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A Novel Ballet-inspired Low-impact At-home Workout Programme for Adults with Stroke

Not Applicable
Completed
Conditions
Memory Impairment
Gait, Unsteady
Balance; Distorted
Stroke
Interventions
Other: Usual care
Behavioral: Ballet-inspired workouts
Registration Number
NCT04460794
Lead Sponsor
Chinese University of Hong Kong
Brief Summary

To explore the feasibility of a novel ballet-inspired low-impact at-home workout programme for community-dwelling stroke survivors in Hong Kong.

Detailed Description

A mixed methods exploratory study incorporating a randomised controlled trial (RCT) and qualitative evaluation will be conducted. A total of 40 stroke participants will be recruited from two acute public hospitals. Participants will be randomly assigned to receive the interention and usual care, or usual care only. Data will be collected in multiple forms: recruitment/retention rates, adherence to the intervention, journals, field notes, verbal feedback, audio records, semi-structured interviews, and questionnaires on outcomes (balance, confidence in balance, gait, walking endurance). This study is the first of its kind in Hong Kong. Findings will address the cross-cultural applicability of dance interventions and lay the groundwork for examination in a larger-RCT about its effects on survivors' balance, gait and memory.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
32
Inclusion Criteria
  1. aged 18 years or above
  2. clinically diagnosed with a first-ever ischaemic/ haemorrhagic stroke
  3. living in home settings
  4. mild-moderate lower limb paresis with a modified Functional Ambulation Classification (MFAC) of III (Dependent walker) or above
  5. a Montreal Cognitive Assessment (MoCA) score>20
  6. able to follow three-step directions
  7. able to communicate in Cantonese and read Traditional Chinese
  8. their hearing and/or visual disturbances corrected by hearing aids and/or glasses
  9. consent to participate in the study
Exclusion Criteria
  1. diagnosed with transcient ischaemic attack, subdural or epidural haemorrhage
  2. experienced cerebrovascular events due to tumours or head trauma
  3. have pre-existing neurological, cardiovascular or orthopaedic conditions that contradict participation in dancing such as shoulder dislocation, myocardial infarction, seizures or acutes illness
  4. mental condition such as depression, schizophrenia or personality disorder
  5. incomprehensible speech
  6. severe hearing and/or visual disturbance

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Usual care (Group B)Usual careControl participants will continue their usual activities and exercises during the study period. In addition, they will be provided with an information sheet about recommendations with pictorial demonstrations on basic stretching and leg exercises for stroke survivors.
Ballet-inspired workout programme (Group A)Ballet-inspired workoutsParticipants will continue their usual activities and exercises, and in addition, receive an 8-week home-based programme delivered by trained volunteers via hybrid on-site and virtual contacts, and supported by volunteer healthcare professionals. A self-directed resource package will be developed.
Primary Outcome Measures
NameTimeMethod
Change in the participants' level of balanceChange from baseline to immediately after completion of the intervention (over 8 weeks)

The 14-item Mini-Balance Evaluation Systems Test (Mini-BESTest) will be used. It measures four domains: anticipatory postural adjustments, reactive postural control, sensory orientation, dynamic gait. Items are rated on a 3-level scale (0="Severe", 1="Moderate", 2="Normal"). Summed total score=0-28 (higher scores representing better balance ability). Cronbach alpha=0.89-0.94.

Secondary Outcome Measures
NameTimeMethod
Change in the participants' level of balance confidenceChange from baseline to immediately after completion of the intervention (over 8 weeks)

The 16-item Activities-specific Balance Confidence Scale (Chinese version) will be adopted. Participants will rate their confidence in balance associated with performing 16 daily functional activities from 0% (absolutely no confidence) to 100% (fully confident). Summed total score=0-100% (higher scores denotes higher confidence). Cronbach alpha=0.97.

Change in the participants' level of gaitChange from baseline to immediately after completion of the intervention (over 8 weeks)

The 31-item Gait Assessment and Intervention tool (G.A.I.T.) will be used to measure gait: upper extremity and trunk movement control; trunk and lower extremity (stance phase); trunk and lower extremity (swing phase). Each item is scored from 0 (normal) to 3, with gradients of variation from normal (Total score: 0 (normal gait) to 62 (greatest extent of gait deviations)). It has good intra-rater and interrater reliability.

Change in participants' level of memoryChange from baseline to immediately after completion of the intervention (over 8 weeks)

The 11-item Rivermead Behavioural Memory Test - Third Version (Chinese version) will be used. For each task, scores range from 0-2 (2-points=normal; 1-point=intermediate; 0-point=error). Total score=0-254. It demonstrated a high inter-rater reliability. Correlation between performance on parallel forms=0.67-0.84.

Change in participants' level of walking enduranceChange from baseline to immediately after completion of the intervention (over 8 weeks)

The 6-Minute Walk Test (MWT) will be performed in accordance with American Thoracic Society guidelines. The distance walked, the time stopped and reason(s) for stopping prematurely will be recorded. 6MWT, 12MWT, and self-paced gait speed were all significantly highly correlated (r\>0.90).

Trial Locations

Locations (1)

Alice Ho Miu Ling Nethersole Hospital

🇭🇰

Hong Kong, Hong Kong

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