Effect of Proprioceptive Neuromuscular Facilitation on Blood Pressure

Study Overview
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Brief Summary
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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
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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.

Official Title
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Effects of Proprioceptive Neuromuscular Facilitation Exercise on Blood Pressure and Ankle Brachial Index in Patient With Hypertension

Conditions
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Hypertension

Intervention / Treatment
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* Other: Proprioceptive Neuromuscular Facilitation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 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. Mild and moderate hypertension with diabetes Exclusion Criteria: Severe hypertensive patients. Patient on smoking Patient with severe complications and comorbidities. Not willing to give consent/ data

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: proprioceptive neuromuscular facilitation<br>proprioceptive neuromuscular facilitation techniques | Other: Proprioceptive Neuromuscular Facilitation<br>* 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<br>|
| No Intervention: control<br>no intervention | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| sphygmomanometer | sphygmomanometer will be used for measuring blood pressure and ankle brachial index | 12 weeks | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| (EuroQoL five-dimensional instrument ) | quality of life measures the five dimension mobility,selfcare,usual activities,pain and anxiety. 0 for minimum 5 for maximum | 12 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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proprioceptive neuromuscular facilitations, ankle brachial index, diabetes