AzTrials
AzTrials

StrokePhase 1/2DarbarIlloraNCT07784231

The Use of Photobiomodulation in the Treatment of Spasticity After Stroke.

A Phase 1/2 study testing Photobiomodulation Therapy and Standard Multidisciplinary Rehabilitation Program for Spasticity in people with Stroke and Spasticity, run by University of Nove de Julho at 1 site in Brazil.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
Search all trials

Trial summary

Stroke is a non-progressive and permanent syndrome in adults, with approximately 60% of patients presenting with spastic hemiparesis. Spasticity leads to changes in the physiological pattern of muscle tissue contraction and hemodynamics, and, when left untreated, negatively impacts functionality. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Stroke, Spasticity, Photobiomodulation
What is being tested?
Photobiomodulation Therapy and Standard Multidisciplinary Rehabilitation Program for Spasticity
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
42 participants
Where
1 siteBrazil
Study dates
28 Aug 2026to 30 Jun 2027
Phase
Phase 1/2
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Adults who have sustained a unilateral ischemic or hemorrhagic cortical motor stroke, with the diagnosis documented in the acute phase by computed tomography (CT) or magnetic resonance imaging (MRI);
  • Patients currently undergoing multidisciplinary rehabilitation at the Rehabilitation Center where the study will be conducted;
  • Patients presenting with a motor pattern of spastic hemiparesis secondary to stroke;
  • Patients demonstrating the ability to perform orthostatism (standing posture) or therapeutic or functional gait activity.

Who cannot join

  • Presence of uncontrolled systemic diseases, including but not limited to cancer, active infections, or uncontrolled diabetes mellitus;
  • History of photosensitivity or known hypersensitivity to light exposure;
  • Triceps surae spasticity graded as 4 on the Modified Ashworth Scale (MAS) at the initial pre-screening assessment;Acute clinical instability or any acute medical condition requiring immediate intervention;
  • Fixed anatomical deformities of the ankle joint that preclude a minimum passive or active range of motion of at least 60 degrees;
  • Malnutrition or significant nutritional deficiencies;Acute clinical conditions with the potential to exacerbate spasticity, such as acute fractures, cutaneous ulcers, or acute infections;Presence of any other movement or tone disorder (e.g., dystonia, chorea, or parkinsonism) that could confound spasticity assessments;
  • Exposed tumors or undiagnosed lesions in the area to be irradiated;
Show all 12Show fewer
  • Change in the pharmacological class of antispastic medications during the therapeutic period of the study. Dose adjustments within the same medication class will be permitted and documented;
  • Administration of botulinum toxin type A injections into the triceps surae muscle during the study period or within six months prior to study enrollment;
  • Discontinuation of the concomitant physical therapy rehabilitation program, even if the participant continues to receive photobiomodulation per the study protocol;
  • Occurrence of any adverse event attributable to photobiomodulation;
  • Death;
  • Withdrawal of informed consent.

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Rebeca B Cecatto, MD, Ph.D. contact

+55 11970842496

rebeca.boltes@gmail.com

Brazil1 site, 1 recruiting
  • CER II Guarulhos

    São Paulo, São Paulo, 05020-000

    Rebeca Cecatto, PhD, MD, 11970842496, rebeca.boltes@gmail.com

    Recruiting

Other trials in Brazil

About this study

Official title: The Use of Photobiomodulation in the Treatment of Spasticity After Stroke: a Blinded Clinical Trial.

Stroke is a non-progressive and permanent syndrome in adults, with approximately 60% of patients presenting with spastic hemiparesis. Spasticity leads to changes in the physiological pattern of muscle tissue contraction and hemodynamics, and, when left untreated, negatively impacts functionality. Photobiomodulation (PBM) has demonstrated positive effects on tissue regeneration, muscle relaxation, reduction of inflammation, fatigue, and pain relief in various muscular and neurological disorders. Methods: This blinded, randomized, controlled clinical trial aims to evaluate the effects of PBM on triceps surae muscle spasticity in adults with stroke. Forty-two participants with spastic hemiparesis post-stroke will be randomized into two groups: active PBM (850 nm, 200 mW, 4 J/point in the gastrocnemius, 12 points, weekly for 8 weeks) or placebo PBM (same protocol, device switched off). Both groups will receive the institute's standard rehabilitation treatment. Outcomes will be assessed using the Modified Ashworth Scale (MAS), ankle range of motion, presence of pain, amount of antispastic medication in use, contraction strength (by manual examination) muscle oxygenation (by transcutaneous near-infrared spectroscopy), functionality, and the occurrence of adverse events before and after the intervention. At the end of recruitment, comparisons between groups and between time points will be performed and statistically analyzed using a two-way repeated means ANOVA test and the Generalized Estimating Equations (GEE) test. We also foresee a pilot interim analysis when recruitment reaches a size of 10 participants per group. This interim analysis will be performed using a two-way/means ANOVA to assess effect size and recalculate sample size, making adjustments to the design if necessary.

