Addition of Proprioceptive Neuromuscular Facilitation to Cardio Respiratory Training Post Stroke

Universidade Federal do Rio Grande do Norte

Status: Enrolling

Conditions: Stroke; Quality of Life; Chest Wall Disorder

Treatments: Other: respiration; Other: Proprioceptive Neuromuscular Facilitation; Other: Upper limbs CRT; Other: Lower limbs CRT

Study type: Interventional

Funder types: Other

Identifiers

NCT03171012

LACAP UFPE/UFRN

Details and patient eligibility

About

Post-stroke hemiparesis causes sequelae in the limbs and also in the trunk and abdomen structures. The level of physical activity decreases and cardiorespiratory training(CRT) is indicated to this population to improve the functions of several systems (respiratory, cardiovascular, muscular). The application of Proprioceptive Neuromuscular Facility(PNF) would imply in the awareness and greater harmony of the functions performed by the trunk of this individual. The objective of this study is to evaluate the effects of respiratory and trunk characteristics of the PNF associated with Cardiorespiratory training in quality of life, gait, distance traveled, peak oxygen consumption, respiratory muscle strength, thoracic cavity volumes, mobility and diaphragmatic thickness of individuals with post stroke.

Full description

Clinical, randomized, blind and allocation. Forty individuals post-stroke will be randomized into four groups: Experimental Lower Limbs(submitted to LL's CRT associated with PNF); Group control Lower Limbs (submitted LL's CRT associated with respiration). Experimental Upper Limbs (submitted to UP's CRT associated with PNF) and Group control Upper Limbs (submitted to UP's CRT associated with respiration). Individuals will be assessed before and immediately after 20 program sessions and one month after the end of treatment. Outcome measures shall be measured by: Stroke Specific Quality of Life Scale; Inertial gear sensor; Maximum volume of oxygen; Spirometry and manovacuometry; Ultrasound of mobility and thickness diaphragmatic; compartmental volumes of the rib cage with opto plethysmography electronics.

For the four groups, the treatment program will have the total duration of one hour including: ten minutes of stretching (five minutes before and five minutes after the therapeutic intervention), ten minutes of rest and 40 minutes of aerobic treatment associated to PNF or to respiration, being performed in 20 Sessions three times a week. The order of application of the techniques will be random, being held until the end of the intervention period. For therapy with the CRT used the cycle ergometer for lower or upper limbs, Based on the criteria of the American College of Sports Medicine and monitoring constant blood pressure, oxygen saturation and perceived exertion. The PNF patterns will be performed in seated, dorsal, ventral and side. The breathing exercises will be performed at the same time and in the positions of the PNF. To analyze the data and to achieve the objectives appropriate statistical tests shall be used, according to the normality of and characteristics of the variables.

Enrollment: 40 estimated patients

Sex: All

Ages: 21 to 65 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Have clinical diagnosis of ischemic or hemorrhagic stroke,
• primary for more than six months resulting in hemiparesis;
• Have mental competence assessed through the Mini-Exam of the Mental State-MMSE;
• Be able to walk 10 meters independently, with or without assistive device;
• Absence of other neurological or orthopedic deficiencies unrelated to stroke;
• Without report of associated pulmonary pathology and not be smoker or ex-smoker.

Exclusion criteria

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Double Blind

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40 participants in 4 patient groups

Lower limbs CRT+ PNF

Experimental group

Description:

Lower Limbs Cardiorespiratory training associated with Proprioceptive Neuromuscular Facilitation

Treatment:

Other: Lower limbs CRT

Other: Proprioceptive Neuromuscular Facilitation

Lower limbs CRT + respiration

Active Comparator group

Description:

Lower limbs Cardiorespiratory training associated with respiration

Treatment:

Other: Lower limbs CRT

Other: respiration

Upper limbs CRT + PNF

Experimental group

Description:

Upper limbs Cardiorespiratory training associated with Proprioceptive Neuromuscular Facilitation

Treatment:

Other: Proprioceptive Neuromuscular Facilitation

Other: Upper limbs CRT

Upper limbs CRT + respiration

Active Comparator group

Description:

Upper limbs Cardiorespiratory training associated with respiration

Treatment:

Other: Upper limbs CRT

Other: respiration