Active Isolated Stretch and Post Facilitation Stretch on Hamstring Flexibility in Trans-tibial Amputees.

NCT04588753 | Completed

• 1 other identifier: REC/00680 Tehmina Khan
• Study Type: interventional
• Target: 38
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to examine the effect of two techniques on hamstrings flexibility in trans-tibial amputees. Reduced flexibility can cause insufficiency at the workplace. Increasing flexibility is to decrease risk of injury, enhances performance and incorporate rehabilitation programs . Further studies are still needed in order to enhance patient rehabilitation protocol and anticipate the prosthetic process. Evidence based Physical therapy could be considered a valid support improving knee contractures in patients with trans-tibial amputation.This research provide an important addition to the evidence-based treatment intervention of physical therapy in amputees rehabilitation as no comparative study between Active Isolated Stretch and Post Facilitation Stretch on hamstring flexibility is done in trans-tibial Amputees.

Conditions

Amputation

Keywords

Trans-tibial Amputees; Isolated Stretch; Post Facilitation Stretch

Outcome Measures

Primary Outcomes (1)

• Active Knee Extension Test (AKE)

  used to measure hamstring flexibility. The subject be asked to lie in supine position with the non-tested limb and the pelvis will be strapped to the plinth for stabilization. The tested leg will be positioned in 90 degrees of hip flexion and the knee flexed. Hip flexion will be maintained through the use of a crossbar to maintain the proper position of hip and thigh. A full circle universal goniometer will be used to measure the angle of knee ROM. The fulcrum of the goniometer will be centered over the lateral condyle of the femur with the fixed arm secured along the femur using the greater trochanter as a reference. The movable arm will be aligned with the lower leg using the lateral malleolus as a reference. Subject will be asked to actively extend the tested knee as far as possible until a mild stretch sensation is felt. The procedure will be repeated 3 times and the average will be taken for analysis. Amputees having short hamstring (\>15- 30 degrees loss of knee extension)

  2 weeks

Study Arms (2)

Active Isolated Stretch

ACTIVE COMPARATOR

active isolated stretching, strengthening exercises

Other: active isolated stretch

Post Facilitation Stretch

ACTIVE COMPARATOR

Post Facilitation Stretching, strengthening exercises

Other: Post Facilitation Stretch

Interventions

active isolated stretch OTHER

Active Isolated Stretch (AIS); * The shortened hamstring muscle will be isolated. * The hamstring will be stretched. * This Stretches will be Repeated eight to 10 times. * Stretch will be hold for no more than two seconds. * Exhale on the stretch; inhale on the release. Other amputees training exercises; * weight-shifting * Dynamic balancing activities * Stool stepping * Braiding * Gait exercises * Climbing/descending the stairs

Active Isolated Stretch

Post Facilitation Stretch OTHER

Participants of this group will receive Post Facilitation Stretch (PFS); * The shortened hamstring muscle will be placed between a fully stretched and a fully relaxed state. * The patient will be asked to contract the hamstring using a maximum degree of effort for 5-10 seconds while the therapist will resists thepatients force. * The patient will be then asked to relax and release the effort, whereas the therapist will apply a rapid stretch to a new barrier and is held for 10 seconds. * The patient relaxes for approximately 20 seconds and the procedure will be repeated to five times (8) (18). 2\. Other amputees training exercises; * weight-shifting * Dynamic balancing activities * Stool stepping * Braiding * Gait exercises * Climbing/descending the stairs

Post Facilitation Stretch

Eligibility Criteria

• Age: 15 Years - 30 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Unilateral Trans-tibial amputees.
• Amputees having short hamstring (\>15- 30 degrees loss of knee extension)
• Patients with traumatic cause of amputation.
• Patients that are mentaly stable.
• Patients having no other physical problems than amputation.
• Patient aged between 15 and 30 years.
• year post amputation and ambulatory with a prosthesis.
• Both male and female patients

You may not qualify if:

• Amputees other than trans-tibial amputees.
• Patients having other cause of amputation than traumatic.
• Requiring intervention before the amputation

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

PIPOS Rehabilitation Services Program

Peshawar, Khyber Pakhtunkhwa, 25000, Pakistan

Location

Related Publications (6)

• Jabeen N, Malik S. Prevalence and pattern of traumatic limb amputations in female population of Bhimber District, Azad Jammu and Kashmir, Pakistan. Pak J Med Sci. 2015 Jan-Feb;31(1):54-9. doi: 10.12669/pjms.311.6423.

  PMID: 25878614 BACKGROUND

• Kwan MK, Penafort R, Saw A. Treatment for flexion contracture of the knee during Ilizarov reconstruction of tibia with passive knee extension splint. Med J Malaysia. 2004 Dec;59 Suppl F:39-41.

  PMID: 15941159 BACKGROUND

• Ghazali MF, Abd Razak NA, Abu Osman NA, Gholizadeh H. Awareness, potential factors, and post-amputation care of stump flexion contractures among transtibial amputees. Turk J Phys Med Rehabil. 2018 Jul 12;64(3):268-276. doi: 10.5606/tftrd.2018.1668. eCollection 2018 Sep.

  PMID: 31453521 BACKGROUND

• Yigiter K, Sener G, Erbahceci F, Bayar K, Ulger OG, Akdogan S. A comparison of traditional prosthetic training versus proprioceptive neuromuscular facilitation resistive gait training with trans-femoral amputees. Prosthet Orthot Int. 2002 Dec;26(3):213-7. doi: 10.1080/03093640208726650.

  PMID: 12562068 BACKGROUND

• Wrisley DM, Marchetti GF, Kuharsky DK, Whitney SL. Reliability, internal consistency, and validity of data obtained with the functional gait assessment. Phys Ther. 2004 Oct;84(10):906-18.

  PMID: 15449976 BACKGROUND

• Page P. Current concepts in muscle stretching for exercise and rehabilitation. Int J Sports Phys Ther. 2012 Feb;7(1):109-19.

  PMID: 22319684 BACKGROUND

Study Officials

• Shafaq Shahid, MSPT(OMPT)

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 9, 2020
• First Posted: October 19, 2020
• Study Start: December 1, 2019
• Primary Completion: December 20, 2020
• Study Completion: December 20, 2020
• Last Updated: December 22, 2020

Record last verified: 2020-12

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)