Core Strengthening Versus Lower Limb Proprioceptive Neuromuscular Facilitation Techniques in Chronic Stroke Patients

NCT ID: NCT05707065

Last Updated: 2023-01-31

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

42 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-01-01

Study Completion Date

2023-03-22

Brief Summary

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Stroke is a global healthcare issue that causes increased death rates. Good trunk stability is essential for balance and extremity use during daily functional activities and higher-level tasks. The anticipatory activity of trunk muscles is impaired in stroke patients. The trunk is the central column of the body; therefore, proximal trunk control is a prerequisite for distal limb movement control, balance, and functional activities. The purpose of the study is to highlight the most appropriate rehabilitation technique for trunk stability.

Detailed Description

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A randomized clinical trial will be performed in which 42 patients with strokes will be included. The data will be collected from Riphah Rehabilitation center Lahore and Ittefaq hospital Lahore. Consecutive sampling technique will be used to collect data. The duration of the study will be 10 months. Trunk impairment scale and berg balance scale will be used as the data collection tool. Data collection will be started after taking informed consent from all the patients. Patients will be allocated to intervention groups by randomization. The patients in group A will be given core strengthening exercise for 4 weeks. The patient in group B will be given PNF exercise for the treatment of trunk for 4 weeks. After data collection analysis of pre and post values will be done by using SPSS version 25.

Conditions

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Stroke

Keywords

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Proprioceptive Neuromuscular Facilitation; Stroke

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

SINGLE

Investigators

Study Groups

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core strengthening exercises

Participants will be positioned in supine.

* first stage participants will be taught to activate abdominal wall musculature. They will be initially trained to perform abdominal bracing.
* Then positioned in quadruped position and asked to lift alternate arms, gradually progressing to alternate leg lifts and alternate arm/leg raises to activate multifidus.
* Then side bridges (side plank) exercise for activation of quadratus lumborum and obliques.
* Then asked to perform trunk curls in crook lying, asking them to lift their upper trunk slightly (15°) from the plinth, hold the position for 5 sec.
* Perform 30 repetitions of each exercise with 8-sec hold.
* Maintain normal diaphragmatic breathing throughout the intervention

Group Type EXPERIMENTAL

core strengthening exercises

Intervention Type OTHER

The core muscles training includes transverse abdominis, multifidus, paraspinals, quadratus lumborum, and obliques.

Proprioceptive Neuromuscular Facilitation

* Rhythmic initiation (RI) Patients progressively performed voluntary relaxation, passive movements, active assisted, active resisted movements and than active movements.
* Dynamic reversals (slow reversals) Isotonic contractions of first agonists and then antagonists performed against resistance was performed initially.
* Stabilizing reversals Isotonic contractions of first agonists, then antagonists against resistance was performed in an alternate way.
* Mixture of isotonic (agonist reversals, AR) resisted concentric, contraction of agonist muscles moving with the range was performed progressively following eccentric, lengthening contraction, moving slowing to the start position. .

Total 30 min for 3 days a week for a total duration of 4 weeks was set as a optimal time frame duration. Each technique was given for 10 min.

Group Type EXPERIMENTAL

Proprioceptive Neuromuscular Facilitation

Intervention Type OTHER

lower limb PNF technique along with conventional treatment i.e., Rhythmic initiation, slow reversal, stabilizing reversal, and combination of isotones.

Interventions

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core strengthening exercises

The core muscles training includes transverse abdominis, multifidus, paraspinals, quadratus lumborum, and obliques.

Intervention Type OTHER

Proprioceptive Neuromuscular Facilitation

lower limb PNF technique along with conventional treatment i.e., Rhythmic initiation, slow reversal, stabilizing reversal, and combination of isotones.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Chronic stroke patients (6 months to 2 years).
* Participants with first ever ischemic stroke of right or left half of the body.
* Participants should be able to walk without support for 10 m.
* MMSE score is ≥ 24.

Exclusion Criteria

* Participants with recurrent stroke; brainstem or cerebellar stroke or hemorrhagic stroke will be excluded.
* Patients with speech problem after stroke
* Patients with other neurological disorders including: Parkinson's disease, multiple sclerosis, epilepsy, etc.
Minimum Eligible Age

50 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Riphah International University

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Ali Raza, MS(OMPT)

Role: PRINCIPAL_INVESTIGATOR

Riphah International University

Locations

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Ittefaq Hospital

Lahore, Punjab Province, Pakistan

Site Status RECRUITING

Countries

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Pakistan

Central Contacts

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Imran Amjad, Phd

Role: CONTACT

Phone: 03324390125

Email: [email protected]

Facility Contacts

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Ali Raza, MS(OMPT)

Role: primary

References

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Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. J Exerc Rehabil. 2017 Apr 30;13(2):200-205. doi: 10.12965/jer.1734892.446. eCollection 2017 Apr.

Reference Type BACKGROUND
PMID: 28503533 (View on PubMed)

Park SE, Moon SH. Effects of trunk stability exercise using proprioceptive neuromuscular facilitation with changes in chair height on the gait of patients who had a stroke. J Phys Ther Sci. 2016 Jul;28(7):2014-8. doi: 10.1589/jpts.28.2014. Epub 2016 Jul 29.

Reference Type BACKGROUND
PMID: 27512254 (View on PubMed)

Suh JH, Lee EC, Kim JS, Yoon SY. Association between trunk core muscle thickness and functional ability in subacute hemiplegic stroke patients: an exploratory cross-sectional study. Top Stroke Rehabil. 2022 Apr;29(3):163-172. doi: 10.1080/10749357.2021.1918840. Epub 2021 Apr 26.

Reference Type BACKGROUND
PMID: 33899701 (View on PubMed)

Asghar M, Fatima A, Warner S, Khan MHU, Ahmad A, Siddique K. Effectiveness of proprioceptive neuromuscular facilitation on balance in chronic stroke patients. Rawal Medical Journal. 2021;46(1):212-5

Reference Type BACKGROUND

Krukowska J, Bugajski M, Sienkiewicz M, Czernicki J. The influence of NDT-Bobath and PNF methods on the field support and total path length measure foot pressure (COP) in patients after stroke. Neurol Neurochir Pol. 2016 Nov-Dec;50(6):449-454. doi: 10.1016/j.pjnns.2016.08.004. Epub 2016 Aug 20.

Reference Type BACKGROUND
PMID: 27585746 (View on PubMed)

Other Identifiers

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REC/RCR&AHS/22/0217

Identifier Type: -

Identifier Source: org_study_id