The Effect Of Multifidus And Transversus Abdominis Muscle Activation On Balance In Hemiplegic Patients

The Effect Of Multifidus And Transversus Abdominis Muscle Activation Measured Under Ultrasound Guidance On Balance In Hemiplegic Patients

Patients with post-stroke hemiplegia may develop balance disorder and limitation in ambulation ability due to multiple mechanisms.

The effects of core muscles on maintaining normal posture, balance and ambulation ability are known. The positive effects of core stabilisation exercises on balance in hemiplegic patients have been shown in previous studies. In this study, we planned to investigate the effects of bilateral transversus abdominis and bilateral lumbar multifidus muscles on balance in patients with stroke-related hemiplegia.

Study Overview

• Status: Completed
• Conditions: Hemiplegia

Detailed Description

Loss of function in the trunk muscles of stroke patients leads to both balance problems and excessive effort to maintain balance. While ambulation ability of some patients is completely lost due to stroke, in others, impaired balance and increased postural oscillation lead to fear of falling and increased risk of falling.

In previous studies, it has been shown that there is a significant relationship between static balance and duration of hospital stay and functional abilities after stroke. In another study, it was shown that the control ability of the trunk muscles in the early post-stroke period was a strong factor affecting general life activities in the first six months after stroke.

Trunk muscles are innervated by both hemispheres unlike the extremities. Therefore, unilateral stroke may impair the function of trunk muscles on both the contralateral and ipsilateral sides. Several studies have shown dysfunction of bilateral trunk flexor, extensor and rotator muscles in patients with unilateral stroke.

Many studies have proven that core stabilisation exercises are effective on both balance and gait function and general life activities in hemiplegic patients.

The aim of this cross-sectional study was to investigate the effect of ultrasound-guided bilateral transversus abdominis and bilateral lumbar multifidus muscle activations on balance in hemiplegic patients.

• Study Type: Observational
• Enrollment (Actual): 36

Contacts and Locations

Study Locations

• Turkey
  • Istanbul, Turkey
    • Istanbul Physical Medicine Rehabilitation Training & Research Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

36 hemiplegic patients who met the inclusion criteria and did not meet the exclusion criteria

Description

Inclusion Criteria:

• Patients aged 18-65 years
• Time after stroke must be at least 1 month
• Unilateral stroke
• Must be cognitively compatible in terms of cooperation
• Standing balance with/without support and/or sitting balance without support
• BMI<30

Exclusion Criteria:

• Patients with a history of hemiplegia in the opposite half of the body
• Patients with extruded or sequestered lumbar hernia and/or history of lumbar operation
• Patients with a history of lumbar vertebral fracture
• Patients with traumatic brain injury
• Patients with neuromuscular muscle disease that may lead to muscle atrophy
• Patients with sensory defects
• Patients with cerebellar defects
• Patients with vestibular balance disorders (vertigo, etc.)
• Patients with Parkinson's disease
• Patients with balance problems due to visual impairment
• Patients with pre-stroke balance problems

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Hemiplegic Patients; Patients with hemiplegia after stroke

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Berg Balance Scale (BBS)	Patients' balance was evaluated using the Berg Balance Scale.	Same day with ultrasound-guided muscle measurement
Postural Assessment Scale For Stroke Patients (PASS)	Posture change and posture maintenance scores of the patients were evaluated using PASS.	Same day with ultrasound-guided muscle measurement
Functional Ambulation Category (FAC)	Ambulation ability of the patients was evaluated using FAC.	Same day with ultrasound-guided muscle measurement

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Brunnstrom Stages	Limb function of the patients was evaluated using Brunnstrom Staging.	Same day with ultrasound-guided muscle measurement
Transversus Abdominis Muscle Activation	[(transversus abdominis contraction thickness)-(transversus abdominis resting thickness)]/transversus abdominis resting thickness	BBS, PASS, FAC and Brunnstrom stages were measured immediately after recording.
Multifidus Muscle Activation	[(multifidus contraction thickness)-(multifidus resting thickness)]/multifidus resting thickness	BBS, PASS, FAC and Brunnstrom stages were measured immediately after recording.

Collaborators and Investigators

• Sponsor: Istanbul Physical Medicine Rehabilitation Training and Research Hospital
• Investigators: Principal Investigator: NAZLI DERYA BUGDAYCI, MD, Istanbul Physical Therapy Rehabilitation Training & Research Hospital

Study record dates

Study Major Dates

• Study Start (Actual): February 1, 2023
• Primary Completion (Actual): September 1, 2023
• Study Completion (Actual): October 31, 2023

Study Registration Dates

• First Submitted: December 13, 2023
• First Submitted That Met QC Criteria: December 13, 2023
• First Posted (Actual): December 26, 2023

Study Record Updates

• Last Update Posted (Actual): December 26, 2023
• Last Update Submitted That Met QC Criteria: December 13, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: stroke; hemiplegia; balance; multifidus; transversus abdominis
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Paralysis; Hemiplegia
• Other Study ID Numbers: ELMTRAMABHP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No