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Trial registered on ANZCTR
Registration number
ACTRN12614000490673
Ethics application status
Approved
Date submitted
15/04/2014
Date registered
12/05/2014
Date last updated
12/05/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Effects of eccentric exercise on calf muscle contracture in people with multiple sclerosis
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Scientific title
In people with multiple sclerosis, do eccentric exercises, compared with routine stretching, reduce contracture in ankle joint and calf muscle?
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Secondary ID [1]
284444
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Ankle joint contracture
291653
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Multiple sclerosis
291654
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Condition category
Condition code
Physical Medicine / Rehabilitation
292040
292040
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0
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Physiotherapy
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Musculoskeletal
292041
292041
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0
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Other muscular and skeletal disorders
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Neurological
292042
292042
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0
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Multiple sclerosis
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Participants in intervention group will be exercising under supervision at a university-based gym two times each week for twelve weeks. Each exercise session will last about 45-60 minutes. The exercise involves walking backwards and downhill on a treadmill. This type of exercise is known to produce muscle soreness - the same sort of soreness that people normally experience after they participate in unaccustomed physical activity. We expect that, if participants in intervention group will experience muscle soreness. However, the soreness will gradually be less and less over the 12-week period. To minimize this muscle soreness, participants will be trained at low intensity at start and gradually increased intensity over the first 8 sessions.
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Intervention code [1]
289196
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Rehabilitation
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Intervention code [2]
289345
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Treatment: Other
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Comparator / control treatment
home-based exercises, including stretching the ankle, to practice at home for 20-30 minutes at least 2 times per week over the 12 week treatment period. Home-based exercises will involve strengthening exercises for affected muscle groups (e.g. hip flexors, knee flexors or ankle dorsiflexors). Participants will learn these exercises at base line testing. The exercises will be either recorded on participant's smart phone or on papers if they do not use smart phones. Adherence to exercises will be monitored monthly by phone calls.
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Control group
Active
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Outcomes
Primary outcome [1]
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passive ankle dorsiflexion range of motion of the affected leg at 12Nm using a Cybex equipment (Humac Norm)
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Assessment method [1]
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Timepoint [1]
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Baseline (before training) and at completion of 12-week training (or 24 sessions)
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Secondary outcome [1]
307823
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The passive mechanical properties of the gastrocnemius muscle including: passive slack length of the gastrocnemius muscle-tendon unit, passive muscle fascicle slack length as well as length–tension curves of the muscle fascicles and tendons. The outcomes are derived from using ultrasound in combination with measurements of passive ankle torques at difference knee angles (Hoang et al, 2007).
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Assessment method [1]
307823
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Timepoint [1]
307823
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Baseline (before training) and at completion of 12-week training (or 24 sessions)
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Secondary outcome [2]
307824
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Mobility capacity (10-meter and 6-minute Walk tests)
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Assessment method [2]
307824
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Timepoint [2]
307824
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Baseline (before training) and at completion of 12-week training (or 24 sessions)
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Secondary outcome [3]
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Gait parameters (step length and gait symmetry) using Gaitrite mat
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Assessment method [3]
307825
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Timepoint [3]
307825
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Baseline (before training) and at completion of 12-week training (or 24 sessions)
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Secondary outcome [4]
307826
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Frequency of accidental falls during the intervention and 3 months after completion. Incidents of falls are collected by using Falls diary: participants in both groups will be given 6 monthly calendars and 6 "reply paid" envelopes. Participants will be asked to record date and time falls (defined as inadvertently ended on the ground during daily activities) and consequences if any (e.g. bruise, broken bones). Calendars are sent back to investigators monthly.
