Roods vs PNF for Upper Limb Function in Acute MCA Stroke

NCT07616622 | Enrolling By Invitation

• 1 other identifier: TUF/EIRB/ 220 /26
• Study Type: interventional
• Target: 28
• Locations: 1 country
• Sites: 1

Brief Summary

Middle cerebral artery (MCA) stroke often causes weakness or stiffness in the arm and hand, making daily activities difficult. This study compares two physical therapy approaches - Rood's facilitatory techniques (using touch, quick stretch, and ice to activate muscles) and PNF sequential patterns (using diagonal movement patterns) - to improve arm function in acute stroke patients. Both groups will also receive neuromuscular electrical stimulation (NMES). A total of 28 patients will be randomly assigned to one of two groups and receive treatment three times per week for eight weeks. Arm function will be measured using the Fugl-Meyer Assessment, and muscle stiffness will be measured using the Modified Ashworth Scale before and after treatment.

Conditions

Stroke; Middle Cerebral Artery Infarction

Keywords

Stroke rehabilitation; Upper limb; PNF; Rood's technique; NMES; Acute stroke

Outcome Measures

Primary Outcomes (1)

• Upper Limb Motor Function

  Fugl-Meyer Assessment for Upper Extremity (FMA-UE). A standardized 66-point scale assessing motor recovery after stroke based on Brunnstrom stages. Evaluates shoulder, elbow, wrist, hand, and coordination functions. Higher scores indicate better motor function.

  Baseline and 8 weeks (post-intervention)

Secondary Outcomes (1)

• Muscle Tone

  Baseline and 8 weeks (post-intervention)

Study Arms (2)

Rood's Facilitatory Techniques Group

EXPERIMENTAL

Participants receive neuromuscular electrical stimulation (NMES) followed by Rood's facilitatory techniques including quick stretch, tactile stimulation for 10-20 seconds over muscle belly, and icing for 5-7 seconds on tendon or muscle surface. Interventions delivered three times per week for eight weeks.

Device: Neuromuscular Electrical Stimulation; Procedure: Rood's Facilitatory Techniques

PNF Sequential Pattern Group

ACTIVE COMPARATOR

Participants receive neuromuscular electrical stimulation (NMES) followed by PNF sequential training with upper limb diagonal functional patterns (D1 and D2), including rhythmic initiation, dynamic reversals, repetitive contractions, and isotonic contractions with moderate resistance (8-12 repetitions per pattern over 20-30 minutes). Interventions delivered three times per week for eight weeks.

Device: Neuromuscular Electrical Stimulation; Procedure: Proprioceptive Neuromuscular Facilitation

Interventions

Neuromuscular Electrical Stimulation DEVICE

Biphasic waveform NMES at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable but visible muscle contraction. Applied to affected upper limb for 30 minutes per session, three times per week for eight weeks.

PNF Sequential Pattern Group; Rood's Facilitatory Techniques Group

Rood's Facilitatory Techniques PROCEDURE

Quick stretch applied before or during movement to activate muscle spindles; tactile stimulation (light stroking) over muscle belly for 10-20 seconds; icing for 5-7 seconds on tendon or muscle surface immediately preceding activation. Applied three times per week for eight weeks following NMES.

Rood's Facilitatory Techniques Group

Proprioceptive Neuromuscular Facilitation PROCEDURE

PNF sequential training with upper limb diagonal functional patterns (D1 and D2). Techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance according to patient's capabilities. Each session includes 8-12 repetitions per pattern over 20-30 minutes, three times per week for eight weeks.

PNF Sequential Pattern Group

Eligibility Criteria

• Age: 40 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults (40-60 years) with confirmed MCA stroke (ischemic or hemorrhagic) on neuroimaging (CT or MRI)
• Mild to moderate upper limb motor dysfunction with MRC ≥2 for proximal limb motor strength
• Cognitive competence to understand instructions (MoCA ≥19 or equivalent)
• First stroke, acute or subacute phase
• Willingness to provide written informed consent
• Both male and female genders

You may not qualify if:

• Severe coexisting medical disorders (heart, liver, kidney failure; malignant tumors)
• Fixed musculoskeletal abnormalities or contracture in affected upper limb
• Severe cognitive impairment or aphasia preventing adherence or consent (MMSE below threshold)
• Skin sores, ulcers, or hypersensitivity (e.g., to cold) contraindicated for sensory stimulation
• Refusal or inability to give informed consent

Sponsors & Collaborators

• University of Faisalabad: lead

Study Sites (1)

The University of Faisalabad

Faisalābad, Punjab Province, 3800, Pakistan

Location

MeSH Terms

Conditions

Stroke; Infarction, Middle Cerebral Artery

Interventions

Muscle Stretching Exercises

Condition Hierarchy (Ancestors)

Cerebrovascular Disorders; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Vascular Diseases; Cardiovascular Diseases; Cerebral Infarction; Brain Infarction; Brain Ischemia; Cerebral Arterial Diseases; Intracranial Arterial Diseases; Infarction; Ischemia; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Necrosis

Intervention Hierarchy (Ancestors)

Exercise Therapy; Rehabilitation; Aftercare; Continuity of Patient Care; Patient Care; Therapeutics; Physical Therapy Modalities; Exercise; Motor Activity; Movement; Musculoskeletal Physiological Phenomena; Musculoskeletal and Neural Physiological Phenomena

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: Only participants are unaware of group allocation
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor, Department of Rehabilitation Sciences

Study Record Dates

• First Submitted: May 23, 2026
• First Posted: June 1, 2026
• Study Start: January 1, 2026
• Primary Completion: June 15, 2026
• Study Completion (Estimated): July 15, 2026
• Last Updated: June 1, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)