Deep Trunk Muscle Activation and Balance in Post-Stroke Hemiplegia

NCT06181877 | Completed

• 1 other identifier: IstanbulPMRTRH-2023-ELMTRABH
• Study Type: observational
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Patients with post-stroke hemiplegia frequently exhibit balance impairments driven by multiple pathophysiological mechanisms. Although the role of core musculature in maintaining normal posture and balance is well established, and the benefits of core stabilization exercises have been documented, further research is needed on individual muscle contributions. Therefore, this study aimed to investigate the specific impact of bilateral transversus abdominis and bilateral lumbar multifidus muscles on balance performance in patients with stroke-related hemiplegia.

Conditions

Hemiplegia

Keywords

hemiplegia; transversus abdominis; multifidus; balance; stroke

Outcome Measures

Primary Outcomes (4)

• Berg Balance Scale (BBS)

  The Berg Balance Scale (BBS) is a 14-item objective clinical measure designed to assess static and dynamic balance performance in post-stroke patients. Items include tasks ranging from sitting unsupported to standing on one leg. Each item is scored on a 5-point ordinal scale from 0 (lowest function/cannot perform) to 4 (highest function/independent performance). The total score ranges from 0 to 56, with higher scores indicating better functional balance and postural control.

  Baseline (Single assessment on the same day as the ultrasonographic evaluation)

• Postural Assessment Scale for Stroke Patients - Total Score (PASS-Total)

  The total score of the Postural Assessment Scale for Stroke Patients (PASS) is obtained by summing the scores of all 12 items across both subscales (5 items for Maintaining a Posture and 7 items for Changing a Posture). Each item is scored from 0 to 3, resulting in a total score ranging from 0 to 36. Higher total scores indicate a higher level of comprehensive postural control, encompassing both static stability and dynamic mobility in stroke patients.

  Baseline (Single assessment on the same day as the ultrasonographic evaluation)

• Postural Assessment Scale for Stroke Patients - Maintaining a Posture Subscale (PASS-MP)

  This subscale evaluates the patient's ability to maintain a given posture across 5 specific items. Each item is scored from 0 (cannot perform) to 3 (can perform for a sustained period), with a subscale total score ranging from 0 to 15. Higher scores indicate better postural maintenance.

  Baseline (Single assessment on the same day as the ultrasonographic evaluation)

• Postural Assessment Scale for Stroke Patients - Changing a Posture Subscale (PASS-CP)

  This subscale assesses the patient's ability to change posture across 7 specific items. Each item is scored from 0 to 3, with a subscale total score ranging from 0 to 21. Higher scores indicate greater mobility and transition capability.

  Baseline (Single assessment on the same day as the ultrasonographic evaluation)

Secondary Outcomes (7)

• Brunnstrom Stages of Recovery (BRS)

  Baseline (Single assessment on the same day as the ultrasonographic evaluation)

• Paretic-Side Transversus Abdominis Thickening Fraction (TF)

  Baseline (concurrent with clinical balance and motor evaluations)

• Transversus Abdominis Resting Thickness Ratio (RTR)

  Baseline (concurrent with clinical balance and motor evaluations)

• Transversus Abdominis Thickening Fraction Ratio (TFR)

  Baseline (concurrent with clinical balance and motor evaluations)

• Paretic-Side Lumbar Multifidus Thickening Fraction (TF)

  Baseline (concurrent with clinical balance and motor evaluations)

Study Arms (1)

Hemiplegic Patients

Patients with hemiplegia after stroke

Eligibility Criteria

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

Study Population

The study population consists of 36 adult patients diagnosed with post-stroke hemiplegia. Participants were selected from patients receiving inpatient or outpatient rehabilitation at a single tertiary training and research hospital, according to specific functional and clinical eligibility criteria

You may qualify if:

• Age 18-65 years
• At least 1 month post stroke
• History of unilateral stroke
• Ability to cooperate cognitively
• Ability to maintain balance while sitting without support and/or balance while standing with or without support
• BMI \< 30 kg/m²

You may not qualify if:

• History of hemiplegia on the opposite side of the body
• Diagnosis of extruded or sequestrated lumbar herniation and/or a history of lumbar surgery
• History of lumbar vertebral fracture
• Traumatic brain injury
• Neuromuscular disorders that may cause muscle atrophy
• Sensory deficits
• Cerebellar sequelae
• Vestibular balance disorders (e.g., vertigo)
• Parkinson's disease
• Balance impairments due to visual deficits
• Pre-stroke balance disorders

Sponsors & Collaborators

• Istanbul Physical Medicine Rehabilitation Training and Research Hospital: lead

Study Sites (1)

Istanbul Physical Medicine Rehabilitation Training & Research Hospital

Istanbul, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Hemiplegia; Stroke

Condition Hierarchy (Ancestors)

Paralysis; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases

Study Officials

• NAZLI DERYA BUGDAYCI, MD

  Istanbul Physical Therapy Rehabilitation Training & Research Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: OTHER
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER GOV
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: December 13, 2023
• First Posted: December 26, 2023
• Study Start: February 1, 2023
• Primary Completion: September 1, 2023
• Study Completion: October 31, 2023
• Last Updated: June 1, 2026

Record last verified: 2026-05

Locations

TU (1)