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Muscle Oxygenation and Spasticity in Hemiparetic Stroke Patients

Completed
Conditions
Stroke
Hemiparesis;Poststroke/CVA
Spasticity as Sequela of Stroke
Interventions
Other: Assessment
Registration Number
NCT06362954
Lead Sponsor
Ankara Medipol University
Brief Summary

Conditions such as hemiparesis, sensory and motor impairment, perceptual impairment, cognitive impairment, aphasia, and dysphagia may be observed after stroke. Motor impairment after stroke may occur due to damage to any part of the brain related to motor control. There is much clinical evidence that damage to different parts of the sensorimotor cortex in humans affects other aspects of motor function. Loss of strength, spasticity, limb apraxia, loss of voluntary movements, Babinski sign, and motor neglect are typical motor deficits following a cortical lesion (upper motor neuron lesion). Post-stroke spasticity can be seen in 19% to 92% of stroke survivors. Post-stroke hemiparesis is a significant cause of morbidity and disability, along with abnormal muscle tone. It has also been recognized that post-stroke hemiparesis may occur without spasticity. Spasticity influences muscle hemodynamic and oxidative metabolism, but its impact on the balance between oxygen delivery and utilization is not well understood.

This study study aims to investigate the effect of spasticity severity on peripheral muscle oxygenation in patients with hemiparetic stroke.

Detailed Description

Conditions such as hemiparesis, sensory and motor impairment, perceptual impairment, cognitive impairment, aphasia, and dysphagia may be observed after stroke. Motor impairment after stroke may occur due to damage to any part of the brain related to motor control. There is much clinical evidence that damage to different parts of the sensorimotor cortex in humans affects other aspects of motor function. Loss of strength, spasticity, limb apraxia, loss of voluntary movements, Babinski sign, and motor neglect are typical motor deficits following a cortical lesion (upper motor neuron lesion). Post-stroke spasticity can be seen in 19% to 92% of stroke survivors. Post-stroke hemiparesis is a significant cause of morbidity and disability, along with abnormal muscle tone. It has also been recognized that post-stroke hemiparesis may occur without spasticity. Spasticity influences muscle hemodynamic and oxidative metabolism, but its impact on the balance between oxygen delivery and utilization is not well understood.

Motor deficits seen in stroke patients and the conditions caused by them cause various limitations in the daily life of patients and affect their participation in daily life and quality of life. Decreased involvement in daily life negatively affects patients both socially and financially. Evaluating and identifying the disorders, taking preventive and developmental measures, and establishing treatment programs are necessary to increase participation. Therefore, objective and accurate assessment significantly affects the progress of the process.

Medical and surgical treatment and physiotherapy and rehabilitation approaches constitute the basis of treatment in stroke disease. The treatment of patients is carried out using a multidisciplinary approach involving many fields, such as medical and surgical treatment, physiotherapy, and rehabilitation practices. For this reason, it is seen that the financial burden, which cannot be covered by the insurance system from time to time, is relatively high. This burden is gradually increasing in direct proportion to the needs of the patients. For this reason, it is essential to develop practices and strategies for the patient's objective and most accurate evaluation, follow the clinical course, and create the most appropriate treatment program.

Although it is not among the routine evaluation methods, considering the studies conducted, "muscle oxygenation" should be considered in the evaluation phase in line with the possibilities.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
30
Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
High-Level SpasticityAssessmentHemiparetic stroke patients with spasticity levels 3 and 4 on The Modified Ashworth Scale
Low-Level SpasticityAssessmentHemiparetic stroke patients with spasticity levels between 1 and 2 on The Modified Ashworth Scale
No SpasticityAssessmentHemiparetic stroke patients with spasticity level 0 on The Modified Ashworth Scale
Primary Outcome Measures
NameTimeMethod
Gastrocnemius Muscle OxygenationDay 1

Gastrocnemius muscle oxygenation will be evaluated with Near-Infrared Spectroscopy at rest, during and after the 6-Minute Walk Test (6MWT) and the Stair Climbing Test (SCT).

SpasticityDay 1

Plantar flexor muscle spasticity on the affected side will be evaluated with Modified Ashworth Scale

Secondary Outcome Measures
NameTimeMethod
Motor FunctionDay 1

Motor function of the affected limb was assessed using the leg and foot sections of the Chedoke-McMaster Stroke Assessment (1-7 scale).

Disability LevelDay 1

Disability level was determined using the Modified Rankin Scale, which ranges from 0 (no symptoms) to 6 (death).

6-Minute Walk TestDay 1

Submaximal functional capacity will be evaluated with 6-Minute Walk Test during muscle oxygenation measurement.

Stair Climbing TestDay 1

Maximal functional capacity will be evaluated with Stair Climbing Test during muscle oxygenation measurement.

Adipose tissue thicknessDay 1

The skinfold thickness of gastrocnemius muscle was evaluated with a Skinfold Caliper. Adipose tissue thickness was obtained by dividing the skinfold thickness by two.

Trial Locations

Locations (1)

Gazi University, Faculty of Health, Department of Physiotherapy and Rehabilitation

🇹🇷

Ankara, Turkey

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