Effect of Transcranial Direct Current Stimulation and Pelvic Proprioceptive Neuromuscular Facilitation in Stroke Patient
Effects of Transcranial Direct Current Stimulation and Pelvic Proprioceptive Neuromuscular Facilitation on Trunk Control, Balance and Functional Mobility in Stroke Patients
Tutkimuksen yleiskatsaus
Tila
Tila
Ehdot
Ehdot
Interventio / Hoito
Interventio / Hoito
Yksityiskohtainen kuvaus
Opintotyyppi
Opintotyyppi
Ilmoittautuminen (Todellinen)
Ilmoittautuminen
Vaihe
Vaihe
- Ei sovellettavissa
Yhteystiedot ja paikat
Opiskelupaikat
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Punjab Province
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Lahore, Punjab Province, Pakistan, 54000
- Dr Salma Physiotherapy Department Psrd Hospital 042-37423455
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Osallistumiskriteerit
Kelpoisuusvaatimukset
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Kuvaus
Inclusion Criteria:
- Both genders
- Middle Cerebral Artery Ischemic Stroke
- Subacute phase of stroke
- Patients experiencing their first ever stroke
- Brunnstrom stage 3
- Patients is capable to follow commands
Exclusion Criteria:
- Frequent seizures or epileptic disorder
- Contractures in the spine and lower limb
- Patients with uncontrolled medical conditions e.g. severe musculoskeletal pain, uncontrolled heart disease, uncontrolled hypertension
- Metallic implant
- History of brain tumor, orthopedic, neurosurgical surgery
- Concurrent participation in another clinical trial.
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
- Ensisijainen käyttötarkoitus: Hoito
- Jako: Satunnaistettu
- Inventiomalli: Rinnakkaistehtävä
- Naamiointi: Yksittäinen
Aseiden lukumäärä
Aseet ja interventiot
Osallistujaryhmä / ArmOsallistujaryhmä / Arm |
Interventio / HoitoInterventio / Hoito |
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Kokeellinen: Experimental: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical therapy
group A will receive pelvic propriceptive neuromuscualar facilitation and transcranial direct current stimulation with routine physical therapy.
The participants will receive 20 min session of transcranial direct current stimulation with intensity of 2 mA in which anodal tDCS applied over ipsilateral side.
Then 20 min session of pelvic PNF will perform with 10 repitition per set for 3 set.
pelvic PNF pattern perform as anterior elevation and posterior elevation using rthymic initiation, slow reversal and stabilizing reversal will perform, Then perform routine therapy as ROM, Bridging, trunk flexion and swiss ball perform for 20 minutre.
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The patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair.
For the groups receiving tDCS, a wireless rechargeable tDCS device will use.
This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline.
The electrodes will be carefully wrap around the patient's head.
The brain remains excited for up to 20 min following tDCS.
The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation.
The PNF will be perform at 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks.
Each session lasted 20 min.
Pelvic PNF pattern as anterior elevation and posterior elevation using rthymic initiation and slow reversal.
RPT include ROM, trunk flexion, bridging and swiss ball exercises.
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Kokeellinen: Experimental: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy
Group B will receive pelvic proprioceptive neuromuscular facilitation with routine physical therapy.
In this group patient receive 20 min session of pelvic PNF with 10 repititions per set for 3 set per session apply moderate manual resistance according to patient tolerance.
Patient should be in side lying position then apply PNF pattern as anterior and posterior elevation using rthymic initiation , slow reversal and stabilizing reversal.
the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball.
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The PNF treatment will be perform at a dosage of 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks.
Each session lasted 20 minutes, depending on the participant's endurance and response to therapy.
The treatment will performed on the affected side, with the hips flexed to 100° and the knees flexed to 45°.
For anterior elevation, the therapist's hands will placed just on the subject's anterior iliac spine, and for posterior depression, they will placed on the patient's ischial tuberosity.
"Pull up" for anterior elevation, and "push down" and "sit into my hands" for posterior depression.
Rhythmic initiation, Slow reversal and stabilizing reversal will used.
routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left.
Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting.
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Kokeellinen: Experimental: Transcranial Direct Current Stimulation and Routine Physical Therapy
Group C will receive transcranial direct current stimulation and routine physical therapy.
The participants will receive 20 min session.
tDCS pads will soaked in saline and then apply to patients head.
Anodal tDCS apply over ipsilesional side with current of 2mA with 30 second ramp up and down in the begining and end of stimulation.
the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball.
|
The patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair.
