Effects of proprioceptive neuromuscular facilitation technique on scapular dyskinesis in patients with subacute stroke

Abstract

The objective of this was to compare the effects of the proprioceptive neuromuscular facilitation (PNF) hold-relax technique on pain severity, range of motion (ROM) of the shoulder, shoulder disability, and scapular asymmetry in stroke patients with scapular dyskinesis. The study used a randomized clinical trial design including 46 patients ranging from 40 to 60 years with at least five months of stroke with type-1 scapular dyskinesia. The participants were divided into two groups, taking the upper limb Diagonal 1 (D1) flexion pattern and Diagonal 2 (D2) flexion pattern, respectively, which were allocated by consecutive sampling using the lottery method. We used a visual analog scale (VAS) for pain, goniometry for shoulder ROM, shoulder pain and disability index (SPADI) for shoulder disability, and lateral scapular slide test for scapular asymmetry. D1 flexion and D2 flexion both improved the ROM in both groups (P < 0.05) and decreased pain and disability, while in-between comparisons did not find a significant difference between the effectiveness of both treatments in terms of pain measured by VAS, ROM, that is, flexion, extension, and abduction (P > 0.05). In terms of external and internal rotation, the D1 flexion pattern of PNF techniques showed more improvement as compared to D2 flexion (P < 0.05). While in terms of SPADI, D2 flexion showed more improvement as compared to D1 flexion (P < 0.05). Scapular PNF substantially influences stroke patients’ shoulder discomfort and ROM.