CClinicalTrials.gg
CompletedNCT02252666Updated Jul 9, 2019Results posted

Exploring the Use of Non-invasive Neuromodulation Combined With Exercise in People With Advanced Multiple Sclerosis (MS)

An interventional study of Neuromodulation Rehabilitation in Multiple Sclerosis, sponsored by University of Wisconsin, Madison. Completed at 1 site in United States. Open to participants aged 18 Years to 90 Years. Per ClinicalTrials.gov, last updated 2019-07-09.

Sponsored by University of Wisconsin, Madison · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
6
Allocation
Not applicable
Ages
18 Years to 90 Years
Sex
All
01

Study summary

The investigators hypothesis is that electrical stimulation to the tongue that directly stimulates two cranial nerve nuclei (Trigeminal and Facial Nerve Nuclei), will excite neural impulses to the brainstem and cerebellum. The investigators call this cranial nerve non-invasive neuromodulation (CN-NINM). The activation of these structures induces neuroplasticity when combined with specific physical exercises, can reduce symptoms of advanced MS, targeting primarily postural stability (sitting and standing), upper extremity movement, and ability to perform self-transfers.

Read the detailed description

The intervention will be similar to that used in the investigators previous work with movement disorders, and will be tailored to the address issues unique to individuals with advanced MS.

The study will enroll a total of 6 subjects having advanced MS that present with significant seated and standing balance, posture, or movement control deficits due to MS.

Subjects will complete twice-daily lab training for two weeks (5 days/week). Each lab training (morning and afternoon) includes 1.5 to 2 hours of instruction in balance, posture and gait activities; therapeutic exercise for isolated muscle control; transfer training; and relaxation training.

Activities are performed in 20-minute sessions with concomitant electrical stimulation of the tongue. The intervention is customized according to each subject's particular symptoms and tolerance. If a subject is not able to perform this amount of training, the training will be adapted to a level that is tolerable.

After these 2 weeks, subjects will continue to perform these same intervention activities at home for 4 weeks. They will return to the lab for 1 week of training and testing, then perform home training for 4 weeks. This cycle is repeated for a total of 5 cycles.

After the 6 months have been completed, subjects may choose to participate in an optional second phase of the study. The second phase includes an additional 12 months of participation in which subjects perform the intervention activities at home training and return to the lab on time per month for 2 hours of testing and 2 hours of training.

If successful, this study would indicate that CN-NINM intervention may reduce the symptoms of advanced MS.

02

Conditions studied

  • Multiple Sclerosis

Keywords

  • MS
  • balance
  • standing
  • control
  • movement
03

In context

Multiple Sclerosis

3,460 studies on the registry are indexed under Multiple Sclerosis; 661 are open to participants now.

This study's enrollment of 6 is below the median of 50 across 2,342 interventional studies indexed under Multiple Sclerosis.

Browse Multiple Sclerosis studies →

Lead sponsor

University of Wisconsin, Madison is the lead sponsor of 1,161 studies on the registry; 182 are open to participants now.

Of its 151 completed or terminated interventional studies of FDA-regulated products, 114 (75%) have results posted.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
18 Years to 90 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subjects must be age 18 or older.
  • Subjects will have a score between 6.5 to 7.5 on the Kurtzke Expanded Disability Status Scale (EDSS). The EDSS is a method of quantifying disability in people with multiple sclerosis.

    • Score of 6.5: needs constant bilateral support to walk 20 meters without resting.
    • Score of 7.0: unable to walk beyond five meters even with aid, and is essentially restricted to a wheelchair; wheels self and transfers alone, and is active in wheelchair about 12 hours a day.
    • Score of 7.5: unable to take more than a few steps and is restricted to wheelchair, and may need aid to transfer; wheels self, but may require a motorized chair for a full day's activities.
  • Subjects will have reached a plateau in an MS focused physical rehabilitation program in the 6 months prior to enrollment.

