Optimizing Walking Function of Stroke Survivors by a Task-Oriented Home Exercise Program

Mahidol University63 enrolled

Overview

In a randomized-controlled study, the effects of a structured, progressive, task-oriented home exercise program to optimize walking competency will be evaluated in subacute stroke survivors.

The majority of stroke individuals unable to reenter their previous community life after they have had a stroke. Reintegration of community life by optimizing walking function is a major goal of stroke rehabilitation. Because not widely available inpatient rehabilitation, discharged with incomplete recovery, limited numbers of technically trained physical therapists, financial saving, and transportation difficulty, home-based stroke rehabilitation setting has been interested in many developing countries. Task- oriented exercise is well known and accepted approach to optimize walking function with underlying principles of motor control and motor learning theories. This approach has been used in the clinical setting with close supervision, but identification of appropriate protocol in the community environment is on progress. To date, no proper home exercise program based on task-oriental principle with minimal supervision for improving walking competency after stroke has been proposed in stroke rehabilitation. The purpose of this study is to investigate the effects of a structured, progressive, task- oriented home exercise program on walking competency in individual post stroke.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Stroke

Interventions

Task-oriented home exercisePROCEDURE

Structured, walking related task-oriented home exercise program with three progressive steps, at moderate to high intensity, 60 minutes per session, three sessions per week for total 8 weeks.

Usual Physiotherapy CarePROCEDURE

Deficits-oriented free active and resisted lower extremity exercises with bicycling and overground walking , 60 minutes per session, three sessions per week for total 8 weeks.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 65 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Either side of both type first stroke within 2 weeks to six months of onset with confirmatory diagnosis by CT Scan and MRI. 2. Age between 40 to 65 years old. 3. Moderate severity of stroke measured by the modified Rankin Scale (mRS- 3) 4. Able to comprehend the instructions with good cognition measured by Mini-Mental State Examination (MMSE \> 23). 5. Postadoption stage of readiness to change measured by the Stages of Change Questionnaire (stage 4 and 5) Exclusion Criteria: 1. Diagnosed with other neurological disorder such as Parkinson's disease, peripheral nerve injury. 2. Serious cardiac conditions (angina and myocardial infarction during the previous month, resting heart rate of more than 120, a systolic blood pressure of more than 180 mm Hg, and a diastolic blood pressure of more than 100 mm Hg) 3. Fugl Meyer Assessment score (lower extremity) less than ≤ 21 4. Significant hip, knee and ankle contracture that would limit ambulation (Fugl Meyer (ROM) ≤1 in each joint). 5. Orthopedic and rheumatological disorder with weight bearing pain (Fugl Meyer (pain) ≤ 1 in hip, knee and ankle joint movement).

Locations (2)

National Rehabilitation Hospital

Yangon, Burma

Physical Medicine and Rehabilitation Department, Yangon General Hospital

Yangon, Burma

Outcomes

Primary Outcomes

6 Minutes Walk Test

Patients will be measured their walking distance by a blind assessor on five occasions:at baseline,1,2,5 and 8 weeks after baseline testing.

Time frame: up to 8 weeks

10 Meter Walk Test

Patients will be measured their walking speed by a blind assessor on five occasions:at baseline,1,2,5 and 8 weeks after baseline testing.

Time frame: up to 8 weeks

Secondary Outcomes

Berg Balance Scale

Patients will be measured their walking balance by a blind assessor on five occasions:at baseline,1,2,5 and 8 weeks after baseline testing.

Time frame: up to 8 weeks

Dynamic Gait Index

Patients will be measured their walking adaptability by a blind assessor on two occasions:at baseline and 8 weeks after baseline testing.

Time frame: Baseline and 8 weeks

Stroke Impact Scale (Participation)

Patients will be measured their community participation by a blind assessor on two occasions:at baseline and 8 weeks after baseline testing.

Time frame: Baseline and 8 weeks

Data from ClinicalTrials.gov

This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.