【論文摘要】A Systematic Review of Proprioceptive Neuromuscular Facilitation on Improvement of Balance and Gait in Patients With Chronic Stroke

【論文摘要】以系統性文獻回顧探討本體感覺神經肌肉誘發技術對於慢性中風患者平衡及步態之治療效果

Phan The Nguyen ； 周立偉(Li-Wei Chou) ； 謝悅齡(Yueh-Ling Hsieh)

《物理治療》 43卷4期 (2018/12) Pp. 303-304

https://doi.org/10.6215/FJPT.201812.O12

摘要

Background and Purpose: Although proprioceptive neuromuscular facilitation (PNF) is currently approved for potential neuromuscular recovery and restoration, its efficacy has not been consistent for reducing disability in patients with chronic stroke. The aim of this systematic review study is to identify the potential benefits of using PNF to improve balance and gait of individuals with chronic stroke. Methods: A systematic electronic search of the scientific literature was performed in PubMed, Physiotherapy Evidence Database (PEDro), Cochrane Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Web of Science for English articles published between January 1990 and January 2018 reporting PNF intervention in stroke patients. Using preselected inclusion criteria, titles and abstracts were screened and full-text articles were reviewed. Study eligibility criteria included randomized controlled trials (RCT), participants more than 5 in each group, more than 6 months after stroke onset, and more than 18 years old, as well as PNF alone or combine techniques. Results: A total 12 studies of 415 participants were included in this systematic review. The PEDro scores ranged from 4 to 7 points. Eleven of included studies demonstrated significant positive effects of PNF on balance and gait recovery in patients with chronic stroke. The results suggested that gait parameters, stride length, cadence, gait velocity, Berg Balance Scale, and scores of Timed Up And Go Test, and a functional reach test were improved in stroke patients after PNF approaches. Conclusion: This systematic review suggested an overall positive effect of PNF interventions on balance and gait for stroke patients. Given the present evidence, future research using meta-analyses to evaluate the long-term efficacy of PNF is needed. Clinical Relevance: We highlighted the need and provided recommendations for well-designed RCT to determine the effect of PNF interventions on clinical outcomes, with specific focus on reaching functional goals and providing the right strategy, as part of an integral stroke care approach.