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Assessment method [4]
307826
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Timepoint [4]
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During 12-week training and 3 month follow-up after completion of training
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Eligibility
Key inclusion criteria
* A definite diagnosis of multiple sclerosis (MS), confirmed by neurologists
* Less than 90 degrees of ankle dorsiflexion range of motion when a dorsiflexion torque of 12 Nm is applied to the relaxed ankle
* Have EDSS scale between 1 and 5
* Able to understand spoken English and follow instructions during testing and exercise
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Minimum age
18
Years
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Maximum age
65
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
* Being unable to give informed consent, or
* Have received a Botox injection for their calf muscles in the past 6 months or expect to receive a Botox injection for their calf muscles in the subsequent 12 weeks
* Have been advised by a medical doctor not to do exercise
* Had a relapse (or attack) of MS in the previous 30 days
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Participants will be randomly allocated to one of two groups - an Eccentric Training group or a Control group - using a simple (unrestricted) allocation procedure. The allocation schedule will be drawn up by a person who is not otherwise involved in the trial. This will be concealed from the researchers involved in recruitment, consent and assessment procedures. After potential participants have given consent and baseline measures have been taken the allocation will be determined by contacting the person holding the allocation sequence. The participant will be considered to have entered the trial when the allocation is divulged.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Parallel
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Other design features
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Phase
Not Applicable
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
2/06/2014
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Actual
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Date of last participant enrolment
Anticipated
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Actual
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
40
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
NSW
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Funding & Sponsors
Funding source category [1]
289094
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Other
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Name [1]
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Neuroscience Research Australia
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Address [1]
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Street Address:
NeuRA
Margarete Ainsworth Building
Barker Street
Randwick NSW 2031
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Country [1]
289094
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Australia
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Primary sponsor type
Other
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Name
Neuroscience Research Australia
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Address
Street Address:
NeuRA
Margarete Ainsworth Building
Barker Street
Randwick NSW 2031
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Country
Australia
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Secondary sponsor category [1]
287755
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Charities/Societies/Foundations
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Name [1]
287755
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Multiple Sclerosis Research Australia
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Address [1]
287755
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Street address:
Level 26, Northpoint, 100 Miller Street, North Sydney NSW 2060
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Country [1]
287755
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Australia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
290881
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Australia Catholics University HREC
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Ethics committee address [1]
290881
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Street address: 25A Barker Rd, Strathfield NSW 2135
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Ethics committee country [1]
290881
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Australia
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Date submitted for ethics approval [1]
290881
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Approval date [1]
290881
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28/11/2013
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Ethics approval number [1]
290881
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2013 312N
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Ethics committee name [2]
290882
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University of New South Wales HREC
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Ethics committee address [2]
290882
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Street address: High St, Kensington NSW 2052
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Ethics committee country [2]
290882
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Australia
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Date submitted for ethics approval [2]
290882
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18/04/2014
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Approval date [2]
290882
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Ethics approval number [2]
290882
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Summary
Brief summary
Many people with MS develop ankle contractures (a stiffening of the ankle joint) that can impact on normal movement at a very early stage. There is moderate-to-high quality evidence that stretch, the first line of intervention for prevention and treatment of joint contracture in physiotherapy, does not have clinically useful immediate, short-term or long-term effects on joint range of motion. This study will investigate whether exercise that stretches the calf muscle while they contract (eccentric exercise) can be used to treat ankle contractures in people with MS. 40 people with MS who have developed ankle contractures will be randomly allocated either to receive or not receive a 12-week program of eccentric exercise of calf muscle. Ankle joint range of motion, calf muscle properties and parameters of gait and mobility will be measured before and after the 12-week period.
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
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/AnzctrAttachments/366173-Approval from ACU.pdf
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Attachments [2]
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/AnzctrAttachments/366173-Previous UNSW Ethics Approval.pdf
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Attachments [3]
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/AnzctrAttachments/366173-HC14073 Letter from 01 Apr2014 Meeting-1.pdf
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Contacts
Principal investigator
Name
47750
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Dr Phu Hoang
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Address
47750
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Neuroscience Research Australia
Margarete Ainsworth Building
Barker Street Randwick Sydney NSW 2031
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Country
47750
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Australia
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Phone
47750
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+61 2 9399 1832
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Fax
47750
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Email
47750
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[email protected]
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Contact person for public queries
Name
47751
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Phu Hoang
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Address
47751
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Neuroscience Research Australia
Margarete Ainsworth Building
Barker Street Randwick Sydney NSW 2031
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Country
47751
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Australia
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Phone
47751
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+61 2 9399 1832
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Fax
47751
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Email
47751
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[email protected]
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Contact person for scientific queries
Name
47752
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Phu Hoang
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Address
47752
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Neuroscience Research Australia
Margarete Ainsworth Building
Barker Street Randwick Sydney NSW 2031
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Country
47752
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Australia
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Phone
47752
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+61 2 9399 1832
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Fax
47752
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Email
47752
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
Download to PDF