Trunk Rotation And Lateral Flexion Exercises In Stroke Patients

NCT06379854 | Recruiting

• 1 other identifier: RCRAHS-ISB/REC/MS-PT/01814
• Study Type: interventional
• Target: 54
• Locations: 1 country
• Sites: 1

Brief Summary

In this study we want to introduce the beneficiary combine effects of chest mobilization and chest physiotherapy exercises by using cough peak flow meter and chest expansion in stroke patients. by using theses combine exercises physiotherapist can develop target rehabilitation strategies for stroke survivors.

Conditions

Stroke, Acute

Keywords

stroke; TRROM trunk rotation range of motion; TLFROM trunk lateral rotation range of motion; CPF cough peak flow meter

Outcome Measures

Primary Outcomes (3)

• Trunk Impairment Scale:

  Changes from baseline this scale is used to assess motor impairment of the trunk after stroke through the evaluation of static and dynamic sitting balance as well as coordination of trunk movement. The initial static sitting balance score 0 means overall total score is O. and full score is 23. This tool is also used to assess progress of trunk movement.

  4th week

• Peak Flow Meter

  Changes from baseline Peak flow meter is used to access the peak cough flow in stroke patient's pre and post intervention. Cough peak flow (CPF) measures the maximum expiratory flow during the phase of a cough just after instant opening of the glottis, but peak expiratory flow rate (PEFR) measures maximum expiratory flow, after a full deep inspiration, through an open glottis Normal peak cough flow is about greater than or equal to 270L/min. And the ineffective cough is about less than 160L/min.

  4th week

• Chest Expansion:

  A tape measure is used to evaluate the both upper and lower chest expansion in stroke patients. These chest expansions were performed three time and mean value of these are taken. By using tape measure, we determine the difference between rib cage circumference at the end of forced inspiration and at the end of forced expiration. The reliability score for chest expansion is about (0.99)

  4th week

Study Arms (2)

chest physiotherapy

EXPERIMENTAL

we take 2 groups in one group only chest physiotherapy introduce

Other: chest physiotherapy

trunk rotation exercises,deep diaphragmatic also chest physiotherapy

ACTIVE COMPARATOR

But in 2nd group chest physiotherapy with trunk rotation exercises and deep diaphragmatic breathing exercises alo introduce.

Other: trunk rotation exercises,deep diaphragmatic also chest physiotherapy

Interventions

chest physiotherapy OTHER

Postural Drainage Frequency: 3 sessions/week Intensity: 5 to 10 minutes Time: For 4 weeks Type: chest physiotherapy Percussion F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Vibration F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Shaking F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Huffing and coughing F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy

chest physiotherapy

trunk rotation exercises,deep diaphragmatic also chest physiotherapy OTHER

Postural Drainage Frequency: 3 sessions/week Intensity: 5 to 10 minutes Time: For 4 weeks Type: chest physiotherapy Percussion F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Vibration F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Shaking F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Huffing and coughing F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy Deep Diaphragmatic Breathing Exercise F: 3 sessions/week I: 3 to 5 minutes T: For 4 weeks T: chest physiotherapy TLFROM F: 3 sessions/week I: 5 to 10 minutes T: For 4 weeks T: Mobilization Exercises TFROM F: 3 sessions/week I: 5 to 10 minutes T: For 4 weeks T: Mobilization Exercises

trunk rotation exercises,deep diaphragmatic also chest physiotherapy

Eligibility Criteria

• Age: Up to 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• Both gender
• Age \> 50
• Right or left hemiplegic acute stroke patients
• Diagnosed cases of stroke patient
• Duration: 4 weeks being diagnosed
• Can sit with at least 10sec
• Can perform exercises with Active Assistance
• Patients who easily perform exercises
• Patients who response to commands

You may not qualify if:

• Patients with serious comorbidities like cancer
• Uncontrolled hypertension SBP \> 140mmhg and DBP \> 90mmhg
• Vitally unstable patient's
• Red flags for physiotherapy i.e. sudden dizziness, unexplained pain during exercise, chest pain.
• DVT Deep Vein Thrombosis

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Shahida Khaliq Health Centre

Islamabad, 44080, Pakistan

RECRUITING

Related Publications (18)

• Sacco RL, Kasner SE, Broderick JP, Caplan LR, Connors JJ, Culebras A, Elkind MS, George MG, Hamdan AD, Higashida RT, Hoh BL, Janis LS, Kase CS, Kleindorfer DO, Lee JM, Moseley ME, Peterson ED, Turan TN, Valderrama AL, Vinters HV; American Heart Association Stroke Council, Council on Cardiovascular Surgery and Anesthesia; Council on Cardiovascular Radiology and Intervention; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Peripheral Vascular Disease; Council on Nutrition, Physical Activity and Metabolism. An updated definition of stroke for the 21st century: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2013 Jul;44(7):2064-89. doi: 10.1161/STR.0b013e318296aeca. Epub 2013 May 7.

  PMID: 23652265 BACKGROUND

• Johnson W, Onuma O, Owolabi M, Sachdev S. Stroke: a global response is needed. Bull World Health Organ. 2016 Sep 1;94(9):634-634A. doi: 10.2471/BLT.16.181636. No abstract available.

