Effects of PNF Patterns Training on Trunk Balance, and Gait in Chronic Stroke Patients

To determine the effects of PNF patterns Training on trunk balance and gait in chronic stroke patients.

This study will be conducted to investigate the effects of PNF patterns training on the trunk control, balance, and gait ability of chronic stroke patients. Data will be collected from stroke patients from Government Mian Munshi hospital (DHQ) and Riphah Rehabilitation center. A consecutive sampling technique will be use which is based on 6 months' time period. TIS (Trunk Impairment Scale), BBS (Berg Balance Scale), 10 MWT (Meter Walk Test) will be used as a tool to collect the data. SPSS 21 version will be used for data entry and analysis. This study will provide the effects of PNF patterns training on the trunk control, balance, and gait ability in chronic stroke patients. All possible patients will be taken using random sampling. Single plane training and diagonal pattern training will use. The subjects will randomly assign to the experiment group (diagonal pattern training) and the control group (single plane training). Diagonal pattern training will modified with proprioceptive neuromuscular facilitation technique's chopping and lifting pattern to create 10 movements. Informed consent will be taken from all patients.

total 30 subjects will be randomly assigned to the experiment group (diagonal pattern training) and the control group (single plane training).Diagonal pattern training will be modified with proprioceptive neuromuscular facilitation technique's chopping and lifting pattern to create 10 movements.

diagonal pattern training group will involve performance of proprioceptive neuromuscular facilitation technique's chopping and lifting pattern to create 10 movements.

patients will receive proprioceptive neuromuscular facilitation technique's chopping and lifting pattern to create 10 movements.

patients will receive single plane training of proprioceptive neuromuscular facilitation in control group

Inclusion Criteria: Chronic stroke patients whose onset of stroke was at least 6 months to two years Ability to maintain an independent standing posture for 30s, ability to walk 30m alone indoor. Patient with the ability to communicate enough and to understand oral instructions given by the therapist. Patients who were not using assistive devices Patients receiving drug therapy of internal medicine for the alleviation of spasticity. Exclusion Criteria: Unconscious patients. Patients undergone Spine surgery. Patients with Hemi neglect. Sensory ataxia or cerebellar ataxia. Coronary heart disease (CHD) or peripheral arterial disease (PAD). Cardio respiratory problems.

Van Criekinge T, Truijen S, Schroder J, Maebe Z, Blanckaert K, van der Waal C, Vink M, Saeys W. The effectiveness of trunk training on trunk control, sitting and standing balance and mobility post-stroke: a systematic review and meta-analysis. Clin Rehabil. 2019 Jun;33(6):992-1002. doi: 10.1177/0269215519830159. Epub 2019 Feb 22.

Zhu Z, Cui L, Yin M, Yu Y, Zhou X, Wang H, Yan H. Hydrotherapy vs. conventional land-based exercise for improving walking and balance after stroke: a randomized controlled trial. Clin Rehabil. 2016 Jun;30(6):587-93. doi: 10.1177/0269215515593392. Epub 2015 Jun 30.

Van Criekinge T, Saeys W, Hallemans A, Velghe S, Viskens PJ, Vereeck L, De Hertogh W, Truijen S. Trunk biomechanics during hemiplegic gait after stroke: A systematic review. Gait Posture. 2017 May;54:133-143. doi: 10.1016/j.gaitpost.2017.03.004. Epub 2017 Mar 4.

Dubey L, Karthikbabu S. Trunk proprioceptive neuromuscular facilitation influences pulmonary function and respiratory muscle strength in a patient with pontine bleed. Neurol India. 2017 Jan-Feb;65(1):183-184. doi: 10.4103/0028-3886.198193. No abstract available.