PNF Versus Conventional Exercise in Sarcopenia

Sarcopenia is a progressive skeletal muscle disorder characterized by reduced muscle strength, impaired muscle quantity or quality, and decreased physical performance. In older adults, sarcopenia is associated with impaired balance, mobility limitations, an increased risk of falls, reduced independence, and adverse health outcomes. Exercise-based interventions are central to the management of sarcopenia. However, evidence regarding the additional functional benefits of proprioceptive neuromuscular facilitation-based exercise in older adults with sarcopenia remains limited.

This prospective, single-center, two-arm randomized clinical study was conducted at the Physical Medicine and Rehabilitation Clinic of Uşak Training and Research Hospital. Adults aged 65 years or older who were diagnosed with sarcopenia and were able to participate safely in an exercise program were included in the study.

Participants were randomly allocated in a 1:1 ratio to the PNF group or the conventional exercise group using a computer-generated randomization sequence. The conventional exercise group received a therapeutic exercise program that included lower-extremity strengthening, balance training, functional mobility exercises, sit-to-stand practice, gait exercises, and stretching. The PNF group received the conventional exercise program together with proprioceptive neuromuscular facilitation techniques. These techniques included diagonal movement patterns, proprioceptive stimulation, coordinated neuromuscular activation, manual resistance, and task-oriented functional movement patterns.

Both groups participated in supervised exercise sessions three times per week for 10 consecutive weeks. Each session lasted approximately 45 minutes. Exercise intensity and progression were individually adjusted according to each participant's functional capacity, clinical tolerance, and improvement during the intervention period.

Participants were assessed at baseline, during the first month, and during the third month after initiation of the exercise program. Balance was evaluated using the Berg Balance Scale. Functional mobility was assessed using the Timed Up and Go Test. Walking capacity was evaluated using the 6-Minute Walk Test. Lower-extremity functional performance was assessed using the Five Times Sit-to-Stand Test and a stair ascent and descent test. Fear of falling was evaluated using the Tinetti Falls Efficacy Scale, and depressive symptoms were assessed using the Geriatric Depression Scale.

The objective of the study was to compare the effects of PNF-based exercise and conventional exercise on balance, functional mobility, walking capacity, lower-extremity functional performance, stair performance, fear of falling, and depressive symptoms in older adults with sarcopenia.

Inclusion criteria

• Adults aged 65 years or older.
• Diagnosis of sarcopenia according to the European Working Group on Sarcopenia in Older People criteria.
• Ability to participate safely in the prescribed exercise program.
• Completion of the baseline clinical assessment.
• Provision of written informed consent to participate in the study.

Exclusion criteria

• Parkinson's disease.
• Previous stroke.
• Multiple sclerosis.
• Vestibular disorders or vertigo.
• Other major neurological diseases that could affect balance, gait, mobility, or physical performance.
• Severe musculoskeletal disorders that could independently affect balance, gait, mobility, or participation in exercise.
• Uncontrolled cardiovascular disease.
• Any medical condition that could preclude safe participation in the exercise program.