Q Therapeutic System for Chronic Stroke Recovery

Official title

Facilitation Recovery For Patients With Chronic Stroke: The Q Therapeutic System, Frequency-Tuned Electromagnetic Field Treatment

Overview

Evaluate the effectiveness of the Q Therapeutic (BQ 3.0) System for individuals with chronic stroke in improving upper extremity function as determined by change in functional outcome measures after 3-month treatment, including in-clinic and at-home sessions.

Detailed description

This is a prospective, single-arm, open-label, single center clinical trial designed to evaluate the safety, feasibility, and efficacy of the Q Therapeutic (BQ 3.0) System in the management of chronic stroke patients. Primarily, the trial will assess the System's impact on the upper extremity function through objective, validated clinical assessments. Secondary endpoints will evaluate additional functional and global disability, quality-of-life and safety outcomes.

The study intervention will consist of a total of 5 sessions per week over a period of 3 months (12 weeks) for a total of up to 60 sessions. Each participant must complete at least 40 sessions over the 12-week period to complete the protocol. No extra time will be given to complete all 60 sessions. Each session will last up to 60 minutes during which 40 minutes of active stimulation using the BQ 3.0 System will be administered to participants. The 40 minutes of stimulation will be paired with seated upper extremity (UE) exercises. Lastly, the device will be removed and 10 minutes of standing balance and LE strengthening exercises will be performed without stimulation. A battery of clinical assessments will be conducted before and after the 60 exercise sessions.

Interventions

• Device Q Therapeutic System (BQ 3.0) - Active
  The BQ 3.0 is a medical device that produces and delivers non-invasive, extremely low intensity and frequency (1-100 Hz.; 0.1-1.0 G), frequency tuned electromagnetic fields in order to stimulate neuronal networks with the aim of reducing disability and promoting neurorecovery

Primary outcome measures

• Fugl-Meyer Assessment - Upper Extremity [Time frame: Baseline, 3 month, 5 month, 6 month]

Secondary outcome measures (10)

• Box and Block Test [Time frame: Baseline, 3 month, 5 month, 6 month]
• Geriatric Depression Scale (Short Form) (GDS) [Time frame: Baseline, 3 month, 5 month, 6 month]
• modified Rankin Scale (mRS) [Time frame: Baseline, 3 month, 5 month, 6 month]
• Stroke Impact Scale (SIS) Hand Domain [Time frame: Baseline, 3 month, 5 month, 6 month]
• Stroke Impact Scale 16 (SIS-16) [Time frame: Baseline, 3 month, 5 month, 6 month]
• Nine Hole Peg Test (9HPT) [Time frame: Baseline, 3 month, 5 month, 6 month]
• 10 Meter Walk Test (10MWT) [Time frame: Baseline, 3 month, 5 month, 6 month]
• Functional Ambulation Categories (FAC) [Time frame: Baseline, 3 month, 5 month, 6 month]
• 5-level EQ-5D (EQ-5D-5L) [Time frame: Baseline, 3 month, 5 month, 6 month]
• Berg Balance Scale (BBS) [Time frame: Baseline, 3 month, 5 month, 6 month]

Eligibility criteria

Inclusion criteria

• FMA-UE score between 22-50 (inclusive) of impaired limb.
• Difference between Screening and Baseline visit FMA-UE is 3 points or fewer.
• Age 18 to 80 years of age (inclusive).
• Stroke due to ischemia or to intracerebral hemorrhage.
• >6 months to 5 years from index stroke onset.
• Box \& Block Test score with affected arm is ≥1 block in 60 seconds at Baseline Visit.
• Able to sit with the investigational System for 40 consecutive minutes.
• Can follow a 3-step command, such as "take the paper, fold it in half, and return it to me", or a non-verbal equivalent.
• Willingness to participate in physical exercises during study intervention sessions.
• Availability of a relative or other caregiver able to assist during study treatment sessions and visits.
• If female, not pregnant or breastfeeding or planning pregnancy during the study period.
• Informed consent signed by subject.

