Effect of Integrated Cueing on Functional Transfers in Chronic Stroke Survivors

NCT04498429 | Completed DMC

• 1 other identifier: 5200090
• Study Type: interventional
• Target: 21
• Locations: 1 country
• Sites: 2

Brief Summary

Physical therapists frequently use manual cueing as a tool to improve movement quality in persons recovering from stroke but evidence to support its effectiveness is lacking. The purpose of this graduate student research study is to determine the immediate and carryover effects of an integrated verbal and manual facilitation approach used by physical therapists during sit to stand training on the midline alignment, muscle activation and quality of movement in chronic stroke survivors with hemiplegia.

Conditions

Hemiplegia and/or Hemiparesis Following Stroke

Keywords

Facilitation; Sit-to-Stand; Manual Cueing; Verbal Cueing

Outcome Measures

Primary Outcomes (4)

• Midline Orientation via Symmetry Ratio

  The participant's ability to equally distribute their weight throughout the sit to stand task will be measured via two force plates integrated with the Qualisys motion capture system. The ratio is calculated via dividing the weight on the hemiparetic leg by the weight on the non-hemiparetic side. A score of 1 indicates equal weight bearing.

  Baseline and immediately after the intervention

• Midline Orientation via Trunk Lateral Lean angle

  The participant's ability to maintain an upright trunk throughout the sit to stand task as measured by computations from the Qualisys motion capture system using 40 trajectory markers. Perfect midline orientation would be a value of 0 degrees indicating midline orientation.

  Baseline and immediately after the intervention

• Muscle Activation

  Comparison of muscle activation between normal and hemiparetic lower extremity extensor muscle groups as measured with surface electromyography (EMG) and processed through the Qualisys motion capture system. Change will be indicated by subtracting max contraction per various extensor muscle groups as a composite measure during the activity from initial max contraction of the same muscle group.

  During after the intervention

• Time to complete Sit to Stand Activity

  A measurement of the total elapsed time to perform the sit to stand activity as measured from initial movement to highest position of center of mass

  Baseline and immediately after the intervention

Study Arms (2)

Integrated Manual and Verbal Cueing Group

EXPERIMENTAL

A series of 40 training repetitions of sit to stand using the Integrated/Manual Cueing intervention.

Other: Integrated Cueing Protocol

Verbal Cueing Group

EXPERIMENTAL

A series of 40 training repetitions of sit to stand using the Verbal Cueing intervention

Other: Verbal Cueing Protocol

Interventions

Integrated Cueing Protocol OTHER

The first 5 repetitions will include part to whole task practice of partial sit to stand using scripted verbal cueing to facilitate understanding of the task. The goal is to improve midline orientation and alignment during the task of moving from sitting to standing. In addition to verbal cueing, the manual cueing group will receive hands-on tactile facilitation from a trained physical therapist to facilitate appropriate midline weight shift during the sit to stand activity for the series of 40 training repetitions.

Also known as: Manual Cueing Protocol

Integrated Manual and Verbal Cueing Group

Verbal Cueing Protocol OTHER

The first 5 repetitions will include part to whole task practice of partial sit to stand using scripted verbal cueing to facilitate understanding of the task. The goal is to improve midline orientation and alignment during the task of moving from sitting to standing. The verbal cueing protocol consists of verbal cueing from a trained physical therapist to facilitate appropriate midline weight shift during the sit to stand activity for the series of 40 training repetitions.

Verbal Cueing Group

Eligibility Criteria

• Age: 21 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Chronic Right CVA with left hemiplegia \> 6 Months
• Able to ambulate with no more than help than supervision
• Must be able to stand without an assistive device or ankle foot orthosis
• Must be able to follow two-step verbal commands

You may not qualify if:

• History of injury from a recent fall within the last 3 months
• Currently participating in rehabilitation during the time frame of their participation in this study
• Additional musculoskeletal or neurological conditions that may impair ability to perform sit to stand safely

Sponsors & Collaborators

• Loma Linda University: lead

Study Sites (2)

Loma Linda University Health

Loma Linda, California, 92350, United States

Location

Loma Linda University

Loma Linda, California, 92350, United States

Location

Study Officials

• Eric G Johnson, DSc

  Loma Linda University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor

Study Record Dates

• First Submitted: July 28, 2020
• First Posted: August 4, 2020
• Study Start: November 6, 2020
• Primary Completion: August 24, 2022
• Study Completion: August 24, 2022
• Last Updated: February 2, 2024

Record last verified: 2024-02

Data Sharing

• IPD Sharing: Will not share

Locations

US (2)