Spinal Straightness, Posture And Balance, Physical Performance And Energy Consumption In Individuals With Stroke

Official title

Investigation Of The Relationship Between Spinal Straightness And Posture And Balance, Physical Performance And Energy Consumption In Individuals With Stroke

Overview

Patients diagnosed with ischemic or hemorrhagic stroke who applied to Kırıkkale University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation will be included in the study. The aim of our study is to investigate the relationship between spinal alignment, posture and weight transfer symmetry with balance, physical performance and energy expenditure in stroke patients.

Detailed description

Patients diagnosed with ischemic or hemorrhagic stroke who applied to Kırıkkale University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation will be included in the study. The number of patients to be included in our study will be determined by power analysis.

Sociodemographic information (Age, Gender, Body Mass Index, Dominant Side) of the individuals included in the study will be recorded.

Information about the stroke (cause of stroke, time elapsed since stroke, side of involvement, neglect after stroke, comorbidities, history of falls in the last six months and 1 year, use of assistive devices, etc.) will be recorded.

1. Motor assessment The motor level of the individuals will be assessed according to the Brunnstrom Assessment. Upper and lower extremities will be evaluated separately. 2. Posture assessment Within the scope of the posture assessment of the individuals, Spinal Mouse, a computer-aided device, will be used for spinal alignment, and Postural Symmetry Index and Weight Transfer Symmetry will be calculated. 3. Balance Trunk control will be assessed with the Postural Assessment Scale for Stroke Patients (PASS), standing balance will be assessed with the Minibestest, Functional reach test (FUT) and timed get up and walk test (ZKTY) 4. Physical performance assessment Six-minute walk test and 5 times sit and stand test will be used to evaluate physical performance. In addition, physiologic energy expenditure index will be calculated during the six-minute walk test.

When we examine the literature, there are many separate studies on the alignment of the pelvis after stroke, weight transfer symmetry, postural control and energy consumption of individuals with stroke. However, there is a lack of studies on spinal alignment in stroke patients in general. Therefore, the aim of this study was to investigate the relationship between spinal alignment, posture and weight transfer symmetry with balance, physical performance and energy expenditure in stroke patients.

Interventions

• Device use of spinal mouse
  Spinal Mouse (SM) is an external non-invasive measurement device that evaluates the spinal angle and shape in the frontal and sagittal planes
• Diagnostic test Brunnstrom's Hemiplegia Recovery Staging
  According to Brunnstrom's stages of recovery, the individual will be identified at which stage
• Diagnostic test The six minute walking test (6MWT)
  It evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation
• Diagnostic test Functional Reach Test (FRT)
  Functional Reach Test (FRT) is a clinical outcome measure and assessment tool for ascertaining dynamic balance in in simple task. In standing, measures the distance between the length of an outstretched arm in a maximal forward reach, while maintaining a fixed base of support. This information is correlated with risk of falling A number of factors exert a major influence on this evaluation: Research revealed that movement strategy and reduced spinal flexibility both affect reach distance.
• Diagnostic test Mini Balance Evaluation Systems Test (Mini-BESTest)
  This test measures dynamic balance, functional mobility, and gait. It is commonly used in populations who have or have had multiple sclerosis (MS), Parkinson disease (PD), strokes, spinal cord injury (SCI), or cancer. The Mini-BESTest was developed in 2010 from the Balance Evaluation Systems Test (BESTest), then revised in 2013 to clarify inconsistencies in scoring. The scoring instructions were different in the published and online versions. The revision clarified that the Mini-BESTest should
• Diagnostic test The five Times Sit to Stand Test (5x Sit-To-Stand Test)
  It's used to asses functional lower limbs strength, transitional movements, balance, and fall risk in older adults.
• Diagnostic test The Postural Assessment Scale for Stroke (PASS)
  The Postural Assessment Scale for Stroke (PASS) is an outcome measure specifically designed to assess and monitor postural control after stroke. It was developed in 1999 as an adaptation of the Fugl-Meyer Assessment balance subscale\[1\]. It contains 12 four-level items of varying difficulty for assessing ability to maintain or change a given lying, sitting or standing posture
• Diagnostic test Postural Symmetry Index and Weight Transfer Symmetry
  It is a form of measurement in which two scales are used to calculate the weight transferred to the intact and stroke limb. The values obtained as a result of the test are calculated with formulas.
• Diagnostic test Measurement of the craniovertebral angle
  Measurement of the craniovertebral angle; the patient is asked to find the most natural position by flexion and extension of the head in the standing position and a photograph is taken with a digital camera from a distance of 1.5 m to the shoulder level of the patient and this process is repeated 3 times. The images obtained are then digitally calculated with the help of an appropriate program.

Primary outcome measures

• Use of Spinal Mouse [Time frame: day 1]
• Postural Symmetry Index [Time frame: day 1]
• The Postural Assessment Scale (PASS) [Time frame: day 1]
• MINI-BEST TEST [Time frame: day 1]
• Functional reach test (FRT) [Time frame: day 1]
• Timed Up and Go Test (TUG) [Time frame: day 1]
• 6 Minute Walk Test(6MWT) [Time frame: day 1]
• The Five Times Sit to Stand Test (5xSTS) [Time frame: day 1]
• Measurement of the craniovertebral angle [Time frame: day 1]

Eligibility criteria

Inclusion criteria

• Individuals between the ages of 18-75 years diagnosed with stroke
• Volunteering to participate in the study
• Diagnosis of hemorrhagic or ischemic stroke,
• No collaboration and communication problems
• Can walk with assistive device or independently

Exclusion criteria

• Have another neurological, cardiopulmonary or orthopedic problem other than stroke that may affect functionality, ambulation and balance
• Patients who refused to participate in the study and did not give written consent.
• Cooperation and communication problems were determined as

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: No

Study design

Observational model

Other

Study locations

Turkey (Türkiye) · 1 center

• Kırıkkale University — Kirikkale

Identifiers

NCT: NCT06699381 · KirikkaleU-SCEYLAN-001

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