Effects of Core Strengthening and PNF Pattern on Static Balance and Plantar Pressure in Chronic Stroke Patients

Stroke is a neurological disease characterized by neurological deficits caused by insufficiency of blood supply to brain. Disruption of blood supply to brain can be due to blockage of blood supply (ischemic) or leakage of blood in brain due to rupture of blood vessel (hemorrhagic). 90.5% of global occurrence of stroke was subjected to modifiable risk factors according to Global Burden of Disease study.

This study aims to compare the effects of core strengthening and proprioceptive neuromuscular facilitation on static standing balance and plantar pressure in chronic stroke patients.

Study Overview

• Status: Completed
• Conditions: Chronic Stroke
• Intervention / Treatment: Other: Routine Physical Therapy; Other: Routine Physical Therapy+ PNF and Core Stregthening

Detailed Description

Background: Stroke is a neurological disease characterized by neurological deficits caused by insufficiency of blood supply to brain. Disruption of blood supply to brain can be due to blockage of blood supply (ischemic) or leakage of blood in brain due to rupture of blood vessel (hemorrhagic). 90.5% of global occurrence of stroke was subjected to modifiable risk factors according to Global Burden of Disease study.

Objective: To compare the effects of core strengthening and proprioceptive neuromuscular facilitation on static standing balance and plantar pressure in chronic stroke patients.

Methodology: 73 patients were enrolled in this study, 37 patients were assigned into control group while 36 participants were assigned into experimental group. Control group received routine physical therapy while experimental group received core strengthening and proprioceptive neuromuscular technique. Static component of berg balance scale and PoData Stabiliometeric plate was used for plantar pressure and measurement of balance respectively.

• Study Type: Interventional
• Enrollment (Actual): 73
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Pakistan
  • Lahore, Pakistan, 54000
    • The University of Lahore Teaching Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age (45-60 years)
• Score of 9 or Higher on static component of berg balance scale
• Having score of equal or less than 2 on Modified Ashworth scale
• Having score of greater than or equal to 24 on Mini Mental State Examination.
• First ever episode of stroke
• Duration of stroke greater than 6 months
• Both genders

Exclusion Criteria:

• Concurrent orthopedic conditions that may hamper standing
• Relevant psychiatric disorders that may prevent from following instructions.
• Medical drugs that may influence intervention
• Conditions contraindicating physical activity
• Use of Cardiac pace maker.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group; Routine Physical Therapy	Other: Routine Physical Therapy; Routine physical therapy involving muscle strengthening exercises, range of motion exercises and stretching exercises up to patient's tolerance. Other exercises were pelvic bridging, rolling, sitting and standing exercises, walking practice and balancing in parallel bars, wobble board exercises. Each session was of 60 minutes 5 times weekly for 6 weeks.
Experimental: Interventional Group; Routine Physical Therapy + PNF + Core Strengthening	Other: Routine Physical Therapy+ PNF and Core Stregthening; Routine physical therapy for 20 minutes and additionally PNF technique (rhythmic initiation, and then agonistic reversals were performed in lower extremity in D1 flexion pattern and D1 extension pattern up to patient's tolerance and core strengthening for 20 minutes 5 times weekly for 6 weeks.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Static Standing Balance	Measure using static component of berg balance scale. The items are scored from 0 to 4 with a score of 0 representing an inability to complete the task. Score of 4 representing independent item completion.	6 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Plantar Pressure	Foot plantar pressure is the pressure field that acts between the foot and support surface during static standing. PoData Stabiliometric plate was used to measure it. Normal value is 16.67% of the body weight on 5th metatarsal.	6 weeks

Collaborators and Investigators

• Sponsor: University of Lahore
• Investigators: Principal Investigator: Safa Saleem, MSPTN, The University of Lahore

Study record dates

Study Major Dates

• Study Start (Actual): March 10, 2024
• Primary Completion (Actual): April 22, 2024
• Study Completion (Actual): April 30, 2024

Study Registration Dates

• First Submitted: March 21, 2024
• First Submitted That Met QC Criteria: March 28, 2024
• First Posted (Actual): April 4, 2024

Study Record Updates

• Last Update Posted (Actual): July 23, 2024
• Last Update Submitted That Met QC Criteria: July 20, 2024
• Last Verified: July 1, 2024

More Information

Terms related to this study

• Keywords: plantar pressure; core strengthening
• Additional Relevant MeSH Terms: Cardiovascular Diseases; Vascular Diseases; Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Stroke
• Other Study ID Numbers: REC-UOL-216-03-2024

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