Neuralgic Amyotrophy: Central Reorganization and Rehabilitation After Peripheral Dysfunction (NA-CONTROL)

Radboud University Medical Center

Status: Completed

Conditions: Neuralgic Amyotrophy, Hereditary; Neuralgic Amyotrophy; Parsonage Turner Syndrome; Brachial Neuritis

Treatments: Other: Usual Care; Behavioral: Specific rehabilitation program

Study type: Interventional

Funder types: Other

Identifiers

NCT03441347

104752

Details and patient eligibility

About

This study evaluates the effect of a specific, multidisciplinary and personalized rehabilitation program compared to usual care, on motor control and functional disability in patients with neuralgic amyotrophy.

Half of the participants will start with the 17-week specific rehabilitation program while the other half will first continue their usual care for 17 weeks, after which they will also receive the 17-week specific rehabilitation program.

Full description

Neuralgic amyotrophy (NA) is a common (incidence 1:1000) peripheral nervous system disorder caused by acute autoimmune inflammation of the brachial plexus, the nerve bundle going to the shoulder and arm. Many NA patients develop abnormal motor control of the shoulder region (i.e. scapular dyskinesia), which persists even after the peripheral nerve damage has recovered. This suggests that persistent scapular dyskinesia in NA may result from (mal)adaptive changes in the central motor system.

Clinical experience shows that the specific, multidisciplinary and personalized rehabilitation program, focused on cognitive motor control can restore scapular dyskinesia in NA patients. This indicates that impairments in the central motor system likely play a role in persistent scapular dyskinesia and that specific rehabilitation may restore any alterations in central motor control.

We hypothesize that the specific rehabilitation program, focused on cognitive motor control is more effective in improving functional disability than usual care and that it can reverse maladaptive changes in central motor control.

Enrollment: 47 patients

Sex: All

Ages: 18+ years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• (Suspected) diagnosis of neuralgic amyotrophy
• In subacute or chronic phase of neuralgic amyotrophy (>2 months after attack onset)
• Right-handed
• Neuralgic amyotrophy predominantly present in right upper extremity
• Presence of scapular dyskinesia

Exclusion criteria

• Patients in the acute phase of NA (characterized by severe pain and inflammation of the brachial plexus)
• (Prior) NA attacks of the lumbosacral plexus or the left upper extremity
• Sever comorbidity
• Any (bio)mechanical constraints of the shoulder girdle
• Any other central nervous system, neurological, or neuromuscular disorder

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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47 participants in 2 patient groups

Specific rehabilitation program

Experimental group

Description:

Specific, personalized, multidisciplinary rehabilitation program consisting of physical- and occupational therapy.

Treatment:

Behavioral: Specific rehabilitation program

Usual Care

Other group

Description:

Usual care for people with neuralgic amyotrophy, may vary per individual

Treatment:

Behavioral: Specific rehabilitation program

Other: Usual Care