Immediate Effects of Open and Closed Kinetic Chain Exercises on Upper Extremity in Stroke Patients.

NCT06272175 | Recruiting

• 1 other identifier: 10102023
• Study Type: interventional
• Target: 50
• Locations: 1 country
• Sites: 1

Brief Summary

Stroke is a sudden disruption of blood flow to the brain, resulting in physical and mental disabilities. It's a global health issue affecting millions each year, often leading to paralysis, altered muscle tone, and loss of motor control and balance. This study aims to examine the immediate effects of open and closed kinetic chain activites on upper extremity spasticity and motor dexterity in hemiplegic patients. This study will be conducted simultaneously at İstinye University Hospital Medical Park Gaziosmanpaşa and İstinye University Physiotherapy and Rehabilitation Application and Research Center (İSÜFİZYOTEM). 50 stroke patients will be included in the study, and all participants will be asked to sign an informed consent form. At the beginning of the session, all participants will be evaluated for their socio-demographic characteristics by a questionnaire created by the researchers, muscle viscoelastic properties by MyotonPRO, upper extremity muscle tone by Modified Ashworth Scale, upper extremity motor dexterity by Box and Block Test, and upper extremity joint range of motion by goniometer and by a phone application named as PhysioMaster. After the assessment, participants will be randomly assigned to two groups: open kinetic chain activity group and closed kinetic chain activity group. After performing the exercises, all evaluations will be conducted again. Thus, the aim is to understand the immediate effects of two different group exercises on the evaluated parameters.

Conditions

Stroke

Keywords

Stroke; Spasticity; Dexterity; Open Kinetic Chain; Closed Kinetic Chain

Outcome Measures

Primary Outcomes (2)

• MyotonPRO digital palpation device

  This device is a patented, certified, digital measurement device that measures the amount of tissue displacement that occurs per unit force applied by a probe pressed perpendicularly to the skin overlying the muscle. It measures the viscoelastic properties of the muscles. Latissimus Dorsi will be measured from a point 5 cm above the lower corner of the scapula with the shoulder in 80 flexion. Pectoralis Major will be measured three-quarters of the way from the line between the sternum and the nodule prominence. Measurement of the Biceps Brachii and Brachioradialis muscles will be made from the most swollen points of the muscles. For measurement of the Flexor Carpi Radialis muscle, patients will be taken supine, with the forearm supinated and the elbow approximately 40 degrees flexed, at the one-third (approximately) point of the distance between the elbow line and the lateral side of the ulnar styloid. All measurements will be repeated 3 times and the average will be calculated.

  6 minutes

• Box and Block Test

  It is a standardized assessment used to measure upper extremity motor dexterity. It involves moving blocks from one side of a box to the other within a minute. It is a clinic-friendly standardized assessment that is portable, easy to obtain, simple to administer, and can be administered quickly without a specific setting.

  1 minute

Secondary Outcomes (3)

• Modified Ashworth Scale

  3 minutes

• Goniometer

  5 minutes

• PhysioMaster

  5 minutes

Study Arms (2)

Open Kinetic Chain Activity Group

EXPERIMENTAL

Open kinetic chain activity will involve Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns from the Proprioceptive Neuromuscular Facilitation (PNF). During the application, participants will lie on their back, and the pattern will be initiated from the opposite direction of the targeted movement. Participants will be encouraged to perform the movement as actively as possible. Assistance will be provided if the participant cannot complete the pattern. No other PNF techniques will be applied. Both patterns will be practiced for 10 repetitions. Resting periods will be provided as needed to prevent fatigue. The entire application is planned to last approximately 5 minutes.

Other: Open Kinetic Chain Activity

Closed Kinetic Chain Activity Group

EXPERIMENTAL

For closed kinetic chain activity of the upper extremity, an activity involving weight shifting onto the hands on a table while standing with the elbows in extension will be used. Participants will be asked to shift weight onto the hemiplegic upper extremity for 30 seconds. After a 30-second rest period, the weight shifting will be repeated for a second time.

Other: Closed Kinetic Chain Activity

Interventions

Open Kinetic Chain Activity OTHER

PNF Flexion-Abduction-External Rotation and Flexion-Adduction-External Rotation patterns will be actively performed on the hemiplegic upper extremity.

Open Kinetic Chain Activity Group

Closed Kinetic Chain Activity OTHER

Weight-bearing on the hemiplegic hand with extended elbow in standing position

Closed Kinetic Chain Activity Group

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Stroke diagnosis;
• Hemiplegia;
• Subacute\&chronic phase (more than 3 months);
• Brunnstrom 3-4-5;
• Unsupported sitting ability;
• Being volunteer.

You may not qualify if:

• Having Botox within the last 6 months;
• according to Modified Ashworth Scale;
• Other neurological diagnosis other than stroke.

Sponsors & Collaborators

• Istinye University: lead

Study Sites (1)

Istinye University Hospital Medical Park Gaziosmanpasa

Istanbul, Turkey (Türkiye)

RECRUITING

MeSH Terms

Conditions

Stroke; Muscle Spasticity

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Muscular Diseases; Musculoskeletal Diseases; Muscle Hypertonia; Neuromuscular Manifestations; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Merve Can

  Istinye University

  STUDY CHAIR

• Seyhan Söyüncü

  Istinye University

  STUDY CHAIR

Central Study Contacts

Çiçek GÜNDAY, PhD(c)

CONTACT

+90 507 188 8848; cckdmn@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: Principal Investigator

Study Record Dates

• First Submitted: February 15, 2024
• First Posted: February 22, 2024
• Study Start: March 4, 2024
• Primary Completion: September 30, 2025
• Study Completion: December 30, 2025
• Last Updated: April 16, 2025

Record last verified: 2025-04

Locations

TU (1)