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Abstract: Background: As the pelvic motion comes from trunk muscles, a specific use of pelvic pattern not only
exercises the pelvis for mobility and stability but also facilitate trunk motion and stability.Objective: To
determine the effect of Pelvic Proprioceptive Neuromuscular Facilitation(PNF) technique on facilitation of
trunk movement in hemip...
Contexts in source publication
Context 1
... results were concluded to be statistically significant with p < 0.05 and highly significant with p < 0.01. (Table 3.1) ...
Context 2
... difference in the pre and post-interventional mean score for the control group was 1.8. (Table 3.2) ...
Context 3
... difference in the pre and post-interventional mean score of the control group for SSB and DSB was 1.9 and 1.6 respectively. (Table 3.2.1) ...
Context 4
... difference in the pre and post-interventional mean score of TLF ROM in the affected side and non-affected side was 0.734 and 3.666 respectively. (Table 3.3.1) ...
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Background:
Following ankle sprain, residual symptoms are often apparent, and proprioceptive training is a treatment approach. Evidence, however, is limited and the optimal program has to be identified.
Objective:
To investigate the effects of two post-acute supervised proprioceptive training programs in individuals with ankle sprain.
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Citations
... Previous prognostic studies show that the components of sitting balance are crucially missing in patients with spinal cord trauma [7]. Although physiotherapy interventions for trunk-pelvic control for individuals with SCI were neglected in past literature, pelvic Proprioceptive Neuromuscular Facilitation (PNF) helps stimulate muscle and joint proprioceptors to improve pelvic stability for maintaining trunk control, balance, and gait in individuals suffering from spinal cord injuries [8]. The trunk and pelvic muscles form the core musculature, which helps maintain spinopelvic stability. ...
Spinal cord injury (SCI) has deleterious effects on quality of life and vocation. A partial or complete loss of sensory and motor functions below the site of injury is a potential clinical sign of SCI. Trunk and pelvic control are crucial for balance and gait to perform vocational tasks of daily living. In this case report, a 40-year-old male with traumatic incomplete paraplegia (AIS Grade C, neurological level T6) received 45 min of intervention per session, which included pelvic proprioceptive neuromuscular facilitation combined with core strengthening exercises 5 times a week for 4 weeks. Baseline and postassessments were done for trunk control with the trunk control test for SCI, balance with the Berg Balance Scale (BBS) and the SCI-functional ambulation inventory (SCI-FAI), and gait with the walking index for SCI II (WISCI). After 4 weeks of intervention, there were significant differences between baseline and postintervention scores on the trunk control test for SCI (16–18), WISCI (Level 1–2), SCI-FAI (03–06), and BBS (04–08). This is the first case report that enabled and promoted potentiate intervention to improve trunk control, balance, and gait in paraplegics. This outcome motivates additional research on its therapeutic potential and mechanism.
... (21) Pyramidal tract and the brain's motor pathways may get excitable as the sensory input coming from the periphery was more significant during PNF. (22) It also helped to normalize the tone of affected side trunk muscles, lengthening the contracted structures, relaxing the hypertonic muscles, initiating the movements, strengthening the weak muscles, and improving the control of the pelvis. (23) There is evidence that trunk training exercises showed moderate evidence to improve trunk performance and dynamic sitting balance. ...
... The data were analyzed by descriptive and inferential statistical methods using Fair (8)(9)(10) Good (11)(12)(13)(14) Normal (15)(16)(17)(18)(19)(20)(21)(22)(23) No Within group analysis, paired t tests compared the experimental group's pretest and post-test levels of trunk control and balance. The experimental group pretest and post-test mean trunk control and balance score was 13.40, 15.03, 25.4, and 27.07, respectively. ...
Background:
Most stroke survivors continue to live with disabilities and may require physical rehabilitation to control the trunk and balance during the post-stroke period. The cause of lack of trunk control and balance among stroke patients is the weakened trunk muscle strength.
Purpose:
To study the effect of proprioceptive neuromuscular facilitation (PNF) neck pattern and trunk-specific exercise on trunk control and balance among stroke patients.
Setting:
The study was conducted at the medical wards of Saveetha Medical College and Hospital, Chennai, India.
Participants:
Sixty patients with stroke who met the inclusion criteria participated in the study.
Research design:
This is a quasi-experimental study.
Intervention:
PNF trunk-specific exercise was administered to the experimental group for 45 min of 28 sessions, which contained 15 min of stretching exercise and 30 min trunk-specific exercise. The control group received routine hospital care services.
Main outcome measures:
The study's primary outcome was balance and trunk control, measured by the Berg Balance Scale (BBS) and Trunk Impairment Scale (TIS) before the intervention and at the end of the intervention of 28 days.
Results:
Within-group analysis, paired t test showed a significant improvement comparing the trunk control and balance score before (13.40±1.04 & 25.40±1.81) and after (15.03±0.96 & 27.07± 1.48) the intervention in the experimental group (p < .001). Between-group analysis, both the experimental and control group post-test mean score of TIS (15.03±0.96 &13.70±1.15) and BBS (27.07±1.48 & 25.30±1.73) showed significant difference (p < .001).
Conclusion:
PNF neck pattern and trunk-specific exercise used in this study effectively improved balance and trunk control among patients with stroke.
... The intervention was delivered daily for at least four weeks, five days a week. Following therapy, there was an enhancement in outcome variables such as trunk performance, and trunk lateral flexion range of motion as measured by an inclinometer, balance, and gait metrics [19]. ...
Background
Stroke is the second leading reason for death and the third most common reason for disability. Stroke is a source of possible substantial harm and is often more disabling than lethal. Common stroke defects include stiffness, tiredness, loss of balance on the afflicted side, as well as gait impairment, resulting in an inability to sustain postural alignment. Pelvic proprioceptive neuromuscular facilitation (PNF) is a physical rehabilitation that combines functionally dependent diagonal activity patterns with neuromuscular facilitator strategies to improve motor behaviour, endurance, and muscle activity and control. This protocol was created to describe the experimental study design for evaluating the combined impact of pelvic PNF and task-oriented exercises in chronic stroke patients to improve balance and gait parameters.
Aim and objective
The purpose of our study is to investigate the effectiveness of pelvic PNF as well as task-oriented exercises on balance, gait parameters, and in pelvic asymmetry.
Methods
The participants (n=30) were stroke survivors who fulfilled the inclusion criteria for research and were divided into two groups. The regimen lasted four weeks and took 30 minutes each day. Patients were evaluated at the beginning and end of their treatment. In both groups, pre- and post-intervention outcome measures were recorded and the data was analyzed.
Result
Following four weeks of rehabilitation, subjects showed remarkable improvement in balance, gait parameters, and pelvic inclination in both groups, i.e., pelvic PNF and task-oriented exercises in group A and task-oriented exercises in group B, but Group A showed a major improvement in outcome measures. A p-value of less than 0.05 was considered significant. Despite the fact that both treatment regimens were successful for the patient, pelvic PNF combined with task-oriented exercises exhibits a statistically significant difference from task-oriented exercises.
Conclusion
Pelvic PNF along with task-oriented exercises proved to be beneficial and can help in the restoration of balance and gait parameters as a result of normalisation in the geometry and symmetry of the pelvis in stroke patients. The pelvis, which is a connecting link between the trunk and lower limbs, plays a crucial role in balance and also in lower limb performance exclusively in gait.
... Specifically effects on gait velocity, cadence and the outcomes on the Wisconsin Gait Scale are substantial and better then in weight supported treadmill training among stroke survivors [60]. Several studies indicate that gait effects can be achieved in patients after stroke by using the PNF pelvis patterns in various starting positions, such as side lying, sitting, stance and during actual gait [61][62][63]. Furthermore, PNF-based gait training has been shown effective in neurological conditions, such as in Huntington's and Parkinson's disease [64,65]. ...
Introduction: The term Proprioceptive Neuromuscular Facilitation (PNF) was introduced in the 1950s by Dr. Kabat and Mrs. Knott. From the
mid-1950s the PNF-concept has been in a progressive development clarifying the use of techniques, performances and clinical applications.
The concept of PNF was originally developed by Dr. Kabat and Mrs. Knott for rehabilitation purposes. The International PNF Association
(IPNFA) consider themselves to be the official successor of Dr. Kabat and Mrs. Knott.
The PNF-concept evolved towards a comprehensive rehabilitation approach for various indications. There seems to be a misunderstanding
about the PNF-concept, it is often seen as a basic stretching regime for wellbeing and general fitness. This has been criticized to avoid a
confusion with the PNF-concept as a comprehensive rehabilitation approach.
Purpose: Providing a background with an explanation for the essential elements of the PNF-concept, being a total and comprehensive
rehabilitation approach in physiotherapy and rehabilitation. The elements from the PNF-concept facilitate treatment effects in the fields of
musculoskeletal and central neurological disorders and indications with a focus on motor learning.
Implications: The clarification of the essential elements from the PNF-concept in various fields of physiotherapy and physical rehabilitation
will simplify how to transfer and incorporate the elements from the PNF-concept into individual treatments.
... It shows patients with trunk impairment due to acute or chronic stroke may benefit from participation of trunk PNF. In this study the subjects were 30, it was well supported by Khanal et al 30 , they conducted a study on the effectiveness of pelvic proprioceptive neuromuscular facilitation technique to improve trunk movement in 30 hemiplegic patients. The age of the subjects were 40-65 years which was similar to that of the population studied by Shanmuganath E. et al 26 in improving postural control in hemiplegic patients using upper trunk and lower trunk PNF. ...
Stroke is the commonest neurological deficit caused by an interruption of the blood flow to the brain and loss of trunk control is commonly observed in patients after stroke. Impaired trunk control has a negative impact on daily activities and quality of life(QOL) in patients after stroke. Proprioceptive Neuromuscular Facilitation (PNF) and Neurodevelopmental technique (NDT), both are effective in improving trunk control in hemiplegic patients by improving trunk muscle endurance, strength, and trunk mobility. This study is aimed to compare the effectiveness of trunk PNF and NDT to improve trunk stability in patients with stroke. The objective of the study was to compare the effectiveness of trunk proprioceptive neuromuscular facilitation and neuro-developmental therapy based on trunk protocol with conventional therapy to improve trunk stability in stroke patients 30 subjects who fulfilled the criteria were taken for the study and was categorised into 2 groups of A and B, each having 15 subjects. Group A received trunk proprioceptive neuromuscular facilitation along with conventional therapy & group B received neuro-developmental therapy based on trunk protocol along with conventional therapy respectively for 4 weeks. Before the study, all the subjects were assessed using a general assessment proforma. Both pre and post-treatment assessments were assessed by using trunk impairment scale and ROM of trunk flexion and extension. The results of statistical analysis were tabulated in terms of mean, standard deviation, variance, t-test, P-value, coefficient of variation in both groups. Paired t-test showed that there was a statistically significant improvement in both groups (P<0.05). The coefficient of variation is significant at the CV of group A (83.34) less than the CV of group B (100.16), therefore group A is more effective compared to group B. In this study, it was found that the trunk PNF technique with conventional exercises and NDT based on trunk protocol with conventional exercises was effective to improve trunk stability in acute or subacute stroke patients. But, the trunk PNF technique with conventional exercises was more effective than NDT based on the trunk protocol conventional exercises technique for improving the trunk stability in acute or sub acute stroke patients.
... According to WHO stroke is defined as "acute onset of neurological dysfunction due to abnormality in cerebral circulation with resultant signs and symptoms that corresponds to involvement of focal area of brain lasting more than 24 hours. 1,2 Stroke is the third leading cause of death and the most common cause of disability among adults in the United States. 3 Approximately 700,000 individuals in United States are affected by this each year. ...
... About 500,000 are new strokes and 200,000 are recurrent strokes. [1][2][3][4] According to W.H.O (16 November 2011) the incidence of stroke in India was 130/100,000 individuals every year. The Indian Council of Medical Research estimates that among the non-communicable disease, stroke contributes for 41% of deaths and 72% of disability adjusted life years. ...
... The Indian Council of Medical Research estimates that among the non-communicable disease, stroke contributes for 41% of deaths and 72% of disability adjusted life years. 1,2 The incidence of stroke is about 1.25 times greater for males than females. 3,5 The most common type of stroke is the ischemic stroke. ...
The trunk control is a basic motor skill necessary to perform many functional tasks and is deficient in patients suffering from cerebrovascular accident (CVA). Stroke or cerebrovascular accident (CVA) is an abrupt onset of a focal neurological deficit lasting more than 24 hours. The aim of the study is to evaluate the effectiveness of PNF technique over trunk mobility exercises for the improvement of trunk control in hemiplegic patients. It is a comparative experimental study. This study includes (N=30) subjects with hemiplegic patients within age group of 45-55 years. They were randomly assigned into 2 groups (Group A and B). Group A had 15 (N=15) subjects who are treated with Proprioceptive Neuromuscular Technique and Group B had 15 (N=15) who are treated with Trunk Mobility Exercises. The subjects were given intervention of 4 days a week for 4 weeks. The outcome measures used are Trunk Impairment Scales and Functional Independence Measure for trunk control and functional ability. This study was an experimental study where pre-test and post-test design were used. Paired 't' test and Independent 't' test were done for statistical analysis. Statistically a highly significant difference is noticed between both the groups. The pre and post intervention mean of both TIS score and FIM score was statistically significant (p=0.02) in both the groups. The results had shown that both groups noted significant difference. But when comparing between these two groups, there is statistical significance is noted. Therefore, on the basis of the results, it can be concluded that, the present study provided more evidence to support the use of Proprioceptive Neuromuscular Facilitation as compared to Trunk Mobility Exercises for improving trunk control in post stroke hemiplegic case.
... After excluding studies that did not meet the inclusion criteria or did not assess the outcomes of interest, we retained 17 RCTs (two studies from the previous review) for inclusion in the review. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] However, one study 31 did not present the numerical data necessary for calculating effect sizes and thus was only included for the qualitative analysis. Finally, 16 studies were included in the quantitative meta-analysis. ...
... 18,19,25 Proprioceptive training combined with treadmill training was employed in two studies, 24,28 and proprioceptive training as a standalone treatment was used in three studies. 23,29,33 Among the 17 included studies, 13 studies evaluated balance performance, eight studies evaluated gait speed, three studies evaluated trunk control, and seven studies evaluated basic functional mobility. After we excluded 1 study that did not present the numerical data for balance performance and gait speed, 12, 7, and 3 studies were included for assessing the effect on balance performance, gait speed, trunk control, and basic functional mobility. ...
Objective
To evaluate the effectiveness of proprioceptive training on balance performance, trunk control, and gait speed in people with stroke.
Methods
We searched PubMed, Science Direct, Cochrane, Embase, and Medline for randomized controlled trials that evaluated the effects of proprioceptive training for patients with stroke from the date of each database's inception to July 26, 2021. Two reviewers independently screened the titles and abstracts of potentially eligible articles that were identified on the basis of the search criteria. Methodological quality was determined using version 2 of the Cochrane risk of bias tool for randomized trials. Data were analyzed using Comprehensive Meta-Analysis software. The treatment effect was estimated by calculating Hedges’ g and 95% confidence intervals (CIs) using a random-effects model. Statistical heterogeneity was assessed according to the I ² value. The primary outcome was balance performance and secondary outcomes were trunk control, gait speed, and basic functional mobility.
