Scapular Training in Stroke Individuals

NCT04743830 | Completed

• 1 other identifier: KA-20074
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

In recent publications evaluating scapular kinematics after stroke, it is emphasized that scapular muscles, which affect the performance of upper limbs in daily life, should not be ignored. When the literature is analyzed for these reasons, the studies in which scapular training was added to the treatment plan of upper limb rehabilitation of stroke individuals are inadequate and the existing studies have methodological deficiencies. Also, it is seen that studies which investigate the effects of these exercises on scapular kinematics, the parameters of periscapular muscle thickness and shoulder subluxation are not included. The purpose of this study is to examine the effects of scapular training on scapular kinematics, periscapular muscle thickness, shoulder subluxation and upper extremity functionality in stroke individuals. The study was planned to include 2 groups, 1 treatment and 1 control group. The control group will receive Neurodevelopmental Treatment - Bobath exercises, while the treatment group will receive exercises for the muscles around the scapula in addition to Neurodevelopmental Treatment - Bobath exercises. Muscle thickness of periscapular muscles, shoulder subluxation, 3D scapular kinematics, upper extremity and trunk performance, pain, activities of daily living and quality of life will be assessed before and after 8 weeks treatment program. As a result; effectiveness of scapular training in addition to Neurodevelopmental Treatment and relationship between scapular kinematics, periscapular muscle thickness, shoulder subluxation, and upper extremity performance will be examined.

Conditions

Stroke

Keywords

Stroke; Muscle Thickness; Scapula; 3-D Kinematics; Upper Extremity Performance

Outcome Measures

Primary Outcomes (3)

• Evaluation of Muscle Thickness with Ultrasonography

  The evaluation of muscle thickness of bilateral serratus anterior and lower trapezius muscles with ultrasonography will be performed by a physician using a 5-10 MHz linear probe (Diasus Dynamic Imaging Ltd, Livingston, Scotland,UK) in resting position. Muscle Thickness would be expressed as centimeters.

  change from baseline in muscle thickness of periscapular muscles at 8 weeks

• Evaluation of Shoulder Subluxation with Ultrasonography

  The evaluation of shoulder subluxation with ultrasonography will be performed by a physician using a 5-10 MHz linear probe (Diasus Dynamic Imaging Ltd, Livingston, Scotland,UK). It will be performed while the individual is sitting on a chair, the shoulder is in neutral rotation, with the elbow at 90 degrees of flexion and the forearm in pronation. The fore-arms will rest on a pillow placed on the patient's lap. The subluxation would be expressed as centimeters.

  change from baseline in shoulder subluxation at 8 weeks

• 3-Dimensional Scapular Kinematics

  3-Dimensional Scapular Kinematics will be measured by electromagnetic tracking system (Motion Monitor®, Innovative Sports Training Inc, Chicago) during elevation of the upper extremity on the scapular and sagittal plane and hair combing activity.

  change from baseline in scapular kinematics at 8 weeks

Secondary Outcomes (7)

• Fugl-Meyer Assessment of Upper Extremity (FMA-UE)

  change from baseline in upper extremity performance at 8 weeks

• Action Research Arm Test (ARAT)

  change from baseline in upper extremity performance at 8 weeks

• Trunk Impairment Scale

  change from baseline in trunk performance at 8 weeks

• Visual Analog Scale

  change from baseline in pain at 8 weeks

• Modified Barthel Index (MBI)

  change from baseline in performance of activities of daily living at 8 weeks

Study Arms (2)

Treatment Group

EXPERIMENTAL

Neurodevelopmental Treatment (Bobath) + Scapular Training Group

Other: Neurodevelopmental Treatment (Bobath) + Scapular Training

Control Group

ACTIVE COMPARATOR

Neurodevelopmental Treatment (Bobath) Group

Other: Neurodevelopmental Treatment (Bobath)

Interventions

Neurodevelopmental Treatment (Bobath) + Scapular Training OTHER

The Bobath concept for 40 minutes will be formed according to the needs of the individual and involve the upper limb, trunk and lower limb. It will be performed with 20 minutes scapular training including scapular exercise such as Proprioceptive Neuromuscular Facilitation (PNF), dynamic hug, towel-wall slide, scapular punch exercises etc. 3 days a week for 8 weeks.

Treatment Group

Neurodevelopmental Treatment (Bobath) OTHER

The Bobath concept for 60 minutes will be formed according to the needs of the individual and involve the upper limb, trunk and lower limb. It will be performed 3 days a week for 8 weeks.

Control Group

Eligibility Criteria

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

You may qualify if:

• Unilateral ischemic / hemorrhagic stroke for more than 3 months
• \> 18 years
• Mild-moderate upper extremity impairment (FMA≥30)
• Active shoulder elevation ≥ 90°
• Shoulder girdle muscles spasticity ≤ 2
• Mini Mental State Examination score ≥ 24

You may not qualify if:

• Body Mass Index ≤ 30 kg/m2
• Having an allergy to adhesive tape
• Clinical diagnosis of another neurologic disease other than stroke which might effect standing independently
• Having a history of humerus, clavicle and scapula fracture
• Having a shoulder surgery such as rotator cuff muscle repair

Sponsors & Collaborators

• Hacettepe University: lead

Study Sites (1)

Hacettepe University, Faculty of Physical Therapy and Rehabilitation

Ankara, Altındağ, 06100, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Özge ONURSAL KILINÇ, MSc

  Hacettepe University, Faculty of Physical Therapy and Rehabilitation

  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: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: February 3, 2021
• First Posted: February 8, 2021
• Study Start: February 1, 2021
• Primary Completion: November 30, 2022
• Study Completion: November 30, 2022
• Last Updated: August 14, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)