Read the detailed description

Stroke is a non-progressive and permanent syndrome in adults, with approximately 60% of patients presenting with spastic hemiparesis. Spasticity leads to changes in the physiological pattern of muscle tissue contraction and hemodynamics, and, when left untreated, negatively impacts functionality. Photobiomodulation (PBM) has demonstrated positive effects on tissue regeneration, muscle relaxation, reduction of inflammation, fatigue, and pain relief in various muscular and neurological disorders. Methods: This blinded, randomized, controlled clinical trial aims to evaluate the effects of PBM on triceps surae muscle spasticity in adults with stroke. Forty-two participants with spastic hemiparesis post-stroke will be randomized into two groups: active PBM (850 nm, 200 mW, 4 J/point in the gastrocnemius, 12 points, weekly for 8 weeks) or placebo PBM (same protocol, device switched off). Both groups will receive the institute's standard rehabilitation treatment. Outcomes will be assessed using the Modified Ashworth Scale (MAS), ankle range of motion, presence of pain, amount of antispastic medication in use, contraction strength (by manual examination) muscle oxygenation (by transcutaneous near-infrared spectroscopy), functionality, and the occurrence of adverse events before and after the intervention. At the end of recruitment, comparisons between groups and between time points will be performed and statistically analyzed using a two-way repeated means ANOVA test and the Generalized Estimating Equations (GEE) test. We also foresee a pilot interim analysis when recruitment reaches a size of 10 participants per group. This interim analysis will be performed using a two-way/means ANOVA to assess effect size and recalculate sample size, making adjustments to the design if necessary.

Being tested
Photobiomodulation Therapy, Placebo PBM, Standard Multidisciplinary Rehabilitation Program for Spasticity
Keywords
stroke, photobiomodulation, spasticity, NIRS
Medical subject headings
Stroke, Muscle Spasticity

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Photobiomodulation TherapyRadiation

    Also called Low level Laser Therapy

    Photobiomodulation (PBM)-formerly referred to as low-level laser therapy (LLLT) or cold laser therapy-is a non-invasive, non-thermal therapeutic modality that employs light in the red to near-infrared spectrum (typically spanning wavelengths from approximately 600 nm to 1,100 nm) to elicit beneficial biological responses in target tissues. The underlying mechanism of action is primarily photochemical rather than photothermal: photons delivered to the tissue are absorbed by endogenous chromophores, most notably cytochrome *c* oxidase (CCO), a key enzyme in the mitochondrial electron transport chain. This absorption transiently increases mitochondrial membrane potential, augments adenosine triphosphate (ATP) synthesis, and modulates the generation of reactive oxygen species (ROS). These primary mitochondrial events subsequently trigger a cascade of secondary intracellular signaling pathways-including the activation of transcription factors such as nuclear factor kappa-B (NF-κB) and hypox

  • Placebo PBMRadiation

    Application of transcutaneous PBM therapy - device switched off- to the gastrocnemius muscles

  • Standard Multidisciplinary Rehabilitation Program for SpasticityOther

    A comprehensive, multidisciplinary intervention delivered by a specialized team-including physical therapists and rehabilitation physicians-who collaboratively develop an individualized treatment plan tailored to each patient's functional deficits, baseline mobility, and specific spasticity profile. The physical therapy component emphasizes a combination of passive and active stretching protocols, therapeutic exercise to strengthen agonist muscles and improve motor control, gait and balance training, and adjunctive modalities such as neuromuscular electrical stimulation or therapeutic ultrasound, all administered at a frequency and intensity commensurate with the patient's tolerance and clinical progression. Concurrently, the multidisciplinary team addresses associated impairments through therapy focused on activities of daily living and limb function, pharmacological management with oral or antispastics injections as indicated

Study groups in NCT07784231
Study groupRoleWhat they receive
PBM groupExperimentalApplication of transcutaneous PBM therapy to the gastrocnemius muscles of the hemiparetic limb associated with standardized rehabilitation therapies according to the institution's protocol
Receives: Radiation: Photobiomodulation Therapy; Other: Standard Multidisciplinary Rehabilitation Program for Spasticity
PlaceboPlacebo comparatorApplication of transcutaneous PBM therapy - device switched off- to the gastrocnemius muscles of the hemiparetic limb associated with standardized rehabilitation therapies according to the institution's protocol
Receives: Radiation: Placebo PBM; Other: Standard Multidisciplinary Rehabilitation Program for Spasticity

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Spasticity Grade

    The change in triceps surae spasticity severity, assessed using the Modified Ashworth Scale (MAS). The MAS is a widely validated, clinician-rated ordinal scale that quantifies muscle hypertonia by measuring the resistance encountered during passive joint mobilization; it grades spasticity from 0 (no increase in muscle tone) through 4 (affected part rigid in flexion or extension), with intermediate scores of 1, 1+, 2, and 3 denoting progressively greater degrees of resistance and catch phenomena throughout the range of motion.

