Clinical Research Directory

Relationship Between Balance, Arm Function and Body Awareness in People With Stroke

Stroke is one of the leading causes of long-term disability worldwide and is frequently associated with impairments in balance, upper extremity function, and body awareness. These impairments may negatively affect independence in activities of daily living and overall quality of life. Although previous studies have investigated the relationships between balance and upper extremity function after stroke, body awareness has received relatively limited attention. The aim of this observational cross-sectional study is to investigate the relationship between balance, upper extremity skills, and body awareness in individuals with chronic stroke. Fifty-three individuals with chronic stroke will be recruited from the Department of Physical Medicine and Rehabilitation at Baskent University Hospital. Balance will be assessed using the Berg Balance Scale and the Tetrax computerized posturography system. Upper extremity motor impairment and functional performance will be evaluated using the Fugl-Meyer Upper Extremity Assessment and the Wolf Motor Function Test. Body awareness will be assessed using the Body Awareness Questionnaire. Additional assessments will include lower extremity motor function, muscle tone, cognitive status, shoulder range of motion, and upper extremity reaction time. The study is expected to provide a better understanding of the relationships among balance, upper extremity function, and body awareness in individuals with chronic stroke. The findings may contribute to the development of individualized rehabilitation strategies and improve clinical assessment approaches in stroke rehabilitation.

Effects of I-STROKEFIT+ on Physical Fitness Among Community-Dwelling Stroke Survivors: A Pilot RCT

This pilot randomized controlled study will evaluate whether a 12-week integrated home-based physical fitness and self-management programme (i-StrokeFit+) can improve physical fitness and physical activity among community-dwelling stroke survivors. The programme combines aerobic exercise, strengthening exercises, stretching, and self-management strategies. The study hypothesizes that participants receiving i-StrokeFit+ will demonstrate greater improvements in physical fitness and physical activity compared with participants receiving stroke education and simple stretching exercises.

Unimanual Versus Bimanual Motor Skill Learning in Acute and Chronic Stroke

To test the capacity of healthy individuals, chronic and acute stroke patients to learn and retain a complex unimanual or bimanual motor skill, trained on the neurorehabiliation robot REAplan® et the Dextrain® device. The goals are (1) to compare head-to-head bimanual versus unimanual motor learning (in the proximal and distal upper limb, UL) during the acute - early subactue stage of stroke with robotics and (2) to identify the neural substrates associated with (and deficits in) unimanual versus bimanual motor control (proximal and distal) after stroke by means of multimodal brain imaging.

Functional Inspiratory Muscle Training for Gait Recovery in Patients With Chronic Stroke

The purpose of this randomized controlled trial is to evaluate the effect of functional inspiratory muscle training (F-IMT) on spatiotemporal gait parameters in patients with chronic stroke. Sixty participants with chronic stroke will be randomly assigned to either a functional inspiratory muscle training group or a conventional inspiratory muscle training group. Both groups will receive the same conventional rehabilitation program for 8 weeks. The primary outcome is spatiotemporal gait parameters measured using the STEADYS gait assessment system. Secondary outcomes include exercise capacity assessed by the Six-Minute Walk Test (6MWT) and health-related quality of life assessed using the EuroQol Five-Dimension (EQ-5D) questionnaire.

TELE-REHABILITATION VERSUS CLINIC-BASED MODIFIED CONSTRAINT-INDUCED MOVEMENT THERAPY FOR UPPER LIMB FUNCTION IN CHRONIC STROKE PATIENTS

Stroke commonly results in persistent upper limb impairment that limits functional independence and participation in daily activities. Modified Constraint-Induced Movement Therapy (mCIMT) is an evidence-based intervention for improving upper limb function after stroke. Tele-rehabilitation has emerged as an alternative method of delivering rehabilitation services, potentially improving accessibility while maintaining treatment effectiveness. This randomized controlled trial will compare the effectiveness of tele-rehabilitation-based mCIMT with clinic-based mCIMT in individuals with chronic stroke. Sixty-eight eligible participants will be randomly allocated into two groups. The tele-rehabilitation group will receive supervised mCIMT through virtual sessions combined with a structured home exercise program, while the clinic-based group will receive the same intervention in a clinical setting. Both groups will receive treatment three times per week for 6 weeks. Upper limb function, spasticity, motor performance, and intrinsic motivation will be assessed at baseline and after the 6-week intervention using the Upper Extremity Fugl-Meyer Assessment (UEFMA), Modified Ashworth Scale (MAS), Wolf Motor Function Test (WMFT), and Intrinsic Motivation Inventory (IMI). The study aims to determine whether tele-rehabilitation is as effective as clinic-based mCIMT for improving upper limb function in individuals with chronic stroke.

Efficacy of Swiss Ball Exercises Versus Kinesthetic Training for Improving Balance and Functional Mobility in Chronic Stroke Patients.

Stroke is one of the leading causes of long-term disability and commonly results in impaired balance, reduced trunk control, and difficulty in functional mobility. Chronic stroke patients often experience limitations in daily activities due to poor postural stability and decreased motor coordination. Various rehabilitation approaches are used to improve balance and mobility, among which Swiss ball exercises and kinesthetic training are considered beneficial interventions. The purpose of this randomized controlled trial is to compare the effectiveness of Swiss ball exercises versus kinesthetic training in improving balance and functional mobility in patients with chronic stroke. A total of 36 participants diagnosed with chronic stroke for more than six months will be recruited and randomly allocated into two groups. Group A will receive Swiss ball exercises focusing on trunk stability, coordination, and balance control, while Group B will receive kinesthetic training aimed at improving proprioception, sensory feedback, and motor control. The intervention program will continue for 8 weeks under the supervision of qualified physiotherapists in the Physiotherapy Department of Shalimar Health Centre. Balance and functional mobility will be assessed before and after the intervention using the Berg Balance Scale (BBS) and Timed Up and Go (TUG) test. This study aims to determine which intervention is more effective in enhancing balance and mobility in chronic stroke patients and may help improve rehabilitation strategies for stroke recovery.

Virtual Reality-Based Upper Limb Rehabilitation in Chronic Stroke

This randomized controlled study aims to evaluate the effectiveness of non-immersive virtual reality-based rehabilitation using the MindMotion™ GO system compared with conventional occupational therapy for improving upper limb motor function in individuals with chronic stroke. Stroke is a leading cause of long-term disability in adults worldwide, and barriers such as limited access to rehabilitation services, low motivation, and reduced adherence may hinder recovery in the chronic phase. Participants will be randomly assigned to either an experimental group receiving non-immersive virtual reality training or a control group receiving conventional occupational therapy according to standard clinical practice. Both groups will complete two rehabilitation sessions per week for eight weeks, with each session lasting approximately 40 minutes. The study will assess upper limb motor function, performance in activities of daily living, and quality of life. In addition, electroencephalography (EEG) will be used before and after the intervention to explore potential neuroplastic changes associated with rehabilitation. Outcome assessments will be conducted at baseline and at follow-up approximately three months after the initial evaluation. The results of this study may help determine whether non-immersive virtual reality is an effective and accessible tool to enhance rehabilitation outcomes in individuals with chronic stroke.

Multifocal Theta-Burst Stimulation to Enhance Upper Limb Motor Recovery After Stroke (INSPIRE)

Stroke is one of the leading causes of long-term disability worldwide. Many individuals who survive a stroke continue to experience weakness and reduced control of one arm, even months or years after the event. These motor impairments significantly affect independence, daily activities, and quality of life. Despite rehabilitation efforts, recovery of upper limb function remains incomplete for many patients. Motor recovery after stroke depends on the brain's ability to reorganize itself, a process known as neuroplasticity. Recent research suggests that motor learning and brain recovery are influenced not only by activity in the primary motor cortex (M1), but also by its functional connectivity with other brain regions, particularly the parietal cortex (PC). Strengthening communication between these regions may enhance motor recovery. This study aims to investigate a novel, non-invasive brain stimulation approach called intermittent theta-burst stimulation (iTBS). Unlike traditional stimulation methods that target a single brain region, this study uses a multifocal stimulation protocol targeting both the primary motor cortex and the parietal cortex. The stimulation is combined with structured motor training using an interactive tablet-based rehabilitation device (REAtouch®Lite 2), designed to improve arm movement through goal-directed reaching tasks. The study is a single-center, randomized, sham-controlled, triple-blind clinical trial with parallel groups. Thirty-six individuals with chronic stroke-related upper limb impairment will be randomly assigned to receive either active multifocal iTBS or sham (placebo) stimulation. Both groups will complete identical motor training sessions. In addition, ten healthy participants will complete the same motor training protocol (without brain stimulation) to provide reference data. Participants will attend six visits over approximately 10 days. Assessments will include motor performance tests using the interactive tablet, a standardized clinical motor scale (Fugl-Meyer Assessment for Upper Extremity), and resting-state electroencephalography (EEG) to measure brain connectivity changes. The primary outcome is improvement in motor performance between baseline and one week after the intervention. Secondary outcomes include short-term motor improvements, retention of learning, changes in movement quality, and changes in brain functional connectivity. This study seeks to determine whether combining multifocal brain stimulation with targeted motor training can enhance motor learning and promote better recovery of arm function after stroke. If effective, this approach could contribute to the development of more precise, network-based neurorehabilitation strategies.

Effects of tES Combined With CMDT Gait Training on Cognition, Cortical Activity, Spinal Motoneuron Excitability and Motor Performance in Stroke Individuals

The present study will use transcranial electrical stimulation (tES) which are transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) combined with conventional physical therapy and cognitive-motor dual task gait training in sub-acute (at least 2 weeks after stroke onset) to chronic (within 5 years post-stroke) to investigate the effect on cortical activity, spinal motoneuron excitability, cognition and motor performance. The findings may enhance the evidence to support usages of tES for improvimg cognition, motor performance as well as cortical activity and spinal motoneuron excitability in a clinical setting.

Q Therapeutic System for Chronic Stroke Recovery

Evaluate the effectiveness of the Q Therapeutic (BQ 3.0) System for individuals with chronic stroke in improving upper extremity function as determined by change in functional outcome measures after 3-month treatment, including in-clinic and at-home sessions.