Cerebrovascular Stroke, Muscle Weakness
Conditions
Keywords
Cross-education, Neuromuscular electrical stimulation, Mirror Therapy
Brief summary
This study was conducted to determine whether mirror therapy has an additive effect on cross-education of the strength of neuromuscular electrical stimulation (NMES) in patients with hemiplegia. As an outcome measure, the ankle dorsiflexion strength of hemiplegic patients was measured.
Detailed description
A total of 29 patients, 7 women, and 22 men were included according to the inclusion and exclusion criteria. The patients were randomly assigned to the control group (n = 14) and the Mirror group (n = 15). Five sessions of neuromuscular electrical stimulation, unaffected side ankle dorsiflexors were applied to the patients in both groups. In addition to the NMES, mirror therapy was applied to the experimental group simultaneously with NMES. Before and after treatment, both ankle dorsiflexor strength was measured with a force sensor. For force measurements, a force transducer (FC2211-0000-0100-L Compression Load Cell, TE Connectivity company, France) was used. Force transducer signals were received with a data acquisition device (POWERLAB® data acquisition system ADInstruments, Oxford, UK) and evaluated offline on the computer. The measurement values were expressed in kilogram.force (kg.f) and this value was normalized according to body weight.
Interventions
DEVICEMirror frame
Combined Mirror and NMES therapy
DEVICEControl
Only NMES therapy
Sponsors
Istanbul Physical Medicine Rehabilitation Training and Research Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Intervention model description
Randomized controlled trial
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* Cases with stroke duration ≥ 1 month * Ability to walk at least 10m (functional ambulation scale ≥3) * Age range 18-75 years * Hemorrhagic or ischemic stroke * Brunnstrom stage ≥4 for lower limb * Unilateral stroke * Cooperating with the examination and tests
Exclusion criteria
* Mini Mental State Assessment score \<21 * Severe spasticity (MAS = 4) in ankle dorsiflexors * Have a contracture on ankle joint * The presence of skin lesions in the application area * Painful pathologies in the lower extremities * Having visual field defects * Active inflammatory, rheumatological or infectious disease * Parent rhythm / conduction block problem in the heart * Uncontrollable hypertension (Maxima\> 140, Minima\> 90) * Presence of lower extremity fracture * Peripheral nerve lesions such as polyneuropathy, radiculopathy * Finding or suspected active deep vein thrombosis * History of deep vein thrombosis and pulmonary embolism
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change of ankle dorsiflexor isometric muscle strength | Change from Baseline muscle strength at 6 days | Force transducer used for measuring maximum voluntary ankle dorsiflexion force. The force unit is kilogram.force |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change of Lower Extremity Brunnstrom score | Change from Baseline Brunnstrom score at 6 days | It evaluates the developmental stages of synergy patterns, muscle tone and isolated movements of the patients in the lower extremities. Patients are categorized between Stage-1 and 6. Stage 1: Flaccidity; Stage 6: Spasticity Disappears and Coordination Reappears |
| Change of Modified Ashworth Scale score | Change from Baseline Modified Ashworth Scale score at 6 days | Modified Ashworth Scale was used for assessment spasticity. Modified Ashworth Scale scores are varied between 0 and 4: 0 points, no increase in muscle tone; 4 points indicate spasticity with a degree of rigidity. |
| Change of Functional Ambulation Scale score | Change from Baseline Functional Ambulation Scale score at 6 days | The Functional Ambulation Classification (FAC) is a method for classifying mobility. The FAC has six categories ranging from 0 (non-functional ambulation) to 5 (independent). |
| Change of Timed Up and Go Test score | Change from Baseline Timed Up and Go Test score at 6 days | It is a test that evaluates the patient's static and dynamic balance, mobility and walking ability. The test's score is the time in seconds it takes the subject takes to complete the test. |
Countries
Turkey (Türkiye)
Outcome results
None listed