    • Requiring prior physical therapy will ensure that subjects have a core level of function that will allow them to participate in the study.
    • Requiring that subjects have reached a plateau will ensure that subjects' response to the intervention is due to the use of the device and not to the physical exercises alone.
    • Subjects who have participated in a physical rehabilitation program demonstrate that they are willing and able to commit to a rigorous training regimen.
  • Subjects will have a maximum score of 20 on the Trunk Impairment Scale (TIS). The TIS assesses static dynamic sitting balance and trunk coordination in a sitting position. A score of 20 or lower indicates that their ability to adequately maintain sitting posture is affected.
  • Subjects may have upper extremity involvement.
  • Subjects may have additional symptoms of nystagmus, dysarthria, sensory disturbance, pain, and/or bowel and bladder function. As they present, we will use appropriate assessments at baseline and successive study test points.
  • Subjects are their own legal guardians, and are able to understand and give informed consent.

Exclusion criteria

Exclusion Criteria:

Subjects will have no major co-morbidities, especially neurological disorders, uncontrolled pain, hypertension or diabetes. All subjects, if on medications, will not have had any major changes in type or dosage in within 3 months of enrollment. Additionally, candidates will be excluded if they:

  • have Functional Systems Scores (FSS) 4 or greater for pyramidal, cerebellar, brainstem, and sensory functions; 3 or greater for bowel and bladder function; and 2 or greater for cerebral function;
  • are able to walk independently;
  • use tobacco products (these activities tend to reduce tactile sensitivity in the oral cavity);
  • have any oral abrasions, cuts, cold sores, piercings, tissue inflammation, or have had oral surgery within the previous 3 months;
  • have a pacemaker, or are identified as at-risk for cardiovascular events;
  • have a history of seizures;
  • have a communicable disease;
  • have a biomechanical prosthetic;
  • are females who are pregnant.
05

Study design

Phase
Not applicable
Primary purpose
Treatment
Allocation
Not applicable
Intervention model
Single group
Masking
None (open label)
Enrollment
6 participants (actual)

Study arms

  • Experimental
    Neuromodulation Rehabilitation

    Balance, posture and gait activities; therapeutic exercise for isolated muscle control; transfer training; and relaxation training using neurostimulation modulation. 2-week in lab intervention training, training at home and periodic return for follow-up testing and instruction on the next phase of the intervention.

    Device: Neuromodulation Rehabilitation

Interventions

  • DeviceNeuromodulation Rehabilitation

    CN-NINM uses sequenced patterns of electrical stimulation on the tongue. Our hypothesis is that CN-NINM induces neuroplasticity by noninvasive stimulation of two major cranial nerves: trigeminal, CN-V, and facial, CN-VII.

    Also known as: Cranial Nerve Non-invasive Neuromodulation (CN-NINM), Portable Neuromodulation Stimulator (PoNS)

06

What researchers measure

Primary outcomes

  1. Trunk Impairment Scale (TIS)

    Static and dynamic sitting balance and trunk coordination are evaluated by a clinician. It is scored on a scale from 0-23, where the higher the score, the more improved the balance. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, and 21 weeks

Secondary outcomes

  1. Static Standing Balance Test

    Clinician measures standing balance for up to 30 seconds in each of 5 conditions: feet 10 cm apart, feet together, stride stance, tandem stance, and single leg stance with eyes open and eyes closed. Total score is the sum of all 5 conditions. Higher scores indicate better balance. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  2. Impact of Visual Impairment Scale (IVIS)

    A 5-item self-report questionnaire that assesses the extent to which various activities dependent upon vision are affected by MS-related visual problems. Scores range from 0-15, with higher scores indicating a greater impact of visual problems on daily activities. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, and 21 weeks

  3. Medical Outcomes Study (MOS) Pain Effects Scale (PES)

    A self-report scale that assesses the ways in which pain and unpleasant sensation interfere with mood, ability to walk or move, sleep, work, recreation, and enjoyment of life. This assessment is used for subjects who have pain. Scores can range from 6-30. Items are scaled so that higher scores indicate a greater impact of pain on a patient's mood and behavior. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, and 21 weeks

