A Comparative study on the Effectiveness of Bobath Approach and Proprioceptive Neuromuscular Facilitation Techniques in Gait Training and Balance among Chronic Stroke Patients

INTRODUCTION: Stroke, also known as cerebrovascular accident (CVA) is an acute neurologic injury in which the blood supply to a part of the brain is interrupted. It is reported that 1.2% of total deaths occur in India due to stroke. Stroke is the 3rd leading cause of death and the 2nd leading cause of disability. Major risk factors are Hypertension, Heart disease and Diabetes. Apart from these, other risk factors for stroke are cigarette smoking, blood cholesterols, oral contraceptives, obesity, alcohol, social deprivation and physical inactivity. Recent studies showed that the age adjusted annual incidence rate was 105 per 100,000 in the urban community and 262 per 100,000 in the rural community. Stroke represented 1.2% of total deaths in India. OBJECTIVES: To evaluate the effectiveness of Bobath approach in gait training and Balance among chronic stroke patients. To evaluate the effectiveness of Proprioceptive Neuromuscular Facilitation in Gait training and balance among chronic patients. To compare the effects of Bobath approach and Proprioceptive Neuromusular Facilitation Techniques in Gait training and Balance among chronic stroke patients. METHODOLOGY: Study Design: Pre- test and post – test experimental design. comparative study. Study Settings: The study was conducted at Outpatient department, Prakash hospital, Udumalpet. Sample Size: 20 Patients were selected as samples for the study and divided into two groups. Criteria for Selection: Inclusion Criteria: Both Gender, Patient between 50 – 60 years, Brunstrom stage -3, Patients with ACA ischemic infarction of more than 6 months post – stroke duration. Exclusion criteria: Patients with severe disabling arthritis, Patients with any cardiac disease, Cognitive dysfunction, Movement disorder patients, Non co-operative patients, Any other neurological deficits like Parkinson’s disease, Past history of seizures, Visual, Cognitive - Perceptual problems. RESULTS : 20 stroke patients was treated for one session a day like that 6 weeks. Before starting the treatment, Assessed by Wisconsin gait scale and Tinnetti balance assessment tool Analysis of Dependent Variable of bobath approach in Group A: The calculated paired ‘t’ value the ‘t’ table value is 13.44 at 0.005 level of significance. Hence, the calculated ‘t’ value is greater than the table ‘t’ value there is significant difference in upper extremity function following motor relearning programme with trunk restraint among stroke subjects. Analysis of Dependent variable of proprioceptive neuromuscular technique Group B: The calculated paired ‘t’ value is 19.44 and the table ‘t’ value is 3.250 at 0.005 level of significant. Hence, the calculated ‘t’ value is greater than the table ‘t’ value there is significant difference in upper extremity function following motor relearning program in stroke subjects. CONCLUSION: An experimental study was conducted to investigate the effectiveness of bobath approach and proprioceptive Neuromuscular Facilitation techniques in gait training and balance among chronic stroke patients. The study was conducted on 20 subjects. The subjects were divided into two groups, Group A and Group B. Group A received Bobath approach. Group B received Proprioceptive Neuromuscular Facilitation. The study was conducted to compare effectiveness of Bobath approach and Proprioceptive Neuromuscular Facilitation in improving Gait training and balance in chronic stroke patients. The statistical result shows that there is improvement in both groups. But when comparing both it was found that Proprioceptive neuromuscular Facilitation is more effective than bobath approach among chronic stroke patients