Virtual Rehabilitation and PNF in the Recovery of the Motor Function Post Stroke

Study Overview
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Brief Summary
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The purpose of this study is to determine the effects of use the Nintendo Wii® (NW) and therapeutic exercises by the method Proprioceptive Neuromuscular Facilitation (PNF) in the recovery of the motor function of poststroke hemiparesis patients.

Detailed Description
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Randomised clinical trial (RCT) will be held in following the recommendations of the CONSORT (Consolidated Standards of Reporting Trials). This RCT have longitudinal and prospective feature, held at the Neurosciences Clinic located at the Clinic Professor Francisco Magalhães Neto the HUPES Complex / Federal University of Bahia from June 2015 until June 2016. In the initial evaluation were obtained by a trained examiner and blinded to the allocation of participants, all personal data of all patients, as well as evaluations of balance and quality of life through specific validated scales: 1. Fugl Meyer scale (FMS); The investigators employ an experimental program of therapeutic exercises for the PNF method and virtual rehabilitation with NW, for a period of two months, with sessions two times a week for 50 minutes (a total of 16 sessions).

Official Title
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Effectiveness of Virtual Rehabilitation and Proprioceptive Neuromuscular Facilitation in the Recovery of the Motor Function Post Stroke: A Randomized Clinical Trial

Conditions
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Stroke, Cerebrovascular Disorders

Intervention / Treatment
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* Other: Virtual Rehabilitation
* Other: PNF Method
* Other: Virtual Rehabilitation and PNF Method


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: age between 18 and 80 years, of both sexes; neurological clinical diagnosis of stroke; owning grade 2-4 spasticity according to the Ashworth scale; hemiparetic patients after 6 months of onset of stroke; deficit moderate gait according to Functional Ambulation Classification (values ≥ 2). Exclusion Criteria: score <24 on the Mini Mental State Examination; other associated neurological diseases, as well as orthopedic and no visual or hearing impairment; participation in other rehabilitation programs.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Virtual Rehabilitation<br>A virtual rehabilitation program (G0) based on the use of the NW for a period of two months, with sessions two times a week for 50 minutes (a total of 16 sessions).All treatment groups prior to perform the study interventions,stretches of upper and lower limbs for 10 minutes. The G0 treatment program consists of the following protocols: a) protocol 1 games (Balance Bubble Plus and Tennis); b) protocol 2 games (Rhythm Parade and Boxing). | Other: Virtual Rehabilitation<br>* It is the use of the NW games for rehabilitation of balance in post-stroke patients.<br>* Other names: NW Wii-rehabilitation Commercial Game;|
| Experimental: PNF Method<br>A program of therapeutic exercises (G1) based on the PNF method for a period of two months, with sessions two times a week for 50 minutes (a total of 16 sessions).All treatment groups prior to perform the study interventions,stretches of upper and lower limbs for 10 minutes. The G1 treatment program consists of the following protocols: a) protocol 1 : 30 minutes diagonal exercise upper limb (flexion-abduction-external rotation and extension-abduction-internal rotation), and 10 minutes diagonal exercise scapula (anterior and posterior elevation); b) protocol 2: 20 minutes diagonal exercise lower limb (flexion-abduction-external rotation and flexion-abduction-internal rotation),10 minutes diagonal exercise pelvis (anterior and posterior depression), and 10 minutes gait cycle training; | Other: PNF Method<br>* It is the use of the therapeutic exercises based on the PNF diagonals for rehabilitation of balance in post-stroke patients.<br>* Other names: Kabat method Diagonals of PNF;|
| Active Comparator: Virtual Rehabilitation and PNF Method<br>In G2 program will be performed 20 minutes G0 protocol (1 or 2, used alternately between sessions a week) and 20 minutes G1 protocol (1 or 2, used alternately between sessions a week), taking the time of the performed activities halved in both protocols. | Other: Virtual Rehabilitation and PNF Method<br>* It is the use of the exercises based on the PNF diagonals and of the NW for rehabilitation of balance in post-stroke patients.<br>* Other names: Kabat method Wii-rehabilitation Commercial Game Diagonals of PNF;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effectiveness of virtual rehabilitation and proprioceptive neuromuscular facilitation in the recovery of the motor function post stroke | Fugl-Meyer Assessment | 8 weeks |