Effectiveness of motor relearning program on balance and upright mobility in sub-acute stroke patients: A randomized control trial: Motor Relearning Program in Sub-Acute Stroke Patients

Afsheen Naz; Sana Batool; Ashfaq Ahmad; Kashif  Siddique

doi:10.54393/pbmj.v5i1.316

Authors

Afsheen Naz Department of Physiotherapy, Faisal Hospital, Lahore
Sana Batool University Institute of Physical Therapy, The University of Lahore
Ashfaq Ahmad University Institute of Physical Therapy, The University of Lahore
Kashif Siddique University Institute of Physical Therapy, The University of Lahore

DOI:

https://doi.org/10.54393/pbmj.v5i1.316

Keywords:

Motor Relearning Program, Routine physical therapy, Balance, upright mobility

Abstract

To determine the effectiveness of the motor relearning program along with routine physical therapy versus routine physical therapy alone on balance and upright mobility in sub-acute stroke patients. Methods: Patients who satisfied inclusion criteria were chosen and randomly allotted into experimental and control group, 34 patients in each. After baseline assessment first follow-up was recorded at fourth week. Patients were guided for home plan for further one month. Second follow-up data was taken at eight week. Experimental group were given motor relearning training along with routine physiotherapy in sit to stand component by putting effected foot behind the sound one, forward movement of knees on chair and trunk in flexion. Gait training, balance training, stretching exercises and strengthening exercises were given to control group. The berg balance scale and time up and go test were used to measure the outcomes. Results: Statistically significant post-treatment p-value<0.05 was shown by both groups in all items of the BBS and time up and go test while doing the intragroup analysis after 8 weeks of intervention. Statistically significant results (P-value=0.000) was shown at 2nd follow up by the BBS score and TUG measure in intergroup analysis. Conclusion: Motor relearning program is demonstrated to have more measurably noteworthy and clinically compelling intervention while comparing to routine physiotherapy alone.

Clinical trial registration number: IRCT20200218046539N1.

References

- Liu D, Hu K, Schmidt M, Müntze J, Maniuc O, Gensler D, et al. Value of the CHA 2 DS 2-VASc score and Fabry-specific score for predicting new-onset or recurrent stroke/TIA in Fabry disease patients without atrial fibrillation. Clinical Research in Cardiology. 2018;107(12):1111-21. https://doi.org/10.1007/s00392-018-1285-4

-Johnson W, Onuma O, Owolabi M, Sachdev S. Stroke: a global response is needed. Bulletin of the World Health Organization. 2016;94(9):634 doi: 10.2471/BLT.16.181636

- Suwanwela NC, Poungvarin N. Stroke burden and stroke care system in Asia. Neurology India. 2016;64(7):46. DOI: 10.4103/0028-3886.1780421.

- Batool S, Soomro N, Amjad F, Fauz R. To compare the effectiveness of constraint induced movement therapy versus motor relearning programme to improve motor function of hemiplegic upper extremity after stroke. Pakistan journal of medical sciences. 2015;31(5):1167 doi: 10.12669/pjms.315.7910

- Sahin IE, Guclu-Gunduz A, Yazici G, Ozkul C, Volkan-Yazici M, Nazliel B, et al. The sensitivity and specificity of the balance evaluation systems test-BESTest in determining risk of fall in stroke patients. NeuroRehabilitation. 2019; 44(1): 67-77.DOI: 10.3233/NRE-182558

-Torkia C, Best KL, Miller WC, Eng JJ. Balance confidence: a predictor of perceived physical function, perceived mobility, and perceived recovery 1 year after inpatient stroke rehabilitation. Archives of physical medicine and rehabilitation. 2016; 97(7): 1064-71.https://doi.org/10.1016/j.apmr.2016.03.004

- Mohammadi R, Mirshoja MS. Sit-to-Stand Task in Stroke Survivors: A Review Study. Middle East Journal of Rehabilitation and Health. 2018;5(4). doi: 10.5812/mejrh.66467

- Terranova T, Simis M, Santos A, Imamura M, Alfieri F, Fregni F, et al. Comparing effects of constraint-induced movement therapy and robotic therapy: Randomized clinical trial. Annals of Physical and Rehabilitation Medicine. 2018; 61: e34.https://doi.org/10.1016/j.rehab.2018.05.076

