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Trial registered on ANZCTR
Registration number
ACTRN12616001720404
Ethics application status
Approved
Date submitted
6/12/2016
Date registered
14/12/2016
Date last updated
24/07/2018
Type of registration
Prospectively registered
Titles & IDs
Public title
The effects of chiropractic care on sensory integration in children with autism.
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Scientific title
Can chiropractic adjustments change multisensory integration and sensorimotor integration in children with autism? A pilot study.
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Secondary ID [1]
290630
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Nil known
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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:
Autism spectrum disorder
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Asperger's Syndrome
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Condition category
Condition code
Mental Health
300909
300909
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0
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Autistic spectrum disorders
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Physical Medicine / Rehabilitation
300910
300910
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0
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Other physical medicine / rehabilitation
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
A single session of high-velocity, low amplitude, spinal manipulative therapy performed by a registered chiropractor in Auckland, New Zealand at the Centre for Chiropractic Research or at another suitable location. The intervention will involve assessing the full spine for any dysfunctional spinal segments and using spinal manipulation where necessary, this intervention will be pragmatic in style to best replicate chiropractic practice. The intervention session will take approximately 10-15 minutes.
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Intervention code [1]
296507
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Treatment: Other
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Comparator / control treatment
Passive spinal range of motion will be used for the control group, performed by a chiropractor. This is aimed to mimic the full spine assessment and positional set up for chiropractic spinal manipulation, to control for any changes that may result simply from movement of the spine and tactile stimulation. This session will be less than 10 minutes.
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Control group
Active
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Outcomes
Primary outcome [1]
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The primary outcome measures will be data collected that relates to all study processes. Feasibility will be assessed by a composite of: recruitment rates, randomisation, percentage rate of completion of tasks for pre and post assessment measures and time taken to complete the protocol.
As the intervention will only be a single session, there will not be a need to measure compliance rates with the intervention, as participants will not be required to do any follow up.
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Assessment method [1]
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Timepoint [1]
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Baseline and throughout all study processes
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Secondary outcome [1]
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Performance on a sound-induced flash illusion task using a custom built Macroderma Sound-Induced Flash Illusion System. This task is used to measure multisensory integration by assessing how susceptible the individual is to experiencing the illusion. Where a greater susceptibility reflects poorer multisensory integration.
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Assessment method [1]
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Timepoint [1]
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Baseline and post-intervention on the same day
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Secondary outcome [2]
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The bilateral manual co-ordination subscale of the Sensory Integration and Praxis Tests will be used to assess vestibular and proprioceptive processing. This involves reproducing co-ordinated movements of the upper and lower limbs as demonstrated by a research assistant, this will be video and audio recorded and scored based on how well the child replicated the movements.
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Assessment method [2]
329675
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Timepoint [2]
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Baseline and post-intervention on the same day
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Secondary outcome [3]
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Fine motor skills assessed by threading beads onto a string, This is a timed activity.
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Assessment method [3]
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Timepoint [3]
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Baseline and post-intervention on the same day
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Secondary outcome [4]
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Fine motor skills assessed by tracing an outline of a shape on a touch-screen tablet using a stylus, A computer program will measure deviation away from line and time taken to complete task.
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Assessment method [4]
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Timepoint [4]
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Baseline and post-intervention on the same day
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Secondary outcome [5]
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Localisation of tactile stimuli is the second subscale of the Sensory Integration and Praxis tests that will be use to measure tactile proprioceptive awareness. While blind-folded the child will be asked to locate a point on the hand or arm with their finger where a research assistant has touched. The points will be marked and then the distance between the target and response points will be measured.
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Assessment method [5]
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Timepoint [5]
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Baseline and post-intervention on the same day
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Secondary outcome [6]
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Kinaesthesia is the third of the Sensory Integration and Praxis tests that will be used, this will assess tactile proprioceptive awareness. While the child's blind-folded, the research assistant will place the child's finger on a specific location on the desk and orientate the child to this spot. The research assistant will then move the child's finger to a second location, asking the child to be aware of how it feels to "move" to this new spot. After approximately 3 seconds, the research assistant will return the child's finger to the first location and then ask them to return the finger to the second location.
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Assessment method [6]
330055
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Timepoint [6]
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Baseline and post-intervention on the same day
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Eligibility
Key inclusion criteria
High-functioning autism (HFA) or Asperger’s Syndrome (AS) confirmed by parental report, and verbal.
Participants will also be screened with the following question, to determine if the child may have issues with sensory processing: “Does your child struggle to cope in environments where there is a lot going on? E.g. environments that are loud/noisy, busy and/or bright?” A ‘yes’ to this question will result in inclusion and a ‘no’ will result in exclusion from the study.
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Minimum age
6
Years
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Maximum age
15
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
non-verbal; hearing or vision impairments; specific reading disorder (such as dyslexia) or genetic disorder (e.g. tuberous sclerosis); or a history of seizures or traumatic brain injury
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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)
Allocation will be concealed as participants will be randomised using online computer software after baseline measures are taken.
