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Sit-to-stand Training With Interactive Feedback in Chronic Stroke

Not Applicable
Not yet recruiting
Conditions
Stroke
Interventions
Other: Conventional STS training
Other: Visual and auditory feedback STS training
Registration Number
NCT05945134
Lead Sponsor
National Yang Ming Chiao Tung University
Brief Summary

The major problems of people with chronic stroke include muscle weakness, sensory alteration, and inter-muscular coordination impairment. Inter-muscular coordination impairment caused altered muscle contraction sequences and weight-bearing asymmetry during functional activities. Sit-to-stand (STS) training is often used to improve functional activities among post-stroke subjects. However, the improvement may come from compensatory movements. Using compensatory movement may cause muscle weakness in the affected side and increase fall risk. This study will develop a novel STS training system with interactive visual and audio feedback emphasizing weight transferring and weight bearing. The present study aims to investigate the effects of sit-to-stand training with interactive visual and audio feedback on muscle contraction sequences and weight bearing symmetry in individuals with chronic stroke.

Detailed Description

This is a prospective randomized single-blinded controlled trial with pre- and post-measurements. 20 individuals will be recruited, and randomly assigned to experimental or control group. Statistical data analysis will be done by SPSS 24.0. Baseline characteristics will be analyzed using independent t-test or Chi-square test. Repeated measures two-way analysis of variance (ANOVA) with Tukey's post-hoc analysis will be used for time-by-group comparisons. The significant level is set at 0.05.

Recruitment & Eligibility

Status
NOT_YET_RECRUITING
Sex
All
Target Recruitment
20
Inclusion Criteria
  • Diagnosis of stroke ≥ 6 months
  • Mini-mental state examination (MMSE) ≥ 24 points
  • Brunnstrom lower limb recovery stage: ≥ stage 3
  • Be able to independently perform STS for at least 10 times
  • Single STS >1.7 seconds
  • Be able to walk ≥10 meters independently
Exclusion Criteria
  • Any other musculoskeletal, neurological and cardiovascular diseases
  • Have visual or language impairments

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Conventional STS training groupConventional STS trainingOnly verbal and visual cues which were commonly used by the therapist.
Visual and auditory feedback STS training groupVisual and auditory feedback STS trainingThe interactive interface of visual and auditory feedback system was designed using LabVIEW and integrated force plates for training. Signals from the pressure detectors of the seat and two force plates on the floor will be converted to the indication of the body weight distribution (indicated by the size of the two circles of both legs, larger circle represented the more weight beard on the leg) and the movement path of the overall center of pressure (indicated by a mobile solid dot).
Primary Outcome Measures
NameTimeMethod
Sit to stand performance: change in onset time of muscle contraction sequences5 minutes, Change from baseline onset time at 3-week post-test

Use the surface electromyography to evaluate the "onset" time (% MT, EMG activities ≥ 2 SD of the baseline for ≥100 ms) of different muscles recruited during sit to stand (rectus femoris, biceps femoris, gluteus maximus, tibialis anterior, gastrocnemius, and soleus)

Sit to stand performance: change in peak force time of muscle contraction sequences5 minutes, Change from baseline peak force time at 3-week post-test

Use the surface electromyography to evaluate the "peak force" time (% MT, maximal EMG activities) of different muscles recruited during sit to stand (rectus femoris, biceps femoris, gluteus maximus, tibialis anterior, gastrocnemius, and soleus)

Sit to stand performance: change in offset time of muscle contraction sequences5 minutes, Change from baseline offset time at 3-week post-test

Use the surface electromyography to evaluate the "offset" time (% MT, EMG activities \< 2 SD of the baseline for ≥100 ms) of different muscles recruited during sit to stand (rectus femoris, biceps femoris, gluteus maximus, tibialis anterior, gastrocnemius, and soleus)

Sit to stand performance: change in COP sway pathway5 minutes, Change from baseline COP sway pathway at 3-week post-test

Use the force plates to evaluate the total length (cm) of the moving pathway of the overall center of pressure in X or Y axis individually

Sit to stand performance: change in weight bearing symmetry5 minutes, Change from baseline weight bearing symmetry at 3-week post-test

Use the force plates to evaluate the "cumulative vertical force " (% of body weight), and calculate with the "asymmetry ratio" = \|1-affected side/less affected side\|

Secondary Outcome Measures
NameTimeMethod
Gait performance: change in symmetry of step time5 minutes, Change from baseline symmetry of step time at 3-week post-test

Use the GAITRite® system to evaluate step time (sec) in comfortable speed (with/ without assisted device), and calculate with the "asymmetry ratio" = \|1-affected side/less affected side\|

Gait performance: change in symmetry of gait speed5 minutes, Change from baseline symmetry of gait speed at 3-week post-test

Use the GAITRite® system to evaluate gait speed (m/s) in comfortable speed (with/ without assisted device), and calculate with the "asymmetry ratio" = \|1-affected side/less affected side\|

Gait performance: change in symmetry of step length5 minutes, Change from baseline symmetry of step length at 3-week post-test

Use the GAITRite® system to evaluate step length (m) in comfortable speed (with/ without assisted device), and calculate with the "asymmetry ratio" = \|1-affected side/less affected side\|

Sit to stand performance: change in sit to stand duration5 minutes, Change from baseline sit to stand duration at 3-week post-test

Use the surface electromyography to evaluate the "movement time" (MT, sec), using the "offset time of the last activated muscle" - "onset time of the first activated muscle"

Trial Locations

Locations (1)

National Yang Ming Chiao Tung University

🇨🇳

Taipei, Taiwan

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