The Effects of WBV on Muscle Stiffness and Reflex Activity in Stroke.

NCT ID: NCT03015545

Last Updated: 2018-12-10

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

36 participants

Study Classification

INTERVENTIONAL

Study Start Date

2017-05-01

Study Completion Date

2017-12-31

Brief Summary

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Spastic hypertonia is common after stroke. Whole-body vibration (WBV) is known to have modulatory effects of muscle reflex activity and blood flow in other populations and thus have potential applications in the management of spastic hypertonia post-stroke. This study aims to investigate the acute effect of WBV on leg muscle H-reflex, stiffness, and blood perfusion in people with chronic stroke.

Detailed Description

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Spastic hypertonia is common after stroke. Whole-body vibration (WBV) is known to have modulatory effects of muscle reflex activity and blood flow in other populations and thus have potential applications in management of spastic hypertonia post-stroke. However, the potential effects of WBV on leg muscle stiffness in stroke rehabilitation remains unknown. Scientific evidence is warranted to fill the knowledge gap.

Purpose This study aims to investigate the acute effect of WBV on leg muscle H-reflex, stiffness and blood perfusion in people with chronic stroke.

Methods Individuals with chronic stroke will be recruited from community self-help groups and existing patient database. Relevant information (e.g. demographic information, medical history) will be obtained from medical records and subject interviews. Each subject will have to fulfill the following inclusion criteria: (1) diagnosis of chronic stroke, (2) community-dwelling, (3) able to follow simple verbal instructions. Exclusion criteria are: (1) other diagnoses of neurological conditions, (2) significant musculoskeletal conditions (e.g. amputations), (3) metal implants in the lower extremity or spine, (4) recent fracture in the lower extremity, (5) diagnosis of osteoporosis, (6) vestibular disorders, (7) peripheral vascular disease, and (11) other serious illnesses or contraindications to exercise.

This is a single-blinded randomized within-patient cross-over study. Each participant was evaluated for the soleus H-reflex, stiffness and blood perfusion of the medial gastrocnemius (MG) using ultrasound on both sides before and after either a 5-minute WBV intervention (30 Hertz, 1.5mm, knee flexed 60 degrees) or a no-WBV condition (5 minutes). The measurements were performed at baseline and every 1-min post-intervention up to 5 minutes. The outcomes generated included the soleus H/M ratio, shear modulus and vascular index (VI) of the MG muscle.

Conditions

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Stroke

Keywords

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Muscle Stiffness Ultrasound elastography H-reflex Whole body vibration blood perfusion

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

CROSSOVER

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Outcome Assessors

Study Groups

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Control

This group will stand with knee flexion 60 degrees on the same vibration platform for 60 seconds for 5 times with 60-seconds rest interval, but no vibration will be given.

Group Type ACTIVE_COMPARATOR

paretic leg-control

Intervention Type DEVICE

standing on the vibration platform, with no vibration signals delivered.

non-paretic leg-control

Intervention Type DEVICE

standing on the vibration platform, with no vibration signals delivered.

High intensity whole body vibration

This group will stand with knee flexion 60 degrees on the same vibration platform for 60 seconds for 5 times with 60-seconds rest interval. The whole body vibration platform will be set with frequency at 30Hz and amplitude at 1.5mm.

Group Type ACTIVE_COMPARATOR

paretic leg-WBV

Intervention Type DEVICE

standing on the vibration platform, with WBV at 30Hz, 1.5mm.

non-paretic leg-WBV

Intervention Type DEVICE

standing on the vibration platform, with WBV at 30Hz, 1.5mm.

Interventions

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paretic leg-control

standing on the vibration platform, with no vibration signals delivered.

Intervention Type DEVICE

paretic leg-WBV

standing on the vibration platform, with WBV at 30Hz, 1.5mm.

Intervention Type DEVICE

non-paretic leg-control

standing on the vibration platform, with no vibration signals delivered.

Intervention Type DEVICE

non-paretic leg-WBV

standing on the vibration platform, with WBV at 30Hz, 1.5mm.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

1. Adult with a diagnosis of a hemispheric stroke \>6 months,
2. Medically stable,
3. Able to stand independently for at least 1 minute and
4. Mas score \>1 measured at the ankle plantar flexors.

Exclusion Criteria

1. Brainstem or cerebellar stroke,
2. Other neurological condition,
3. Serious musculoskeletal or cardiovascular disease,
4. Severe contracture of the ankle that the cannot be put in the neutral position.
5. Metal implants or recent fractures in the lower extremities or spine,
6. Fresh skin wound in lower extremities, especially popliteal fossa
7. Other severe illnesses or contraindication for exercise.
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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The Hong Kong Polytechnic University

OTHER

Sponsor Role lead

Responsible Party

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Marco Yiu-Chung Pang

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Hector WH Tsang, PhD

Role: STUDY_CHAIR

Department of Rehabilitation Sciences, The Hong Kong Polytechnic University

Locations

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The Hong Kong Polytechnic University

Hung Hom, Kowloon, Hong Kong

Site Status

Countries

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Hong Kong

Other Identifiers

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HSEARS20161117007

Identifier Type: -

Identifier Source: org_study_id