Turning Dysfunction After Stroke: Assessment and Intervention
13 décembre 2020 mis à jour par: Pei Jung Liang, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation
Turning Dysfunction After Stroke And Its Association To Trunk Control: Underlying Mechanisms And Training Effects
The study aims to investigate the 1) differences between stroke patients and healthy controls in time, steps, angular velocity, stepping patterns, electromyographic responses during turning, and the association of turning to trunk control and motor function after stroke; 2) the effectiveness of trunk training on turning performance, trunk control and motor function in stroke patients.
Aperçu de l'étude
Statut
Complété
Intervention / Traitement
Description détaillée
This study has two parts.
The first part is a cross-sectional observatory study.Eligible stroke and healthy subjects are asked their demographic data and assessed for turning performance (stepping patterns and electromyography data of trunk muscles), trunk control (muscle strength, active range of motion, muscle mass and motor control in trunk) and motor function (recovery of extremities and balance function).
The second part is a randomized controlled trial.
Stroke participants are randomly allocated into trunk exercise and control groups.
Trunk exercise group receives trunk exercise including trunk muscles stretching, trunk muscles strengthening, and task-related trunk control training for 30 minutes per session, twice a week for 12 weeks while control group remains their regular activities.
Turning performance, trunk control and motor function are evaluated before and after training session.
Type d'étude
Interventionnel
Inscription (Réel)
42
Phase
- N'est pas applicable
Contacts et emplacements
Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.
Lieux d'étude
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-
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New Taipei City, Taïwan
- Taipei Tzu Chi Hospital
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-
Critères de participation
Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.
Critère d'éligibilité
Âges éligibles pour étudier
20 ans à 80 ans (Adulte, Adulte plus âgé)
Accepte les volontaires sains
Oui
Sexes éligibles pour l'étude
Tout
La description
Inclusion Criteria:
- age between 20 and 80 years old
- survivors of a single and unilateral stroke with hemiparesis experienced at least 6 months prior to their participation in the study
- able to walk independently over a distance of 10 m without walking aids or orthoses
- able to provide informed consent and follow instructions.
Exclusion Criteria:
- having additional musculoskeletal conditions or comorbid disabilities that could affect the assessment
- having cognitive problems with a Mini-Mental State Examination score less than 24 or aphasia that could prevent subjects from following instructions.
Plan d'étude
Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.
Comment l'étude est-elle conçue ?
Détails de conception
- Objectif principal: Traitement
- Répartition: Randomisé
- Modèle interventionnel: Affectation parallèle
- Masquage: Seul
Armes et Interventions
Groupe de participants / Bras |
Intervention / Traitement |
|---|---|
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Expérimental: Trunk exercise group
Participants received trunk exercise for 30 minutes per session, twice a week for 12 weeks.
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Trunk exercise includes trunk muscles stretching, trunk muscles strengthening, and task-related trunk control training for 30 minutes per session, twice a week for 12 weeks.
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Aucune intervention: Control group
Participants remained their regular activities.
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Que mesure l'étude ?
Principaux critères de jugement
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from Baseline in turning duration at Week 12
Délai: Baseline and Week 12
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Turning duration (s) was recorded during turning 360-degree in place using APDM Opal wireless sensors.
Longer duration represents poorer turning performance.
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Baseline and Week 12
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Change from Baseline in turning angular velocity at Week 12
Délai: Baseline and Week 12
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Angular velocity (m/s2) was recorded during turning 360-degree in place using APDM Opal wireless sensors.
Slower angular velocity represents instability during turning.
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Baseline and Week 12
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Change from Baseline in trunk muscles electromyography during turning at Week 12
Délai: Baseline and Week 12
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Muscle activation patterns (amplitude, % reference voluntary contraction) are observed in bilateral External abdominal oblique (EO) and erector spinae (ES) through an electromyographic analysis.
Greater muscle amplitude represents greater muscle contraction.
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Baseline and Week 12
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Mesures de résultats secondaires
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from Baseline in trunk range of motion at Week 12
Délai: Baseline and Week 12
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The trunk range of motion (ROM) was measured using a tape measure in sitting position.
The spinous processes at C7 and S1 served as landmarks for placement of the tape and measurement for trunk flexion and extension ROM.
