Cerebrovascular Accident Clinical Trial
Official title:
The Effects of Body Weight Supported Treadmill Training On Static And Dynamic Balance In Stroke Patients: A Randomized-Single Blind Study
Stroke is one of the most common causes of acquired adult disability. The majority of stroke
survivors have mobility difficulties such as poor standing, decreased walking speed, balance
disturbances, and increased risk for falls. Improving mobility, functional walking and
balance are the main goals of stroke rehabilitation. Robotic technologies are becoming more
promising intervention for the locomotor training in stroke rehabilitation. Static or
dynamic balance deficits act crucial role on gait performance among stroke survivors.
Therefore it is important to determine the effects of BWSTT in improving balance in persons
with stroke. Although it has been demonstrated that BWSTT improved balance and gait
performance in stroke patients, it is not clear whether the improvements are greater
compared with those associated with other gait rehabilitation methods. To the investigators
knowledge, there are also limited studies in the literature concerning the effects of BWSTT
on falling risk in stroke patients. The strong evidence is needed about the effectiveness of
BWSTT including comprehensive determinants of balance with combined and isolated
intervention groups.This study aims to compare the effects of BWSTT with combined and
isolated intervention on balance, gait and fall risk in patients with subacute and chronic
stroke. The investigators hypotheses are that after stroke:
1. the combination of BWSTT with conventional training may lead to more improved balance
parameters;
2. when applied as an isolated intervention, BWSTT or conventional training may lead to
similar results.
Participants:
All participants with stroke were recruited from a government rehabilitation hospital
between November 2014 and November 2015. All treatments were performed in the same hospital.
Sample Size:
"Power and Sample Size Program" was used to calculate sample size. It was determined by
considering a previous study which calculated minimal detectable change of Berg Balance
Scale (BBS) for stroke patients(20). According to this study to the response within each
subject group was normally distributed with standard deviation 7.87 and minimal detectable
change was found 10% for BBS. It was calculated that 15 participants were needed in each
group with probability (power) 0.8 and 0.016 alpha level computed by Bonferroni adjustment.
Procedure:
One hundred and seven stroke patient were assessed for eligibility by two physiatrists (B.E
and B.G). Forty-two (13 women, range of age: 18-75 years) patients were found to be suitable
for inclusion criteria of the study. Randomisation was performed by using randomisation
function of Microsoft Office Excel programme by another researcher (ARO). Random number
generator of Microsoft Office Excel Software gave a random number between 0 and 1 to the
each treatment columns which were created by ARO. Sorting the random number row from the
largest to the smallest number was performed by the sort and filter menu. Treatment
assignments were stratified according to the severity of impairment at baseline and the
study site to ensure balanced distribution among the three groups.After the
randomisation,assessments at baseline and after training were performed by two
physiotherapists who were blind to the interventions (IY, BEH). All the participants were
treated in the rehabilitation hospital by a physiotherapist who was experienced in stroke
rehabilitation. BWSTT Training was performed by RM.
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