Effect of Jack Knife Stretching Versus Proprioceptive Neuromuscular Facilitation (Hold Relax) Stretching Technique in Asymptomatic Individuals with Hamstring Tightness: A Randomized Clinical Trial

Abstract Background Breast cancer (BC) is a major public health issue. More than one out of five women treated for breast cancer will develop lymphedema in an upper extremity. Current evidence advocates transdisciplinary oncological rehabilitation. Therefore, research in this area is necessary since limited consensus having been reached with regard to the basic essential components of this rehabilitation. Consensus has, however, been reached on the use of decongestive lymphedema therapy (DLT), but due to a lack of tests, the necessary dosages are unknown and its level is moderately strong. This study attempts to verify both the efficacy of activity-oriented proprioceptive antiedema therapy (TAPA), as compared to conventional treatments such as DLT or Complex Physical Therapy (CPT), as well as its efficiency in terms of cost-effectiveness, for patients affected by breast cancer-related arm lymphedema. Methods Controlled, randomized clinical trial with dual stratification, two parallel arms, longitudinal and single blind. 64 women with breast cancer-related arm lymphedema will take part in the study. The experimental group intervention will be the same for stage I and II, and will consist of neuro-dynamic exercises oriented to the activity, proprioceptive neuromuscular facilitation activities and proprioceptive anti-edema bandaging. The control group intervention, depending on the stage, will consist of preventive measures, skin care and exercise-prescribed training in the lymphedema workshop as well as compression garments (Stage I) or conservative Complex Decongestive Therapy treatment (skin care, multi-layer bandaging, manual lymphatic drainage and massage therapy) (Stage II). Results Sociodemographic and clinical variables will be collected for the measurement of edema volume and ADL performance. Statistical analysis will be performed on intent to treat. Discussion It has been recommended that patient training be added to DLT, as well as a re-designing of patient lifestyles and the promotion of health-related aspects. In addition, clinical trials should be undertaken to assess neural mobilization techniques and proprioceptive neuromuscular facilitation should be included in the therapy. Cohesive bandaging will also be performed as an early form of pressotherapy. The proposed study combines all of these aspects in order to increased comfort and promote the participation of individuals with lymphedema in everyday situations. Limitations The authors have proposed the assessment of the experimental treatment for stages I and II. One possible limitation is the lack of awareness of whether or not this treatment would be effective for other stages as well as the concern for proper hand cleansing during use of bandages, given the current COVID-19 pandemic situation. Trial registration This trial was registered in ClinicalTrials.gov (NCT03762044). Date of registration: 23 November 2018. Prospectively Registered.

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Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Children with Spastic Diplegia: A Study Protocol for a Randomized Clinical Trial

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34356 ◽

2021 ◽

pp. 88-95

Author(s):

Vikrant Salphale ◽

Rakesh Krishna Kovela ◽

Mohammad Irshad Qureshi ◽

Pallavi Harjpal

Keyword(s):

Clinical Trial ◽

Cerebral Palsy ◽

Randomized Clinical Trial ◽

Lower Limb ◽

The Other ◽

Spastic Diplegia ◽

Gait Parameters ◽

Proprioceptive Neuromuscular Facilitation ◽

Task Oriented ◽

Facilitation Techniques

Background: Cerebral Palsy is a spacious term which highlights an extensive gamut of motor affliction which has a stagnant tendency. The estimated Cerebral Palsy is indeed very prevalent in developed nations 2 out of the next 1000 live births and neonatal survivors. Among several Cerebral Palsy comes in a variety of manifestations. Spastic Diplegia is common in a majority of Preterm babies. Several treatment strategies of Physical therapy are utilized for Spastic Diplegia. This research focusses on assessing the Efficiency of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) techniques over the Dimensions of Balance and Gait in children with Spastic Diplegia. Objective: To evaluate the Effectiveness and impact of the techniques of Pelvic Proprioceptive Neuromuscular Facilitation (PNF) on Balance, Gait Parameters and Pelvic Asymmetry in children having Spastic Diplegia. Methods: In this Randomized Clinical Trial, subjects (n= 40) having Spastic Diplegia will be selected and segregated in two groups using simple random sampling method with 1:1 allocation ratio. The allocation will be done through sequentially numbered opaque sealed envelope (SNOSE). Subjects in the experimental group will receive Pelvic PNF techniques like Rhythmic initiation and Slow reversal with Task- Oriented training which will contain sit to stand exercises, walking on the ground and reaching tasks for improving the balance and those in the other group will be given only Task- Oriented training for 4 weeks following baseline assessments. Throughout the treatment session and following 4 weeks follow up will be taken by assessing the Balance and Gait parameters of the subjects. The study duration will. be of 1 year. Subjects with Spastic Diplegia with an age group of 8 to 12 years who are able to do independent sitting, who are coming under GMFCS level I to III and those who are having pelvic asymmetry will be included in the study while subjects who had any surgery of spine or lower limb in past 6 months, who are having fixed deformities of spine or lower limb or any fracture or dislocation of spine or lower limb will be excluded from the study. Results: Results will be recorded by using the outcome measures and instruments such as Pediatric Balance Scale, Gait Parameters and Palpation meter device at the end of the intervention and the effects of Pelvic PNF techniques will be compared with the other group which will receive Task oriented training. The statistical analysis will be done by using paired t test but if the data does not follow a normal distribution then Wilcoxon sign rank test will be used. Discussion: The intention and motive of the study is to check the Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation techniques on Balance and Gait Parameters in children with Spastic Diplegia. Conclusion: The conclusion of this research is to acquire the fruitfulness of Approaches of Pelvic PNF on Balance and Gait Parameters in children having Spastic Diplegia.

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