Stroke
Conditions
Keywords
exercise, motor skills, rehabilitation, stroke, upper extremity
Brief summary
The aim of the study is to determine the comparative effects of perceptual motor training and repetitive facilitation exercises on upper limb quality of movement and motor function in Stroke patients.
Detailed description
Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation. This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks. Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.
Interventions
8 set of exercises 1. Balance training and related exercises 2. Tones of awareness training, body parts' role and related exercises 3. Space awareness training and related exercises 4. Perception of shape training and related exercises 5. Visual perception training and related exercise. 6. Kinesthetic-tactile perception training and related exercises 7. Auditory perception training and related exercises 8. Eye and hand coordination, fine motor movements and related Exercises
OTHERRepetitive Facilitation Exercises
Eight set of exercises: 1. Shoulder Flexion with 90° Elbow Flexion (Supine). 2. Shoulder Horizontal Extension/Flexion with Elbow flexion (supine). 3. Complex Shoulder and Upper Limb Movements (Supine) 4. Shoulder Flexion/Abduction/External Rotation with Elbow and Forearm Supination (Supine) 5. Forearm Supination/Pronation with 90° Elbow Flexion (Sitting) 6. Wrist Extension and Forearm Pronation with Finger Extension (Supine) 7. Finger Extension with Wrist Flexion (Supine) 8. Finger Extension/Flexion with Wrist Flexion (Sitting) • Therapist facilitate the movement by rubbing, tapping and gentle stretching.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
; * Both male and female patients. * Age 40-65 years * 1st ever stroke confirmed by MRI * mild-to-moderate upper-limb motor paralysis * sub-acute and chronic stroke patients * ability to understand tasks such as evaluations in the intervention * Modified Ashworth scale score \< 3 * Mini Mental State Examination Score should be\>24 out of 30
Exclusion criteria
* Participants who have a history of significant neurological or psychiatric disorders, other than stroke, that could interfere with upper limb motor recovery * Patients with pain, contracture and profound atrophy in arm and fingers. * Participants with severe cognitive dysfunction that would interfere with understanding instructions from the physician or therapist. * Presence of any other musculoskeletal condition. e.g. (Frozen shoulder, any recent fractures of upper limb. * Any accompanying diseases or disorders, other than stroke, that could interfere with upper extremity training. * Uncontrolled health conditions for which exercise was contraindicated.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| 1. Motor Evaluation Scale For Upper Extremity In Stroke Patients (MESUPES) | 8 week | A 17-items into two sub scales ; MESUPES Arm function; 8 items(score 0-5) MESUPES-Hand function; 9 items (score0-2) objective evaluation scale designed to assess quality of movement of arm and hand function after stroke. MESUPES takes 5-15 min to complete. Total score 58. A higher score indicates the greater the quality of movement |
| 2. Fugl-Meyer Assessment (FMA): | 8 weeks | The Fugl-Meyer Assessment is used to assess motor function. It is a well-designed, feasible and efficient clinical examination method that has been tested widely in the stroke population. A three-level ordinal scale (0, can perform no part of the test; 1, performs test partially; 2, performs test normally) is applied to each item. A total possible score for the upper extremity is 66. The higher the score, the better the performance. |
Countries
Pakistan
Contacts
Primary ContactHira Jabeen, MS-NMPT
Outcome results
None listed