Effects of Multi-direction Stepping and Weight Shifting Exercises in Stroke Patients

Sponsor

King Saud University (Other)

Overall Status

Completed

CT.gov ID

NCT05285241

Collaborator

(none)

Enrollment

Location

Arms

12.4

Actual Duration (Months)

1.9

Patients Per Site Per Month

Study Details

Study Description

Brief Summary

Stoke is a leading cause of disability that results not only in persistent neurological deficits but also profound physical de-conditioning that propagates stroke-related secondary disability. Several kinds of research have reported that there has been asymmetrical weight bearing on the affected side while sitting and standing resulting in impaired performance especially reaching in sitting, rising from the chair, walking, and climbing stairs. Despite the stroke patient being able to walk independently with or without the walking aids, the patient still lacks the normal movement pattern especially weight transfers on the affected side while performing such activities which subsequently decreases the patient to restrain the challenges while walking, decrease confidence in functional activities. Also, further, there hasn't been enough literature on this topic. Therefore, the objective of this study is to find out the effectiveness of multidirectional stepping and weight shifting exercises to improve dynamic balance and gait speed in stroke patients.

Condition or Disease	Intervention/Treatment	Phase
Stroke	Other: Multidirectional stepping exercises Other: Conventional physiotherapy group	N/A

Detailed Description

The twenty-four subjects who fulfilled the inclusion criteria were selected for the study and were randomly assigned into two groups of 12 subjects each by simple random sampling based on inclusion criteria. First, all the subjects were assessed with a detailed neurological assessment form after the consent form was taken from the patients. The experimental group was given multidirectional stepping exercise with conventional therapy whereas are control group was given only conventional therapy.

Study Design

Study Type:

Interventional

Actual Enrollment :

24 participants

Allocation:

Randomized

Intervention Model:

Parallel Assignment

Intervention Model Description:

Two arms parallel designTwo arms parallel design

Masking:

Single (Outcomes Assessor)

Primary Purpose:

Treatment

Official Title:

Effects of Multi-direction Stepping and Weight Shifting Exercises on Balance and Gait in Stroke Patients

Actual Study Start Date :

May 11, 2016

Actual Primary Completion Date :

Mar 14, 2017

Actual Study Completion Date :

May 22, 2017

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Multidirectional exercise group Multidirectional stepping exercises along with conventional physiotherapy were provided to the patients. Conventional physiotherapy included one-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min).	Other: Multidirectional stepping exercises These exercises included stepping of the legs in different directions i.e. sideways, sideways and forefoot (forward), sideways and heel (backward).
Active Comparator: Conventional Physiotherapy Group One-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min) were provided to the patients.	Other: Conventional physiotherapy group Conventional physiotherapy included a one-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min)

Arm

Intervention/Treatment

Experimental: Multidirectional exercise group

Multidirectional stepping exercises along with conventional physiotherapy were provided to the patients. Conventional physiotherapy included one-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min).

Other: Multidirectional stepping exercises

These exercises included stepping of the legs in different directions i.e. sideways, sideways and forefoot (forward), sideways and heel (backward).

Active Comparator: Conventional Physiotherapy Group

One-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min) were provided to the patients.

Other: Conventional physiotherapy group

Conventional physiotherapy included a one-to-one range of motion exercises (10min), Strengthening exercises (10 min), Functional mat exercises (10 min), Stretching exercises (5 min), and Gait exercises (10 min)

Outcome Measures

Primary Outcome Measures

Berg Balance Scale [4 weeks.]
The Berg Balance Scale (BBS) is used to objectively determine a patient's ability (or inability) 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. Minimum possible value is 0 and maximum possible value is 56. Higher score represents better outcome.
Functional gait assessment [4 weeks.]
The Functional Gait Assessment (FGA) assesses postural stability during walking tasks in persons with gait impairments.

Eligibility Criteria

Criteria

Ages Eligible for Study:

N/A and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

Inclusion Criteria:

Diagnosed with stroke via CT Scan or MRI
Maintain the independent standing posture for 30 sec
Ability to walk 3 meters independently without an assistive device
Mini-Mental status examination score >21 points
Could communicate and understand therapist's verbal command
Voluntary agreed to participate in the study
Age above 18 years old
Medically stable (e.g. recent myocardial infarction, unstable angina, ventricular tachycardia)

Exclusion Criteria:

Visual disorders and visual deficits
History of any neurological pathology like Parkinson's or Alzheimer's disease
Conditions affecting balance like vertigo
Medications affecting balance
Dementia
Impaired conscious level or concomitant medical illness
Lower Motor Neuron lesions
Anti-spasmodic medication (e.g. Baclofen, Dantrolene Sodium, etc.)
Severe orthopedic diseases in lower extremities (e.g. Osteoarthritis, fracture, sprain, strain)