scholarly journals Efficacy of bilateral lower limb training over unilateral to re-educate balance and walking in post stroke survivors: a protocol for randomized clinical trial

2021 ◽  
Author(s):  
Pallavi Harjpal ◽  
Mohd Irshad Qureshi
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lower Limb ◽  
Stroke Survivors ◽  
Clinical Trial Registry ◽  
Post Stroke ◽  
Subacute Stroke ◽  
Bilateral Training ◽  
Bilateral Lower Limb ◽  
Group B

Abstract Background: Stroke is the leading cause of global morbidity and a major contributor to disability. According to the National Stroke Association, as many as 9 out of 10 stroke survivors have some degree of paralysis immediately after the stroke. Aim is to evaluate the level to which the bilateral lower limb training compared to unilateral alone, reinforces the lower limb functional recovery in the subjects with sub-acute stroke.Methods: The participants (n=40) with subacute stroke will be included in assessor blinded, randomized clinical trial. Participants will be categorized into 2 groups after performing baseline assessments and equal randomization. The participants in Group A will receive only training to the affected side, and those in the Group B will receive bilateral training. We will be evaluating the improvement in lower limb function by balance and walking along with gait parameters.Discussion: Findings of the study will provide further insight into the effectiveness of bilateral training over unilateral in post stroke survivors. If this study is proved to be effective it will improve the balance and gait impairments in post stroke patients.The clinical trial registry-India(CTRI) registration number for this trial is CTRI/2021/05/033621.

scholarly journals Efficacy of Bilateral Lower Limb Training over Unilateral to Re-educate Balance and Walking in Post-stroke Survivors: A Protocol for Randomized Clinical Trial

2021 ◽  
pp. 281-287
Author(s):  
Pallavi Harjpal ◽  
Moh'd Irshad Qureshi ◽  
Rakesh Krishna Kovela ◽  
Moli Jain
Keyword(s):  
Lower Limb ◽  
Dynamic Balance ◽  
Stroke Survivors ◽  
Stroke Patients ◽  
Unaffected Side ◽  
Post Stroke ◽  
Randomized Clinical Study ◽  
Subacute Stroke ◽  
Proprioceptive Neuromuscular Facilitation ◽  
Group B

Background: One of the significant causes of morbidity worldwide and an essential contributor to disability is Stroke. As said by the National Stroke Association, nine post-stroke survivors out of 10 experience some degree of weakness post-stroke. The hemiplegic patients with sub-acute stroke, who will undergo training to both the lower limb overtraining to only involved side will have an improvement in balance and walking. The goal of this study is to see how much training to both the lower limb improves functional recovery in patients who have had a subacute stroke compared to unilateral, more insufficient limb training. Objective: The goal of this study was to see how training to both the lower limb overtraining to the hemiparetic lower limb on balance and walking in subacute stroke patients. Methods: A randomized clinical study with assessor blinding will be conducted with participants with subacute stroke (n=40). Participants will be randomized to one of two groups after performing baseline assessments: Group A or Group B.1st group will receive training only to the hemiparetic side, i.e., Motor Relearning Programme and Proprioceptive Neuromuscular Facilitation, and 2nd group participants will receive bilateral training, i.e., Strengthening to the unaffected side along with Motor Relearning Programme and Proprioceptive Neuromuscular Facilitation to the affected side. During the therapy period, we will assess lower limb function through static and dynamic balance, walking, and gait measures. Results: The purpose of the research is to look into the effect of training to both the lower limb overtraining to the hemiparetic lower limb on balance and walking in subacute stroke patients. The results of this study will be based on the outcome measures that are static and dynamic balance in the stroke patients and walking. Conclusion: The study's findings will shed more light on the benefits of training to both the lower limb overtraining to only involved side in patients post-stroke. If this trial proves successful, it will help post-stroke patients improve their balance and walking.

scholarly journals Comparative Effectiveness of Electrical Stimulation and Aerobic Exercise in the Management of Erectile Dysfunction: A Randomized Clinical Trial

2020 ◽  
Vol 30 (6) ◽  
Author(s):  
Adamu Rislanu ◽  
Hassan Auwal ◽  
Danazumi Musa ◽  
Abdulahi Auwal
Keyword(s):  
Clinical Trial ◽  
Electrical Stimulation ◽  
Erectile Dysfunction ◽  
Aerobic Exercise ◽  
Randomized Clinical Trial ◽  
Group Differences ◽  
Clinical Trial Registry ◽  
Significant Difference ◽  
Group A ◽  
Group B

BACKGROUND፡ Electrical stimulation and aerobic exercise have been indicated to be beneficial in the management of erectile dysfunction individually. However, there is a scarcity of evidence comparing the two treatment approaches. This study investigated the effects of Electrical Stimulation (ES) compared with Eerobic Exercise (AE) in the management of individuals with Erectile Dysfunction (ED).METHODS: This study was a single-blind parallel randomized clinical trial. Thirty (30) patients diagnosed with ED (Mean age of 39.17 ± 6.21 years) were recruited and randomized into two groups, A and B with 15 participants in each group. Group A received ES while Group B received AE. International Index of Erectile Function (IIEF-5) was used to assess the sexual functions of the participants at baseline and after 6 weeks of intervention. Within-group and between-group differences were analyzed using dependent and independent t-tests respectively.RESULTS: The result indicated a significant difference between groups A and B [20.83 (1.83) Vs 14.33 (2.07), p=0.001] after 6 weeks of intervention. However, the mean effect was significantly higher in the ES group than in the AE group.CONCLUSION: The finding of this study indicated that ES is more effective than AE in the management of individuals withED. Trial Registration: Pan African Clinical Trial Registry (PACTR201906776769795)

Upper limbs cycle ergometer increases muscle strength, trunk control and independence of acute stroke subjects: A randomized clinical trial

2021 ◽  
pp. 1-10
Author(s):  
Douglas Rafael da Rosa Pinheiro ◽  
Maria Eduarda Parcianello Cabeleira ◽  
Luigi Antonio da Campo ◽  
Laís Andrielli Ferreira Gattino ◽  
Kellen Sábio de Souza ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Muscle Strength ◽  
Randomized Clinical Trial ◽  
Acute Phase ◽  
Functional Independence ◽  
Cycle Ergometer ◽  
Upper Limbs ◽  
Trunk Control ◽  
Post Stroke ◽  
Conventional Physiotherapy

BACKGROUND: Studies demonstrate the benefits of upper limbs cycle ergometer (ULCE) in subacute and chronic stroke subjects, but the literature still needs to explore the acute phase of the disease. OBJECTIVE: Verify the effects of ULCE on muscular strength, trunk control and independence of post-stroke subjects in hospital acute phase. METHODS: In this randomized clinical trial participants were allocated into two groups. The control group (CG) performed two daily sessions of conventional physiotherapy, while the intervention group (IG) had one daily session of conventional physiotherapy and one of ULCE. The interventions were carried out for 20 minutes for five days. Both groups were assessed before and after the treatment for upper limbs strength by manual dynamometer, trunk control by Trunk Impairment Scale and level of independence by the Modified Rankin Scale. RESULTS: Twenty subjects with mean ages of 63.5±4.5 were enrolled. There was a significant intra-group difference of palmar grip, shoulder abductors, elbow flexor and wrist extensor strength, trunk control and functional independence only in IG. Inter-group difference for all variables showed superiority in IG. CONCLUSIONS: ULCE is an effective device for increasing muscle strength, trunk control and consequently improving the independence of post-stroke subjects in the acute hospital phase.

scholarly journals Telemanagement of Home-Isolated COVID-19 Patients Using Oxygen Therapy With Noninvasive Positive Pressure Ventilation and Physical Therapy Techniques: Randomized Clinical Trial (Preprint)

