Effect of Proprioceptive Neuromuscular Facilitation on Blood Pressure

Hypertension Clinical Trial

Official title:

Effects of Proprioceptive Neuromuscular Facilitation Exercise on Blood Pressure and Ankle Brachial Index in Patient With Hypertension

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT05110365
• Other study ID #: REC/01045 Raja Saddam
• Status: Completed
• Phase: N/A
• Start date: June 26, 2021
• Est. completion date: August 18, 2022

Study information

• Verified date: September 2022
• Source: Riphah International University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

To determine the effect of Proprioceptive Neuromuscular Facilitation exercise on blood pressure in patient with mild to moderate hypertension.Both genders will be included.Patients aged between 40 and 60 years with mild and moderate hypertension.Systolic blood pressure 130-160 mmHg or Diastolic Blood Pressure 80-100 mmHg.

Sphygmomanometer and EuroQoL five-dimensional instrument would be used for the 'Pre' & 'Post' assessment.

Description:

There is a belief that proprioceptive neuromuscular facilitation exercises cause cardiac overload as blood pressure in immediately influenced by exercise but Pereira concluded in his research that proprioceptive neuromuscular facilitation exercises with minimum repetitions are safe for hypertensive or cardiovascular patients because in his study there is no increase in blood pressure in older women after performing three different types of PNF exercises. Pereira discovered that rhythmic initiation , dynamic reversals , and combination of isotonic techniques did not raise blood pressure levels, thus it is recommended to use up to five repeats of repetition maximum . One study observed at the effects of passive and modified proprioceptive neuromuscular facilitation (PNF)stretching techniques on acute systolic and diastolic blood pressure responses. All PNF treatments were beneficial in increasing Range of motion, as we all know.

PNF improves Range Of Motion while avoiding an increase in Systolic blood pressure in one or two trials, but increases Systolic blood pressure in a third trial. Blood pressure rises by 40% with conventional exercise programmers and because PNF involves near-maximal resistance,researchers anticipated a considerable rise in blood pressure during PNF execution. It was discovered that elderly subjects could not readily execute more than five to seven repetitions of PNF exercises, which has also been shown by others. Due to the low repetition number of each movement pattern, the results showed that PNF did not induce a high enough workload to increase blood pressure in the elderly.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 24
• Est. completion date: August 18, 2022
• Est. primary completion date: August 15, 2022
• Accepts healthy volunteers: No
• Gender: All
• Age group: 40 Years to 60 Years

Eligibility

Inclusion Criteria:

• Both genders will be included.

• Patients aged between 40 and 60 years with mild and moderate hypertension.

• Systolic blood pressure 130-160 mmHg or Diastolic blood pressure 80-100 mmHg.

• Mild and moderate hypertension with diabetes

Exclusion Criteria:

• Severe hypertensive patients.

• Patient on smoking

• Patient with severe complications and comorbidities.

• Not willing to give consent/ data

Related Conditions & MeSH terms

• Hypertension

Intervention

Other:
• Proprioceptive Neuromuscular Facilitation
The patient will be provided with mild to moderate resistance PNF pattern which is a type of Endurance training which decreases BP through a reduction in systemic vascular resistance(15).In a regimen as follow with the frequency of 3 days a week, a repetition of 3 sets for one hour and a total duration of 3 months(16). The PNF patterns will be diagonal 1 (D1) and diagonal 2 (D2) patterns. Both patterns are subdivided into: A) Moving into Flexion: the toes start flexed and ends extended. Ankle and foot start plantar flexed; everted and ends dorsiflexed inverted. Tibia starts externally rotated and ends internally rotated. Knee starts extended, and ends flexed. The hip starts extended, abducted, internally rotated and ends flexed, adducted, externally rotated.B) Moving into Extension: The start and end are reversed to "D1 Moving into Flexion"

Locations

Country	Name	City	State
Pakistan	Valley Medical Complex Abbottabad	Abbottabad	Kpk

Sponsors (1)

Lead Sponsor	Collaborator
Riphah International University

Country where clinical trial is conducted

Pakistan, 

References & Publications (9)

Fagard RH, Cornelissen VA. Effect of exercise on blood pressure control in hypertensive patients. Eur J Cardiovasc Prev Rehabil. 2007 Feb;14(1):12-7. — View Citation

Hindle KB, Whitcomb TJ, Briggs WO, Hong J. Proprioceptive Neuromuscular Facilitation (PNF): Its Mechanisms and Effects on Range of Motion and Muscular Function. J Hum Kinet. 2012 Mar;31:105-13. doi: 10.2478/v10078-012-0011-y. Epub 2012 Apr 3. — View Citation

Kim EK, Lee DK, Kim YM. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients. J Phys Ther Sci. 2015 Jan;27(1):213-5. doi: 10.1589/jpts.27.213. Epub 2015 Jan 9. — View Citation

Linke A, Erbs S, Hambrecht R. Effects of exercise training upon endothelial function in patients with cardiovascular disease. Front Biosci. 2008 Jan 1;13:424-32. Review. — View Citation

Papadopoulos DP, Sanidas EA, Viniou NA, Gennimata V, Chantziara V, Barbetseas I, Makris TK. Cardiovascular hypertensive emergencies. Curr Hypertens Rep. 2015 Feb;17(2):5. doi: 10.1007/s11906-014-0515-z. Review. — View Citation

Papaioannou TG, Oikonomou E, Lazaros G, Christoforatou E, Vogiatzi G, Tsalamandris S, Chasikidis C, Kalambogias A, Mavratzas T, Stofa E, Mystakidi VC, Latsios G, Deftereos S, Tousoulis D. Arterial stiffness and subclinical aortic damage of reclassified subjects as stage 1 hypertension according to the new 2017 ACC/AHA blood pressure guidelines. Vasa. 2019 May;48(3):236-243. doi: 10.1024/0301-1526/a000765. Epub 2018 Dec 10. — View Citation

Pereira MP. Proprioceptive neuromuscular facilitation does not increase blood pressure of healthy elderly women. Physiother Theory Pract. 2012 Jul;28(5):412-6. doi: 10.3109/09593985.2011.609582. Epub 2011 Oct 18. — View Citation

Singh S, Shankar R, Singh GP. Prevalence and Associated Risk Factors of Hypertension: A Cross-Sectional Study in Urban Varanasi. Int J Hypertens. 2017;2017:5491838. doi: 10.1155/2017/5491838. Epub 2017 Dec 3. — View Citation

Varounis C, Katsi V, Nihoyannopoulos P, Lekakis J, Tousoulis D. Cardiovascular Hypertensive Crisis: Recent Evidence and Review of the Literature. Front Cardiovasc Med. 2017 Jan 10;3:51. doi: 10.3389/fcvm.2016.00051. eCollection 2016. Review. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	sphygmomanometer	sphygmomanometer will be used for measuring blood pressure and ankle brachial index	12 weeks
Secondary	(EuroQoL five-dimensional instrument )	quality of life measures the five dimension mobility,selfcare,usual activities,pain and anxiety.; 0 for minimum 5 for maximum	12 weeks