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Trial registered on ANZCTR
Registration number
ACTRN12624001283561
Ethics application status
Approved
Date submitted
23/08/2024
Date registered
22/10/2024
Date last updated
22/10/2024
Date data sharing statement initially provided
22/10/2024
Type of registration
Prospectively registered
Titles & IDs
Public title
Functional Neurological Disorder (FND)- Informed Physiotherapy for organic tremor disorder - A Feasibility Study
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Scientific title
FND-informed physiotherapy for organic tremor disorders in adults – A feasibility study
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Secondary ID [1]
312749
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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:
Functional Neurologic disorder
334871
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Condition category
Condition code
Neurological
331424
331424
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Phase 2: Intervention phase: Patients will undergo a standardised 5-week program of weekly targeted physiotherapy sessions. The FND- informed will involve breathing exercises, grounding and distraction techniques.
The Physiotherapy sessions will be 30min each in duration and will focus on the following areas: 1) Education about principles of brain retraining, 2) Breathing and grounding techniques, 3) Distraction techniques, 4) Overriding abnormal movements, 5) Summary and development of patient-specific management advice.
Patients will be provided with written management advice for tremor flares. Patients will also be provided with exercise diaries by the study coordinator to monitor adherence.
Phase 3: 'Washout' and Reassessment phase: Patients will again undergo a formal tremor assessment in clinic with the use of the 3D accelerometer devices. After that patients will again wear these 3D accelerometers at home for 1 week while performing their everyday activities. During this phase patients will also be asked to keep a written diary for tremor flares and activities related to them.
The diary will be provided to the participants by the study coordinator.
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Intervention code [1]
329343
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Treatment: Other
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Comparator / control treatment
In this study the participants themselves act as a comparator. The Phase 1 Of this study will act as the comparator arm of the study. In Phase 1 patients will initially undergo an initial tremor assessment in clinic with the use of two 3D accelerometer systems. One of the devices Blue Trident IMU, specifically measures tremor severity and frequency and the other device GENEActiv wristwatch monitors general activities (wake: standing, sitting, walking; sleep: duration, quality). After the initial assessment patients will wear the two 3D accelerometer systems at home for one week while performing their everyday activities. During this phase patients will also be asked to keep a written diary for tremor flares and activities related to them. The diary will be provided to the participants by the study coordinator.
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Control group
Active
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Outcomes
Primary outcome [1]
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Quality of life
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Assessment method [1]
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Quality of Life in Essential Tremor Questionnaire (QUEST).
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Timepoint [1]
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [1]
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Identification of variability of tremor severity in relation to daily activities through objective measures with IMU device.
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Assessment method [1]
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IMU device
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Timepoint [1]
438956
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [2]
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Comparison of objective tremor data from IMU and GENEactive before and after intervention.
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Assessment method [2]
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IMU and GENEactive devices
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Timepoint [2]
438957
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [3]
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Overall changes to participant’s status on the Clinical Global Impressions-Improvement scale (CGI- I).
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Assessment method [3]
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Clinical Global Impressions-Improvement scale (CGI- I).
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Timepoint [3]
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [4]
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Correlation of tremor severity according to the Tremor Research Group Essential Tremor Rating Scale (TETRAS) at baseline compared to phase 3 assessment.
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Assessment method [4]
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Tremor Research Group Essential Tremor Rating Scale (TETRAS)
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Timepoint [4]
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Baseline and at the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [5]
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General quality of life
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Assessment method [5]
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36-Item Short Form Survey (SF-36)
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Timepoint [5]
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Baseline and at the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [6]
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Emotional well being
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Assessment method [6]
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Depression Anxiety Stress Scale (DASS).
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Timepoint [6]
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Baseline and at the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [7]
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Changes of tremor frequency during home assessment and determination of which activities flares of tremors are associated with as derived from IMU device data
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Assessment method [7]
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IMU device
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Timepoint [7]
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [8]
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Identification of variability of tremor severity in relation to daily activities through objective measures with GENEactive devices.
