Stroke PatientsNCT06259877
Relationship Between Respiratory Muscle Strength, Balance, Trunk Control, Functional Capacity in Stroke Patients
An observational study of Stroke Patients, run by Kırıkkale University at 1 site in Turkey (Türkiye).
Trial summary
The purpose of this study; To determine the relationship between respiratory muscle strength, balance, trunk control, functional capacity and motor functions in stroke patients and compare them with healthy individuals. Read more about this study
- Who is it for?
- Ages 18 years and olderHealthy volunteers can take part
- Conditions the study is for
- Stroke Patients
- How many people
- 44 participants
- Where
- 1 siteTurkey (Türkiye)
- Study dates
- 1 Mar 2021to 1 Jul 2025
- Phase
- Observational
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 years and older
- All sexes
- Healthy volunteers accepted
- Adult, Older adult
Study population: Stroke individuals over the age of 18 and healthy individuals who are followed up with a diagnosis of ischemic or hemorrhagic stroke and who apply to Kırıkkale University Faculty of Medicine Physical Medicine and Rehabilitation clinic will be included in our study. Socio-demographic characteristics of all individuals (age, height, body weight, body mass index, exercise and smoking habits, dominant side, lesion side, stroke type and onset, comorbid conditions, fall history, etc.) will be recorded.
Who may be able to join
- Stroke individuals over the age of 18
Who cannot join
- Patients with another neurological problem (Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance other than stroke
- Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease
- Patients with cooperation and communication problems
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Turkey (Türkiye)1 site, 1 recruiting
- Recruiting
Kirikkale University
Kirikkale
Saniye Aydoğan Arslan, +905053333457, fztsaniye1982@gmail.com
About this study
Official title: Determination of the Relationship Between Respiratory Muscle Strength, Respiratory Functions, Balance, Trunk Control, Functional Capacity and Motor Functions in Stroke Patients and Comparison With Healthy Individuals
The purpose of this study; To determine the relationship between respiratory muscle strength, balance, trunk control, functional capacity and motor functions in stroke patients and compare them with healthy individuals.
Read the detailed description
Stroke is one of the most important causes of chronic disability in adults. Hemiplegia and hemiparesis are common neurological conditions following stroke. Neurological findings associated with hemiplegia negatively affect posture, muscle tone, motor control, voluntary motor activation and trunk muscle synergy. The effect of stroke on the respiratory system depends on the structures affected by the lesion. The continuation of normal ventilation also depends on the influence of the neuromuscular system. The interference in trunk muscle synergies brings about loss of respiratory muscle function. Symptoms associated with respiratory problems, especially dyspnea, reduce exercise performance. On the other hand, motor control function losses; It disrupts the coordination of the respiratory muscles and changes the thickness of the diaphragm muscle, causing asymmetry between the affected and unaffected sides. Developing asymmetry can lead to progressive loss of strength in the respiratory muscles.
In the evaluation of stroke patients, measurements of the pulmonary system are rarely included. It is thought that the fact that patients do not have symptoms and/or diseases related to the pulmonary system before the development of stroke may explain the insufficient attention to respiratory evaluations. However, in a few studies, respiratory system evaluations were also made in stroke patients; It has been reported that there are effects related to pulmonary functions such as partial or total diaphragm on the affected side and weakening of intercostal and abdominal muscles.
- Conditions
- Stroke Patients
- Keywords
- Respiratory Function, Postural Control, Balance
- Medical subject headings
- Respiratory Aspiration
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
| Study group | Role | What they receive |
|---|---|---|
| Individuals with stroke over the age of 18 | nclusion Criteria: Stroke individuals over the age of 18 Exclusion Criteria: Patients with another neurological problem (Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance other than stroke Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease Patients with cooperation and communication problems | |
| Healthy individuals over the age of 18 | Exclusion Criteria: Patients with neurological problem (Stroke, Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease Patients with cooperation and communication problems |
What is being measured
The primary outcome is the main question the study is designed to answer.