Exclusion criteria

• Severe neglect impairment interfering with assessments or treatments.
• Severe depression, defined as GDS Score >10/15
• The presence of MR-incompatible implanted devices or MR-incompatible retained objects; or the presence of life-sustaining MR-compatible devices (e.g. pacemaker or internal cardiac defibrillator).
• Active epilepsy or currently taking anti-epileptic medication (indicated for the treatment of a seizure disorder), or any epileptic seizure in the last 5 years
• Botulinum toxin to the paretic arm: received in the prior 3 months OR expected before the 6-Month Visit
• Severe UE spasticity, defined as presence of upper extremity contracture or modified Ashworth Scale score≥3 in either biceps or pectoralis
• Pre-existing neurological condition (eg, Alzheimer's disease, Parkinson's disease, multiple sclerosis, traumatic brain injury, spinal cord injury) or physical limitation that would interfere significantly with the subject's participation in the study and/or confound neurological or functional evaluation.
• Significant visual disturbances, pre-existing or resulting from the index stroke, that cannot be corrected and that would interfere significantly with the subject's participation in the study and/or confound neurological or functional evaluation.
• Unstable serious illness/condition (eg, active cancer, severe heart failure, active major psychiatric condition) or life expectancy of less than 12 months.
• Alcohol abuse and/or illicit drug abuse in the past 6 months, which is likely to influence ability to fully participate in the trial.
• Participation in another interventional trial that would conflict with the current study or clinical endpoint interference may occur.
• Participation in an upper extremity rehabilitation program provided by a licensed provider in the 4 weeks prior to the Screening visit, or a or planned participation in such program at any time between the Screening Visit and the primary endpoint visit.
• Employee of the Sponsor.
• Prisoner.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Allocation

N/A

Model

Single group

Masking

Open label

Primary purpose

Treatment

Study locations

United States · 1 center

• Burke Rehabilitation Hospital — White Plains

Publications

• Weisinger B, Pandey DP, Saver JL, Hochberg A, Bitton A, Doniger GM, Lifshitz A, Vardi O, Shohami E, Segal Y, Reznik Balter S, Djemal Kay Y, Alter A, Prasad A, Bornstein NM. Frequency-tuned electromagnetic field therapy improves post-stroke motor function: A pilot randomized controlled trial. Front Neurol. 2022 Nov 14;13:1004677. doi: 10.3389/fneur.2022.1004677. eCollection 2022. PMID 36452175
• Saver JL, Duncan PW, Stein J, Cramer SC, Eng JJ, Lifshitz A, Hochberg A, Bornstein NM. EMAGINE-Study protocol of a randomized controlled trial for determining the efficacy of a frequency tuned electromagnetic field treatment in facilitating recovery within the subacute phase following ischemic stroke. Front Neurol. 2023 May 5;14:1148074. doi: 10.3389/fneur.2023.1148074. eCollection 2023. PMID 37213907
• Segal Y, Segal L, Blumenfeld-Katzir T, Sasson E, Poliansky V, Loeb E, Levy A, Alter A, Bregman N. The Effect of Electromagnetic Field Treatment on Recovery from Ischemic Stroke in a Rat Stroke Model: Clinical, Imaging, and Pathological Findings. Stroke Res Treat. 2016;2016:6941946. doi: 10.1155/2016/6941946. Epub 2016 Feb 1. PMID 26949561
• Okabe N, Hovanesyan M, Azarapetian S, Dai W, Weisinger B, Parabucki A, Balter SR, Shohami E, Segal Y, Carmichael ST. Theta Frequency Electromagnetic Stimulation Enhances Functional Recovery After Stroke. Transl Stroke Res. 2025 Apr;16(2):194-206. doi: 10.1007/s12975-023-01202-z. Epub 2023 Nov 14. PMID 37962771

Identifiers

NCT: NCT06979466 · BRH_EMAGINE C IIT_202501

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