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Active, not recruitingNCT03306615Updated Jun 30, 2026

Peripheral Modulation of Muscle Stiffness and Spasticity

A Phase 2 interventional study of Hyaluronidase and Placebo in Muscle Spasticity, sponsored by Johns Hopkins University. Active, not recruiting at 1 site in United States. Open to participants aged 18 Years and older. Per ClinicalTrials.gov, last updated 2026-06-30.

Sponsored by Johns Hopkins University · Phase 2, Interventional, and Treatment

Phase
Phase 2
Study type
Interventional
Enrollment
56
Allocation
Randomized
Ages
18 Years and older
Sex
All
01

Study summary

This is a single-center, double-blind, randomized, placebo-controlled, sequential Phase II trial of human recombinant hyaluronidase injections in individuals with post-stroke upper limb muscle stiffness. The investigators will recruit 56 subjects, who will be randomized to receive either the intervention or normal saline injections (first injection), and then the intervention the participants did not receive first (second injection). All individuals will receive the treatment by the end of the study.

Read the detailed description
  1. To test the effect of hyaluronidase injections on upper limb outcomes. The investigators will test the hypothesis that compared to placebo, human recombinant hyaluronidase injections will increase passive range of motion (ROM) in the most affected joint of the upper limb (primary outcome), isometric muscle strength or force generation capacity using Maximum Voluntary Contraction (MVC) on electromyography (EMG), reduce upper limb motor impairment as measured by the Fugl-Meyer (FM) scale, and improve function as measured by the Wolf Motor Function Test (WMFT).
  2. To evaluate the effect of hyaluronidase on neural and non-neural components of muscle stiffness. The investigators will test the hypothesis that compared to placebo, intramuscular (IM) hyaluronidase will modulate the passive and potentially also the active component of the stretch reflex, reduce stiffness and improve arm motor control.
  3. To determine the effect of hyaluronidase on intramuscular glycosaminoglycans (GAG) content. The investigators will test the hypothesis that compared to placebo, IM hyaluronidase will reduce the T1rho relaxation times in the biceps and triceps muscles of the affected arm.
02

Conditions studied

  • Muscle Spasticity

Keywords

  • Muscle Stiffness
  • Muscle Spasticity
  • Stroke
  • Cerebral Palsy
  • Hyperreflexia
03

In context

Muscle Spasticity

621 studies on the registry are indexed under Muscle Spasticity; 127 are open to participants now.

This study's planned enrollment of 56 is above the median of 36 across 472 interventional studies indexed under Muscle Spasticity.

Browse Muscle Spasticity studies →

Lead sponsor

Johns Hopkins University is the lead sponsor of 1,815 studies on the registry; 315 are open to participants now.

Of its 208 completed or terminated interventional studies of FDA-regulated products, 144 (69%) have results posted.

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

04

Who can participate

Ages eligible
18 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Ischemic or hemorrhagic stroke 4-180 months prior
  • Moderately-severe muscle stiffness
  • Lack of full passive and active range of motion in at least 2/4 areas (shoulder, elbow, forearm, wrist) in the hemiparetic upper limb;
  • Willingness to have MRI, complete all clinical assessments, and comply with study protocols;
  • Ability to give and HIPPA certifications; and

Exclusion criteria

Exclusion Criteria:

  • treatment of spasticity with Botulinum toxin or intrathecal baclofen within the past six months, phenol injections within the past 12 months, or ongoing adjustment of anti-spastic medications;
  • other neurologic condition that may affect motor response (e.g., Parkinson's disease, amyotrophic lateral sclerosis (ALS), MS);
  • cognitive dysfunction with score \<19 on Folstein's Mini Mental Status Examination or depression with score >10 on the Patient Health Questionnaire-9 (PHQ-9);
  • pregnancy;
  • known to hyaluronidase;
  • claustrophobia;
  • standard for MRI
  • Any condition that will preclude the patient from completing the protocol as determined by the PI
Terms in these criteria, in plain language(4)

Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.

