Stroke, Stroke Ischemic
Conditions
Keywords
Stroke, cerebral vascular accident, Vojta therapy, pose estimation, posture control, trunk control, upper extremity function
Brief summary
Vojta therapy that is reflex locomotion therapy is a neurophysiological rehabilitation approach that stimulates specific reflex zones on the body to activate global, innate movement patterns. In stroke rehabilitation, it is used to improve postural control, trunk stability, and functional movement by engaging automatic motor responses. Vojta stimulation can activate motor cortical and subcortical areas as well as postural muscles. Pose estimation will be used to analyze human motion in stroke patients. The study will identify if there is significant difference in the comparative effects of Vojta therapy in addition to routine physical therapy on posture, trunk control and upper extremity motor function in sub-acute stroke patients
Detailed description
Vojta therapy can be used in the early stages of stroke patients' rehabilitation because acute stroke patients are characterized by a disruption in their capacity to react to changes in body posture, necessitating automatic postural adjustment. This study will determine the comparative effects of Vojta therapy in addition to routine physical therapy on posture, trunk control and upper extremity motor function in patients with sub-acute stroke. Body angles will be measured used Vojta therapy.
Interventions
OTHERVojta therapy
Vojta therapy will be implemented for reflex rolling and reflex creeping. A small pressure with dorsal, medial and cranial directional stimuli will be provided. After stimulation the reactions are extension of spine, flexion of hip joint, then knee joint and in the end at ankle joint. 5 sessions per week with a 60-minute session are part of protocol for routine physical therapy and vojta therapy for 8 weeks.
OTHERRoutine physical therapy
The control group will receive routine physical therapy treatment which will consist of positioning, passive movements of the limbs, sensorimotor exercises for the affected limb using task-oriented training and motor relearning program consisting of repetitive motor skills consisting of functional tasks and involves task breakdown, such as transfers, upper limb function will be performed. 5 sessions per week with a 60-minute session are part of protocol for routine physical therapy and core stability for 8 weeks.
Sponsors
University of Lahore
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
45 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
* Age 45-65 years * Both males and females * First time subacute stroke (7 days post stroke to 3 months) * Brunnstrom stage 1,2 * A confirmed CT scan for subacute ischemic stroke * A hemiplegia with score of ≤2 of medical research council scale for muscle strength of the arm (MRCS) * Premorbid modified Rankin scale score ≤ 3 * Stroke patient who can achieve supported standing * Patients having NIHSS score 16-20 will be included * Patient who can achieve sitting for 30 seconds
Exclusion criteria
* Severe cognitive impairments that can hinder rehabilitation * Limitations in communication due to aphasia * Altered consciousness or dementia (Epple et al., 2020b) * Patients suffering from postural hypotension
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Posture control | 8 weeks | To measure posture control posture assessment scale for stroke will be used. It will determine posture after stroke in sitting, standing and lying position. It's a 4-point scale and ranges from 0-36. It consists of 12 items where items are scored from 0-3.It will measure balance in sitting, standing and lying. It will measure the ability of the individual to maintain balance with different positions. Inter ratter reliability for individual items is α=0.88. It has excellent predictive validity with α=0.86 |
| Trunk control | 8 weeks | Trunk performance will be assessed with Trunk control test. It consists of four items assessed on a three-point ordinal scale. Items include rolling to affected and non-affected side, sitting, and balance in the sitting position for 30 seconds. The total score is from 0 to 100, a higher score of 50 points indicates better performance. A 12-point score indicates abnormal pattern of movement while a 25 -point score means movement was normal. Internal validity is a= o.86 while r= 0.76 It is a validated test for posture control and motor |
| Motor Evaluation Scale for upper extremity | 8 weeks | Motor evaluation scale for upper extremity will be used to measure motor activity of arm and hand. It has 8 tasks for arm with six categories of responses and hand has 6 tasks items with three categories. While functional tasks have three items with three categories. It has items of arm with total score of 40 and hand items with total score of 18. The maximum score for the scale is 58. The scale has good test-retest reliability. Reliability is 0.99 for MESUPES arm and 0.97 for MESUPES hand. Validity is 0.87 |
| Pose estimation | 8 weeks | Pose estimation software will be used for posture information. It will use key points as joints from the body and their position in space and time. In pose estimation the position of each body joint is estimated. It is based on activity recognition. The recognition is done by segmenting the position of the key points of the joints of the individuals in the scene. The Smart phone cameras are used for picture and then the software recognizes the key points on the picture. The software will record precise posture information. The program uses user-selected images to determine angles between various body components |
Countries
Pakistan
Contacts
Primary ContactWajeeha Mahmood, BSPT,PPDPT,MSNMPT
Outcome results
None listed