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this study was designed to investigate the effect of soleus muscle kinetic control training on Gait and electromyographic activity of the calf muscle in patients with stroke
Stroke is a neurological condition characterized by a reduced blood supply to the brain tissue, resulting in paralysis of part or all of the body, limiting physical activity and social participation. Gait impairment accounts for the largest proportion of physical activity limitations in stroke patients and is characterized by muscle weakness, foot drop, spasticity, and foot deformity .Gait abnormalities following stroke are often disabling. Reduced ankle dorsiflexion, knee flexion, or hip flexion torques are often postulated causes of compromised toe clearing during the swing phase of gait. conversely, gait asymmetry and reduced walking speed has been attributed to weakness of the planter flexors.The kinetic control comprises balanced presentation of the movement choices with ideal interaction among the key components for the sensorimotor neuromuscular control that mediated by afferent sensory input, particularly the proprioceptive input, CNS integration, optimal motor co-ordination, and physiological stresses to assure functional dynamic stability and controlled mobility. forty patients with stroke will be assigned to two groups; one group will recieve kinetic control plus conventional therapy and control group will receive conventinoal therapy alone.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| soleus kinetic control | Experimental | twenty patients will receive soleus kinetic control plus conventional physiotherapy three times a week for 8 weeks |
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| conventional therapy | Active Comparator | twenty patients will receive conventional physiotherapy three times a week for 8 weeks |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| soleus kinetic control | Other | patients will receive kinetic control for 30 minutes structural progressive training for the soleus muscle guided by the EMG biofeedback plus conventional therapy; 1)Start in crook lying position with the heels level with the pelvis and lift the pelvis clear of the floor followed by bilateral heel raise,2)Progress further by shifting weight onto one leg and holding the heel raise and slowly lowering eccentrically on 1 foot, the next progression is to perform the same movement with the heels lower than the pelvis on step -below the pelvis. The exercise graduation will be guided by the visual EMG Biofeedback participants will receive feedback on soleus activation throughout the training. |
| Measure | Description | Time Frame |
|---|---|---|
| muscle amplitude | A steady device will be used to assess muscle amplitude in the form of RMS with microvolt as the measurement unit | up to eight weeks |
| giat function | The Dynamic Gait Index (DGI) is an ordinal test of gait function evaluates the capacity to adapt gait to complex walking tasks encountered in everyday life. Eight aspects of gait are scored based on observation as the patient walks over a 6.1-m level surface. The rater records an ordinal score that ranges from 0 (unable or done very poorly) to 3 (normal score) for a total point value of 24. Scores of less than 21 appear to suggest risk for falls | up to eight weeks |
| Gait Cycle time | time of gait cycle (seconds) will be measured by steady device | up to eight weeks |
| step time | the time of step by seconds will be measured by steady device | up to eight weeks |
| cadence | Cadence, number of steps per minute, will be measured by steady device | up to eight weeks |
| stance phase percentage | the percentage of stance phase will be measured by steady device | up to eight weeks |
| swing phase percentage | the percentage of swing phase will be measured by steady device | up to eight weeks |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| habiba mohamed, master | Contact | 0 10 90708377 | dochabiba4@gmail.com |
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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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kinetic and traditional therapy
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opaque sealed envelope
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| conventional therapy | Other | the patients will receives conventional physiotherapy program static stretching and stretching board for calf muscle, stretching board, and push off exercises by having the patient push against the therapist or a treatment table during forward gait ( 30 minute), static stretch(30sec\set , rest 20sec\set total 5 set, 3 times \week , for 8 week ), stretching board (4 min\set , rest 1 min\set total 2 set , 3 times \week , for 8 week ) (10 minute) push off training (15 minute 3 times \week , for 8 week )x2 |
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| single and double support percentage | single and double support percentage of gait cycle will be measured by steady device | up to eight weeks |
| first and second double support percentage | first and second double support percentage of gait cycle will be measured by steady devcie | up to eight weeks |
| stride length | stride length by cm will be measured by steady device | up to eight weeks |
| gait speed | gait speed by km/h will measured by steady device | up to eight weeks |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |