StrokeRVP-MCANCT07616622
Roods vs PNF for Upper Limb Function in Acute MCA Stroke
A study testing Neuromuscular Electrical Stimulation, Rood's Facilitatory Techniques and Proprioceptive Neuromuscular Facilitation in people with Stroke and Middle Cerebral Artery Infarction, run by University of Faisalabad at 1 site in Pakistan.
Trial summary
Middle cerebral artery (MCA) stroke often causes weakness or stiffness in the arm and hand, making daily activities difficult. This study compares two physical therapy approaches - Rood's facilitatory techniques (using touch, quick stretch, and ice to activate muscles) and PNF sequential patterns (using diagonal… Read more about this study
- Who is it for?
- Ages 40 to 60 years
- Conditions the study is for
- Stroke, Middle Cerebral Artery Infarction
- What is being tested?
- Neuromuscular Electrical Stimulation, Rood's Facilitatory Techniques and Proprioceptive Neuromuscular Facilitation
- Type of treatment
- Medical device, Surgery or procedure
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 28 participants
- Where
- 1 sitePakistan
- Study dates
- 1 Jan 2026to 15 Jul 2026
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 to 60 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- Adults (40-60 years) with confirmed MCA stroke (ischemic or hemorrhagic) on neuroimaging (CT or MRI)
- Mild to moderate upper limb motor dysfunction with MRC ≥2 for proximal limb motor strength
- Cognitive competence to understand instructions (MoCA ≥19 or equivalent)
- First stroke, acute or subacute phase
- Willingness to provide written informed consent
- Both male and female genders
Who cannot join
- Severe coexisting medical disorders (heart, liver, kidney failure; malignant tumors)
- Fixed musculoskeletal abnormalities or contracture in affected upper limb
- Severe cognitive impairment or aphasia preventing adherence or consent (MMSE below threshold)
- Skin sores, ulcers, or hypersensitivity (e.g., to cold) contraindicated for sensory stimulation
- Refusal or inability to give informed consent
Trial locations and contacts
1 site in 1 country. Contact the study team or a site near you to ask about taking part.
Pakistan1 site
The University of Faisalabad
Faisalābad, Punjab Province, 3800
About this study
Official title: Comparison Between Roods Facilitatory Techniques and Sequential PNF Pattern on Upper Limb Function in Acute Phase of Middle Cerebral Artery Stroke Patients
Middle cerebral artery (MCA) stroke often causes weakness or stiffness in the arm and hand, making daily activities difficult. This study compares two physical therapy approaches - Rood's facilitatory techniques (using touch, quick stretch, and ice to activate muscles) and PNF sequential patterns (using diagonal movement patterns) - to improve arm function in acute stroke patients. Both groups will also receive neuromuscular electrical stimulation (NMES). A total of 28 patients will be randomly assigned to one of two groups and receive treatment three times per week for eight weeks. Arm function will be measured using the Fugl-Meyer Assessment, and muscle stiffness will be measured using the Modified Ashworth Scale before and after treatment.
Read the detailed description
This is a single-blind, parallel-group randomized controlled trial. The study will be conducted at three settings in Faisalabad, Pakistan: Allied Hospital, Madinah Teaching Hospital, and Shahid Heera's Health Clinic. Adult patients (≥18 years) with CT or MRI-confirmed MCA stroke (ischemic or hemorrhagic), mild to moderate upper limb motor dysfunction (MRC ≥2), and cognitive competence (MoCA ≥19) will be included. Exclusion criteria include severe comorbidities, fixed contractures, severe cognitive impairment, skin contraindications to sensory stimulation, and inability to provide consent. A sample size of 28 participants (14 per group) was calculated using Rao soft app based on previous literature. Participants will be randomly assigned using a computer-generated sequence. The single-blind design keeps participants unaware of group allocation. Group A receives NMES followed by Rood's facilitatory techniques: quick stretch before or during movement to activate muscle spindles, tactile stimulation (light stroking) over the muscle belly for 10-20 seconds, and icing for 5-7 seconds on the tendon or muscle surface immediately preceding activation. Group B receives NMES followed by PNF sequential training using conventional upper limb diagonal functional patterns (D1 and D2). PNF techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance, performing 8-12 repetitions per pattern over 20-30 minutes per session. NMES parameters: biphasic waveform at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable visible contraction, administered for 30 minutes per session. Both groups receive interventions three times per week for eight weeks. Outcome measures: Fugl-Meyer Assessment for Upper Extremity (FMA-UE, score range 0-66) measures motor function; Modified Ashworth Scale (MAS, score range 0-4) measures muscle tone. Assessments are conducted at baseline and post-intervention by a qualified physiotherapist. Data will be analyzed using SPSS version 22.
