OPTIMIZING MOTOR FUNCTION RECOVERY IN STROKE PATIENTS THROUGH STRUCTURED EXERCISE PROGRAMS

Abstract

Mohammad Saleh Alsaeed*, Zainah Ali Alqahtani, Shouq Abdulaziz Altamami, Abdulmajeed Ali Ahmed Alshehri, Sarah Juwayid Alnawmasi, Arwa Mohammed Aziz, Bayan Abdullah Alyahya, Maymonah Ahmed Homdi, Hyam Al.Hossin Al.Assiry, Fahad Mohammed Alshehri, Yahya Mohammed Alharobi, Zainab Abbas Alhajjaj and Hosam Eldin Mostafa

Background: Stroke is a major neurological condition that often results in significant motor, cognitive, and functional impairments, impacting daily living activities. Various rehabilitation techniques, including neurofunctional exercises such as Proprioceptive Neuromuscular Facilitation (PNF) and Bo bath Neurodevelopmental Therapy (NDT), are utilized to enhance recovery. However, the effectiveness of these interventions compared to conventional physical activity remains unclear. This study aimed to evaluate the impact of neurofunctional exercises versus standard rehabilitation on functional recovery in stroke survivors over a six-month period.

Methods: This study was conducted, involving stroke patients who were divided into two groups: one undergoing rehabilitation incorporating neurofunctional exercises (study group, SG) and another engaging in standard physical activity at home (control group, CG). Functional recovery was assessed using the Barthel Scale (BS), Rankin Scale (RS), and National Institutes of Health Stroke Scale (NIHSS) at baseline (during hospitalization) and six months’ post-stroke. Statistical analyses included Mann–Whitney U and Wilcoxon signed-rank tests for group comparisons and within-group changes.

Results: Baseline comparisons indicated significantly higher BS scores in the control group (U = 820.5; p = 0.001), while the study group had significantly greater NIHSS (U = 647.5; p = 0.001) and RS (U = 811.5; p < 0.001) scores. After six months, the CG retained significantly better BS scores than the SG (p = 0.021), while RS was significantly higher in the SG (p = 0.019). No significant between-group differences were observed in NIHSS scores (p = 0.755). Within-group analyses revealed significant improvements in BS for both groups (SG: p < 0.001; CG: p = 0.005), while NIHSS significantly improved only in the CG (p < 0.001).

Conclusion: Neurofunctional exercises did not provide substantial additional benefits compared to standard rehabilitation. Patients in the control group demonstrated greater functional improvements in daily activities, suggesting that conventional home-based physical activity may be equally or more effective in stroke recovery. Future research should explore individualized rehabilitation strategies and long-term functional outcomes. Keywords: Stroke rehabilitation; Neurofunctional exercises; Proprioceptive Neuromuscular Facilitation (PNF); Bobath Neurodevelopmental Therapy (NDT); Functional recovery