Investigation of Knee Hyperextension and Femoral Cartilage Thickness in Chronic Stroke Patients

Stroke Clinical Trial

Official title:

Investigation of Knee Hyperextension and Femoral Cartilage Thickness in Chronic Stroke Patients

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05513157
• Other study ID #: E-59394181-604.01.02-37185
• Status: Completed
• Start date: August 15, 2022
• Est. completion date: February 1, 2023

Study information

• Verified date: June 2023
• Source: Hacettepe University
• Contact: n/a
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

It is aimed to measure knee hyperextension and knee joint cartilage thickness in chronic stroke patients and to examine the relationship between the factors affecting knee hyperextension and knee joint cartilage thickness.

This study, it is aimed to compare the knee joint cartilage thicknesses of the affected and unaffected extremities and to examine the relationship between knee hyperextension and knee joint cartilage thickness.

The second aim is to compare the knee joint cartilage thickness of the paretic and nonparetic extremities and in stroke patients with and without knee hyperextension.

The hypotheses of the study are:

Hypothesis 1;

H0: There is no difference between the knee joint cartilage thickness of the affected and unaffected extremities in chronic stroke patients with knee hyperextension.

H1: In chronic stroke patients with knee hyperextension, there is a difference between the knee joint cartilage thicknesses of the affected and unaffected extremities.

Hypothesis 2;

H0: There is no relationship between knee hyperextension during the stance phase of gait and knee joint cartilage thickness in chronic stroke patients.

H1: There is a relationship between knee hyperextension during the stance phase of gait and knee joint cartilage thickness in chronic stroke patients.

Hypothesis 3;

H0: There is no relationship between lower extremity muscle strength and spasticity and knee joint cartilage thickness in chronic stroke patients with knee hyperextension.

H1: There is a relationship between lower extremity muscle strength and spasticity and knee joint cartilage thickness in chronic stroke patients with knee hyperextension.

Hypothesis 4;

H0: There is no difference between the cartilage thickness of the knee joint in chronic stroke patients with and without knee hyperextension.

H1: There is a difference between the cartilage thickness of the knee joint in chronic stroke patients with and without knee hyperextension.

Description:

Immobilization of extremities after stroke causes articular cartilage degeneration. Likewise, since patients tend to transfer weight to the non-paretic extremity, a load difference occurs between the lower extremity joints. Therefore, it is thought that the femoral cartilage thickness will be affected in stroke patients. Considering this information, it is thought that the femoral cartilage thickness will be different between the paretic and non-paretic extremities, and also between stroke patients with and without knee hyperextension in the stance phase. Accordingly, the first aim of this study is to measure knee hyperextension and femoral cartilage thickness (paretic and nonparetic side) of stroke patients. The second aim is to compare the femoral cartilage thickness of the paretic and nonparetic extremities and in stroke patients with and without knee hyperextension.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 40
• Est. completion date: February 1, 2023
• Est. primary completion date: January 20, 2023
• Gender: All
• Age group: 40 Years to 65 Years

Eligibility

Inclusion Criteria:

• Being between the ages of 40-65

• At least 6 months have passed since the stroke

Ambulation with or without a walking aid (walker, cane, or tripod)

• Being between 0-3 points according to the Modified Rankin Score

• Getting a score of 24 or higher on the Mini Mental Test

• Volunteering to participate in the study

Exclusion Criteria:

• Having a history of more than one stroke

• Known presence of dementia

• Having a known orthopedic, psychiatric or other neurological disease

• Having a situation that prevents communication

• Having a history of surgery involving lower extremities and gait

Related Conditions & MeSH terms

• Stroke

Locations

Country	Name	City	State
Turkey	Hacettepe University	Altindag	Ankara

Sponsors (2)

Lead Sponsor	Collaborator
Hacettepe University	Atilim University

Country where clinical trial is conducted

Turkey, 

References & Publications (3)

Cooper A, Alghamdi GA, Alghamdi MA, Altowaijri A, Richardson S. The relationship of lower limb muscle strength and knee joint hyperextension during the stance phase of gait in hemiparetic stroke patients. Physiother Res Int. 2012 Sep;17(3):150-6. doi: 10.1002/pri.528. Epub 2011 Dec 7. — View Citation

Tunc H, Oken O, Kara M, Tiftik T, Dogu B, Unlu Z, Ozcakar L. Ultrasonographic measurement of the femoral cartilage thickness in hemiparetic patients after stroke. Int J Rehabil Res. 2012 Sep;35(3):203-7. doi: 10.1097/MRR.0b013e3283532736. — View Citation

Yalcin S, Kara M, Ozturk GT, Ozcakar L. Ultrasonographic measurements of the metacarpal and talar cartilage thicknesses in hemiplegic patients after stroke. Top Stroke Rehabil. 2017 Jan;24(1):1-4. doi: 10.1080/10749357.2016.1183357. Epub 2016 May 9. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Movement Analysis	Reflective signs will be placed on certain anatomical points on the participants and participants will be asked to walk at a distance of 5 meters. The three-dimensional positions of these reflective marks will be captured by the 8-camera Vicon motion capture system and recorded in the computer environment using Blade software.	Baseline
Primary	Ultrasonography	Ultrasonographic evaluations were made by the same investigator using a linear/convex probe. In the supine position, with the knees fully flexed, the linear probe was placed axially in the suprapatellar region, and the distal femoral cartilage thickness was measured from the midpoints of the lateral femoral condyle, intercondylar area and medial femoral condyle. Outcome values were determined by taking the average of three consecutive measurements.	Baseline
Secondary	Muscle Strength Assessment	Manual muscle testing will be performed on patients' lower extremity muscles (hip flexors, hip extensors, hip abductors, hip adductors, knee flexors, knee extensors, dorsiflexors, and plantar flexors). Manual muscle testing, Dr. It will be applied according to the method developed by Robert W. Lowett. According to this method, points between 0 and 5 will be given to the muscles according to the ability of the muscles to move against gravity in certain positions and the resistance of the movement against gravity.	Baseline
Secondary	Spasticity Assessment	Spasticity will be evaluated in patients' quadriceps muscle, hip extensors, hip adductors, hip internal retractors, and plantar flexors. Spasticity assessment will be made according to the Modified Ashword Scale and points will be given between 0 and 4. The method does not require any device and points are given between 0 and 4 according to the resistance of the muscles to be evaluated in the supine position against passive movement.	Baseline