Abstract 102: Effects of Proprioceptive Neuromuscular Facilitation Exercises on Upper Extremity Function in the Patients With Acute Stroke

Abstract

Background: Stroke leads to impairment in upper extremity function and hence impairment in performance of activities of daily living. The studies that emphasize the effects of PNF (Proprioceptive Neuromuscular Facilitation) in acute stroke are still lacking. Aim: In this study we aim to investigate the effects of PNF exercises on upper extremity function in acute stroke. Methods: Total 35 patients were recruited from the OPD of Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow. Written informed consent was obtained from their legal relatives. Patients were given PNF exercises for scapula from the first day of their admission to the hospital and then arm pattern (D1 and D2 flexion , extension) by using rhythmic initiation technique until discharge from the hospital (Mean 15.2+ 3.9days). PNF was given twice daily for 30 minutes for 5 days a week. Arm recovery was assessed by Fugl- Meyer scale and arm function was assessed by Arm Motor Ability Test (AMAT). Patients were followed up in neurology OPD on monthly basis up to 6 months. Results: Out of 35, 26 were of ischemic stroke and 9 were of haemorrhagic stroke. 17 were left sided and 18 were right sided hemiplegics. 15 were females and 20 were males. Mean age of the patient was 56.45 + 12.14. Glasgow coma scale at the time of admission was 14.6+ .338. Mean NIH stroke severity was 7.48 + 3.95, shows all the patients were of mild to moderate stroke. The mean Fugl- Meyer score before the intervention was 151.60+ 41.72 with SE= 7.05 and after intervention was 209.9. Paired t - test was run to determine if PNF is effective in improving upper extremity function in acute stroke t (34)= - 9.920, p= .001. There was significant improvement in upper extremity functions. The mean AMAT score before intervention was 63.53+ 28.32 and after intervention was 120.22+ 12.12 and t(34)= 5.92 p= .026 which shows significant improvement in upper extremity function. Conclusion: Proprioceptive neuromuscular facilitation exercises are very effective in generating voluntary control and improving functional activities of daily living if given from the first day of stroke. For improvement in arm function the intervention should be started first from scapula. Due to the irradiation effect, there is generation and improvement of tone and power in upper extremity. Acknowledgements: This study was supported by the department of Science and Technology, New Delhi, India.