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NCT Number: NCT07524790

The Effect of Proprioceptive Neuromuscular Facilitation on Haemodynamic Responses in a Neurological Intensive Care

Although there are studies examining the effect of actively performed PNF exercises on haemodynamic responses in intensive care patients and healthy individuals, there are no studies investigating their effect on circulation and haemodynamic responses in unconscious patients. Therefore, this study was designed to investigate the acute effects of proprioceptive neuromuscular facilitation (PNF) exercises on peripheral circulation and haemodynamic responses in patients admitted to a neurological intensive care unit.

Hypotheses:

H1-1: Passively administered PNF exercises have beneficial effects on peripheral circulation.

H2-1: Passively administered PNF exercises have beneficial effects on haemodynamic responses.

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Key information

Conditions

Neurologic Disorder Nervous System Diseases

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Patients being monitored in the neurology intensive care unit
  • Aged 18 years or over
  • Haemodynamically stable
  • No orthopaedic condition preventing the performance of passive joint movements in the upper and lower limbs
  • A signed informed consent form from a patient's next of relative for participation in the study

Exclusion criteria

  • Presence of haemodynamic instability
  • Fractures, contractures or serious orthopaedic conditions in the upper or lower limbs that restrict movement
  • Diagnosis or suspicion of deep vein thrombosis
  • Severe peripheral arterial disease
  • Serious cardiac arrhythmia that may prevent exercise

Treatment and study plan

proprioceptive neuromuscular facilitation exercises

Other

The following PNF patterns will be applied to the upper extremity:

  • flexion - abduction - external rotation → extension - adduction - internal rotation
  • extension - abduction - internal rotation → flexion - adduction - external rotation

The following PNF patterns will be applied to the lower extremities:

  • flexion - adduction - external rotation (with the knee extended) → extension - abduction - internal rotation
  • extension - adduction - external rotation (with the knee extended) → flexion - abduction - internal rotation All exercises will be performed passively by the physiotherapist. Each movement will be performed in sets of 10-12 repetitions, with a 30-second rest period between sets.

Other names: PNF

Passive Range of Motion Exercises

Other

Exercises for the upper extremities:

  • shoulder flexion - extension
  • shoulder abduction - adduction
  • shoulder internal - external rotation
  • elbow flexion - extension
  • wrist flexion - extension
  • finger flexion - extension

Exercises for the lower extremities:

  • hip flexion - extension
  • hip abduction - adduction
  • hip internal - external rotation
  • knee flexion - extension
  • ankle dorsiflexion - plantar flexion All exercises will be performed passively by the physiotherapist. Each movement will be performed in sets of 10-12 repetitions, with a 30-second rest period between sets.

Other names: PROM

Primary outcomes

  1. Ankle-Brachial İndex

    Time frame: Baseline and five or ten minutes after exercise

    Systolic blood pressure will be measured at the brachial artery (upper limb) and the posterior tibial or dorsalis pedis artery (lower limb) using a Hadesco ES-101EX Doppler device, with patients in a supine resting position. The cuff will be placed at mid-arm and above the malleolus. It will be inflated until the pulse disappears and deflated slowly; the first reappearance of the pulse will be recorded as systolic pressure.

    Measurements will be taken in order: same-side arm, same-side leg, opposite leg, and opposite arm. The ankle-brachial index will be calculated as the ratio of the highest lower limb systolic pressure to the highest upper limb systolic pressure.

  2. Heart Rate

    Time frame: Baseline and five or ten minutes after exercise

    Heart rate will be recorded as beats per minute and breaths per minute, respectively, based on data obtained from the patient monitor. Measurement will be taken whilst patients are in the supine position and at rest.

  3. Systolic blood pressure and diastolic blood pressure

    Time frame: Baseline and five or ten minutes after exercise

    Systolic and diastolic blood pressure measurements will be taken from the patient's upper extremity using an appropriately sized cuff and recorded in millimetres of mercury (mmHg). Measurement will be taken whilst patients are in the supine position and at rest.

  4. Respiratory rate

    Time frame: Baseline and five or ten minutes after exercise

    respiratory rate will be recorded as beats per minute and breaths per minute, respectively, based on data obtained from the patient monitor. Measurement will be taken whilst patients are in the supine position and at rest.

  5. Peripheral oxygen saturation (SpO₂)

    Time frame: Baseline and five or ten minutes after exercise

    Peripheral oxygen saturation (SpO₂) will be measured using a pulse oximeter. Measurement will be taken whilst patients are in the supine position and at rest.

Secondary outcomes

  1. Rate Pressure Product

    Time frame: Baseline and five or ten minutes after exercise

    Rate Pressure Product is calculated by dividing the product of heart rate and systolic blood pressure by 1,000

  2. Quadriceps circumference measurement

    Time frame: Baseline and five or ten minutes after exercise

    Measurements will be taken whilst patients are in the supine position or, where appropriate, in a seated position. During the measurement, a non-elastic tape measure will be used to measure the circumference at the widest part of the thigh. The tape measure will be placed parallel to the thigh circumference, and the measurement result will be recorded in centimetres (cm).

    To enhance the reliability of the measurement, two separate measurements will be taken for each patient, and the average of the obtained values will be used in the analyses.

  3. Oxford Acute Severity of Illness Score

    Time frame: Baseline and five or ten minutes after exercise

    Oxford Acute Severity of Illness Score comprises a total of 10 parameters: age, heart rate, mean arterial pressure, respiratory rate, body temperature, Glasgow Coma Scale, urine output, mechanical ventilation status, length of stay in intensive care, and the presence of elective surgery. Each parameter is assessed according to specific score ranges, and the total score indicates the severity of the illness. Higher scores indicate a higher risk of mortality.

Sponsors and collaborators

Lead sponsor

Abant Izzet Baysal University

Other

Registry information

Official study title

The Effect of Proprioceptive Neuromuscular Facilitation on the Ankle-Brachial Index and Haemodynamic Responses in Patients in a Neurological Intensive Care Unit: A Randomised Controlled Trial

Important dates

Study start
2026
Primary completion
2027
Study completion
2027
First posted
Apr 13, 2026
Registry last updated
Apr 13, 2026

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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