Lumbar Spinal Manipulation in Stroke
Effects of Lumbar Spinal Manipulation on Balance and Fall Risk in Patients With Chronic Stroke: A Randomized Crossover Trial
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: burak mavuş, M.Sc.
- Phone Number: +90 5388178351
- Email: a.burakmavus@gmail.com
Study Contact Backup
- Name: Ömer Dursun, Assoc. Prof.
- Phone Number: 05426088687
- Email: fztomrdrsn@gmail.com
Study Locations
-
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Bolu, Merkez
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Bolu, Bolu, Merkez, Turkey (Türkiye), 14280
- Bolu İzzet Baysal Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi
-
Contact:
- Birkan Özkardaş, Mr.
- Phone Number: +90 5550639585
- Email: brknzkrds31@gmail.com
-
Contact:
- burak mavuş, M.Sc.
- Phone Number: +90 5388178351
- Email: a.burakmavus@gmail.com
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Having chronic stroke,
- A Mini-Mental State Examination score of 24 or higher,
- Ability to stand independently for 20 seconds or more,
- Being between 18 and 75 years of age,
- Ability to walk independently for 10 meters, using assistive devices or orthoses if necessary,
- Daily blood pressure not exceeding 140/90 mmHg (or controlled with antihypertensive medication)
Exclusion Criteria:
- Presence of severe cardiac, pulmonary, hepatic, or renal dysfunction,
- Presence of severe bone or joint disease, particularly affecting the spine,
- Presence of risk factors for osteoporosis, especially involving the spine,
- Orthopedic conditions limiting spinal rotation,
- History of cancer or diabetic neuropathy,
- Presence of vestibular disorders,
- Presence of lower extremity ulceration or amputation,
- Alcohol consumption within the last 24 hours,
- Hemodynamic instability,
- Diagnosis of posterior circulation stroke involving the basilar artery and cerebellum,
- Presence of neurological diseases such as multiple sclerosis or Parkinson's disease,
- History of acute lower extremity injury within the last 6 weeks,
- History of lower extremity surgery
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Crossover Assignment
- Masking: Double
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Placebo Comparator: Placebo Comparator: Placebo Lumbar Spinal Manipulation Group
Participants will receive placebo lumbar spinal manipulation in the first session and lumbar spinal manipulation after a washout period.
|
This technique is based on the application of a high-velocity, low-amplitude force to the lumbar spine with the aim of increasing mobility.
This intervention is a classic method used to evaluate the effect of lumbar spinal manipulation.
|
|
Active Comparator: Active Comparator: Lumbar Spinal Manipulation Group
Participants will receive lumbar spinal manipulation in the first session and placebo lumbar spinal manipulation after a washout period.
|
This technique is based on the application of a high-velocity, low-amplitude force to the lumbar spine with the aim of increasing mobility.
This intervention is a classic method used to evaluate the effect of lumbar spinal manipulation.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Overall Postural Stability Index Measurement
Time Frame: Change from baseline overall postural stability index immediately after the intervention
|
This index will be assessed by measuring deviations of the center of gravity in the anteroposterior and mediolateral directions.
Lower scores indicate smaller deviations and better postural stability.
The test will be performed on a stable platform with three trials of 30 seconds each.
The average of the three trials will be automatically calculated by the TechnoBody balance system.
|
Change from baseline overall postural stability index immediately after the intervention
|
|
Fall Risk Assessment
Time Frame: Change from baseline fall risk immediately after the intervention
|
Fall risk will be assessed by measuring the patient's ability to maintain balance on an unstable platform.
Based on their ability to maintain balance, a fall risk score will be generated, with higher scores indicating a greater risk of falling.
The test will be performed with three 30-second trials.
The average of the three trials will be calculated automatically by the TechnoBody balance system.
|
Change from baseline fall risk immediately after the intervention
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Anteroposterior Stability Index Measurement
Time Frame: Change from baseline anteroposterior postural stability index immediately after the intervention
|
The anteroposterior stability index will be assessed by measuring deviations of the center of gravity in the anteroposterior direction.
Lower scores indicate smaller deviations and better anteroposterior postural stability.
The test will be performed on a stable platform with three trials of 30 seconds each.
The average of the three trials will be automatically calculated by the TechnoBody balance system.
|
Change from baseline anteroposterior postural stability index immediately after the intervention
|
|
Mediolateral Stability Index Measurement
Time Frame: Change from baseline mediolateral stability index immediately after the intervention
|
The mediolateral stability index will be assessed by measuring deviations of the center of gravity in the mediolateral direction.
Lower scores indicate smaller deviations and better mediolateral postural stability.
The test will be performed on a stable platform with three trials of 30 seconds each.
The average of the three trials will be automatically calculated by the TechnoBody balance system.
|
Change from baseline mediolateral stability index immediately after the intervention
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: burak mavuş, M.Sc., Bolu Abant İzzet Baysal Physiotherapy and Rehabilitation Training and Research Hospital
- Principal Investigator: merve tunçdemir, Asst. Prof., Bitlis Eren University
- Principal Investigator: Ömer DURSUN, Assoc. Prof., Bitlis Eren University
Publications and helpful links
General Publications
- Geurts AC, de Haart M, van Nes IJ, Duysens J. A review of standing balance recovery from stroke. Gait Posture. 2005 Nov;22(3):267-81. doi: 10.1016/j.gaitpost.2004.10.002. Epub 2004 Dec 7.
