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Combined Effects of Tactile -kinesthetic stimulation with Neural mobilization on sensory and motor functions of upper limb in stroke patients
Stroke ranks among the primary causes of lasting disability, frequently leaving the upper limb weak, numb, or clumsy and thereby curtailing daily independence and overall well-being. Although multiple therapy regimens appear helpful, research to date Meestal tests each method alone, obscuring how paired sensory and motor targets might accelerate recovery. The present study investigates combined the effect of tactile-kinesthetic input with neural mobilization against standard care, hypothesizing that the blend will produce broader gains in sensation and movement.
This randomized clinical trial will be conducted at Ittefaq Hospital (Trust) Lahore and Gulab Devi Chest Hospital Lahore over duration of 11 months. The sample size will be (53) participants. Participants which meet the inclusion criteria will be taken through non-probability convenience sampling technique, which will further be randomized through lottery method. Group A (27) participants will be assigned to combined tactile kinesthetic stimulation plus neural mobilization and Group B (27)participants will be assigned to conventional therapy. Data will be collected through different assessment tools, including Fugyl-Meyer Assessment for motor function, Nottingham Sensory Assessment Scale (NAS) for sensory function. Pre-interventions assessments will be conducted for both groups. The effects of the interventions will be measured at pre-treatment and post-treatment of 6 weeks. Data analysis will be performed by using SPSS 26 software.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Combine effects of Tactile with neural of sensory and motor functions of upper limb stroke | Experimental | Tactile Kinesthetic with Neural Mobilization: participants receive TKS WITH NM for 20 mins for 3 days per week for 4 weeks |
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| Combine effects of Tactile with neural mobilization of sensory and motor functions of upper limb str | Active Comparator | Tks With Nm receive 20 mins therapy for 3 days per week |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tactile kinesthetic stimulation with neural mobilization | Other | The therapist rests a light touch on the limb, applying only the weight of fingertips Soft, gliding strokes travel across the skin, delivered with the very tips of the fingers Pressure remains steadily upon targeted patches of tissue without sliding away Measured, rhythmical strokes creep up and down the length of the arm or leg Smooth silk, rough jute, coarse sponge, and other materials are brushed over the skin in turn.Slowly glide the median nerve by extending wrist and fingers while gently abducting the shoulder. |
| Measure | Description | Time Frame |
|---|---|---|
| 1.Fugl-Meyer Assessment (FMA) | The Fugl-Meyer Assessment (FMA) was developed specifically for stroke survivors and is a performance-based tool that gauges sensorimotor deficits in people living with hemiplegia. The FMA examines five key areas: voluntary motor control, sensory perception, balance, passive joint range of motion, and joint-related pain. Within this battery, the motor section commands the most attention; it rates movement, coordination, and reflex activity in the arms and legs, yielding a ceiling score of 100 points (66 for the arm and 34 for the leg). | baseline with 4 week |
| 2.Nottingham Sensory Assessment (NSA) | The Nottingham Sensory Assessment, or NSA, provides clinicians with a standard method for mapping sensory loss after a stroke. Designed to examine both arms and legs, it centers on three core domains: touch, proprioception, and stereognosis. Within the protocol, practitioners test responses to light touch, gentle pressure, pinprick, temperature changes, and passive joint positioning. Because around half of all stroke survivors carry hidden somatosensory deficits that often impede movement, the tool is essential for early identification. | baseline with 4 week |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Sabiha Arshad, Ms | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Lahore | Punjab Province | 54000 | Pakistan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 35251715 | Background | Battesha HHM, Wadee AN, Shafeek MM, Tawfick AM, Ibrahim HM. Maze Control Training on Kinesthetic Awareness in Patients with Stroke: A Randomized Controlled Trial. Rehabil Res Pract. 2022 Feb 24;2022:5063492. doi: 10.1155/2022/5063492. eCollection 2022. | |
| 35266005 | Background | Takahashi R, Koiwa M, Ide W, Okawada M, Akaboshi K, Kaneko F. Visually Induced Kinaesthetic Illusion Combined with Therapeutic Exercise for Patients with Chronic Stroke: A Pilot Study. J Rehabil Med. 2022 Apr 7;54:jrm00276. doi: 10.2340/jrm.v54.29. |
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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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| kinesthetic therapy | Other | Median nerve mobilization: Slowly glide the median nerve by extending wrist and fingers while gently abducting the shoulder. Ulnar nerve mobilization: Control elbow flexion and wrist extension while holding shoulder in slight abduction Radial nerve mobilization: Passively flex the wrist, pronate the forearm, and depress the shoulder to slide the radial nerve |
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| 29661237 | Background | Afzal MR, Pyo S, Oh MK, Park YS, Yoon J. Evaluating the effects of delivering integrated kinesthetic and tactile cues to individuals with unilateral hemiparetic stroke during overground walking. J Neuroeng Rehabil. 2018 Apr 16;15(1):33. doi: 10.1186/s12984-018-0372-0. |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |