Can Lumbar Mulligan Mobilization Improve Gait, Balance, and Trunk Position Sense After Stroke?
Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age30-65
SponsorGulhane School of Medicine
About this trial
Stroke is a pathology caused by disturbances in the brain's arterial circulation, leading to high morbidity rates. Individuals who experience a stroke often face neurological impairments such as motor, sensory, and cognitive dysfunctions, which negatively impact muscle strength, postural control, sensation, and gait, reducing their independence in daily activities. Balance deficits in stroke patients increase the risk of falls and contribute to a fear of falling. Improving balance control is a key goal in rehabilitation. The importance of the trunk in balance control and rehabilitation is well-established, as it plays a central role in maintaining stability. In individuals with restricted lumbar mobility, weakened trunk muscles and altered muscle activation can lead to a reduction in proprioception, hip strategy, and spinal stabilization, further impairing balance. Combining conventional exercise approaches with other rehabilitation techniques has been shown to yield more effective outcomes. This study aims to investigate the effects of Mulligan-based lumbar spine mobilization on balance, trunk position sense, and gait in individuals with stroke.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Diagnosed with stroke by a neurologist.
Aged 30 to 65 years.
First-ever stroke (single episode).
Stroke duration between 6 to 24 months.
Disqualifiers
History of musculoskeletal disorders affecting the spine (e.g., cancer, scoliosis, spondylolisthesis, rheumatoid arthritis, ankylosing spondylitis).
Previous lumbar spine surgery.
Presence of neurological conditions other than stroke (e.g., Parkinson's disease, multiple sclerosis).
Severe visual impairment affecting balance or walking.
Trial design
Design model
Parallel
Treatments tested in this trial
Experimental Group (Mulligan Mobilization + Conventional Therapy)
Other interventionMulligan Sustained Natural Apophyseal Glides (SNAGs) applied to the lumbar spine, combined with conventional rehabilitation exercises (neuromuscular training, stretching, strengthening, and balance exercises).
(Conventional Therapy Only)
Other interventionNeuromuscular training, stretching, strengthening, balance exercises, and gait training performed without Mulligan mobilization.
Treatment groups
40 Participants
are divided into 2 treatment groupsGroup A: Study GroupExperimental treatment 1 intervention
Group B: Control GroupActive comparator 1 intervention
Trial outcomes
Primary outcomes
1
Static Balance Assessment (Mini-BESTest)
The Mini Balance Evaluation Systems Test (Mini-BESTest) assesses balance control, including anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait. It consists of 14 items scored from 0 to 28, with higher scores indicating better balance.
Time frame
Baseline and After 4 Weeks2
Static Balance Assessment (ALDA Balance Device)
The ALDA Balance Device uses a motion sensor placed at the L3-5 vertebrae to assess postural sway. It records movement data via a wireless system to analyze balance responses.
Time frame
Baseline and After 4 Weeks3
Dynamic Balance Assessment (Trunk Impairment Scale - TIS)
The TIS assesses trunk control in stroke patients through three subcomponents: static sitting balance, dynamic sitting balance, and coordination. The scale consists of 17 items, with a total score ranging from 0 to 23, where higher scores indicate better trunk control.
Time frame
Baseline and After 4 Weeks4
Dynamic Balance Assessment (Functional Reach Test - FRT)
The Functional Reach Test evaluates balance stability by measuring the maximum distance a participant can reach forward while maintaining a fixed base of support. Three trials are conducted, and the average distance is recorded. A reach distance of 15 cm or less indicates a high fall risk.
Time frame
Baseline and After 4 WeeksSecondary outcomes
1
Fall Risk (Timed Up and Go (TUG) Test)
Evaluates functional mobility by measuring the time taken to stand from a chair, walk 3 meters, turn, walk back, and sit down.
Time frame
Baseline and After 4 Weeks2
Cognitive Function (Standardized Mini Mental Test (SMMT))
Assesses cognitive status, including memory, attention, and visuospatial abilities.
Time frame
Baseline and After 4 Weeks3
Functional Independence (Barthel Index)
Assesses independence in daily living activities such as mobility, self-care, and transfers.
Time frame
Baseline and After 4 WeeksSponsors and contacts
Click on the lead sponsor to view all of their trials.
Source ClinicalTrials.gov