- Conditions
- Stroke, Middle Cerebral Artery Infarction
- Being tested
- Neuromuscular Electrical Stimulation, Rood's Facilitatory Techniques, Proprioceptive Neuromuscular Facilitation
- Keywords
- Stroke rehabilitation, Upper limb, PNF, Rood's technique, NMES, Acute stroke
- Medical subject headings
- Stroke, Infarction, Middle Cerebral Artery
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Neuromuscular Electrical StimulationDevice
Biphasic waveform NMES at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable but visible muscle contraction. Applied to affected upper limb for 30 minutes per session, three times per week for eight weeks.
Rood's Facilitatory TechniquesProcedure or surgery
Quick stretch applied before or during movement to activate muscle spindles; tactile stimulation (light stroking) over muscle belly for 10-20 seconds; icing for 5-7 seconds on tendon or muscle surface immediately preceding activation. Applied three times per week for eight weeks following NMES.
Proprioceptive Neuromuscular FacilitationProcedure or surgery
PNF sequential training with upper limb diagonal functional patterns (D1 and D2). Techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance according to patient's capabilities. Each session includes 8-12 repetitions per pattern over 20-30 minutes, three times per week for eight weeks.
| Study group | Role | What they receive |
|---|---|---|
| Rood's Facilitatory Techniques Group | Experimental | Participants receive neuromuscular electrical stimulation (NMES) followed by Rood's facilitatory techniques including quick stretch, tactile stimulation for 10-20 seconds over muscle belly, and icing for 5-7 seconds on tendon or muscle surface. Interventions delivered three times per week for eight weeks. Receives: Device: Neuromuscular Electrical Stimulation; Procedure: Rood's Facilitatory Techniques |
| PNF Sequential Pattern Group | Active comparator | Participants receive neuromuscular electrical stimulation (NMES) followed by PNF sequential training with upper limb diagonal functional patterns (D1 and D2), including rhythmic initiation, dynamic reversals, repetitive contractions, and isotonic contractions with moderate resistance (8-12 repetitions per pattern over 20-30 minutes). Interventions delivered three times per week for eight weeks. Receives: Device: Neuromuscular Electrical Stimulation; Procedure: Proprioceptive Neuromuscular Facilitation |
What is being measured
The primary outcome is the main question the study is designed to answer.
Upper Limb Motor Function
Fugl-Meyer Assessment for Upper Extremity (FMA-UE). A standardized 66-point scale assessing motor recovery after stroke based on Brunnstrom stages. Evaluates shoulder, elbow, wrist, hand, and coordination functions. Higher scores indicate better motor function.
Measured: Baseline and 8 weeks (post-intervention)
Secondary outcomes (1)
Muscle Tone
Modified Ashworth Scale (MAS). A 5-point scale (0-4) measuring resistance during passive stretching of the affected upper limb muscles. 0 = normal tone; 4 = rigidity. Assesses spasticity reduction.
Measured: Baseline and 8 weeks (post-intervention)
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted1 Jun 2026
- Study start1 Jan 2026
- Primary completion15 Jun 2026 (estimated)
- Study completion15 Jul 2026 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for StrokeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind
- Who is masked
- Participant
- Enrolment
- 28 participants (estimated)
Sponsor and investigators
- Lead sponsor
- University of Faisalabad
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Dr. Marium Zafar, University of Faisalabad
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07616622
- Sponsor's protocol ID
- TUF/EIRB/ 220 /26
- Acronym
- RVP-MCA
- Status last verified
- May 2026
- First submitted
- 23 May 2026
- Last updated
- 1 Jun 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Study at a glance
From the registry record, last updated by the sponsor on 1 Jun 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Roods Facilitatory Techniques and Sequential PNF Pattern on Upper Limb Function in Acute Phase of Middle Cerebral Artery Stroke Patients
- ClinicalTrials.gov ID
- NCT07616622
- Acronym / sponsor ID
- RVP-MCA / TUF/EIRB/ 220 /26
- Conditions
- Stroke, Middle Cerebral Artery Infarction
- Keywords
- Stroke rehabilitation, Upper limb, PNF, Rood's technique, NMES, Acute stroke
- Study type
- Interventional
- Recruitment status
- Enrolling by invitation
- Enrolment
- 28 participants (estimated)
- Lead sponsor
- University of FaisalabadUniversity, hospital or other
- Study start
- 1 Jan 2026 (actual)
- Primary completion
- 15 Jun 2026 (estimated)
- Study completion
- 15 Jul 2026 (estimated)
- First posted
- 1 Jun 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Middle cerebral artery (MCA) stroke often causes weakness or stiffness in the arm and hand, making daily activities difficult. This study compares two physical therapy approaches - Rood's facilitatory techniques (using touch, quick stretch, and ice to activate muscles) and PNF sequential patterns (using diagonal movement patterns) - to improve arm function in acute stroke patients. Both groups will also receive neuromuscular electrical stimulation (NMES). A total of 28 patients will be randomly assigned to one of two groups and receive treatment three times per week for eight weeks. Arm function will be measured using the Fugl-Meyer Assessment, and muscle stiffness will be measured using the Modified Ashworth Scale before and after treatment.
