Investigation of the Effects of Vestibular Rehabilitation and Dynamic Neuromuscular (Dynamic)

August 4, 2026 updated by: merve yilmaz menek, Istanbul Medipol University Hospital

Investigation of the Effects of Vestibular Rehabilitation and Dynamic Neuromuscular Stabilization Exercises on Balance and Mobility in Patients With Hemiplegia

This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. A total of 45 hemiplegic patients will enrolled and randomized into three groups: Conventional Exercise Group (CEG, n = 15), Dynamic Neuromuscular Stabilization Group (DNSG, n = 15), and Vestibular Rehabilitation Group (VRG, n = 15). Each group will be participated in specialized exercise programs twice a week for six weeks. All groups will be underwent assessments before and after treatment. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.

Study Type

Interventional

Enrollment (Actual)

45

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

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

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Being 18 years of age or older
  • Having experienced at least one stroke and presenting with hemiplegic symptoms
  • Having passed at least one year since the stroke even
  • Scoring at least 24 points on the Mini-Mental State Examination (MMSE)
  • Being able to walk independently for at least 30 meters without assistance
  • Being able to comply with and participate in the exercise program

Exclusion Criteria:

  • Individuals with chronic pulmonary and/or cardiac diseases
  • Presence of uncontrolled hypertension
  • Conditions accompanied by peripheral nerve injury or lower motor neuron disorders
  • Presence of additional neurological disorders such as ataxia, dyskinesia, or dystonia
  • Severe spasticity, peripheral lesions, pressure ulcers, marked muscle atrophy, obesity, skin irritation, or use of a cardiac pacemaker
  • Presence of vestibular symptoms such as vertigo or dizziness

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: Single

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Group 1: Conventional Exercise Group
Conventional Exercise will be conducted in this group
Other: Conventional Exercise programs
This group participated in Conventional Exercise programs twice a week for six weeks.
Experimental: Group 2: Dynamic Neuromuscular Stabilization Group
Dynamic Neuromuscular Stabilization exercises will be done in this group
Other: Dynamic Neuromuscular Stabilization
This group participated in Dynamic Neuromuscular Stabilization Exercise programs twice a week for six weeks.
Experimental: Group 3: Vestibular Rehabilitation Group
Vestibular Rehabilitation will be conducted in this group
Other: Vestibular Rehabilitation Group
This group participated in Vestibular Rehabilitation programs twice a week for six weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
The Fugl-Meyer Assessment of Upper Extremity
Time Frame: From the beginning of treatment to the end of the 6th week
It is a standardized, stroke-specific, performance-based outcome measure used in clinical trials to evaluate motor recovery of the upper limb. It assesses movement, coordination, and reflex activity of the shoulder, elbow, forearm, wrist, and hand, providing a quantitative measure of motor impairment and recovery over time. The maximum score for the arm section is 36. During the finger-to-nose test, coordination and speed of movement are evaluated out of 6 points, while tremor, dysmetria, and speed of movement in the upper extremity are also examined in detail.
From the beginning of treatment to the end of the 6th week
Modified Ashworth Scale (MAS)
Time Frame: From the beginning of treatment to the end of the 6th week
It is a widely used clinical outcome measure in clinical trials to assess spasticity by grading the resistance encountered during passive muscle stretching. The joint is passively moved with repetitive and rapid movements, and the joint's resistance to these movements is scored.
From the beginning of treatment to the end of the 6th week
Mini-Mental State Examination (MMSE)
Time Frame: From the beginning of treatment to the end of the 6th week
It is a brief, standardized cognitive screening tool used in clinical trials to assess global cognitive function, including orientation, attention, memory, language, and visuospatial abilities. The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. Scores of 24-30 indicate normal cognition, 18-23 mild cognitive impairment, and ≤17 moderate to severe cognitive impairment.
From the beginning of treatment to the end of the 6th week
Berg Balance Scale (BBS)
Time Frame: From the beginning of treatment to the end of the 6th week
This is a 14-item scale that assesses a patient's ability to maintain balance for a specific period during static and various functional movements. The scoring system ranges from 0 to 4, with 0 meaning "cannot" and 4 meaning "can do independently," and the maximum total score is 56. A total score between 0-20 indicates a high risk of falls; between 21-40 indicates a moderate risk of falls; and between 41-56 indicates a low risk of falls.
From the beginning of treatment to the end of the 6th week
Stroke Impact Scale (SIS)
Time Frame: From the beginning of treatment to the end of the 6th week
It is a stroke-specific, patient-reported outcome measure widely used in clinical trials to evaluate the perceived impact of stroke on multiple domains of health-related quality of life. Based on the obtained score, 0 indicates no recovery, whereas 100 represents complete recovery.
From the beginning of treatment to the end of the 6th week
Timed Up and Go (TUG)
Time Frame: From the beginning of treatment to the end of the 6th week
The test is a simple and widely used functional mobility assessment in clinical trials. It measures the time required for an individual to stand up from a chair, walk 3 meters, turn around, walk back, and sit down. Shorter completion times indicate better functional mobility and balance, and the test is commonly used to assess fall risk and mobility limitations.
From the beginning of treatment to the end of the 6th week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Istanbul Medipol University Hospital

Investigators

  • Principal Investigator: MERVE YILMAZ MENEK, Medipol University

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

Helpful Links

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)

January 17, 2026

Primary Completion (Actual)

March 1, 2026

Study Completion (Actual)

August 5, 2026

Study Registration Dates

First Submitted

January 28, 2026

First Submitted That Met QC Criteria

January 28, 2026

First Posted (Actual)

February 4, 2026

Study Record Updates

Last Update Posted (Actual)

August 6, 2026

Last Update Submitted That Met QC Criteria

August 4, 2026

Last Verified

August 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • E-10840098-202.3.02-3748

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will be made available to other researchers upon reasonable request, if deemed necessary.

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.

Subscribe