Effects of Core Strengthening and PNF Pattern on Static Balance and Plantar Pressure in Chronic Stroke Patients

University of Lahore73 enrolled

Overview

Stroke is a neurological disease characterized by neurological deficits caused by insufficiency of blood supply to brain. Disruption of blood supply to brain can be due to blockage of blood supply (ischemic) or leakage of blood in brain due to rupture of blood vessel (hemorrhagic). 90.5% of global occurrence of stroke was subjected to modifiable risk factors according to Global Burden of Disease study. This study aims to compare the effects of core strengthening and proprioceptive neuromuscular facilitation on static standing balance and plantar pressure in chronic stroke patients.

Background: Stroke is a neurological disease characterized by neurological deficits caused by insufficiency of blood supply to brain. Disruption of blood supply to brain can be due to blockage of blood supply (ischemic) or leakage of blood in brain due to rupture of blood vessel (hemorrhagic). 90.5% of global occurrence of stroke was subjected to modifiable risk factors according to Global Burden of Disease study. Objective: To compare the effects of core strengthening and proprioceptive neuromuscular facilitation on static standing balance and plantar pressure in chronic stroke patients. Methodology: 73 patients were enrolled in this study, 37 patients were assigned into control group while 36 participants were assigned into experimental group. Control group received routine physical therapy while experimental group received core strengthening and proprioceptive neuromuscular technique. Static component of berg balance scale and PoData Stabiliometeric plate was used for plantar pressure and measurement of balance respectively.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

Interventions

Routine Physical TherapyOTHER

Routine physical therapy involving muscle strengthening exercises, range of motion exercises and stretching exercises up to patient's tolerance. Other exercises were pelvic bridging, rolling, sitting and standing exercises, walking practice and balancing in parallel bars, wobble board exercises. Each session was of 60 minutes 5 times weekly for 6 weeks.

Routine Physical Therapy+ PNF and Core StregtheningOTHER

Routine physical therapy for 20 minutes and additionally PNF technique (rhythmic initiation, and then agonistic reversals were performed in lower extremity in D1 flexion pattern and D1 extension pattern up to patient's tolerance and core strengthening for 20 minutes 5 times weekly for 6 weeks.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 60 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Age (45-60 years) * Score of 9 or Higher on static component of berg balance scale * Having score of equal or less than 2 on Modified Ashworth scale * Having score of greater than or equal to 24 on Mini Mental State Examination. * First ever episode of stroke * Duration of stroke greater than 6 months * Both genders Exclusion Criteria: * Concurrent orthopedic conditions that may hamper standing * Relevant psychiatric disorders that may prevent from following instructions. * Medical drugs that may influence intervention * Conditions contraindicating physical activity * Use of Cardiac pace maker.

Outcomes

Primary Outcomes

Static Standing Balance

Measure using static component of berg balance scale. The items are scored from 0 to 4 with a score of 0 representing an inability to complete the task. Score of 4 representing independent item completion.

Time frame: 6 weeks

Secondary Outcomes

Plantar Pressure

Foot plantar pressure is the pressure field that acts between the foot and support surface during static standing. PoData Stabiliometric plate was used to measure it. Normal value is 16.67% of the body weight on 5th metatarsal.