Effect of Intermittent Pneumatic Compression on Ankle Joint Proprioception and Balance in Patients With Stroke
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Nagwa Ibrahim Rehab, PhD
Study Contact Backup
- Name: Heba Ashraf Sayed Abd El-Hadi, M.Sc
- Phone Number: +20 11 10635773
- Email: hebaashraf66677@yahoo.com
Study Locations
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Cairo, Egypt
- Ministry of Health
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Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- The age of the patients will range from 50-65 years old.
- Patients with stroke duration of illness ranged from six months to 18 months.
- BMI (Body Mass Index) ranged from 20- 30 Kg/m2.
- The muscle tone of the affected lower limb muscles ranged from 1 to 2 grade according Modified Aschworth Scale.
- Patients who have moderate impaired balance.
- Patients who have impaired proprioception.
Exclusion Criteria:
- Patients with cardiovascular problems (open heart surgery or pacemaker).
- Patients with neurological diseases that affect lower limb function other than stroke (ex: Multiple sclerosis, Peripheral neuropathy, Parkinsonism…. etc.).
- Patients Suffered of Deep veins thrombosis (DVT).
- Patient with recurrent stroke.
- Patients with musculoskeletal disorders such as severe arthritis, knee surgery, total hip joint replacement, lower limb fractures or contractures of fixed deformity, leg length discrepancy after total hip replacement
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Single
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
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Experimental: Intermitted pneumatic pressure + Conventional physical therapy
Participants will receive the intermitted pneumatic pressure in addition to conventional physical therapy, 3 times per week for six weeks.
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Intermittent pneumatic compression will be applied with the patient positioned comfortably in a supported supine lying position on an appropriately sized treatment table.
The treated limb will be inspected for skin integrity, with any bandages removed, and a cotton gauze sleeve will be applied prior to placement of the compression sleeve.
The compression unit will be placed on a stable surface, checked for cleanliness and proper assembly, and securely connected to the limb.
Treatment parameters will be set at a pressure of 40 mmHg with an intermittent cycle of 90 seconds of inflation followed by 90 seconds of deflation.
Each treatment session will last 30 minutes.
Conventional physical therapy will be received in the form of range of motion exercises, strength exercise, stretching exercises, sit to stand, proprioception training and balance training, 3 times per week for 6 weeks.
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Active Comparator: Conventional physical therapy
Participants will receive conventional physical therapy only, 3 times per week for six weeks.
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Conventional physical therapy will be received in the form of range of motion exercises, strength exercise, stretching exercises, sit to stand, proprioception training and balance training, 3 times per week for 6 weeks.
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What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Ankle proprioception
Time Frame: 6 weeks
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It will be assessed by measuring the absolute error between target and reproduced ankle angles using an isokinetic dynamometer.
Participants attempt to reproduce 10° and 20° of plantar flexion without visual feedback.
The absolute error represents the difference between the target and reproduced angles.
Smaller errors indicate better proprioceptive accuracy, while larger errors reflect impaired proprioception.
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6 weeks
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Mediolateral Stability Index (MLSI)
Time Frame: 6 weeks
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It reflects the individual's ability to control balance from side to side.
Measured on the Biodex Balance System, it quantifies mediolateral sway.
Higher MLSI values indicate increased instability, while lower values reflect better control.
It is particularly useful for assessing balance deficits in conditions like stroke, where lateral stability is often impaired, aiding in targeted rehabilitation strategies.
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6 weeks
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Anteroposterior Stability Index (APSI)
Time Frame: 6 weeks
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It measures front-to-back balance control using the Biodex Balance System.
It evaluates how well an individual stabilizes posture in the forward and backward directions.
Elevated APSI scores indicate greater postural sway and instability, while lower scores indicate better balance.
This index is critical in identifying anteroposterior balance deficits and guiding targeted rehabilitation.
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6 weeks
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Overall Stability Index (OSI)
Time Frame: 6 weeks
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is a composite measure reflecting balance control in all directions-mediolateral and anteroposterior.
Assessed via the Biodex Balance System, a higher OSI indicates greater overall body sway and instability.
Lower OSI values reflect better multi-directional balance.
This index is crucial in providing a global assessment of postural control and is used to monitor progress in balance rehabilitation.
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6 weeks
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Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
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Limits of Stability (LOS) score
Time Frame: 6 weeks
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LOS test evaluates patient's ability to intentionally shift center of gravity in eight directions (Forward, Backward, Right, Left, Forward-Right, Forward-Left, Backward-Right, Backward-Left) without losing balance.
Three trials per direction; averages calculated.
Lower scores indicate restricted stability limits common post-stroke, affecting functional mobility and fall risk.
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6 weeks
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The Berg Balance Scale (BBS)
Time Frame: 6 weeks
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It is a 14-item clinical test used to objectively measure balance ability during functional tasks.
Each task is scored from 0 (unable) to 4 (independent), with a total score out of 56.
Lower scores indicate higher fall risk.
It assesses static and dynamic balance in tasks like standing, turning, and reaching.
The BBS is widely used in stroke rehabilitation to evaluate balance improvements over time.
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6 weeks
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The Timed Up and Go (TUG) test
Time Frame: 6 weeks
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It measures functional mobility and fall risk.
Participants stand from a chair, walk 3 meters, turn, return, and sit.
The time in seconds is recorded.
A completion time of ≥12 seconds indicates increased fall risk.
The TUG is a simple, reliable test used in clinical settings to track progress in mobility and balance rehabilitation.
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6 weeks
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Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Chair: Mohammad Sadik Badway, PhD, Professor, Cairo University
- Study Director: Ebtessam Mohamed Fahmy, PhD, Professor, Cairo University
- Study Director: Nagwa Ibrahim Rehab, PhD, Assis. Professor, Cairo University
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Actual)
Primary Completion
Study Completion (Actual)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- P.T.REC/012/005794
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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