Comparative Effects of PNF and mCIMT on Lower Limb Function in Patient With Stroke

December 29, 2025 updated by: Riphah International University

Comparative Effects of Proprioceptive Neuromuscular Facilitation and Modified Constraint Induced Movement Therapy on Lower Limb Function in Patient With Stroke

Stroke, which is frequently characterized by weakness, poor balance, and decreased mobility that impede independence in everyday activities, has been identified as a major cause of long-term impairment globally. There have been reports of an increasing number of stroke survivors in Pakistan, however access to proper rehabilitation is sometimes hampered by a lack of resources and awareness. It is thought that improving walking ability, balance, and day-to-day functioning requires the restoration of lower limb function. Modified Constraint-Induced Movement Therapy (mCIMT) and Proprioceptive Neuromuscular Facilitation (PNF) have been found to be successful physiotherapy interventions for improving motor recovery, but there is little comparative data on their impact on lower limb function.

The purpose of this study is to examine the effects of PNF and mCIMT in order to identify whether strategy is better for lower limb rehabilitation after stroke. The findings are expected to give physiotherapists evidence-based recommendations for treatment choices, enabling stroke patients to recover more quickly and become more independent. In the end, community-level advantages are anticipated in the form of less impairment, less caregiver stress, and an overall improvement in the quality of life for stroke victims.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

54

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Pakistan
      • Lahore, Pakistan
        • Sehat medical complex hanjerwal

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

Patients who are chronic stroke post-stroke or longer will be included. Both males and females are included. Stroke between ages 45 -75 years. Mild to moderate disability assessed using the Modified Rankin Scale (mRS) with a score of 2 to 3.

Pain more than 4 on visual analogue scale in the affected lower limb.

Exclusion Criteria:

Recurring stroke Cognitive impairment (Less than 24 points on Mini Mental Status Examination) Peripheral vascular disease (such as Parkinsonism, epilepsy, multiple sclerosis, or spinal cord injury.

No surgical procedure performed on lower limbs

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

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

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PNF
First receive a general preparatory treatment, including hot pack and TENS for 10 minutes to facilitate relaxation, followed by active range of motion exercises as baseline therapy The intervention focused on PNF diagonal patterns, rhythmic initiation, resistance training and dynamic reversals.
Other: PNF
PNF training was administered for 10 weeks (Time), 5 days per week (Frequency), for 45 minutes per session (Time), using moderate-to-maximal manual resistance (Intensity) with rhythmic initiation, diagonal patterns, dynamic reversals, and resistance training (Type)
Experimental: mCIMT
Initially all participants will receive baseline treatment which include general relaxation followed by AROM. Limb will be constraint to 2.5 hours for 5 days a week and therapy time will be 45 minutes focusing on the use of affected limb up to 10 weeks. Side stepping, Ball kicking, Stair climbing, and Knee control on a step.
Other: mCIMT
mCIMT was administered for 10 weeks (Duration), 5 days per week (Frequency), for 45 minutes per session (Time), involving task-oriented lower limb activities including side stepping, ball kicking, stair climbing, and knee control on a step (Type), performed at moderate functional intensity (Intensity).

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
motor function
Time Frame: 10 week
The Fugl-Meyer Assessment of Lower Extremity (FMA-LE) is a widely used and recommended scale for evaluation of post-stroke motor impairment. The FMA-LE is a reliable tool for assessment of motor impairment both within and between raters early after stroke. The scale can be recommended internationally. A unified international use of FMA-LE would allow comparison of stroke recovery outcomes worldwide and thereby potentially improve the quality of stroke rehabilitation. The scale is recognized as a gold standard and is recommended both for clinical use and research world wide. The scale includes assessment of reflex activity, voluntary movements within and outside of synergies, ability to perform isolated movement, and coordination. This means that the scale is valid for determining level of motor function in people with stroke.The total score of the Fugl-Meyer Assessment for the Lower Extremity (FMA-LE) is 34 points.Each item is scored on a 0-2 scale.
10 week
Muscle Strength
Time Frame: 10 week
The Motricity Index (MI) is an ordinal measure used to assess muscle strength in individuals with post-stroke hemiparesis, originally developed by Demeurisse et al. in 1980. It evaluates three key upper limb movements-pinch grip (PG), elbow flexion (EF), and shoulder abduction (SA)-and three lower limb movements-ankle dorsiflexion (AD), knee extension (KE), and hip flexion (HF), each graded using the Medical Research Council (MRC) 6-point scale and then converted into modified weighted scores. A total score ranging from 0 (complete paresis) to 100 (normal strength) is computed for each limb, and a side score may also be obtained by averaging upper and lower limb totals. Administration time ranges from 5 to 20 minutes depending on the examiner's experience and the severity of impairment. The MI demonstrates excellent inter-rater reliability, strong construct and concurrent validity with established motor impairment scales, and good predictive validity as initial MI scores correlates
10 week
range of motion
Time Frame: 10 week
Goniometer refers to the measurement of angles in particular the measurement of angles created at human joints by the bones of the body. These measurement are obtained by placing the parts of measuring instrument, called a goniometer. Goniometery may be used to determine both a particular joint position and the total amount of motion available at a joint. The data analysis revealed the inter tester reliability and validity were high
10 week
stroke specific quality of life
Time Frame: 10 week
Stroke-specific quality of life (SS-QOL) is a standardized, reliable, and disease-specific questionnaire designed to evaluate quality of life in individuals with stroke. It consists of twelve domains and forty-nine items, each scored on a 5-point Likert scale. The domains include energy, language, mobility, self-care, family roles, social roles, vision, mood, thinking, upper extremity function, and work and productivity. The SS-QOL has been widely validated and is considered an effective tool for assessing functional and psychosocial outcomes in stroke patients.Stroke-Specific Quality of Life (SS-QOL) scale consists of 49 items across 12 domains.Each item is scored on a 5-point Likert scale (1-5). Minimum possible total score is 49 and maximum possible total score is 245.Higher scores indicate better quality of life in stroke patients.
10 week

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Riphah International University

Investigators

  • Principal Investigator: Riffat Malik, Riphah International University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

April 17, 2025

Primary Completion (Actual)

December 17, 2025

Study Completion (Actual)

December 17, 2025

Study Registration Dates

First Submitted

December 29, 2025

First Submitted That Met QC Criteria

December 29, 2025

First Posted (Estimated)

January 12, 2026

Study Record Updates

Last Update Posted (Estimated)

January 12, 2026

Last Update Submitted That Met QC Criteria

December 29, 2025

Last Verified

December 1, 2025

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • REC/RCR & AHS/24/0294

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

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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