Stroke
Conditions
Keywords
Balance, Motor function, Modified otago exercises, Task oriented progressive resistance training
Brief summary
Comparative Effects of Task Oriented Progressive Resistance Training and Modified Otago Exercise on Balance and Lower Limb Motor Function Among Stroke Patients.
Detailed description
Stroke is a clinical syndrome marked by the sudden onset of localized neurological indications that persist longer than 24 hours or result in death. This definition includes stroke both due to infarction and due to hemorrhage. Stroke is the second or third most common cause of death, one of the main causes of adult disability worldwide, and a global health problem. The remaining 80% are due to ischemic stroke which itself has a number of different subtypes, including large artery disease, cardio embolism, and small vessel disease. This study aims to evaluate the effects of Task Related Progressive Resistance Training and Modified Otago Exercises on balance and lower limb motor function in stroke patients. A randomized controlled trial will be conducted over eleven months. Fifty-two stroke patients aged 45 to 65 years will be selected using non-probability convenient sampling technique. Participants will be randomly allocated into two groups using a lottery method. Group A will receive Task-Oriented Progressive Resistance Training which includes functional strengthening activities targeting lower limb muscles, while Group B will undergo Modified Otago Exercise Program which involves balance and strength exercises used to prevent fall in stroke. Interventions will be carried out over eight weeks, with assessments conducted pre- and post-intervention using the Berg Balance Scale (for balance), Fugl-Meyer Assessment (for lower limb motor function) and Mini Mental State Examination (for cognitive function). Data will be analysed using SPSS version 26, applying parametric or non-parametric tests based on data normality.
Interventions
Warm up Head, neck, back extension, trunk, and ankle movement * Muscle strengthening: * Front knee (3) * Back knee * Side hip * Calf raises * Toe rises * Balance training: * Knee bends * Backward walking * Walk and turn * Sideways walk * Heel toe stand * Heel toe walk * One leg stand * Heel walk * Toe walk * Heel toe backward walk * Sit to stand * Stair walk
Standing and reaching in different directions for objects beyond arm's length * Sit to stand from various chair heights to strengthen lower limb extensors (3) * Stepping forward and backward on blocks of various heights * Stepping sideways on blocks of various heights * Forward stepping on blocks of various heights * Heel raise and lower in standing to strengthen plantar flexors (3)
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults aged 45 to 65 years. (9) * Both genders male and female. * Clinically diagnosed with ischemic stroke. * Chronic stroke patients 6 to 10 months. * Presence of hemiparesis with mild to moderate motor deficits FMA-LE score 34. * Cognitive impairment MMSE score more than 26. * Ability to walk at least 10 meters with or without an assistive device
Exclusion criteria
* Dementia or major neurocognitive disorder. (6) * Complete paralysis or unable to participate in active exercise. (11) * Patients with severe joint pain or arthritis are excluded due to reduce risk of injury and avoid confounding factors. * Recent fractures, or other musculoskeletal issues limiting exercise participation. * Suffering from physical diseases that prevent full participation in training.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Fugl-Meyer Assessment (FMA) | baseline to 4rth week | Fugl-Meyer Assessment of Lower Extremity (FMA-LE) total score interpretation ranges from 0 to 34, with higher scores indicating better motor function. Generally, a score of 34 represents normal function, while scores below 29 indicate varying degrees of disability. (15) All FMA-LE forms and subscales showed a high internal consistency (Cronbach's alpha\>0.91). |
| Berg Balance Scale (BBS) | Baseline to 4rth week | The BBS is postural balance scale containing 14 items including standing and sitting unsupported, reaching forward, and placing the alternating foot on a stool. Administering the BBS takes approximately 15 min. Each of the 14 items are scored on a 5-level ordinal scale from 0 (-unable to perform or requiring help‖) to 4 (-normal performance‖), thus providing a potential maximum score of 56 points. (13) test-retest (ICC = 0.96; 95% CI, 0.93-0.98) and inter-rater (ICC = 0.93; 95% CI, 0.87-0.97) reliability was excellent |
| Mini Mentel Scale (MMS) | baseline to 4rth week | The Mini-Mental State Examination (MMSE) is a brief test used to screen for cognitive impairment, particularly in older adults. It assesses different aspects of cognitive function, including orientation, attention, memory, and language. The MMSE is scored on a scale of 0-30, with a score of 24 or higher generally considered normal. (17) The Mini-Mental State Examination (MMSE) generally demonstrates good internal consistency reliability, as indicated by Cronbach's alpha values ranging from 0.78 to 0.81. |
Countries
Pakistan
Contacts
Riphah International University