ARAT) on the 14th day after the start of treatment
Secondary outcome measuresThe following secondary outcome measures are assessed on day 15:
1. The severity of neurological deficit measured using the NIH Stroke Scale/Score (NIHSS) scale
2. Daily life activity measured using the Barthel scale (and Rankin scale)
3. Cognitive functions measured using the Mini-Mental State Examination (MMSE) scale (or Functional Independence Measure (FIM), Montreal Cognitive Assessment (MoCA))
4. Functional activity of the upper limbs measured using the ARAT
5. Electrical activity of the muscles measured using electromyography (EMG)
Overall study start date01/03/2024
Completion date01/03/2026

Eligibility

Participant type(s)Health professional
Age groupMixed
Lower age limit18 Years
Upper age limit85 Years
SexBoth
Target number of participants60
Key inclusion criteria1. Ischemic stroke patients
2. Non-transient arm paresis
3. Aged 18-85
4. Intact cortico-spinal tract
5. Baseline NIHSS above 8.
Key exclusion criteria1. Progressive or unstable stroke
2. Preexisting or active major neurological or psychiatric disease
3. History of significant alcohol or drug abuse within the previous 3 years
4. Advanced liver, kidney, cardiac, or pulmonary disease
5. Terminal medical diagnosis with an expected survival of <l year
6. Substantial decrease in alertness at the time of randomization
7. Any condition that would represent a contraindication for cerebrolysin administration, including allergy
8. Pregnancy or lactation
9. Participation in another therapeutic study of stroke or stroke recovery
Date of first enrolment01/03/2024
Date of final enrolment01/03/2026

Locations

Countries of recruitment

  • Azerbaijan

Study participating centre

Azerbaijan Scientific Research Institute of Medical Rehabilitation
AZ1073, 103 Mikail Mushfig
Baku
AZ1073
Azerbaijan

Sponsor information

Azerbaijan Medical University
University/education

Samad Vurghun
Baku
AZ1022
Azerbaijan

Phone +994125973898
Email info@amu.edu.az
Website https://amu.edu.az/
ROR logo "ROR" https://ror.org/016a0n751

Funders

Funder type

University/education

Azerbaijan Scientific Research Institute of Medical Rehabilitation

No information available

Results and Publications

Intention to publish date31/10/2026
Individual participant data (IPD) Intention to shareYes
IPD sharing plan summaryAvailable on request
Publication and dissemination planPlanned publication in a peer-reviewed journal.
IPD sharing planThe datasets generated during and/or analysed during the current study will be available upon request from Mrs Huseynova Sadagat, hsadagat@gmail.com, huseynova-sadagat@rambler.ru

Editorial Notes

30/01/2025: Study's existence confirmed by the Ethics Committee of Azerbaijan Medical University.