For the groups receiving tDCS, a wireless rechargeable tDCS device will use.
This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline.
The electrodes will be carefully wrap around the patient's head.
The brain remains excited for up to 20 min following tDCS.
The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation.
routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left.
Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting for 20 min duration
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Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
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Trunk impairement scale
Aikaikkuna: [Time Frame: baseline, week 6 and week 12]
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Trunk impairment scale evaluates static and dynamic trunk balance and trunk coordination.
These tasks are design to reflect the patient's ability to activate trunk musculature, which is often impaired after stroke.
It evaluates three components: static sitting balance (score range 0-7), dynamic sitting balance (0-10), and trunk coordination (0-6).
The total score ranges from 0 to 23, with higher scores indicating better trunk performance.
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[Time Frame: baseline, week 6 and week 12]
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Berg Balance Scale
Aikaikkuna: baseline, week 6 and week 12
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The BBS is a 14-item ordinal scale that measures balance performance during functional tasks such as sitting, standing, and weight shifting.
Each item is rate on a 5-point scale (0-4), with a maximum total score of 56.
Higher scores indicate better balance ability.
It has excellent inter-rater reliability, with ICC values of 0.989.
Concurrent validity (r = 0.970).
Interpretation of 0 to 20 (High Risk): Severe balance impairment; patients typically require a wheelchair for mobility and significant assistance.
21 to 40 (Moderate Risk): Increased fall risk; these individuals typically require walking aids and environmental modifications.
41 to 56 (Low Risk): Good balance function with minimal fall risk.
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baseline, week 6 and week 12
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Time up and go test
Aikaikkuna: baseline, week 6 and week 12
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This test measures functional mobility and fall risk by timing the patient as they rise from a chair, walk a short distance, turn around, return, and sit down.
The time taken is record in seconds and categorized into normal mobility, low, moderate, or high fall.
Reliability ICC for the TUG were 0.998 and 0.992
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baseline, week 6 and week 12
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Fugl-Meyer Assessment (FMA) for the lower extremity
Aikaikkuna: baseline, week 6 and week12
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This scale measure the motor control in stroke patients.
FMA consists of 17 items, with a maximum total score of 34 points.
Each task is rate on a 3-point ordinal scale.
0: Movement cannot be performed, 1: Movement can be performed partially, 2: Movement can be performed fully.
The higher the score, the better your motor recovery.
The scores indicate: 0-10: Severe motor impairment, 11-23: Moderate motor impairment, 24-33: Mild motor impairment, 34: Minimal to no impairment (full motor recovery).
Reliability, with Intra-class Correlation Coefficient (ICC) values 0.90 to 0.97 high inter-and intra-rater reliability (ICC > 0.90) for the total FMA-LL score.
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baseline, week 6 and week12
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Yhteistyökumppanit ja tutkijat
Sponsori
Sponsori
Tutkijat
Tutkijat
- Päätutkija: psrd hospital, Pakistan Society for Rehabilitation of Disabled Hospital Lahore
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- El-Sherbini AEIEM, Elgayar SL, Elhamrawy MY, Youssef TM. Unlocking trunk potential after stroke: a novel approach combining transcranial direct current stimulation and core stability exercise: a randomized controlled trial. J Neuroeng Rehabil. 2026 Apr 10;23(1):128. doi: 10.1186/s12984-026-01949-0.
- Boob MA, Kovela RK. Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Chronic Stroke Patients: A Randomized Clinical Trial. Cureus. 2022 Oct 24;14(10):e30630. doi: 10.7759/cureus.30630. eCollection 2022 Oct.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Opiskelun aloitus
Ensisijainen valmistuminen (Todellinen)
Ensisijainen valmistuminen
Opintojen valmistuminen (Todellinen)
Opintojen valmistuminen
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Ensimmäinen Lähetetty
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin päivitys julkaistu
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
- Aivoverenkiertohäiriöt
- Aivojen sairaudet
- Keskushermoston sairaudet
- Hermoston sairaudet
- Verisuonisairaudet
- Sydän-ja verisuonitaudit
- Aivohalvaus
- Terapeuttiset lääkkeet
- Käyttäytymistieteet ja toiminnot
- Sähköstimulaatioterapia
- Kouristushoito
- Psykiatriset somaattiset hoidot
- Sähköshokki
- Psykologiset tekniikat
- Transkraniaalinen tasavirran stimulaatio
Muut tutkimustunnusnumerot
Muut tutkimustunnusnumerot
- UBAS/ERB/26/07/080
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