  4. Bladder Control Scale (BLCS)

    A 4-item self-report scale to evaluate the impact of bladder control on lifestyle. This assessment is used for subjects with bladder issues. Scores can range from 0-22, with higher scores indicating greater bladder control problems. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  5. Bowel Control Scale (BWCS)

    A 5-item self-report scale to evaluate the impact of bowel control on lifestyle. This assessment is used for subjects with bowel issues. Scores can range from 0-26, with higher scores indicating greater bowel control problems. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  6. Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)

    A brief, clinician-administered test that helps determine the neuropsychological status of adults who have neurologic injury or disease such as dementia, head injury, and stroke. This tool consists of a battery of tests. Raw scores are transformed to a 0-120 scale, with a higher score indicating higher function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  7. Walking Distance

    Clinician measures how far the individual can walk until fatigue requires him/her to stop. Longer distances demonstrate improvement. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  8. Walking Speed

    Assessed by timing the first 25 feet that the person walked. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  9. 12-item MS Walking Scale (MSWS-12)

    A 12-item self-report measure of the impact of MS on a person's walking. Raw scores are transformed to a 0-100 scale. A reduction in score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  10. Box & Blocks (B&B) Assessment - Right

    A standardized clinical assessment of gross upper limb dexterity. Subjects move small blocks from one side of a box to the other within a time period (one minute). Each side is tested separately. The score is the number of blocks moved from 0-150. A higher score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  11. Box & Blocks (B&B) Assessment - Left

    A standardized clinical assessment of gross upper limb dexterity. Subjects move small blocks from one side of a box to the other within a time period (one minute). Each side is tested separately. The score is the number of blocks moved from 0-150. A higher score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  12. Multiple Sclerosis Impact Scale (MSIS-29) - Physical

    A 29-item self-report tool that measures the impact of MS on day-to-day life. There are 3 scores, physical, psychological, and total score. Raw scores are transformed to a 0-100 scale. A higher score indicates a greater impact of disease on daily function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  13. Multiple Sclerosis Impact Scale (MSIS-29) - Psychological

    A 29-item self-report tool that measures the impact of MS on day-to-day life. There are 3 scores, physical, psychological, and total score. Raw scores are transformed to a 0-100 scale. A higher score indicates a greater impact of disease on daily function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  14. Modified Fatigue Impact Scale (MFIS)

    A self-report tool that assesses the perceived impact of fatigue on daily activities. Consists of 21 items selected from the Fatigue Impact Scale. Scored on a 0-84 scale. A higher score indicates a greater impact of fatigue on daily activities. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  15. Gross Motor Function Measure (GMFM)

    The GMFM a standardized observational instrument that measures change in gross motor function. Subscales include lying \& rolling; sitting; crawling \& kneeling; standing; and walking, running \& jumping. For the complete test, the raw scores are converted to a 0-100 scale, with higher scores indicating greater functional mobility. The items that we used were scored on a 0-3 scale and changes reported in percent improvement. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 6, 11, 16, 21 and 27 weeks

  16. Slump Test

    Measures and quantifies changes in trunk control during functional sitting. It was quickly determined that this test duplicated the TIS and was difficult to score objectively so the decision was made not to use it for the study. Performance-based and tested in participants who possessed the ability to perform the assessment.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

  17. Modified Rivermead Mobility Index

    An 8 item assessment that quantifies the ability to perform transfers. It has been validated in persons with stroke and a mixed neurologic population (43% MS). Score is a 0-40 scale. A higher score indicates higher function. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

Other outcomes

  1. Video Nystagmography (VNG)

    VNG is a standardized eye tracking test used to measure static and dynamic eye movement control to detect oculomotor abnormalities typically associated with degenerative neurological disorders, particularly in the brainstem and cerebellum. The subject wears goggles while an infrared video camera monitors and records eye movement as the eyes follow a dot on a computer screen.

