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This study aims to investigate the effects of a proprioceptive neuromuscular facilitation (PNF)-based lower extremity rehabilitation program on balance, gait performance, functional independence, and quality of life in individuals with stroke.
Stroke is a leading cause of long-term disability and is commonly associated with impairments in motor control, balance, and walking ability, which negatively affect independence and daily functioning.
In this randomized controlled trial, participants with stroke will be randomly assigned to either a PNF-based rehabilitation group or a control group receiving conventional physiotherapy. The intervention will focus on lower extremity PNF techniques to improve motor control, balance, and gait performance.
Assessments will be conducted at baseline and at the end of the intervention period.
The findings are expected to contribute to the development of evidence-based rehabilitation strategies for individuals with stroke.
This study is designed as a prospective, randomized, parallel-group controlled trial to evaluate a PNF-based lower extremity rehabilitation program in individuals with stroke.
A total of 60 participants will be randomly allocated in a 1:1 ratio to either an intervention group or a control group using a computer-generated randomization sequence.
The intervention group will receive a structured rehabilitation program based on proprioceptive neuromuscular facilitation principles. The program will incorporate techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization. These techniques will be applied through lower extremity diagonal movement patterns (D1 and D2) in functional positions including supine, sitting, and standing. The intervention will be individualized and progressively adjusted according to participant performance and tolerance.
The control group will receive a conventional physiotherapy program consisting of range of motion exercises, muscle strengthening, balance training, and gait-related activities consistent with standard rehabilitation practice.
Both groups will receive interventions with equivalent duration and frequency.
Outcome assessments will be performed by an independent assessor who is blinded to group allocation.
Statistical analyses will be conducted to evaluate changes over time and differences between groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| PNF Training Group | Experimental | Participants in this group will receive a proprioceptive neuromuscular facilitation (PNF)-based lower extremity rehabilitation program. The intervention will include specific PNF techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization aimed at improving balance, gait performance, and lower extremity motor control in individuals with stroke. |
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| Conventional Physiotherapy Group | Active Comparator | Participants in the control group will receive conventional physiotherapy exercises focusing on lower extremity strengthening, balance training, and functional mobility exercises commonly used in stroke rehabilitation. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Proprioceptive Neuromuscular Facilitation Training | Other | No drug or medical device is used as part of the intervention. The study involves only physiotherapy-based rehabilitation programs. A structured PNF-based exercise program targeting lower extremity motor function, balance, and gait performance. The intervention will include techniques such as rhythmic initiation, dynamic reversals, stabilizing reversals, and rhythmic stabilization applied using diagonal movement patterns (D1 and D2). Exercises will be performed in functional positions (supine, sitting, standing) and progressively adjusted according to patient tolerance. |
| Measure | Description | Time Frame |
|---|---|---|
| Berg Balance Scale | The Berg Balance Scale (BBS) is a 14-item scale used to assess functional balance. Each item is scored from 0 to 4, with a total score ranging from 0 to 56. Higher scores indicate better balance performance. | Baseline and 8 weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Timed Up and Go Test | The Timed Up and Go Test (TUG) measures functional mobility and dynamic balance. It records the time (in seconds) required to stand up from a chair, walk 3 meters, turn, walk back, and sit down. Lower values indicate better performance. | Baseline and 8 weeks |
| Fugl-Meyer Motor Assessment (Lower Extremity) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Mehmet Salih Tan, Doctora | Contact | Türkiye | +905467266876 | mstan@medipol.edu.tr |
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ndividual participant data (IPD) from this study will not be shared with other researchers. The study data will be used only for academic purposes within the study team, and all personal identifiers will be anonymized and kept confidential in accordance with ethical regulations.
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Participants will be randomly assigned to either a proprioceptive neuromuscular facilitation (PNF) intervention group or a control group receiving conventional physiotherapy exercises. Outcomes will be assessed before and after the intervention period.
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Due to the nature of the physiotherapy intervention, blinding of participants and therapists is not feasible.
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| Conventional Physiotherapy | Other | Standard physiotherapy exercises including balance training, gait training, and strengthening exercises for individuals with stroke. |
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The Fugl-Meyer Assessment (Lower Extremity section) evaluates motor recovery after stroke. Scores range from 0 to 34, with higher scores indicating better motor function. |
| Baseline and 8 weeks |
| 10-Meter Walk Test | The 10-Meter Walk Test assesses walking speed (m/s). Higher walking speed indicates better gait performance. | Baseline and 8 weeks |
| 6-Minute Walk Test | The 6-Minute Walk Test measures walking endurance and functional exercise capacity as the total distance walked in meters. Higher values indicate better performance. | Baseline and 8 weeks |
| Stroke Specific Quality of Life Scale | The Stroke-Specific Quality of Life Scale (SS-QOL) evaluates health-related quality of life. Scores range from 49 to 245, with higher scores indicating better quality of life. | Baseline and 8 weeks |
| ID | Term |
|---|---|
| D020521 | Stroke |
| ID | Term |
|---|---|
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
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