STROKE
Conditions
Keywords
Barthel Scale, Disability, Modified Ashworth Scale, Right Arm, Neuromodulation, Spasticity, Stroke
Brief summary
The objective of the present trial is to demonstrate Magnetic stimulation as an useful complementary treatment in order to improve patients' evolution without the need of extensive surgical lesion.
Detailed description
Patients with refractory post stroke upper right limb spasticity will operated by Median nerve or Median/ Cubital selective neurotomy depending upon more affected territories. Some of them could be also also operated with posterioris tibialis neurotomy to treat equine's foot whenever also clinically present. Preoperative motor blocks might be possitive in all cases. A week later, they will be treated by magnetic stimulation on selected antagonistic muscles, related to pre - operative affected ones, mostly deltoids, triceps and finger extensors with an equipment Dipol Zeta D5 (Russian Federation), with 1.5 tesla of intensity. Trials will be repeated twice a week in sessions of 30 minutes during 6 months with simultaneous intensive classic rehabilitation. Patients will be monthly evaluated by the mean score of Modified Ashworth Scale, related to fingers, wrist, elbow and shoulder and also with Barthel Scale.
Interventions
PROCEDURE- Postoperative Antagonistic Peripheral Magnetic Stimulation
Selected patients will be treated with Selective peripheral Neurotomy followed by an standartized cycle of Selective Peripheral Magnetic Stimulation and classic post operative Kinesic Therapy. * Sham patients (n 10) will be treated with classic post operative Kinesic Therapy. * Comparision of both groups will be statistified
DEVICESelective Peripheral Magnetic Stimulation
Peripheral 1.5 tesla intensity, 10 Hz of Frequency, with eight saped bovine, of 30 minutes, aplied on antagonistic muscles, twice a week. Intensity will be infrathreshold, 80 per cent of the individual threshold (minimal amount of intensity producing always a muscle motor response in each particular patient)
OTHERKinesics
Session of classic Kinetic Rehabilitation and motor exercises, twice a week on Physicians´s office and dayly on patient´s home.
Sponsors
Juan Carlos M. Andreani MD
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Severe and refractory right Hemiparesia or Hemiplegia, affecting hand function. * Failure of kinesic treatment * 2 points or more Improvement on Modified Ashworth Scale after anestethic blockade
Exclusion criteria
* Severe cardiovascular disease * Severe pulmonary disease * Neoplasia advanced disease * Joint anchylosis * Irreversible retraction for muscle fibrosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Modified Ashworth Scale (MAS) | Post operative Modified Ashworth Scale /MAS) setted up monthly for each patient taking into account the postoperative date, during six continued months. | \- Mean Preoperative and sequencial monthly postoperative evaluation of stiffness and ranges of joint pasive movements at the shoulder, elbow, wrist and fingers. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Fugl - Meyer Scale | Post operative Fugl - Meyer Scale evaluation, setted up monthly for each patient taking into account the postoperative date, during six continued months. | Pre and post operative evaluation of a set of active and pasive movements and articular angles in the upper limb |
| Barthel Scale | Post operative Barthel Scale evaluation setted up monthly for each patient taking into account the postoperative date, during six continued months. | Pre and post operative evaluation of ten basic current dayly life activities, scored 10, 5 or 0 points each one, a total of 100 points |
Contacts
Primary ContactJuan Carlos Mario Andreani, MD
Outcome results
None listed