This study aims to fill this gap by investigating the effects of scapular and upper limb proprioceptive neuromuscular facilitation techniques on shoulder pain, upper limb function \& gait in stroke with scapular dyskinesia. This study is a randomized control trial that includes 44 patients which were randomly divided into two groups each containing 22 participants. Experimental group will receive scapular PNF coupled with upper limb PNF and conventional physiotherapy treatment and Control group will receive only Conventional treatment.
• Sub-acute
MCA
Age bracket 40-65 years.
Gender Male or Female.
• Inability to communicate/understand instructions.
Stroke with other neurological conditions.
Patient with any other psychological and medical condition.
Parallel
Scapular PNF
Other interventionscapular PNF coupled with upper limb PNF and conventional physiotherapy treatment . It was a 6 week's intervention in which patients got treatment protocol for 30 mints 5 times a week.
Conventional treatment
Other interventionConventional treatment. It includes closed kinematic chain exercises of upper limb, upper and lower extremity range of motion exercises, stretching and strengthening exercises for upper limb, trunk and lower limb, balance \& coordination, manual dexterity exercises (e.g., grasp release), and teaching of ADLs.. It was a 6 week's intervention in which patients got treatment protocol for 30 mints 5 times a week.
Fugl-Meyer Assessment of Upper Extremity (FMA-UE)
After a stroke, the FMA-UE is frequently used to evaluate and track recovery in hemiplegic patients.. It is a specific tool for quantifying upper limb impairment and rehabilitation outcomes in stroke patients with hemiparesis. Using a 3-point ordinal scale, the assessment rates the patient's ability to complete each task: 0 denotes incapacity to execute, 1 denotes partial completion, and 2 denotes full performance. All item scores, which range from 0 to 126, are added up to determine the final score.
Dynamic gait index (DGI)
A participant's ability to maintain walking balance while adjusting to different task demands and dynamic situations is evaluated by the Dynamic Gait Index (DGI). It is especially helpful for people who have balance and vestibular problems, as well as those who are at risk of falling. Every item has a rating between 0 and 3, where 0 denotes significant impairment and 3 denotes normal performance. 24 is the maximum possible score. A total score of less than 19 out of 24 indicates that older adults are more likely to fall, whereas a score of more than 22 indicates safe walking.
Visual Analogue Scale
Hayes and Patterson employed the visual analog scale (VAS), a pain rating tool, for the first time in 1921. A single handwritten mark is placed at one point along a 10-cm line that represents a continuum between the two ends of the scale, with "no pain" at the left end (0 cm) and the "worst pain" at the right end (10 cm). Self-identified evaluations of symptoms are used to calculate scores. The patient's discomfort is calculated by measuring the distance in centimeters between the patient's marks and the scale's beginning point (left end). The figures can be used to gauge a patient's pain progression or to compare pain across people with comparable diseases. 0 No pain, 1-3 slight pain, 4-6 moderate pain, and 7-10 excruciating pain.
10-Meter Walk Test (10MWT)
The test calculates walking speed over a brief distance in meters per second. To the closest tenth of a second, the total time spent walking six meters (m) is recorded. Then, 6 meters is divided by the whole time (in seconds) to convert this distance to m/s. The following categories apply to walking speeds: Family Ambulatory \<0.40 m/s; Community Ambulator ≥0.80 m/s; Limited Community Ambulator 0.40 to \<0.80 m/s
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