Effect of HABIT-ILE on Balance and Coordination Among Stroke Patients

Riphah International University44 enrolled

Overview

Strokes frequently affect motor function, balance, and coordination, reducing independence. HABIT-ILE combines upper and lower limb exercises to improve coordination and balance. Objective To determine the effectiveness of HABIT-ILE on balance and coordination among stroke patients. we used randomized controlled trails (two-arm parallel design) on 44 people who were allocated evenly into two groups using purposive sampling. The Berg Balance Scale, Finger-to-Nose Test, and 6-Minute Walk Test were administered during a six-month period at HHRD Center, Mansehra. Data was analyzed using SPSS 25 with repeated measures ANOVA and the Shapiro-Wilk test to ensure normality

Stroke often causes weakness, impaired coordination, and poor balance, leading to difficulties in performing daily activities independently. HABIT-ILE (Hand-Arm Bimanual Intensive Therapy Including Lower Extremity) is a task-oriented rehabilitation approach that focuses on intensive, repetitive practice of coordinated movements involving both upper limbs and lower extremities. It aims to improve motor control, balance, gait, and functional independence by encouraging the use of the affected side during meaningful activities. The purpose of this topic is to evaluate the effectiveness of HABIT-ILE in improving balance and coordination among stroke patients. By enhancing bilateral limb function and postural control, this therapy may help patients regain mobility, reduce the risk of falls, and improve their overall quality of life. The findings may provide evidence for incorporating HABIT-ILE into stroke rehabilitation programs to achieve better functional outcomes.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Enrollment

Interventions

Lower Extremity HABIT-ILE GROUP AOTHER

Hand Arm Bimanual intensive therapy including lower extremity (HABIT-ILE) is among the few neuro-rehabilitation treatments that specifically target UE and LE (19) This method uses concepts from motor skill learning in intensive training; it calls for postural control and continuous stimulation of UE and LE through various activities that are done continuously, progressively more difficult, for two hours every day for three weeks in group therapy (20) It is suggested that participants engage in structured tasks that gradually increase in motor complexity based on their development. Similarly, it involves postural and/or locomotor movements as well as functional tasks that call for the simultaneous use of both hands. (21) A variety of exercises that test the patient's ability to utilize their lower extremities to carry out daily duties are usually included in the rehabilitation program

group B Conventional treatment ( Conventional TreatmentOTHER

Conventional physical therapy intervention The conventional physical therapy intervention included 5 minutes of range of motion, 10 minutes of stretching, 10 minutes of strengthening, and 5 minutes of muscle relaxation in each 30-minute session. Stretching tight muscles and strengthening weak muscles were the main focus of each session.

Eligibility

Sex: ALLMin age: 40 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Participants falling in the following category would be recruited into the study: 1. A hemiplegic patient due to unilateral stroke 2. Patients having sub-acute and chronic stroke 3. Stroke survivors between 40 and 60years old 4. Both genders 5. A hemiparetic patient with a chronic stroke (over 6 months of evolution) Exclusion Criteria: * Participants falling in the following category would be excluded from the study: 1. Pregnancy 2. Major cognitive impairment interfering with the study (severe aphasia, psychiatric conditions) 3. Uncontrolled health issues (cardiac/renal failure) 4. Patients with depression who will be unable to cooperate during treatment 5. Patients who cannot perform the active movement of limb due to pre-stroke musculoskeletal problems 6. Cardiopulmonary diseases which could hinder their ability to participate in rehabilitation 7. Patients with any neuron disease and with lower-limb impairment caused by other neurological diseases 8. Visual and auditory abnormalities

Outcomes

Primary Outcomes

Finger to nose test

The finger-to-nose test (FNT) is a basic and simple physical examination that has been conventionally used to examine cerebellar function. In the FNT, patients are asked to alternately touch their own nose and the evaluator's stationary or moving finger while lying supine, or while sitting or standing. The Finger-to-Nose-Test measures smooth, coordinated upper-extremity movement by having the examinee touch the tip of his or her nose with his or her index finger. On one variation of the test, the examiner holds out his or her finger, about an arm's length from the patient. The patient is instructed to touch the examiner's finger, then his or her own nose. After several successful trials, the patient is then asked to repeat the action more quickly. Moving the target finger can increase the difficulty of the task. This test is part of a comprehensive neurological examination. It is typically employed as part of coordination testing. The examiner looks for evidence of intention tremor or

Time frame: 6 Weeks

berg balance scale

The Berg Balance Scale is a testing tool with high validity and reliability used to measure balance. Balance gives an individual the ability to achieve physical movement and further carry out the activities of daily living. A five-point scale, ranging from 0-4. "0" indicates the lowest level of function and "4" the highest level of function. Total Score = 0-56. Score of 41-56 = low fall risk, 21-40 = medium fall risk, 0-20 = high fall risk. The Berg Balance Scale has a high relative reliability with interrater reliability estimatedat0.97 (95% CI 0.96 to 0.98) and interrater reliability estimated at 0.98 (95%CI0.97to0.99). The absolute reliability of the Berg Balance Scale varies across the scale, with minimal detectable change with 95%confidencevaryingbetween 2.8/56 and 6.6/56

Time frame: 6 weeks

6 min walk test

An increase in the distance walked indicates improvement in basic mobility. Resnik et al (2011) suggested in Amputee rehabilitation, Post training a difference of at least 45m should be observed for the 6 minute walk test to be sure that a "real" change in the patient's condition. The six-minute walk test is a simple cardiopulmonary functional testing modality. Its straightforward nature allows for a non-specific, integrated assessment of the many systems involved during physical activity. Specifically, its results can assist in ascertaining the degree of functional impairment and potentially lead to modifications in therapy for some cardiovascular and pulmonary conditions. This activity reviews the six-minute walking test, its physiological basis, uses in practice, and outlines the role of the healthcare team in its performance.