Dynamic Neural Mobilization Versus Proprioceptive Neuromuscular Facilitation On Grip Strength And Upper Limb Function In Sub-Acute Stroke Subjects

Background: Neural mobilization helps to reduce spasticity, improve muscle flexibility and balance thereby improving mobility and elasticity of the nervous system in stroke subjects. Objectives: The objective of the study was to compare the effect of Dynamic Neural Mobilization and Proprioceptive Neuromuscular Facilitation on grip strength and upper limb function in sub-acute stroke subjects. Materials and methods: 30 post-stroke subjects were recruited for the study based on the inclusion and exclusion criteria and were randomly divided into two groups. 15 subjects in Group A received Dynamic Neural Mobilization while 15 subjects in Group B received Proprioceptive Neuromuscular Facilitation. The treatment sessions were scheduled for 30 minutes per day, 5 times per week, for 4 weeks. Subjects were assessed for the upper limb function and grip strength prior to- and post-intervention using Fugl Meyer Assessment –Upper Extremity (FMA-UE) subscale and Hand Held Dynamometer. Results: The pre-test score of FMA-UE and grip strength were 33.60±7.13 and 2.92±1.07 in Group A and 32.60±9.85 and 1.70±0.68 in Group B respectively. The post-test scores of FMA-UE and grip strength were 41.00±7.07 and 5.12±203 in Group A and 34.13±10.40 and 3.32±0.82 in Group B. Within group comparison showed significant improvement in Group A and in grip strength of Group B subjects. FMA-UE in Group B did not show significant results compared to pre-test scores. Between groups comparison showed statistically significant improvement in Group A in both the outcomes. Conclusion: Based on the results, it can be concluded that Dynamic Neural Mobilization was more effective than Proprioceptive Neuromuscular Facilitation in improving grip strength and upper limb function in subacute stroke subjects.