-Craik RL. In Tribute: Janet H. Carr. Physical therapy. 2015; 95(1): DOI:10.2522/ptj.2015.95.1.6

- Singha R. MOTOR RELEARNING PROGRAM VERSUS PROPRIOCEPTIVE NEURO-MUSCULAR FACILITATION TECHNIQUE FOR IMPROVING BASIC MOBILITY IN CHRONIC STROKE PATIENTS-A COMPARATIVE STUDY. Int J Physiother Res. 2017;5(6):2490-500. DOI: https://dx.doi.org/10.16965/ijpr.2017.235

- Min G, Si-wei L, Bao-jin L, Cheng L, Yun Q. Effect of motor relearning programme on motor function recovery of acute stroke patients with hemiplegia. Chinese Journal of Contemporary Neurology & Neurosurgery. 2017; 17(3): 197.DOI: 10.3969/j.issn.1672-6731.2017.03.007

-Farqalit R, Shahnawaz A. Effect of foot position during sit-to-stand training on balance and upright mobility in patients with chronic stroke. Hong Kong Physiotherapy Journal. 2013;31(2):75-80 https://doi.org/10.1016/j.hkpj.2013.06.001

- Balpande S, Qureshi MI, Iratwar S, Kovela R, Dadgal R, Phansopkar P, et al. Effectiveness of Motor Re-Learning Programme along with Functional Electrical Stimulation on Functional Mobility and Quality of Life in Subjects with Sub-Acute Stroke-An Experimental Study. 2021.https://doi.org/10.21203/rs.3.pex-1538/v1

-Kannabiran B, Cathrine S, Nagarani R, Senthil R, Sahayaraj S. A study on efficacy of Bobath Technique and motor relearning programme on functional activities in hemiplegic patients. Int J Neurorehabilitation. 2016;3(235):2376-0281.1000235 https://doi.org/10.4172/2376-0281.1000235

- Yadav R, Kuma S, Aafreen, Yadav S. Robotic tilt table exercises versus conventional exercises in rehabilitation of hemiplegic patients. International Journal of Therapy And Rehabilitation. 2018;25(9):475-80.https://doi.org/10.12968/ijtr.2018.25.9.475

- Park JH, Kim YM, Lee NK. The effects of repetitive sit-to-stand training with a paretic-side asymmetrical foot position on the balance of chronic stroke subjects. The Journal of Korean Physical Therapy. 2015; 27(3): 169-73. https://doi.org/10.18857/jkpt.2015.27.3.169

- Khurana B, Dobhal A, Singhal V. MOTOR IMAGERY TOGETHER WITH CONVENTIONAL THERAPY WILL BE EQUAL TO OR MORE EFFECTIVE THAN CONVENTIONAL ALONE FOR IMPROVEMENT OF GAIT IN STROKE PATIENT. International Journal of Medical and Biomedical Studies. 2019;3(4).

DOI: https://doi.org/10.32553/ijmbs.v3i4.182

- Shears JS. Comparing methods to facilitate sit to stand post-stroke: Memorial University of Newfoundland; 2018;18(6):132-4.URI:http://research.library.mun.ca/id/eprint/13245

- Liu M, Chen J, Fan W, Mu J, Zhang J, Wang L, et al. Effects of modified sit-to-stand training on balance control in hemiplegic stroke patients: a randomized controlled trial. Clinical rehabilitation. 2016; 30(7): 627-36.https://doi.org/10.1177/0269215515600505

-Boukadida A, Piotte F, Dehail P, Nadeau S. Determinants of sit-to-stand tasks in individuals with hemiparesis post stroke: a review. Annals of physical and rehabilitation medicine. 2015;58(3):167-72.https://doi.org/10.1016/j.rehab.2015.04.007

- Jung K-S, In T-S, Cho H-y. Effects of sit-to-stand training combined with transcutaneous electrical stimulation on spasticity, muscle strength and balance ability in patients with stroke: a randomized controlled study. Gait & posture. 2017;54:183-7.https://doi.org/10.1016/j.gaitpost.2017.03.007