Evaluation of Lower Extremity Interventions in Individuals With Chronic Stroke

Summary

This study aims to evaluate the effectiveness of closed kinetic chain (CKC) exercises and kinesio taping on knee joint proprioception, balance, functional performance, and quality of life in individuals with chronic stroke. Stroke often results in proprioceptive deficits and postural control impairments, which negatively impact rehabilitation outcomes. While CKC exercises are believed to enhance proprioceptive input through joint compression and sensory feedback, kinesio taping is used as a complementary intervention to support motor control and stability. The study will compare the effects of these two interventions to determine their potential roles in improving sensorimotor function and promoting functional independence in stroke rehabilitation.

A total of 30 participants were enrolled in this study.

Inclusion Criteria:

* Patients who had a stroke more than 6 months ago,
* Having a stable medical condition,
* Ability to understand simple instructions,
* Individuals with spasticity between grades 0-2 according to the Modified Ashworth Scale,
* Individuals who can walk independently or with assistive devices,
* Those who agree to participate and comply with the study procedures.

Exclusion Criteria:

* Severe cognitive impairment (MMSE score \< 24),
* Orthopedic conditions that may cause knee pain during exercise,
* Other neurological conditions that may affect proprioception,
* Severe joint contracture,
* Refusal or unwillingness to participate in the study.

Conditions

• Chronic Stroke Patients
• Lower Extremity
• Knee Proprioception
• Closed Kinetic Chain Exercises
• Kinesiotape
• Physiomaster

Interventions

OTHER

Measurement of Knee Joint Position Sense

Joint position sense will be assessed using active and passive joint position sense tests. Before starting the movement, the extremity will be moved ten times to prepare for movement. The "Physio Master" phone application will be used to measure the angle difference between the affected and unaffected knees at the end point of the movement. With the individual sitting upright with their back straight, knees flexed at 90 degrees, the participant's knee will be flexed to 45 degrees and the participant will be asked to repeat the same angle with their eyes closed. The error in angles (°) will be calculated. Passive position sense will be measured and recorded by passively moving the participant to the determined angle (15-30-45-60) and then asking them to estimate the angle upon returning to the starting position. Repeated flexion and extension will be performed to assess any errors in the movement. Placebo exercises will also be administered during the assessment. The test was repeated t

OTHER

Berg Balance Scale (BDS)

The Berg Balance Scale was developed primarily to assess postural control and is widely used in many rehabilitation settings. The 14 items in the scale assess expected balance during common activities of daily living, including standing and static sitting balance, as well as turning, picking up objects from the floor, and transfers. Scoring is typically done on a 5-point scale that assesses whether the patient can perform the task safely and independently for a specific time period. A score of 0 is given when the patient cannot perform the movement at all, and a score of 4 is given when the patient completes the movement independently. The maximum score is 56, with a score of 0-20 indicating impaired balance, 21-40 indicating acceptable balance, and 41-56 indicating good balance. The completion of the scale takes approximately 10 to 20 minutes. The Turkish validity and reliability study of the scale was conducted by Şahin et al. in 2008 on stroke patients.

OTHER

Timed Up and Go Test (TUG)

It measures the time it takes for a patient to stand up from a chair, walk 3 meters, turn, and sit back down. The test time was recorded in seconds. The test was repeated three times, and the average time was recorded as a score. If necessary, the patient was allowed to perform the test using a walking aid. It is an objective clinical measurement used to assess functional mobility, dynamic balance, and fall risk in older individuals. It has also been shown to be a valid and reliable test in stroke patients.

OTHER

10-Meter Walking Test

This test is used to determine walking speed. Two to three trials will be conducted at both comfortable and maximum speeds of their choosing. Participants will be instructed to walk at a "normal comfortable speed" or "as fast as safely possible." No practice trials will be conducted, and participants will rest for at least 30 seconds between trials. Typical shoes, standard orthotics, and any necessary assistive devices will be worn. Participants will walk approximately 14 meters, including a 2-meter acceleration and deceleration zone. The time participants spend walking the middle 6 meters of this walkway will be measured with a stopwatch, from the moment their toes first pass the starting cone to the moment they first pass the finishing cone. Walking speed will be calculated for each trial.

OTHER

Stroke-Specific Quality of Life Scale

Quality of life is also an important prognostic indicator for stroke and provides a broader definition of the disease. This scale consists of 49 items in 12 domains: mobility, energy, upper extremity functionality, work/productivity, mood, self-care, social roles, family roles, vision, language, thinking, and personality. SS-QOL items are assessed on a five-point Likert-type scale. Responses range from 1 (Strongly disagree) to 5 (Strongly agree). High scores on the scale indicate high quality of life, while low scores indicate low quality of life.

Sponsors & Collaborators

• Medipol University

  lead OTHER

Principal Investigators

• Dilanur Ö Özkaraoğlu, Doctor Physiotherapist · Medipol University

Study Design

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

18 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2025-05-30

Primary Completion

2025-08-30

Completion

2025-12-30

Countries

• Turkey (Türkiye)

Study Locations