300,000+ clinical trials. Find the right one.

902 active trials for Stroke

Efficacy of Modified Constraint Induced Movement Therapy Combined With Threshold Electrical Stimulation in Stroke Patients

In this study, we aimed to investigate the effectiveness of applied modified constraint induced movement therapy (M-CIMT) with threshold electrical stimulation (TES) in addition to conventional therapy (therapeutic exercise program) in patients wtih stroke. Studies investigating the effectiveness of modified constraint induced movement therapy on the upper extremity in patients with stroke are available in the literature, but there is no study investigating the effectiveness of modified constraint induced movement therapy with threshold electrical stimulation. M-CIMT treatment applied together with TES will be performed electric stimulation without causing discomfort in patients with stroke and at the same time, the duration of use of the affected extremity can be extended with task-oriented exercises with M-CIMT treatment. In this way, the efficiency of the applied treatment program will be evaluated, the gains obtained will be investigated and presented as a suggestion to physiotherapists working with stroke patients. Before and after the treatment program we will evaulate, the pain level of the participants is measured with visual pain scale; sensory functions with Semmes Weinstein monofilament test battery; muscle tone and spasticity with the modified tardieu scale and Myoton®PRO Digital Palpation Device, which has a very high proof value; functional status with Wolf motor function test and Motor Activity Log-28 (MAG-28); quality of life will be assessed by Stroke Specific Quality of Life Scale. The sample size of our study, in the power analysis performed through the G * Power 3.0.10 program, the sample size was calculated to be at least 15 for each group for 80% power (effect size: 0.8, α: 0.05). It is planned to include 30% (5 people) more participants in each group against the possibility of data loss, and 20 (15 + 5) participants in each group. The study example exemplified in the literatüre for power analysis belongs to Yoon and his colleagues (Yoon et al, 2014). Participants will be included in the study according to the inclusion criteria, the first evaluation of the participants will be made according to the evaluation parameters, and the participants will be randomly distributed into three groups. The first group will be treated with M-CIMT, the second group will be treated with M-CIMT with TES for 4 weeks, and the third group will be the control group. A total of 60 participants will be included in the study. Participants in all three groups will be included in the routine conventional physiotherapy program. M-CIMT and TES treatment will be applied 3 days a week for a total of 4 weeks. Each treatment session will continue for one and half hours. A total of two evaluations will be applied before and after treatment. In the classification of the data to be obtained in the study, qualitative and quantitative statistical methods will be evaluated with the SPSS 11.5 statistical program within 95% confidence interval, and the significance level will be evaluated at p<0.05 level.

IstanbulStart: September 2021
A Genomic Approach for Clopidogrel in Caribbean Hispanics

Clopidogrel is a prescription medicine used to minimize blood clot formation in patients with cardiovascular disease, particularly those undergoing heart catheterization and stroke. A substantial amount of medical evidence has proven that patients with stroke or heart diseases can benefit from this medicine. However, significant variability in such expected benefits has been found among individuals receiving clopidogrel, with some patients not having the benefit of reduced complications and adverse cardiovascular events. Prior studies have demonstrated a significant association between certain variants on patient's genes (e.g., CYP2C19) and poor response to clopidogrel and, therefore, major adverse cardiovascular events. Variation in other genes and other factors such as platelet activation, weight, diabetes mellitus (a medical condition that produces high blood sugar), concomitant use of other drugs, and smoking status have also been proposed to be related to the same adverse outcomes. In this study, the investigators would like to determine a possible association between these genes and the response to the medication among Caribbean Hispanic cardiovascular patients on clopidogrel. In other populations, it is known that patients with certain genetic variants have lower or magnified responses to this medication when compared to those individuals taking the same dose and not carrying the genetic variations. However, a fundamental gap remains in understanding whether the genomic diversity of Caribbean Hispanics accounts for the observed high inter-individual variability of clinical outcomes to preventive dual antiplatelet therapy (DAPT) with clopidogrel.

CarolinaStart: September 2020
Ultrasound Application on the Suprascapular Nerve for Stroke Patients

The suprascapular nerve is the first nerve that branches from the upper trunk of brachial plexus. It receives signals transmitted from the fifth and sixth cervical root. The clinical importance of suprascapular nerve is mainly based on its distribution of 70% sensory innervation to the glenohumeral joint. After being divided from the upper trunk, the suprascapular nerve goes laterally and posteriorly. First, it passes underneath the omohyoid muscle, and then goes through the suprascapular notch into the suprascapular fossa. If there are some problems inside the supraspinatus muscle at the suprascapular fossa, the suprascapular nerve below it may be compromised. After the suprascapular nerve passes the suprascapular fossa, it courses through the spinoglenoid notch, and then goes into the infraspinatus fossa to innervate the infraspinatus muscle. Based on the sensory and motor innervation of the suprascapular nerve to the shoulder joint, the sonographic images of the suprascapular nerves would add tremendous values in assessing patients with refractory shoulder pain. Although there are some studies trying to measure the size of the suprascapular nerve, no available research can be found in stroke patients. Our study aims to explore the ultrasound morphology of the suprascapular nerves as well as subacromial dynamic imaging in patients with stroke. A control group without stroke will be recruited for comparison.

TaipeiStart: October 2021