Blepharoptosis, Lagophthalmos
Conditions
Keywords
NMES
Brief summary
Traumatic brain injury, stroke and other neurological conditions may result in weakness of the muscles that either open or close the eye. This is generally a result of impaired functioning of the oculomotor or facial cranial nerves. Current treatments to improve eye opening or closing are either invasive or largely ineffective. This study tests a noninvasive means of improving eyelid opening and closing by applying a previously demonstrated safe and effective neuromuscular electrical stimulation (NMES) intervention to the muscles controlling eyelid movement. Participants in this study will either receive the investigational NMES protocol 30 min per day for five days or a sham NMES for the same period. The primary outcome for this study is the participants' ability to open or close their affected eye. Secondary outcomes include additional measures of eye and corneal health.
Interventions
DEVICENeuromuscular electrical stimulation
A low level electrical current is applied to the muscle that control eyelid function through small electrodes applied to the skin over the target muscles. Treatment is applied daily for 5 consecutive days and exercises for eyelid function are performed in conjunction with the stimulation.
Electrodes are applied to the skin over the target muscles and patient perform the exercises for eyelid function for 5 consecutive days just as in the experimental group, However participants do not receive the electrical stimulation. Due to the low intensity of the stimulation all participants regardless of group allocation are told they may or may not feel the electrical stimulation.
Sponsors
Brooks Rehabilitation
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
TRIPLE (Subject, Investigator, Outcomes Assessor)
Masking description
Participants in treatment and sham group undergo all of the same procedures except a sham NMES treatment is provided to the control group. Only the treating clinician is aware of group allocation. The investigator and outcomes assessor are unaware of group allocation.
Intervention model description
Active treatment vs. Sham control
Eligibility
Sex/Gender
ALL
Age
19 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Cranial nerve III (oculomotor nerve) and/or cranial nerve IV (facial nerve) palsy. * Able to read and communicate in English.
Exclusion criteria
* Idiopathic onset of CN III and/or CN IV palsy. * Traumatic injury to the eye or eyelid. * Active wounds in the treatment area. * Presence of swelling or infection in or surrounding the affected eye. * Diminished sensation in the area to be treated.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Marginal reflex distance-1 (MRD-1) | Within 1 week of last treatment session. | Measure of eyelid function for participants with CN III or CN VII palsy |
| Palpebral fissure height | Within 1 week of last treatment session. | Measure of eyelid function for participants with CN III or CN VII palsy |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| World Health Organization Quality of Life - BREF (WHOQOL-BREF) | Within 1 week of last treatment session. | Measure of Quality of Life for participants with CN III or CN VII palsy |
| Upper eyelid crease distance | Within 1 week of last treatment session. | Measure of eyelid function in participants with CN III or CN VII palsy |
Other
| Measure | Time frame | Description |
|---|---|---|
| Distance visual acuity | Within 1 week of last treatment session. | Measure of overall eye health and function |
| Cornea, Static Asymmetry, Dynamic Function, Synkinesis Classification Scale (CADS). | Within 1 week of last treatment session. | Measure of ophthalmic involvement in facial function in participants with CN VII palsy |
| Distance alternate cover test. | Within 1 week of last treatment. | Measure of overall eye health and function |
| Pupil test | Within 1 week of last treatment session. | Measure of overall eye health and function |
| Oculomotor exam | Within 1 week of last treatment session. | Measure of overall eye health and function in participants with CN III palsy |
Countries
United States
Outcome results
None listed