    Time frame: Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

07

Results

Posted Jun 28, 2019

Participant flow

Participant flow — Overall Study
MilestoneNeuromodulation Rehabilitation
Started6
Completed6
Not completed0

Outcome measures

PrimaryTrunk Impairment Scale (TIS)

Static and dynamic sitting balance and trunk coordination are evaluated by a clinician. It is scored on a scale from 0-23, where the higher the score, the more improved the balance. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, and 21 weeks
Reported as:
Number · percentage of change
Trunk Impairment Scale (TIS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.82
Baseline to Week 62.58
Baseline to Week 111.47
Baseline to Week 161.63
Baseline to Week 213.06
SecondaryStatic Standing Balance Test

Clinician measures standing balance for up to 30 seconds in each of 5 conditions: feet 10 cm apart, feet together, stride stance, tandem stance, and single leg stance with eyes open and eyes closed. Total score is the sum of all 5 conditions. Higher scores indicate better balance. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Static Standing Balance Test
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.90
Baseline to Week 60.57
Baseline to Week 111.04
Baseline to Week 160.90
Baseline to Week 210.49
Baseline to Week 270.32
SecondaryImpact of Visual Impairment Scale (IVIS)

A 5-item self-report questionnaire that assesses the extent to which various activities dependent upon vision are affected by MS-related visual problems. Scores range from 0-15, with higher scores indicating a greater impact of visual problems on daily activities. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, and 21 weeks
Reported as:
Number · percentage of change
Impact of Visual Impairment Scale (IVIS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 21.27
Baseline to Week 62.12
Baseline to Week 113.54
Baseline to Week 163.54
Baseline to Week 212.12
SecondaryMedical Outcomes Study (MOS) Pain Effects Scale (PES)

A self-report scale that assesses the ways in which pain and unpleasant sensation interfere with mood, ability to walk or move, sleep, work, recreation, and enjoyment of life. This assessment is used for subjects who have pain. Scores can range from 6-30. Items are scaled so that higher scores indicate a greater impact of pain on a patient's mood and behavior. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, and 21 weeks
Reported as:
Number · percentage of change
Medical Outcomes Study (MOS) Pain Effects Scale (PES)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.55
Baseline to Week 60.64
Baseline to Week 110.71
Baseline to Week 160.40
Baseline to Week 211.00
SecondaryBladder Control Scale (BLCS)

A 4-item self-report scale to evaluate the impact of bladder control on lifestyle. This assessment is used for subjects with bladder issues. Scores can range from 0-22, with higher scores indicating greater bladder control problems. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Bladder Control Scale (BLCS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.30
Baseline to Week 60.30
Baseline to Week 110.13
Baseline to Week 160.41
Baseline to Week 210.62
Baseline to Week 270.27
SecondaryBowel Control Scale (BWCS)

A 5-item self-report scale to evaluate the impact of bowel control on lifestyle. This assessment is used for subjects with bowel issues. Scores can range from 0-26, with higher scores indicating greater bowel control problems. Symptom specific test, only used for participants who presented symptom. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Bowel Control Scale (BWCS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 21.20
Baseline to Week 60.68
Baseline to Week 110.52
Baseline to Week 161.04
Baseline to Week 210.86
Baseline to Week 270.35
SecondaryRepeatable Battery for the Assessment of Neuropsychological Status (RBANS)

A brief, clinician-administered test that helps determine the neuropsychological status of adults who have neurologic injury or disease such as dementia, head injury, and stroke. This tool consists of a battery of tests. Raw scores are transformed to a 0-120 scale, with a higher score indicating higher function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 2-0.12
Baseline to Week 60.39
Baseline to Week 110.24
Baseline to Week 160.78
Baseline to Week 211.94
Baseline to Week 270.51
SecondaryWalking Distance

