Neuralgic Amyotrophy: Central Reorganization and Rehabilitation After Peripheral Dysfunction
关键词
抽象
描述
Neuralgic amyotrophy (NA) is a common (incidence 1:1000) peripheral nervous system disorder caused by acute autoimmune inflammation of the brachial plexus, the nerve bundle going to the shoulder and arm. Many NA patients develop abnormal motor control of the shoulder region (i.e. scapular dyskinesia), which persists even after the peripheral nerve damage has recovered. This suggests that persistent scapular dyskinesia in NA may result from (mal)adaptive changes in the central motor system.
Clinical experience shows that the specific, multidisciplinary and personalized rehabilitation program, focused on cognitive motor control can restore scapular dyskinesia in NA patients. This indicates that impairments in the central motor system likely play a role in persistent scapular dyskinesia and that specific rehabilitation may restore any alterations in central motor control.
We hypothesize that the specific rehabilitation program, focused on cognitive motor control is more effective in improving functional disability than usual care and that it can reverse maladaptive changes in central motor control.
日期
| 最后验证: | 08/31/2019 |
| 首次提交: | 02/14/2018 |
| 提交的预估入学人数: | 02/14/2018 |
| 首次发布: | 02/21/2018 |
| 上次提交的更新: | 09/24/2019 |
| 最近更新发布: | 09/26/2019 |
| 实际学习开始日期: | 04/03/2018 |
| 预计主要完成日期: | 11/30/2020 |
| 预计完成日期: | 03/31/2021 |
状况或疾病
干预/治疗
Behavioral: Specific rehabilitation program
Other: Usual Care
相
手臂组
| 臂 | 干预/治疗 |
|---|---|
| Experimental: Specific rehabilitation program Specific, personalized, multidisciplinary rehabilitation program consisting of physical- and occupational therapy. | |
| Other: Usual Care Usual care for people with neuralgic amyotrophy, may vary per individual | Other: Usual Care Participants will receive their usual care for 17 weeks, which may vary for each individual |
资格标准
| 有资格学习的年龄 | 18 Years 至 18 Years |
| 有资格学习的性别 | All |
| 接受健康志愿者 | 是 |
| 标准 | Inclusion Criteria: - (Suspected) diagnosis of neuralgic amyotrophy - In subacute or chronic phase of neuralgic amyotrophy (>2 months after attack onset) - Right-handed - Neuralgic amyotrophy predominantly present in right upper extremity - Presence of scapular dyskinesia Exclusion Criteria: - Patients in the acute phase of NA (characterized by severe pain and inflammation of the brachial plexus) - (Prior) NA attacks of the lumbosacral plexus or the left upper extremity - Sever comorbidity - Any (bio)mechanical constraints of the shoulder girdle - Any other central nervous system, neurological, or neuromuscular disorder |
结果
主要结果指标
1. Change in Shoulder Rating Questionnaire (SRQ) score from baseline [Baseline (0 weeks) and post-intervention (17 weeks)]
2. Change in brain activity related to central motor control from baseline [Baseline (0 weeks) and post-intervention (17 weeks)]
次要成果指标
1. Change in performance on motor imagery tasks assessing motor control [Baseline (0 weeks), post-intervention (17 weeks)]
2. Change in Disability of Shoulder, Arm and Hand (DASH) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
3. Change in Checklist individual strength - subscale fatigue (CIS-fatigue) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
4. Change in McGill Pain Questionnaire (MPQ) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
5. Change in self-efficacy for performing energy conservation strategies assessment (SEPECSA) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
6. Change in Utrecht scale for evaluation of rehabilitation-participation (USER-P) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
7. Change in Pain self efficacy questionnaire (PSEQ) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
8. Change in Patient activation measure (PAM) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
9. Change in Short-form 36 (SF-36) score from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
10. Change in serratus anterior muscle strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
11. Change in shoulder endorotation strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
12. Change in shoulder exorotation strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
13. Change in key grip strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
14. Change in pinch grip strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
15. Change in hand grip strength from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
16. Change in reachable workspace from baseline [Baseline (0 weeks), post-intervention (17 weeks)]
