The Assessment of Knee Joints Function in People After Stroke

Is it Important to Assess the Function of the Knee Joint After a Stroke

The study aims to assess the function of knee joints in patients after stroke compared to healthy people and evaluate the impact of rehabilitation on the function of knee joints in people after stroke.

Study Overview

• Status: Completed
• Conditions: Stroke
• Intervention / Treatment: Other: Rehabilitation

Detailed Description

Stroke patients were examined twice at the beginning of rehabilitation and after approximately 15 days of exercise. The control group (healthy participants) was assessed once. Wireless motion sensors connected to a mobile application were used to assess the kinematics of the knee joints. They were used to assess the range of motion in the knee joints (passive, active, active at maximum speed), proprioception (joint position sense tests), step-up test, step-down test, getting up and sitting on a chair, step and squat. Functional tests such as The Five Times Sit-to-Stand Test, Timed Up&Go, The Step Test, the 5m walking test, and the 30-s Chair Stand Test were carried out. The strength of the knee extensors and flexors was also assessed using the Leg Force Feedback device. Balance was assessed on a posturography platform by performing tests such as standing with eyes open and closed on a stable surface and standing with eyes open and closed on an unstable surface. The symmetry of lower limb loads in a standing position was also assessed.

• Study Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• Poland
  • Poznań, Poland, 61-701
    • Poznan University of Medical Sciences

Participation Criteria

Eligibility Criteria

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

• Sampling Method: Non-Probability Sample

Study Population

The study group comprised patients after stroke. The control group consisted of healthy volunteers.

Description

Inclusion criteria to the stroke group were as follows :

• the time from stroke: less than a year,
• age: between 35 and 65 years old,
• ability to stand independently for at least 5 minutes without an assistive device,
• ability to walk 5 m independently,
• ability to communicate and understand the tasks required in the study,
• a modified Ashworth scale spasticity score of 1+ or less in the affected knee (0: no resistance, 5: affected parts stiff in flexion or extension),
• muscle strength on the Manual Muscle Test of 3/4 or more in the affected knee,
• Barthel Index score 80 or more.

Exclusion criteria from the post-stroke group were as follows:

• age below 35 or over 65,
• sensorimotor aphasia,
• cognitive disorders that make it impossible to understand and obey commands,
• lack of active movement in the knee joint,
• Manual Muscle Test strength of the quadriceps muscles below 3,
• no ability to walk 5 meters,
• lack of informed consent to participate in the study,
• other neurological diseases (such as MS, Parkinson's disease, neuropathies),
• fractures in the lower limbs, which could affect the structure and function of the knee joint,
• previous operations on the lower limbs (including ACL reconstruction, knee arthroplasty or hip, osteotomy of the knee joint).
• vision disorders,
• unilateral spatial neglect syndrome.

The control group consisted of healthy volunteers with no prior history of trauma or neurological disease affecting the structure and function of the lower limb.

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Stroke group; All patients from the stroke group were examined twice at the beginning and the end of this trial by a physical therapist. Patients participated in a rehabilitation program at the Neurological Rehabilitation Department between measurements.	Other: Rehabilitation; People after a stroke participated in a standard rehabilitation process carried out at the neurological rehabilitation department.; Other Names: Physical rehabilitation
Control group; The control group consisted of healthy subjects.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of the passive and active range of motion of the knee joint using wireless motion sensors connected to a mobile application.	Measurement of the passive and active range of motion of the knee joint in degrees in lying position using wireless motion sensors connected to a mobile application.	Baseline and after about 15 days of exercise.
Proprioception	Assessment of joint position sensation (3 different positions indicated) in degrees using wireless sensors.	Baseline and after about 15 days of exercise.
Assessment of the active range of motion of the knee and hip joint during functional tasks	Measurement of the range of motion of the knee and hip joint using wireless motion sensors connected to a mobile application during functional tasks such as: step up, step down, squat, sitting on a chair and getting up from a chair and step forward.	Baseline and after about 15 days of exercise.
Assessment of the maximum angle of varus and valgus at the knee joint during functional tasks	Measurement of the maximum angle of varus and valgus at the knee joint using wireless motion sensors connected to a mobile application during functional tasks such as: step up, step down, squat, sitting on a chair and getting up from a chair and step forward.	Baseline and after about 15 days of exercise.
Assessment of the mean squared error at the knee joint during functional tasks	Measurement of the mean squared error using wireless motion sensors connected to a mobile application during active flexion and extension motion in the knee joint at maximum speed and functional tasks such as: step up, step down, squat, sitting on a chair and getting up from a chair and step forward.	Baseline and after about 15 days of exercise.
Assessment of the speed of movement in the knee joint during functional tasks	Measurement of the speed of movement in the knee joint during active flexion and extension motion in the knee joint at maximum speed and functional tasks such as: squat and sitting on a chair and getting up from a chair.	Baseline and after about 15 days of exercise.
Step test	Assessment of the number of repetitions.	Baseline and after about 15 days of exercise.
The Five Times Sit-to-Stand Test	Assessment of task completion time.	Baseline and after about 15 days of exercise.
Timed Up&Go Test	Assessment of task completion time.	Baseline and after about 15 days of exercise.
30-s Chair Stand Test	Assessment of the number of repetitions.	Baseline and after about 15 days of exercise.
5m walking test	Assessment of task completion time.	Baseline and after about 15 days of exercise.
Assessment of isometric muscle strength of knee flexors and extensors using Leg Force Feedback device.	Measurement of the maximal voluntary isometric contraction torque of the knee extensor and flexor muscle groups in Newton-meter.	Baseline and after about 15 days of exercise.
Symmetry	Assessment of the load on the lower limbs while standing in percentage.	Baseline and after about 15 days of exercise.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of the center of pressure path length when measuring on a balance platform	Measurement of parameter such as total path length (cm). A test was performed in four conditions: standing with eyes open and closed on a stable surface and standing with eyes open and closed on an unstable surface.	Baseline and after about 15 days of exercise.
Assessment of the center of pressure velocity when measuring on a balance platform	Assessment of parameter such as average speed (cm/s). A test was performed in four conditions: standing with eyes open and closed on a stable surface and standing with eyes open and closed on an unstable surface.	Baseline and after about 15 days of exercise.
Balance	The test was performed in four conditions: standing with eyes open and closed on a stable surface and standing with eyes open and closed on an unstable surface. The results were obtained in percentage values and compared to the normative results from the system.	Baseline and after about 15 days of exercise.

Collaborators and Investigators

• Sponsor: Poznan University of Medical Sciences
• Investigators: Principal Investigator: Agnieszka Wareńczak-Pawlicka, PhD, Poznan University of Medical Sciences

Study record dates

Study Major Dates

• Study Start (Actual): November 10, 2021
• Primary Completion (Actual): April 7, 2022
• Study Completion (Actual): June 15, 2022

Study Registration Dates

• First Submitted: March 11, 2024
• First Submitted That Met QC Criteria: December 20, 2024
• First Posted (Actual): March 25, 2025

Study Record Updates

• Last Update Posted (Actual): March 25, 2025
• Last Update Submitted That Met QC Criteria: December 23, 2024
• Last Verified: December 1, 2024

More Information

Terms related to this study

• Keywords: physiotherapy; functional tests; function of knee joint; wireless sensors
• Additional Relevant MeSH Terms: Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Stroke
• Other Study ID Numbers: 822/21

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: The data is available in the form of an anonymized CSV sheet.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No