Acute Effects of Proprioceptive Neuromuscular Facilitation Compared to Active Range of Motion Exercises on Respiratory and Hemodynamic Responses in Critically Ill Patients: A Pilot Study

Purpose: Proprioceptive Neuromuscular Facilitation (PNF) is a widely used rehabilitation approach. However, there are limited studies examining the effect of PNF in a critical care setting. Therefore, we aimed to investigate the acute effects of PNF-based exercises compared to active range of motion (ROM) exercises on respiratory and hemodynamic responses in critically ill patients. Material and Methods: Twenty-one spontaneously breathing non-intubated adult critically ill patients were randomly assigned to either PNF-based exercise group (n=10) or active ROM exercise group (n=11). Respiratory rate (RR; breath/min), peripheral oxygen saturation (SpO2; %), heart rate (HR; beat/min), systolic blood pressure (SBP; mmHg), diastolic blood pressure (DBP; mmHg) and mean blood pressure (MBP; mmHg) were measured using bedside monitoring system. The dyspnea severity and perceived exertion of patients were evaluated using the 0-10 numeric rating scale. Data were recorded at before, immediately after, and 5 minutes after (recovery) each exercise session. Results: Two-way repeated-measures ANOVA revealed that there were no clinically significant differences between groups in RR (breath/min), SpO2 (%), HR (beat/min), SBP (mmHg), DBP (mmHg), and MBP (mmHg) variables, the severity of dyspnea (score) and perceived exertion (score) (P>0.05). Conclusion: In the treatment of spontaneously breathing non-intubated patients, exercises based on the PNF technique can be safely performed in terms of respiratory and hemodynamic responses compared to active ROM exercises in a critical care setting.