THE EFFECTS OF FUNCTIONAL ELECTRICAL STIMULATION-ASSISTED BICYCLE ERGOMETRY IN PATIENTS DIAGNOSED WITH COMPLEX REGIONAL PAIN SYNDROME.(CRPS) (CRPS)
THE EFFECTS OF FUNCTIONAL ELECTRICAL STIMULATION-ASSISTED BICYCLE ERGOMETER TRAINING ON PAIN, FUNCTIONAL OUTCOMES, AND QUALITY OF LIFE IN PATIENTS WITH POST-STROKE UPPER EXTREMITY COMPLEX REGIONAL PAIN SYNDROME.
The goal of this clinical study is to evaluate the effectiveness of functional electrical stimulation (FES)-assisted cycling in patients with post-stroke Complex Regional Pain Syndrome (CRPS) Type 1. It also aims to assess its effects on pain, edema, functional status, and quality of life. The main questions it aims to answer are:
Does FES-assisted cycling reduce pain levels in patients with CRPS Type 1 after stroke? Does FES-assisted cycling improve functional independence and motor recovery? Does FES-assisted cycling contribute to reductions in edema and improvements in quality of life?
Researchers will compare FES-assisted cycling in addition to conventional rehabilitation with conventional rehabilitation alone to determine whether FES provides additional therapeutic benefits.
Participants will:
Receive conventional rehabilitation treatment consisting of exercises, TENS, contrast bath, and whirlpool therapy Receive FES-assisted cycling (intervention group) or only conventional rehabilitation (control group) for a total of 20 sessions Be evaluated at baseline, at the end of treatment (4th week), and at the 12th week using clinical scales and outcome measures
Tutkimuksen yleiskatsaus
Tila
Interventio / Hoito
Yksityiskohtainen kuvaus
A total of 44 patients who developed Complex Regional Pain Syndrome (CRPS) Type 1 in the upper extremity following a cerebrovascular event, diagnosed according to the Modified Budapest Criteria, and who were admitted to an inpatient physical therapy and rehabilitation program were included in the study. All participants met the inclusion criteria and provided written informed consent after being fully informed about the study procedures and treatment protocol. The study was conducted in accordance with the principles of the Declaration of Helsinki and Good Clinical Practice guidelines.
Demographic data including age, sex, height, weight, educational level, occupation, marital status, and comorbid systemic diseases were recorded for all participants. Patients with a Mini-Mental State Examination score of 23 or higher were included in the study. All participants were evaluated at baseline (pre-treatment), at the end of treatment (4th week), and at the 12th week.
Clinical assessments included evaluation of pain, edema, spasticity, range of motion, motor function, activities of daily living, and quality of life of the upper extremity. The following outcome measures were used:
Visual Analog Scale (VAS) Self-report Leeds Assessment of Neuropathic Symptoms and Signs (S-LANSS) Volumetric Measurement Modified Ashworth Scale (MAS) Range of Motion (ROM) Measurement Brunnstrom Motor Staging CRPS Severity Score (CSS) Functional Independence Measure (FIM) Stroke Impact Scale (SIS)
Eligible patients were randomized into two groups using the sealed envelope method. Both groups received a conventional neurorehabilitation program consisting of whirlpool therapy, transcutaneous electrical nerve stimulation (TENS), contrast bath, and therapeutic exercises.
In addition to conventional therapy, patients in the intervention group received upper extremity functional electrical stimulation (FES)-assisted cycling using a cycle ergometer. This intervention was applied for 30 minutes per day, 5 days per week, for a total of 4 weeks.
The groups were defined as follows:
Group 1: Exercise + TENS + whirlpool therapy + contrast bath + FES-assisted cycling ergometer Group 2: Exercise + TENS + whirlpool therapy + contrast bath
Opintotyyppi
Ilmoittautuminen (Todellinen)
Yhteystiedot ja paikat
Opiskelupaikat
-
-
Çankaya
-
Ankara, Çankaya, Turkki (Türkiye), 06800
- Ankara Bilkent City Hospital
-
-
Osallistumiskriteerit
Kelpoisuusvaatimukset
Opintokelpoiset iät
- Lapsi
- Aikuinen
- Vanhempi Aikuinen
Hyväksyy terveitä vapaaehtoisia
Näytteenottomenetelmä
Tutkimusväestö
Kuvaus
Inclusion Criteria:
History of ischemic or hemorrhagic stroke Patients who experienced their first stroke within the last 1 year Diagnosis of upper extremity CRPS Type 1 according to the Modified Budapest Criteria No cognitive impairment (Mini-Mental State Examination score ≥ 23) Provision of written informed consent by the patient or their legal guardian
Exclusion Criteria:
Unstable medical condition Presence of visual impairment Presence of shoulder subluxation or contracture in the upper extremity and hand joints History of upper extremity injections within the last 6 months (e.g., suprascapular nerve block, intra-articular shoulder injections, hand/wrist intra-articular or peri-tendinous injections) History of systemic steroid use within the last 6 months Use of neuropathic pain medications within the last 6 months, including tricyclic antidepressants and gabapentinoids such as gabapentin or pregabalin Presence of neglect syndrome Presence of another etiology causing upper extremity pain Presence of another neurological disorder (e.g., progressive central nervous system disease, peripheral neuropathy) Presence of concomitant rheumatologic or orthopedic conditions in the upper extremity or hand (e.g., inflammatory arthritis, cellulitis, osteomyelitis) Presence of active deep vein thrombosis or thrombophlebitis in the upper extremity Conditions characterized by pain, swelling, and edema of the extremity, such as chronic vascular disorders Presence of malignancy History of epilepsy Presence of aphasia Pregnancy or suspicion of pregnancy
Opintosuunnitelma
Miten tutkimus on suunniteltu?
Suunnittelun yksityiskohdat
Kohortit ja interventiot
Ryhmä/Kohortti |
Interventio / Hoito |
|---|---|
|
Group 1
Exercise + TENS + whirlpool therapy + contrast bath + FES-assisted cycling ergometer
|
Although the FES cycling ergometer is a treatment modality used in various patient groups in neurological rehabilitation, no study has been found in the literature evaluating its effectiveness in patients with upper extremity CRPS following stroke.
Therefore, the aim of this study was to investigate the effects of FES cycling ergometer, added to a conventional physical therapy and rehabilitation program, on pain, edema, functional status, and quality of life in patients diagnosed with post-stroke upper extremity CRPS Type 1.
|
|
Group 2
Exercise + TENS + whirlpool therapy + contrast bath
|
Mitä tutkimuksessa mitataan?
Ensisijaiset tulostoimenpiteet
Tulosmittaus |
Toimenpiteen kuvaus |
Aikaikkuna |
|---|---|---|
|
volumetric measurement
Aikaikkuna: All measurements were performed at baseline (pre-treatment), at the end of treatment (4th week), and at the 12th week, by the same investigator, with the patient in a seated position and at the same time of day.
|
The total volume of the hand was measured using a volumetric device based on the water displacement method. The volumeter method has been used since the 1950s and is considered a highly valid and reliable measurement tool with a very low margin of error. It is accepted as the "gold standard" for assessing hand edema, particularly in cases of diffuse swelling. The patient immersed the affected extremity into the volumeter, positioning the hand so that the web space between the third and fourth fingers rested on a plastic rod. The displaced water was collected in a beaker and subsequently measured using a graduated cylinder. Measurements were recorded in milliliters.Considering that water temperature may influence measurement results, it was maintained between 20-35 °C. |
All measurements were performed at baseline (pre-treatment), at the end of treatment (4th week), and at the 12th week, by the same investigator, with the patient in a seated position and at the same time of day.
|
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visual analog scala
Aikaikkuna: Within the scope of the study, measurements were performed at baseline (pre-treatment), at the end of treatment (4th week), and at the 12th week. Pain was evaluated separately under three conditions: at rest, during movement, and at night.
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Pain intensity was assessed subjectively using a 10-cm Visual Analog Scale (VAS) (Appendix 2).
Participants were shown a horizontal line with the left end defined as "0 = no pain" and the right end as "10 = unbearable pain," and were asked to mark the point that best represented their current pain level.
The distance from the starting point to the marked point was measured in millimeters and recorded, with higher scores indicating greater pain intensity.
|
Within the scope of the study, measurements were performed at baseline (pre-treatment), at the end of treatment (4th week), and at the 12th week. Pain was evaluated separately under three conditions: at rest, during movement, and at night.
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Yhteistyökumppanit ja tutkijat
Sponsori
Tutkijat
- Opintojohtaja: Güldal Funda Yüzer Nakıpoğlu, Prof. Dr., Ankara City Hospital Bilkent
Julkaisuja ja hyödyllisiä linkkejä
Yleiset julkaisut
- Sousa ASP, Moreira J, Silva C, Mesquita I, Macedo R, Silva A, Santos R. Usability of Functional Electrical Stimulation in Upper Limb Rehabilitation in Post-Stroke Patients: A Narrative Review. Sensors (Basel). 2022 Feb 12;22(4):1409. doi: 10.3390/s22041409.
- Devrimsel G, Turkyilmaz AK, Yildirim M, Beyazal MS. The effects of whirlpool bath and neuromuscular electrical stimulation on complex regional pain syndrome. J Phys Ther Sci. 2015 Jan;27(1):27-30. doi: 10.1589/jpts.27.27. Epub 2015 Jan 9.
Opintojen ennätyspäivät
Opi tärkeimmät päivämäärät
Opiskelun aloitus (Todellinen)
Ensisijainen valmistuminen (Todellinen)
Opintojen valmistuminen (Todellinen)
Opintoihin ilmoittautumispäivät
Ensimmäinen lähetetty
Ensimmäinen toimitettu, joka täytti QC-kriteerit
Ensimmäinen Lähetetty (Todellinen)
Tutkimustietojen päivitykset
Viimeisin päivitys julkaistu (Todellinen)
Viimeisin lähetetty päivitys, joka täytti QC-kriteerit
Viimeksi vahvistettu
Lisää tietoa
Tähän tutkimukseen liittyvät termit
Avainsanat
Muita asiaankuuluvia MeSH-ehtoja
- Neurologiset ilmenemismuodot
- Aivoverenkiertohäiriöt
- Aivojen sairaudet
- Keskushermoston sairaudet
- Hermoston sairaudet
- Verisuonisairaudet
- Sydän-ja verisuonitaudit
- Neuromuskulaariset sairaudet
- Ääreishermoston sairaudet
- Autonomisen hermoston sairaudet
- Patologiset tilat, merkit ja oireet
- Merkit ja oireet
- Kipu
- Aivohalvaus
- Monimutkaiset alueelliset kipuoireyhtymät
Muut tutkimustunnusnumerot
- TABED 1-24-352
Yksittäisten osallistujien tietojen suunnitelma (IPD)
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