Primary Condition: Stroke
Conditions
Keywords
Chronic stroke; trunk control; postural stability; diaphragmatic breathing; physical therapy; balance; functional mobility
Brief summary
This randomized controlled trial will investigate whether adding diaphragmatic breathing training to conventional physiotherapy improves trunk control and postural stability in individuals with chronic stroke compared with conventional physiotherapy alone. Forty participants with chronic unilateral stroke will be randomly allocated in a 1:1 ratio to either an experimental group receiving diaphragmatic breathing training plus conventional physiotherapy or a control group receiving conventional physiotherapy alone. The intervention will be provided three times per week for six weeks.
Detailed description
The study will use a prospective, two-arm, parallel-group randomized controlled design. Forty individuals with chronic unilateral stroke will be recruited and randomly allocated to either an experimental group or a control group in a 1:1 ratio. The experimental group will receive standard diaphragmatic breathing training in addition to conventional physiotherapy. The control group will receive the same conventional physiotherapy program without diaphragmatic breathing training. Both groups will receive three treatment sessions per week for six weeks, for a total of 18 sessions. Trunk control and postural stability will be assessed at baseline and after completion of the six-week intervention. Trunk control will be assessed using the Trunk Impairment Scale, while postural stability will be assessed using the Biodex Balance System. Functional mobility will be assessed using the Timed Up and Go test. Primary C
Interventions
BEHAVIORALDiaphragmatic Breathing Training and Conventional Physiotherapy
Standard diaphragmatic breathing training involving slow nasal inspiration with abdominal and lower rib cage expansion, minimal upper chest movement, and slow controlled oral expiration. Participants will perform approximately 10 breaths per set for three sets, with rest periods as needed. Training will be provided for approximately 10-15 minutes per session, three times per week for six weeks.A standardized conventional physiotherapy program including postural alignment and trunk activation, sitting weight-shifting, controlled trunk rotation, sit-to-stand training, standing weight-shifting, static standing balance, and functional mobility/gait training. Treatment will be provided three times per week for six weeks.
Sponsors
fatma shehata
Suez University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Intervention model description
Parallel Assignment
Eligibility
Sex/Gender
ALL
Age
40 Years to 65 Years
Healthy volunteers
No
Inclusion criteria
Adults aged 40-65 years. * Clinically diagnosed unilateral stroke. * Chronic stroke stage of at least 6 months. * Able to sit independently without physical assistance. * Able to walk 10 meters with or without an assistive device. * Mini-Mental State Examination (MMSE) score ≥24. * Modified Ashworth Scale (MAS) score ≤2 in the affected upper and lower limb muscles. * Medically stable. * Able to understand and follow simple instructions. * Willing to participate and provide written informed consent.
Exclusion criteria
Other neurological disorders. * Bilateral neurological deficits or multiple deficits substantially interfering with trunk control, balance, or gait. * Severe cardiopulmonary disease limiting participation in exercise. * Severe musculoskeletal disorders affecting the trunk or lower limbs. * Severe cognitive impairment. * Severe aphasia preventing understanding of instructions. * Significant visual or vestibular impairment affecting balance assessment. * Uncontrolled medical conditions. * Current participation in another structured rehabilitation program.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Trunk Impairment Scale | Baseline (Week 0) and post-intervention (Week 6) | Trunk control will be assessed using the original 17-item Trunk Impairment Scale, which evaluates static sitting balance, dynamic sitting balance, and coordination. Total scores range from 0 to 23, with higher scores indicating better trunk control. |
| Trunk Impairment Scale (TIS) | Baseline (Week 0) and post-intervention (Week 6) | Trunk control will be assessed using the original 17-item Trunk Impairment Scale, which evaluates static sitting balance, dynamic sitting balance, and coordination. Total scores range from 0 to 23, with higher scores indicating better trunk control. |
| Biodex Postural Stability | Baseline (Week 0) and post-intervention (Week 6) | Postural stability will be assessed using the Biodex Balance System. The selected postural stability index will be recorded under standardized testing conditions, with the same test configuration used at baseline and post-intervention. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Timed Up and Go (TUG) | Baseline (Week 0) and post-intervention (Week 6) | Functional mobility will be assessed using the 3-meter Timed Up and Go test. The time required for the participant to stand up from a chair, walk 3 meters, turn, return to the chair, and sit down will be recorded in seconds. Lower completion time indicates better functional mobility. |
Contacts
CONTACTfatma shehata mohamad, phD
Outcome results
None listed