Immediate Effects of Open and Closed Kinetic Chain Exercises on Upper Extremity in Stroke Patients.

June 15, 2026 updated by: Çiçek Günday, Istinye University

Immediate Effects of Open and Closed Kinetic Chain Activities on Upper Extremity Spasticity and Motor Dexterity in Stroke Patients"

Stroke is a sudden disruption of blood flow to the brain, resulting in physical and mental disabilities. It's a global health issue affecting millions each year, often leading to paralysis, altered muscle tone, and loss of motor control and balance. This study aims to examine the immediate effects of open and closed kinetic chain activites on upper extremity spasticity and motor dexterity in hemiplegic patients. This study will be conducted simultaneously at İstinye University Hospital Medical Park Gaziosmanpaşa and İstinye University Physiotherapy and Rehabilitation Application and Research Center (İSÜFİZYOTEM). 50 stroke patients will be included in the study, and all participants will be asked to sign an informed consent form. At the beginning of the session, all participants will be evaluated for their socio-demographic characteristics by a questionnaire created by the researchers, muscle viscoelastic properties by MyotonPRO, upper extremity muscle tone by Modified Ashworth Scale, upper extremity motor dexterity by Box and Block Test, and upper extremity joint range of motion by goniometer and by a phone application named as PhysioMaster. After the assessment, participants will be randomly assigned to two groups: open kinetic chain activity group and closed kinetic chain activity group. After performing the exercises, all evaluations will be conducted again. Thus, the aim is to understand the immediate effects of two different group exercises on the evaluated parameters.

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
30

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Contact

The name and contact information for the person who can answer enrollment questions for a clinical study. Each location where the study is being conducted may also have a specific contact, who may be better able to answer those questions.
  • Name: Çiçek GÜNDAY, PhD(c)
  • Phone Number: +90 507 188 8848
  • Email: cckdmn@gmail.com

Study Locations

  • Turkey (Türkiye)
      • Istanbul, Turkey (Türkiye)
        • Istinye University Hospital Medical Park Gaziosmanpasa

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Stroke diagnosis;
  • Hemiplegia;
  • Subacute&chronic phase (more than 3 months);
  • Brunnstrom 3-4-5;
  • Unsupported sitting ability;
  • Being volunteer.

Exclusion Criteria:

  • Having Botox within the last 6 months;
  • 4 according to Modified Ashworth Scale;
  • Other neurological diagnosis other than stroke.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Double

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: Open Kinetic Chain Activity Group
Open kinetic chain activity will involve Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns from the Proprioceptive Neuromuscular Facilitation (PNF). During the application, participants will lie on their back, and the pattern will be initiated from the opposite direction of the targeted movement. Participants will be encouraged to perform the movement as actively as possible. Assistance will be provided if the participant cannot complete the pattern. No other PNF techniques will be applied. Both patterns will be practiced for 10 repetitions. Resting periods will be provided as needed to prevent fatigue. The entire application is planned to last approximately 5 minutes.
Other: Open Kinetic Chain Activity
PNF Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns will be actively performed on the hemiplegic upper extremity.
Experimental: Closed Kinetic Chain Activity Group
For closed kinetic chain activity of the upper extremity, an activity involving weight shifting onto the hands on a table while standing with the elbows in extension will be used. Participants will be asked to shift weight onto the hemiplegic upper extremity for 30 seconds. After a 30-second rest period, the weight shifting will be repeated for a second time.
Other: Closed Kinetic Chain Activity
Weight-bearing on the hemiplegic hand with extended elbow in standing position

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
MyotonPRO digital palpation device
Time Frame: 6 minutes
This device is a patented, certified, digital measurement device that measures the amount of tissue displacement that occurs per unit force applied by a probe pressed perpendicularly to the skin overlying the muscle. It measures the viscoelastic properties of the muscles. Latissimus Dorsi will be measured from a point 5 cm above the lower corner of the scapula with the shoulder in 80 flexion. Pectoralis Major will be measured three-quarters of the way from the line between the sternum and the nodule prominence. Measurement of the Biceps Brachii and Brachioradialis muscles will be made from the most swollen points of the muscles. For measurement of the Flexor Carpi Radialis muscle, patients will be taken supine, with the forearm supinated and the elbow approximately 40 degrees flexed, at the one-third (approximately) point of the distance between the elbow line and the lateral side of the ulnar styloid. All measurements will be repeated 3 times and the average will be calculated.
6 minutes
Box and Block Test
Time Frame: 1 minute
It is a standardized assessment used to measure upper extremity motor dexterity. It involves moving blocks from one side of a box to the other within a minute. It is a clinic-friendly standardized assessment that is portable, easy to obtain, simple to administer, and can be administered quickly without a specific setting.
1 minute

Secondary Outcome Measures

Secondary Outcome Measures

In a clinical study's protocol, a planned outcome measure that is not as important as the primary outcome measure for evaluating the effect of an intervention but is still of interest. Most clinical studies have more than one secondary outcome measure.
Outcome Measure
Measure Description
Time Frame
Modified Ashworth Scale
Time Frame: 3 minutes
Upper extremity spasticity level of participants will be evaluated with the Modified Ashworth Scale (MAS). In the MAS evaluation, participants were in a supine position, with the arms next to the body and the shoulder in slight abduction. Shoulder adductors, elbow flexors and wrist flexors will be assessed.
3 minutes
Goniometer
Time Frame: 5 minutes
It will be used to measure the range of motion. Shoulder flexion and abduction, elbow extension, supination and pronation, and wrist extension, ulnar & radial deviation will be measured.
5 minutes
PhysioMaster
Time Frame: 5 minutes
This phone application will be used to measure the range of motion. Shoulder flexion and abduction, elbow extension, supination and pronation, and wrist extension, ulnar & radial deviation will be measured.
5 minutes

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Istinye University

Investigators

Investigators

A researcher involved in a clinical study. Related terms include site principal investigator, site sub-investigator, study chair, study director, and study principal investigator.
  • Study Chair: Merve Can, Istinye University
  • Study Chair: Seyhan Söyüncü, Istinye University

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
March 4, 2024

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
December 30, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
December 30, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
February 15, 2024

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
February 15, 2024

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
February 22, 2024

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
June 16, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
June 15, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
June 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • 10102023

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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