Comparison of Upper Limb Functional Outcomes in Stroke patients receiving Motor Relearning Programme (MRP) Vs. Proprioceptive Neuromuscular Facilitation (PNF)

BACK GROUND: The patients affected by stroke have been found to experience variety of difficulties. These disabilities produce physical, psychological and functional limitations in their day to day life. The major disruptive factor impending rehabilitation is the functional limitations of affected extremities. This study aims to compare two different concepts in clinical rehabilitation- First the specific reflex based neuro-facilitation technique of 1960’s PNF and Second motor control and motor learning concept based technique of 1980’s MRP on the upper extremity functions in stroke patients. AIM OF THE STUDY: The aim of the study was to compare the two techniques- the Poprioceptive Neuromuscular Facilitation (PNF) and Motor Relearning Program (MRP) on the upper limb functions in stroke patients. METHODOLOGY: A total of 30 patients suffering from stroke were selected and randomly allocated to two experimental groups (Group I and Group II ) till the number of 15 subjects were reached in each group. Assessments were done to measure level of upper extremity function using MAS (Motor Assessment Scale), functional independence using FIM (Functional Independence Measures) and Spasticity using Modified Ashworth scale. A structured- Occupational therapy protocols were tailored on PNF and MRP techniques and implemented. Group I is treated with MRP protocol and Group II is treated with PNF protocol. RESULT: After the implementation there is no significant improvement in MRP protocol than PNF protocol in improving upper limb functions. DISCUSSION: Occupational therapy activities are always graded and goal directed which depends primarily in the training of task parameters and functional adaptation. These occupational Therapy strategies have yielded improvements of in both PNF and MRP techniques. And there is no significant improvement in MRP than PNF. The result shows that no technique could show 100% improvement but they work on different aspects of disability. Therefore altogether these techniques will help in the improvement of the functional status of the stroke patients and there by reducing the disability related to stroke. CONCLUSION: The conclusion of the present study is that no one technique is found to be more effective over the other and the hypothesis that MRP is more effective in treatment of upper limb functions in stoke patients is found to be wrong. Both the treatment techniques were found to improve the upper limb functions in one or the other aspect and there fore it is more beneficial if the techniques will be used in adjunct to each other for rehabilitation so that the overall all improvement could be achieved