About this trial
Patients diagnosed with ischemic or hemorrhagic stroke who applied to Kırıkkale University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation will be included in the study. The aim of our study is to investigate the relationship between spinal alignment, posture and weight transfer symmetry with balance, physical performance and energy expenditure in stroke patients.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
Individuals between the ages of 18-75 years diagnosed with stroke
Volunteering to participate in the study
Diagnosis of hemorrhagic or ischemic stroke,
No collaboration and communication problems
Disqualifiers
Have another neurological, cardiopulmonary or orthopedic problem other than stroke that may affect functionality, ambulation and balance
Patients who refused to participate in the study and did not give written consent.
Cooperation and communication problems were determined as
Trial population
Individuals aged 18-75 years with ischemic or hemorrhagic stroke who applied to Kırıkkale University, Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation will be included in our study
Trial design
Other
Cross-sectional
Treatments tested in this trial
use of spinal mouse
DeviceSpinal Mouse (SM) is an external non-invasive measurement device that evaluates the spinal angle and shape in the frontal and sagittal planes
Brunnstrom's Hemiplegia Recovery Staging
Diagnostic testAccording to Brunnstrom's stages of recovery, the individual will be identified at which stage
The six minute walking test (6MWT)
Diagnostic testIt evaluates the functional capacity of the individual and it provides valuable information regarding all the systems during physical activity, including pulmonary and cardiovascular systems, blood circulation, neuromuscular units, body metabolism, and peripheral circulation
Functional Reach Test (FRT)
Diagnostic testFunctional Reach Test (FRT) is a clinical outcome measure and assessment tool for ascertaining dynamic balance in in simple task. In standing, measures the distance between the length of an outstretched arm in a maximal forward reach, while maintaining a fixed base of support. This information is correlated with risk of falling A number of factors exert a major influence on this evaluation: Research revealed that movement strategy and reduced spinal flexibility both affect reach distance.
Mini Balance Evaluation Systems Test (Mini-BESTest)
Diagnostic testThis test measures dynamic balance, functional mobility, and gait. It is commonly used in populations who have or have had multiple sclerosis (MS), Parkinson disease (PD), strokes, spinal cord injury (SCI), or cancer. The Mini-BESTest was developed in 2010 from the Balance Evaluation Systems Test (BESTest), then revised in 2013 to clarify inconsistencies in scoring. The scoring instructions were different in the published and online versions. The revision clarified that the Mini-BESTest should be scored out of 28 points. Explanations for how to score items 3, 6, and 14 were also given. The Mini-BESTest consists of 14 items, including 4 of the 6 sections (anticipatory postural adjustments, reactive postural control, sensory orientation, and dynamic gait) from the BESTest.
The five Times Sit to Stand Test (5x Sit-To-Stand Test)
Diagnostic testIt's used to asses functional lower limbs strength, transitional movements, balance, and fall risk in older adults.
The Postural Assessment Scale for Stroke (PASS)
Diagnostic testThe Postural Assessment Scale for Stroke (PASS) is an outcome measure specifically designed to assess and monitor postural control after stroke. It was developed in 1999 as an adaptation of the Fugl-Meyer Assessment balance subscale\[1\]. It contains 12 four-level items of varying difficulty for assessing ability to maintain or change a given lying, sitting or standing posture
Postural Symmetry Index and Weight Transfer Symmetry
Diagnostic testIt is a form of measurement in which two scales are used to calculate the weight transferred to the intact and stroke limb. The values obtained as a result of the test are calculated with formulas.
Measurement of the craniovertebral angle
Diagnostic testMeasurement of the craniovertebral angle; the patient is asked to find the most natural position by flexion and extension of the head in the standing position and a photograph is taken with a digital camera from a distance of 1.5 m to the shoulder level of the patient and this process is repeated 3 times. The images obtained are then digitally calculated with the help of an appropriate program.
Treatment groups
Trial outcomes
Primary outcomes
Use of Spinal Mouse
The SM device is started at the 7th cervical vertebra and advanced to the anal line. During the measurement, the mouse is lowered from the skin surface at a constant speed from top to bottom at the midpoint of the processus spinosus. Individuals are asked to assume the upright, maximal flexion, maximal extension positions in sequence. The relevant parameters in each position are thoracic curvature angle, lumbar curvature angle, sacrum-hip angle, tilt angle, mobility assessment (from extension to flexion position). The data transferred by the SM device to the computer via Bluetooth is analyzed and the angular deviation between each vertebra is calculated by the SM software as an angle value. The raw data of the wireless and handheld mouse is transferred to the computer via bluetooth and the data is analyzed by the SM software.
Postural Symmetry Index
A form of measurement in which two scales are used to calculate the weight transferred to the intact and paralyzed limb. The values obtained as a result of the test are calculated with the following formulas. In this index, percentages close to 0 define equal symmetry and good postural control while standing, while higher percentages define asymmetry and poor postural control. Postural Symmetry (%) = Weight on Paralytic Side / Body Weight - 0.5\| x 100 Weight Transfer Symmetry = Weight on Intact Side - Weight on Paralytic Side (%) Total Body Weight.
The Postural Assessment Scale (PASS)
The PASS contains 12 items that measure a person's balance performance in situations of varying difficulty, such as lying, sitting, standing or changing standing position. The scale is administered under two main headings: during posture maintenance and posture change. Sitting without support, standing with support, standing without support, standing on paretic and nonparetic legs are the balance assessments under the heading of maintaining posture. Lateral rotation from supine to paretic and nonparetic side, lateral rotation from supine to sitting, from sitting to supine, from sitting to supine, from sitting to supine, from sitting to standing, from standing to sitting, and picking up a pen on the floor while standing are balance assessments under the heading of posture change. The scale is evaluated between 0-36. The feasibility of the movement is tested between 0-3; "0" is the lowest value; "3" is the highest value
MINI-BEST TEST
Mini-BEST Test will be used to determine balance level. It consists of 4 sub-parameters including preparatory movement, reactive postural control, sensory orientation, dynamic walking and a total of 14 items. It is a test that is evaluated over a total of 28 points and requires an average of 10-15 minutes. High score indicates high function
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