Combining specific task-oriented training with manual therapy to improve balance and mobility in patients after stroke: a mixed methods pilot randomised controlled trial.
In absence of existing studies, to describe changes in balance and mobility, following specific task-oriented training (TOT), its combination with talocrural manual therapy (MT-TOT) or no intervention, in chronic stroke patients. To explore the feasibility of a full-scale randomised controlled trial...
| Published in: | Disability & Rehabilitation Vol. 46; no. 7; pp. 1318 - 1330 |
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| Main Authors: | , , , , , |
| Format: | equations & formulas research tables/charts randomized controlled trial Journal Article |
| Published: |
Taylor & Francis Ltd
Apr2024
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=176341370&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 176341370 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09638288 B73 jtl: Disability & Rehabilitation issn: 09638288 maglogo: Y pubinfo: dt: Apr2024 vid: 46 iid: 7 pid: 377 pub: Taylor & Francis Ltd place: Philadelphia, Pennsylvania artinfo: ui: 176341370 163043851 176341370 176341370 10.1080/09638288.2023.2193432 176341370 ppf: 1318 ppct: 12 formats: tig: atl: Combining specific task-oriented training with manual therapy to improve balance and mobility in patients after stroke: a mixed methods pilot randomised controlled trial. aug: au: Traxler, Kristina Baum, Eva Klotz, Edith Reindl, Markus Schinabeck, Franz Seebacher, Barbara affil: Therapiezentrum Kinema, Neukirchen b. hl. Blut, Germany sug: subj: Stroke Rehabilitation Balance, Postural Evaluation Manual Therapy Methods Physical Mobility Evaluation Stroke Therapy Task Performance and Analysis Adverse Health Care Event Accidental Falls Training Effect (Physiology) Ankle Joint Physiology Dorsiflexion Physiology Quality of Life Evaluation Range of Motion Evaluation Chronic Disease Treatment Outcomes Human Male Female Middle Age Aged Randomized Controlled Trials Random Assignment Multimethod Studies Pilot Studies Stroke Patients Qualitative Studies Semi-Structured Interview Prospective Studies Single-Blind Studies Walking Speed Social Participation Data Analysis Software Descriptive Statistics Kruskal-Wallis Test Middle Aged: 45-64 years Aged: 65+ years Male Female ab: In absence of existing studies, to describe changes in balance and mobility, following specific task-oriented training (TOT), its combination with talocrural manual therapy (MT-TOT) or no intervention, in chronic stroke patients. To explore the feasibility of a full-scale randomised controlled trial (RCT) based on criteria of recruitment, retention and adherence rates, adverse events, falls and acceptability of the intervention. Using an assessor-blinded pilot RCT, 36 stroke patients were allocated to either MT-TOT, TOT, or controls. Supervised interventions were performed 45 min, 2×/weekly, for 4 weeks, and home-based practice 20 min, 4x/weekly for 4 weeks. Qualitative interviews evaluated intervention acceptability. Outcomes of balance, mobility, ankle dorsiflexion range of motion (ROM), falls and health-related quality of life (HRQoL) were assessed at baseline, post-intervention and 4-week follow-up. Preliminary efficacy of MT-TOT and TOT was shown in improving balance (effect size 0.714), walking speed (0.683), mobility (0.265), dual-tasking mobility (0.595), falls (0.037), active and passive talocrural ROM (0.603; 0.751) and activities and social participation related HRQoL domains (0.332–0.784) in stroke patients. The feasibility of a larger RCT was confirmed. Specific MT-TOT and TOT appeared effective and are feasible in stroke patients. A larger RCT is needed to validate the results.Trial Registration: German Clinical Trials Register, DRKS00023068. Registered on 21.09.2020, A specific goal- and task-oriented training involving timed mobility and dynamic balance activities based on the demands of daily life, of high intensity and progressed in difficulty according to predefined criteria is feasible in patients after stroke. In this mixed methods pilot study patients indicated high acceptability of task-oriented training with and without ankle mobilisations, with their descriptions being in line with the Theoretical Framework of Acceptability. Specific task-oriented training and its combination with talocrural joint manual therapy improved balance, mobility, talocrural dorsiflexion range of motion and some domains of health-related quality of life in people after stroke. pubtype: Academic Journal doctype: equations & formulas research tables/charts randomized controlled trial Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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