Comparison of Mirror Therapy and Modified Constrain Induced Movement Therapy on Risk of Fall, Balance and Gait in Stroke

Study Overview
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Brief Summary
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There will be a difference between modified constraint induced movement therapy and Mirror Therapy on lower limb for risk of fall, balance and gait in stroke patients.

Official Title
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Comparison of Mirror Therapy and Modified Constrain Induced Movement Therapy on Risk of Fall, Balance and Gait in Stroke

Conditions
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Stroke

Intervention / Treatment
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* Other: CIMT Group
* Other: Mirror Therapy group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: A Hemiplegia due to unilateral stroke Sub-acute and chronic stroke Stroke survivors between 21 and 70 years old will be recruited Both genders NIH Stroke scale below 20 Mini-Mental State Examination above 24 Function in Sitting Test (FIST) above 42/56 Exclusion Criteria: Patients with depression who will be unable to cooperate during treatment Patients who cannot perform the active movement of limb due to prestroke muscoskeletal problems Cardiopulmonary diseases which could hinder their ability to participate in rehabilitation Spasticity of Modified Ashworth Scale (MAS) II or higher Patients with Any neuron disease and Patients with lower-limb impairment caused by other neurological diseases or inability to comply with study protocol will be excluded. Visual and auditory abnormalities

Ages Eligible for Study
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Minimum Age: 21 Years
Maximum Age: 70 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 |
| --- | --- |
| Experimental: CIMT Group<br>In this group of patients CIMT technique will be used for treatment | Other: CIMT Group<br>* In this group of patients CIMT technique will be used for treatment<br>|
| Experimental: Mirror Therapy Group<br>patient will perform movements in semi-reclined and sitting positions with the mirror placed between the two lower extremities. | Other: Mirror Therapy group<br>* patient will perform movements in semi-reclined and sitting positions with the mirror placed between the two lower extremities.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| NIH Stroke Scale - NIHSS | It comprises of 15 items with each having responses scored on a 0-4 points scale. The overall score ranges from 0-42 points with higher scores specifying pronounced neurological deficits | 2,4,8 week | 
| Mini-mental state examination | Cognitive status by the mini-mental state examination (mmse)Mini-Mental State Examination (MMSE) is a tool that can quickly diagnose if a person suffers from mild cognitive impairment (MCI) through answering questions in different cognitive domains. The MMSE demonstrates moderately high levels of reliability. It has been reported to be internally consistent | 2,4,8 week | 
| POMA | After interventions POMA for assessing risk of fall will be used. The POMA is used to examine balance and mobility in the elderly (Tinetti 1986). This examination tool consists of the balance subscale (9 items, 16 points) and gait subscale (8 items, 12 points), totaling 28 points. | 2,4,8 week | 
| Berg balance scale | A five-point scale, ranging from 0-4. 0 indicates the lowest level of function and 4 the highest level of function. Total Score = 0-56. Score of 41-56 = low fall risk, 21-40 = medium fall risk, 0-20 = high fall risk. | 2,4,8 week | 
| 10 Meter walk test / 10mwt | Calculating Gait Speed - total distance/time. For example: if you did a 10-meter gait speed test and it took you 7 seconds, the equation would like: 10 meters / 7 seconds = 1.4 meters per second. The 10MWT intra-rater and inter-rater reliability were good (ICC between 0.76 until 0.9) and excellent (ICC > 0.9), respectively. The minimal detectable change for intra-rater reliability was 0.188 m/s. | 2,4,8 week | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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CIMT, Mirror Therapy