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks. It will also be assessed immediately before and after each PBM session.

  2. Spasticity Grade

    Quantity of antispastic medications used. Information regarding the medications (class, quantity, dose, and route of administration) used by participants for the treatment of spasticity before and after the end of the 8-week therapeutic period will be collected from medical records.

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks.

Secondary outcomes (6)
  1. Pain Intensity

    The presence of pain in the cutaneous reference region of the triceps surae will be assessed using a Numerical Pain Scale (NPS) / The NPS is an aid in measuring the intensity of pain felt by the patient, an important instrument to verify progress and analyze the treatment instituted. The participant should be asked about their level of pain, where 0 means total absence of pain and 10 the maximum pain level.

    Measured: Baseline" or "Day 1" , and immediately before and after each weekly PBM session and through study completion, an average of 8 weeks

  2. Active and Passive Ankle Range of Motion

    Active and passive range of motion (ROM) of the ankle joint on the affected hemibody will be assessed using standard goniometry. Goniometric measurement is a reliable and widely accepted clinical method for quantifying joint mobility, performed with a universal goniometer aligned to the anatomical landmarks of the ankle joint complex. Active ROM will be measured with the participant performing the ankle movement independently through the available range, whereas passive ROM will be measured with the examiner passively mobilizing the joint through its full available range of motion, ensuring that no excessive force is applied (McRae, 2011). This outcome provides an objective indicator of joint mobility impairment and allows for the evaluation of treatment-related changes in musculoskeletal restriction secondary to spasticity.

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks

  3. Functional Independence

    Functional status will be assessed using the Functional Independence Measure (FIM) is an 18-item, 7-point ordinal scale that evaluates the level of assistance required for activities of daily living across motor and cognitive domains, with higher scores indicating greater independence .

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks

  4. Motor recovery

    the lower-extremity motor subscale of the Fugl-Meyer Assessment (FMA-LE) will be employed to evaluate sensorimotor recovery, focusing on volitional movement, coordination, and reflex activity of the affected lower limb; this scale is scored on a 3-point ordinal system (0 = no performance, 1 = partial performance, 2 = full performance), with higher scores reflecting better motor function (Shim, 2025).

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks

  5. Oxygenation of the Gastrocnemius Muscles

    To assess the oxygenation of the gastrocnemius muscles in real time, a non-invasive transcutaneous muscle oxygen sensor using near-infrared spectroscopy will be employed

    Measured: Baseline" or "Day 1" , on fifth PBM session, and * through study completion, an average of 8 weeks

  6. Contraction force of the triceps surae

    Triceps surae muscle strength manual test (Polkey, 1977) MRC

    Measured: Baseline" or "Day 1" and * through study completion, an average of 8 weeks

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted25 Aug 2026
  2. Study start28 Aug 2026
  3. Primary completion30 Apr 2027 (estimated)
  4. Study completion30 Jun 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 1/2
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Triple blind
Who is masked
Participant, Care provider, Investigator
Enrolment
42 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07784231
Sponsor's protocol ID
DarbarIllora
Acronym
DarbarIllora
Status last verified
Aug 2026
First submitted
18 Aug 2026
Last updated
1 Sep 2026
Results posted
No
Data monitoring committee
Yes
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing Photobiomodulation Therapy and Standard Multidisciplinary Rehabilitation Program for Spasticity in people with Stroke and Spasticity, run by University of Nove de Julho at 1 site in Brazil.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 12 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 1 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Brazil. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Rebeca B Cecatto, MD, Ph.D. (+55 11970842496, rebeca.boltes@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Spasticity Grade (time frame: Baseline" or "Day 1" and * through study completion, an average of 8 weeks. It will also be assessed immediately before and after each PBM session.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Sep 2026.

Free account

Log in to keep searching

You’ve used your 3 free searches. AzTrials is free: log in or create a free account to keep searching clinical trials and save the ones you want to follow.

Create a free accountLog in