Different Treatment Methods Effect on Upper Extremity Spasticity and Decreased Functionality After Stroke
Condition: Stroke; Spasticity as Sequela of Stroke; Limitation, Mobility
MeSH terms: Muscle Spasticity; Stroke; Mobility Limitation
Study type: Interventional

Summary: 
      The aim of our study is to objectively and clearly determine the differences between the
      Spasticity and Decreased Functionality in the Upper Extremity Flexor Group Muscles After
      Stroke, the Vibration, mBZHT and Physiotherapy and Rehabilitation Applications in terms of
      treatment process and effectiveness, and to increase the use of the hands and upper
      extremities in the daily life activities of the patient.
    

Detailed description: 
      The World Health Organization has defined stroke as a clinical condition that occurs
      suddenly, with no apparent cause other than a vascular cause, leading to focal or global
      cerebral dysfunction, lasting 24 hours or longer, or resulting in death. Stroke ranks third
      among the causes of death and first in terms of disability. Spasticity, a velocity-dependent
      increase in muscle tone as a part of upper motor neuron syndrome, is seen in a wide variety
      of neurological diseases, including stroke, and may occur in the first week after
      stroke.Rehabilitation aims to inhibit spasticity, improve motor functions, gain independence
      in activities of daily living, and improve health-related quality of life in stroke
      patients.This is an observational study within a study.This study was carried out in
      Kırıkkale University Faculty of Medicine, Physical Therapy and Rehabilitation Hospital and
      Tokat State Hospital Physical Therapy and Rehabilitation Unit 45 volunteers who were
      diagnosed with stroke, aged 18-75 years, who met the inclusion criteria of the study planned
      for the individual.In the study, patients were divided into 3 groups according to different
      treatment methods the effects of Local Vibration and m(CIMT) applied to upper extremity
      flexor muscle groups on spasticity and upper extremity functionality will be examined in
      addition to the conventional rehabilitation program in stroke individuals. A program that
      includes joint range of motion exercises, strengthening exercises, mobility and transfer
      activities and various activities to increase participation in daily life activities will be
      applied routinely for 3 sessions 45 minutes a week for 8 weeks in the first group of patients
      in the training group.In addition, in addition to conventional physiotherapy, patients in the
      1st group immediately after the sessions. Upper extremity flexor on the hemiplegic side in
      supine position, 3 sessions per week with a CE certified vibration device with a frequency of
      50-110 Hz and an amplitude of 1-4 mm.Vibration will be done for 15 minutes each.From the
      patients in the second group, for 8 weeks, 3 days a week, 60 minutes joint range of motion
      exercises as routine conventional treatment in sessions,strengthening exercises, mobility and
      transfer activities, and activities of daily living.In order to increase participation, a
      program including various activities will be implemented. Moreover after the sessions,
      patients can use their intact extremities with shoulder stabilization orthosis at home
      restraint, grasping on the hemiplegic side, using spoons and forks, combing hair daily life
      activities, 8 weeks, 3 days a week, and approximately 3 hours Modified Restrictor Forced
      Movement Therapy m(CIMT) will be applied.In the third group, the last group in the third
      group, for 8 weeks, 3 days a week, 60 minutes joint range of motion exercises as routine
      conventional treatment only in sessions, strengthening exercises, mobility and transfer
      activities, and activities of daily living. In order to increase participation, a program
      including various activities will be implemented.

      First of all, all individuals; Demographic characteristics such as age, gender, height,
      weight, case report form will be questioned. Upper extremity of all subjects before and 8
      weeks after treatment.

      Spasticity (tonus, elasticity, stiffness) in flexor group muscles Modified Ashworth and It
      will be measured with modified Tardieu Scales. Manual dexterity, speed and coordination of
      upper extremity activities were determined by Fugl-Meyer Upper Limb Evaluation Scale, 9-Hole
      Peg Test, Box and Block Test [BBT]) and Upper Extremity Motor Activity Diary-28; The quality
      of life of individuals with stroke, with the Stroke-Specific Quality of Life Scale; Cognitive
      states of stroke individuals will be evaluated with the Mini Mental Test.
    

Intervention name(s): Vibration; Modified Constraint-İnduced Movement Therapy; Conventional Therapy
Intervention type(s): Other; Other; Other
Intervention description(s): Vibration is used as an alternative to physical exercise in various areas to increase muscle performance and flexibility, improve balance and proprioception, reduce spasticity and increase bone density.; Compulsory use therapy is a form of treatment in which the movements of the healthy side are prevented and the use of the weak side is encouraged in the stroke patient.; Conventional exercises
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: In the study, 45 individuals between the ages of 18-75 who were diagnosed with stroke and met the inclusion criteria will be recruited. Individuals will be divided into 3 groups according to different treatment methods.
Masking: Double (Participant, Investigator)
Primary purpose: Treatment