Effects of Backward Gait Training in Chronic Stroke Patients

NCT04903392 | Unknown

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

Brief Summary

Loss of motor control after stroke, muscle weakness, abnormal movement patterns, spasticity, range of motion limitations and sensory dysfunction, resulting in a decrease in the load transferred to the affected limb, changes in gait pattern and balance skills. Post-stroke muscle weakness has been shown to occur not only in the lower and upper extremity muscles but also in the respiratory muscles. It was found that the plantar pressure distribution in the affected side feet was decreased in individuals with stroke and this situation negatively affected the walking function. A systematic review of treadmill training revealed that treadmill training significantly increased walking speed and walking distance. Learning to walk backwards is also recommended to improve the movement components required for walking forward. As a result of the investigations, although there are studies about the effects of back-walking training on walking and balance function in chronic stroke patients, there is no study investigating the effects on plantar pressure distribution and respiratory parameters. Therefore, this study, which planned to investigate the effects of treadmill retching training on balance, plantar pressure distribution and respiratory parameters in chronic stroke patients, will contribute to the literature.

Conditions

Chronic Stroke Patients

Keywords

Chronic Stroke Patients; Balance; Plantar Pressure Distribution; Respiratory Parameters; Backward Gait Training

Outcome Measures

Primary Outcomes (8)

• Plantar pressure assessment

  Plantar pressure distribution will be evaluated.

  6 weeks

• Balance assessment

  Static and dynamic balance will be evaluated with The Korebalance Premiere device.

  6 weeks

• Pulmonary function (Forced vital capacity (FVC))

  Pulmonary function will be evaluated with the spirometry. Dynamic lung volume measurements will be made according to American Thoracic Society and European Respiratory Society criteria. With the device, forced vital capacity (FVC) will be evaluated.

  6 weeks

• Pulmonary function (Forced expiratory volume in the first second (FEV1))

  Pulmonary function will be evaluated with the spirometry. Dynamic lung volume measurements will be made according to American Thoracic Society and European Respiratory Society criteria. With the device, forced expiratory volume in the first second (FEV1) will be evaluated.

  6 weeks

• Pulmonary function (FEV1 / FVC)

  Pulmonary function will be evaluated with the spirometry. Dynamic lung volume measurements will be made according to American Thoracic Society and European Respiratory Society criteria. With the device, FEV1 / FVC will be evaluated.

  6 weeks

• Pulmonary function (Flow rate 25-75% of forced expiratory volume (FEF 25-75%))

  Pulmonary function will be evaluated with the spirometry. Dynamic lung volume measurements will be made according to American Thoracic Society and European Respiratory Society criteria. With the device, flow rate 25-75% of forced expiratory volume (FEF 25-75%) will be evaluated.

  6 weeks

• Pulmonary function (Peak flow rate (PEF))

  Pulmonary function will be evaluated with the spirometry. Dynamic lung volume measurements will be made according to American Thoracic Society and European Respiratory Society criteria. With the device, peak flow rate (PEF) will be evaluated.

  6 weeks

• Respiratory Muscle Strength

  Maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP) will be measured using portable, electronic, oral pressure measuring device

  6 weeks

Study Arms (2)

Backward Walking Group

EXPERIMENTAL

Conventional therapy + Backward Walking Training

Other: Backward Walking Training

Forward Walking Group

OTHER

Conventional therapy + Forward Walking Training

Other: Forward Walking Training

Interventions

Backward Walking Training OTHER

The training speed will start at the basic walking speed and will increase by 5% of the starting speed each week. The training, which will take 30 minutes, will be as follows: 5 minutes forward walking (warm-up phase), 20 minutes backward walking (intervention phase) and 5 minutes forward (cooling phase). -three times a week for six weeks

Backward Walking Group

Forward Walking Training OTHER

The training speed will start at the basic walking speed and will increase by 5% of the starting speed each week. It will be in the form of walking forward for 30 minutes. -three times a week for six weeks

Forward Walking Group

Eligibility Criteria

• Age: 40 Years - 65 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Volunteering to participate in the study
• More than 6 months have passed since the onset of stroke
• First time stroke diagnosis
• Being between the ages of 40-65
• Spasticity severity in lower extremity less than 3 according to Modified Ashworth Scale,
• Being medically stable
• Ability to walk 10 meters and above without assistance

You may not qualify if:

• Presence of other neurological or orthopedic diseases that affect standing and walking involving the lower limbs
• Uncontrollable Hypertension
• Having been diagnosed with any pulmonary disease
• Severe cardiac conditions
• Uncontrollable DM
• Lack of cooperation

Sponsors & Collaborators

• Bandırma Onyedi Eylül University: lead

Study Sites (1)

Burçin Akçay

Balıkesir, 10200, Turkey (Türkiye)

RECRUITING

Related Publications (5)

• Kim KH, Lee KB, Bae YH, Fong SSM, Lee SM. Effects of progressive backward body weight suppoted treadmill training on gait ability in chronic stroke patients: A randomized controlled trial. Technol Health Care. 2017 Oct 23;25(5):867-876. doi: 10.3233/THC-160720.

  PMID: 28759977 BACKGROUND

• Munari D, Serina A, Disaro J, Modenese A, Filippetti M, Gandolfi M, Smania N, Picelli A. Combined effects of backward treadmill training and botulinum toxin type A therapy on gait and balance in patients with chronic stroke: A pilot, single-blind, randomized controlled trial. NeuroRehabilitation. 2020;46(4):519-528. doi: 10.3233/NRE-203067.

  PMID: 32508341 BACKGROUND

• Nadeau S, Amblard B, Mesure S, Bourbonnais D. Head and trunk stabilization strategies during forward and backward walking in healthy adults. Gait Posture. 2003 Dec;18(3):134-42. doi: 10.1016/s0966-6362(02)00070-x.

  PMID: 14667946 BACKGROUND

• Weng CS, Wang J, Pan XY, Yu ZZ, Wang G, Gao LP, Huo CN. [Effectiveness of backward walking treadmill training in lower extremity function after stroke]. Zhonghua Yi Xue Za Zhi. 2006 Oct 10;86(37):2635-8. Chinese.

  PMID: 17198591 BACKGROUND

• Yang YR, Yen JG, Wang RY, Yen LL, Lieu FK. Gait outcomes after additional backward walking training in patients with stroke: a randomized controlled trial. Clin Rehabil. 2005 May;19(3):264-73. doi: 10.1191/0269215505cr860oa.

  PMID: 15859527 BACKGROUND

Central Study Contacts

Burçin Akçay

CONTACT

+905056533273; akcayburcin@gmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor

Study Record Dates

• First Submitted: May 18, 2021
• First Posted: May 26, 2021
• Study Start: December 1, 2021
• Primary Completion: December 1, 2022
• Study Completion: December 1, 2023
• Last Updated: March 15, 2022

Record last verified: 2022-03

Data Sharing

• IPD Sharing: Will not share

Locations

TU (1)