Effect of scapular proprioceptive neuromuscular facilitation on shoulder pain, range of motion, and upper extremity function in hemiplegic patients: A randomized controlled trial

• Main Authors: Deepak Joshi, Jeba Chitra
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2017-01-01
• Series: Indian Journal of Health Sciences and Biomedical Research KLEU
• Subjects: Hemiplegia; lateral scapular slide distance; poststroke shoulder pain; scapular proprioceptive neuromuscular facilitation; shoulder range of motion; upper extremity function
• Online Access: http://www.ijournalhs.org/article.asp?issn=2542-6214;year=2017;volume=10;issue=3;spage=276;epage=282;aulast=Joshi

Background and Purpose: Poststroke shoulder pain is one of the most prevalent impairments (34%–86%) and it hinders the performance of daily activities and also interferes with stroke rehabilitation. The purpose of this study was to examine the effect of scapular proprioceptive neuromuscular facilitation (PNF) on shoulder pain, range of motion (ROM), and upper extremity (UE) function in hemiplegic patients. Methods: Thirty hemiplegic patients were recruited and randomly allocated to Group A (n = 15) and Group B (n = 15). Experimental group received conventional treatment plus scapular PNF-hold relax technique while control group received only conventional treatment comprised passive shoulder ROM and stretching exercises and transcutaneous electrical nerve stimulation for 12 sessions (4 sessions/week). The outcome measures used were visual analog scale, shoulder ROM, lateral scapular slide test, and Fugl-Meyer motor assessment. Results: Statistical analysis showed significant change in shoulder pain and UE function in both the groups with no significant differences between the groups; significant improvement in shoulder ROM in both the groups (except internal rotation in controls) and between-group comparison favored the intervention; scapular position improved significantly in experimental group for position A while all postintervention scapular positions in both the groups showed concordance with position of scapula on unaffected side. Conclusion: Scapular PNF has positive impact on poststroke shoulder pain and ROM, helps in strengthening of proximal muscles of UE, thereby correcting scapular alignment and improving the UE function in stroke patients.