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Although there are studies examining the effect of actively performed PNF exercises on haemodynamic responses in intensive care patients and healthy individuals, there are no studies investigating their effect on circulation and haemodynamic responses in unconscious patients. Therefore, this study was designed to investigate the acute effects of proprioceptive neuromuscular facilitation (PNF) exercises on peripheral circulation and haemodynamic responses in patients admitted to a neurological intensive care unit.
Hypotheses:
H1-1: Passively administered PNF exercises have beneficial effects on peripheral circulation.
H2-1: Passively administered PNF exercises have beneficial effects on haemodynamic responses.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PNF Group | Experimental | Patients in the PNF group will undergo proprioceptive neuromuscular facilitation (PNF) exercises. The exercises will be performed with patients in the supine position and the head elevated by 30°. |
|
| Control Group | Sham Comparator | Patients in the control group will undergo passive range of motion (PROM) exercises in the same position. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proprioceptive Neuromuscular Facilitation Exercises | Other | The following PNF patterns will be applied to the upper extremity:
The following PNF patterns will be applied to the lower extremities:
|
| Measure | Description | Time Frame |
|---|---|---|
| Ankle-Brachial Ä°ndex | Systolic blood pressure will be measured at the brachial artery (upper limb) and the posterior tibial or dorsalis pedis artery (lower limb) using a Hadesco ES-101EX Doppler device, with patients in a supine resting position. The cuff will be placed at mid-arm and above the malleolus. It will be inflated until the pulse disappears and deflated slowly; the first reappearance of the pulse will be recorded as systolic pressure. Measurements will be taken in order: same-side arm, same-side leg, opposite leg, and opposite arm. The ankle-brachial index will be calculated as the ratio of the highest lower limb systolic pressure to the highest upper limb systolic pressure. | Baseline and five or ten minutes after exercise |
| Heart Rate | Heart rate will be recorded as beats per minute and breaths per minute, respectively, based on data obtained from the patient monitor. Measurement will be taken whilst patients are in the supine position and at rest. | Baseline and five or ten minutes after exercise |
| Systolic blood pressure and diastolic blood pressure | Systolic and diastolic blood pressure measurements will be taken from the patient's upper extremity using an appropriately sized cuff and recorded in millimetres of mercury (mmHg). Measurement will be taken whilst patients are in the supine position and at rest. | Baseline and five or ten minutes after exercise |
| Respiratory rate | respiratory rate will be recorded as beats per minute and breaths per minute, respectively, based on data obtained from the patient monitor. Measurement will be taken whilst patients are in the supine position and at rest. | Baseline and five or ten minutes after exercise |
| Peripheral oxygen saturation (SpOâ‚‚) | Peripheral oxygen saturation (SpOâ‚‚) will be measured using a pulse oximeter. Measurement will be taken whilst patients are in the supine position and at rest. |
| Measure | Description | Time Frame |
|---|---|---|
| Rate Pressure Product | Rate Pressure Product is calculated by dividing the product of heart rate and systolic blood pressure by 1,000 | Baseline and five or ten minutes after exercise |
| Quadriceps circumference measurement |
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Inclusion Criteria:
Exclusion Criteria:
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two groups with a conventional therapy control group.
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The researcher conducting the measurements will not know which group the patients have been assigned to; this will ensure that the study is as blinded as possible. However, due to the nature of the exercises being performed, it will not be possible for the physiotherapist administering the treatment or the patients themselves to be blinded to the group allocation.
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|
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| Passive Range of Motion Exercises | Other | Exercises for the upper extremities:
Exercises for the lower extremities:
|
|
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| Baseline and five or ten minutes after exercise |
Measurements will be taken whilst patients are in the supine position or, where appropriate, in a seated position. During the measurement, a non-elastic tape measure will be used to measure the circumference at the widest part of the thigh. The tape measure will be placed parallel to the thigh circumference, and the measurement result will be recorded in centimetres (cm).
To enhance the reliability of the measurement, two separate measurements will be taken for each patient, and the average of the obtained values will be used in the analyses.
| Baseline and five or ten minutes after exercise |
| Oxford Acute Severity of Illness Score | Oxford Acute Severity of Illness Score comprises a total of 10 parameters: age, heart rate, mean arterial pressure, respiratory rate, body temperature, Glasgow Coma Scale, urine output, mechanical ventilation status, length of stay in intensive care, and the presence of elective surgery. Each parameter is assessed according to specific score ranges, and the total score indicates the severity of the illness. Higher scores indicate a higher risk of mortality. | Baseline and five or ten minutes after exercise |
| ID | Term |
|---|---|
| D009422 | Nervous System Diseases |
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