  PMID: 27708464 BACKGROUND

• Saini V, Guada L, Yavagal DR. Global Epidemiology of Stroke and Access to Acute Ischemic Stroke Interventions. Neurology. 2021 Nov 16;97(20 Suppl 2):S6-S16. doi: 10.1212/WNL.0000000000012781.

  PMID: 34785599 BACKGROUND

• Turana Y, Tengkawan J, Chia YC, Nathaniel M, Wang JG, Sukonthasarn A, Chen CH, Minh HV, Buranakitjaroen P, Shin J, Siddique S, Nailes JM, Park S, Teo BW, Sison J, Ann Soenarta A, Hoshide S, Tay JC, Prasad Sogunuru G, Zhang Y, Verma N, Wang TD, Kario K; HOPE Asia Network. Hypertension and stroke in Asia: A comprehensive review from HOPE Asia. J Clin Hypertens (Greenwich). 2021 Mar;23(3):513-521. doi: 10.1111/jch.14099. Epub 2020 Nov 15.

  PMID: 33190399 BACKGROUND

• Farooq A, Venketasubramanian N, Wasay M. Stroke Care in Pakistan. Cerebrovasc Dis Extra. 2021;11(3):118-121. doi: 10.1159/000519554. Epub 2021 Oct 25.

  PMID: 34695824 BACKGROUND

• Yew KS, Cheng EM. Diagnosis of acute stroke. Am Fam Physician. 2015 Apr 15;91(8):528-36.

  PMID: 25884860 BACKGROUND

• Rochester CL, Mohsenin V. Respiratory complications of stroke. Semin Respir Crit Care Med. 2002 Jun;23(3):248-60. doi: 10.1055/s-2002-33033.

  PMID: 16088617 BACKGROUND

• Jeong, J.-H., Brain and lung: lung injury in patients with brain injury. Journal of Neurocritical Care, 2017. 10(1): p. 1-6.

  BACKGROUND

• Kim, A., et al., Effects of rib cage joint mobilization combined with diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Journal of International Academy of Physical Therapy Research, 2020. 11(3): p. 2113-2118.

  BACKGROUND

• Belal, E.S., S. Selim, and A. Mohammad, Detection of airway protective level of the cough reflex in acute stroke patients. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery, 2020. 56(1): p. 1-6.

  BACKGROUND

• Park, S.J., Effects of inspiratory muscles training plus rib cage mobilization on chest expansion, inspiratory accessory muscles activity and pulmonary function in stroke patients. Applied Sciences, 2020. 10(15): p. 5178.

  BACKGROUND

• Khedr EM, El Shinawy O, Khedr T, Aziz Ali YA, Awad EM. Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. Eur J Neurol. 2000 May;7(3):323-30. doi: 10.1046/j.1468-1331.2000.00078.x.

  PMID: 10886317 BACKGROUND

• Verheyden G, Nieuwboer A, De Wit L, Feys H, Schuback B, Baert I, Jenni W, Schupp W, Thijs V, De Weerdt W. Trunk performance after stroke: an eye catching predictor of functional outcome. J Neurol Neurosurg Psychiatry. 2007 Jul;78(7):694-8. doi: 10.1136/jnnp.2006.101642. Epub 2006 Dec 18.

  PMID: 17178824 BACKGROUND

• Waseem, M.H., et al., Effectiveness of chest physiotherapy in cerebrovascular accident patients with aspiration pneumonia. Journal of Modern Rehabilitation, 2021. 15(1): p. 47-52.

  BACKGROUND

• Jang SH, Bang HS. Effect of thoracic and cervical joint mobilization on pulmonary function in stroke patients. J Phys Ther Sci. 2016 Jan;28(1):257-60. doi: 10.1589/jpts.28.257. Epub 2016 Jan 30.

  PMID: 26957769 BACKGROUND

• Park HY, Hwang UJ, Kwon OY. Correlation between trunk rotation and lateral flexion range of motion, peak cough flow, and chest expansion in stroke patients. Physiother Res Int. 2023 Jan;28(1):e1970. doi: 10.1002/pri.1970. Epub 2022 Aug 12.

  PMID: 35962597 BACKGROUND

• Messaggi-Sartor M, Guillen-Sola A, Depolo M, Duarte E, Rodriguez DA, Barrera MC, Barreiro E, Escalada F, Orozco-Levi M, Marco E. Inspiratory and expiratory muscle training in subacute stroke: A randomized clinical trial. Neurology. 2015 Aug 18;85(7):564-72. doi: 10.1212/WNL.0000000000001827. Epub 2015 Jul 15.

  PMID: 26180145 BACKGROUND

• Jo, M.-R., N.-S. Kim, and J.-H. Jung, The effects of respiratory muscle training on respiratory function, respiratory muscle strength, and cough capacity in stroke patients. Journal of Korean Society of Physical Medicine, 2014. 9(4): p. 399-405.

  BACKGROUND

MeSH Terms

Conditions

Stroke

Condition Hierarchy (Ancestors)

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

Study Officials

• Aruba Saeed, phd*

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Imran amjad, phd

CONTACT

03324390125; imran.amjad@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 18, 2024
• First Posted: April 23, 2024
• Study Start: April 1, 2024
• Primary Completion: June 1, 2024
• Study Completion: June 1, 2024
• Last Updated: April 23, 2024

Record last verified: 2024-04

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)