Combined Effect of CIMT and Brunnstrom Therapy on UE in Stroke Patients

NCT06762249 | Enrolling By Invitation

• 1 other identifier: REC/RCR & AHS/24/0250
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 2

Brief Summary

Stroke is a leading cause of disability characterized by inadequate blood supply to the brain, leading to cell death and neurological deficits. Motor impairment of the upper extremity is a common consequence among stroke patients, resulting in paralysis of the upper limb. Both Constraint Induced Movement Therapy and Brunnstrom therapy have shown promise in improving motor activity and overall quality of life in stroke patients.This randomized controlled trial will be carried out at in Multan over 10 months. Total number of 56 participants meeting the inclusion criteria will be included in this study. Participants will be randomly assigned into 2 groups . Both groups will receive interventions for five days a week for 4 weeks.

Conditions

Stroke Patients

Keywords

Brunnstrom movement therapy; Constraint induced movement therapy; motor activity; quality of life; spacticity; stroke patients

Outcome Measures

Primary Outcomes (4)

• Fugl-Meyer Upper Extremity Motor Evaluation Scale (FM-UE)

  The FMA-UE consists of 30 items assessing motor function and 3 items assessing reflex function. The score most applicable to task performance is given from "0, inability," "1, beginning ability," to "2, normal"

  4 weeks

• Functional Independence Measure (FIM)

  The scale consists of six sub-headings and a total of 18 items. Scores that can be obtained from the scale range from 18-126, and higher scores indicate that the individual is more independent in daily life

  4 weeks

• Modified Ashworth scale

  The modified Ashworth scale is a muscle tone assessment scale used to assess the resistance experienced during passive range of motion, which does not require any instrumentation and is quick to perform.

  4 weeks

• Mini Mental state examination

  The MMSE is a widely used cognition screening test. It has a maximum score of 30 points. It assesses aspects of orientation, recall, language and visual construction.

  4 weeks

Study Arms (2)

CIMT+ Brunnstrom therapy + routine physical therapy.

EXPERIMENTAL

Group A participants will receive Constraints innduced movement therapy and Brunnstrom movement therapy along with routine physical therapy This therapy will be given as 5 days session for 4 weeks.

Other: CIMT + Brunnstrom therapy + routine physical therapy

CIMT + routine physical therapy

ACTIVE COMPARATOR

Group B participants will receive Constraint Induced movement therapy along with routine physical therapy exercises. This therapy will be given for 4 weeks.

Other: CIMT + routine physical therapy

Interventions

CIMT + Brunnstrom therapy + routine physical therapy OTHER

this therapy will be given for 5 days per week for 4 weeks.

CIMT+ Brunnstrom therapy + routine physical therapy.

CIMT + routine physical therapy OTHER

this therapy will be given for 5 days per week for 4 weeks

CIMT + routine physical therapy

Eligibility Criteria

• Age: 40 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age group between 40 and 70 years
• Both male and female
• Patient being diagnosed with hemiplegic stroke
• Patient having hemorrhagic stroke or ischemic stroke
• Patient able to give their consent for rehabilitation program
• Patient having 24 or higher score from Standardized Mini-Mental Test
• Patient being able to stand for 2 min without assistance from a person

You may not qualify if:

• Patient with cognitive impairment or dementia
• Patient having any other disease that prevents participation in the rehabilitation program
• Patient that participated in any ongoing rehabilitation program
• Patient having pain in UE 4 or higher according to the Visual Analog Scale which is scored 0-10
• Patient had spasticity in any joint of the UE and scored 2 or higher according to the Modified Ashworth Scale

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (2)

Azeem Electroneurophysiology diognostic and Physiotherapy center Multan

Multan, Punjab Province, Pakistan

Location

Qaisrani Hospital Multan

Multan, Punjab Province, Pakistan

Location

Related Publications (8)

• Abba M, Muhammad A, Badaru U, Abdullahi A. Comparative effect of constraintinduced movement therapy and proprioceptive neuromuscular facilitation on upper limb function of chronic stroke survivors. Physiotherapy Quarterly. 2020;28(1):1-5.

  BACKGROUND

• . Shaheen S, Afzal B, Tahir M, Mahmood U, Yousaf F, Tariq F. Combined Effects of Brunnstorm Movement Therapy and Low-Level Laser Therapy on Upper Limb Function and Hand Dexterity in Chronic Stroke Patient. Journal of Health and Rehabilitation Research. 2024;4(1):1457-62

  BACKGROUND

• Rocha LSO, Gama GCB, Rocha RSB, Rocha LB, Dias CP, Santos LLS, Santos MCS, Montebelo MIL, Teodori RM. Constraint Induced Movement Therapy Increases Functionality and Quality of Life after Stroke. J Stroke Cerebrovasc Dis. 2021 Jun;30(6):105774. doi: 10.1016/j.jstrokecerebrovasdis.2021.105774. Epub 2021 Apr 10.

  PMID: 33848906 BACKGROUND

• Terranova TT, Simis M, Santos ACA, Alfieri FM, Imamura M, Fregni F, Battistella LR. Robot-Assisted Therapy and Constraint-Induced Movement Therapy for Motor Recovery in Stroke: Results From a Randomized Clinical Trial. Front Neurorobot. 2021 Jul 21;15:684019. doi: 10.3389/fnbot.2021.684019. eCollection 2021.

  PMID: 34366819 BACKGROUND

• Nasb M, Li Z, S A Youssef A, Dayoub L, Chen H. Comparison of the effects of modified constraint-induced movement therapy and intensive conventional therapy with a botulinum-a toxin injection on upper limb motor function recovery in patients with stroke. Libyan J Med. 2019 Dec;14(1):1609304. doi: 10.1080/19932820.2019.1609304.

  PMID: 31032717 BACKGROUND

• Puri S, Kovela RK, Qureshi MI, Dadgal R, Timothy R, Samal S. Effect of Brunnstrom Movement Therapy Combined with Neurodevelopmental Therapy on Balance and Mobility in a Patient with Acute Stroke: An Interesting Case Report. JPRI. 2022:6-9.

  BACKGROUND

• Dhanalakshmi L, Alagesan J, Buvanesh A. Effectiveness of Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation on Upper Extremity Functions in Stroke. Indian Journal of Physiotherapy & Occupational Therapy. 2024;18.

  BACKGROUND

• Akter R, Sharma N, Ahmed S, Srivastav AK. Combined effect of Brunnstrom's hand rehabilitation and functional electrical stimulation for improving hand function in patients with chronic stroke: A randomized controlled trial. J Bodyw Mov Ther. 2023 Jul;35:84-90. doi: 10.1016/j.jbmt.2023.04.021. Epub 2023 Apr 28.

  PMID: 37330808 BACKGROUND

MeSH Terms

Conditions

Motor Activity

Condition Hierarchy (Ancestors)

Behavior

Study Officials

• Sabiha Arshad

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: January 1, 2025
• First Posted: January 7, 2025
• Study Start: October 1, 2024
• Primary Completion: February 1, 2025
• Study Completion: May 1, 2025
• Last Updated: January 7, 2025

Record last verified: 2025-01

Data Sharing

• IPD Sharing: Will not share

Locations

PA (2)