THE EFFECTS OF SUBTALAR JOINT MOBILIZATION ON PATIENTS WITH CHRONIC STROKE

NCT03788629 | Completed

• 1 other identifier: 2018500
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

Adequate ankle motion for normal gait ranges from 10° to 15° of dorsiflexion passive range of motion (DF-PROM) to allow the tibia to move over the talus. However, limited ankle mobility is a common impairment in patients with stroke whose DF-PROM has been shown to be approximately half of that in healthy subjects. As a result, these patients have impaired dynamic balance in standing or gait. Mulligan first proposed mobilization with movement (MWM) as a joint mobilization technique. Talocrural MWM to facilitate DF-ROM is performed by applying a posteroanterior tibia glide over a fixed talus while the patient actively moves into a dorsiflexed position while standing. Talocrural MWM has been applied to chronic ankle instability and has been proven effective in improving DF-PROM and standing balance. Subtalar MWM to facilitate DF-ROM is performed by bringing foot to dorsiflexion-abduction-eversion by flexing patient' knee. The effects of subtalar MWM have not been investigated in patients with stroke. Therefore, the purpose of the present study is to examine the effects of subtalar MWM on muscle strength, balance, functional performance, and gait parameters in patients with chronic stroke.

Conditions

Hemiplegia, Spastic

Keywords

hemiplegia; foot; mobilization

Outcome Measures

Primary Outcomes (1)

• Isokinetic Strength Dynamometer

  Maximal concentric contraction was measured for the dorsiflexors and plantarflexors using an isokinetic dynamometer (Biodex System Pro 4 Isokinetic Strength Dynamomter , Inc., Shirley, NY). The participants were seated with the ankle joint axis aligned.with the mechanical axis of the dynamometer. A performed practice trial to familiarize themselves with the test protocol, the participants were instructed to push and pull the attachment as hard and as fast as possible. Five maximum concentric contractions were performed at 30°/s and the peak torque generated over 5 repetitions was recorded and normalized to body weight (Nm/kg).

  6 weeks

Secondary Outcomes (3)

• Timed up and Go Test

  6 weeks

• Berg Balance Scale

  6 weeks

• Biodex Gait Trainer Treadmill System (BGTTS)

  6 weeks

Study Arms (2)

Study Group 1

EXPERIMENTAL

Bobath Concept+ Talocrural joint Mulligan MWM techniques were applied to this group.

Other: Talocrural joint MWM mobilization

Study Group 2

ACTIVE COMPARATOR

Subtalar joint Mulligan MWM techniques were applied to this group in addition to Bobath Concept+ Talocrural joint Mulligan MWM techniques

Other: Subtalar joint MWM mobilization

Interventions

Talocrural joint MWM mobilization OTHER

There were two groups for this study. In addition to Bobath Concept, talocrural joint mobilization was performed.

Study Group 1

Subtalar joint MWM mobilization OTHER

There were two groups for this study. In addition to treatment of control group, subtalar joint mobilization was performed.

Study Group 2

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• hemiplegic stroke (\>6 months post stroke),
• ability to perform a single-leg lunge on the paretic lower limb onto a stool from a standing position,
• ability to walk without an assistive device for more than 10 m,
• limited dorsiflexion passive ROM with contracture of the paretic ankle, and capability of following simple verbal instructions.

You may not qualify if:

• visual impairment,
• unilateral neglect,
• aphasia.
• contraindications for joint mobilization (i.e., ankle joint hypermobility, trauma, or inflammation),
• ankle sprain in the previous 6 weeks,
• any history of ankle surgery,
• and those concurrently receiving similar interventions outside of the present study

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Caner KARARTI

Kırşehir, 40100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Hemiplegia

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: CARE PROVIDER
• Masking Details: Single blinded
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Caner Karartı, Hacettepe University

Model Details: Randomized

Study Record Dates

• First Submitted: December 25, 2018
• First Posted: December 27, 2018
• Study Start: June 30, 2018
• Primary Completion: August 20, 2018
• Study Completion: September 20, 2018
• Last Updated: April 7, 2020

Record last verified: 2020-04

Locations

TU (1)