Informed consent

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You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.

Clinically significant

Judged by the study doctor to matter for your health or for the study. It is a doctor’s decision, so ask the study team if you are unsure whether something counts.

Hypersensitivity

An allergy, or another reaction of the immune system, to a substance. “Hypersensitivity to the study drug” means a known allergic reaction to it — not every side effect a medicine can have.

Contraindication

A reason a treatment, test or procedure should not be given to a particular person, such as an allergy, another illness or a medicine they take.

05

Study design

Phase
Phase 2
Primary purpose
Treatment
Allocation
Randomized
Intervention model
Parallel assignment
Masking
Double (Participant, Care provider)
Enrollment
56 participants (estimated)

Study arms

  • Experimental
    Treatment Arm

    Hyaluronidase plus saline

    Drug: Hyaluronidase

  • Placebo comparator
    Control Arm

    Normal Saline

    Drug: Placebo

Interventions

  • HYLENEX recombinant, diluted with 0.9% Sodium Chloride Injection

    Also known as: Hylenex

  • DrugPlacebo

    0.9% Sodium Chloride Injection

    Also known as: Normal saline

06

What researchers measure

Primary outcomes

  1. Most affected upper limb joint passive range of motion (Cohort 1)

    passive range of motion in most affected joint across the upper limb

    Time frame: 9 weeks

  2. Most affected upper limb joint passive range of motion (Cohort 2)

    passive range of motion in most affected joint across the upper limb

    Time frame: 15 weeks

Secondary outcomes

  1. Total upper limb passive and active range of motion

    passive and active range of motion in shoulder, elbow and forearm joints

    Time frame: 15 weeks

  2. Change in upper limb Fugl-Meyer Assessment Score

    measures motor impairment in the affected upper limb, Score range is 0-66, and a higher score indicates a better outcome

    Time frame: 15 weeks

  3. Change in Wolf-Motor Function Test (WMFT) Score

    Measures upper extremity function following stroke, Includes 6 items, with a 0-5 score range for each item, and a higher score indicates a better outcome

    Time frame: 15 weeks

07

Study locations

1 site
08

Timeline

Tracking since Sep 25, 2026
ElapsedEstimatedEstimated, not yet reached

Ran from Oct 2021 to primary completion in Jun 2026, 56 months.

How these figures are worked out, and which studies are left out of them.

Registered
Oct 3, 2017
First posted
Oct 11, 2017
StartActual
Oct 11, 2021
Primary completionActual
Jun 26, 2026
CompletionEst.
Jun 26, 2027
Last update
Jun 30, 2026
What these dates mean
Start.
When the first participant enrolled; while estimated, when the study expects to open to recruitment.
Primary completion.
When the last participant was examined or treated to collect data for the study's main question, its primary outcome. A study that stopped early gives the date its data collection stopped.
Completion.
When the last participant's last visit took place, for every outcome, secondary ones and side effects included: the end of the study. Often later than primary completion, sometimes the same day.
Actual and Est.
Actual means the registry says the date has happened. Est. (estimated) is a date the sponsor plans or expects. It can still move, and the sponsor is expected to change it to actual once it has passed.
No changes since tracking began. The registry record was last updated on Jun 30, 2026, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
09

Registry details

Key details

Study ID
NCT03306615
Collaborators
Sheikh Khalifa Stroke Institute
Responsible party
Sponsor
First posted
Oct 11, 2017
Start date
Oct 11, 2021
Primary completion
Jun 26, 2026
Completion
Jun 26, 2027 (estimated)
Last update
Jun 30, 2026

Study contacts

Ning Cao, MD
principal investigator · Johns Hopkins University

Oversight

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

Not currently enrolling

This study is active, not recruiting, as verified in Jun 2026. You cannot join it, but the record below documents what was studied.

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Studies of the drug tested here: Hyaluronoglucosaminidase

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