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This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.
This study will aim to investigate the effects of vestibular rehabilitation, dynamic neuromuscular stabilization (DNS), and conservative rehabilitation exercises on balance and mobility in hemiplegic patients, and to compare the exercise programs with one another. A total of 45 hemiplegic patients will enrolled and randomized into three groups: Conventional Exercise Group (CEG, n = 15), Dynamic Neuromuscular Stabilization Group (DNSG, n = 15), and Vestibular Rehabilitation Group (VRG, n = 15). Each group will be participated in specialized exercise programs twice a week for six weeks. All groups will be underwent assessments before and after treatment. Evaluation tools include the Brunnstrom Motor Staging, Fugl-Meyer Upper Extremity Motor Function Scale, Modified Ashworth Scale, Mini-Mental State Examination, Berg Balance Scale, Stroke Impact Scale, and Timed Up and Go test.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Group 1: Conventional Exercise Group | Experimental | Conventional Exercise will be conducted in this group |
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| Group 2: Dynamic Neuromuscular Stabilization Group | Experimental | Dynamic Neuromuscular Stabilization exercises will be done in this group |
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| Group 3: Vestibular Rehabilitation Group | Experimental | Vestibular Rehabilitation will be conducted in this group |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Conventional Exercise programs | Other | This group participated in Conventional Exercise programs twice a week for six weeks. |
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| Measure | Description | Time Frame |
|---|---|---|
| The Fugl-Meyer Assessment of Upper Extremity | It is a standardized, stroke-specific, performance-based outcome measure used in clinical trials to evaluate motor recovery of the upper limb. It assesses movement, coordination, and reflex activity of the shoulder, elbow, forearm, wrist, and hand, providing a quantitative measure of motor impairment and recovery over time. The maximum score for the arm section is 36. During the finger-to-nose test, coordination and speed of movement are evaluated out of 6 points, while tremor, dysmetria, and speed of movement in the upper extremity are also examined in detail. | From the beginning of treatment to the end of the 6th week |
| Modified Ashworth Scale (MAS) | It is a widely used clinical outcome measure in clinical trials to assess spasticity by grading the resistance encountered during passive muscle stretching. The joint is passively moved with repetitive and rapid movements, and the joint's resistance to these movements is scored. | From the beginning of treatment to the end of the 6th week |
| Mini-Mental State Examination (MMSE) | It is a brief, standardized cognitive screening tool used in clinical trials to assess global cognitive function, including orientation, attention, memory, language, and visuospatial abilities. The total score ranges from 0 to 30, with higher scores indicating better cognitive performance. Scores of 24-30 indicate normal cognition, 18-23 mild cognitive impairment, and ≤17 moderate to severe cognitive impairment. | From the beginning of treatment to the end of the 6th week |
| Berg Balance Scale (BBS) | This is a 14-item scale that assesses a patient's ability to maintain balance for a specific period during static and various functional movements. The scoring system ranges from 0 to 4, with 0 meaning "cannot" and 4 meaning "can do independently," and the maximum total score is 56. A total score between 0-20 indicates a high risk of falls; between 21-40 indicates a moderate risk of falls; and between 41-56 indicates a low risk of falls. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| MERVE YILMAZ MENEK | Medipol University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Istanbul Medipol University | Istanbul | Turkey (Türkiye) |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 32250328 | Result | Yoon HS, Cha YJ, You JSH. Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial. NeuroRehabilitation. 2020;46(3):381-389. doi: 10.3233/NRE-192983. |
| Label | URL |
|---|---|
| Effects of dynamic core-postural chain stabilization on diaphragm movement, abdominal muscle thickness, and postural control in patients with subacute stroke: A randomized control trial. NeuroRehabilitation | View source |
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Individual participant data (IPD) will be made available to other researchers upon reasonable request, if deemed necessary.
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Outcomes Assessor will be masked in the assesment part in the study.
| Dynamic Neuromuscular Stabilization | Other | This group participated in Dynamic Neuromuscular Stabilization Exercise programs twice a week for six weeks. |
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| Vestibular Rehabilitation Group | Other | This group participated in Vestibular Rehabilitation programs twice a week for six weeks. |
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| From the beginning of treatment to the end of the 6th week |
| Stroke Impact Scale (SIS) | It is a stroke-specific, patient-reported outcome measure widely used in clinical trials to evaluate the perceived impact of stroke on multiple domains of health-related quality of life. Based on the obtained score, 0 indicates no recovery, whereas 100 represents complete recovery. | From the beginning of treatment to the end of the 6th week |
| Timed Up and Go (TUG) | The test is a simple and widely used functional mobility assessment in clinical trials. It measures the time required for an individual to stand up from a chair, walk 3 meters, turn around, walk back, and sit down. Shorter completion times indicate better functional mobility and balance, and the test is commonly used to assess fall risk and mobility limitations. | From the beginning of treatment to the end of the 6th week |
| ID | Term |
|---|---|
| D006429 | Hemiplegia |
| ID | Term |
|---|---|
| D010243 | Paralysis |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
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