Comparing Perceptual Motor Training and Repetitive Facilitation Exercises on UE in Stroke

Perceptual-motor training enhances proprioception, spatial awareness, and coordination through object manipulation. On the other hand, Repetitive facilitation exercises aim to improve motor control and reduce spasticity by stimulating muscles repetitively. Decreased dexterity, coordination, muscle tone abnormalities, and diminished sensation are frequently observed in stroke patients. Effective rehabilitation in daily tasks depends on coordinated efforts among muscles, joints, and body segments, influenced by environmental factors and personal constraints. Visual input, perception, and cognitive processing play crucial roles in action planning during rehabilitation.

This is a randomized clinical trial. The data will be collected from DHQ hospital, Sargodha. 50 stroke patients will be included using convenience sampling. The participants who meet the inclusion criteria will be randomly allocated into two groups. Twenty-five participants will be included in both Groups A and B. Group A (perceptual motor training with routine physical therapy) and Group B (Repetitive facilitation exercises with routine physical therapy) will receive 60 minutes treatment session that consists of 40 minutes of intervention and 20 minutes of routine physical therapy four sessions per week for 8 weeks.

Quality of movement will be assessed using Motor Evaluation Scale for Upper Extremity in Stroke Patients (MESUPES) and motor function by Fugl-Meyer Assessment (FMA-UE) Assessments will occur at baseline, 4 weeks, and 8 weeks. Data analysis will utilize SPSS version 27 for Windows, with statistical significance set at p ≤ 0.05.

Inclusion criteria

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• Both male and female patients.
• Age 40-65 years
• 1st ever stroke confirmed by MRI
• mild-to-moderate upper-limb motor paralysis
• sub-acute and chronic stroke patients
• ability to understand tasks such as evaluations in the intervention
• Modified Ashworth scale score < 3
• Mini Mental State Examination Score should be>24 out of 30

Exclusion criteria

• Participants who have a history of significant neurological or psychiatric disorders, other than stroke, that could interfere with upper limb motor recovery
• Patients with pain, contracture and profound atrophy in arm and fingers.
• Participants with severe cognitive dysfunction that would interfere with understanding instructions from the physician or therapist.
• Presence of any other musculoskeletal condition. e.g. (Frozen shoulder, any recent fractures of upper limb.
• Any accompanying diseases or disorders, other than stroke, that could interfere with upper extremity training.
• Uncontrolled health conditions for which exercise was contraindicated.