Proprioceptive Neuromuscular Facilitation and Mirror Therapy Methods Are Comparable Methods of Rehabilitation after a First-Ever Ischemic Stroke: A Randomized Study

Abstract

Stroke is a serious cause of premature death among adults and the reason for much long-term disability. Understanding the mechanisms of disability and the potential for recovery of stroke patients should be one of the highest priorities of the health care system. Neurorehabilitation of post-stroke patients focuses on functional recovery by activating mechanisms of natural reorganization. Proprioceptive neuromuscular facilitation (PNF) and mirror therapy (MT) are neurorehabilitation methods activating brain plasticity, and their clinical utility for stroke survivors is still under studied. This study compared two neurorehabilitation methods using PNF or MT on functional recovery in patients after a first-ever ischemic stroke. This prospective and interventional randomized clinical study involved a group of 50 patients (34 males and 16 females) with first-ever ischemic stroke, aged 48–82 years being in the recovery-compensation stage and admitted to the unit for early post-stroke rehabilitation. Patients were randomly enrolled into two groups in terms of rehabilitation method used: PNF (n = 26) or MT (n = 24). Barthel Index (BI) was used for assessing functional status at baseline (M0), and 3 (M1) and 6 weeks (M2) after intervention), and modified Rankin Scale (mRS) was used for assessing a disability level at baseline (M0), and 6 weeks (M2) after the intervention. Statistically significant differences were noted in the two study groups in BI (main effect: <0.05). There was an improvement in the MT group between M1 and M2 by 3.6 points, M1 and M3 by 6.9 points, and M2 and M3 by 6.9 points. For the PNF group, there were differences between M1 and M2 by 4.1 points, M1 and M3 by 7.2 points, and M2 and M3 by 3.1 points. Moreover, statistically significant differences were noted in both groups in mRS (main effect: p < 0.05). There was a decrease of 2.2 points in the MT group between M1 and M2 measurements. For the PNF group, there were differences between M1 and M2 by 2.3 points. There were no statistically significant differences between the MT and PNF groups in both BI and mRS scores (p < 0.05). In conclusion, both PNF and MT neurorehabilitation methods could be useful for improving functional status and reducing disability level in patients after first-ever stroke during the regenerative-compensatory stage.