Stroke
Conditions
Keywords
Vibration Stimuli, Contraversive Pusher Syndrome
Brief summary
The purpose of this study is to investigate the effects of vibration stimuli to contra lateral neck muscles on Contraversive Pusher Syndrome, function and neglect in stroke patients.
Detailed description
12 post-stroke subjects will be recruited from neurological rehabilitation department at Loewenstein rehabilitation hospital, Raanana, Israel. The patients will be randomly assigned to one of two groups: 1) Experimental group. 2) Control group. The 2 weeks intervention (10 sessions) in each group will include vibration stimuli (frequency of 1 Hz and amplitude of 20 mm) for 20 minutes and structured standard physiotherapy for 45 minutes. The vibration stimuli in the experimental group will be done to the contralesional neck muscles, whereas the vibration stimuli in the control group will be done in the contralesional hand. Different assessments will be done before the intervention, after the first day of intervention, after two weeks of intervention and one months post-intervention. The tests will include: Clinical Scale for Contraversive Pushing, Lateropulsion Scale, Subjective Straight Ahead, Postural Assesment Scale for Stroke Patients, Anterior and Lateral Functional Reach Test, Posturography, Behavioral Inattention Test, Mesulam Cancellation Test, Line Bisection Test, Dynamic Starry Night and sensation. Differences between groups will be calculated using t-tests or Mann-Whitney, depending on distribution of normality with corrections for multiple comparisons. Smallest Real Difference (SRD) will be calculated for detecting the minimal detectable change.
Interventions
DEVICEVibration stimuli to neck muscles
DEVICEVibration stimuli to hand
BEHAVIORALconventional physiotherapy
Sponsors
Tel Aviv University
Nachum Soroker, MD
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
25 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* First stroke * Age 25-75 years * Able to understand research instructions * Stable clinical/metabolic state. * Having Contraversive Pushing Syndrome, based on Clinical Scale for Contraversive Pushing.
Exclusion criteria
* Having previous neurological and orthopedic disability. * Having pacemakers.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Clinical Scale for Contraversive Pushing | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Score range: 0-6. Score of zero indicates no pushing. Assesses pushing during spontaneous body posture, abduction and extension of the nonparetic extremities and resistance to passive correction of tilted posture. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Postural Assessment Scale for Stroke Patients | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Score range: 0-36. Score of 36 indicates performance without help. Assesses maintenance and change of posture. |
| Change in Anterior and lateral functional reach test | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Assesses equilibrium during sitting by measuring the distance of the anterior and lateral reaching with the upper limb. |
| Change in Posturography | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Force Platform that calculates the amount of weight bearing on right and left side during sitting. |
| Change in Neglect - Behavioral Inattention Test | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Score range: 0-146. Cutoff score: 129. Assesses the amount of attention to the left side during different task (such as: star and lines cancellation). |
| Change in Lateropulsion Scale | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Score range: 0-17. Score of zero indicated no pushing. Assesses pushing during supine, sitting, standing, transfers and walking. |
| Change in Neglect - Line Bisection | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Assesses the amount of deviation from the center of different lines decided by the subject. Assesses the amount of attention to the left side. |
| Change in Neglect - Test Dynamic Starry Night | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Computerized task. Measures the reaction time and the number of neglected goals. |
| Change in Subjective Straight Ahead | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Assesses the subjective alignment of the body. |
| Change in Sensory evaluation | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Assesses superficial sensation in foot and proprioception in toes. |
| Change in Neglect - Mesulam Cancellation Test | Before the intervention, after the first day of intervention, after 2 weeks (end of intervention), and one month after the end of the intervention (follow up) | Cancellation of forms. Assesses the amount of attention to the left side. |
Outcome results
None listed