Clinician measures how far the individual can walk until fatigue requires him/her to stop. Longer distances demonstrate improvement. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Walking Distance
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.89
Baseline to Week 60.75
Baseline to Week 110.76
Baseline to Week 160.69
Baseline to Week 210.67
Baseline to Week 270.26
SecondaryWalking Speed

Assessed by timing the first 25 feet that the person walked. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Walking Speed
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.77
Baseline to Week 60.84
Baseline to Week 111.00
Baseline to Week 161.01
Baseline to Week 21-0.41
Baseline to Week 27-0.94
Secondary12-item MS Walking Scale (MSWS-12)

A 12-item self-report measure of the impact of MS on a person's walking. Raw scores are transformed to a 0-100 scale. A reduction in score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
12-item MS Walking Scale (MSWS-12)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 2-0.50
Baseline to Week 60.43
Baseline to Week 110.87
Baseline to Week 160.50
Baseline to Week 211.33
Baseline to Week 27-0.42
SecondaryBox & Blocks (B&B) Assessment - Right

A standardized clinical assessment of gross upper limb dexterity. Subjects move small blocks from one side of a box to the other within a time period (one minute). Each side is tested separately. The score is the number of blocks moved from 0-150. A higher score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Box & Blocks (B&B) Assessment - Right
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.52
Baseline to Week 60.45
Baseline to Week 110.47
Baseline to Week 161.17
Baseline to Week 210.21
Baseline to Week 274.95
SecondaryBox & Blocks (B&B) Assessment - Left

A standardized clinical assessment of gross upper limb dexterity. Subjects move small blocks from one side of a box to the other within a time period (one minute). Each side is tested separately. The score is the number of blocks moved from 0-150. A higher score indicates improvement. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Box & Blocks (B&B) Assessment - Left
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.07
Baseline to Week 60.50
Baseline to Week 110.80
Baseline to Week 160.58
Baseline to Week 21-0.04
Baseline to Week 270.00
SecondaryMultiple Sclerosis Impact Scale (MSIS-29) - Physical

A 29-item self-report tool that measures the impact of MS on day-to-day life. There are 3 scores, physical, psychological, and total score. Raw scores are transformed to a 0-100 scale. A higher score indicates a greater impact of disease on daily function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Multiple Sclerosis Impact Scale (MSIS-29) - Physical
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 21.58
Baseline to Week 60.61
Baseline to Week 110.94
Baseline to Week 160.89
Baseline to Week 211.46
Baseline to Week 27-0.71
SecondaryMultiple Sclerosis Impact Scale (MSIS-29) - Psychological

A 29-item self-report tool that measures the impact of MS on day-to-day life. There are 3 scores, physical, psychological, and total score. Raw scores are transformed to a 0-100 scale. A higher score indicates a greater impact of disease on daily function. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Multiple Sclerosis Impact Scale (MSIS-29) - Psychological
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 21.77
Baseline to Week 61.17
Baseline to Week 110.86
Baseline to Week 160.98
Baseline to Week 212.05
Baseline to Week 270.35
SecondaryModified Fatigue Impact Scale (MFIS)

A self-report tool that assesses the perceived impact of fatigue on daily activities. Consists of 21 items selected from the Fatigue Impact Scale. Scored on a 0-84 scale. A higher score indicates a greater impact of fatigue on daily activities. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Modified Fatigue Impact Scale (MFIS)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 20.87
Baseline to Week 63.10
Baseline to Week 112.54
Baseline to Week 161.75
Baseline to Week 211.40
Baseline to Week 270.20
SecondaryGross Motor Function Measure (GMFM)

The GMFM a standardized observational instrument that measures change in gross motor function. Subscales include lying \& rolling; sitting; crawling \& kneeling; standing; and walking, running \& jumping. For the complete test, the raw scores are converted to a 0-100 scale, with higher scores indicating greater functional mobility. The items that we used were scored on a 0-3 scale and changes reported in percent improvement. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Gross Motor Function Measure (GMFM)
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 60.82
Baseline to Week 111.10
Baseline to Week 161.19
Baseline to Week 210.84
Baseline to Week 270.16
SecondarySlump Test

Measures and quantifies changes in trunk control during functional sitting. It was quickly determined that this test duplicated the TIS and was difficult to score objectively so the decision was made not to use it for the study. Performance-based and tested in participants who possessed the ability to perform the assessment.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

No measurements were reported for this outcome.

