A Stroke, also known as cerebrovascular accident, is defined as rapid clinical signs of focal (or global) damage to brain function, along with symptoms that last longer than 24 hours or lead to death, with an apparent cause, mainly vascular origin. Globally, cerebrovascular damage is the second-biggest cause of death and the third-largest cause of disability. This ratio is 1 in 19 deaths. Stroke is a substantial source of injury in the long tenure and is more disabled than fatal.
To compare the effects of proprioceptive neuromuscular facilitation strengthening exercises with Delorme and Watkins exercises program to improve the upper extremity function and strength in chronic stroke patients.
A randomized clinical trial was conducted on 20 chronic stroke patients, age of 50 to70 years. Clinical trial registry number was NCT05904795. Sample was collected from Shahida Islam Teaching Hospital Lodhran through convenience sampling technique and then patients were randomly allocated to 2 groups. Group A received PNF strengthening exercises
training while Group B received Delorme and Watkins exercise program. Upper limb motor functions, and grip strength, were checked by The Barthel Index Scale and Handheld Dynamometer. SPSS version 25 used for statistical work.
Independent sample t test was used for between group analysis, which shows that upper limb function assessment through Barthel index shows that pre-intervention score of PNF+PT group is 37.60 ±5.60, whilst DL&WE group is 35.80 ±2.78 and post-intervention scores of the PNF+PT group is 75.70 ± 5.53 and DL&WE group is 44.70 ± 4.52 correspondingly. Strength is checked by dynamometer and pre-intervention score of PNF+PT ii group is 76.80 ±19.43, whilst DL&WE group is 71.32 ±25.23. The post-intervention scores of the PNF+PT group is 92.73± 18.48 and DL&WE group is 75.70± 22.86. P-value of both outcome variables were less than 0.05 in post-intervention, which means there is a statistical difference observed in post-interventions of between group studies.
Within group studies done by applying paired sample t test which shows in PNF+PT group mean paired difference is -38.10 and DL&WE+PT group is -15.93.
It is concluded that both interventions group shows difference, but Proprioceptive neuromuscular strengthening training group shows better results.
Table of Contents
1. INTRODUCTION
1.1 Objectives
1.2 Hypotheses
1.2.1 Null hypothesis
1.2.2 Alternate hypothesis
2. LITERATURE REVIEW
3. MATERIAL & METHODS
3.1 Study Design
3.2 Sample Size
3.3 Sampling Technique
3.4 Setting
3.5 Duration of the Study
3.6 Selection Criteria
3.6.1 Inclusion Criteria
3.6.2 Exclusion Criteria
3.7 Data Collection Tool:
3.8 Data Collection Procedure:
3.8.1 Recruitment:
3.8.2 Enrolment:
3.8.3 Randomization:
3.8.4 Blinding:
3.9 Intervention:
3.10 Data Analysis:
3.11 Consort
4. RESULTS
5. Discussions
6. CONCLUSION
6.1 Limitations:
6.2 Recommendations:
Objectives & Core Topics
The primary objective of this study is to conduct a comparative analysis of the effects of Proprioceptive Neuromuscular Facilitation (PNF) strengthening exercises versus the De-Lorme and Watkins exercise program on improving upper limb function and muscle strength in patients suffering from chronic stroke.
- Comparative analysis of PNF and De-Lorme/Watkins exercises.
- Assessment of upper extremity function post-stroke.
- Evaluation of muscle strength using objective dynamometry.
- Functional outcome analysis via the Barthel Index Scale.
- Long-term rehabilitation strategies for chronic stroke survivors.
Excerpt from the Book
3. MATERIAL & METHODS
The study design was Randomized Clinical Trial. Clinical trial registry number was NC05904795.
Sample size was calculated through EPITOOL Software. The estimated sample size was 18 and 9 in each after adding 10% attrition rate it was 20 in both groups.(55)
Sample technique is Non-Probability Convenience sampling.
The study was conducted at the Physiotherapy outpatient department of Shahida Islam Teaching Hospital, Lodhran.
The duration of study was 6 months after approval of synopsis.
Summary of Chapters
1. INTRODUCTION: Outlines the clinical burden of stroke and the consequent impairments, justifying the need for comparative research on effective rehabilitation protocols for upper limb recovery.
2. LITERATURE REVIEW: Summarizes previous clinical studies and meta-analyses regarding various physical therapy interventions, including PNF and resistive strength training, in the context of stroke rehabilitation.
3. MATERIAL & METHODS: Details the randomized controlled trial design, including participant recruitment, criteria for inclusion and exclusion, the specific PNF and De-Lorme/Watkins exercise protocols, and the assessment tools utilized.
4. RESULTS: Presents the statistical data and outcome metrics derived from the Barthel Index and Dynamometer evaluations, showing differential improvements between the study groups.
5. Discussions: Interprets the study findings in relation to existing scientific literature, discussing the efficacy of different muscle strengthening techniques on neurophysiological motor control.
6. CONCLUSION: Synthesizes the findings, confirming that while both interventions yield positive results, PNF strengthening appears highly effective for improving upper limb functional outcomes in stroke survivors.
Keywords
Stroke, Proprioceptive Neuromuscular Facilitation, De-Lorme and Watkins, Barthel Index, Physiotherapy, Upper Limb Function, Muscle Strength, Randomized Clinical Trial, Chronic Stroke, Rehabilitation, Motor Control, Hemiparesis, Dynamometer, Resistive Training, Exercise Therapy
Frequently Asked Questions
What is the core focus of this research study?
The study investigates the comparative effectiveness of two distinct exercise regimens—Proprioceptive Neuromuscular Facilitation (PNF) and the De-Lorme & Watkins program—for recovering muscle strength and function in the upper limbs of chronic stroke patients.
What are the primary fields of study involved?
The research sits at the intersection of neurology, physical therapy, and rehabilitation science, focusing on post-stroke motor deficits and the efficacy of specific strengthening protocols.
What is the main research question or goal?
The goal is to determine which of the two specific physical therapy protocols (PNF or De-Lorme/Watkins) provides superior improvements in upper limb function and strength as measured by the Barthel Index and हैंडहेल्ड dynamometry.
Which scientific method was applied?
The study utilizes a randomized clinical trial (RCT) framework, drawing a sample of 20 chronic stroke patients and assigning them to two experimental groups for an 8-week intervention period followed by statistical analysis.
What topics are discussed in the main body?
The body covers medical backgrounds on stroke, detailed protocols for the exercises, data collection procedures, statistical analysis of patient demographics and performance, and a thorough discussion on how these therapies impact muscle activation.
How is the study characterized by its keywords?
It is characterized by terms such as stroke recovery, PNF, resistive strength training, and functional assessment, indicating a focus on practical rehabilitation outcomes for clinical practitioners.
Why was the Barthel Index used in this study?
The Barthel Index was chosen as a reliable and validated instrument to quantify the changes in the independence of stroke patients regarding their activities of daily living (ADL).
How was the PNF approach different from the De-Lorme program?
While the De-Lorme and Watkins program focused on progressive resistance training with specific weighted loads, the PNF approach utilized diagonal movement patterns, rhythmic initiation, and neurological stimulation to enhance muscle control and function.
What were the major conclusions regarding the PNF group?
The study concluded that the PNF intervention group demonstrated superior results in improving functional scores and overall strength compared to the De-Lorme and Watkins group, suggesting its potential value for standard rehab programs.
- Quote paper
- Muflaha Jafar (Author), 2022, Effects of PNF and de-Lorme and Watkins exercises on UE function and strength in stroke, Munich, GRIN Verlag, https://www.grin.com/document/1380639
