Stroke is the leading cause of disability leading to Gait and balance dysfunction leading to decreased Quality of Life. Difficulty in turning is a major target in Gait Rehabilitation. Task specific exercises has proven to be effective in all stages of stroke rehabilitation, therefore Turning based specific training is to be used in order to improve turning and balance in post stroke patients moreover functional strength training of lower extremities prove to be more effective than traditional training.
The objectives of this study are: 1. To determine the additional effects of functional muscle training with turning based specific training on turning in Gait among post stroke patients. 2. To the determine the additional effects of functional muscle training with turning based specific training on balance in post stroke patients. 3. To determine the additional effects of functional muscle training with turning based specific training on Quality of LIfe aming post stroke patients. HYPOTHESIS: Alternate hypothesis 1.1HA-There will be a statistically significant difference of muscle training in addition with turning based specific training in turning among post stroke patients (p\<0.05). 2\. 2HA- There will be statistically significant difference between muscle training in addition with turning based specific training on balance in post stroke patients (p\<0.05). Null hypothesis: 1.1H0 -There will be statistically no significant difference of muscle training with turning based specific training on turning in Gait among post-stroke patients (p\>0.05) 2 .2HO-There will be statistically no significant difference of muscle training with turning specific training on balance in post stroke patients (p\>0.05)Research Design: Experimental study. Randomized Control Trial Clinical setting: Rehabilitation department, Fauji Foundation Hospital. Selection Criteria: Inclusion Criteria * Age group: 45-60 years onwards * Both males and females * Patients with subacute and chronic stroke (MCA \>6months) * MMSE- 25 or higher, Functional ambulatory capacity-3 Exclusion Criteria * Hemorrhagic stroke. * Patients with epilepsy * Patients with other neurological conditions loke Alzheimer, parkinsons and dementias. Sampling technique: non-probability purposive sampling. Outcome Measures: TURNING: 1) Standing Turn Test, 2) Figure of 8 Test. BALANCE: 1) Berg Balance Scale, 2) Timed up and Go Test, 3) Modified 4 square step Test. Outcome measures will be evaluated at baseline and then after 6 weeks of intervention. Experimental Group (A) = This group will recieve Turning based specific training along with Functional muscle training for 6 weeks. Control group (B) = This group will recieive Turning Based Specific Training only for 6 weeks Data analysis techniques: The data will be analyzed through SPSS 21 and Data would be analyzed based on the study design chosen that is random control experimental study. Significance of the study: Turning is a major component of ambulation. Difficulty in turning results in increased risk of fall. Stroke results in step asymmetry which increases difficulty in changing direction. There is sufficient evidence available for normal gait training but limited protocols for targetting turning in Gait. The current study aims to fill this gap by providing research data and developing a treatment protocol.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
32
Experimental group will receive Turning based specific training protocol for 6 weeks along with functional muscle training, training will be done on alternate days. Functional muscle training: Details: Week 1-6: 3 days a week on alternate days. Hip Abductors: Side lying leg raises Single leg squatting Standing leg wall press Progressing to Adding resistance bands Hip adductors: Side lying adduction Standing Adduction Progress to adding resistance bands Hip Flexors: Standing leg lift Straight leg raises Progress to adding resistance bands Hip Extensors: Prone lying raises Standing single leg extension Progress to adding resistance bands Plantarflexors/ DorsiFlexors: Plantarflexors: Plantarflexion against resistance Toe raises Dorsiflexors: Dorsiflexion against resistance Heel raises Hip external rotators: Sitting-externally rotate hip 0-30° Add resistance bands Hip Internal rotators: Sitting-internally rotate the hip 0-30° Add resistance bands.
Week 1: 90 Degrees turns on the spot Visual cues to follow Week 2-3: 90 degrees turns on the spot Figure of 8 walking Visual cues to follow Week 4-5: 90 Degrees turns on the spot Figure of 8 walking Step across body Braiding Week 6: 90 degree turns on the spot Figure of 8 walking Step across body Braiding Visual cues to follow Obstacle avoidance
Foundation University College of Physical Therapy
Islamabad, Punjab Province, Pakistan
RECRUITINGTurning performance.
Standing turn test will be used for turning performance
Time frame: 6 weeks
turning ability
Figure of 8 test will be used for turning ability
Time frame: 6 weeks
Balance
Berg Balance Scale will be used to assess balance
Time frame: 6 weeks
Balance
Four square stand test will be used for this
Time frame: 6 weeks
Balance
Timed up and go test will be used for this
Time frame: 6 weeks
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