- Arene N, Hidler J. Understanding motor impairment in the paretic lower limb after a stroke: a review of the literature. Top Stroke Rehabil. 2009 Sep-Oct;16(5):346-56. doi: 10.1310/tsr1605-346.
- Speelman AD, van de Warrenburg BP, van Nimwegen M, Petzinger GM, Munneke M, Bloem BR. How might physical activity benefit patients with Parkinson disease? Nat Rev Neurol. 2011 Jul 12;7(9):528-34. doi: 10.1038/nrneurol.2011.107.
- Pollock A, Baer G, Campbell P, Choo PL, Forster A, Morris J, Pomeroy VM, Langhorne P. Physical rehabilitation approaches for the recovery of function and mobility following stroke. Cochrane Database Syst Rev. 2014 Apr 22;2014(4):CD001920. doi: 10.1002/14651858.CD001920.pub3.
- Khalifeloo M, Naghdi S, Ansari NN, Akbari M, Jalaie S, Jannat D, Hasson S. A study on the immediate effects of plantar vibration on balance dysfunction in patients with stroke. J Exerc Rehabil. 2018 Apr 26;14(2):259-266. doi: 10.12965/jer.1836044.022. eCollection 2018 Apr.
- Yates JS, Lai SM, Duncan PW, Studenski S. Falls in community-dwelling stroke survivors: an accumulated impairments model. J Rehabil Res Dev. 2002 May-Jun;39(3):385-94.
- Divani AA, Vazquez G, Barrett AM, Asadollahi M, Luft AR. Risk factors associated with injury attributable to falling among elderly population with history of stroke. Stroke. 2009 Oct;40(10):3286-92. doi: 10.1161/STROKEAHA.109.559195. Epub 2009 Jul 23.
- Lamb SE, Ferrucci L, Volapto S, Fried LP, Guralnik JM; Women's Health and Aging Study. Risk factors for falling in home-dwelling older women with stroke: the Women's Health and Aging Study. Stroke. 2003 Feb;34(2):494-501.
- del Pozo-Cruz B, Adsuar JC, Parraca JA, del Pozo-Cruz J, Olivares PR, Gusi N. Using whole-body vibration training in patients affected with common neurological diseases: a systematic literature review. J Altern Complement Med. 2012 Jan;18(1):29-41. doi: 10.1089/acm.2010.0691. Epub 2012 Jan 10.
- Wenning GK, Ebersbach G, Verny M, Chaudhuri KR, Jellinger K, McKee A, Poewe W, Litvan I. Progression of falls in postmortem-confirmed parkinsonian disorders. Mov Disord. 1999 Nov;14(6):947-50. doi: 10.1002/1531-8257(199911)14:63.0.co;2-o.
- Chen JC, Shaw FZ. Progress in sensorimotor rehabilitative physical therapy programs for stroke patients. World J Clin Cases. 2014 Aug 16;2(8):316-26. doi: 10.12998/wjcc.v2.i8.316.
- Tyson SF, Hanley M, Chillala J, Selley A, Tallis RC. Balance disability after stroke. Phys Ther. 2006 Jan;86(1):30-8. doi: 10.1093/ptj/86.1.30.
- Joo S, Lee Y, Song CH. Immediate Effects of Thoracic Spinal Manipulation on Pulmonary Function in Stroke Patients: A Preliminary Study. J Manipulative Physiol Ther. 2018 Sep;41(7):602-608. doi: 10.1016/j.jmpt.2017.12.005. Epub 2018 Aug 16.
- Chen C, Yan B, He S, Wu R, Han X, Chen Y, Chen H, Xie L. Effects of lumbar joint mobilization on trunk control, balance, and gait in patients with stroke: study protocol for a randomized controlled trial. Trials. 2025 Feb 12;26(1):50. doi: 10.1186/s13063-025-08767-0.
- Park SJ, Cho KH. The Immediate Effects of Lumbar Rotational Mobilization on Trunk Control and Gait Parameter in Patients with Stroke. J Stroke Cerebrovasc Dis. 2022 Aug;31(8):106582. doi: 10.1016/j.jstrokecerebrovasdis.2022.106582. Epub 2022 Jun 24.
- Dursun O, Mavus AB. The effect of talocrural joint manipulation on static balance in patients with stroke: a randomized crossover trial. Physiother Theory Pract. 2025 Nov;41(11):2352-2364. doi: 10.1080/09593985.2025.2556133. Epub 2025 Sep 5.
- Diao Y, Liu Y, Pan J, Chen J, Pan J, Liao M, Liu H, Liao L. Efficacy and safety of spinal manipulative therapy in the management of acute neck pain: a systematic review and meta-analysis. Syst Rev. 2025 May 1;14(1):97. doi: 10.1186/s13643-025-02855-7.
Study record dates
Study Major Dates
Study Start (Estimated)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
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
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- BEUFTR-12
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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