Neuropilates and Otago Exercises on Balance, Posture and Functional Independence in Chronic Stroke

Official title

Comparative Effects of Neuropilates and Otago Exercises on Balance, Posture and Functional Independence in Individuals With Chronic Stroke

Overview

This randomized clinical trial will be conducted at various physical therapy clinics of Faisalabad over a six-month period, enrolling a total of 32 participants selected through non probability convenience sampling technique. Participants will be randomly assigned to one of two groups: those undergoing Neuropilates and those performing Otago exercises, with each group consisting of 16 individuals. Assessments will utilize the TUG (Timed Up and Go) to evaluate balance, the Postural Assessment Scale for Stroke Patients (PASS) for posture, and the Functional Independence Measure (FIM) for functional independence. Pre-intervention assessments will establish baseline measures, followed by evaluations at 4 weeks, and post-intervention to track progress. Data analysis will be conducted using SPSS 26 software, allowing for a comprehensive comparison of the interventions' effectiveness. The findings from this study will contribute valuable insights for clinicians and rehabilitation specialists, enhancing therapeutic strategies to support chronic stroke patients in regaining their independence.

Detailed description

Chronic stroke survivors often face profound challenges that considerably impact their balance, posture, and functional independence. These issues can compromise their ability to perform daily activities, reduce their quality of life, and lead to increased dependency on caregivers. Effective rehabilitation strategies are essential for improving these aspects of recovery. Neuropilates, a novel approach that merges the foundational principles of Pilates with targeted neurological rehabilitation techniques, has shown promise in enhancing physical and cognitive function. By focusing on core strength, flexibility, and body awareness, Neuropilates aims to facilitate motor learning and improve overall stability. This study is designed to compare the effectiveness of Neuropilates with Otago exercises-an evidence-based program specifically designed to enhance strength and balance in older adults-on key rehabilitation outcomes for individuals living with chronic stroke. The Otago program emphasizes lower limb strength and balance training, making it a relevant comparison for assessing improvements in functionality.

The randomized clinical trial will be conducted at various physical therapy clinics of Faisalabad over a six-month period, enrolling a total of 32 participants selected through non probability convenience sampling technique. Participants will be randomly assigned to one of two groups: those undergoing Neuropilates and those performing Otago exercises, with each group consisting of 16 individuals. Assessments will utilize the TUG (Timed Up and Go) to evaluate balance, the Postural Assessment Scale for Stroke Patients (PASS) for posture, and the Functional Independence Measure (FIM) for functional independence. Pre-intervention assessments will establish baseline measures, followed by evaluations at 4 weeks, and post-intervention to track progress. Data analysis will be conducted using SPSS 26 software, allowing for a comprehensive comparison of the interventions' effectiveness. The findings from this study will contribute valuable insights for clinicians and rehabilitation specialists, enhancing therapeutic strategies to support chronic stroke patients in regaining their independence.

Interventions

• Other neuropilates
  50 minutes session of Neuropilates thrice a week for total of eight weeks which will include activation warm-up exercises for 10 minutes, main exercises for 30 minutes and cool-down exercises for 10 minutes
• Other otago exercises
  50 minutes each session of Otago exercise thrice a week for total of eight weeks which will include, muscle strengthening, balance training and 2x week 30 minutes walking session. Depending on the individual's strength and mobility, the exercises will be progressed, by increasing the amount of repetitions or weight

Primary outcome measures

• The Postural Assessment Scale for Stroke (PASS) [Time frame: baseline, 4thweek, 8thweek]
• The Functional Independence Measure (FIM) [Time frame: baseline, 4thweek, 8thweek]
• Timed Up and Go (TUG) [Time frame: baseline, 4thweek , 8thweek]

Eligibility criteria

Inclusion criteria

• Age 40-70 years
• Both male and female
• Chronic stroke, 6-18 months post-stroke
• Stroke severity score >6 on NIHSS
• MMSE ≥24

Exclusion criteria

• • Symptoms of global or receptive aphasia

• Other neurological disorders: tumors, anoxia, TBI, neurodegenerative diseases, ataxia.
• Significant cardiorespiratory conditions
• Currently receiving other complementary interventions
• Severe motor impairment preventing safe participation

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

Healthy volunteers: No

Study design

Allocation

Randomized

Model

Parallel assignment

Masking

Single blind

Primary purpose

Treatment

Study locations

Pakistan · 3 centers

• Al-Mahmood Physiotherapy Clinic — Faisalabad
• Faisal Hospital Faisalabad — Faisalabad
• Syeda Khatoon e Jannat Trust Hospital — Faisalabad

Publications

• Cronin E, Broderick P, Clark H, Monaghan K. What are the effects of pilates in the post stroke population? A systematic literature review & meta-analysis of randomised controlled trials. J Bodyw Mov Ther. 2023 Jan;33:223-232. doi: 10.1016/j.jbmt.2022.09.028. Epub 2022 Sep 29. PMID 36775522
• Chen SC, Lin CH, Su SW, Chang YT, Lai CH. Feasibility and effect of interactive telerehabilitation on balance in individuals with chronic stroke: a pilot study. J Neuroeng Rehabil. 2021 Apr 26;18(1):71. doi: 10.1186/s12984-021-00866-8. PMID 33902646

Identifiers

NCT: NCT07293416 · REC/S24C14G37016 Zobia Tariq

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