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Assessment method [8]
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GENEactive devices.
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Timepoint [8]
439632
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [9]
439633
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Changes of tremor severity during home assessment and determination of which activities flares of tremors are associated with as derived from GENEactive device data
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Assessment method [9]
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GENEactive device
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Timepoint [9]
439633
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [10]
440226
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Changes of tremor frequency during home assessment and determination of which activities flares of tremors are associated with as derived from GENEactive device data
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Assessment method [10]
440226
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GENEactive device
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Timepoint [10]
440226
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At the end of phase 3 after a 'washout' period of 5 weeks
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Secondary outcome [11]
440227
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Changes of tremor frequency and severity during home assessment and determination of which activities flares of tremors are associated with as derived from IMU device data
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Assessment method [11]
440227
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IMU device
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Timepoint [11]
440227
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At the end of phase 3 after a 'washout' period of 5 weeks
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Eligibility
Key inclusion criteria
1. Adults over the age of 18 years old and over.
2. Have received diagnosis of an organic tremor disorder affecting one or both upper limbs.
3. Able to read and write English.
4. Access to an Apple IOS device (iPhone or iPad
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Minimum age
18
Years
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Maximum age
No limit
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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
None
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Study design
Purpose of the study
Prevention
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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)
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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
Single group
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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
1/11/2024
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Actual
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Date of last participant enrolment
Anticipated
19/02/2025
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Actual
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Date of last data collection
Anticipated
30/04/2025
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Actual
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Sample size
Target
20
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
QLD
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Recruitment hospital [1]
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Princess Alexandra Hospital - Woolloongabba
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Recruitment postcode(s) [1]
43051
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4102 - Woolloongabba
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Funding & Sponsors
Funding source category [1]
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Government body
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Name [1]
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SERTA Grant- Metro South Health
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Address [1]
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Country [1]
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Australia
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Primary sponsor type
University
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Name
Queensland University of Technology
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Address
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Country
Australia
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Secondary sponsor category [1]
319448
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None
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Name [1]
319448
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Address [1]
319448
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Country [1]
319448
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Metro South Human Research Ethics Committee
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Ethics committee address [1]
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https://metrosouth.health.qld.gov.au/research/about-us/hrec
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
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31/01/2024
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Approval date [1]
315924
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02/02/2024
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Ethics approval number [1]
315924
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Summary
Brief summary
Tremors are uncontrollable shaking movements. Organic tremors are usually the result of structural damage to the parts of the brain that coordinate muscular movement. Current treatments for organic tremors are mainly medication based. Up to 30% of tremor patients do not respond to medication and therefore need alternative treatment options. For some of these patients surgical treatment options can be considered. These treatments are invasive (with significant risks of complications), expensive and difficult to access for many patients. Also, many patients cannot undergo surgery for treatment of their tremors due to age or unacceptably high surgical risk. Functional Neurological Disorder (FND) is one of the most common diagnoses in general neurology clinic. Functional tremors are not caused by structural damage to the brain, but are due to a problem with communication between different brain areas. Functional tremors can often be treated by teaching patients strategies to retrain control over their movements. In this study we want to test if this approach can also work for patients with organic tremor disorders. Acute flares of organic tremors share many features with functional tremors. We hypothesized that it will be possible to use the physiotherapy-based treatment approaches that have been shown to be beneficial in patients with functional tremors to help patients with organic tremors to manage their acute tremor flares.
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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 Alexander Lehn
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Address
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Princess Alexandra Hospital,199 Ipswich Road, Woolloongabba, QLD 4102
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Country
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Australia
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Phone
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+61 0731764246
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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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Schible Treasa Kurian
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Address
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Princess Alexandra Hospital,199 Ipswich Road, Woolloongabba, QLD 4102
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Country
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Australia
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Phone
136235
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+61 0436447386
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Professor Graham Kerr
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Address
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Queensland University of Technology | Kelvin Grove, Brisbane, QLD 4059,
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Country
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Australia
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Phone
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+61 0731386303
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Fax
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Email
136236
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
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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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