Combined Effects of PNF and Electrical Muscle Stimulation on Spasticity and Hand Function in Stroke Patients.

Study Overview
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Brief Summary
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To determine the combined effects of proprioceptive neuromuscular facilitation and electrical muscle stimulation on spasticity and hand function in stroke patients.

Detailed Description
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It will be a randomized controlled trial. The stroke patients aged between 30-70 years will be included in this study. Participants will be selected with non-probability convenience sampling technique. Participants will be randomly allocated into two groups by lottery method i.e experimental group and control group. The experimental group will receive proprioceptive neuromuscular technique (contract relax-10 repetition) (5-min) and electrical muscle stimulation(10 min) as 15 min session 3 times a week for four weeks while the control group will receive only conventional therapy. The outcome measure will be calculated by modified barthel index, modified ashworth scale and wolf motor function test.

Official Title
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Combined Effects of Proprioceptive Neuromuscular Facilitation and Electrical Muscle Stimulation on Spasticity and Hand Function in Stroke Patients.

Conditions
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Stroke, Proprioceptive Disorders, Balance; Distorted

Intervention / Treatment
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* Other: experimental group
* Other: control group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Both ischemic and haemorrhagic stroke patients Chronic stroke patients from 6 month to 2years Mini Mental Scale Examination (MMSE) more than 25 Exclusion Criteria: Transient ischemic attack Recurrent stroke Stroke patient with comorbidity and cardiac disease Myopathies

Ages Eligible for Study
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Minimum Age: 30 Years
Maximum Age: 70 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
Interventional Model Description: patients will be allocated to two groups by randomization. Patients in Group A will receive Proprioceptive Neuromuscular Facilitation (contract-relax) technique & EMS patients in Group B will receive conventional therapy.
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: experimental group<br>patients in this group will receive contract relax exercises along with EMS | Other: experimental group<br>* Patients will receive Proprioceptive Neuromuscular Facilitation (contract-relax) technique with EMS<br>|
| Active Comparator: control group<br>patients in groups B will receive conventional therapy. | Other: control group<br>* Patients will receive conventional therapy.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Modified Barthel Index: | It is used for assessing the activities of daily living. It is composed of 10 questions that link the degree of independence to daily living activities. Collin et, al; proposed amendment in 1988, in which each domain was scored in one-point increments, ranging from 0 to 2 or 3 for each activity with a maximum score of 20 suggesting functional independence. It is highly reliable and has a good correlation with other disability measures. | 9 months | 
| Modified Ashworth Scale: | Modified Ashworth Scale: It is used to assess the spasticity in patients of stroke or spinal cord injury. Scores range from 0 to 4, where lower scores represent normal muscle tone and higher scores represent spasticity. It is characterized by exaggerated deep tendon reflexes that interfere with muscular activity, gait, movement, or speech. It has excellent validity and reliability. | 9 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Stroke, Proprioceptive Disorders, Balance; Distorted