Boccia Exercises and Upper Limb Muscle Adaptations in Hemiparetic Individuals

Bayburt University

Status: Completed

Conditions: Hemiparesis After Stroke

Treatments: Other: physiotherapy; Other: Boccia exercise

Study type: Interventional

Funder types: Other

Identifiers

NCT07254273

E-15604681-100-234561

Details and patient eligibility

About

This study investigates whether adding Boccia exercises to conventional rehabilitation improves upper extremity muscle thickness and grip strength in individuals with hemiparesis following stroke. The research aims to determine if Boccia training can enhance muscle morphology and functional strength beyond standard physical therapy.

Full description

Loss of upper extremity function after stroke significantly reduces independence in daily living. Changes in muscle morphology (muscle thickness, echogenicity, pennation, etc.) can affect strength, coordination, and functional performance. Boccia is a sport originally designed for individuals with special needs, encouraging hand-eye coordination, targeting, and force-controlled repetitions. Due to these characteristics, it has been suggested that boccia may positively impact both motor control and muscle tone; however, its effects on muscle morphology and grip strength in hemiparetic individuals have been limitedly studied. This study will investigate the contribution of boccia exercises to conventional physiotherapy on upper extremity muscle thickness and grip strength.

Primary objective: To evaluate whether boccia exercises provide significant improvements in upper extremity muscle thickness and grip strength after hemiparesis, in addition to conventional physical therapy.

Hypothesis: Participants who receive up to nine weeks of extended or eight weeks (8 weeks in the protocol) of boccia practice will show greater improvements in upper extremity muscle thickness and grip strength than those who receive conventional physical therapy alone.

This study is a parallel-group, random assignment controlled trial. The total sample included 22 stroke (hemiparetic) individuals; participants were randomly assigned to two groups: Boccia + physical therapy (Boc, n = 12) and physical therapy alone (Ctrl, n = 10). Assessments will be conducted at pre-intervention (baseline) and post-intervention (after 8 weeks). Assessors will be blinded to the measurements; complete blinding of operators and participants is not possible.

Enrollment: 22 patients

Sex: All

Ages: 18 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Adults aged 18-75
• Having had a stroke within the last 6-24 months and diagnosed with hemiparesis
• Mild to moderate motor function loss in the upper extremity (e.g., Fugl-Meyer Upper Extremity Score ≥ 20/66)
• Clinically stable individuals eligible to participate in sessions
• Be conscious, cognitively able to follow instructions, and consent
• Be physically fit enough to participate in exercise at least 3 days a week

Exclusion criteria

• Limited upper extremity movement due to severe spasticity, contracture, or joint deformity (Modified Ashworth Scale ≥ 3)
• Contraindication to exercise due to severe cardiovascular, pulmonary, or systemic disease
• Serious diseases other than neurological disorders (e.g., Parkinson's, MS, tumor)
• History of upper extremity surgery or trauma within the last 6 months
• Inability to exercise due to severe pain, infection, or skin lesions
• Inability to follow instructions due to psychiatric or cognitive impairment
• Concurrent participation in other clinical trials

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

---

22 participants in 2 patient groups

Boccia Exercise Group

Experimental group

Description:

Participants in this group will receive conventional physical therapy combined with Boccia exercises three times per week for 8 weeks. Each session lasts approximately 45-60 minutes and includes warm-up, Boccia skill drills (target aiming, throwing control), and cool-down activities.

Treatment:

Other: Boccia exercise

Other: physiotherapy

Control Group

Active Comparator group

Description:

Participants in this group will receive only conventional physical therapy three times per week for 8 weeks. The program includes strengthening, range of motion, and task-specific functional exercises matched in duration and frequency to the experimental group.

Treatment:

Other: physiotherapy