Stroke-induced lower limb impairments severely inhibit functional independence and mobility in survivors. Inventive techniques like Synergy-Based Electrical Stimulation (SBES) and Task-Oriented Training (TOT) support favorable rehabilitation results based on Neuroplasticity. This study aims to compare the effectiveness of these in restoring purposeful movements and enhancing motor functions in post-stroke patients.This study aims to compare the efficacy of (SBES) and Task-Oriented Training (TOT) in improving lower limb motor control in sub-acute post-stroke patients. This study will be a single-blinded randomized clinical trial design. Participants, aged 40-60 will be recruited in this study by Non-Probability convenience sampling from Rehabilitation centers and Neurology departments. Informed consent and consistent attendance throughout the intervention will be required. Through the computerized table generator method of randomization, participants will be evenly divided into two groups. Both groups will receive conventional therapy, like stretching, strengthening, and isometrics, with modalities. Group A will receive 30 Hz electrical stimulation on the affected lower limb muscles (hip flexors, knee flexors, and ankle dorsiflexors) in a synergic pattern, for 60 minutes, thrice weekly for 6 weeks. Group B will engage in functional tasks for 60 minutes, thrice weekly for 6 weeks, repeated 10 times per set with 2 sets of each activity, plus an additional self-practice session. Outcome measures will be assessed at baseline and post-intervention stages by the Fugl-Meyer Assessment for motor recovery, Time UP and Go Test (TUG) and 10 Meter Walk Test for functional mobility, gait, and balance. The paired sample t-test will be used for within-group analysis in the parametric data and the Wilcoxon test for non-parametric data, whereas, for between-group analysis independent t-test will be used for parametric data and Mann Whitney U test will be used for non-parametric data. Statistical analysis will be done by using SPSS version 26. Keywords: Lower Limb, motor control, SBES, Strength, Stroke, TOT.
The synopsis will be presented to the Research Ethical Committee of Riphah International University, Lahore, for ethical approval to conduct this study. RECRUITMENT: Eligible participants will be recruited from Neurology departments and Rehabilitation centers. RANDOMIZATION: Patients will be recruited using a non-probability convenience sampling technique, and then they will be divided into two groups by simple random sampling through sealed, opaque envelopes. BLINDNESS: This study will be a single-blinded study in which the outcome assessor will be blind. INTERVENTION: Participants who will meet the inclusion criteria will be recruited, and written informed consent will be obtained before enrollment. The initial assessment will include the Fugl-Meyer Assessment to measure motor recovery and the 10-M Walk Test and TUG to evaluate functional mobility. Participants will be allocated to either the Synergy-Based Electrical Stimulation (SBES) group or the Task-Oriented Training group.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
32
Synergy based visible but comfortable muscle contraction in semi-supine position, surface electrodes on hip and knee flexors and dorsiflexors.• Intensity adjusted based on tolerance • Monitor muscle response and patient comfort
Tot Sit-to-stand, reaching, weight shifting, gait training, ball-kicking, tandem/side walking• Increase intensity by slightly reducing assistance • Add unstable surfaces for gait
Unnamed facility
Lahore, Punjab Province, Pakistan
Fugl-Meyer Assessment:
The Fugl-Meyer Assessment for Lower Extremity (FMA-LE) is a reliable tool to evaluate motor recovery in post-stroke patients. It consists of 17 items divided into five sections: reflex activity, volitional movement within synergy, mixing synergies, movement with little or no synergy, and coordination/speed. Each item is scored from 0 to 2, giving a maximum score of 34. Higher scores indicate better motor function. Reflex activity includes 3 items (max 6 points), synergy movements have 6 items (12 points), mixed synergy includes 2 items (4 points), isolated movements have 3 items (6 points), and coordination/speed includes 3 items (6 points). The heel-to-shin test is used for coordination. Scoring interpretation is: 0-10 severe, 11-20 moderate, 21-29 mild, and 30-34 minimal impairment. It takes 20-30 minutes and is administered by a trained professional.
Time frame: Baseline to 4 weeks
The Timed Up and Go (TUG) Test
This is a quick and reliable assessment used to evaluate mobility, balance, and fall risk in older adults and patients with neurological conditions like stroke. It involves timing how long it takes for a person to stand from a chair, walk three meters, turn, return, and sit down. Times under 10 seconds indicate normal mobility, while over 30 seconds suggest high fall risk. The test is simple, requires minimal equipment, and is widely used in clinical and rehabilitation settings. It helps monitor patient progress and guides treatment planning.
Time frame: Baseline to 4 weeks
10-Meter Walk Test
The 10MWT is a quick and reliable assessment of gait speed over a short distance, commonly used in stroke rehabilitation. It involves timing a patient when they walk a 10-m path, typically within a 14-m walkaway to account for acceleration and deceleration. The test can be performed at a comfortable or fast pace. Gait speed is calculated in meters per second and is considered a strong predictor of functional mobility, fall risk, and community ambulation. It is widely used to monitor progress in stroke patients.
Time frame: Baseline to 4 weeks
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