Functional Outcome of Hemiplegic Upper Extremity in Patients With Subacute Stroke After Kinesiotaping and Rehabilitation
Condition: Stroke; Hemiplegia
MeSH terms: Stroke; Hemiplegia
Study type: Interventional

Summary: 
      1. To explore the role of sonoelastography with shear wave velocity to assess poststroke
           spasticity of affected arm and forearm muscles in patients with stroke.

        2. To investigate the effects of Kinesiotaping applications on motor recovery, functional
           performance, and spasticity of affected upper extremity in patients with subacute
           stroke.
    

Detailed description: 
      Clinical characteristics of impaired motor performance on affected upper extremity in stroke
      patients included muscle weakness, increased muscle tone, contracture, joint instability, or
      impaired motor control. Poststroke spasticity (PSS) is also a common complication in stroke
      patients with limbs weakness and impaired coordination between agonist and antagonist
      contraction. Upper extremity impairments and PSS have negative effects on functional
      performances and quality of daily livings. In patients with subacute stroke, strengthening
      exercises, constraint-induce movement therapy, mirror therapy, mental practice, and
      neuromuscular electrical stimulation, botulinum toxin, and antidepressants are recommended.
      For managing PSS, several therapeutic interventions include stretching and range of motion
      exercises, antispasticity splint, neuromuscular electrical stimulation, oral medications,
      local injection with phenol or botulism, or surgery. Some investigators found that
      Kinesiotaping (KT) combined with other interventions may facilitate muscle function, provide
      joint support and proprioception feedback, and reduce pain in stroke patients with
      hemiplegia. The investigators will perform KT applications both on the proximal and distal
      parts of affected upper extremity to facilitate motor recovery and performance in subacute
      stroke patients with hemiplegia while receiving rehabilitation.

      After reviewing literatures, sonoelastography and shear wave velocity (SWV) was applied to
      evaluate the muscle stiffness in stroke patients with upper limb spasticity, but mostly on
      biceps brachii muscle. The investigators try to use musculoskeletal sonography to explore the
      feasibility of sonoelastography as a quantitative tool for measuring PSS both on spastic arm
      and forearm muscles in patients with stroke.

      In this study, sixty stroke patients with hemiplegia will be recruited for physical
      evaluations for PSS and functional performance of upper extremity, and sonoelastography with
      shear wave velocity (SWV) on biceps brachii, brachioradialis, flexor carpal radialis, and
      flexor carpal ulnaris muscles to explore the relationship between physical and sonographic
      assessements for PSS. In the next phase, 60 subacute patients with hemiplegia would be
      enrolled, then randomly divided into experimental or control groups. In experimental group
      (n=30), the patients will receive KT combined with rehabilitation once daily for five days,
      three weeks. In the control group (n=30), the patient will receive the same program without
      KT. All participants will receive following evaluations, including modified Ashworth and
      Tardieu scales, Fugl-Meyer Assessment for upper extremity, box and block test, the Wolf motor
      function test, and sonoelastography with shear wave velocity (SWV) before intervention, right
      after the three-week intervention, and three-week post intervention.

      The aims of this study are:

        1. To explore the role of sonoelastography with shear wave velocity to assess poststroke
           spasticity of affected arm and forearm muscles in patients with stroke.

        2. To investigate the effects of Kinesiotaping applications on motor recovery, functional
           performance, and spasticity of affected upper extremity in patients with subacute
           stroke.
    

Intervention name(s): Kinesiotaping; Hand rehabilitation program; Sham taping
Intervention type(s): Other; Other; Other
Intervention description(s): inesio tape would be applied over the extensor muscles of the affected hand for facilitating the extension of hand. We will apply the tape from the upper 1/3 length of dorsal side of the forearm and split the tape into five equal bars to the distal interphalangeal joint of each finger along the finger bones. This intervention would be executed for five days per week for three weeks.; In the thirty-minute hand rehabilitation program, a motor-relearning theory would be implemented into the intervention by teaching the participants how to use their upper limb properly without any compensatory motions. Therefore, for establishing a correct movement pattern, an occupational therapist would provide a hand-guided activity, in which the participants could practice reaching movement as well as hand grasp and release in a more natural way. Besides, the therapist would also help the patients release their muscle tone by stretching the spastic muscles for five minutes before and after this hand rehabilitation period.; A short piece of kinesio tape would be cut into half and applied over the lateral side of the forearm from the lateral epicondyle till the half of the forearm. The tape would not cover the both the flexor and extensor muscle bellies.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Kinesiotaping; Spasticity; Elastosonography; Stroke