The Effects of Reaching Task Following Selective Trunk Stability Exercise
Study Details
Study Description
Brief Summary
This study is performed in a controlled randomized, two-period crossover design to test the efficacy of Abdominal drawing-in maneuver (ADIM) exercise compared to conventional physiotherapy in chronic stroke survivors.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
All participants provided written informed consent and are assigned to Group A or Group B. The inclusion criteria are Exclusion criteria are
Abdominal drawing-in maneuver exercise is following as:
It's for strengthening the Transversus Abdominis muscle(TrA). The simple device, that observes the pressure changes by the gauge. Subjects receive intervention 2 times a week for 4 weeks. Each session is 40 minutes. From the supine position to the hook-lying position (hip joint at 40 degrees and the knee joint at 80 degrees) and pull the navel deeply to the lumbar region through the Stabilizer™ Pressure Biofeedback that stabilizes transversus abdominis muscle. At this time, subjects are controlled to maintain contraction while keep breathing lightly, to contract slowly, also to not move the pelvis and chest while exercising The device assists in body control movements of the spine and abdominal muscle.
Conventional physiotherapy is following as:
Release pain, limb stretching, mobilization of joint and pelvic movement. Subjects receive 2 times a week for 4 weeks. Each session is 40 minutes. Group A received Abdominal drawing-in maneuver exercise for 4 weeks on period 1. Afterward washout period in a month, follow period 2 of conventional physiotherapy.
On the other side, Group B receives first conventional physiotherapy on period 1. Afterward washout period in a month, follow period 2 of Abdominal drawing-in maneuver exercise.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Abdominal drawing-in maneuver exercise, afterward Sham therapy(conventional physiotherapy) Participants first received Abdominal drawing-in maneuver exercise 2 times a week for 4 weeks. Each session is 40 minutes for additional 10 min with conventional therapy. Afterward a washout period of one month, they then received sham therapy (conventional therapy_release pain or upper limb mobilization) 2 times a week for 4 weeks. Each session is 40 minutes. |
Behavioral: Abdominal drawing-in maneuver exercise
From the supine position to the hook-lying position (hip joint at 40 degrees and the knee joint at 80 degrees) and pull the navel deeply to the lumbar region through the Stabilizer™ Pressure Biofeedback that stabilize transversus abdominis muscle. At this time, subjects are controlled to maintain contraction while keep breathing lightly, to contract slowly, also to not move the pelvis and chest while exercising
Other Names:
Behavioral: sham
Release pain or upper limb mobilization
Other Names:
|
| Experimental: Sham therapy(conventional physiotherapy), afterward Abdominal drawing-in maneuver exercise Participants first received sham therapy(release pain or upper limb mobilization)2 times a week for 4 weeks. Each session is 40 minutes. Afterward a washout period of one month, they then received Abdominal drawing-in maneuver exercise 2 times a week for 4 weeks. Each session is 40 minutes for additional 10 min with conventional therapy |
Behavioral: Abdominal drawing-in maneuver exercise
From the supine position to the hook-lying position (hip joint at 40 degrees and the knee joint at 80 degrees) and pull the navel deeply to the lumbar region through the Stabilizer™ Pressure Biofeedback that stabilize transversus abdominis muscle. At this time, subjects are controlled to maintain contraction while keep breathing lightly, to contract slowly, also to not move the pelvis and chest while exercising
Other Names:
Behavioral: sham
Release pain or upper limb mobilization
Other Names:
|
Outcome Measures
Primary Outcome Measures
- Change from baseline in compensatory trunk dislocation at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Dislocation distance in millimeters(mm) for reaching phase
- Change from baseline in smoothness movement at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Number of movement units for reaching phase
- Change from baseline in elbow angle at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Elbow angle in degree for reaching phase -elbow angle: joining vector of acromion to lateral epicondyle and vector of lateral epicondyle and medial styloid process.
