Boxing Training for Upper Limb Functions, Balance, and Quality of Life in Stroke
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      The World Health Organization's (WHO) definition of stroke is a clinical syndrome
      characterized by rapidly developing clinical signs of focal (or global) disturbance of
      cerebral function lasting more than 24 hours or leading to death with no apparent cause other
      than a vascular origin'.Stroke has further three types i.e. ischemic, hemorrhagic, and
      transient ischemic stroke. As most gestures in daily life involve the upper limbs and hands,
      patients who cannot use their hands not only suffer from severe physical and psychological
      pain but also encounter difﬁculties in the activities of daily living that primarily involve
      upper limb function. Stroke patients have various problems such as asymmetrical posture,
      abnormal body balance, and decreased ability to move the weight.
    

Detailed description: 
      As most gestures in daily life involve the upper limbs and hands, patients who cannot use
      their hands not only suffer from severe physical and psychological pain but also encounter
      difﬁculties in the activities of daily living that primarily involve upper limb function.
      Stroke patients have various problems such as asymmetrical posture, abnormal body balance,
      and decreased ability to move the weight. The loss of motion element involved in ﬁne
      functions, and the above-mentioned problems can lead to decreased muscle cooperativity of the
      lower limbs while walking and may also result in an asymmetric gait due to imbalance in the
      ability to perform the exercise. Due to such persistent disorders, most stroke patients
      suffer from depression, problems in interpersonal relationships and social life, and a
      generally lower quality of life. Recent studies on the treatment of stroke patients reported
      that approaches such as more intensive and repetitive training as compared to conventional
      general and passive intervention, training related to reality, intervention involving
      motivation and active participation and forced induction exercise, visual exercise feedback,
      purpose-oriented training, and task-oriented training are more effective in promoting
      function after stroke onset. Virtual reality (VR) is frequently used in different disease
      groups at the clinic for rehabilitation purposes. Xbox Kinect, Nintendo Wii, Sony
      PlayStation, and Cyber Glove are among the most commonly used VR applications in
      rehabilitation. Several studies reported that VR applications improved both upper and lower
      extremity functions and promoted independence in performing activities of daily living.
      Task-specific training focused on both upper limbs and lower limbs could have a greater
      impact in improving mobility and physical activity in individuals with stroke but these
      studies have very little impact on balance, gait, and quality of life in patients with
      stroke. Previous studies reported that task-oriented training programs in stroke patients
      only focus on lower limb and upper limb function. The main barrier or limitation in
      task-oriented training is the repetition of tasks in an appropriate manner, and most patients
      lose interest and feel bored and there is less active participation during the performance of
      similar tasks. This will affect their performance and function and not very much effective
      intervention for treating stroke patients.

      In recent years, it has been observed that boxing therapy has positive outcomes in
      individuals with neurological diseases. In the literature, the first study, including boxing
      therapy, was conducted in patients with Parkinson's disease, which concluded that boxing
      therapy was feasible and reliable for Parkinson's patients. As a form of high-intensity
      exercise, it is argued that goal-based activities such as boxing can be engaging and
      accessible for people with chronic diseases. Boxing incorporates high-intensity exercise,
      with movements of all regions of the body in a weight-bearing and aerobic context. Either
      non-contact or as a contact sport, boxing movements can be performed in sitting, standing, or
      as part of dynamic, complex movement sequences. In able-bodied people, high-intensity boxing
      programs performed for 50-minutes four times per week improved fitness, health, and
      well-being. The other preliminary on the effects of the sitting boxing program in stroke
      patients investigated and demonstrated that the sitting boxing program had a positive impact
      on upper extremity function, balance, gait, and quality of life in stroke patients.
    

Intervention name(s): Boxing training; Task Oriented Training
Intervention type(s): Other; Other
Intervention description(s): Boxing training: warm-up. Mitt hitting, sandbag hitting, in sitting, cool down, Assessment after 4 weeks boxing training: warm-up. Mitt hitting, sandbag hitting, below hips, cool down, Assessment after 6 weeks Boxing training: warm-up. Mitt hitting, sandbag hitting, both inn sitting and standing, cool down, Post assessment; Task-oriented training: 6 tasks in sitting and standing position for both upper and lower limb Assessment after 4 weeks Task oriented training: 6 tasks in sitting and standing position for both upper and lower limb Assessment after 6 weeks Task oriented training: 6 tasks in sitting and standing position for both upper and lower limb Post assessment
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment