Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke

Abstract

The purpose of this study was to evaluate the effects of core strengthening combined with pelvic proprioceptive neuromuscular facilitation (PNF) on trunk impairment, balance, gait, and functional ability of chronic stroke patients. Twenty-three participants with chronic stroke were recruited and randomly allocated to one of the two groups: core strengthening combined with pelvic PNF (group 1, n=13), and pelvic PNF with trunk flexibility exercises (group 2, n=10). Intervention was given to both groups for 60 min per session 5 times per week for 4 weeks. Performance of both groups was evaluated on Trunk Impairment Scale, Tinetti Performance Oriented Mobility Assessment (Tinetti-POMA), Balance Evaluation Systems Test (Mini-BESTest), Wisconsin Gait Scale, and Barthel Activities of Daily Living Index prior to and after the completion of the intervention. The comparison between postintervention scores of Tinetti-POMA between group 1 (18.76±1.78) and group 2 (16.8±1.87) and Mini-BESTest group 1 (16.15±1.28) and group 2 (14.7±1.41) showed significant difference (P=0.018). The results indicated that core stabilisation combined with pelvic PNF was more effective for improving trunk impairment, balance and gait of chronic stroke patients.

Effectiveness of a multimodal exercise rehabilitation program on walking capacity and functionality after a stroke

“…The 2013 Cochrane review ( Saunders et al, 2013 ) recommends the repetitive practice of sit-to-stand in order to promote an ergonomic and automatic pattern of this movement. Recent studies demonstrate that exercises that improve trunk stability and balance provide a solid base for body and leg movements that entail an improved gait in people affected by stroke ( Sharma and Kaur, 2017 ). Conventional rehabilitation programs after stroke focus on the subacute period.…”

Pelvic floor dysfunction negatively impacts general functional performance in patients with multiple sclerosis

“…On the contrary, in contrast to our theory on the relevance of the core in the independence of patients with MS, we found studies reporting an absence of improvement in perceived gait limitations as well as in the TUG test 32,33 after a core training program focused on the abdominal musculature. However, this training modality has been shown to be effective for this same purpose in patients with stroke, 11 observing a greater benefit when the abdominal muscles were trained together with the pelvic floor 34 . Thus, it is possible that patients with MS have a greater involvement of the pelvic floor, which is responsible for gait alteration and balance.…”

“…However, this training modality has been shown to be effective for this same purpose in patients with stroke, 11 observing a greater benefit when the abdominal muscles were trained together with the pelvic floor. 34 Thus, it is possible that patients with MS have a greater involvement of the pelvic floor, which is responsible for gait alteration and balance. In fact, there is evidence that patients with MS with severe urinary disorders have a greater degree of disability and pyramidal dysfunction in the lower extremities, 35 which concurs with our results.…”

Physical Therapy for Neurological Conditions in Geriatric Populations

“…Proprioceptive neuromuscular facilitation is a common stretching and strengthening practice with broad applications in treating patients with neurological and musculoskeletal conditions mainly for increasing muscle elasticity and endurance, and improve active, passive range of motions, to increase joint stability, to enhance neuromuscular coordination and control in the athletic and clinical setting ( 51 , 52 ). When performed in addition to prescribed exercise, PNF may also increase muscular performance.…”