Examining the Effectiveness of Video-Based Proprioceptive Home Exercise Program in Amyotrophic Lateral Sclerosis Patients
Overview
- Phase
- Not Applicable
- Status
- Recruiting
- Sponsor
- Tarsus University
- Enrollment
- 20
- Locations
- 1
- Primary Endpoint
- muscle strength assesment
Overview
Brief Summary
In the project, it was aimed to evaluate the proprioceptive system in the disease, which is still mysterious and therefore has no curative treatment under current conditions, and to examine the effects of the video-based proprioceptive home exercise programme on trunk and limb control and daily life activity as well as trunk and limb control. The study was planned to include 20 patients with a definite diagnosis of ALS. Proprioceptive sensory examination will be performed again in these patients, who are currently being followed up with ALS diagnosis and whose physical examination including neurological examination has been performed in detail, and the "Revised Amyotrophic Lateral Sclerosis Functional Rating Scale" (R-ALSFRS) will be applied to the patients. Subsequently, the patients will be followed up by applying a video-based proprioceptive home exercise programme 3 days a week for 8 weeks. At the end of the 8th week, a detailed neurological examination including proprioceptive sensation will be performed and the R-ALSFRS scale will be applied. In addition, ALS quality of life scale will be applied to the patients before and after the home programme. The data obtained after the treatment programme will be analysed and interpreted.
Detailed Description
Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease characterised mainly by degeneration of upper and lower motor neurons. In recent years, the disease paradigm has changed and ALS has been increasingly recognised as a multi-systemic disease in which the sensory system is also affected rather than a disease limited to motor neurons. The proprioceptive system is the primary sensory system that is vital in managing motor control. Recent studies suggest that sensory impairment may occur early in ALS and that there is degeneration in proprioceptive sensory neurons. However, in the current literature, there is no study that clinically evaluates proprioception in ALS patients or provides proprioceptive training to patients. In addition, progressive muscle degeneration is frequently seen in the trunk and distal muscles in ALS, which negatively affects trunk control and leads to a decrease in the independence of patients in daily life activities and thus quality of life. In the project, it was aimed to evaluate the proprioceptive system in the disease, which is still mysterious and therefore has no curative treatment under current conditions, and to examine the effects of the video-based proprioceptive home exercise programme on trunk and limb control and daily life activity as well as trunk and limb control. The study was planned to include 20 patients with a definite diagnosis of ALS. Proprioceptive sensory examination will be performed again in these patients, who are currently being followed up with ALS diagnosis and whose physical examination including neurological examination has been performed in detail, and the "Revised Amyotrophic Lateral Sclerosis Functional Rating Scale" (R-ALSFRS) will be applied to the patients. Subsequently, the patients will be followed up by applying a video-based proprioceptive home exercise programme 3 days a week for 8 weeks. At the end of the 8th week, a detailed neurological examination including proprioceptive sensation will be performed and the R-ALSFRS scale will be applied. In addition, ALS quality of life scale will be applied to the patients before and after the home programme. The data obtained after the treatment programme will be analysed and interpreted. In the literature, the number of publications on proprioception in ALS patients is very limited. The successful completion of this project will shed light on the pathogenesis of the disease and will contribute to the planning of new researches at national and international level.
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to 70 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Inclusion Criteria:
- •ALS patients aged 18-70
- •Those with a definite ALS diagnosis according to the Gold Coast criteria
- •Those who can sit independently
- •Those who have no cognitive problems
- •Those who agree to participate in the study will be included in the study.
Exclusion Criteria
- •ALS patients with neurological, orthopedic or visual dysfunction mimicking ALS,
- •Those who cannot complete active joint movements in the upper and lower extremities,
- •ALS patients who do not agree to participate in the study will not be included in the study.
Outcomes
Primary Outcomes
muscle strength assesment
Time Frame: 1st week and 7th week
The muscle strength assessment of ALS patients will be performed with Hoggan microFET2 (Hoggan Scientific, LLC, Salt Lake City UT, USA). It is a hand-held dynamometer. Patients are asked to perform the movement at maximum force without using a compensation mechanism, and the researcher applies resistance in the opposite direction of the movement without creating any movement in the joint, in a way that creates isometric contraction. The strength of the hip flexor, quadriceps femoris, shoulder flexor, elbow extensor, elbow flexor, trunk extensor and flexor muscles will be evaluated. 3 measurements will be taken for each muscle group and the average will be taken. There will be a 30-second rest period between measurements. The evaluations will be made by the physiotherapist.
proprioception assessment
Time Frame: 1st week and 7th week
For proprioception assessment, upper extremity position sense, lower extremity position sense and trunk position sense will be assessed. Assessment of position sense J-Tech™ dual Inclinometer will be used to assess position sense. Participants will be asked to stand in a static position. For upper extremity position sense, measurements will be made in 3 separate tests with the shoulder at 60 degrees of flexion, 60 degrees of abduction and the elbow at 65 degrees of flexion. First, individuals will be asked to learn the target angle with their eyes open, then they will be asked to find the target angle with their eyes closed. Both extremities will be measured with an inclinometer and recorded. Each measurement will be performed 3 times and the average of the 3 measurements will be used for the final analysis. The knee joint will be evaluated for lower extremity position sense measurement. The knees of the errors will be flexed to 60 degr
functional status
Time Frame: 1st week and 7th week
Revised Amyotrophic Lateral Sclerosis Functional Rating Scale (R-ALSFRS) This scale, which determines the functional status of ALS patients, is the most frequently used scale in daily practice and in studies on the subject and consists of 12 headings, each scored between 0-4. While a functionally normal patient receives 48 points, the scores decrease downward due to functional deterioration. The Turkish validity and reliability study of the scale was conducted by Koç et al.
Secondary Outcomes
- Trunk control(1st week and 7th week)
- QoL(1st week and 7th week)
Investigators
Evrim GÖZ
Assoc. Prof.
Tarsus University