2020 ◽  
Author(s):  
Aya Sedky Adly ◽  
Mahmoud Sedky Adly ◽  
Afnan Sedky Adly
Keyword(s):  
Health Care ◽  
Clinical Trial ◽  
Physical Therapy ◽  
Randomized Clinical Trial ◽  
Health Care System ◽  
Oxygen Therapy ◽  
Early Stage ◽  
Home Based ◽  
Group A ◽  
Group B

BACKGROUND With the growing stress on hospitals caused by the COVID-19 pandemic, the need for home-based solutions has become a necessity to support these overwhelmed hospitals. OBJECTIVE The goal of this study was to compare two nonpharmacological respiratory treatment methods for home-isolated COVID-19 patients using a newly developed telemanagement health care system. METHODS In this single-blinded randomized clinical trial, 60 patients with stage 1 pneumonia caused by SARS-CoV-2 infection were treated. Group A (n=30) received oxygen therapy with bilevel positive airway pressure (BiPAP) ventilation, and Group B (n=30) received osteopathic manipulative respiratory and physical therapy techniques. Arterial blood gases of PaO<sub>2</sub> and PaCO<sub>2</sub>, pH, vital signs (ie, temperature, respiratory rate, oxygen saturation, heart rate, and blood pressure), and chest computed tomography scans were used for follow-up and for assessment of the course and duration of recovery. RESULTS Analysis of the results showed a significant difference between the two groups (<i>P</i>&lt;.05), with Group A showing shorter recovery periods than Group B (mean 14.9, SD 1.7 days, and mean 23.9, SD 2.3 days, respectively). Significant differences were also observed between baseline and final readings in all of the outcome measures in both groups (<i>P</i>&lt;.05). Regarding posttreatment satisfaction with our proposed telemanagement health care system, positive responses were given by most of the patients in both groups. CONCLUSIONS It was found that home-based oxygen therapy with BiPAP can be a more effective prophylactic treatment approach than osteopathic manipulative respiratory and physical therapy techniques, as it can impede exacerbation of early-stage COVID-19 pneumonia. Telemanagement health care systems are promising methods to help in the pandemic-related shortage of hospital beds, as they showed reasonable effectiveness and reliability in the monitoring and management of patients with early-stage COVID-19 pneumonia. CLINICALTRIAL ClinicalTrials.gov NCT04368923; https://clinicaltrials.gov/ct2/show/NCT04368923

Abstract 13345: Efficacy and Safety of an Anticoagulation Clinic in Low-income Brazilian Patients With Heart Disease: a Randomized Clinical Trial

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Maria A Martins ◽  
João A Oliveira ◽  
Daniel D Ribeiro ◽  
Cibele C César ◽  
Vandack A Nobre ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Heart Disease ◽  
Randomized Clinical Trial ◽  
Incidence Rate ◽  
Latin American ◽  
Low Income ◽  
Efficacy And Safety ◽  
Low Literacy ◽  
Clinical Trial Registration ◽  
Group B

Introduction: Anticoagulation clinics (AC) have better impact on anticoagulation control than usual medical care (UMC). However, there is no randomized trial testing the results of AC in low-income realities. We sought to examine the performance of an AC in a group of patients treated at a Brazilian public hospital. Hypothesis: The assistance provided by AC presents difference in TTR when compared to the UMC. Methods: This was a randomized clinical trial to test the efficacy and safety of a recently-implemented AC over UMC in a group of outpatients with heart disease. The primary and secondary endpoints were time in the therapeutic range (TTR) and warfarin-associated complications, respectively. Overall, 280 patients were enrolled and randomly assigned to one of the two arms: group A: one year at AC (A1: first semester; A2: second semester); and group B: one semester receiving UMC (B1) and other at AC (B2). Results: The mean age was 56.8±13.1 years and patients were mostly female (54.6%). The median monthly income was 464 US dollars. Low literacy was predominant in this group of studied patients (>68%). A1 showed higher TTR (62.4±20.8%) than B1 (55.1±28.5%) (p=0.014). An improvement of TTR was observed within group B, rising from 55.1±28.5% (B1) to 62.2±23.1% (B2) (p=0.008). A1 showed lower incidence rate (IR) per patients-year (p-y) of total bleedings than B1 (incidence rate ratio (IRR): 0.78; p=0.041) and a decline in the IR p-y was found for intra-group comparisons, both presenting IRR 0.58; p<0.001. A1 showed lower IR p-y for thromboembolism than B1 (IRR=0.12; p=0.047). (Clinical trial registration: www.clinicaltrials.gov/. Identifier: NCT01006486) Conclusions: AC helped increase TTR and reduce warfarin-complications, even in low-income settings. Extending this assistance to similar populations in other Latin American countries could reduce hospitalizations and deaths related to warfarin use.

scholarly journals β-Oscillations Reflect Recovery of the Paretic Upper Limb in Subacute Stroke

2020 ◽  
Vol 34 (5) ◽  
pp. 450-462 ◽  
Author(s):  
Chih-Wei Tang ◽  
Fu-Jung Hsiao ◽  
Po-Lei Lee ◽  
Yun-An Tsai ◽  
Ya-Fang Hsu ◽  
...  
Keyword(s):  
Motor Function ◽  
Upper Limb ◽  
Primary Motor Cortex ◽  
Hand Movement ◽  
Stroke Recovery ◽  
Stroke Survivors ◽  
Healthy Controls ◽  
Functional Changes ◽  
Post Stroke ◽  
Subacute Stroke

Background. Recovery of upper limb function post-stroke can be partly predicted by initial motor function, but the mechanisms underpinning these improvements have yet to be determined. Here, we sought to identify neural correlates of post-stroke recovery using longitudinal magnetoencephalography (MEG) assessments in subacute stroke survivors. Methods. First-ever, subcortical ischemic stroke survivors with unilateral mild to moderate hand paresis were evaluated at 3, 5, and 12 weeks after stroke using a finger-lifting task in the MEG. Cortical activity patterns in the β-band (16-30 Hz) were compared with matched healthy controls. Results. All stroke survivors (n=22; 17 males) had improvements in action research arm test (ARAT) and Fugl-Meyer upper extremity (FM-UE) scores between 3 and 12 weeks. At 3 weeks post-stroke the peak amplitudes of the movement-related ipsilesional β-band event-related desynchronization (β-ERD) and synchronization (β-ERS) in primary motor cortex (M1) were significantly lower than the healthy controls (p<0.001) and were correlated with both the FM-UE and ARAT scores (r=0.51-0.69, p<0.017). The decreased β-ERS peak amplitudes were observed both in paretic and non-paretic hand movement particularly at 3 weeks post-stroke, suggesting a generalized disinhibition status. The peak amplitudes of ipsilesional β-ERS at week 3 post-stroke correlated with the FM-UE score at 12 weeks (r=0.54, p=0.03) but no longer significant when controlling for the FM-UE score at 3 weeks post-stroke. Conclusions. Although early β-band activity does not independently predict outcome at 3 months after stroke, it mirrors functional changes, giving a potential insight into the mechanisms underpinning recovery of motor function in subacute stroke.

Kinesio taping effect on quadriceps strength and lower limb function of healthy individuals: A blinded, controlled, randomized, clinical trial

2016 ◽  
Vol 18 ◽  
pp. 27-31 ◽  
Author(s):  
Julio Fernandes de Jesus ◽  
Aline de Almeida Novello ◽  
Gustavo Bezerra Nakaoka ◽  
Amir Curcio dos Reis ◽  
Thiago Yukio Fukuda ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Lower Limb ◽  
Quadriceps Strength ◽  
Healthy Individuals ◽  
Limb Function ◽  
Kinesio Taping ◽  
Lower Limb Function
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