Combined Effects of Segmental Vibrator With Neuromuscular Electrical Stimulation for Flexor and Extensor Muscle Groups on Upper Limb Function in Sub Acute Stroke
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Subacute Stroke
- Sponsor
- Riphah International University
- Enrollment
- 50
- Locations
- 1
- Primary Endpoint
- MoCA(Montreal Cognitive Assessment)
- Status
- Completed
- Last Updated
- last year
Overview
Brief Summary
Stroke is leading cause of death and disability worldwide, resulting in significant functional limitations and disabilities experienced by stroke survivors, particularly in the upper limb. There is a need for more effective interventions targeting upper limb sensory motor impairments. The aim of this study is to study combined effect of segmental vibrator and neuromuscular electrical stimulation for flexor and extensor muscle groups on upper limb function in sub-acute stroke.
Detailed Description
This study will be a randomized clinical trial and will be conducted in physiotherapy department of Allama Iqbal Memorial Teaching Hospital Sialkot, National Bone and Joint Hospital and Bashir Hospital Sialkot. Forty stroke patients will be recruited through non-probability convenience sampling technique and will be randomly divided in two equal groups Group A and group B through lottery method. Group A will receive high frequency segmental vibration on flexor and extensor muscle groups while group B will receive neuromuscular electrical stimulation along with high frequency segmental vibration(100Hz) on flexor and extensor muscle groups Data will be collected from patients of sub-acute stroke by using screening tool MoCA(for cognition) and assessment tools Fugl-Meyer Assessment Scale(for upper limb function), Wolf Motor Functional Test(for motor function), Modified Ashworth Scale(for spasticity) , Barthel Index(for ADLs), Maximal Hand Grip Strength(for manual dexterity), Maximal Pinch Grip(for manual dexterity), Nottingham Sensory Assessment(for somatosensory function). An informed consent will be taken. Outcome measures will be assessed at baseline, at 4th week and at 8th week. Follow up will be performed at 12th week. Data analysis will be done by SPSS version 28.0.
Investigators
Eligibility Criteria
Inclusion Criteria
- •Patients of both genders
- •Aged between 45 and 65 years old
- •First ever ischemic stroke experienced more than 3 months before the enrollment
- •Spasticity of spastic agonist muscles ranging from 0-2 on the MAS
Exclusion Criteria
- •Patients with bilateral brain lesions
- •Ischemic involvement of cerebellum or basal ganglia
- •Psychiatric disease and cognitive impairment
- •Previous history of other neurological diseases,rheumatic and orthopaedic conditions
- •Patients under anti-spastic therapy or other clinical trials
- •Metal implants e.g. cardiac pacemakers
Outcomes
Primary Outcomes
MoCA(Montreal Cognitive Assessment)
Time Frame: Baseline and 8 weeks
MoCA is a screening tool used to evaluate the cognition in stroke patients. Maximum Score 30 Score \> 25 considered normal cognition
Fugl-Meyer Assessment
Time Frame: Baseline and 8 weeks
Fugl-Meyer is an assessment tool used to evaluate the upper limb function in stroke patients. Upper Extrimity Maximum Score: 66
Barthel Index
Time Frame: Baseline and 8 weeks
BI is an assessment tool used to evaluate ADLs in stroke patients. Minimum Score: 0 (completely dependent) and Maximum Score: 100 (fully independent)
Nottingham Sensory Assessment
Time Frame: Baseline and 8 weeks
Nottingham Sensory Assessment is an assessment tool used to evaluate somatosensory sensation in stroke patients. Minimum Score: 0, Maximum Score: 42 (normal sensation)
Wolf Motor Functional Test
Time Frame: Baseline and 8 weeks
Wolf Motor Functional Test is an assessment tool used to evaluate motor function in stroke patients. The WMFT consists of 15 functional tasks and 2 strength-based tasks (total 17 items). Each task is rated on a 6-point ordinal scale
Maximal Hand and Pinch Grip Strength
Time Frame: Baseline and 8 weeks
Maximal Hand and Pinch Grip Strength is an assessment tool used to evaluate manual dexterity in stroke patients measured by Dynamometer.
Modified Ashworth Scale
Time Frame: Baseline and 8 weeks
MAS is an assessment tool used to evaluate spasticity in stroke patients. Minimum score 0 and maximum score 4