Stroke, which is frequently characterized by weakness, poor balance, and decreased mobility that impede independence in everyday activities, has been identified as a major cause of long-term impairment globally. There have been reports of an increasing number of stroke survivors in Pakistan, however access to proper rehabilitation is sometimes hampered by a lack of resources and awareness. It is thought that improving walking ability, balance, and day-to-day functioning requires the restoration of lower limb function. Modified Constraint-Induced Movement Therapy (mCIMT) and Proprioceptive Neuromuscular Facilitation (PNF) have been found to be successful physiotherapy interventions for improving motor recovery, but there is little comparative data on their impact on lower limb function. The purpose of this study is to examine the effects of PNF and mCIMT in order to identify whether strategy is better for lower limb rehabilitation after stroke. The findings are expected to give physiotherapists evidence-based recommendations for treatment choices, enabling stroke patients to recover more quickly and become more independent. In the end, community-level advantages are anticipated in the form of less impairment, less caregiver stress, and an overall improvement in the quality of life for stroke victims.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
54
PNF training was administered for 10 weeks (Time), 5 days per week (Frequency), for 45 minutes per session (Time), using moderate-to-maximal manual resistance (Intensity) with rhythmic initiation, diagonal patterns, dynamic reversals, and resistance training (Type)
mCIMT was administered for 10 weeks (Duration), 5 days per week (Frequency), for 45 minutes per session (Time), involving task-oriented lower limb activities including side stepping, ball kicking, stair climbing, and knee control on a step (Type), performed at moderate functional intensity (Intensity).
Sehat Medical Complex Hanjerwal
Lahore, Pakistan
motor function
The Fugl-Meyer Assessment of Lower Extremity (FMA-LE) is a widely used and recommended scale for evaluation of post-stroke motor impairment. The FMA-LE is a reliable tool for assessment of motor impairment both within and between raters early after stroke. The scale can be recommended internationally. A unified international use of FMA-LE would allow comparison of stroke recovery outcomes worldwide and thereby potentially improve the quality of stroke rehabilitation. The scale is recognized as a gold standard and is recommended both for clinical use and research world wide. The scale includes assessment of reflex activity, voluntary movements within and outside of synergies, ability to perform isolated movement, and coordination. This means that the scale is valid for determining level of motor function in people with stroke.The total score of the Fugl-Meyer Assessment for the Lower Extremity (FMA-LE) is 34 points.Each item is scored on a 0-2 scale.
Time frame: 10 week
Muscle Strength
The Motricity Index (MI) is an ordinal measure used to assess muscle strength in individuals with post-stroke hemiparesis, originally developed by Demeurisse et al. in 1980. It evaluates three key upper limb movements-pinch grip (PG), elbow flexion (EF), and shoulder abduction (SA)-and three lower limb movements-ankle dorsiflexion (AD), knee extension (KE), and hip flexion (HF), each graded using the Medical Research Council (MRC) 6-point scale and then converted into modified weighted scores. A total score ranging from 0 (complete paresis) to 100 (normal strength) is computed for each limb, and a side score may also be obtained by averaging upper and lower limb totals. Administration time ranges from 5 to 20 minutes depending on the examiner's experience and the severity of impairment. The MI demonstrates excellent inter-rater reliability, strong construct and concurrent validity with established motor impairment scales, and good predictive validity as initial MI scores correlates
Time frame: 10 week
range of motion
Goniometer refers to the measurement of angles in particular the measurement of angles created at human joints by the bones of the body. These measurement are obtained by placing the parts of measuring instrument, called a goniometer. Goniometery may be used to determine both a particular joint position and the total amount of motion available at a joint. The data analysis revealed the inter tester reliability and validity were high
Time frame: 10 week
stroke specific quality of life
Stroke-specific quality of life (SS-QOL) is a standardized, reliable, and disease-specific questionnaire designed to evaluate quality of life in individuals with stroke. It consists of twelve domains and forty-nine items, each scored on a 5-point Likert scale. The domains include energy, language, mobility, self-care, family roles, social roles, vision, mood, thinking, upper extremity function, and work and productivity. The SS-QOL has been widely validated and is considered an effective tool for assessing functional and psychosocial outcomes in stroke patients.Stroke-Specific Quality of Life (SS-QOL) scale consists of 49 items across 12 domains.Each item is scored on a 5-point Likert scale (1-5). Minimum possible total score is 49 and maximum possible total score is 245.Higher scores indicate better quality of life in stroke patients.
Time frame: 10 week
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