- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04887376
Mirror Therapy and Cross-Education of Muscle Strength
May 11, 2021 updated by: Istanbul Physical Medicine Rehabilitation Training and Research Hospital
Additive Effect of Mirror Therapy on Effects of Cross-Education of Muscle Strength of Neuromuscular Electrical Stimulation In Hemiplegic Patients
This study was conducted to determine whether mirror therapy has an additive effect on cross-education of the strength of neuromuscular electrical stimulation (NMES) in patients with hemiplegia.
As an outcome measure, the ankle dorsiflexion strength of hemiplegic patients was measured.
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
A total of 29 patients, 7 women, and 22 men were included according to the inclusion and exclusion criteria.
The patients were randomly assigned to the control group (n = 14) and the Mirror group (n = 15).
Five sessions of neuromuscular electrical stimulation, unaffected side ankle dorsiflexors were applied to the patients in both groups.
In addition to the NMES, mirror therapy was applied to the experimental group simultaneously with NMES.
Before and after treatment, both ankle dorsiflexor strength was measured with a force sensor.
For force measurements, a force transducer (FC2211-0000-0100-L Compression Load Cell, TE Connectivity company, France) was used.
Force transducer signals were received with a data acquisition device (POWERLAB® data acquisition system ADInstruments, Oxford, UK) and evaluated offline on the computer.
The measurement values were expressed in kilogram.force
(kg.f) and this value was normalized according to body weight.
Study Type
Interventional
Enrollment (Actual)
29
Phase
- 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 Locations
-
-
-
Istanbul, Turkey, 34173
- Istanbul Physical Medicine Rehabilitation Training & Research Hospital
-
-
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
Ages Eligible for Study
18 years to 75 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Genders Eligible for Study
All
Description
Inclusion Criteria:
- Cases with stroke duration ≥ 1 month
- Ability to walk at least 10m (functional ambulation scale ≥3)
- Age range 18-75 years
- Hemorrhagic or ischemic stroke
- Brunnstrom stage ≥4 for lower limb
- Unilateral stroke
- Cooperating with the examination and tests
Exclusion Criteria:
- Mini Mental State Assessment score <21
- Severe spasticity (MAS = 4) in ankle dorsiflexors
- Have a contracture on ankle joint
- The presence of skin lesions in the application area
- Painful pathologies in the lower extremities
- Having visual field defects
- Active inflammatory, rheumatological or infectious disease
- Parent rhythm / conduction block problem in the heart
- Uncontrollable hypertension (Maxima> 140, Minima> 90)
- Presence of lower extremity fracture
- Peripheral nerve lesions such as polyneuropathy, radiculopathy
- Finding or suspected active deep vein thrombosis
- History of deep vein thrombosis and pulmonary embolism
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 |
Intervention / Treatment |
|---|---|
|
Active Comparator: Mirror Therapy
Participants were asked to sit with their knee joints in full extension and both ankle joints in a neutral position.
Five sessions of neuromuscular electrical stimulation (NMES) were applied to the non-affected side ankle dorsiflexors.
In addition to this application, mirror therapy was applied simultaneously with NMES.
|
Combined Mirror and NMES therapy
|
|
Placebo Comparator: Control
Participants were asked to sit with their knee joints in full extension and both ankle joints in a neutral position.
Five sessions of neuromuscular electrical stimulation (NMES) were applied to the non-affected side ankle dorsiflexors.
|
Only NMES therapy
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of ankle dorsiflexor isometric muscle strength
Time Frame: Change from Baseline muscle strength at 6 days
|
Force transducer used for measuring maximum voluntary ankle dorsiflexion force.
The force unit is kilogram.force
|
Change from Baseline muscle strength at 6 days
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Change of Lower Extremity Brunnstrom score
Time Frame: Change from Baseline Brunnstrom score at 6 days
|
It evaluates the developmental stages of synergy patterns, muscle tone and isolated movements of the patients in the lower extremities.
Patients are categorized between Stage-1 and 6.
Stage 1: Flaccidity; Stage 6: Spasticity Disappears and Coordination Reappears
|
Change from Baseline Brunnstrom score at 6 days
|
|
Change of Modified Ashworth Scale score
Time Frame: Change from Baseline Modified Ashworth Scale score at 6 days
|
Modified Ashworth Scale was used for assessment spasticity.
Modified Ashworth Scale scores are varied between 0 and 4: 0 points, no increase in muscle tone; 4 points indicate spasticity with a degree of rigidity.
|
Change from Baseline Modified Ashworth Scale score at 6 days
|
|
Change of Functional Ambulation Scale score
Time Frame: Change from Baseline Functional Ambulation Scale score at 6 days
|
The Functional Ambulation Classification (FAC) is a method for classifying mobility.
The FAC has six categories ranging from 0 (non-functional ambulation) to 5 (independent).
|
Change from Baseline Functional Ambulation Scale score at 6 days
|
|
Change of Timed Up and Go Test score
Time Frame: Change from Baseline Timed Up and Go Test score at 6 days
|
It is a test that evaluates the patient's static and dynamic balance, mobility and walking ability.
The test's score is the time in seconds it takes the subject takes to complete the test.
|
Change from Baseline Timed Up and Go Test score at 6 days
|
Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Ilhan Karacan, Assoc Prof, Istanbul Physical Medicine Rehabilitation Training & Research Hospital
Publications and helpful links
The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.
General Publications
- Lee D, Lee G. Effect of afferent electrical stimulation with mirror therapy on motor function, balance, and gait in chronic stroke survivors: a randomized controlled trial. Eur J Phys Rehabil Med. 2019 Aug;55(4):442-449. doi: 10.23736/S1973-9087.19.05334-6. Epub 2019 Mar 22.
- Howatson G, Zult T, Farthing JP, Zijdewind I, Hortobagyi T. Mirror training to augment cross-education during resistance training: a hypothesis. Front Hum Neurosci. 2013 Jul 24;7:396. doi: 10.3389/fnhum.2013.00396. eCollection 2013.
- Zult T, Goodall S, Thomas K, Solnik S, Hortobagyi T, Howatson G. Mirror Training Augments the Cross-education of Strength and Affects Inhibitory Paths. Med Sci Sports Exerc. 2016 Jun;48(6):1001-13. doi: 10.1249/MSS.0000000000000871.
- Sariyildiz M, Karacan I, Rezvani A, Ergin O, Cidem M. Cross-education of muscle strength: cross-training effects are not confined to untrained contralateral homologous muscle. Scand J Med Sci Sports. 2011 Dec;21(6):e359-64. doi: 10.1111/j.1600-0838.2011.01311.x. Epub 2011 Apr 18.
- Kim H, Lee G, Song C. Effect of functional electrical stimulation with mirror therapy on upper extremity motor function in poststroke patients. J Stroke Cerebrovasc Dis. 2014 Apr;23(4):655-61. doi: 10.1016/j.jstrokecerebrovasdis.2013.06.017. Epub 2013 Jul 16.
- Ji SG, Cha HG, Kim MK, Lee CR. The effect of mirror therapy integrating functional electrical stimulation on the gait of stroke patients. J Phys Ther Sci. 2014 Apr;26(4):497-9. doi: 10.1589/jpts.26.497. Epub 2014 Apr 23.
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)
February 1, 2020
Primary Completion (Actual)
January 31, 2021
Study Completion (Actual)
January 31, 2021
Study Registration Dates
First Submitted
May 7, 2021
First Submitted That Met QC Criteria
May 11, 2021
First Posted (Actual)
May 14, 2021
Study Record Updates
Last Update Posted (Actual)
May 14, 2021
Last Update Submitted That Met QC Criteria
May 11, 2021
Last Verified
May 1, 2021
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- IstPMRTRH-MT
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
No
Studies a U.S. FDA-regulated device product
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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