HYBRID EVENT: You can participate in person at Baltimore, Maryland, USA or Virtually from your home or work.

10th Edition of International Conference on Neurology and Brain Disorders

October 21-23, 2024

October 21 -23, 2024 | Baltimore, Maryland, USA
INBC 2024

Rikesh Shrestha

Speaker at Brain Disorders Conference - Rikesh Shrestha
Sentara Health, United States
Title : Effect of lower extremity proprioceptive neuromuscular facilitation on stair ambulation in persons with stroke: A pre-post study


Background and objectives: Persons with stroke often encounter challenges in ambulation due to impaired motor function and coordination. The aftermath of stroke can significantly affect a person’s ability to ambulate independently, necessitating tailored intervention for rehabilitation. Moreover, stair ambulation poses a complex challenge requiring a rehabilitation strategy focused to the lower extremities (LE), incorporating multidisciplinary approach. Furthermore, physiotherapy interventions form the basis of the stroke rehabilitation. One such intervention is Proprioceptive neuromuscular Facilitation (PNF) patterns for LE motor control. Hence, the aim of our study is to investigate the effect of LE PNF patterns on stair ambulation in persons with stroke.

Method: This one-group pre-post study included 30 participants with acute stroke. The participants were included if they were able perform the 6-minute walk test, were at the Brunnstorm recovery stage 2, and had a Mini-Mental State examination score of more than 23. The participants were excluded if they had musculoskeletal or cardiovascular conditions, apart from known and controlled hypertension. Bilateral LE PNF patterns was provided, with each session consisting of (Diagonal 1) D1 and (Diagonal 2) D2 patterns, for 10 repetitions of 3 sets of each pattern, performed thrice per week for 4 weeks which is total of 12 sessions. The outcomes measures included the Stroke Impact Scale (SIS) and Timed Up and Go Stairs (TUGS).

Result: This study included 22 male and 8 female participants with stroke, with a mean age of 54 ± 13 years. The pretest score of SIS was 33.64 ± 8.66, which increased to 57.80 ± 6.66, signifying 76.7% improvement. Similarly, the pretest score of TUDS test was 96.60±20.73 and the posttest score increased to 80.50 ± 19.22, showcasing 50% improvement. Hence, there was a significant improvement in both SIS and TUDS test following the intervention.

Conclusion: Physiotherapy intervention in the form of PNF D1 and D2 pattern has demonstrated a significant efficacy on stair ambulation in persons with stroke, showcasing its potential as a valuable and targeted intervention in stroke rehabilitation. However, further studies with larger sample size and better study design are warranted to confirm the effectiveness of PNF intervention.

Audience Take Away Notes:

  • The audience will gain insights into a physical therapy intervention strategy which can be learnt and performed at the comfort of their home post discharge.
  • The audience will learn about the activation mechanism of mirror neurons resulting from the repetitive performance of PNF patterns, which may explain the observed effectiveness.
  • This concept can be utilized to conduct various other physical therapy interventions in conjunction with novel approaches, thus triggering the potential exploration in future research strategies.


Dr. Rikesh Shrestha, DPT is a board-certified physical therapist at Sentara Health, Virginia, USA. His clinical expertise includes Certification in Dry Needling, Taping, Vestibular Rehabilitation and Concussion, and Manual Therapy. He completed his Bachelors and Masters of Physiotherapy in Neurological and Psychosomatic Disorders from Rajiv Gandhi University of Health Sciences, Bangalore, India. His research focused on cross-sectional survey of awareness of caregivers about stroke and the need for early rehabilitation in a tertiary care hospital in South India. He has been contributing as co-authors for many scholarly outputs and aspires to pursue a PhD in the field of Vestibular Rehabilitation.