Effectiveness of Proprioceptive Neuromuscular Facilitation in the Stroke Population: A Systematic Review

Purpose: The purpose of this systematic review was to evaluate the effectiveness of proprioceptive neuromuscular facilitation (PNF) for treatment of patients post stroke. Methods: A search of electronic databases (Pubmed, CINHAL, PeDRO, and Scopus) was conducted with the keywords "proprioceptive neuromuscular facilitation" and "stroke". This yielded 172 articles and 89 remained after screening for duplicates. Thirty articles were included for final review based on exclusion criteria. Studies included adults 18 years and older after a cerebrovascular accident (CVA), PNF as the main intervention, and availability in English. Results: Thirty articles met the criteria: 16 randomized control trials, 7 quasi-experimental, 3 case controls, and 4 case reports. Sample size ranged from 1 to 131 participants and 802 subjects were analyzed. Age ranged from 32 to 82. Session duration ranged from 10 to 60 minutes and intervention length ranged from 1 to 12 weeks. Frequency ranged from 1 to 6 sessions per week. Many outcome measures were used, and improvements were found in the following domains: functional outcome measures, gait/mobility, tone/spasticity, stroke specific assessment, balance, strength, range of motion, sensation, and dysphagia. Conclusion: Based on this review, PNF is effective for addressing the dysfunctions commonly seen after a stroke. No adverse outcomes were reported. Variability existed in study design concerning population, frequency, duration, PNF techniques, and outcome measures. The majority of studies had small sample sizes & the overall number of studies were low. Additional research is needed to further support the effectiveness of PNF with patients after CVA.