Secondary Outcome Measures
- Change from baseline in reaching time at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Duration of time in second(s) for reaching phase
- Change from baseline in peak velocity at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Hand distance and duration of time are combined in mm/s for reaching phase
- Change from baseline in elbow angular velocity at 4weeks [Baseline, two period(each 4weeks), wash out(4weeks)]
Change in elbow angle and time rate are combined in rad/s for reaching phase
Other Outcome Measures
- Modified Ashworth Scale(MAS)_Stiffness of chronic stroke [Baseline]
Scoring for Biceps and Triceps MAS 0: No increase in tone MAS 1: slight increase in tone giving a catch when slight increase in muscle t-tone, manifested by the limb was moved in flexion or extension. MAS 1+: slight increase in muscle tone, manifested by a catch followed by minimal resistance throughout (ROM ) MAS 2: more marked increase in tone but more marked increased in muscle tone through most limb easily flexed MAS 3: considerable increase in tone, passive movement difficult MAS 4: limb rigid in flexion or extension
- Range of motion_Health status chronic stroke [Baseline]
Shoulder and elbow joint range of motion Shoulder: flexion, adduction, abduction, external rotation, internal rotation Elbow: flexion, extension
- Trunk impairment scale(TIS)_Health status chronic stroke [Baseline]
The total score ranges from minimum 0 to maximum 23 points, a higher score indicating a better performance. Static sitting balance Dynamic sitting balance Coordination Total score is 23 points
- Postural assessment scale for stroke(PASS)_Health status chronic stroke [Baseline]
-Maintaining posture Sitting without support Standing with support Standing without support Standing on non paretic leg Standing on paretic leg -Changing a posture Supine to paretic side lateral Supine to non-paretic side lateral Supine to sitting up on the edge mat Sitting on the edge of mat to supine Sitting to standing up Standing up to sitting down Standing, picking up a pencil from the floor Total scoring ranges from 0 to 36
- Fugl Meyer Assessment(FMA)_Health status chronic stroke [Baseline]
Upper extremity(UE) Commonly used FMA-UE cutoff scores defined each category: 0 to 20 severe, 21 to 50 moderate, and 51 to 66 mild. Shoulder, Elbow and Forearm Reflex activity Volitional movement within synergies Volitional movement mixing synergies Volitional movement with little or no synergy Normal reflex activity Wrist Hand Coordination/Speed Total score is 66 points
Eligibility Criteria
Criteria
Inclusion Criteria:
-
The subject consisted of the physician's confirmation of chronic hemiplegia
-
onset ≥ 6 months
-
Mini-mental state examination≥25
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Biceps ≤2, Triceps≤2
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Ability to Sit on a chair alone
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FMA UE score ≥ 21points, FMA UE≤ 66 points
Exclusion Criteria:
-
Biceps>2, Triceps>2
-
Flaccid
-
Neglect syndrome
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Have neurological disease and orthopedic disease
-
Lack of coordination
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | Ulsan National Institute of Science and Technology | Ulsan | Ulju | Korea, Republic of | 44919 |
Sponsors and Collaborators
- University of Valencia
- Ulsan National Institute of Science and Technology
Investigators
- Principal Investigator: Jóse Casaña Granell, PhD, University of Valencia
- Principal Investigator: Joaquin Calatayud Villalba, PhD, University of Valencia
- Principal Investigator: Sang Hoon Kang, PhD, Ulsan National Institute of Science&Technology
Study Documents (Full-Text)
None provided.More Information
Publications
- Cirstea MC, Levin MF. Compensatory strategies for reaching in stroke. Brain. 2000 May;123 ( Pt 5):940-53. doi: 10.1093/brain/123.5.940.
- Kelli A, Kellis E, Galanis N, Dafkou K, Sahinis C, Ellinoudis A. Transversus Abdominis Thickness at Rest and Exercise in Individuals with Poststroke Hemiparesis. Sports (Basel). 2020 Jun 12;8(6):86. doi: 10.3390/sports8060086.
- Lee PY, Huang JC, Tseng HY, Yang YC, Lin SI. Effects of Trunk Exercise on Unstable Surfaces in Persons with Stroke: A Randomized Controlled Trial. Int J Environ Res Public Health. 2020 Dec 7;17(23):9135. doi: 10.3390/ijerph17239135.
- Messier S, Bourbonnais D, Desrosiers J, Roy Y. Dynamic analysis of trunk flexion after stroke. Arch Phys Med Rehabil. 2004 Oct;85(10):1619-24. doi: 10.1016/j.apmr.2003.12.043.
- Velozo CA, Woodbury ML. Translating measurement findings into rehabilitation practice: an example using Fugl-Meyer Assessment-Upper Extremity with patients following stroke. J Rehabil Res Dev. 2011;48(10):1211-22. doi: 10.1682/jrrd.2010.10.0203.
- Verheyden G, Nieuwboer A, Mertin J, Preger R, Kiekens C, De Weerdt W. The Trunk Impairment Scale: a new tool to measure motor impairment of the trunk after stroke. Clin Rehabil. 2004 May;18(3):326-34. doi: 10.1191/0269215504cr733oa.
- ADIM exercise