About this trial
This clinical trial aims to compare the effects of kinesio taping and PNF on hemiplegic hand functions. In addition, the effects of these applications on body structure, activity, and participation will be examined. The main questions it aims to answer are:
Do kinesio taping and PNF applications have different effects on hemiplegic hand function? Are kinesio taping and PNF applications effective in body structure, activity, and participation? The researchers will compare the advantages of kinesio taping and PNF applications over each other.
Participants:
Kinesio taping and/or PNF applications will be applied 3 days a week for 8 weeks.
Tests will be performed on the first and last day of the study to evaluate hand functions.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Stroke diagnosed by MRI or CT, regardless of ischemic or hemorrhagic origin,
Hemiplegia caused by stroke alone,
At least 6 and at most 24 months have passed since the stroke was diagnosed
Being over 18 years of age,
Disqualifiers
Exclusion Criteria (Junior et al., 2019; Kim & Kim, 2015; Saklecha et al., 2023)
Individuals with bilateral hemiplegia
Individuals with unstable vital signs
Individuals with any open wound in the upper extremity
Trial design
Parallel
Treatments tested in this trial
PNF application Group
Procedure/SurgeryPNF Application; in the application method, the subjects will be in a sitting position. The application will be made to the fingers, wrist and forearm in both D1 and D2 directions in flexion and extension patterns. The techniques will start using rhythmic initiation, then the combination of isotonics, dynamic-opposite, rhythmic stabilization and muscle-relaxation are determined. The movements will be made in 10 repetitions with rest in between (Saklecha et al., 2023).
KB application Group
Procedure/SurgeryKB Application; In the taping treatment to be applied, taping will be applied starting from the fingers and up to the elbow with kinesiology taping (Huang et al., 2019). Taping will be done 3 days a week and the tape will remain on the patient for 2 days.
PNF+KB application Group
Procedure/SurgeryPNF+ KB Application; In this application, both PNF and taping will be applied. After each application, conventional treatment will be applied to all three groups at the end of each session. When all treatments are completed, re-evaluations will be made by the blind physiotherapist
Treatment groups
Trial outcomes
Primary outcomes
The Fugl Meyer assessment
The Fugl Meyer assessment scale is a stroke-specific, performance-based scale, and each parameter is scored as 0; unsuccessful, 1; partially successful, and 2; completely successful performance. In the shoulder, elbow, and forearm, reflex activity, voluntary movements performed with dynamic flexor and/or extensor synergies, voluntary movements performed using dynamic flexor and extensor synergies together, voluntary movements performed without or with very little dependence on synergies, and normal reflex activity parameters are evaluated. When evaluating the wrist, three different functions of the wrist muscles are evaluated. In the hemiplegia hand evaluation, 7 movements (flexion, extension, and five grip functions) are evaluated. In the coordination/speed evaluation, a finger-nose test is performed for the upper extremity. During this test, tremor, dysmetria, and speed of movement are evaluated. The maximum motor performance score for the upper extremity is 66 points.
Action Research Arm Test (ARAT)
The ARAT observes arm and hand movements during the performance of a variety of reaching and grasping tasks. It measures the ability to qualitatively manipulate and carry large or small objects in relation to manual dexterity and proximal strength for the upper extremity. The ARAT rates the upper extremity on a 4-point scale (maximum of 57 points for each upper extremity): 3 points if the task is performed normally; 2 points if the task is completed but takes an abnormally long time; 2 points if performed with great difficulty or poorly coordinated movements; 1 point if the task is only partially completed; and 0 points if the task is not performed at all.
The Box-Block Test
The Box-Block Test measures unilateral manual dexterity. It is a fast, simple and inexpensive test. It can be used in a wide variety of diseases, including stroke patients. It consists of a box divided into two and 150 blocks. The wooden blocks are cubes measuring 2.5 cm x 2.5 cm x 2.5 cm. The barrier in the middle of the box is 15.2 cm. Patients are asked to throw the blocks from one section to the other, one by one, within 60 seconds and the number of blocks is recorded.
Nine hole Peg Test
It is a simple and quick test used to evaluate changes in hand functions. The participant is asked to insert nine rods into a wooden block with nine holes as quickly as possible and then remove them. The test is repeated twice and the score is determined as the average of the two trials. The participant is expected to perform the test with the hand on the affected side of the body.
Secondary outcomes
Environmental Quality Scale
The scale evaluates the impact of the environment on the individual's abilities and limitations while performing daily activities. The short form consists of 26 questions in total. Each question includes two options: facilitating and challenging. The scale's scoring ranges from -3 to 3. The facilitating option includes a score of 1 to 3, and the challenging option includes a score of -1 to -3. A score between 1 and 3 indicates that environmental factors facilitate the individual's daily life and social roles, and a score of zero indicates that they have no effect on social interaction. A score between -1 and -3 is considered negative. All positive and negative results are added up separately. The application takes approximately 10 minutes.
Upper Extremity Motor Activity Diary-28
This scale, which aims to evaluate the function of the hemiparetic upper extremity, was developed by Uswatte et al. in 2006. 30 upper extremity functions are evaluated and scored with 2 different scales as "level of use" and "quality of use". The scores for each scale are calculated by adding them up and dividing them by the number of marked items. The validity and reliability of the scale in Turkish has been done.
Social Adaptation Scale
The social adaptation scale is a scale consisting of 10 items (34). The survey focuses on personal experiences, perspectives and personal satisfaction with the level of integration with society rather than the objective and observable aspects of social integration.
Sponsors and contacts
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Istinye University
Lead sponsor
Ondokuz Mayıs University
Collaborator