Effects of proprioceptive neuromuscular facilitation technique on scapular dyskinesis in patients with subacute stroke

Abstract

Objectives: The objective of this was to compare the effects of the proprioceptive neuromuscular facilitation (PNF) hold-relax technique on pain severity, range of motion (ROM) of the shoulder, shoulder disability, and scapular asymmetry in stroke patients with scapular dyskinesis. Methods: The study used a randomized clinical trial design including 46 patients ranging from 40 to 60 years with at least five months of stroke with type-1 scapular dyskinesia. The participants were divided into two groups, taking the upper limb Diagonal 1 (D1) flexion pattern and Diagonal 2 (D2) flexion pattern, respectively, which were allocated by consecutive sampling using the lottery method. We used a visual analog scale (VAS) for pain, goniometry for shoulder ROM, shoulder pain and disability index (SPADI) for shoulder disability, and lateral scapular slide test for scapular asymmetry. Results: D1 flexion and D2 flexion both improved the ROM in both groups (P < 0.05) and decreased pain and disability, while in-between comparisons did not find a significant difference between the effectiveness of both treatments in terms of pain measured by VAS, ROM, that is, flexion, extension, and abduction (P > 0.05). In terms of external and internal rotation, the D1 flexion pattern of PNF techniques showed more improvement as compared to D2 flexion (P < 0.05). While in terms of SPADI, D2 flexion showed more improvement as compared to D1 flexion (P < 0.05). Conclusion: Scapular PNF substantially influences stroke patients’ shoulder discomfort and ROM.