Sensor-Augmented Lower-Limb Proprioceptive Neuromuscular Facilitation for Balance Recovery after Middle Cerebral Artery Stroke: A Randomized Controlled Trial

Abdul Rahim Shaik

doi:10.47310/jpms202515S0132

Author(s)

Abdul Rahim Shaik College of Applied Medical Sciences, Majmaah University, Al Majma’ah , Saudi Arabia

Abstract

Background: Balance impairment is a major contributor to falls, mobility restriction, and reduced quality of life following middle cerebral artery (MCA) stroke. Conventional physiotherapy improves balance primarily through repetitive task practice, yet outcomes often plateau due to limited sensory feedback and inadequate engagement of postural control mechanisms. Objective: To examine the effectiveness of sensor-augmented lower-limb proprioceptive neuromuscular facilitation (SA-PNF) incorporating real-time biofeedback on balance, postural stability, and functional mobility in individuals with MCA stroke. Methods: Thirty individuals with chronic MCA stroke (age 45-75 years) and moderate balance impairment were randomly allocated to SA-PNF (n = 15) or conventional physiotherapy (n = 15). Interventions were delivered three times weekly for eight weeks. Primary outcomes included the Berg Balance Scale (BBS) and instrumented postural sway parameters. Secondary outcomes were Timed Up and Go (TUG), Limits of Stability (LOS), and gait symmetry index. Data were analyzed using mixed-model ANOVA. Results: Both groups showed significant improvements over time (p<0.05). However, the SAPNF group demonstrated significantly greater gains in BBS (+12.1 vs +5.3), TUG (-8.2 s vs -3.6 s), mediolateral sway reduction (-34% vs -14%), and LOS excursion (+31% vs +12%) compared with conventional physiotherapy (Group × Time interaction, p<0.001). Conclusion: Sensor-augmented PNF produced superior balance and postural control improvements compared with conventional physiotherapy. The integration of real-time feedback with neurophysiological facilitation appears to enhance motor relearning and postural adaptability after MCA stroke.

Publication Details

Page(s) 179-183

DOI 10.47310/jpms202515S0132

Published Journal: Journal of Pioneering Medical Sciences, Volume: 15, Issue: s1, Year: 2026

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Keywords

Proprioceptive neuromuscular facilitation, Stroke, rehabilitation, Biofeedback, Postural balance, Gait Disorders

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