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this study will be conducted to investigate the effect of planter flexors spasticity on postural stability, risk of falling and function outcomes in patients with stroke
Lower limb spasticity is a common following a cerebrovascular attack (CVA) or stroke, which can affect the balance and gait of patients. This then not only affects independence, and quality of life but increases the risk for other concerns, such as falling and an increased sedentariness, which could further affect health outcomes.The spasticity of the planter flexors disturbs walking, can impede toe clearance during the swing phase of gait causing the patient to fall as a result their toe 'catching' on the ground .In stroke patients characteristically the extensors of the leg are spastic and the flexors are weak . All these changes lead to gait disturbance as well as impaired functional mobility of patients.Studies have shown that patients with stroke have a higher risk of developing the fear of falling, which may be related to an increased risk of falling after stroke .The incidence of fear of falling after stroke has been reported to be approximately 32 to 66 percent. Fear of falling is associated with adverse consequences such as limited activity, increased incidence of falls, decreased quality of life, and increased hospitalization and case fatality rates
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Low spasticity group | thirty four patients with low spasticity grade (grade I and 2) will participate in this group |
| |
| High spasticity group | thirty four patients with high spasticity grade (grade 3 and 4) will participate in this group |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Low spasticity group | Other | low sapsticity (grade 1-2) unilateral ischemic stroke will be participate in this group |
|
| Measure | Description | Time Frame |
|---|---|---|
| spasticity | Modified Ashworth scale will be used to assess spasticity.The rater will score muscle spasticity from 0 to 4. Only one passive stretch will be applied to rate spasticity The scale is as follows: 0: No increase in muscle tone
| up to thirty minutes |
| muscle spasticity | MyotonPRO will be used to assess spasticity. it can assess regional differences in tendon stiffness, such as variations along the Achilles tendon, and monitor stiffness modulation with joint position changes. It is placed on the skin over the muscle. A brief, gentle tap from the probe causes the muscle to oscillate. The oscillations are analysed automatically by the device to calculate the muscle's mechanical characteristics, such as its tone, stiffness and how elastic it is. | up to thirty minutes |
| postural stability | biodex balance system will be used to assess postural stability | up to thirty minutes |
| risk of falling index | biodex balance system will be used to assess risk of falling | up to thirty minutes |
| risk of falling | The Morse Fall Scale (MFS) is one of the well- known tools both domestically and internationally for measuring fall risk in adults. It has the advantage of being easy to measure. The MFS has been validated in several studies and is considered a reliable tool for measuring fall risk. The MFS is composed of six variables that assess different risk factors for falling. Each variable is scored, and the total score determines the patient's fall risk.Each of the six variables is assigned a score, and the total score ranges from 0 to 125. The risk levels are categorized as follows: Low Risk: 0-24 Moderate Risk: 25-44 High Risk: 45 and above |
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Inclusion Criteria:
Exclusion Criteria:
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Sixty eight unilateral ischemic stroke patients as diagnosed by CT ''computed topography'' or MRI ''magnetic resonance imaging from both sexes and will be assigned to two groups depending on level of spasticity.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| radwa ameen, master | Contact | 01140174591 | radwashokry@pt.svu.edu.eg |
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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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| High spasticity group | Other | high sapsticity (grade 3-4) unilateral ischemic stroke will be participate in this group |
|
| up to thirty minutes |
| functional mobility | The Timed Up and Go (TUG) test is a widely utilized clinical tool to assess functional Mobility.It involves timing an individual as they stand up from a chair with armrests, walk a distance of three meters at a comfortable place (with or without their usual walking aid), turn around, walk back, and sit down again
| up to thirty minutes |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |