Effect of Soleus Muscle Kinetic Control Training on Gait and Electromyographic Activity in Patients With Stroke

Overview

this study was designed to investigate the effect of soleus muscle kinetic control training on Gait and electromyographic activity of the calf muscle in patients with stroke

Detailed description

Stroke is a neurological condition characterized by a reduced blood supply to the brain tissue, resulting in paralysis of part or all of the body, limiting physical activity and social participation. Gait impairment accounts for the largest proportion of physical activity limitations in stroke patients and is characterized by muscle weakness, foot drop, spasticity, and foot deformity .Gait abnormalities following stroke are often disabling. Reduced ankle dorsiflexion, knee flexion, or hip flexion torques are often postulated causes of compromised toe clearing during the swing phase of gait. conversely, gait asymmetry and reduced walking speed has been attributed to weakness of the planter flexors.The kinetic control comprises balanced presentation of the movement choices with ideal interaction among the key components for the sensorimotor neuromuscular control that mediated by afferent sensory input, particularly the proprioceptive input, CNS integration, optimal motor co-ordination, and physiological stresses to assure functional dynamic stability and controlled mobility. forty patients with stroke will be assigned to two groups; one group will recieve kinetic control plus conventional therapy and control group will receive conventinoal therapy alone.

Interventions

• Other soleus kinetic control
  patients will receive kinetic control for 30 minutes structural progressive training for the soleus muscle guided by the EMG biofeedback plus conventional therapy; 1)Start in crook lying position with the heels level with the pelvis and lift the pelvis clear of the floor followed by bilateral heel raise,2)Progress further by shifting weight onto one leg and holding the heel raise and slowly lowering eccentrically on 1 foot, the next progression is to perform the same movement with the heels lowe
• Other conventional therapy
  the patients will receives conventional physiotherapy program static stretching and stretching board for calf muscle, stretching board, and push off exercises by having the patient push against the therapist or a treatment table during forward gait ( 30 minute), static stretch(30sec\\set , rest 20sec\\set total 5 set, 3 times \\week , for 8 week ), stretching board (4 min\\set , rest 1 min\\set total 2 set , 3 times \\week , for 8 week ) (10 minute) push off training (15 minute 3 times \\week ,

Primary outcome measures

• muscle amplitude [Time frame: up to eight weeks]
• giat function [Time frame: up to eight weeks]
• Gait Cycle time [Time frame: up to eight weeks]
• step time [Time frame: up to eight weeks]
• cadence [Time frame: up to eight weeks]
• stance phase percentage [Time frame: up to eight weeks]
• swing phase percentage [Time frame: up to eight weeks]
• single and double support percentage [Time frame: up to eight weeks]
• first and second double support percentage [Time frame: up to eight weeks]
• stride length [Time frame: up to eight weeks]

Eligibility criteria

Inclusion criteria

• Ischemic or hemorrhagic stroke, as confirmed by CT and or MRI scan.
• Age of the patients between 45 to 60 years old.
• Ability to walk a minimum of 10 m with or without some physical assistance from a therapist (functional ambulation category more than 2).
• Demonstrate weakness of the foot muscles, measured by muscle function tests according Medical Research council scale more than 3.
• Muscle tone of the affected lower limb ranges from 1 to +1 according to modified Ashworth scale.

Exclusion criteria

• Unilateral neglect, hemianopia, or apraxia
• Having any other neurological disorder affecting their lower extremities e.g. MS, Parkinsonism, peripheral neuropathy.
• Patients with previous fractures in lower limb (Ankle or foot).
• Patients with musculoskeletal disorder such as severe arthritis, ankle surgery, leg length discrepancy or contractures of fixed deformity of ankle joint.
• Patients with visual, auditory impairment affecting their ability to complete tasks.
• Patients with cognitive impairments

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

Center list to be confirmed — check the primary protocol.

Identifiers

NCT: NCT07309081 · P.T.REC/012/006089

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