PNF Strengthening and De-lorme and Watkins Exercises on Upper Extremity Function and Strength in Stroke Patients

Comparative Effects of Proprioceptive Neuromuscular Facilitation Strengthening Exercises and De-lorme and Watkins Exercises Program on Upper Limb Function and Strength in Chronic Stroke Patients

The aim of this study is to evaluate the effects of proprioceptive neuromuscular facilitation strengthening exercises and de-Lorme and Watkins exercises program in stroke patients with upper limb weakness in chronic stroke patients. The randomized central trial will recruit patients according to consecutive sampling into two intervention groups. One group will receive proprioceptive neuromuscular facilitation strengthening exercises and other group will receive de-Lorme and Watkins exercises program.

Study Overview

• Status: Recruiting
• Conditions: Upper Extremity Paresis
• Intervention / Treatment: Other: PNF strengthening exercises; Other: de-lorme and watkins exercises

Detailed Description

A study in which the participants (n=26) were recruited in the study suffering from stroke and meeting the inclusion criteria. Two groups formed such that patients in group A will be treated with conventional therapy and PNF and group B will be treated with PNF and NMES in along with conventional therapy. The protocol will cover 6 weeks of treatment. Regular assessment at 0,3rd and 6th week will be carried out. In the rehabilitation period, we will evaluate upper extremity function, activities of daily living(ADLs), mental status examination at regular interval during the rehabilitation.In previous studies there is less literature regarding the combine effects of proprioceptive neuromuscular facilitation techniques and de-Lorme and Watkins exercise program on upper limb function and strength in chronic stroke patients with upper limb weakness. Therefore there is dire need to explore which training technique is most effective in improving upper limb function and strength in chronic stroke patients therefore this study aims in comparative effects of proprioceptive neuromuscular facilitation strengthening exercises and de-Lorme and Watkins exercise program on upper limb function and strength in chronic stroke patients.

• Study Type: Interventional
• Enrollment (Estimated): 20
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Hira Jabeen, MSNMPT; Phone Number: 03234116506; Email: hirajabeen@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab
    • Lodhran, Punjab, Pakistan, 47541
      • Recruiting
      • Shahida Islam teaching hospital Lodhran
      • Contact: Hira Jabeen, MSNMPT; Phone Number: +92-323-4116506; Email: hirajabeen@riphah.edu.pk
      • Principal Investigator: Zainab Tehreem, MSNMPT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Chronic stroke patients.
• Medically stable patients having a single stroke.
• History of stroke 6 to 24 months.
• A score greater than 24-30 in mini-mental test.
• Patients having consciousness with GC;10

Exclusion Criteria:

• Recurrent stroke
• Patients with gullian berrie syndrome, multiple sclerosis lesion osteoarthritis of shoulder.
• Manual muscle testing below grade II.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: PNF strengthening exercises; Pnf strengthening exercises along with isometrics and range of motion exercises	Other: PNF strengthening exercises; PNF strengthening exercises 10 repetitions, 1set , 4 days/week along with range of motion exercises total of 4 sessions were given consisting 40 minutes
Active Comparator: de-lorme and watkins progressive resistance exercises; progressive resistance exercises along with isometrics and range of motion exercises	Other: de-lorme and watkins exercises; The group was given de-lorme and watkins progressive resistance exercises along with range of motion exercises .10 repetitions, 1set, 4 days /week along with range of motion exercises. total of 4 sessions per week each consisting of 40 minutes.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
The barthel index scale	The Barthel Index (BI) is a measure of independence in activities of daily living (ADL).It contains 10 components which has different scores.The total score is calculated by dividing 100.	4th day
Hand held dynamometer	The hand held dynamometry is an objective method in detecting minimum muscle strength change, which has an impact on the physical function of ICU survivors. The minimum change in the fore can be measured in units of weight such as pounds or kilograms.	4th day

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Hira Jabeen, MSNMPT, Riphah International Universiry

Publications and helpful links

General Publications

• Harris JE, Eng JJ. Paretic upper-limb strength best explains arm activity in people with stroke. Phys Ther. 2007 Jan;87(1):88-97. doi: 10.2522/ptj.20060065. Epub 2006 Dec 19.
• Andrade SE, Harrold LR, Tjia J, Cutrona SL, Saczynski JS, Dodd KS, Goldberg RJ, Gurwitz JH. A systematic review of validated methods for identifying cerebrovascular accident or transient ischemic attack using administrative data. Pharmacoepidemiol Drug Saf. 2012 Jan;21 Suppl 1(Suppl 1):100-28. doi: 10.1002/pds.2312.
• Zuber M, Mas JL. [Epidemiology of cerebrovascular accidents]. Rev Neurol (Paris). 1992;148(4):243-55. French.
• Gillespie CD, Wigington C, Hong Y; Centers for Disease Control and Prevention (CDC). Coronary heart disease and stroke deaths - United States, 2009. MMWR Suppl. 2013 Nov 22;62(3):157-60.
• Mergenthaler P, Dirnagl U, Meisel A. Pathophysiology of stroke: lessons from animal models. Metab Brain Dis. 2004 Dec;19(3-4):151-67. doi: 10.1023/b:mebr.0000043966.46964.e6.
• Hendricks HT, van Limbeek J, Geurts AC, Zwarts MJ. Motor recovery after stroke: a systematic review of the literature. Arch Phys Med Rehabil. 2002 Nov;83(11):1629-37. doi: 10.1053/apmr.2002.35473.
• Pak S, Patten C. Strengthening to promote functional recovery poststroke: an evidence-based review. Top Stroke Rehabil. 2008 May-Jun;15(3):177-99. doi: 10.1310/tsr1503-177.

Study record dates

Study Major Dates

• Study Start (Actual): February 25, 2023
• Primary Completion (Estimated): October 18, 2023
• Study Completion (Estimated): October 30, 2023

Study Registration Dates

• First Submitted: June 6, 2023
• First Submitted That Met QC Criteria: June 6, 2023
• First Posted (Actual): June 15, 2023

Study Record Updates

• Last Update Posted (Actual): June 15, 2023
• Last Update Submitted That Met QC Criteria: June 6, 2023
• Last Verified: June 1, 2023

More Information

Terms related to this study

• Keywords: Proprioceptive neuromuscular facilitation
• Additional Relevant MeSH Terms: Nervous System Diseases; Neurologic Manifestations; Paresis
• Other Study ID Numbers: REC/LHR/23/0215 ZAINAB TEHREEM

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No