Effect of Proprioceptive Neuromuscular Facilitation on Blood Pressure
Condition: Hypertension
MeSH terms: Hypertension
Study type: Interventional

Summary: 
      To determine the effect of Proprioceptive Neuromuscular Facilitation exercise on blood
      pressure in patient with mild to moderate hypertension.Both genders will be included.Patients
      aged between 40 and 60 years with mild and moderate hypertension.Systolic blood pressure
      130-160 mmHg or Diastolic Blood Pressure 80-100 mmHg.

      Sphygmomanometer and EuroQoL five-dimensional instrument would be used for the 'Pre' & 'Post'
      assessment.
    

Detailed description: 
      There is a belief that proprioceptive neuromuscular facilitation exercises cause cardiac
      overload as blood pressure in immediately influenced by exercise but Pereira concluded in his
      research that proprioceptive neuromuscular facilitation exercises with minimum repetitions
      are safe for hypertensive or cardiovascular patients because in his study there is no
      increase in blood pressure in older women after performing three different types of PNF
      exercises. Pereira discovered that rhythmic initiation , dynamic reversals , and combination
      of isotonic techniques did not raise blood pressure levels, thus it is recommended to use up
      to five repeats of repetition maximum . One study observed at the effects of passive and
      modified proprioceptive neuromuscular facilitation (PNF)stretching techniques on acute
      systolic and diastolic blood pressure responses. All PNF treatments were beneficial in
      increasing Range of motion, as we all know.

      PNF improves Range Of Motion while avoiding an increase in Systolic blood pressure in one or
      two trials, but increases Systolic blood pressure in a third trial. Blood pressure rises by
      40% with conventional exercise programmers and because PNF involves near-maximal
      resistance,researchers anticipated a considerable rise in blood pressure during PNF
      execution. It was discovered that elderly subjects could not readily execute more than five
      to seven repetitions of PNF exercises, which has also been shown by others. Due to the low
      repetition number of each movement pattern, the results showed that PNF did not induce a high
      enough workload to increase blood pressure in the elderly.
    

Intervention name(s): Proprioceptive Neuromuscular Facilitation
Intervention type(s): Other
Intervention description(s): The patient will be provided with mild to moderate resistance PNF pattern which is a type of Endurance training which decreases BP through a reduction in systemic vascular resistance(15).In a regimen as follow with the frequency of 3 days a week, a repetition of 3 sets for one hour and a total duration of 3 months(16). The PNF patterns will be diagonal 1 (D1) and diagonal 2 (D2) patterns. Both patterns are subdivided into: A) Moving into Flexion: the toes start flexed and ends extended. Ankle and foot start plantar flexed; everted and ends dorsiflexed inverted. Tibia starts externally rotated and ends internally rotated. Knee starts extended, and ends flexed. The hip starts extended, abducted, internally rotated and ends flexed, adducted, externally rotated.B) Moving into Extension: The start and end are reversed to "D1 Moving into Flexion"
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: proprioceptive neuromuscular facilitations; ankle brachial index; diabetes