Effectiveness of Proprioceptive Neuromuscular Facilitation on Spasticity in Hemiplegia: Randomised Controlled Trial

Abstract

Introduction: Stroke is one of the major causes of morbidity and mortality worldwide. Spasticity is one of the positive feature of stroke. Hence, this study aimed at evaluation of effectiveness of propriocetive neuromuscular facilitation (PNF) over conventional physiotherapy on spasticity in hemiplegia. Materials and Methods: Randomised controlled trial was done on 30 stroke patients with minimum Grade 1 spasticity. The subjects were randomly allotted for intervention period of 4 weeks into two groups with those receiving PNF technique and conventional physiotherapy. The spasticity and functional independency was evaluated using Ashworth Scale and Barthel index respectively results obtained were compared. Results: The Ashworth Scale in PNF group showed significant improvement from 2.46±0.51 to 1.13±0.35 as compared to conventional group with 2.4±0.5 to 1.86±0.35. The Barthel index in PNF group showed significant improvement from 54.33±7.52 to 85±5 as compared to conventional group with 53±2.53 to79±7.6. The ROM also had shown significant improvement in PNF group. Discussion: Both the techniques showed significant reduction in spasticity measured on Ashworth scale, with PNF being more effective (p<0.0001). The improvement in Barthel Index showed both the interventions to be effective with PNF being more effective in improving the functional independency (p<0.0001). Patients treated with PNF showed significant improvement in shoulder joint abduction, adduction (p<0.0001); elbow joint flexion, extension (p=0.0042); hip joint external rotation (p=0.0098) and flexion (p=0.0091) and extension (p=0.0091) of knee joint as compared to conventional group. Conclusions: PNF technique is significantly effective over conventional physiotherapy for reducing spasticity and improving functional activities in hemiplegia.