Stroke. Abnormalities of gait and mobility.
Conditions
Interventions
Twenty-eigth patients of both sexes, aged between 18 and 90 years with chronic hemiparesis (6 months after stroke) will be randomly (by lottery distributing computer-generated) into 2 groups: Group I
Other
E02.779.483.875
Sponsors
Universidade Federal de Ciências da Saúde de Porto Alegre
Hospital Mãe de Deus
Eligibility
Inclusion criteria
Inclusion criteria: six months to five years since the onset of a unilateral stroke; ability to comprehend simple instructions (Mini-Mental State Examination with a minimum score of 20); no pain, contractures, or severe weakness in shoulder flexion muscles (< 3 in the Manual Muscular Testing); and no upper-limb rehabilitation during this research.
Exclusion criteria
Exclusion criteria: other neurological, neuromuscular, or orthopedic disease; severe comorbidity diseases; or severe increase of upper extremity muscular tone(> 3 points according to the modified Ashworth scale).
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To evaluate the improvement of performance of the upper limb in unilateral and bilateral activities through evaluation test of the upper limb of elderly (TEMPA - Test d'évaluation des des Personnes Membres Superieus Agées);TEMPA scores significantly improved in both groups throughout the intervention period (outcome measures) and at the follow-up. The main between groups analysis demonstrated that the FS group had the largest change in the unilateral task analysis (rate of change of 43%; p=0.04) and in the unilateral total score (rate of change of 46%; p=0.04), compared to the AS group with a rate of change of 13% and 13.5%, respectively. In the follow-up measures, although the rate of change was higher in the FS group, no statistically significant differences were observed. | — |
Secondary
| Measure | Time frame |
|---|---|
| The ANOVA for hand grip strength demonstrated a main effect for time (F(1,25) = 12.20; p=0.002). Both groups had an increased grip strength at the outcome (FS group; p=0.03 and the AS group; p=0.002) and the effect remained at follow-up. No statistically significant differences were observed between groups at the outcome (p=0.32) and follow-up (p=0.7). There was no difference between groups for shoulder flexion strength neither at the outcome (p=0.43) nor at follow-up (p=0.9). However, both groups showed improvement in strength after each intervention (AS and FS, p=0.001) and at the follow-up (AS, p=0.003; FS, p=0.002). For active shoulder ROM, a two-way ANOVA only revealed a significant effect of time (F(1,25) = 24.95; p<0.01). No group or time-group interaction effect was observed. The quantitative analysis of intra-group effect demonstrated an improvement of 33% (p=0.003) in the FS group and 26% (p=0.002) in the AS group after the strength protocols. This effect persisted at 10 month follow-up. No difference was identified between groups for the motor assessment (UE-FM) at the outcome (p=0.83) or follow-up (p=0.96). Participants in both intervention protocols exhibited a significant motor recovery in the paretic upper-extremity at the outcome (p=0.001) and at follow-up (p=0.001). Muscle tone evaluation (Ashworth scale) demonstrated a statistically significant improvement in both FS (p=0.04) and AS (p=0.03) intervention groups at the outcome and at follow-up.;Increased muscle strength of shoulder flexors assessed in the sagittal plane through the load cell. Increased grip strength evaluated by dynamometer. Increased active range of motion assessed by electrogoniometer. Increased muscle tone assessed by the Modified Ashworth Scale. Motor recovery assessed by the test section of the upper-extremity Fugl-Meyer scale (UE-FM). | — |
Countries
Brazil
Contacts
Public ContactAline;Aline Pagnussat;Pagnussat
Universidade Federal de Ciências da Saúde de Porto Alegre;Universidade Federal de Ciências da Saúde de Porto Alegre
Outcome results
None listed