Association of Vestibular and Postural Impairments With Functional Status in Stroke

NCT ID: NCT05139537

Last Updated: 2021-12-01

Basic Information

• Recruitment Status: COMPLETED
• Total Enrollment: 64 participants
• Study Classification: OBSERVATIONAL
• Study Start Date: 2021-01-15
• Study Completion Date: 2021-08-30

Brief Summary

: Stroke is leading cause of long-term disability in individuals. The location and extent of brain injury determines the severity of neurological deficits. The incidence of stroke dramatically increases in old age. Patients with stroke always come across with problems associated with balance, vertigo, dizziness and posture resulting in compromised activities of daily life. This study is aimed to collect data regarding the functional status of patients due to vestibular and postural impairments with stroke. The study will be descriptive comparative cross-sectional. It will be conducted at Idress Hospital Sialkot. This study will be completed within the time duration of six months. Convenient sampling techniques will be used to collect the data. Both genders with equal ratio will be included in this study after fulfillments of inclusion and exclusion criteria. Visual vertigo analogue scale, Dix-Hallpike Maneuver, DHI (Dizziness Handicap Inventory), Posture assessment scale for stroke (PASS) score, Time up and go test will be used as data collection tools. All data will be collected after informed consent from patient. All data will be collected under complete supervision of physiotherapist. All the data will be demonstrated as mean and percentage. The analysis of data will be done by using SPSS.26(Statistical Package For social science) and Excel. Statistical significance will be set as P = 0.05. Frequency tables, pie charts, bar charts will be used to show summary of group measurements measured over time. Our analysis will provide the association of vestibular and postural impairments with functional status in both males and females after stroke

Detailed Description

Stroke (cerebrovascular accident CVA) is a medical condition associated with neurological deficits caused by interruption of blood flow to brain. Main types of strokes are ischemic (due to blood loss) and hemorrhagic (due to bleeding). Sign and symptoms of stroke may include inability to move or feel, problem understanding and speaking, dizziness, unable to walk and dependency in daily life. All these factors effect the functionality of the patient. If symptoms last less than one or two hours then it is transient ischemic stroke (TIA), also known as mini stroke. Modifiable risk factors associated with stroke are high blood pressure, smoking, diabetes, metabolic diseases and obesity. Male gender , ethnicity, family history , genetic predisposition and old age all are non-modifiable risk factors.

Vestibular dysfunction is define as the disturbance in body's balance system. It may be due to peripheral or central disorders. The peripheral cause for vestibular dysfunction is peripheral neuritis. The most common cause of the central vestibular dysfunction is an ischemic stroke of posterior fossa which contains brain stem and cerebellum. Vestibular dysfunction often present as dizziness. patients with vestibular dysfunction are at high risk of fall due to vertigo and gait imbalances, postural instability, increased sway and irregulated gate Risk factors associated with vestibular dysfunctions include female gender, age more than 40 years, depression and poor educational status.

The balance impairments in post stroke state is complex. It includes weight bearing asymmetry, muscles weakness, increased visual dependency and disturbed perceptions. All these factors effect the independent functionality of the patient. Postural instability increases after stroke which result in restriction in independence of daily activities.

There is relation between dizziness and stoke. Patients with dizziness or vertigo are at higher risk of stroke than general population. Dizziness is common in patients who experience stroke for the first time. Dizziness is a cognitive manifestation of disturbed balance system of body. Dizziness is a risk factor for fall and it has negative influence on quality of life.

Balance is defined as the ability to maintain the center of gravity within base of support with minimal postural sway. Balance is classified as static and dynamic balance. Static balance is associated with sitting and standing, while dynamic balance is associated with walking and running. Insufficient balance in stroke survivors due to sensory and motor deficits results in decrease activities of daily life and functional status.

Patients suffering from posterior inferior cerebral artery PICA stroke, present with vertigo, dizziness, vomiting, headache, gait changes, impairments in postural control and horizontal nystagmus ipsilateral to the lesion. These symptoms are result of a compromised vestibular afferent sensory input which impairs the motor output for the management/maintenance of balance.

The aim of this study is to find the association between vestibular and postural impairment on functional status of patients .Our study will also provide the difference of result between male and females whether they are equally effected or not.

Conditions

Stroke

Keywords

vestibular impairments, functional status.

Study Design

• Observational Model Type: OTHER
• Study Time Perspective: CROSS_SECTIONAL

Eligibility Criteria

Inclusion Criteria

1. Age 35-70

2. Male and female equal ratio

3. Mine-mental state examination (MMSE) more than 25

4. Confirmed ischemic stroke referred by neurologist using computerized tomography(CT)

5. Patient after 6 months of 1st ischemic stroke

6. Hypertensive patient

Exclusion Criteria

1. Unstable cardiovascular status

2. Musculoskeletal conditions that influence posture e.g implants , orthodesis , fixation

3. Unable to follow verbal commands

4. Unable to keep any(sitting and standing) positions for 30 seconds.

5. Diabetic neuropathy

• Minimum Eligible Age: 35 Years
• Maximum Eligible Age: 70 Years
• Eligible Sex: FEMALE
• Accepts Healthy Volunteers: No

Sponsors

Riphah International University

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Principal Investigators

Tehreem Mukhtar, MS

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

Riphah International University

Lahore, Pakistan(Punjab_, Pakistan

Countries

Pakistan

Other Identifiers

RiphahIU Maryam Bashir

Identifier Type: -

Identifier Source: org_study_id