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Trial registered on ANZCTR
Registration number
ACTRN12614001011673
Ethics application status
Approved
Date submitted
10/09/2014
Date registered
19/09/2014
Date last updated
19/09/2014
Type of registration
Prospectively registered
Titles & IDs
Public title
Electrical therapy for faecal incontinence in children with spina bifida
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Scientific title
Transcutaneous electrical stimulation as an alternative therapy for faecal incontinence in children with spina bifida
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Secondary ID [1]
285148
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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:
Faecal incontinence
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Spina bifida
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Condition category
Condition code
Neurological
293031
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0
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Other neurological disorders
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Human Genetics and Inherited Disorders
293358
293358
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0
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Other human genetics and inherited disorders
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Oral and Gastrointestinal
293359
293359
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
The transcutaneous electrical stimulation (TES) machine is a small device (approximately 20 cm x 30 cm), connected to 240V power source. It has two independent channels of current. We use electrodes that are small sticky pads of 4 cm x 4 cm (pure silicon). The device delivers an interferential current with a carrier frequency of 4 Hz, a beat frequency sweep covering 80 to 160 Hz, with an adjustable intensity less than 33 milliA. Individual pulses have duration of 250 micros (constant alternating current).
Two pairs of electrodes are placed on the front and on the back of the inferior abdomen. Stimulation will be delivered daily for 1 hour, either mornings or evenings, for 2 months, at home, by the participant themselves or their carer.
Patients will be in contact by phone each week and asked if they have used the TES each day and for how long. TES use will be recorded on the daily bowel diary.
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Intervention code [1]
289998
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Treatment: Devices
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Comparator / control treatment
Participants will provide their own control data.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Severity of faecal incontinence (based on the bowel diaries). The bowel diaries will record frequency of bowel movements, time spent for defecation, need for help for evacuation (digital stimulation, laxatives, enemas), feeling of completeness of evacuation, associated pain, frequency of faecal incontinence, incontinence for solid or liquid stool, incontinence for gas, need to wear a pad or a plug. It is a composite primary outcome: this will allow us to obtain a score of faecal incontinence (St-Marks faecal incontinence score).
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Assessment method [1]
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Timepoint [1]
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Daily diaries will be completed by the participant during a two times two-week period, during the 2 months of baseline measurements and then during the 2 months of the intervention (stimulation), .
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Secondary outcome [1]
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Quality of life (assessed by the FICQOL questionnaire)
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Assessment method [1]
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Timepoint [1]
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Before intervention (baseline) and on completion of the 2-month intervention period
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Secondary outcome [2]
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Colonic transit time (evaluation by radiopaque markers)
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Assessment method [2]
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Timepoint [2]
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Before intervention and on completion of the 2-month intervention period
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Eligibility
Key inclusion criteria
*Presenting with spina bifida aperta or open neural tube defect (i.e. myelomeningocele, meningocele or myeloschisis);
*Aged between 8 and 18 years old at the time of screening;
*Faecal incontinence reported for the last 6 months,
*Failed management of faecal incontinence with retrograde continence enema,
*Ability to answer questionnaires and complete the diary, with parental assistance if necessary.
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Minimum age
8
Years
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Maximum age
18
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
*Has a heart pacemaker or a cochlear implant;
*Has abnormal abdominal sensation
*Presents symptoms or signs of bowel obstruction;
*Has cancer;
*Is pregnant (pregnancy test planned before TES);
*Has had a previous diagnosis of a metabolic or hormonal disorder; and,
*Non English speaking.
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Faecal incontinence in children with spina bifida is currently treated by retrograde continence enema. Transcutaneous electrical therapy will be proposed as an alternative therapy to children with spina bifida aged 8-18 who have failed retrograde continence enema treatment.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 2
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Type of endpoint/s
Safety/efficacy
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Statistical methods / analysis
This phase II study will provide data about the distribution of the incontinence frequency in the population of children with spina bifida who failed treatment with retrograde continence enema. The population is foreseen to be heterogeneous.
We will compare the severity of faecal incontinence and the quality of life before and at the end of 2 months of transcutaneous electrical stimulation. After this study, the range of confidence intervals could be estimated.
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Recruitment
Recruitment status
Not yet recruiting
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Date of first participant enrolment
Anticipated
1/10/2014
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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
15
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
VIC
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Recruitment hospital [1]
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The Royal Childrens Hospital - Parkville
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Recruitment hospital [2]
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Monash Medical Centre - Clayton campus - Clayton
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Recruitment postcode(s) [1]
8519
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3052 - Parkville
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Recruitment postcode(s) [2]
8520
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3168 - Clayton
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Funding & Sponsors
Funding source category [1]
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Hospital
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Name [1]
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Urology department,
The Royal Children's Hospital
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Address [1]
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50 Flemington Road
Parkville Victoria 3052 Australia
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Country [1]
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Australia
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Funding source category [2]
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Other
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Name [2]
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Surgical Research
Murdoch Childrens Research Institute
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Address [2]
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50 Flemington Road
Parkville Victoria 3052
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Country [2]
289761
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Australia
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Funding source category [3]
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Hospital
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Name [3]
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Departement de medico-chirurgical de pediatrie
Centre Hospitalier Universitaire Vaudois
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Address [3]
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21 Rue du Bugnon
1011 Lausanne
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Country [3]
289762
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Switzerland
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Primary sponsor type
Other
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Name
Murdoch Childrens Research Institute
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Address
50 Flemington Road
Parkville Victoria 3052
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
288451
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Country [1]
288451
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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The Royal Children's Hospital HREC
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Ethics committee address [1]
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50 Flemington Road Parkville Victoria 3052
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291484
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Approval date [1]
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01/08/2014
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Ethics approval number [1]
291484
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34056A
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Summary
Brief summary
The aim of the study is to determine if transcutaneous electrical stimulation can reduce the severity of persistent faecal incontinence in a group of children with spina bifida previously unsuccessfully treated with retrograde continence enema. Faecal incontinence in children with spina bifida is currently treated by retrograde continence enema. Transcutaneous electrical therapy will be proposed as an alternative therapy to children with spina bifida aged 8-18 who have failed retrograde continence enema treatment. We have not tested transcutaneous electrical stimulation on children with spina bifida. There has been one study using transcutaneous electrical stimulation to treat faecal incontinence in children with spina bifida but there were no quantitative outcome measures that could be used to predict the number of patients needed in a randomized control trial. A baseline period will be followed with a therapy (stimulation) period. Outcomes measurements will be compared before and after stimulation. Outcomes are severity of faecal incontinence, quality of life and colonic transit time.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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A/Prof Yves Heloury
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Address
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Urology department,
The Royal Children's Hospital
50 Flemington Road
Parkville Victoria 3052
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Country
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Australia
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Phone
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+61393455400
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Lefteris Stathopoulos
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Address
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Surgical Research
Murdoch Childrens Research Institute
50 Flemington Road
Parkville Victoria 3052
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Country
50631
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Australia
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Phone
50631
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+61399366757
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Fax
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Email
50631
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[email protected]
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Contact person for scientific queries
Name
50632
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Lefteris Stathopoulos
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Address
50632
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Surgical Research
Murdoch Childrens Research Institute
50 Flemington Road
Parkville Victoria 3052
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Country
50632
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Australia
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Phone
50632
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+61399366757
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Fax
50632
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Email
50632
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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.
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