Evaluation of the Effects of Closed Kinetic Chain Exercises and Kinesio Taping on the Lower Extremity in Individuals With Chronic Stroke
试验速览
- 阶段
- 不适用
- 状态
- 进行中（未招募）
- 发起方
- 入组人数
- 30
- 试验地点
- 1
- 主要终点
- Measurement of knee joint position sense
研究概览
简要总结
This study aims to evaluate the effectiveness of closed kinetic chain (CKC) exercises and kinesio taping on knee joint proprioception, balance, functional performance, and quality of life in individuals with chronic stroke. Stroke often results in proprioceptive deficits and postural control impairments, which negatively impact rehabilitation outcomes. While CKC exercises are believed to enhance proprioceptive input through joint compression and sensory feedback, kinesio taping is used as a complementary intervention to support motor control and stability. The study will compare the effects of these two interventions to determine their potential roles in improving sensorimotor function and promoting functional independence in stroke rehabilitation.
A total of 30 participants were enrolled in this study.
Inclusion Criteria:
- Patients who had a stroke more than 6 months ago,
- Having a stable medical condition,
- Ability to understand simple instructions,
- Individuals with spasticity between grades 0-2 according to the Modified Ashworth Scale,
- Individuals who can walk independently or with assistive devices,
- Those who agree to participate and comply with the study procedures.
Exclusion Criteria:
- Severe cognitive impairment (MMSE score < 24),
- Orthopedic conditions that may cause knee pain during exercise,
- Other neurological conditions that may affect proprioception,
- Severe joint contracture,
- Refusal or unwillingness to participate in the study.
详细描述
Stroke is defined as a sudden loss of neurological function lasting more than 24 hours, occurring in central nervous system regions such as the brain, spinal cord, or retina, due to infarction or hemorrhage. Etiologically, stroke is classified into two main groups: hemorrhagic and ischemic. Ischemic stroke occurs due to insufficient blood flow to cerebral tissue, while hemorrhagic stroke is characterized by bleeding into brain tissue or the subarachnoid space. Of all stroke cases, approximately 44% occur in men and 56% in women. The prevalence of stroke is around 22% in individuals aged 15 to 49 and increases to 67% when examined up to the age of 70.
The post-stroke period is typically divided into phases. The Stroke Roundtable Consortium recommends the following classification: the first 24 hours as the hyperacute phase, the first 7 days as the acute phase, the first 3 months as the early subacute phase, months 4 to 6 as the late subacute phase, and after 6 months as the chronic phase.
Following a stroke, patients commonly experience postural control loss, asymmetric weight distribution, abnormal gait patterns, and balance impairments, all of which negatively affect functional independence and quality of life.
Sensory deficits are also prevalent in stroke patients, with exteroception affected in 7-53%, proprioception in 34-64%, and higher cortical functions in 31-89% of cases. Most patients experience impairments in multiple types of sensation. These sensory disturbances reduce the feedback received from objects, potentially leading to non-use of the affected limb. Among these, proprioceptive deficits pose significant challenges during rehabilitation. Studies have shown that reduced proprioception in individuals with stroke negatively affects motor control and should be addressed in rehabilitation programs.
Progressive resistance exercise has been shown to be an effective treatment for strengthening weak muscles caused by various musculoskeletal and neuromuscular disorders. It is a training method that gradually increases the level of resistance to improve force generation capacity. Closed kinetic chain (CKC) and open kinetic chain (OKC) exercises are two widely used progressive resistance training methods aimed at improving proprioception and motor functions in stroke patients. CKC exercises are believed to enhance proprioception by providing greater sensory feedback through joint position sense and mechanoreceptor activation.
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
- None
入排标准
- 年龄范围
- 18 Years 至 65 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients who had a stroke more than 6 months ago,
- •Individuals with a medically stable condition,
- •Ability to understand simple instructions,
- •Individuals with spasticity graded between 0 and 2 according to the Modified Ashworth Scale,
- •Individuals who can walk independently or with assistive devices,
- •Individuals who agree to participate in the study and are able to comply with the study procedures.
排除标准
- •Severe cognitive impairment (Mini-Mental Test score < 24),
- •Orthopedic conditions that may cause knee pain during exercise,
- •Other neurological conditions that may affect proprioception,
- •Severe joint contracture,
- •Individuals who do not wish to voluntarily participate in the study.
研究组 & 干预措施
the group engaged in closed kinetic chain exercises
Closed kinetic chain exercises of the lower extremity are typically performed with the feet secured to a stable object that generates compressive forces at the hip, knee, and ankle joints. Participants will perform closed kinetic chain exercises in 40-minute sessions, twice a week for 8 weeks. Each exercise will be repeated 3 to 5 times, depending on the individual's strength .Exercises include: wall squats, forward and upward step-ups, side and upward step-ups, double-leg squats, bridges, and quadriceps isometric strengthening exercises.
干预措施: Berg Balance Scale (BDS) (Other)
the group engaged in closed kinetic chain exercises
Closed kinetic chain exercises of the lower extremity are typically performed with the feet secured to a stable object that generates compressive forces at the hip, knee, and ankle joints. Participants will perform closed kinetic chain exercises in 40-minute sessions, twice a week for 8 weeks. Each exercise will be repeated 3 to 5 times, depending on the individual's strength .Exercises include: wall squats, forward and upward step-ups, side and upward step-ups, double-leg squats, bridges, and quadriceps isometric strengthening exercises.