Results
In total, 17 trials involving 447 people with stroke were included. Proprioceptive training had a significant effect on balance performance (Hedges’ g = 0.69, 95% CI = 0.36–1.01), gait speed (Hedges’ g = 0.57, 95% CI = 0.19–0.94), trunk control (Hedges’ g = 0.75, 95% CI = 0.33–1.17), and basic functional mobility (Hedges’ g = 0.63, 95% CI = 0.31–0.94) among people with stroke.
Conclusion
Proprioceptive training may be effective in improving balance performance, gait speed, trunk control, and basic functional mobility among people with stroke.
... Diagonal pattern training has been conducted for trunk control rehabilitation in several studies for the selective movement of the spine and pelvis in stroke patients [13][14][15]. Diagonal pattern training is one of the trunk rehabilitation training methods that improve the movement, trunk asymmetry, flexibility, and strength provided by various planes [13]. It produces greater adaptive plasticity as the neural recruitment increases and dorsolateral prefrontal cortex and the primary motor cortex changes when compared to single plane movements [16]. ...
Introduction: Trunk control disability commonly occurs after stroke. This study investigated the effect of diagonal pattern training in the sitting position to improve trunk control ability and gait performance. Method: 46 stroke patients were enrolled in this study. We used single plane training and diagonal pattern training. Additionally, the subjects were randomly assigned to the experiment group (diagonal pattern training) and the control group (single plane training). Diagonal pattern training was modified with proprioceptive neuromuscular facilitation technique’s chopping and lifting pattern to create 10 movements. Results: the trunk impairment scale score, Berg balance scale score, 10 m walking test result, and gait significantly increased in the experiment group compared to the control group. Conclusions: diagonal pattern training can be regarded as a promising method to improve postural control and increase balance and gait in stroke patients
... The techniques of PNF like rhythmic initiation, slow reversal and agonistic reversal might have helped to normalize the tone of affected side trunk muscles, lengthening the contracted structures, relax the hypertonic muscles, initiating the movements, strengthening the weak muscles and improving the control of the pelvis. [27] All these effects might directly or indirectly aid in improving the trunk control. The study by Dickstein et al. showed similar results using three exercise therapy approaches where they found pattern of muscle tone improvement in the PNF treatment group. ...
BACKGROUND: Stratified Back care is a recently developed method for treating low back pain.
PURPOSE: This study compared the effects of two stratified care approaches (sub-grouping for targeted treatment [STarT] and specific treatment of the problems of the spine [STOPS] in patients with nonspecific low back pain [NSLBP]).
MATERIALS AND METHODS: Forty-six individuals, with NSLBP, participated in this single-blinded, randomized clinical trial. Participants were randomly assigned into one of the two groups: STarT Back Group (n = 23) or STOPS group (n = 23). Treatment was applied twice weekly for 8 weeks. Outcomes assessed pre- and post-interventions were pain intensity (PI) using numeric pain rating scale and functional disability (FD) using the Oswestry Disability Index. Participants in both groups were comparable in age (44.65 ± 9.03 vs. 46.40 ± 7.39) years. At baseline, PI, FD, and anthropometric values were comparable in both groups.
RESULTS: The Results showed a significant difference in PI between the STarT and STOPS with a mean difference of −1.24 and 95% confidence interval (−0.86 to −0.04), P < 0.05, with no significant difference in FD, P > 0.05 between the groups. However, there was a significant difference within each group in pain and FD with P < 0.05.
CONCLUSION: It was concluded that STarT Back approach was more effective in reducing PI only than STOPS approach in individuals with NSLBP.
Keywords: Nonspecific low back pain, specific treatment of the problems of the spine (STOPS), Stratified Back care, subgrouping for targeted treatment
... The techniques of PNF like rhythmic initiation, slow reversal and agonistic reversal might have helped to normalize the tone of affected side trunk muscles, lengthening the contracted structures, relax the hypertonic muscles, initiating the movements, strengthening the weak muscles and improving the control of the pelvis. [27] All these effects might directly or indirectly aid in improving the trunk control. The study by Dickstein et al. showed similar results using three exercise therapy approaches where they found pattern of muscle tone improvement in the PNF treatment group. ...
