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Effects of Instrument-Assisted Soft Tissue Mobilization (IASTM) Along With Conventional Physical Therapy on Upper Limb Function, Strength, Range of Motion, and Spasticity in Patients With Subacute Stroke.

8. november 2026 opdateret af: Ibadat International University, Islamabad

This randomized controlled trial aims to compare the effects of IASTM (Instrument-Assisted Soft Tissue Mobilization) along with conventional physical therapy on function, strength, range of motion, and spasticity of the upper limb in patients with subacute stroke.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

46

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Undersøgelse Kontakt Backup

  • Navn: Nazish Rafique Dr Nazish Rafique, DPT, MS-PT NMPT
  • Telefonnummer: 03002132436
  • E-mail: nazish2312@gmail.com

Studiesteder

    • Balochistan
      • Quetta, Balochistan, Pakistan
        • Rekruttering
        • Barkat Medical and Physical-Therapy Center Hazaratown Quetta
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

40 år til 60 år (Voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Beskrivelse

Inclusion Criteria:

  • First-ever stroke (ischemic or hemorrhagic) diagnosed via CT/MRI
  • Subacute stage (2 weeks to 6 months post-stroke)
  • Age 40-60 years
  • Upper limb hemiparesis with Modified Ashworth Scale score 2 and 3
  • MMSE (Mini-Mental State Examination) score ≥ 24
  • Capable of follow simple verbal commands

Exclusion Criteria:

  • Severe cognitive impairment affecting the ability to follow instructions.
  • Recurrent stroke
  • Presence of other neurological disorders such as Parkinson's disease or multiple sclerosis etc.
  • Recent upper limb surgery, fractures or musculoskeletal injury affecting the arm or hand.
  • Fixed contracture of upper limb joints
  • Severe aphasia or inability to follow commands
  • Uncontrolled diabetes mellitus, hypertension
  • Serious cardiac problems or unstable cardiovascular disease
  • Skin conditions, open wounds, or infections affecting upper limb

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Group A: IASTM + Conventional Physical Therapy

IASTM + Conventional Physical Therapy

5-10 minutes per session applied to affected upper limb muscles (biceps brachii, brachialis, flexor carpi radialis, flexor carpi ulnaris, thenar and hypothenar muscles) using stainless steel instruments

  • Technique: Multidirectional strokes at 30-60 second intervals
  • Intensity: Moderate pressure causing mild erythema without bruising
  • Frequency: 3 sessions/week for 6 weeks
  • Conservative Physical Therapy: 45-minute session including
  • Passive stretching of spastic muscles (15 min)
  • Active-assisted ROM exercises (10 min)
  • Strengthening exercises (10 min) - including isometric holds, concentric/eccentric contractions as tolerated
  • Task-oriented Training of upper limb, {Reaching activities, Grasping & releasing objects, Object manipulation tasks (stacking blocks, turning objects), Simulated ADL tasks (feeding, grooming) (10 min)}
Aktiv komparator: Group B: Conventional Physical Therapy

Conventional Physical Therapy

45-minute session.

  • Passive stretching of spastic muscles (15 min)
  • Active-assisted ROM exercises (10 min)
  • Strengthening exercises (10 min)-including isometric holds and concentric/eccentric contractions as tolerated
  • Task-oriented Training of upper limb, {Reaching activities, Grasping & releasing objects, Object manipulation tasks (stacking blocks, turning objects), Simulated ADL tasks (feeding, grooming)} (10 min)

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Modified Ashworth Scale (MAS)
Tidsramme: Baseline, 3rd week, 6th week

Moderate-good reliability (κ = 0.65-0.78). The modified Ashworth scale will be used to determine the level of spasticity in the participants. The assessment is done by bringing the patient's limb to the possible maximal extension from flexion and then flexion to extension until the point of resistance is met. Scoring is done from 0-4 (0 being normal while 4 being rigid).

Baseline, 3rd week, 6th week
Fugl-Meyer Assessment Upper Extremity (FMA-UE)
Tidsramme: Baseline, 3rd week, 6th week

It is a stroke-specific, performance-based outcome measure used to assess upper limb motor recovery following a stroke. The FMA-UE consists of 33 items evaluating reflex activity, voluntary movement within and out of synergy, wrist and hand function, and coordination/speed. Each item is scored on a 3-point ordinal scale (0 = cannot perform, 1 = performs partially, 2 = performs fully), with a maximum score of 66 indicating optimal motor function.

Baseline, 3rd week, 6th week
Muscle Strength Manual Muscle Testing (MMT)
Tidsramme: Baseline, 3rd week, 6th week

A standardized, performance-based outcome measure assessing muscle strength on a 6-point ordinal scale (0 = no contraction to 5 = normal strength). Evaluates key upper limb muscle groups, including shoulder, elbow, forearm, wrist, and grip bilaterally. Requires no equipment, is clinically feasible, and provides immediate interpretable results. Excellent reliability (ICC = 0.84-0.92) in stroke.

Baseline, 3rd week, 6th week
Goniometry
Tidsramme: Baseline, 3rd week, 6th week

Good-excellent reliability (ICC = 0.90-0.98). A goniometer will be used to assess the range of motion of all joints. A goniometer can assess both active and passive ROM.

Baseline, 3rd week, 6th week

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Efterforskere

  • Studiestol: Nazish Rafique, DPT, MS-PT NMPT, Ibadat International University

Publikationer og nyttige links

Den person, der er ansvarlig for at indtaste oplysninger om undersøgelsen, leverer frivilligt disse publikationer. Disse kan handle om alt relateret til undersøgelsen.

Generelle publikationer

  • Shahid J, Kashif A, Shahid MK. A comprehensive review of physical therapy interventions for stroke rehabilitation: impairment-based approaches and functional goals. Brain Sciences. 2023;13(5):717. Sherin A, Ul-Haq Z, Fazid S, Shah BH, Khattak MI, Nabi F. Prevalence of stroke in Pakistan: Findings from Khyber Pakhtunkhwa integrated population health survey (KP-IPHS) 2016-17. Pakistan Journal of Medical Sciences. 2020;36(7):1435. Baker, R. T., Nasypany, A., Seegmiller, J. G., & Baker, J. G. (2023). Instrument-assisted soft tissue mobilization: A systematic review and meta-analysis of current literature. Journal of Athletic Training, 58(2), 112-125. Cheatham, S. W., Baker, R. T., & Abdenour, T. E. (2021). Instrument-assisted soft tissue mobilization: A clinical commentary. International Journal of Athletic Therapy and Training, 26(4), 187-193. Cuesta-Vargas, A. I., González-Sánchez, M., & Kuisma, R. (2022). Reliability of goniometric measurements in stroke patients: A systematic review. Disability and Rehabilitation, 44(8), 1342-1352. Grefkes, C., & Fink, G. R. (2020). Recovery from stroke: Current concepts and future perspectives. Neurological Research and Practice, 2(1), 17-29. Harb, A., & Kishner, S. (2023). Modified Ashworth Scale. In StatPearls. StatPearls Publishing.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

9. juli 2026

Primær færdiggørelse (Anslået)

15. november 2026

Studieafslutning (Anslået)

30. november 2026

Datoer for studieregistrering

Først indsendt

8. november 2026

Først indsendt, der opfyldte QC-kriterier

8. november 2026

Først opslået (Faktiske)

13. november 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. november 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. november 2026

Sidst verificeret

1. november 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • IIUI/RERC/ADT/2026/07/368

Plan for individuelle deltagerdata (IPD)

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