Combined Effect of Proprioceptive Neuromuscular Facilitation And Electrical Muscle Stimulation In Hemiplegic Stroke Patients To Enhance Upper Extremity Function: A Research Protocol
Keywords:Stroke, Proprioceptive Neuromuscular Facilitation, Neuromuscular Electrical Stimulation, Conventional Therapy, Physiotherapy.
Background- : Stoke is characterized as rapid clinical signs of focal (or global) impairment of brain
function, with symptoms that last longer than one day or lead to death, with no other apparent cause than
vascular origin. Globally, Cerebrovascular(CVE)damage is the second-biggest root cause of death and the
third-largest cause of disability. This is 1 in 19 deaths. Stroke is a significant source of injury in the long
term and is more disabled than fatal. This protocol has been created that describes the design of experimental
study to evaluate the combined effect of Neuromuscular Electrical Stimulation(NMES) with Proprioceptive
Neuromuscular Facilitation(PNF) to enhance the upper- extremity functions in hemiplegic stroke patients.
Methods-The participants (n=26) will be recruited in the study suffering from stroke and meeting the
inclusion criteria. Two groups will be formed such that patients in group A will be treated with conventional
therapy and PNF group B will be treated with PNF and NMES in alongwith conventional therapy. The
protocol will cover 6 weeks of treatment. Regular assessment at 0,3rdand 6th week will be carried out.
In the rehabilitation period, we will evaluate upper extremity function, activities of daily living(ADLs),
mental status examination at regular interval during the rehab.Our outcome measures will be- Glasgow
coma scale (GCS), Mini-Mental Scale Examination (MMSE), Modified Ashworth Scale (MAS), Modified
BarthelIndex(MBI) and Action Research Arm Test(ARAT).
Discussion-Efficacy of the intervention will be evaluated by analyzing the upper extremity function using
Action Research Arm Test (ARAT) and level of disability by using Modified Barthel Index Scale. The result
of the study will significantly provide affirmation on using combination therapy of PNF with NMES in
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