The length between iliac crest and contralateral acromion of scapula was measured for trunk rotation ROM while the distance between the tip of the middle finger and the floor for trunk lateral flexion ROM.
The difference between tape measures in starting and ending positions was calculated for all trunk movement directions.
Greater value of trunk flexion and rotation but smaller value of trunk extension and lateral flexion represents better trunk ROM.
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Baseline and Week 12
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Change from Baseline in trunk muscles strength at Week 12
Délai: Baseline and Week 12
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Trunk flexors, extensors, rotators, and lateral flexors strength were measured using a MicroFET3 dynamometer.
Participants were asked to generate the maximum trunk flexion, extension, rotation bilaterally and lateral flexion bilaterally for a period of 6 seconds each.
Resistance was applied using the dynamometer to obtain the value of each trunk muscle (kg).
Greater value represents greater muscle strength.
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Baseline and Week 12
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Change from Baseline in Trunk Impairment Scale at Week 12
Délai: Baseline and Week 12
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Trunk control was assessed by the Trunk Impairment Scale (TIS) which has good inter-rater reliability with intra-class coefficient 0.85-0.99 and internal consistency with Cronbach's α 0.65-0.89.
The TIS evaluates static and dynamic sitting balance and trunk coordination in a sitting position.
On the static and dynamic sitting balance and coordination subscales the maximal scores that can be attained are 7, 10 and 6 points.
The total score for TIS ranges between 0 for a minimal performance to 23 for a perfect performance.
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Baseline and Week 12
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Autres mesures de résultats
Mesure des résultats |
Description de la mesure |
Délai |
|---|---|---|
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Change from Baseline in Modified Clinical Test of Sensory Integration and Balance at Week 12
Délai: Baseline and Week 12
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Modified Clinical Test of Sensory Integration and Balance (mCTSIB) is designed to assess how well an older adult is using sensory inputs when one or more sensory systems are compromised.
The postural sway was measured in 4 sensory conditions through visual and proprioceptive manipulation using APDM Opal wireless sensors.
The greater postural sway represents the poorer balance.
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Baseline and Week 12
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Change from Baseline in Berg Balance Scale at Week 12
Délai: Baseline and Week 12
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The Berg balance scale (BBS) is used to objectively determine a participant's ability to safely balance during a series of predetermined tasks.
It is a 14 item list with each item consisting of a five-point ordinal scale ranging from 0 to 4, with 0 indicating the lowest level of function and 4 the highest level of function.
The total score is 56.
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Baseline and Week 12
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Change from Baseline in Timed Up and Go test at Week 12
Délai: Baseline and Week 12
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Function mobility was assessed by the Timed Up and Go (TUG) test.
Participants were instructed to stand up from a chair, walk 3 meters, turn around, and walk back to the chair sit down.
Time to complete the task was recorded.
The more time taken is representative of the lower level of functional mobility.
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Baseline and Week 12
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Collaborateurs et enquêteurs
C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.
Collaborateurs
Les enquêteurs
- Chercheur principal: Pei-Jung Liang, Taichung Tzu Chi Hospital
Dates d'enregistrement des études
Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.
Dates principales de l'étude
Début de l'étude (Réel)
13 juillet 2020
Achèvement primaire (Réel)
31 octobre 2020
Achèvement de l'étude (Réel)
31 octobre 2020
Dates d'inscription aux études
Première soumission
8 décembre 2020
Première soumission répondant aux critères de contrôle qualité
13 décembre 2020
Première publication (Réel)
16 décembre 2020
Mises à jour des dossiers d'étude
Dernière mise à jour publiée (Réel)
16 décembre 2020
Dernière mise à jour soumise répondant aux critères de contrôle qualité
13 décembre 2020
Dernière vérification
1 décembre 2020
Plus d'information
Termes liés à cette étude
Termes MeSH pertinents supplémentaires
Autres numéros d'identification d'étude
- 08-XD-051
Plan pour les données individuelles des participants (IPD)
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NON
Informations sur les médicaments et les dispositifs, documents d'étude
Étudie un produit pharmaceutique réglementé par la FDA américaine
Non
Étudie un produit d'appareil réglementé par la FDA américaine
Non
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