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Computerised sequence generation
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
The people assessing the outcomes
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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
Efficacy
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Statistical methods / analysis
Similar to other studies, a sample of 30 participants will allow us to assess the feasibility aspects of the study and to calculate potential effect sizes
After data cleaning, assuming normality, paired t-tests will examine between group differences on each outcome measure. In any instances where normality is not maintained, a Wilcoxon Signed Rank Test will be used. Effect sizes (Eta squared) will inform sample size calculations for a full-scale clinical trial. Descriptive statistics will assess the feasibility of key study processes, including completion rates, time taken to complete the entire selection of tasks and recruitment. Significance will be set at P = .05.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
24/02/2017
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Actual
20/09/2017
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Date of last participant enrolment
Anticipated
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Actual
31/05/2018
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Date of last data collection
Anticipated
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Actual
15/06/2018
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Sample size
Target
30
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Accrual to date
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Final
8
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Recruitment outside Australia
Country [1]
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New Zealand
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State/province [1]
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Auckland
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Funding & Sponsors
Funding source category [1]
295060
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Other Collaborative groups
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Name [1]
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College of Chiropractic Neurodevelopmental Paediatrics
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Address [1]
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PO Box 1539
Noosa Heads
QLD 4567
Australia
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Country [1]
295060
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Australia
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Funding source category [2]
295061
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Other Collaborative groups
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Name [2]
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The Kids Summit
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Address [2]
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2 Lincoln St
Charlestown
NSW 2290
Australia
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Country [2]
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Australia
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Funding source category [3]
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Other Collaborative groups
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Name [3]
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Centre for Chiropractic Research
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Address [3]
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6 Harrison Rd,
Mount Wellington,
Auckland, 1060
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Country [3]
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New Zealand
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Primary sponsor type
University
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Name
Auckland University of Technology
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Address
55 Wellesley St E, Auckland, 1010
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Country
New Zealand
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Secondary sponsor category [1]
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None
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Name [1]
293875
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Address [1]
293875
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Country [1]
293875
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Other collaborator category [1]
279324
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Other Collaborative groups
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Name [1]
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Centre for Chiropractic Research
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Address [1]
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6 Harrison Rd,
Mount Wellington,
Auckland 1060
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Country [1]
279324
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New Zealand
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Health and Disability Ethics Committee
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Ethics committee address [1]
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Ministry of Health Ethics Department 133 Molesworth Street Thorndon Wellington 6011
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Ethics committee country [1]
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New Zealand
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Date submitted for ethics approval [1]
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16/12/2016
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Approval date [1]
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28/07/2017
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Ethics approval number [1]
296460
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17/NTA/58
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Summary
Brief summary
The principal study question being tested is, whether or not it would be worthwhile to perform a full scale study investigating if chiropractic adjustments can positively influence the way sensory information is processed by children with autism. To our knowledge there has been no study similar to this in the past, prior studies have used various outcome measures to determine that children with Autism spectrum disorder (ASD) have poor sensory integration. It appears that no studies have used these measures with a chiropractic intervention to determine if they are able to change the way children with ASD process and integrate sensory information in the brain. Furthermore, there is now a growing body of literature demonstrating that children with ASD have dysfunctional motor learning and motor control. For example: poor balance, poor handwriting skills, clumsiness, frequent delay in reaching motor milestones and difficulty with postural control, with studies of adults with ASD showing that some of these adults never reach the same level of postural control as typically developed adults (Freitag, Kleser, Schneider, & von Gontard, 2007; Minshew, Sung, Jones, & Furman, 2004; Wing, 1981). Moreover, a study by Freitag et al. (2007), found an association between the level of motor control impairment and the degree of social impairment. Those with the greatest degree of social impairment in general performed more poorly in terms of motor control. Some authors suggest that these motor control impairments seen in ASD may be a result of disrupted sensorimotor integration (SMI) (Siaperas et al., 2012; Weimer, Schatz, Lincoln, Ballantyne, & Trauner, 2001). Current literature suggests that chiropractic adjustments help to improve SMI and multisensory integration (MSI) in adult, subclinical pain patients, as well as geriatric populations (Haavik Taylor, Holt, & Murphy, 2010; Holt, 2014). Results demonstrated greater awareness of where the body was in space as well as improvements in processing visual and auditory information. Therefore, this study will assist in the planning of a future full-scale study, which will investigate if chiropractic adjusting can enhance SMI and MSI in children with ASD. As well as if these changes can result in improvements in motor control and social dysfunction.
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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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Dr Kelly Jones
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Address
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National Institute for Stroke and Applied Neurosciences (mail code A-11)
AUT University
Private Bag 92006
Auckland 1142
New Zealand
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Country
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New Zealand
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Phone
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+64 212460587
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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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Kelly Jones
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Address
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National Institute for Stroke and Applied Neurosciences (mail code A-11)
AUT University
Private Bag 92006
Auckland 1142
New Zealand
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Country
70791
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New Zealand
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Phone
70791
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+64 9 921 9999
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Fax
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Email
70791
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[email protected]
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Contact person for scientific queries
Name
70792
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Kelly Jones
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Address
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National Institute for Stroke and Applied Neurosciences (mail code A-11)
AUT University
Private Bag 92006
Auckland 1142
New Zealand
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Country
70792
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New Zealand
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Phone
70792
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+64 9 921 9999
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Fax
70792
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Email
70792
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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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