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Roods vs PNF for Upper Limb Function in Acute MCA Stroke (RVP-MCA)

23. maj 2026 opdateret af: Dr. Marium Zafar, University of Faisalabad

Comparison Between Roods Facilitatory Techniques and Sequential PNF Pattern on Upper Limb Function in Acute Phase of Middle Cerebral Artery Stroke Patients

Middle cerebral artery (MCA) stroke often causes weakness or stiffness in the arm and hand, making daily activities difficult. This study compares two physical therapy approaches - Rood's facilitatory techniques (using touch, quick stretch, and ice to activate muscles) and PNF sequential patterns (using diagonal movement patterns) - to improve arm function in acute stroke patients. Both groups will also receive neuromuscular electrical stimulation (NMES). A total of 28 patients will be randomly assigned to one of two groups and receive treatment three times per week for eight weeks. Arm function will be measured using the Fugl-Meyer Assessment, and muscle stiffness will be measured using the Modified Ashworth Scale before and after treatment.

Studieoversigt

Status

Tilmelding efter invitation

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

This is a single-blind, parallel-group randomized controlled trial. The study will be conducted at three settings in Faisalabad, Pakistan: Allied Hospital, Madinah Teaching Hospital, and Shahid Heera's Health Clinic. Adult patients (≥18 years) with CT or MRI-confirmed MCA stroke (ischemic or hemorrhagic), mild to moderate upper limb motor dysfunction (MRC ≥2), and cognitive competence (MoCA ≥19) will be included. Exclusion criteria include severe comorbidities, fixed contractures, severe cognitive impairment, skin contraindications to sensory stimulation, and inability to provide consent. A sample size of 28 participants (14 per group) was calculated using Rao soft app based on previous literature. Participants will be randomly assigned using a computer-generated sequence. The single-blind design keeps participants unaware of group allocation. Group A receives NMES followed by Rood's facilitatory techniques: quick stretch before or during movement to activate muscle spindles, tactile stimulation (light stroking) over the muscle belly for 10-20 seconds, and icing for 5-7 seconds on the tendon or muscle surface immediately preceding activation. Group B receives NMES followed by PNF sequential training using conventional upper limb diagonal functional patterns (D1 and D2). PNF techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance, performing 8-12 repetitions per pattern over 20-30 minutes per session. NMES parameters: biphasic waveform at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable visible contraction, administered for 30 minutes per session. Both groups receive interventions three times per week for eight weeks. Outcome measures: Fugl-Meyer Assessment for Upper Extremity (FMA-UE, score range 0-66) measures motor function; Modified Ashworth Scale (MAS, score range 0-4) measures muscle tone. Assessments are conducted at baseline and post-intervention by a qualified physiotherapist. Data will be analyzed using SPSS version 22.

Undersøgelsestype

Interventionel

Tilmelding (Anslået)

28

Fase

  • Ikke anvendelig

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiesteder

  • Pakistan
    • Punjab Province
      • Faisalābad, Punjab Province, Pakistan, 3800
        • The University of Faisalabad

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

  • Voksen

Tager imod sunde frivillige

Ingen

Beskrivelse

Inclusion Criteria:

  • Adults (40-60 years) with confirmed MCA stroke (ischemic or hemorrhagic) on neuroimaging (CT or MRI)
  • Mild to moderate upper limb motor dysfunction with MRC ≥2 for proximal limb motor strength
  • Cognitive competence to understand instructions (MoCA ≥19 or equivalent)
  • First stroke, acute or subacute phase
  • Willingness to provide written informed consent
  • Both male and female genders

Exclusion Criteria:

  • Severe coexisting medical disorders (heart, liver, kidney failure; malignant tumors)
  • Fixed musculoskeletal abnormalities or contracture in affected upper limb
  • Severe cognitive impairment or aphasia preventing adherence or consent (MMSE below threshold)
  • Skin sores, ulcers, or hypersensitivity (e.g., to cold) contraindicated for sensory stimulation
  • Refusal or inability to give informed consent

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Primært formål: Behandling
  • Tildeling: Randomiseret
  • Interventionel model: Parallel tildeling
  • Maskning: Enkelt

Våben og indgreb

Deltagergruppe / Arm
Intervention / Behandling
Eksperimentel: Rood's Facilitatory Techniques Group
Participants receive neuromuscular electrical stimulation (NMES) followed by Rood's facilitatory techniques including quick stretch, tactile stimulation for 10-20 seconds over muscle belly, and icing for 5-7 seconds on tendon or muscle surface. Interventions delivered three times per week for eight weeks.
Enhed: Neuromuscular Electrical Stimulation
Biphasic waveform NMES at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable but visible muscle contraction. Applied to affected upper limb for 30 minutes per session, three times per week for eight weeks.
Procedure: Rood's Facilitatory Techniques
Quick stretch applied before or during movement to activate muscle spindles; tactile stimulation (light stroking) over muscle belly for 10-20 seconds; icing for 5-7 seconds on tendon or muscle surface immediately preceding activation. Applied three times per week for eight weeks following NMES.
Aktiv komparator: PNF Sequential Pattern Group
Participants receive neuromuscular electrical stimulation (NMES) followed by PNF sequential training with upper limb diagonal functional patterns (D1 and D2), including rhythmic initiation, dynamic reversals, repetitive contractions, and isotonic contractions with moderate resistance (8-12 repetitions per pattern over 20-30 minutes). Interventions delivered three times per week for eight weeks.
Enhed: Neuromuscular Electrical Stimulation
Biphasic waveform NMES at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable but visible muscle contraction. Applied to affected upper limb for 30 minutes per session, three times per week for eight weeks.
Procedure: Proprioceptive Neuromuscular Facilitation
PNF sequential training with upper limb diagonal functional patterns (D1 and D2). Techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance according to patient's capabilities. Each session includes 8-12 repetitions per pattern over 20-30 minutes, three times per week for eight weeks.

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Upper Limb Motor Function
Tidsramme: Baseline and 8 weeks (post-intervention)
Fugl-Meyer Assessment for Upper Extremity (FMA-UE). A standardized 66-point scale assessing motor recovery after stroke based on Brunnstrom stages. Evaluates shoulder, elbow, wrist, hand, and coordination functions. Higher scores indicate better motor function.
Baseline and 8 weeks (post-intervention)

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Muscle Tone
Tidsramme: Baseline and 8 weeks (post-intervention)
Modified Ashworth Scale (MAS). A 5-point scale (0-4) measuring resistance during passive stretching of the affected upper limb muscles. 0 = normal tone; 4 = rigidity. Assesses spasticity reduction.
Baseline and 8 weeks (post-intervention)

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

University of Faisalabad

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2026

Primær færdiggørelse (Anslået)

15. juni 2026

Studieafslutning (Anslået)

15. juli 2026

Datoer for studieregistrering

Først indsendt

23. maj 2026

Først indsendt, der opfyldte QC-kriterier

23. maj 2026

Først opslået (Faktiske)

1. juni 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

1. juni 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

23. maj 2026

Sidst verificeret

1. maj 2026

Mere information

Begreber relateret til denne undersøgelse

Nøgleord

Yderligere relevante MeSH-vilkår

Andre undersøgelses-id-numre

  • TUF/EIRB/ 220 /26

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

INGEN

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

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