Combination Effect of Proprioceptive Training and Transcranial Magnetic Stimulation on Selected Gait Kinematic Parameters in Stroke Patients
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Assessment of gait function using Dynamic Gait Index:
研究概览
简要总结
this study was done to investigate the Combination effect of proprioceptive training and transcranial magnetic stimulation on selected gait kinematic parameters in stroke patients.
详细描述
After a stroke, mobility is influenced by the central nervous system and peripheral neuromuscular and sensory systems. Effective standing and walking require managing body support against gravity and generating propulsion. Gait deficits in stroke survivors often arise from neural, sensory, muscular issues, and coordination problems, leading to movement disorders like spasticity and ataxia that hinder motor control and gait performance. Typically, stroke patients display reduced gait velocity and abnormal kinematics, marked by asymmetries and decreased weight bearing on the affected limb. Research indicates that combining high-frequency Transcranial magnetic stimulation with task-oriented mirror therapy enhances motor function more effectively than Transcranial magnetic stimulation alone, yielding improvements in hand function and cortical excitability. Similar findings for subacute stroke patients highlight the benefits of integrating action observation with Transcranial magnetic stimulation for better upper limb function.
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)
入排标准
- 年龄范围
- 50 Years 至 60 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Thirty patients with stroke from both sexes.
- •2) Age will range from 50 to 60 years old.
- •3) Duration of stroke ≥ 6 months.
- •4) Spasticity of the lower limb ranges from 1+ to 2 according to modified ashworth scale
- •5) The patients able to walk with or without assistive device.
- •6) Body mass index is less than 30 kg/m
- •7) Patients with sufficient cognitive abilities that enables them to understand and follow instructions (Mini-Mental State Examination scale >24).
排除标准
- •Previous history of any other neurological disorder
- •Recurrent stroke.
- •Vestibular deficits.
- •Cognitive impairment (a score less than 24 according to mini mental state examination).
- •5- Cardiac pacemaker
- •6- Metallic Implants.
- •7- Aphasia, deafness or blindness
- •7. Deformities or contractures of the lower limbs
研究组 & 干预措施
Transcranial Magnetic Stimulation and proprioceptive training
this group received a transcranial magnetic stimulation session for 20 min ,15 min of strengthening of lower limb and bridging exercises, and passive stretching for lower limb, and adding five exercises of proprioceptive training post Transcranial Magnetic Stimulation session for 15 min.
干预措施: Transcranial Magnetic Stimulation (Device)
Transcranial Magnetic Stimulation and proprioceptive training
this group received a transcranial magnetic stimulation session for 20 min ,15 min of strengthening of lower limb and bridging exercises, and passive stretching for lower limb, and adding five exercises of proprioceptive training post Transcranial Magnetic Stimulation session for 15 min.
干预措施: selected physical therapy program (Other)
Transcranial Magnetic Stimulation and proprioceptive training
this group received a transcranial magnetic stimulation session for 20 min ,15 min of strengthening of lower limb and bridging exercises, and passive stretching for lower limb, and adding five exercises of proprioceptive training post Transcranial Magnetic Stimulation session for 15 min.
干预措施: proprioceptive training (Other)
Transcranial Magnetic Stimulation only
this group received only Rtms session for 20 min and 30 min of strengthening of lower limb and bridging exercises and passive stretching for lower limb
干预措施: Transcranial Magnetic Stimulation (Device)
Transcranial Magnetic Stimulation only
this group received only Rtms session for 20 min and 30 min of strengthening of lower limb and bridging exercises and passive stretching for lower limb
干预措施: selected physical therapy program (Other)
结局指标
主要结局
Assessment of gait function using Dynamic Gait Index:
时间窗: At baseline and after 6 weeks
For two groups a. Assessment of gait function using Dynamic Gait Index: Each item is scored on a 4-level ordinal scale. * Grade 3 = normal performance * Grade 2 = minimal impairment, * Grade 1 = moderate impairment, * Grade 0 = severe impairment. The maximum possible score is 24 points. The Dynamic gait index can be administered in 10 minutes and requires a box, 2 cones, stairs and twenty-foot walkway.
次要结局
- Assessment of ankle range of motion(At baseline and after 6 weeks)
- Assessment of step length(At baseline and after 6 weeks)
- Assessment of step duration(At baseline and after 6 weeks)
- Assessment of cadence(At baseline and after 6 weeks)
研究者
Mahmoud Alaa Shabaan
principal investigator
Cairo University