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The Relationship of Trunk Control With Lower Extremity Sense, Balance and Gait in Stroke

8. února 2022 aktualizováno: Zekiye İpek KATIRCI KIRMACI, Kahramanmaras Sutcu Imam University
Cerebrovascular accident is the third leading cause of death in developed countries after heart disease and cancer. In adults, it ranks first among neurological diseases in terms of causing death and disability. About one-third of stroke patients experience permanent physical dysfunction. This situation has a negative impact on the economic, social, psychological life and general quality of life of the patient and his family. Stroke is one of the leading causes of long-term disability in adults due to problems such as activity limitations and participation restrictions caused by disorders in body functions. Movement disorder is one of the most common symptoms of stroke, and people with stroke often have trouble falling while walking after they are discharged from the hospital. Therefore, one of the main goals of stroke rehabilitation is to regain independent mobility with a safe and stable gait pattern. In addition to all these, one of the problems faced by most stroke patients is sensory-perception disorders. Sensory impairment can be experienced as the inability to perceive the senses or the inability to distinguish the senses. It should be considered that sensory awareness decreases as more than one sensory impulse competes with each other at the same time, and this situation should not be ignored during the evaluation. Although motor movement is governed by the normal motor field, the adjustment of our position in space is entirely the task of the sensory field. It is not possible to initiate and coordinate movement without sensory control. Since environmental change cannot be perceived during movement, it is not possible to provide environmental adaptation.

Přehled studie

Postavení

Dokončeno

Podmínky

Intervence / Léčba

Detailní popis

When the literature is examined, it is stated that the best functional results are revealed by a good postural control. Because the trunk is the key point of the body. Proximal trunk control is essential for distal extremity movements, balance and functional activities. It provides trunk control, static and dynamic posture, upright posture of the body, and selective trunk movements. Studies have emphasized the importance of intensive rehabilitation therapy targeting trunk control after stroke. Several randomized controlled trials have looked at the effects of trunk exercises in people with stroke. Saeys and colleagues have shown that the effects of trunk exercises improve standing balance and mobility as well as trunk performance.

There are only a few clinical assessment tools in the literature to evaluate trunk performance. The Trunk Disorder Scale examines static and dynamic sitting balance and trunk coordination. "Postural Assessment Scale for Stroke Patients" (PASS) was developed to evaluate postural control and balance in detail in stroke patients. This scale helps to evaluate postural control and balance of stroke patients, to predict prognosis, to shape treatment, and to observe time-dependent development.

In the literature, the rate of sensory problems accompanying stroke is given differently. In the study conducted by Kim and Choi-Kwon in 67 individuals with acute stroke, two-point discrimination, localization identification, position sense, and stereognosis senses were evaluated and it was found that these senses were affected in 85% of the individuals. In another study, it was stated that sensory impairment in the lower extremities affected gait speed, gait symmetry, standing and walking balance.

However, the relationship between trunk control and lower extremity sense of stroke individuals has not been examined in the literature. In addition, studies on balance and walking have not been sufficiently observed.

Typ studie

Pozorovací

Zápis (Aktuální)

30

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

      • Kahramanmaraş, Krocan
        • Kahramanmaraş Sütçü İmam University

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

30 let až 85 let (Dospělý, Starší dospělý)

Přijímá zdravé dobrovolníky

N/A

Pohlaví způsobilá ke studiu

Všechno

Metoda odběru vzorků

Ukázka pravděpodobnosti

Studijní populace

Stroke Patients

Popis

Inclusion Criteria:

  • Able to walk 10 m without physical assistance,
  • Lower extremity functions are in stages 2-6 according to Brunnstrom motor recovery stages,
  • At least 3 days and at most 24 months have passed since the stroke,
  • Stroke individuals with a score of 7 or higher on the Hodkinson Mental score

Exclusion Criteria:

  • Having neurological and orthopedic problems that may affect walking other than stroke,
  • Having a history of cardiovascular and rheumatological diseases that prevent daily activities,
  • Lesion or fracture in the lower extremity,
  • Lower extremity spasticity 4 according to the modified Ashworth Scale,
  • Individuals with aphasia and communication disorders

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

Kohorty a intervence

Skupina / kohorta
Intervence / Léčba
One group
Stroke patients
Měření

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Trunk Impairment Scale
Časové okno: At baseline
The Trunk Impairment Scale consists of 3 subscales: static sitting balance (3 items), dynamic sitting balance (10 items) and coordination (4 items). The maximum score of the owner is 7, 10 and 6 points respectively. The Total Trunk Impairment Scale score ranges from 0 to 23, with higher scores indicating better trunk control.
At baseline
Tinetti Balance and Gait Test
Časové okno: At baseline
It consists of two parts, walking and balance. Consisting of 16 questions in total, the scale consists of 9 questions in which balance is evaluated first, followed by 7 questions in which gait is evaluated. The total score obtained by the evaluated participant from the first 9 questions constitutes the balance score, and the total score obtained from the following 7 questions constitutes the walking score. 2 points means that the requested task was done correctly, 1 point means that the task was done with adaptations, and 0 points means that the desired task could not be done. A total test score of 18 or less indicates a high fall risk, a moderate fall risk of 19-24 points, and a low-level fall risk with a score above 24.
At baseline
Ten Meter Walking Test
Časové okno: At baseline
During the test, the patient walks at a normal walking pace for a distance of 10 meters and the time is recorded.
At baseline
Fugl Mayer Assesment of Sensorimotor Function
Časové okno: At baseline
The sensory subscale of FMA (FMA-S) consists of 12 sub-parameters; 4 items are for light touch and 8 items are for proprioception sense. Scoring is between 0-24 points. The light touch sensation is subjectively tested. Joint position is tested on the thumb, wrist, elbow, and interphalangeal joint of the glenohumeral joint. Position sense of the lower extremities is tested on the toe, ankle, knee and hip joint.
At baseline

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Turkish version of Postural Assessment Scale for Stroke Patients (PASS-T)
Časové okno: At baseline
PASS is a special scale used to measure balance even in stroke patients with very low physical performance. The PASS includes 12 items that measure a person's balance performance in situations where the degree of difficulty is different, that is, when changing positions while lying, sitting, standing or standing. The scale is evaluated between 0-36. Between 0-3, the feasibility of the movement is tested; "0" is the lowest; "3" is the highest value.
At baseline

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

15. ledna 2021

Primární dokončení (Aktuální)

1. června 2021

Dokončení studie (Aktuální)

15. června 2021

Termíny zápisu do studia

První předloženo

8. února 2022

První předloženo, které splnilo kritéria kontroly kvality

8. února 2022

První zveřejněno (Aktuální)

17. února 2022

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

17. února 2022

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

8. února 2022

Naposledy ověřeno

1. února 2022

Více informací

Termíny související s touto studií

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