Effects of Proprioceptive Neuromuscular Facilitation-Based Lower Extremity Training on Balance, Gait, and Functional Independence in Individuals With Stroke (PNF-STROKE)

May 20, 2026 updated by: salih tan, Istanbul Medipol University Hospital

The Effects of Proprioceptive Neuromuscular Facilitation-Based Lower Extremity Rehabilitation on Balance, Gait Performance, Functional Independence, and Quality of Life in Individuals With Stroke: A Randomized Controlled Study

This study aims to investigate the effects of a proprioceptive neuromuscular facilitation (PNF)-based lower extremity rehabilitation program on balance, gait performance, functional independence, and quality of life in individuals with stroke.

Stroke is a leading cause of long-term disability and is commonly associated with impairments in motor control, balance, and walking ability, which negatively affect independence and daily functioning.

In this randomized controlled trial, participants with stroke will be randomly assigned to either a PNF-based rehabilitation group or a control group receiving conventional physiotherapy. The intervention will focus on lower extremity PNF techniques to improve motor control, balance, and gait performance.

Assessments will be conducted at baseline and at the end of the intervention period.

The findings are expected to contribute to the development of evidence-based rehabilitation strategies for individuals with stroke.

Study Overview

Status

Not yet recruiting

Conditions

Intervention / Treatment

Detailed Description

This study is designed as a prospective, randomized, parallel-group controlled trial to evaluate a PNF-based lower extremity rehabilitation program in individuals with stroke.

A total of 60 participants will be randomly allocated in a 1:1 ratio to either an intervention group or a control group using a computer-generated randomization sequence.

The intervention group will receive a structured rehabilitation program based on proprioceptive neuromuscular facilitation principles. The program will incorporate techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization. These techniques will be applied through lower extremity diagonal movement patterns (D1 and D2) in functional positions including supine, sitting, and standing. The intervention will be individualized and progressively adjusted according to participant performance and tolerance.

The control group will receive a conventional physiotherapy program consisting of range of motion exercises, muscle strengthening, balance training, and gait-related activities consistent with standard rehabilitation practice.

Both groups will receive interventions with equivalent duration and frequency.

Outcome assessments will be performed by an independent assessor who is blinded to group allocation.

Statistical analyses will be conducted to evaluate changes over time and differences between groups.

Study Type

Interventional

Enrollment (Estimated)

60

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 Contact

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:

  • Diagnosis of stroke confirmed by a neurologist
  • Age between 40 and 80 years
  • Ability to walk with or without an assistive device
  • Medically stable condition
  • Ability to understand and follow verbal instructions
  • Willingness to participate and provide informed consent

Exclusion Criteria:

  • Severe cognitive impairment preventing participation
  • Other neurological disorders affecting mobility
  • Severe musculoskeletal disorders affecting lower extremity function
  • Severe cardiovascular conditions contraindicating exercise
  • Participation in another rehabilitation study

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: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: PNF Training Group
Participants in this group will receive a proprioceptive neuromuscular facilitation (PNF)-based lower extremity rehabilitation program. The intervention will include specific PNF techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization aimed at improving balance, gait performance, and lower extremity motor control in individuals with stroke.
Other: Proprioceptive Neuromuscular Facilitation Training

No drug or medical device is used as part of the intervention. The study involves only physiotherapy-based rehabilitation programs.

A structured PNF-based exercise program targeting lower extremity motor function, balance, and gait performance. The intervention will include techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization applied using diagonal movement patterns (D1 and D2). Exercises will be performed in functional positions (supine, sitting, standing) and progressively adjusted according to patient tolerance.
Active Comparator: Conventional Physiotherapy Group
Participants in the control group will receive conventional physiotherapy exercises focusing on lower extremity strengthening, balance training, and functional mobility exercises commonly used in stroke rehabilitation.
Other: Conventional Physiotherapy
Standard physiotherapy exercises including balance training, gait training, and strengthening exercises for individuals with stroke.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Berg Balance Scale
Time Frame: Baseline and 8 weeks
The Berg Balance Scale (BBS) is a 14-item scale used to assess functional balance. Each item is scored from 0 to 4, with a total score ranging from 0 to 56. Higher scores indicate better balance performance.
Baseline and 8 weeks

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Timed Up and Go Test
Time Frame: Baseline and 8 weeks
The Timed Up and Go Test (TUG) measures functional mobility and dynamic balance. It records the time (in seconds) required to stand up from a chair, walk 3 meters, turn, walk back, and sit down. Lower values indicate better performance.
Baseline and 8 weeks
Fugl-Meyer Motor Assessment (Lower Extremity)
Time Frame: Baseline and 8 weeks
The Fugl-Meyer Assessment (Lower Extremity section) evaluates motor recovery after stroke. Scores range from 0 to 34, with higher scores indicating better motor function.
Baseline and 8 weeks
10-Meter Walk Test
Time Frame: Baseline and 8 weeks
The 10-Meter Walk Test assesses walking speed (m/s). Higher walking speed indicates better gait performance.
Baseline and 8 weeks
6-Minute Walk Test
Time Frame: Baseline and 8 weeks
The 6-Minute Walk Test measures walking endurance and functional exercise capacity as the total distance walked in meters. Higher values indicate better performance.
Baseline and 8 weeks
Stroke Specific Quality of Life Scale
Time Frame: Baseline and 8 weeks
The Stroke-Specific Quality of Life Scale (SS-QOL) evaluates health-related quality of life. Scores range from 49 to 245, with higher scores indicating better quality of life.
Baseline and 8 weeks

Collaborators and Investigators

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

Sponsor

Istanbul Medipol University Hospital

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 (Estimated)

April 30, 2026

Primary Completion (Estimated)

June 20, 2026

Study Completion (Estimated)

August 20, 2026

Study Registration Dates

First Submitted

April 6, 2026

First Submitted That Met QC Criteria

April 6, 2026

First Posted (Actual)

April 13, 2026

Study Record Updates

Last Update Posted (Actual)

May 22, 2026

Last Update Submitted That Met QC Criteria

May 20, 2026

Last Verified

April 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • PNF-REHAB-STROKE-01

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

ndividual participant data (IPD) from this study will not be shared with other researchers. The study data will be used only for academic purposes within the study team, and all personal identifiers will be anonymized and kept confidential in accordance with ethical regulations.

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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