NA-CONTROL: a study protocol for a randomised controlled trial to compare specific outpatient rehabilitation that targets cerebral mechanisms through relearning motor control and uses self-management strategies to improve functional capability of the upper extremity, to usual care in patients with neuralgic amyotrophy

Autor: Baziel G.M. van Engelen, Renee Lustenhouwer, Nens van Alfen, Jan T. Groothuis, Alexander C. H. Geurts, Ian G. M. Cameron, Rick C. Helmich, Ivan Toni
Jazyk: angličtina
Rok vydání: 2019
Předmět:
medicine.medical_treatment
Medicine (miscellaneous)
Parsonage Turner syndrome
Neurological disorder
law.invention
240 Systems Neurology
Study Protocol
0302 clinical medicine
Randomized controlled trial
law
Outcome Assessment
Health Care
Outpatients
Medicine
Pharmacology (medical)
030212 general & internal medicine
111 000 Intention & Action
Randomized Controlled Trials as Topic
lcsh:R5-920
Rehabilitation
Neuralgic amyotrophy
Disorders of movement Donders Center for Medical Neuroscience [Radboudumc 3]
3. Good health
Scapular dyskinesia
Peripheral nerve dysfunction
Research Design
medicine.symptom
lcsh:Medicine (General)
medicine.medical_specialty
Weakness
Shoulder
Upper extremity
Occupational therapy
03 medical and health sciences
Motor imagery
Physical medicine and rehabilitation
All institutes and research themes of the Radboud University Medical Center
Motor control
Maladaptive neuroplasticity
Brachial Plexus Neuritis
Humans
Neurorehabilitation
business.industry
Action
intention
and motor control
Self-Management
medicine.disease
Dyskinesia
business
Physical therapy
030217 neurology & neurosurgery
Zdroj: Trials
Trials, 20
Trials, Vol 20, Iss 1, Pp 1-17 (2019)
ISSN: 1745-6215
Popis: Background Neuralgic amyotrophy (NA) is a distinct peripheral neurological disorder of the brachial plexus with a yearly incidence of 1/1000, which is characterised by acute severe upper extremity pain. Weakness of the stabilising shoulder muscles in the acute phase leads to compensatory strategies and abnormal motor control of the shoulder - scapular dyskinesia. Despite peripheral nerve recovery, scapular dyskinesia often persists, leading to debilitating residual complaints including pain and fatigue. Evidence suggests that persistent scapular dyskinesia in NA may result from maladaptive cerebral neuroplasticity, altering motor planning. Currently there is no proven effective causative treatment for the residual symptoms in NA. Moreover, the role of cerebral mechanisms in persistent scapular dyskinesia remains unclear. Methods NA-CONTROL is a single-centre, randomised controlled trial comparing specific rehabilitation to usual care in NA. The rehabilitation programme combines relearning of motor control, targeting cerebral mechanisms, with self-management strategies. Fifty patients will be included. Patients are recruited through the Radboud university medical center Nijmegen, the Netherlands. Patients with a (suspected) diagnosis of NA, with lateralized symptoms and scapular dyskinesia in the right upper extremity, who are 18 years or older and not in the acute phase can be included. The primary outcome is the Shoulder Rating Questionnaire score, which measures functional capability of the upper extremity. Secondary clinical outcomes include measures of pain, fatigue, participation, reachable workspace, muscle strength and quality of life. In addition, motor planning is assessed with first-person motor imagery and functional magnetic resonance imaging. In a sub-study the patients are compared to 25 healthy participants, to determine the involvement of cerebral mechanisms. This will enable interpretation of cerebral changes associated with the rehabilitation programme and functional impairments in NA. Discussion NA-CONTROL is the first randomised trial to investigate the effect of specific rehabilitation on residual complaints in NA. It also is the first study into the cerebral mechanisms that might underlie persistent scapular dyskinesia in NA. It thus may aid the further development of mechanism-based interventions for disturbed motor control in NA and in other peripheral neurological disorders. Trial registration ClinicalTrials.gov, NCT03441347. Registered on 20 February 2018. Electronic supplementary material The online version of this article (10.1186/s13063-019-3556-4) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
Externí odkaz: