Can Lumbar Mulligan Mobilization Improve Gait, Balance, and Trunk Position Sense After Stroke?
Effects of Mulligan-Based Lumbar Mobilization on Trunk Position Sense, Balance, and Gait in Stroke Survivors: A Randomized Study
Gulhane School of Medicine
40 participants
May 8, 2024
INTERVENTIONAL
Conditions
Summary
Stroke is a pathology caused by disturbances in the brain's arterial circulation, leading to high morbidity rates. Individuals who experience a stroke often face neurological impairments such as motor, sensory, and cognitive dysfunctions, which negatively impact muscle strength, postural control, sensation, and gait, reducing their independence in daily activities. Balance deficits in stroke patients increase the risk of falls and contribute to a fear of falling. Improving balance control is a key goal in rehabilitation. The importance of the trunk in balance control and rehabilitation is well-established, as it plays a central role in maintaining stability. In individuals with restricted lumbar mobility, weakened trunk muscles and altered muscle activation can lead to a reduction in proprioception, hip strategy, and spinal stabilization, further impairing balance. Combining conventional exercise approaches with other rehabilitation techniques has been shown to yield more effective outcomes. This study aims to investigate the effects of Mulligan-based lumbar spine mobilization on balance, trunk position sense, and gait in individuals with stroke.
Eligibility
Inclusion Criteria7
- Participants must meet all of the following conditions to be eligible for the study:
- Diagnosed with stroke by a neurologist.
- Aged 30 to 65 years.
- First-ever stroke (single episode).
- Stroke duration between 6 to 24 months.
- Score of ≤3 on the Modified Rankin Scale (mRS).
- Score of ≥24 on the Mini-Mental State Examination (MMSE).
Exclusion Criteria5
- Participants will be excluded if they meet any of the following conditions:
- History of musculoskeletal disorders affecting the spine (e.g., cancer, scoliosis, spondylolisthesis, rheumatoid arthritis, ankylosing spondylitis).
- Previous lumbar spine surgery.
- Presence of neurological conditions other than stroke (e.g., Parkinson's disease, multiple sclerosis).
- Severe visual impairment affecting balance or walking.
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Interventions
Mulligan Sustained Natural Apophyseal Glides (SNAGs) applied to the lumbar spine, combined with conventional rehabilitation exercises (neuromuscular training, stretching, strengthening, and balance exercises).
Neuromuscular training, stretching, strengthening, balance exercises, and gait training performed without Mulligan mobilization.
Locations(1)
View Full Details on ClinicalTrials.gov
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NCT06887114