Clinical trial NCT06109194: Immediate Effect of Ankle Mobilization on Active Range of Motion and Gait in Subacute Stroke
Official title: Immediate Effect of Ankle Mobilization on Active Range of Motion and Gait in Subacute Stroke
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hemiparesis;Poststroke/CVA
Keywords: subacute stroke, gait, dorsiflexion, joint mobilization
Lead sponsor: Loma Linda University
Sponsor class: OTHER
First posted: 2023-10-31
Enrollment: 20
Sex: ALL
Minimum age (years): 21
Maximum age (years): 86
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: pre-test, intervention, post-test
Primary purpose: TREATMENT

Brief summary: The goal of this observational study is to determine the effect of ankle joint mobilization on active range of motion and gait in subacute first-time stroke. The main questions it aims to answer are:

* What is the effect of ankle joint mobilization on active range of motion in the ankle and gait qualities?
* What is the effect of ankle joint mobilization on self-perceived gait ability?

Participants will receive physical therapy interventions of:

* Grade III ankle joint mobilization
* stretching of ankle plantarflexor muscles
* ankle muscle activation training
* assisted gait as part of assessment

Study design is to measure conditions before and after the intervention to determine effect(s) of one treatment dose, completed within one session of 90 minutes.

Detailed description: Initial passive and active ankle range of motion measured by goniometer. Initial gait quality will be measured by walking with splinting for frontal plane ankle stability if indicated, assistive device for body weight support if needed, and manual assistance from an experienced physical therapist, on a Zeno Walkway pressure-sensitive mat for five complete stride cycles, taking 3 to 5 minutes. Data collected from the mat will be electronically captured using ProtoKinetics software. Participant initial self-rated perception of ability to walk will be marked on a 0-10 scale, on paper. Treatment intervention follows. With participant lying on the back, paretic ankle moderate-force grade III anterior to posterior-directed manual joint mobilizations will be performed by therapist; three sets of fifteen oscillations. Ankle plantarflexor muscles will be stretched for 75 seconds in supported standing. Ankle dorsiflexion muscle activation training will be performed for three minutes while in a seated position. Post-intervention measurements will proceed in the same sequence as initial measurements listed above: Ankle passive and active range of motion and walking ability will be reassessed, and self-perceived ability to walk will be rated again.

Eligibility criteria: Inclusion Criteria:

* First stroke
* subacute phase after stroke
* able to follow one-step commands
* paretic passive ankle dorsiflexion less than 5 degrees

Exclusion Criteria: referring to paretic ankle;

* ankle pain of undetermined cause at rest
* fracture in paretic lower extremity
* muscle or ligament tear
* recent ankle sprain
* skin tear or wound
* joint fusion or implanted hardware

Primary outcomes:
measure: Active range of motion of the paretic ankle
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
measure: Gait characteristic of: velocity
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
measure: Gait characteristic of: stride length
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
measure: Gait characteristic of: second double-limb stance time
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
measure: Gait characteristic of: stride length symmetry
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
measure: Gait characteristic of: second double limb stance symmetry
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
Secondary outcomes:
measure: Subjective rating of perceived ability to walk
timeFrame: Change between baseline assessment and post-intervention assessment, immediately following intervention
Other outcomes:
Locations:
city: Loma Linda
country: United States
facility: Loma Linda University Health
state: California
Study officials:
affiliation: Loma Linda University
name: Eric G Johnson, PT, DSc
role: STUDY_CHAIR
References:
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