NCT07512492

Combination Effect of Proprioceptive Training and Transcranial Magnetic Stimulation on Selected Gait Kinematic Parameters in Stroke Patients

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 30 (actual)
• Sponsor: Cairo University · Academic / Other
• Sex: All
• Age: 50 Years – 60 Years
• Healthy volunteers: Not accepted

Summary

this study was done to investigate the Combination effect of proprioceptive training and transcranial magnetic stimulation on selected gait kinematic parameters in stroke patients.

Detailed description

After a stroke, mobility is influenced by the central nervous system and peripheral neuromuscular and sensory systems. Effective standing and walking require managing body support against gravity and generating propulsion. Gait deficits in stroke survivors often arise from neural, sensory, muscular issues, and coordination problems, leading to movement disorders like spasticity and ataxia that hinder motor control and gait performance. Typically, stroke patients display reduced gait velocity and abnormal kinematics, marked by asymmetries and decreased weight bearing on the affected limb. Research indicates that combining high-frequency Transcranial magnetic stimulation with task-oriented mirror therapy enhances motor function more effectively than Transcranial magnetic stimulation alone, yielding improvements in hand function and cortical excitability. Similar findings for subacute stroke patients highlight the benefits of integrating action observation with Transcranial magnetic stimulation for better upper limb function.

Conditions

• Transcranial Magnetic Stimulation
• Stroke
• Gait Disorders, Neurologic
• Proprioceptive Training

Interventions

Type	Name	Description
DEVICE	Transcranial Magnetic Stimulation	Transcranial Magnetic Stimulation (TMS) is a non-invasive method that uses magnetic fields to stimulate brain nerve cells through figure-eight or circular coils with strengths of 1.5 to 3.0 Tesla. The TMS pulses, lasting about 100 microseconds, can be adjusted to induce excitatory or inhibitory responses, with a focus on specific brain regions. Although Transcranial Magnetic Stimulation is safe with mild side effects, its efficacy declines with depth. It is commonly used in treating depression and anxiety, as well as in cognitive neuroscience research, often employing a protocol of high-frequency Transcranial Magnetic Stimulation (≥5 Hertz) for 20 minutes on the lower limb region of the bilateral cerebrum at 90% of the motor threshold.
OTHER	selected physical therapy program	The program provides a set of exercises focused on improving ankle and knee movements, building muscle strength, and increasing the range of motion. It details eight activities: Ankle Movements for controlling foot actions; Active Knee Extension to strengthen the quadriceps; Gluteus maximus Squeezes for gluteal muscle enhancement; Inner Range Quadriceps involving a towel for knee support; Bridging to elevate the pelvis; a Passive Stretching Program for gentle knee stretches; Trunk Rotation to improve mobility; and Ankle Flexion to bend the ankle without foot rotation. The exercises are designed for gradual progression based on patient tolerance.
OTHER	proprioceptive training	The program outlines techniques for enhancing patient mobility and balance through various exercises. In modified plantigrade, patients practice stepping forward and backward while weight shifting, facilitated by a therapist's manual contact on the pelvis. Activities with footprint markers encourage active stepping, while resisted stepping involves pushing against elastic resistance. Utilizing a wobble board helps patients maintain balance and perform self-initiated tilts to improve stability. Prerequisite exercises for stair climbing, such as bridging and sit-to-stand transfers, include verbal cues to guide weight shifts and step placements, progressing from low to standard steps with therapist assistance as necessary.

Timeline

• Start date: 2024-12-01
• Primary completion: 2025-08-01
• Completion: 2025-10-01
• First posted: 2026-04-06
• Last updated: 2026-04-06

Locations

1 site across 1 country: Egypt