Talocrural Joint Manipulation in Stroke

Bitlis Eren University64 enrolled

Overview

The primary aim of the study is to investigate the effect of talocrural joint manipulation on the static balance of patients with stroke. The secondary aim of this study is to investigate the effect of talocrural joint manipulation on the dorsiflexion range of motion of patients with stroke.

The study, utilizing a randomized crossover design, is planned to be conducted on a minimum of 26 patients with stroke who meet the inclusion and exclusion criteria. Patients included in the study will be randomly assigned to receive both placebo talocrural joint manipulation and talocrural joint manipulation treatments.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

DOUBLE

Enrollment

Conditions

Stroke

Interventions

Talocrural Joint ManipulationOTHER

This technique, aiming to increase ankle dorsiflexion and mechanoreceptor activation, is based on the application of high velocity low amplitude traction to the joint.

Placebo Talocrural Joint ManipulationOTHER

This intervention is a classic method used to evaluate the effect of talocrural joint manipulation.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: * 1\. Two months or longer elapsed since the stroke, * 2\. A Mini-Mental State Examination score of 24 or higher, * 3\. The ability to stand independently for 20 seconds or more, * 4\. The ability to walk independently for 10 meters with the use of walking aids or orthoses if necessary, * 5\. Being between 45 and 75 years of age, * 6\. Having a Brunnstrom stage of 4 or above Exclusion Criteria: * 1\. The presence of severe osteoarthritis in the lower extremity, * 2\. The presence of cancer or diabetic neuropathy, * 3\. The presence of vestibular disorder, * 4\. The presence of lower extremity ulceration or amputation, * 5\. History of vertigo, * 6\. Alcohol consumption within the last 24 hours, * 7\. Hemodynamic instability, * 8\. Diagnosis of posterior circulation stroke involving the basilar artery and cerebellum, * 9\. The presence of other neurological disorders (such as multiple sclerosis, Parkinson's disease), * 10\. Having experienced an acute lower extremity injury in the last six weeks, * 11\. History of lower extremity surgery

Locations (1)

Bolu İzzet Baysal Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi

Bolu, Merkez, Turkey (Türkiye)

Outcomes

Primary Outcomes

Overall Stability Index Measurement

Overall stability index, evaluated using the Biodex Balance System. Overall stability index scores were derived from calculations of deviations from the center of gravity in the anteroposterior and mediolateral axes by the device. A lower score indicates smaller deviation and better postural stability. The assessment was conducted on a stable platform with three 20-second repetitions interspersed with 10-second rest periods. Participants remained standing during the rest periods, and the device automatically computed the average of the three repetitions. As the general stability index value increases, overall stability decreases. No definable minimum or maximum theoretical value.

Time frame: Change from baseline overall stability immediately after intervention

Secondary Outcomes

Mediolateral Stability Index Measurement

Mediolateral stability index, evaluated using the Biodex Balance System. Mediolateral stability index scores were derived from calculations of deviations from the center of gravity in the mediolateral axis by the device. As the mediolateral index value increases, mediolateral stability decreases. No definable minimum or maximum theoretical value.

Time frame: Change from baseline mediolateral stability immediately after intervention

Anteroposterior Stability Index Measurement

Anteroposterior stability index, evaluated using the Biodex Balance System. Anteroposterior stability index scores were derived from calculations of deviations from the center of gravity in the anteroposterior axis by the device. As the overall anteroposterior stability value increases, anteroposterior stability decreases. No definable minimum or maximum theoretical value.

Time frame: Change from baseline anteroposterior stability immediately after intervention

Ankle Dorsiflexion Range of Motion Measurement With Knee in Extended and Flexed Positions

The patient was asked to stand facing the wall and place their hands on the wall at shoulder width apart, with the affected foot positioned behind and the knee in full extension. Then, without lifting the back foot or compromising knee extension, the patient was instructed to reach forward as far as possible. Subsequently, the calcaneal tubercle was placed one centimeter above the floor, and the measurement was taken with a water level gauge attached to the phone. The same measurement was repeated with the knee in flexion (20 degrees or more).

Data from ClinicalTrials.gov

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