Article Figures & Data
Figures
- Figure 1
General time line of intervention of 4 cases that received proprioceptive neuromuscular facilitation.
- Figure 2
Proprioceptive neuromuscular facilitation mat exercises consisting of: A) lower extremity flexion-adduction with knee flexion and B) pelvic bridging with resistance
- Figure 3
Proprioceptive neuromuscular facilitation gait exercises consisting of A) one leg stance with resistance B) stabilizing reversals and C) resisted backwards gait.
Tables
- Table 1
Baseline demographic information of 4 older adults with chronic stroke who received proprioceptive neuromuscular facilitation.
Case 1 2 3 4 Age 65 62 63 69 Gender Male Male Female Female Duration post-stroke 18 years 1 year 0.75 year 9 years Side of hemiparesis Right Left Right Right Level of assistance/function Walks using quad cane without assistance Uses a wheelchair propelled by caregiver; walks over short distances at home with quad cane and contact guarding Walks with quad cane with close guarding from caregiver Uses a wheelchair propelled by caregiver; walks over short distances at home with quad cane, ankle-foot orthosis, and contact guarding History of falls Yes No Yes Yes Co-morbid conditions Hypertension Type II diabetes COPD Prostate enlargement Hypertension Hypertension Type II diabetes Hypertension COPD Osteoarthritis Therapy goal Improve endurance adversely affected by limited physical activity and COPD Prevent falls Improve indoor ambulation Prevent falls Improve indoor and community ambulation Prevent falls Improve indoor ambulation Prevent falls Other findings (+) spasticity, ankle muscles (+) impaired tactile sensation NS proprioception NS cognition NS muscle tone NS sensation NS cognition NS muscle tone NS sensation NS cognition (+) impaired tactile sensation and proprioception (+) history of musculoskeletal injury to right foot NS muscle tone NS cognition COPD – chronic obstructive pulmonary disease, NS – non-significant/normal finding
- Table 2
Summary of proprioceptive neuromuscular facilitation interventions and progressions of exercises received by four cases of older adults with chronic stroke.
Case Interventions Progression Case 1 Pelvic anterior elevation and posterior depression LE flexion-adduction with knee flexion LE extension-abduction with knee extension Rolling from supine to side lying Pelvic bridging Stabilizing reversals in standing One leg stance Resisted forward walking RI to DR RI to DR RI to DR Start in side lying progressed to start in supine Bridging on two legs to bridging on one leg Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration Case 2 Pelvic anterior elevation and posterior depression LE flexion-adduction with knee flexion LE extension-abduction with knee extension Pelvic bridging Stabilizing reversals in sitting and standing Resisted forward walking Walking sidewards RI to DR RI to DR RI to DR Bridging on two legs to bridging on one leg Increase in repetitions and duration; SR to COI Increase in repetitions and duration Increase in repetitions and duration Case 3 Pelvic anterior elevation and posterior depression LE flexion-adduction with knee flexion LE extension-abduction with knee extension Pelvic bridging Stabilizing reversals in sitting and standing One leg stance Resisted forward walking Resisted backward walking Walking sideward Tandem walking Braiding RI to DR RI to DR RI to DR Bridging on two legs to bridging on one leg Increase in repetitions and duration; SR to COI Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration Case 4 Pelvic anterior elevation and posterior depression LE flexion-adduction with knee flexion LE extension-abduction with knee extension LE flexion-abduction with knee flexion Pelvic bridging Stabilizing reversals in sitting and standing One leg stance Resisted forward walking Walking sideward RI; discontinued due to difficulty RI to DR RI to DR RI to DR Bridging on two legs to bridging on one leg Increase in repetitions and duration; SR to COI Increase in repetitions and duration Increase in repetitions and duration Increase in repetitions and duration COI – combination of isotonics; DR – dynamic reversal; LE – lower extremity; PNF – Proprioceptive Neuromuscular Facilitation; RI – rhythmic initiation; SR – stabilizing reversal
- Table 3
Results of pretest and posttest of the lower extremity strength, balance, balance confidence, and mobility of four older adults with chronic stroke that received proprioceptive neuromuscular facilitation.
Case 1 2 3 Pre Post Change Pre Post Change Pre Post Change UMCT-F Moderate Moderate Strong Strong Weak Weak UMCT-E Strong Strong Weak Moderate Weak Moderate FTSST (s) 17.09 16 1.09 42.02 37.75 4.27* 41.84 23.75 18.09* ABC (%) 83 79 -4 66 45 -21* 14 36 22* Mini-BESTest 20 21 1 17 25 8* 7 13 6* Self-selected velocity (m/s) 0.47 0.41 -0.06 0.16 0.57 0.41* 0.27 0.36 0.09 Fast velocity (m/s) 0.57 0.60 0.03 0.19 0.82 0.63* 0.30 0.41 0.11 ↵* Significant change based on available MCID or MDC values published in previous case report, ABC - Activities-specific Balance Confidence Scale, FTSST - Five Time Sit-to-Stand Test, MCID - minimal clinically important difference, MDC - minimal detectable change, Mini-BESTest - Mini Balance Evaluation Systems Test, UMCT-F - Upright Motor Control Test Flexion, UMCT - Upright Motor Control Test Knee Flexion
- Table 3
Results of pretest and posttest of the lower extremity strength, balance, balance confidence, and mobility of four older adults with chronic stroke that received proprioceptive neuromuscular facilitation.
Case 4 Case XXX(6) MCID/MDC Pre Post Change Pre Post Change UMCT-F Weak Weak Strong Strong UMCT-E Weak Weak Weak Moderate FTSST (s) 48.37 34.50 13.87* 30.27 27.47 2.8* MCID = 2.3 ABC (%) 25 50 25* 78 71 -7 MDC = 13 Mini-BESTest 4 10 6* 21 25 4* MCID = 4 Self-selected velocity (m/s) 0.24 0.35 0.11 0.50 0.57 0.07 MDC = 0.18 Fast velocity (m/s) 0.31 0.37 0.06 0.67 0.82 0.15* MDC = 0.13 * Significant change based on available MCID or MDC values published in previous case report, ABC - Activities-specific Balance Confidence Scale, FTSST - Five Time Sit-to-Stand Test, MCID - minimal clinically important difference, MDC - minimal detectable change, Mini-BESTest - Mini Balance Evaluation Systems Test, UMCT-F - Upright Motor Control Test Flexion; UMCT - Upright Motor Control Test Knee Flexion
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