Stroke is a neurological event that leads to significant motor and functional impairments due to disruption of cerebral blood flow. The subacute phase, typically ranging from day of attack up to three months post-stroke, is a critical window for neuroplasticity and functional recovery. The proposed study will find out the effects of motor relearning program combined with neck stabilization exercises for health-related quality of life, sensorimotor function and upper extremity functionality.
This is a randomized clinical trial. Target population is patients suffering from subacute stroke with an MMSE score of 24 and above. Data will be collected from The University of Lahore teaching Hospital and Shadman Medical Center. This study will include 96 participants with 10% dropout ratio, according to the selection criteria. The participants will be randomly divided into two groups through a computer-generated random number table. Group A will recruit 48 patients to fulfil the inclusion criteria. These patients will undergo a 60 minutes session delivered for four weeks with 5 sessions every week, including warm-up, neck stabilization exercises, cranio-cervical flexion, cervical isometrics, 3 sets x 10 repetitions each 10 seconds hold, eye head coordination drills, 3 sets 60 seconds, focusing on target (right, left, up, down) neck control while reaching, 10 successful attempts, all performed in assisted sitting position. Combined with motor relearning program activities assisted supported sitting \& standing grasping and releasing cylinder progressing to cloth, reaching targets forward and sideways, picking objects and transferring over shelves 2 meters apart, Coin stacking, assisted grooming and ADLs (combing hair, turning keys, drinking water) 10 successful attempts of each activity. Group B will recruit 48 patients which fulfill the inclusion criteria. These patients will be treated by routine physical therapy, evidence-based exercises including AAROM of shoulder, elbow \& wrist joint, Scapular retraction, Shoulder and elbow isometrics, stretching of pectoralis minor and shoulder internal rotators, therapist assisted PNF diagonals for upper limb (Three sets of 10 repetitions each, squeeze hold for 10 seconds, stretch hold for 30 seconds and motor relearning program activities same as Group A, delivered under supervision over a timeframe of 60 minutes per session for four weeks, 5 times per week. The Statistical analysis will be performed through SPSS Software 21
Study Type
INTERVENTIONAL
Allocation
Neck stabilization exercises and Motor relearning program based functional activities will be performed
Routine Physical therapy exercises and Motor relearning program based functional activities will be performed
Shadman Medical Center
Lahore, Punjab Province, Pakistan
The University of Lahore Teaching Hospital
Lahore, Punjab Province, Pakistan
Sensorimotor Function
Sensorimotor function will be assessed by using Urdu translated version of Fugl-Meyer Assessment (FMA) for Upper Extremity (UE)
Time frame: Four weeks
Upper Limb Functionality
Functionality, assessed by using Wolf Motor Functional Test
Time frame: Four weeks
Health Related Quality of Life
Health Related Quality of life will be assessed by using Stroke Impact Scale
Time frame: Four weeks
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RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
96