Evaluation of respiratory functions
Measurements will be made in a sitting position using a spirometer (BTL-08 Spiro Pro system, Germany). Measurements are carried out in accordance with the recommendations of ATS (American Thoracic Society). The best of three consecutive measurements in each case is recorded. After respiratory function tests, FEV1, FVC, FEV1/FVC and PEF values are recorded. Pulmonary function test parameters are expressed as a percentage of expected values according to age, height, body weight and gender. Evaluations will be made by a physiotherapist experienced in Cardiopulmonary Rehabilitation.
Measured: 5 minutes
Respiratory Muscle Strength Measurement
Respiratory muscle strength will be measured using a portable, electronic mouth pressure measuring device (MEC Pocket Spiro MPM100, Belgium). One of the most frequently used and non-invasive methods for evaluating respiratory muscles is the measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). These are the intraoral pressures measured during maximal inspiration and expiration against a valve that closes the respiratory tract. MIP is the pressure (in effect negative pressure) created to open closed alveoli at the highest level of residual volume. The person being tested is made to take maximum inspiration, and at the end of this, the respiratory tract is closed with a valve and the person is asked to take maximum inspiration and continue this for 1-3 seconds.In MEP measurement, the person is asked to perform maximal inspiration against the closed airway for 1-3 seconds after maximal inspiration.
Measured: 5 minutes
Evaluation of Balance
Berg Balance Scale was designed to quantitatively evaluate balance and determine the risk of falling, and was preferred because it evaluates people's ability to maintain their balance while performing functional activities. BBS consists of 14 items for direct observation of maintaining body balance during performance. Each item is scored between 0-4 depending on the patient's ability to meet the specific time and distance requirements for the test. In the test, which is made more difficult by reducing the support base, a score of 4 indicates the ability to complete the task independently and a score of 0 indicates an inability to initiate the task. The test measures the level of dependence and/or independence and the person's ability to change positions during positions such as standing from sitting to standing, standing with feet together, standing in tandem position, balancing on one leg.
Measured: 5 minutes
Functional reach test
It is used to measure the stability limits of patients. For the test, the patient is asked to raise his unaffected arm forward 90° and make a fist with his hand, and to reach forward as much as he can by following the meter placed at shoulder level, without any loss of movement or balance in the feet, and the distance between the first and last measurement is measured by taking the 3rd Metacarpolaryngeal joint as a criterion. The test was repeated 3 times and the average value was recorded in cm.
Measured: 5 minutes
Trunk Impairment Scale
Developed to evaluate trunk balance (control) in patients with neurological deficits, GDS consists of 17 parameters. It evaluates static (3 parameters and 7 points in total) and dynamic (10 parameters, 10 points in total) sitting balance and trunk coordination (4 parameters, 6 points in total). The Trunk Impairment Scale is scored out of 2 and 3 points. The total score can be a minimum of 0 and a maximum of 23 points.
Measured: 5 minutes
The Stroke Rehabilitation Assessment Of Movement Scale
STREAM is a scale used for clinical motor assessment in stroke patients. This scale consists of 3 parts, each consisting of 10 items: upper extremity voluntary movement, lower extremity voluntary movement and basic mobility. There are 30 sub-items in total. Scoring should be done separately for voluntary movements and basic mobility. Points are given according to the quality of the movement and the amount of execution.
Measured: 5 minutes
6 Minute Walk Test
It has been used to evaluate physical activity and functional capacity in many pulmonary rehabilitation programs for patients with chronic pulmonary disease and limited respiratory capacity. 6MWT is a simple, low-cost test that monitors blood pressure (BP), heart rate (HR), respiratory frequency (SF), pulse oxygen saturation (SpO2), Borg Scale score and distance walked. This test allows determination of physical fitness and VO2max and also evaluates the patient's capacity and exercise tolerance
Measured: 10 minutes
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted14 Feb 2024
- Study start1 Mar 2021
- Primary completion20 Jun 2025 (estimated)
- Study completion1 Jul 2025 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (5)Papers the sponsor has linked to this study.
- Other trials for Stroke PatientsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Enrolment
- 44 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Kırıkkale University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Saniye Aydoğan Arslan, Kırıkkale University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT06259877
- Sponsor's protocol ID
- StrokeRespiratoryMuscles
- Status last verified
- Apr 2025
- First submitted
- 7 Feb 2024
- Last updated
- 30 Apr 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Macchiavelli A, Giffone A, Ferrarello F, Paci M. Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis. Neurol Sci. 2021 Jan;42(1):81-87. doi: 10.1007/s10072-020-04829-0. Epub 2020 Oct 16.
PubMed 33064231Kilinc M, Avcu F, Onursal O, Ayvat E, Savcun Demirci C, Aksu Yildirim S. The effects of Bobath-based trunk exercises on trunk control, functional capacity, balance, and gait: a pilot randomized controlled trial. Top Stroke Rehabil. 2016 Feb;23(1):50-8. doi: 10.1179/1945511915Y.0000000011. Epub 2015 Aug 10.
PubMed 26260878Sag S, Buyukavci R, Sahin F, Sag MS, Dogu B, Kuran B. Assessing the validity and reliability of the Turkish version of the Trunk Impairment Scale in stroke patients. North Clin Istanb. 2018 Aug 14;6(2):156-165. doi: 10.14744/nci.2018.01069. eCollection 2019.
PubMed 31297483Jung KJ, Park JY, Hwang DW, Kim JH, Kim JH. Ultrasonographic diaphragmatic motion analysis and its correlation with pulmonary function in hemiplegic stroke patients. Ann Rehabil Med. 2014 Feb;38(1):29-37. doi: 10.5535/arm.2014.38.1.29. Epub 2014 Feb 25.
PubMed 24639923Jung JH, Kim NS. The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. J Phys Ther Sci. 2015 Oct;27(10):3267-9. doi: 10.1589/jpts.27.3267. Epub 2015 Oct 30.
PubMed 26644689
Study at a glance
From the registry record, last updated by the sponsor on 30 Apr 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Determination of the Relationship Between Respiratory Muscle Strength, Respiratory Functions, Balance, Trunk Control, Functional Capacity and Motor Functions in Stroke Patients and Comparison With Healthy Individuals
- ClinicalTrials.gov ID
- NCT06259877
- Acronym / sponsor ID
- StrokeRespiratoryMuscles
- Conditions
- Stroke Patients
- Keywords
- Respiratory Function, Postural Control, Balance
- Study type
- Observational
- Recruitment status
- Recruiting
- Enrolment
- 44 participants (estimated)
- Lead sponsor
- Kırıkkale UniversityUniversity, hospital or other
- Study start
- 1 Mar 2021 (actual)
- Primary completion
- 20 Jun 2025 (estimated)
- Study completion
- 1 Jul 2025 (estimated)
- First posted
- 14 Feb 2024 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The purpose of this study; To determine the relationship between respiratory muscle strength, balance, trunk control, functional capacity and motor functions in stroke patients and compare them with healthy individuals.
Detailed description
Stroke is one of the most important causes of chronic disability in adults. Hemiplegia and hemiparesis are common neurological conditions following stroke. Neurological findings associated with hemiplegia negatively affect posture, muscle tone, motor control, voluntary motor activation and trunk muscle synergy. The effect of stroke on the respiratory system depends on the structures affected by the lesion. The continuation of normal ventilation also depends on the influence of the neuromuscular system. The interference in trunk muscle synergies brings about loss of respiratory muscle function. Symptoms associated with respiratory problems, especially dyspnea, reduce exercise performance. On the other hand, motor control function losses; It disrupts the coordination of the respiratory muscles and changes the thickness of the diaphragm muscle, causing asymmetry between the affected and unaffected sides. Developing asymmetry can lead to progressive loss of strength in the respiratory muscles.
In the evaluation of stroke patients, measurements of the pulmonary system are rarely included. It is thought that the fact that patients do not have symptoms and/or diseases related to the pulmonary system before the development of stroke may explain the insufficient attention to respiratory evaluations. However, in a few studies, respiratory system evaluations were also made in stroke patients; It has been reported that there are effects related to pulmonary functions such as partial or total diaphragm on the affected side and weakening of intercostal and abdominal muscles.
Study design
- Observational model
- Case-control
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Individuals with stroke over the age of 18 | – | –nclusion Criteria: Stroke individuals over the age of 18 Exclusion Criteria: Patients with another neurological problem (Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance other than stroke Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease Patients with cooperation and communication problems |
| Healthy individuals over the age of 18 | – | –Exclusion Criteria: Patients with neurological problem (Stroke, Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease Patients with cooperation and communication problems |
Who may qualify
- Ages
- 18 years and older
- Sex
- All
- Healthy volunteers
- Accepted
- Age groups
- Adult, Older adult
- Study population
- Stroke individuals over the age of 18 and healthy individuals who are followed up with a diagnosis of ischemic or hemorrhagic stroke and who apply to Kırıkkale University Faculty of Medicine Physical Medicine and Rehabilitation clinic will be included in our study. Socio-demographic characteristics of all individuals (age, height, body weight, body mass index, exercise and smoking habits, dominant side, lesion side, stroke type and onset, comorbid conditions, fall history, etc.) will be recorded.
Key inclusion criteria (1 listed)
- Stroke individuals over the age of 18
Key exclusion criteria (3 listed)
- Patients with another neurological problem (Parkinson, Multiple sclerosis, etc.) that will affect functionality and balance other than stroke
- Patients with orthopedic problems (short limbs, spine and lower extremity surgery) with pulmonary disease
- Patients with cooperation and communication problems
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Primary outcome
Evaluation of respiratory functions
Time frame: 5 minutes
Measurements will be made in a sitting position using a spirometer (BTL-08 Spiro Pro system, Germany). Measurements are carried out in accordance with the recommendations of ATS (American Thoracic Society). The best of three consecutive measurements in each case is recorded. After respiratory function tests, FEV1, FVC, FEV1/FVC and PEF values are recorded. Pulmonary function test parameters are expressed as a percentage of expected values according to age, height, body weight and gender. Evaluations will be made by a physiotherapist experienced in Cardiopulmonary Rehabilitation.
Respiratory Muscle Strength Measurement
Time frame: 5 minutes
Respiratory muscle strength will be measured using a portable, electronic mouth pressure measuring device (MEC Pocket Spiro MPM100, Belgium). One of the most frequently used and non-invasive methods for evaluating respiratory muscles is the measurement of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). These are the intraoral pressures measured during maximal inspiration and expiration against a valve that closes the respiratory tract. MIP is the pressure (in effect negative pressure) created to open closed alveoli at the highest level of residual volume. The person being tested is made to take maximum inspiration, and at the end of this, the respiratory tract is closed with a valve and the person is asked to take maximum inspiration and continue this for 1-3 seconds.In MEP measurement, the person is asked to perform maximal inspiration against the closed airway for 1-3 seconds after maximal inspiration.
Evaluation of Balance
Time frame: 5 minutes
Berg Balance Scale was designed to quantitatively evaluate balance and determine the risk of falling, and was preferred because it evaluates people's ability to maintain their balance while performing functional activities. BBS consists of 14 items for direct observation of maintaining body balance during performance. Each item is scored between 0-4 depending on the patient's ability to meet the specific time and distance requirements for the test. In the test, which is made more difficult by reducing the support base, a score of 4 indicates the ability to complete the task independently and a score of 0 indicates an inability to initiate the task. The test measures the level of dependence and/or independence and the person's ability to change positions during positions such as standing from sitting to standing, standing with feet together, standing in tandem position, balancing on one leg.
Functional reach test
Time frame: 5 minutes
It is used to measure the stability limits of patients. For the test, the patient is asked to raise his unaffected arm forward 90° and make a fist with his hand, and to reach forward as much as he can by following the meter placed at shoulder level, without any loss of movement or balance in the feet, and the distance between the first and last measurement is measured by taking the 3rd Metacarpolaryngeal joint as a criterion. The test was repeated 3 times and the average value was recorded in cm.
Trunk Impairment Scale
Time frame: 5 minutes
Developed to evaluate trunk balance (control) in patients with neurological deficits, GDS consists of 17 parameters. It evaluates static (3 parameters and 7 points in total) and dynamic (10 parameters, 10 points in total) sitting balance and trunk coordination (4 parameters, 6 points in total). The Trunk Impairment Scale is scored out of 2 and 3 points. The total score can be a minimum of 0 and a maximum of 23 points.
The Stroke Rehabilitation Assessment Of Movement Scale
Time frame: 5 minutes
STREAM is a scale used for clinical motor assessment in stroke patients. This scale consists of 3 parts, each consisting of 10 items: upper extremity voluntary movement, lower extremity voluntary movement and basic mobility. There are 30 sub-items in total. Scoring should be done separately for voluntary movements and basic mobility. Points are given according to the quality of the movement and the amount of execution.
6 Minute Walk Test
Time frame: 10 minutes
It has been used to evaluate physical activity and functional capacity in many pulmonary rehabilitation programs for patients with chronic pulmonary disease and limited respiratory capacity. 6MWT is a simple, low-cost test that monitors blood pressure (BP), heart rate (HR), respiratory frequency (SF), pulse oxygen saturation (SpO2), Borg Scale score and distance walked. This test allows determination of physical fitness and VO2max and also evaluates the patient's capacity and exercise tolerance
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 30 Apr 2025.
- Background: PubMed 33064231Macchiavelli A, Giffone A, Ferrarello F, Paci M. Reliability of the six-minute walk test in individuals with stroke: systematic review and meta-analysis. Neurol Sci. 2021 Jan;42(1):81-87. doi: 10.1007/s10072-020-04829-0. Epub 2020 Oct 16.
- Background: PubMed 26260878Kilinc M, Avcu F, Onursal O, Ayvat E, Savcun Demirci C, Aksu Yildirim S. The effects of Bobath-based trunk exercises on trunk control, functional capacity, balance, and gait: a pilot randomized controlled trial. Top Stroke Rehabil. 2016 Feb;23(1):50-8. doi: 10.1179/1945511915Y.0000000011. Epub 2015 Aug 10.
- Background: PubMed 31297483Sag S, Buyukavci R, Sahin F, Sag MS, Dogu B, Kuran B. Assessing the validity and reliability of the Turkish version of the Trunk Impairment Scale in stroke patients. North Clin Istanb. 2018 Aug 14;6(2):156-165. doi: 10.14744/nci.2018.01069. eCollection 2019.
- Results publication: PubMed 24639923Jung KJ, Park JY, Hwang DW, Kim JH, Kim JH. Ultrasonographic diaphragmatic motion analysis and its correlation with pulmonary function in hemiplegic stroke patients. Ann Rehabil Med. 2014 Feb;38(1):29-37. doi: 10.5535/arm.2014.38.1.29. Epub 2014 Feb 25.
- Results publication: PubMed 26644689Jung JH, Kim NS. The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. J Phys Ther Sci. 2015 Oct;27(10):3267-9. doi: 10.1589/jpts.27.3267. Epub 2015 Oct 30.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Stroke Patients, run by Kırıkkale University at 1 site in Turkey (Türkiye).
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 3 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 30 Apr 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Saniye Aydoğan Arslan (+905053333457, fztsaniye1982@gmail.com), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Evaluation of respiratory functions (time frame: 5 minutes). The study lists 7 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT06259877, which also lists 5 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 30 Apr 2025.