Neuromuscular Electrical Stimulation (NMES) Applied to Back Extensors in Stroke Patients; Effects on Functional Capacity and Mobility
试验速览
- 阶段
- 不适用
- 发起方
- 入组人数
- 2
- 主要终点
- Brunnel Balance Scale:
研究概览
简要总结
Specific clinical tools and treatment variables have a key role on the results to be obtained. Therefore, there is a need for well-planned studies on the effect of Neuromuscular Electrical Stimulation (NMES) on stroke patients. Although NMES is frequently used in patients with stroke, scientific evidence regarding back extensor muscle stimulation, functional capacity, balance and mobility efficiency in this patient group is not sufficient. This study was planned to compare controlled individuals with neurological rehabilitation. According to the definition of World Health Organization (WHO) stroke; It is a rapidly developing clinical condition due to local or general impairment of brain functions, without apparent cause other than vascular causes. In the world, the loss of disability and labor force is known as the first and the second cause of deaths.
Post-stroke intensive care and rehabilitation processes vary between countries. For example, in Australia, $ 2.14 billion is spent each year for the treatment of stroke-diagnosed individuals, while US $ 65 million is spent annually. For these reasons, it is very important to choose low-cost, effective and evidence-based physiotherapy approaches for people with stroke. Hemiparesis, which is characterized by a loss of power on one side of the body, is the most common neurological loss after stroke. Patients with hemiparetic stroke often have impaired balance, mobility and functional capacity. This results in a high economic burden and social problem in this person. Among the functional problems after stroke; impaired balance, abnormal walking pattern with abnormal asymmetry, abnormal body and spinal movement can be shown. The most important problem is the loss of mobility; bed activities include sitting and standing. The most important goal of stroke rehabilitation is the recovery of mobility and balance. Changes in walking pattern and balance abilities occur due to motor control loss, spasticity, muscle weakness, joint motion deficit, abnormal movement patterns and sensory dysfunction. In addition to neurophysiological treatment techniques such as Bobath, conventional exercise programs, Brunnstrom and proprioceptive neuromuscular parasilication, with the aim of improving the quality of movement and maintaining the balance in rehabilitation of stroke-diagnosed patients, electrical stimulation is also used.Although the importance of back extensor muscle strength is documented in the literature, it is observed that studies focusing on back extensor muscle strength in limb rehabilitation are limited.
Control disorders in the posterior extensor muscles after stroke are found to be significantly associated with balance, gait and upper extremity dysfunctions.
Based on this idea, our study was planned to examine the effect of NMEs application on functional capacity, balance and mobility in stroke individuals.
详细描述
Our study will be carried out in Fırat University Training and Research Hospital. Individuals who are diagnosed with stroke by the Physical Medicine and Rehabilitation Specialist and who are directed to the physiotherapy program will be included. 20 hemiparesis patients who underwent stimulation and conventional physiotherapy and rehabilitation of the back extensors, will constitute 20 volunteer patients who only provided conventional physiotherapy and rehabilitation applications. 20 cases were included in the study and 20 cases as control group. All cases will be informed and approved before they start working.
Inclusion Criteria
- Having a chart of hemiplegia or hemiparesis due to the first story of cerebrovascular accident (SVO)
- At least 3 months after SVO
- Mini-mental State Examination (MMSE) value ≥ 15
- Being in the 30 to 80 age range
- Back extensor muscle spasticity value <4 according to modified Ashworth Scale
Criteria for Inclusion of Patients in the Study
- Ataxia, dystonia, dyskinesia
- The presence of lower motor neuron or peripheral nerve lesion
- Degraded deep senses
- Detection disorder and dementia
- Skin and peripheral circulatory disorder
- History of CVO, bilateral hemiplegia
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- Single (Participant)
盲法说明
Patient will not know the applications
入排标准
- 年龄范围
- 30 Years 至 80 Years(Adult, Older Adult)
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Having a chart of hemiplegia or hemiparesis due to the first story of cerebrovascular accident (SVO)
- •At least 3 months after SVO
- •Mini-mental State Examination (MMSE) value ≥ 15
- •Being in the 30 to 80 age range
- •Back extensor muscle spasticity value <4 according to modified Ashworth Scale
排除标准
- •Ataxia, dystonia, dyskinesia
- •The presence of lower motor neuron or peripheral nerve lesion
- •Degraded deep senses
- •Detection disorder and dementia
- •Skin and peripheral circulatory disorder
- •History of CVO, bilateral hemiplegia
研究组 & 干预措施
NMES + PT
NMES will be applied to the back muscles with the chattanooga intelect advanced device. In addition, conventional physiotherapy and rehabilitation applications will be made.
干预措施: NeuromuscularElectricalStimulation+ConventionalPhysiotherapy (Device)
PT
Conventional physiotherapy and rehabilitation practices will be carried out.
干预措施: Conventional physiotherapy and rehabilitation (Other)
结局指标
主要结局
Brunnel Balance Scale:
时间窗: 8 Months
It was developed to evaluate the effectiveness of rehabilitation approaches in stroke patients. Balance performance will be evaluated by 12 tests based on functional performance
Functional Ambulation Classification
时间窗: 8 Months
Ambulation categories will be determined according to the Functional Ambulation Classification (FAS) developed by Massachusetts General Hospital
Short Form-36
时间窗: 8 Months
Quality of life is evaluated by the Short Form-36 health screening form.
Effects on Functional Capacity and Mobility
时间窗: 8 Months
Survey reviews
Stroke Rehabilitation Assesment of Movement (STREAM)
时间窗: 8 Months
Specially designed by physiotherapists to ensure the quantitative assessment of motor function in patients with stroke. It is easy to perform in the clinic. The most important advantage of this scale is not only the breadth of active movement but also the quality of the movement. Evaluates voluntary movement and basic mobility separately
Adapted Patient Evaluation and Conference System
时间窗: 8 Months
The balance states of the patients will be evaluated with the evaluation form of Adapted Patient Evaluation and Conference System (APECS).
Postural Assesment of Stroke Scale (PASS)
时间窗: 8 Months
It is the scale used to evaluate postural control in stroke. It will be used to evaluate the static and dynamic balance of stroke patients
Mini Mental State Examination Test
时间窗: 8 Months
Cognitive functions will be evaluated on a total of 30 points
次要结局
未报告次要终点
研究者
Furkan BİLEK
Principal Investigator
Firat University