干预措施: Timed Up and Go Test (TUG) (Other)
the group engaged in closed kinetic chain exercises
Closed kinetic chain exercises of the lower extremity are typically performed with the feet secured to a stable object that generates compressive forces at the hip, knee, and ankle joints. Participants will perform closed kinetic chain exercises in 40-minute sessions, twice a week for 8 weeks. Each exercise will be repeated 3 to 5 times, depending on the individual's strength .Exercises include: wall squats, forward and upward step-ups, side and upward step-ups, double-leg squats, bridges, and quadriceps isometric strengthening exercises.
干预措施: 10-Meter Walking Test (Other)
the group engaged in closed kinetic chain exercises
Closed kinetic chain exercises of the lower extremity are typically performed with the feet secured to a stable object that generates compressive forces at the hip, knee, and ankle joints. Participants will perform closed kinetic chain exercises in 40-minute sessions, twice a week for 8 weeks. Each exercise will be repeated 3 to 5 times, depending on the individual's strength .Exercises include: wall squats, forward and upward step-ups, side and upward step-ups, double-leg squats, bridges, and quadriceps isometric strengthening exercises.
干预措施: Stroke-Specific Quality of Life Scale (Other)
the group engaged in closed kinetic chain exercises
Closed kinetic chain exercises of the lower extremity are typically performed with the feet secured to a stable object that generates compressive forces at the hip, knee, and ankle joints. Participants will perform closed kinetic chain exercises in 40-minute sessions, twice a week for 8 weeks. Each exercise will be repeated 3 to 5 times, depending on the individual's strength .Exercises include: wall squats, forward and upward step-ups, side and upward step-ups, double-leg squats, bridges, and quadriceps isometric strengthening exercises.
干预措施: Measurement of Knee Joint Position Sense (Other)
Kinesiotaping Group (KB)
Kinesiotaping will be applied to increase proprioceptive awareness of the knee joint. Taping will be applied using the *"Y" technique and *"I" technique, focusing on medial and lateral support. The kinesio tape will remain in place for 3 days, followed by a 1-day break, and then reapplied. Tape changes will be performed by a physical therapist for a total of 8 weeks.
干预措施: Measurement of Knee Joint Position Sense (Other)
Kinesiotaping Group (KB)
Kinesiotaping will be applied to increase proprioceptive awareness of the knee joint. Taping will be applied using the *"Y" technique and *"I" technique, focusing on medial and lateral support. The kinesio tape will remain in place for 3 days, followed by a 1-day break, and then reapplied. Tape changes will be performed by a physical therapist for a total of 8 weeks.
干预措施: Berg Balance Scale (BDS) (Other)
Kinesiotaping Group (KB)
Kinesiotaping will be applied to increase proprioceptive awareness of the knee joint. Taping will be applied using the *"Y" technique and *"I" technique, focusing on medial and lateral support. The kinesio tape will remain in place for 3 days, followed by a 1-day break, and then reapplied. Tape changes will be performed by a physical therapist for a total of 8 weeks.
干预措施: Timed Up and Go Test (TUG) (Other)
Kinesiotaping Group (KB)
Kinesiotaping will be applied to increase proprioceptive awareness of the knee joint. Taping will be applied using the *"Y" technique and *"I" technique, focusing on medial and lateral support. The kinesio tape will remain in place for 3 days, followed by a 1-day break, and then reapplied. Tape changes will be performed by a physical therapist for a total of 8 weeks.
干预措施: 10-Meter Walking Test (Other)
Kinesiotaping Group (KB)
Kinesiotaping will be applied to increase proprioceptive awareness of the knee joint. Taping will be applied using the *"Y" technique and *"I" technique, focusing on medial and lateral support. The kinesio tape will remain in place for 3 days, followed by a 1-day break, and then reapplied. Tape changes will be performed by a physical therapist for a total of 8 weeks.
干预措施: Stroke-Specific Quality of Life Scale (Other)
结局指标
主要结局
Measurement of knee joint position sense
时间窗: 2 months
Knee joint position sense will be evaluated using active and passive joint position sense tests. Prior to testing, the limb will be passively moved 10 times to prepare for the movement. The Physiomaster mobile application will be used to measure the angular difference between the affected and unaffected knees at the end of the movement. Active joint position sense will be measured by asking participants to replicate a 45° knee flexion angle with their eyes closed. The angular error will be calculated. Passive joint position sense will be assessed by passively positioning the knee, then asking participants to estimate the angle after returning to the starting position. Repetitive flexion and extension movements will be performed, and error detection will be recorded. Placebo movements will be included in the evaluation.
次要结局
- Berg Balance Scale (BBS)(2 months)
- Timed Up and Go Test (TUG)(2 months)
- 10-Meter Walk Test (10MWT)(2 months)
- Stroke-Specific Quality of Life Scale (SS-QOL)(2 months)
研究者
Sezen Pehlivan
Master's Student
Medipol University