Effect of Upper Limb Proprioceptive Neuromuscular Facilitation with Resistance Training on Respiratory Muscle Strength in Quadriplegics: A Randomized Controlled Trial

Abstract

OBJECTIVES Spinal cord injuries lead to impairment of the respiratory system due to paresis or paralysis of the respiratory muscles leading to respiratory insufficiency, which is dependent on the level and completeness of the injury. The aim of this study was to evaluate the effect of upper limb proprioceptive neuromuscular facilitation (PNF) combined with resistance training on respiratory muscle strength and perceived difficulty of breathing in individuals with tetraplegia. METHODS 26 participants with traumatic tetraplegia C5-C8 participated in the study. They were then allocated in two different groups. PNF Group received upper extremity PNF combined with resistance training for 10 repetitions per set, 3 sets 3 times a week for 4 weeks, and CONT Group received respiratory training with triflow type incentive spirometer. Participants were evaluated for maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and modified borg scale (MBS). RESULTS After four weeks of intervention, there were significant improvement in the scores of MIP, MEP, MBS in both groups separately. Also between group comparison showed significant improvement in scores of MIP (P=0.004), MEP (P=0.004), MBS (P=0.001) in PNF Group as compared to CONT Group. CONCLUSIONS This study concludes that there was significant improvement in respiratory muscle strength and rate of perceived difficulty of breathing using upper limb PNF combined with resistance training in tetraplegics.

Keywords

• proprioceptive neuromuscular
• facilitation
• rehabilitation
• resistance training
• tetraplegia