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Stroke is a leading cause of balance impairment and trunk muscle weakness, which restricts independence in daily activities. Neuromuscular electrical stimulation (NMES) is a safe rehabilitation method to activate muscles. This study will evaluate the effects of NMES applied to the abdominal muscles on balance and ultrasound-measured muscle thickness in stroke patients. The findings may provide evidence for new treatment strategies to enhance trunk function and improve quality of life after stroke.
Stroke is a leading cause of long-term disability and frequently results in impaired balance and trunk muscle weakness, limiting independence in daily life. Abdominal muscles are essential for postural stability, and their weakness may adversely affect mobility and functional outcomes in stroke patients. Neuromuscular electrical stimulation (NMES) is a safe rehabilitation method used to promote muscle contraction and improve strength. While NMES has shown positive effects on limb muscles, its impact on abdominal muscles and balance remains insufficiently studied.
In this prospective randomized controlled trial, participants will be randomly allocated into two groups. The control group will perform core stabilization exercises, while the intervention group will receive core stabilization exercises combined with abdominal NMES. Balance will be assessed using validated clinical scales, and abdominal muscle thickness will be measured by ultrasound. The study aims to determine the additional effects of abdominal NMES on balance, trunk control, and functional recovery in stroke patients.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| NMES + Core Stabilization Exercises | Experimental |
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| Core Stabilization Exercises Only | Active Comparator |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Neuromuscular Electrical Stimulation | Device | NMES will be applied to the abdominal muscles using a multichannel stimulator. Each session will last approximately 20 minutes, administered 5 times per week for a total of 15 sessions, in addition to core stabilization exercise program performed with the same frequency. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Balance Performance (Berg Balance Scale) | Balance will be assessed using the Berg Balance Scale (BBS; maximum score: 56, minimum score: 0). Higher scores indicate better balance, lower scores indicate worse balance. | Baseline and after 15 sessions (≈3 weeks) |
| Abdominal Muscle Thickness (Ultrasound) | Abdominal muscle thickness will be measured in millimeters by ultrasound at rest. Higher values indicate greater muscle thickness. | Baseline and after 15 sessions (≈3 weeks)] |
| Measure | Description | Time Frame |
|---|---|---|
| Trunk Control (Trunk Control test) | Baseline and after 15 sessions (≈3 weeks)] | |
| Fear of Falling (Visual Analog Scale - VAS) | Fear of falling will be evaluated using a Visual Analog Scale (VAS; score range: 0-10 cm, where 0 = no fear and 10 = maximum fear). Higher scores indicate greater fear of falling. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Tuba SARIKAYA | Başakşehir Çam & Sakura City Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Başakşehir Çam and Sakura City Hospital | Istanbul | 34480 | Turkey (Türkiye) |
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| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
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This study is a prospective, randomized, parallel-group trial. Stroke patients will be randomly assigned to one of two groups: (1) an intervention group receiving neuromuscular electrical stimulation (NMES) applied to the abdominal muscles in addition to core stabilization exercises, or (2) a control group performing only core stabilization exercises.
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| Core Stabilization Exercises | Behavioral | Participants will perform a structured core stabilization exercise program. The program will be administered 5 times per week for a total of 15 sessions. |
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| Baseline and after 15 sessions (≈3 weeks)] |
| Change in Postural Control (Postural Assessment Scale for Stroke Patients) | Postural control will be assessed using the Postural Assessment Scale for Stroke Patients (PASS; score range: 0-36). Higher scores indicate better postural control, lower scores indicate worse control. | Baseline and after 15 sessions (≈3 weeks)] |
| Functional Ambulation (Functional Ambulation Classification - FAC) | Ambulation will be measured using the Functional Ambulation Classification (FAC; score range: 0-5). Higher scores indicate better functional ambulation. | Baseline and after 15 sessions (≈3 weeks)] |
| Mobility (Timed Up and Go Test - TUG) | Mobility will be assessed using the Timed Up and Go Test (TUG; measured in seconds). Lower times indicate better mobility, higher times indicate worse mobility. | Baseline and after 15 sessions (≈3 weeks)] |
| Motor Recovery (Brunnstrom Stages) | Motor recovery will be assessed using Brunnstrom Stages of Motor Recovery (score range: Stage 1-6). Higher stages indicate better motor recovery. | Baseline and after 15 sessions (≈3 weeks)] |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |