Volume 25, Issue 118, December 2021

Effectiveness of diaphragm activation using reflex mediated dynamic neuromuscular stabilization on trunk function in hemiplegia

Raghumahanti Raghuveer^1♦, Ekta Chitkara², Parul Raj Agarwal³

¹Ph.D. Scholar, Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
²Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India
³Department of Physiotherapy, Heritage Institute of Medical Sciences, Varanasi, Uttar Pradesh, India

^♦Corresponding author
Ph.D. Scholar, Department of Physiotherapy, Faculty of Allied Health Sciences, Manav Rachna International Institute of Research and Studies, Faridabad, Haryana, India

ABSTRACT

Introduction: Trunk muscle strength is impaired multidirectionally in hemiplegic patients and its identification plays a crucial role in planning treatment strategies in rehabilitation. Neurodevelopmental treatment (NDT) is commonly used to improve postural core stability but requires conscious effort by the patient. Dynamic Neuro Muscular Stabilization (DNS) utilizes the subconscious stimulation of trunk to reflexively mediate the diaphragm and other core stabilization muscles, which is extremely effective for individuals with, reduced somatosensory or movement awareness. Materials and Methods: Aim of this study is to find out effects of training utilizing conscious and subconscious activation of diaphragm by NDT and DNS strategies over 6-weeks on trunk function in Hemiplegics. This prospective randomized comparison study was conducted with Thirty hemiplegic subjects who were randomly allocated into two groups, Group A- NDT Group and Group B- DNS Group with 15 in each group (n=15). Trunk Impairment Scale (TIS), Modified Rankin Scale (MRS), Stroke specific Quality of life (SSQOL) and walking ability (WA) were measured as Pre-test and post-test scores. Results: Analyzed data showed significant improvements with in both the groups for all variables with P<0.05. Between group comparisons showed significant improvements in TIS and SSQOL and non-significant differences for MRS and WA. Conclusion: The study findings conclude that DNS, a reflex mediated diaphragmatic and core muscle activation can be more useful in improving trunk function when compared with conscious activation by NDT in subjects with Hemiplegia.

Keywords: Neurodevelopmental Therapy, Dynamic Neuromuscular Stabilization, Stroke Rehabilitation, Hemiplegia, Diaphragm stabilization, core stabilization

Medical Science, 2021, 25(118), 3132-3139

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