SecondaryModified Rivermead Mobility Index

An 8 item assessment that quantifies the ability to perform transfers. It has been validated in persons with stroke and a mixed neurologic population (43% MS). Score is a 0-40 scale. A higher score indicates higher function. Performance-based and tested in participants who possessed the ability to perform the assessment. Effect size is reported (quantified difference between baseline and time point). The larger the absolute value, the stronger the effect. Cohen's guidelines for social sciences indicate 0.10 as a "small" effect size, 0.30 as a "medium" effect size, and 0.50 as a "large" effect size.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks
Reported as:
Number · percentage of change
Modified Rivermead Mobility Index
percentage of changeNeuromodulation Rehabilitation
Baseline to Week 21.01
Baseline to Week 61.21
Baseline to Week 110.94
Baseline to Week 161.44
Baseline to Week 211.15
Baseline to Week 270.38
Other pre-specifiedVideo Nystagmography (VNG)

VNG is a standardized eye tracking test used to measure static and dynamic eye movement control to detect oculomotor abnormalities typically associated with degenerative neurological disorders, particularly in the brainstem and cerebellum. The subject wears goggles while an infrared video camera monitors and records eye movement as the eyes follow a dot on a computer screen.

Time frame:
Change from Baseline at 2, 6, 11, 16, 21 and 27 weeks

No measurements were reported for this outcome.

Adverse events

Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
Neuromodulation Rehabilitation0/6 (0%)0/6 (0%)6/6 (100%)
Most frequent other events
Most frequent other events
EventNeuromodulation Rehabilitation
Viral InfectionInfections and infestations2/6
InjuryInjury, poisoning and procedural complications1/6
Trigeminal Neuralgia (TN)Nervous system disorders1/6
FatigueGeneral disorders1/6
Osteoarthritis PainMusculoskeletal and connective tissue disorders1/6

Baseline characteristics

Age, Categorical
Age, Categorical(Participants)Neuromodulation Rehabilitation
<=18 years0
Between 18 and 65 years5
>=65 years1
Sex: Female, Male
Sex: Female, Male(Participants)Neuromodulation Rehabilitation
Female5
Male1
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)Neuromodulation Rehabilitation
Hispanic or Latino1
Not Hispanic or Latino5
Unknown or Not Reported0
Race (NIH/OMB)
Race (NIH/OMB)(Participants)Neuromodulation Rehabilitation
American Indian or Alaska Native0
Asian0
Native Hawaiian or Other Pacific Islander0
Black or African American0
White5
More than one race0
Unknown or Not Reported1
Region of Enrollment
Region of Enrollment(participants)Neuromodulation Rehabilitation
United States6
Disease Chronicity
Disease Chronicity(years)Neuromodulation Rehabilitation
Mean17.7 ± 7.4
EDSS Score
EDSS Score(units on a scale)Neuromodulation Rehabilitation
Mean7.0 ± 0.4
MS Subtype
MS Subtype(participants)Neuromodulation Rehabilitation
SPMS5
PPMS1
08

Study locations

1 site
  • TCNL, 455 Science Drive, Suite 165
    Madison, Wisconsin 53711, United States
09

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jul 9, 2019, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
10

Registry details

Key details

Study ID
NCT02252666
Lead sponsor
University of Wisconsin, Madison
Responsible party
Sponsor
First posted
Sep 30, 2014
Start date
Mar 2014
Primary completion
Jan 2017
Completion
Jun 28, 2017
Results posted
Jun 28, 2019
Last update
Jul 9, 2019

Study contacts

Mitchell E Tyler, MS
principal investigator · University of Wisconsin, Madison

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

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