Early PNF exercises functional outcome and quality in patients with stroke of urban and rural area in Uttar Pradesh: a prospective community based study

Authors

  • Ajai K. Singh Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Poonam Chaturvedi Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Pradeep K. Maurya Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Dinkar Kulshreshtha Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Abdul Qavi Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
  • Anup Thacker Department of Neurology, Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20180313

Keywords:

Barthel's- Index, Early Rehabilitation, Quality of Life, Stroke, Urban

Abstract

Background: Early rehabilitation plays a very important role in stroke outcome. In India people from rural areas get primary treatment from district hospitals, where the rehabilitation facilities are not available, and then referred to the tertiary care hospital (after 2-3weeks) hence the rehabilitation process is delayed. It may delay the improvement in functional outcome and quality of life. These factors should be evaluated. To evaluate effects of PNF intervention in urban and rural population in Uttar Pradesh.

Methods: Total 90 patients were recruited in this study and divided into rural (coming from rural areas of Uttar Pradesh) and urban (coming from urban areas) groups. Patients were given rehabilitation for 4weeks and improvement in functional activities was assessed by Barthel's-Index (BI), Quality of Life was assessed by Stroke Specific Quality of Life Scale (SSQOL) and sensory motor improvement was assessed by Fugl- Meyer Assessment before and after the intervention. Patients were again assessed at 6months.

Results: 41 patients in experimental and 49 patients in control group completed the 6 months follow up and were available for analysis. On analysis urban group showed better (<0.05) improvement in functional activities, sensory motor improvement (FMA) and quality of life (SSQOL) as well. People who directly admitted to our multispecialty and tertiary care hospital and received early rehabilitation showed better improvement than the patients who received late rehabilitation.

Conclusions: Early rehabilitation leads to early improvement in functional activities. PNF exercises are very effective in improving motor function and should be given from the first day after stroke.

References

Manimmanakorn N, Vichiansiri R, Nuntharuksa C, Permsirivanich W, Kuptniratsaikul V. Quality of life after stroke rehabilitation among urban vs. rural patients in Thailand. J Med Assoc Thail Chotmaihet Thangphaet. 2008;91:394-9.

Allen L, McIntyre A, Janzen S, Richardson M, Meyer M, Ure D, et al. Community stroke rehabilitation: how do rural residents fare compared with their urban counterparts? Canadian J Neurol Sci Le J Canadien Des Sci Neurol. 2016;43:98-104.

Kabat H. Studies on neuromuscular dysfunction: The role of central facilitation techniques for treatment of paralysis. Arch Phys Med. 1952;33:521-33.

Kabat H. Central facilitation: The basis of treatment for paralysis. Permanente Foundation Medical Bulletin. 1952;10:190-204.

Sherrington CS. The Integrative Action of the Nervous System, ed 2, New Haven, CT, Yale University Press:1947:36-115.

Irwin OC. Proximodistal differentiation of limbs in young organisms. Psychol Rev. 1993;40:467-77.

McGraw M. Grasping in infants and the proximo-distal course of growth. Psychol Rev. 1993;40:301-2.

Voss DE. Proprioceptive neuromuscular facilitation. Am J Phys Med. 1967;46:838-98.

Census of India 2011. Provisional population totals. Some concepts and definitions. Census of India. 2011:1.

O'Neill NP, Godden DJ. Stroke outcomes in Northern Scotland: does rurality really matter? Rural and remote health. 2003;3:243.

Sacco RL, Wolf PA, Kannel WB, McNamara PM. Survival and recurrence following stroke. The Framingham study. Stroke. 1982;13:290-5.

Bamford J, Dennis M, Sandercock P, Burn J, Warlow C. The frequency, causes and timing of death within 30 days of a first stroke: the Oxfordshire Community Stroke Project. J Neurol Neurosurg Psychiatry. 1990;53:824-9.

Lauria G, Gentile M, Fassetta G, Casetta I, Agnoli F, Andreotta G, et al. Incidence and prognosis of stroke in the Belluno province, Italy. First-year results of a community-based study. Stroke. 1995;26:1787-93.

Anderson CS, Jamrozik KD, Broadhurst RJ, Stewart-Wynne EG. Predicting survival for 1 year among different subtypes of stroke. Results from the Perth Community Stroke Study. Stroke. 1994;25:1935-44.

Ellekjaer H, Holmen J, Indredavik B, Terent A. Epidemiology of stroke in Innherred, Norway, 1994 to 1996. Incidence and 30-day case-fatality rate. Stroke. 1997;28:2180-4.

Di Carlo A, Inzitari D, Galati F, Baldereschi M, Giunta V, Grillo G, et al. A prospective community-based study of stroke in Southern Italy: the Vibo Valentia incidence of stroke study (VISS). Methodology, incidence and case fatality at 28 days, 3 and 12 months. Cerebrovascular diseases (Basel, Switzerland). 2003;16:410-7.

Tsiskaridze A, Djibuti M, van Melle G, Lomidze G, Apridonidze S, Gauarashvili I, et al. Stroke incidence and 30-day case-fatality in a suburb of Tbilisi: results of the first prospective population-based study in Georgia. Stroke. 2004;35:2523-8.

Lavados PM, Sacks C, Prina L, Escobar A, Tossi C, Araya F, et al. Incidence, 30-day case-fatality rate, and prognosis of stroke in Iquique, Chile: a 2-year community-based prospective study (PISCIS project). Lancet (London, England). 2005;365:2206-15.

Corbin DO, Poddar V, Hennis A, Gaskin A, Rambarat C, Wilks R, et al. Incidence and case fatality rates of first-ever stroke in a black Caribbean population: the Barbados Register of Strokes. Stroke. 2004;35:1254-8.

Nam HU, Huh JS, Yoo JN, Hwang JM, Lee BJ, Min YS, et al. Effect of dominant hand paralysis on quality of life in patients with subacute stroke. Annals of rehabilitation medicine. 2014;38:450-7.

Haacke C, Althaus A, Spottke A, Siebert U, Back T, Dodel R. Long-Term Outcome After Stroke:Evaluating Health-Related Quality of Life Using Utility Measurements. Stroke. 2006;37:6.

King RB. Quality of life after stroke. Stroke. 1996;27:1467-72.

Harris JE, Eng JJ. Individuals with the dominant hand affected following stroke demonstrate less impairment than those with the nondominant hand affected. Neurorehabilitation and neural repair 2006;20:380-9.

Spaulding SJ, McPherson JJ, Strachota E, Kuphal M, Ramponi M. Jebsen hand function test: performance of the uninvolved hand in hemiplegia and of right-handed, right and left hemiplegic persons. Archives of physical medicine and rehabilitation. 1988;69:419-22.

Hopman WM, Verner J. Quality of life during and after inpatient stroke rehabilitation. Stroke. 2003;34:801-5.

Kelley RE, Borazanci AP. Stroke rehabilitation. Neurological research. 2009;31:832-40.

Kwok T, Lo RS, Wong E, Wai-Kwong T, Mok V, Kai-Sing W. Quality of life of stroke survivors: a 1-year follow-up study. Archives of physical medicine and rehabilitation. 2006;87:1177-82.

Paolucci S, Antonucci G, Grasso MG, Bragoni M, Coiro P, De Angelis D, et al. Functional outcome of ischemic and hemorrhagic stroke patients after inpatient rehabilitation. Stroke. 2003;34(12):2861-5.

Pyun SB, Kim SH, Hahn MS, Kwon HK, Lee HJ. Quality of life after stroke. J Korean Academy Rehabilitation Medicine. 1999;23(2):233-9.

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Published

2018-01-24

How to Cite

Singh, A. K., Chaturvedi, P., Maurya, P. K., Kulshreshtha, D., Qavi, A., & Thacker, A. (2018). Early PNF exercises functional outcome and quality in patients with stroke of urban and rural area in Uttar Pradesh: a prospective community based study. International Journal of Research in Medical Sciences, 6(2), 639–644. https://doi.org/10.18203/2320-6012.ijrms20180313

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Original Research Articles