Effect of Core Stability and Sensorimotor Training Exercises on Postural Stability Post Lower Limb Burn

The purpose of the study is to determine the effect of core stability and sensorimotor training exercises on postural stability post lower limb burn.

Study Overview

• Status: Not yet recruiting
• Conditions: Burns
• Intervention / Treatment: Other: Core Stability Exercises; Other: Traditional physical therapy program; Other: Sensorimotor Training Exercises

Detailed Description

The need for this study develops from the lack of information in the published studies about the effectiveness of core stability exercises and sensorimotor training on the rehabilitation of burned patients.

Severe burn injuries, particularly those encompassing over 20% of the total body surface area (TBSA), trigger elevated catabolism and hypermetabolic responses in adult and pediatric burn patients. This wide spectrum of pronounced effects stemming from the hypermetabolic response and catabolism includes substantial muscle mass depletion, reduced muscle strength and endurance, hindered wound healing, impaired sensory perception, constrained ambulatory capacity, postural instability, and diminished functional mobility.

Core stability exercises improve neuromuscular system performance that causes the optimal lumbar-pelvic -hip chain mobility and good acceleration and deceleration, appropriate muscular balance, proximal stability and good function.

Sensorimotor training exercise emphasizes postural control and progressive challenges to the sensorimotor system to restore normal motor programs in patients. The proprio sensory system helps the motor system to maintain equilibrium on a reflex, automatic basis. In response to a sudden load, "the muscles will respond rapidly to stabilize the body, i.e., they will try to maintain balance and posture.

The present study is designed to investigate the effect of core stability and sensorimotor training exercises on postural stability in burned patients.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Rofaida Mohie Eldeen Ali Sobh, M.Sc; Phone Number: 01270214420; Email: sobhrofaida@gmail.com
• Study Contact Backup: Name: Khadra Mohamed Ali, PhD

Study Locations

• Egypt
  • Giza, Egypt
    • Faculty of physical therapy, Cairo University
    • Contact: Rofaida Mohie Eldeen Ali Sobh, M.Sc; Phone Number: 01270214420; Email: sobhrofaida@gmail.com
    • Contact: Khadra Mohamed Ali, PhD

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients are both males and females.
• Their age will range from (20-50) years.
• Patients will suffer from lower limb second degree burn (Partial thickness of thermal injury).
• Total body surface area (TBSA) for the burns will be ranged from 20% to 35% .
• Patients will begin the training program after complete wound healing.
• Patients will be given their informed consent.

Exclusion Criteria:

• Patients who had an open wound at or near treatment site.
• Patients who had chemical or electrical burn.
• Musculoskeletal disorders that will impair performance during training and tests.
• Uncontrolled cardiovascular or pulmonary diseases .
• Neurological and renal disorders.
• Metabolic or vascular disease with a neurological component such as diabetes.
• Malignant conditions.
• Psychiatric illness, severe behavior or cognitive disorders.
• Uncooperative patients.
• Pregnancy.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Core Stability Exercises + Traditional physical therapy program; This group will be composed of 30 patients with lower limb burns. Patients will receive core stability exercises in addition to a traditional physical therapy program in the form of stretching exercises, strengthening exercises and scar management. Exercises will be applied for 3 times a week for 8 consecutive weeks.	Other: Core Stability Exercises; Patients will perform core stability exercises three times weekly for eight weeks. The exercises include abdominal hollowing, bridge, right-angle leg lifts with thigh press, seated twist, knee-to-chest with elbow flexion, prone abdominal hollowing, prone arm and leg lift, quadruped abdominal hollowing, quadruped arm or arm-leg lifts, and various plank positions: forearm plank, side plank, forearm plank with hip raise, and forearm plank with straight legs.; Other: Traditional physical therapy program; All patients will undergo a traditional physical therapy program consisting of stretching exercises, strengthening exercises, and scar management techniques, three times weekly for eight weeks.
Experimental: Sensorimotor Training Exercises + Traditional physical therapy program; This group will be composed of 30 patients with lower limb burns. Patients will receive sensorimotor training exercise in addition to traditional physical therapy program in the form of stretching exercises, strengthening exercises and scar management. Exercises will be applied for 3 times a week for 8 consecutive weeks.	Other: Traditional physical therapy program; All patients will undergo a traditional physical therapy program consisting of stretching exercises, strengthening exercises, and scar management techniques, three times weekly for eight weeks.; Other: Sensorimotor Training Exercises; Patients will perform sensorimotor training exercises three times weekly for eight weeks, progressing through three phases: static (weeks 1-2), dynamic (weeks 3-4), and functional (weeks 5-8). Exercises, repeated 3-5 times per session with rest intervals, advance from simple to complex as patients master each level. Static exercises include standing on firm/soft surfaces and single-leg balances. Dynamic exercises add forward lunges and T-band kicks. Functional training incorporates walking on various surfaces, toe and heel skipping, squats, balance drills on wobble boards, and multidirectional rolling movements with visual and single-leg variations. This progression enhances coordination, balance, and functional stability.
Experimental: Core Stability Exercises + Sensorimotor Training Exercises + Traditional physical therapy program; This group will be composed of 30 patients with lower limb burns. Patients will receive core stability exercises and sensorimotor training exercise in addition to traditional physical therapy program in the form of stretching exercises, strengthening exercises and scar management. Exercises will be applied for 3 times a week for 8 consecutive weeks.	Other: Core Stability Exercises; Patients will perform core stability exercises three times weekly for eight weeks. The exercises include abdominal hollowing, bridge, right-angle leg lifts with thigh press, seated twist, knee-to-chest with elbow flexion, prone abdominal hollowing, prone arm and leg lift, quadruped abdominal hollowing, quadruped arm or arm-leg lifts, and various plank positions: forearm plank, side plank, forearm plank with hip raise, and forearm plank with straight legs.; Other: Traditional physical therapy program; All patients will undergo a traditional physical therapy program consisting of stretching exercises, strengthening exercises, and scar management techniques, three times weekly for eight weeks.; Other: Sensorimotor Training Exercises; Patients will perform sensorimotor training exercises three times weekly for eight weeks, progressing through three phases: static (weeks 1-2), dynamic (weeks 3-4), and functional (weeks 5-8). Exercises, repeated 3-5 times per session with rest intervals, advance from simple to complex as patients master each level. Static exercises include standing on firm/soft surfaces and single-leg balances. Dynamic exercises add forward lunges and T-band kicks. Functional training incorporates walking on various surfaces, toe and heel skipping, squats, balance drills on wobble boards, and multidirectional rolling movements with visual and single-leg variations. This progression enhances coordination, balance, and functional stability.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
overall stability index	It was evaluated using the Biodex Balance System (BBS) before and after the eight-week treatment program. Patients will stand barefoot on the locked platform, centering themselves using visual feedback on the screen. Once stable, foot angles and heel coordinates will be recorded, and tests will commence with stability levels gradually decreasing from level eight to level four. Each test will last 30 seconds, with patients maintaining the cursor within the smallest balance zones. Postural stability measures will be calculated as the mean of three trials.	8 weeks
anterior-posterior stability index	It was evaluated using the Biodex Balance System (BBS) before and after the eight-week treatment program. Patients will stand barefoot on the locked platform, centering themselves using visual feedback on the screen. Once stable, foot angles and heel coordinates will be recorded, and tests will commence with stability levels gradually decreasing from level eight to level four. Each test will last 30 seconds, with patients maintaining the cursor within the smallest balance zones. Postural stability measures will be calculated as the mean of three trials.	8 weeks
medial-lateral stability index	It was evaluated using the Biodex Balance System (BBS) before and after the eight-week treatment program. Patients will stand barefoot on the locked platform, centering themselves using visual feedback on the screen. Once stable, foot angles and heel coordinates will be recorded, and tests will commence with stability levels gradually decreasing from level eight to level four. Each test will last 30 seconds, with patients maintaining the cursor within the smallest balance zones. Postural stability measures will be calculated as the mean of three trials.	8 weeks

Collaborators and Investigators

• Sponsor: Cairo University
• Investigators: Study Chair: Haidy Nady Ashem, PhD, Professor, Cairo university

Study record dates

Study Major Dates

• Study Start (Estimated): December 10, 2024
• Primary Completion (Estimated): May 10, 2025
• Study Completion (Estimated): May 25, 2025

Study Registration Dates

• First Submitted: December 2, 2024
• First Submitted That Met QC Criteria: December 2, 2024
• First Posted (Estimated): December 5, 2024

Study Record Updates

• Last Update Posted (Estimated): December 5, 2024
• Last Update Submitted That Met QC Criteria: December 2, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Wounds and Injuries; Burns
• Other Study ID Numbers: P.T.REC/012/005151

Drug and device information, study documents

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