Constraint Induced Movement Therapy and Proprioceptive Neuromuscular Facilitation on Lower Limb Motor Function
Condition: Stroke
MeSH terms: Stroke
Study type: Interventional

Summary: 
      Stroke, described as a neurological deficit caused by the interruption of cerebral blood
      flow, is one of the leading causes of mortality and morbidity throughout the world. It is the
      second most common medical condition and the major cause of disability in adults. Recovery
      following stroke revolves around the severity of sensory, motor, and cognitive impairments.
      Lower extremity impairment is one of the major post-stroke conditions which can cause
      difficulty in performing activities of daily living, gait abnormalities, increased risk of
      fall, and restriction in social participation. Rehabilitation after stroke is the primary
      mechanism through which it can achieve functional recovery and independence, which is based
      on the principles of motor learning and neuroplasticity.
    

Detailed description: 
      There have been many rehabilitation techniques to treat post-stroke impairments. These
      include aerobic exercises, the Bobath approach, proprioceptive neuromuscular facilitation
      (PNF) constraint-induced movement therapy (CIMT), and mobilization and stimulation of
      neuromuscular tissue. The selection of techniques at the defined level of recovery varies
      among clinicians.

      Constraint-induced movement therapy (CIMT) is a neurological rehabilitation technique that
      has been used in various neurological disorders including stroke both in acute and chronic
      stages, traumatic brain injury, cerebral palsy, multiple sclerosis, and spinal cord injury to
      improve motor function and strengthen weak muscles which are characterized by the restraint
      of the less affected extremity accompanied by the shaping and repetitive task-oriented
      training of more affected extremity.

      Proprioceptive facilitation (PNF) is one of the major therapeutic techniques aimed at
      enhancing the essential characteristics required for the functional ambulation of patients
      with hemiplegia, such as muscular control, strength, and flexibility. Changes in the
      excitation of the cortical motor area mediate this and the corresponding.

      Motor neurons. Previous researches are on the separate effect of CIMT and they have conducted
      PNF approaches, but there is no study available on the comparison of the effect of both
      techniques on lower limb function in stroke patients. Most of the studies administered PNF in
      combination with other approaches and the duration of intervention in these studies was in
      favor of CIMT groups compared to PNF. Therefore, this study is aimed at determining the
      comparative effect of CIMT and PNF on lower limb recovery.
    

Intervention name(s): Constrained induced movement; Proprioceptive Neuromuscular facilitation
Intervention type(s): Other; Other
Intervention description(s): Practice in two sessions per day (supervised) for 3 days per week, for six consecutive weeks. The unaffected limb will be constraint using a knee immobilizer only during practice sessions. We will perform the interventions under the supervision of a trained physiotherapist.; Group B will receive PNF intervention given for 30 minutes to the lower limb 3 times a week for 6 weeks
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment