Effects of Strength Training of Non-paretic Upper and Lower Limb With or Without Mirror Therapy

Effect of Strength Training of Non-paretic Upper and Lower Limb With or Without Mirror Therapy on Motor Function Recovery of the Pareytic Side in Stroke Patients.

The aim of this study is to find the effects of strength training with or without mirror therapy of non-paralytic upper limb for functional activities and in lower limb for gait pattern, balance and stability, and ADLs of paralytic side in patients with acute and sub-acute stroke. A randomized controlled trial that will include total 44 participants .The control group will undergo usual rehabilitation training along with strength training. The trial group will undergo strength training and mirror therapy of NHS on the basis of usual rehabilitation training. For the control group, training time will be 30 minutes, once a day, 3 days a week for 8 weeks. IN trial group, training time will be 30 minutes therapy, once a day, 3 days a week for 8 weeks. were allowed to rest for 3-5 min during each training. Data collected will be analyzed through SPSS 25.

Study Overview

• Status: Not yet recruiting
• Conditions: Stroke
• Intervention / Treatment: Other: Strength Training; Other: Mirror therapy

Detailed Description

Stroke is defined as rapidly developing clinical signs of focal or global cerebral function disturbance that lasts more than 24 hours or leads to death, with no other apparent cause than that of vascular origin. Hemiplegia shows one side of the body paralysis involving one upper and one lower extremity. The term hemiplegia is often used generically to refer to the wide variety of motor problems that result from stroke.There are several stroke rehabilitation strategies for UL motor impairment including strength training and mirror therapy.

The idea is to re-educate the brain through a simple task, in which the individual performs a series of movements with the healthy arm, which is reflected in the mirror as if it was the injured arm. In this way, the reflex in the mirror of the healthy arm tricks the brain in believing that the injured arm is functioning as it should before the stroke. Isokinetic strengthening may provide motor and functional improvement in paretic upper extremity among patients with post-stroke hemiplegia. This strategy makes use of the brain's adaptability to enhance motor function after a stroke .

Monika Ehrensberger et al (2019) in a study concluded potential effectiveness of mirror-aided cross-education was undertaken and results portray that, in the case of training isometrically, cross-education was not augmented by mirror therapy. (The effectiveness of strength training of the NHS is evidenced in terms of promoting recovery in patients with stroke experiencing balance, mobility, and muscle strength of the paretic side .

Chenlan Shao et al (2022) conducted his study on the effect of strength training of the non-hemiplegic side (NHS) on balance function, mobility, and muscle strength of patients with stroke. He concluded that Strength training of the NHS can promote recovery of balance, mobility, and muscle strength of the paretic side of patients with stroke.

Harris et al demonstrated that leg weakness develops on the non hemiplegic side (NHS) in the first week after acute stroke. This decline in NHS muscle strength must not be ignored in patients with stroke, because it is highly associated with functional performance, and it can be used as an independent predictor of short-term functional gain and outcomes after stroke.

The previous study investigated the feasibility and potential effectiveness of mirror-aided cross-education compared with cross-education alone in post stroke upper limb recovery only. In addition, previous studies, mirror therapy, and contralateral strength training have shown promising results individually, but their direct comparison for both upper and lower limbs remains under-explored in the literature.

The rationale for this study stems from the critical need to understanding the effectiveness of only mirror-therapy performed solely versus mirror-aided treatment coupled with strength training in enhancing motor functionality across both upper and lower limbs can significantly impact rehabilitative protocols.

This research could uncover potential synergies between the two interventions, presenting an opportunity to develop cost effective novel combined approaches that capitalize on their respective strengths. Ultimately, the study's findings have the potential to advance the field of neuroplasticity aided neurorehabilitation and contribute to improved quality of life for individuals dealing with hemiplegia.

• Study Type: Interventional
• Enrollment (Estimated): 44
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Sara Aabroo Aabroo, Ms NMPT; Phone Number: 03155185508; Email: sara.aabroo@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Rawalpindi, Punjab, Pakistan
      • Fatima Hospital
      • Contact: Sara Aabroo, NMPT; Phone Number: 03155185508; Email: sara.aabroo@riphah.edu.pk
      • Contact: Farwa Akhtar, NMPT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Girls aged 17-24 years with regular --Menstrual cycle
• Unmarried girls

Exclusion Criteria:

• Athletes
• Married women
• Girls who were regularly exercising
• Having any pelvic pathology
• Abnormal menstrual cycle.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Strength Training; Non-hemiplegic lower limb stepping forward training Non-hemiplegic upper limb pulling elastic belt in standing position repeatedly Hemiplegic lower limb stepped over an obstacle or climbed a platform The patients will stretch their arms to touch distant objects in a standing position repeatedly.	Other: Strength Training; training time will be 30 minutes therapy, once a day, 3 days a week for 8 weeks. were allowed to rest for 3-5 min during each training.
Experimental: Mirror Therapy and strength Training Group; Participants in the (trial group) mirror and strength training group observed the reflection of the exercising arm and leg in the mirror. Participants in the (control group) strength training only group will exercise without a mirror entirely.	Other: Strength Training; training time will be 30 minutes therapy, once a day, 3 days a week for 8 weeks. were allowed to rest for 3-5 min during each training.; Other: Mirror therapy; Participants in the (trial group) mirror and strength training group observed the reflection of the exercising arm and leg in the mirror. Participants in the (control group) strength training only group will exercise without a mirror entirely.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Modified Barthel Index	MBI is a five-level rating scale, including evaluation of bathing, grooming, feeding, dressing, bowels, bladder, toilet, stairs, chair/bed transfers, and walking. Higher scores represent higher degree of ADL independence. MBI was an efficient, reliable, and valid assessment of ADL for stroke patients.	8 weeks
Dynamic Gait Index	Dynamic Gait Index (DGI) is a performance-based tool that quantifies the dynamic balance instability developed by Shumway-Cook and Woollacott, evaluates the ability of the individual to modify gait in response to changing functions during walking.	8 weeks
Berg Balance Scale	Consists of 14 tasks and total score of 56.score of 0-20 indicates severe fall risk, 20-45 includes moderate risk of fall and 45-60 illustrates thr functional balances state.	8 weks

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Sara Aabroo Aabroo, Nmpt, Riphah International University

Study record dates

Study Major Dates

• Study Start (Estimated): March 10, 2024
• Primary Completion (Estimated): December 30, 2024
• Study Completion (Estimated): January 1, 2025

Study Registration Dates

• First Submitted: November 24, 2023
• First Submitted That Met QC Criteria: March 4, 2024
• First Posted (Estimated): March 5, 2024

Study Record Updates

• Last Update Posted (Estimated): March 5, 2024
• Last Update Submitted That Met QC Criteria: March 4, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: stroke rehabilitation; Hemiplegic stroke; strength training AND stroke; Mirror therapy AND stroke; strength training and mirror therapy
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: Farwa Akhtar

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