The Efficacy of Proprioceptive Neuromuscular Facilitation-Based Robot-Assisted Therapy in Individuals With Stroke: A Randomized Controlled Trial
Archives of Physical Medicine and Rehabilitation, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.apmr.2026.04.027
- Dergi Adı: Archives of Physical Medicine and Rehabilitation
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE, MLA - Modern Language Association Database, SportDiscus, MLA International Bibliography
- Anahtar Kelimeler: Motor performance, Proprioceptive neuromuscular facilitation, Rehabilitation, Robot-assisted therapies, Stroke, Upper extremity
- Hacettepe Üniversitesi Adresli: Evet
Özet
Objectives: The effects of combining robot-assisted therapy (RAT) with other physiotherapy approaches in stroke rehabilitation are of current interest. The aim of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF)–based RAT on upper extremity (UE) motor performance, spasticity, activities of daily living (ADL), and quality of life (QoL) in individuals with stroke. Design: Single-blind randomized controlled trial. Setting: Neurologic rehabilitation unit at a university. Participants: Thirty-nine individuals with stroke were enrolled in the study (RAT, n=20; Control group [CG], n=19). Interventions: Both groups received 30 minutes of conventional rehabilitation per session; in addition, RAT completed 30 minutes of PNF and commonly used daily movement patterns with a robotic device, whereas CG performed the same exercises manually. All interventions were delivered 3 days per week for 8 weeks (60 min/session). Main Outcome Measures: Participants’ UE performance was assessed using the Fugl-Meyer Upper Extremity Scale, Action Research Arm Test, Box and Block Test, and Nine-Hole Peg Test. Spasticity severity was assessed using the Modified Ashworth Scale, and ADL, QOL were assessed using ACTIVLIM, ABILHAND, Stroke Impact Scale (SIS). Results: Mean age was 58.40±14.95 years in the RAT and 54.79±16.47 years in the CG. Fugl-Meyer Upper Extremity Scale, ACTIVLIM, ABILHAND, and SIS significantly increased in all groups after treatment (P<.05). At posttreatment, RAT showed significantly greater improvements than CG in Fugl-Meyer Upper Extremity Scale, Action Research Arm Test, Box and Block Test, Nine-Hole Peg Test, and muscle spasticity. In addition, decreases in wrist flexor and elbow flexor measurements were associated with 8.065- and 5.051-fold higher odds of being in the RAT, respectively. Conclusions: Conventional treatment combined with PNF-based RAT application has been shown to be more effective than traditional training in improving spasticity, motor performance, ADL, and QoL of patients with stroke.