The effects of a multimodality balance training on physical and psychological function in stroke survivors: A protocol for a single blinded randomized controlled trial.

The effects of a multimodality balance training compared with conventional balance training on physical and psychological function in stroke survivors.

Status

Not yet recruiting

Phases

Unknown

Study type

Interventional

Source

ANZCTR

Registry ID

ACTRN12612001228875

Enrollment

Registered

2012-11-20

Start date

2013-01-01

Completion date

Unknown

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

This study will be conducted to determine the effects of a multimodality balance training for stroke survivors in order to improve the physical and psychological function when compared with conventional balance training. Forty-eight chronic stroke survivors who fulfil the inclusion criteria will be recruited from Physiotherapy Department of Hospital Sungai Buloh and Physiotherapy Department of Faculty of Medicine, Universiti Teknologi MARA. Subjects who consented would be randomized into a control or intervention group. Data collection will be done at baseline level, week 12 and week 24 by a blinded assessor. The primary outcome measure would include balance performances. Secondary outcome measure would be lower limb physical performance, lower limb muscle strength, mobility and dynamic balance, level of depression, activities of daily living and quality of life. It is hypothesized that a multimodality balance training may significantly improve the scores of these outcome measures. Thus, the result of this study will have a direct implication in term of cost effectiveness for stroke survivors and health care providers.

Interventions

Subjects in the intervention group will perform the multimodality balance training. This training incorporates multisensorial training and specific lower limb muscle strength training into a single balance training regime. Intensity of exercises will be modified according to the level of tolerance of subjects. The protocol for the multimodality balance training as follow: A: Multisensorial training regime in multimodality balance training. Movements: 1) Stand independently with feet close together. Frequency: Twice per week; Time: 20 secs; Intensity: Time increased 10 secs every week; Sets: 3-4; Progression: To be performed with eyes closed/soft surface. 2) Alternately lift left and right leg during standing on firm surface. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed/soft surface. 3) Touch an object on the floor while standing with feet apart. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed/soft surface with feet close together. 4) Sidewalks forward, right and left alternately on firm surface. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed/soft surface. 5) Walk in a figure of eight formation. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed/soft surface. 6) Walk ahead and make a sharp turn towards right/left. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed/soft surface. 7) Walk ahead crossing over obstacles. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed on a soft surface and to increase the height and number of obstacles. 8) Tandem walking. Frequency: Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed. 9) Sit to stand and walk 10 meter forward. Twice per week; Repetitions/intensity: 10 reps (Increased by 10 reps every 6 week); Sets: 3-4; Progression: To be performed with eyes closed. B: Specific lower limb training regime in multimodality balance training (with 3 minutes rest intervals between sets). Movements: 1) Ankle dorsiflexion. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 Repetition Maximum (RM). Sets: 3-4; Progression: 1RM to be reassessed biweekly. 2) Ankle plantarflexion. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. 3) Knee extension. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. 4) Knee flexion. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. 5) Hip extension. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. 6) Hip flexion. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. 7) Hip abduction. Frequency: Twice per week; Repetitions/intensity: 8-10/ 70% of 1 RM. Sets: 3-4; Progression: 1RM to be reassessed biweekly. In the intervention group, subjects will perform both multisensorial training and specific lower limb muscle strength training in a single 60 minutes training session, twice per week for 24 weeks. However, subjects may pause at any time during the training session if feeling tired, dizzy or shortness of breath.

Study design

Allocation

Randomised controlled trial

Intervention model

Parallel

Primary purpose

Treatment

Masking

Blinded (masking used)

Eligibility

Sex/Gender

All

Age

40 Years to 60 Years

Healthy volunteers

Inclusion criteria

1)Diagnosed as having ischemic or hemorrhagic brain injury which by MRI or computed tomography. 2)More than 6 month after the onset of stroke. 3)BBS scoring less than 41 during baseline. 4)Having high to moderate level of depression which BDI scoring more than 30 during baseline. 5)Able to walk 10 meter without the use of assistive device. 6)Age between 40 to 60 years old.

Exclusion criteria

1)Having other neurological disorder other than ischemic or hemorrhagic stroke such as Parkinson disease or cerebellar stroke. 2)Having severe heart disease. 3)Unable to understand command. 4)Undergoing rehabilitation from other institution or personal healthcare provider.

Outcome results