Comparison of CIMT with PNF versus NMES with PNF to improve Upper Limb Function in Hemiparetic Patients

Abstract

Background: Stroke frequently results in motor and sensory deficits leading to functional dependence. After a stroke, upper-limb weakness is prevalent throughout the different phases of recovery, impacting daily activities and QoL. Current rehabilitation approaches have incorporated evidence-based techniques to enhance upper limb recovery. Proprioceptive neuromuscular facilitation (PNF) employs particular movement patterns to aid the improvement of muscle function and strength in stroke patients. Constraint-induced movement therapy (CIMT) is an extensively researched strategy for treating upper-limb deficits following stroke, demonstrating improvements in motor function with forced-shift paradigms. Additionally, Neuromuscular electrical stimulation (NMES) has been shown to improve motor control by facilitating recovery of volitional movement. Although the individual therapies have proven effective, the comparative
effect of the combination therapies has yet to be explored. Hence, our study aims to compare the effectiveness of CIMT with PNF versus NMES with PNF in enhancing upper-limb function in hemiparetic patients.
Methods: The comparative study was done with 30 stroke patients. The patients aged 50-70 in the sub-acute stage of stroke with MAS <3, GCS = 15 were included in the study. The patients were randomly divided into Group A and Group B, receiving CIMT with PNF and NMES with PNF, respectively. UEFI & FMA- UE were used as outcome measures to assess both groups at baseline and after 8 weeks of intervention.
Results: To analyze the difference between UEFI and FMA-UE across both groups, a paired t-test was applied. Both groups showed significant improvement, but group B showed comparatively better improvement with p<0.0001
Conclusion: Neuromuscular electrical stimulation with PNF is an effective therapy for enhancing UL function poststroke.