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Stroke is leading cause of death and disability worldwide, resulting in significant functional limitations and disabilities experienced by stroke survivors, particularly in the upper limb. There is a need for more effective interventions targeting upper limb sensory motor impairments. The aim of this study is to study combined effect of segmental vibrator and neuromuscular electrical stimulation for flexor and extensor muscle groups on upper limb function in sub-acute stroke.
This study will be a randomized clinical trial and will be conducted in physiotherapy department of Allama Iqbal Memorial Teaching Hospital Sialkot, National Bone and Joint Hospital and Bashir Hospital Sialkot. Forty stroke patients will be recruited through non-probability convenience sampling technique and will be randomly divided in two equal groups Group A and group B through lottery method. Group A will receive high frequency segmental vibration on flexor and extensor muscle groups while group B will receive neuromuscular electrical stimulation along with high frequency segmental vibration(100Hz) on flexor and extensor muscle groups Data will be collected from patients of sub-acute stroke by using screening tool MoCA(for cognition) and assessment tools Fugl-Meyer Assessment Scale(for upper limb function), Wolf Motor Functional Test(for motor function), Modified Ashworth Scale(for spasticity) , Barthel Index(for ADLs), Maximal Hand Grip Strength(for manual dexterity), Maximal Pinch Grip(for manual dexterity), Nottingham Sensory Assessment(for somatosensory function). An informed consent will be taken. Outcome measures will be assessed at baseline, at 4th week and at 8th week. Follow up will be performed at 12th week. Data analysis will be done by SPSS version 28.0.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group A | Experimental | Group A received the high frequency segmental vibrator. |
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| Group B | Experimental | Group B received the combined effects of high frequency segmental vibrator and neuromuscular electrical stimulation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| High frequency Segmental Vibrator | Other | Segmental vibrations of high frequency was used on each flexor and extensor interspersed with a 1 minute break. |
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| Measure | Description | Time Frame |
|---|---|---|
| MoCA(Montreal Cognitive Assessment) | MoCA is a screening tool used to evaluate the cognition in stroke patients. Maximum Score 30 Score > 25 considered normal cognition | Baseline and 8 weeks |
| Fugl-Meyer Assessment | Fugl-Meyer is an assessment tool used to evaluate the upper limb function in stroke patients. Upper Extrimity Maximum Score: 66 | Baseline and 8 weeks |
| Wolf Motor Functional Test | Wolf Motor Functional Test is an assessment tool used to evaluate motor function in stroke patients. The WMFT consists of 15 functional tasks and 2 strength-based tasks (total 17 items). Each task is rated on a 6-point ordinal scale | Baseline and 8 weeks |
| Barthel Index | BI is an assessment tool used to evaluate ADLs in stroke patients. Minimum Score: 0 (completely dependent) and Maximum Score: 100 (fully independent) | Baseline and 8 weeks |
| Modified Ashworth Scale | MAS is an assessment tool used to evaluate spasticity in stroke patients. Minimum score 0 and maximum score 4 | Baseline and 8 weeks |
| Maximal Hand and Pinch Grip Strength | Maximal Hand and Pinch Grip Strength is an assessment tool used to evaluate manual dexterity in stroke patients measured by Dynamometer. | Baseline and 8 weeks |
| Nottingham Sensory Assessment |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Aruba Saeed, MS-NMPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| National Bone and Joint Hospital | Sialkot | Punjab Province | 51310 | Pakistan |
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| Combined effects of high frequency segmental vibrator and neuromuscular electrical stimulation. | Other | Segmental vibrations of high frequency with Neuromuscular Electrical Stimulation was given on each flexor and extensor. |
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Nottingham Sensory Assessment is an assessment tool used to evaluate somatosensory sensation in stroke patients. Minimum Score: 0, Maximum Score: 42 (normal sensation)
| Baseline and 8 weeks |