Detailed description
This is a single-blind, parallel-group randomized controlled trial. The study will be conducted at three settings in Faisalabad, Pakistan: Allied Hospital, Madinah Teaching Hospital, and Shahid Heera's Health Clinic. Adult patients (≥18 years) with CT or MRI-confirmed MCA stroke (ischemic or hemorrhagic), mild to moderate upper limb motor dysfunction (MRC ≥2), and cognitive competence (MoCA ≥19) will be included. Exclusion criteria include severe comorbidities, fixed contractures, severe cognitive impairment, skin contraindications to sensory stimulation, and inability to provide consent. A sample size of 28 participants (14 per group) was calculated using Rao soft app based on previous literature. Participants will be randomly assigned using a computer-generated sequence. The single-blind design keeps participants unaware of group allocation. Group A receives NMES followed by Rood's facilitatory techniques: quick stretch before or during movement to activate muscle spindles, tactile stimulation (light stroking) over the muscle belly for 10-20 seconds, and icing for 5-7 seconds on the tendon or muscle surface immediately preceding activation. Group B receives NMES followed by PNF sequential training using conventional upper limb diagonal functional patterns (D1 and D2). PNF techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance, performing 8-12 repetitions per pattern over 20-30 minutes per session. NMES parameters: biphasic waveform at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable visible contraction, administered for 30 minutes per session. Both groups receive interventions three times per week for eight weeks. Outcome measures: Fugl-Meyer Assessment for Upper Extremity (FMA-UE, score range 0-66) measures motor function; Modified Ashworth Scale (MAS, score range 0-4) measures muscle tone. Assessments are conducted at baseline and post-intervention by a qualified physiotherapist. Data will be analyzed using SPSS version 22.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (participant)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Rood's Facilitatory Techniques Group | Experimental | Device: Neuromuscular Electrical Stimulation, Procedure: Rood's Facilitatory TechniquesParticipants receive neuromuscular electrical stimulation (NMES) followed by Rood's facilitatory techniques including quick stretch, tactile stimulation for 10-20 seconds over muscle belly, and icing for 5-7 seconds on tendon or muscle surface. Interventions delivered three times per week for eight weeks. |
| PNF Sequential Pattern Group | Active comparator | Device: Neuromuscular Electrical Stimulation, Procedure: Proprioceptive Neuromuscular FacilitationParticipants receive neuromuscular electrical stimulation (NMES) followed by PNF sequential training with upper limb diagonal functional patterns (D1 and D2), including rhythmic initiation, dynamic reversals, repetitive contractions, and isotonic contractions with moderate resistance (8-12 repetitions per pattern over 20-30 minutes). Interventions delivered three times per week for eight weeks. |
Who may qualify
- Ages
- 40 to 60 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (6 listed)
- Adults (40-60 years) with confirmed MCA stroke (ischemic or hemorrhagic) on neuroimaging (CT or MRI)
- Mild to moderate upper limb motor dysfunction with MRC ≥2 for proximal limb motor strength
- Cognitive competence to understand instructions (MoCA ≥19 or equivalent)
- First stroke, acute or subacute phase
- Willingness to provide written informed consent
Key exclusion criteria (5 listed)
- Severe coexisting medical disorders (heart, liver, kidney failure; malignant tumors)
- Fixed musculoskeletal abnormalities or contracture in affected upper limb
- Severe cognitive impairment or aphasia preventing adherence or consent (MMSE below threshold)
- Skin sores, ulcers, or hypersensitivity (e.g., to cold) contraindicated for sensory stimulation
- Refusal or inability to give informed consent
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Neuromuscular Electrical StimulationBiphasic waveform NMES at 30-40Hz frequency with pulse duration of 200-300μs, producing comfortable but visible muscle contraction. Applied to affected upper limb for 30 minutes per session, three times per week for eight weeks. | Device | PNF Sequential Pattern Group, Rood's Facilitatory Techniques Group |
| Rood's Facilitatory TechniquesQuick stretch applied before or during movement to activate muscle spindles; tactile stimulation (light stroking) over muscle belly for 10-20 seconds; icing for 5-7 seconds on tendon or muscle surface immediately preceding activation. Applied three times per week for eight weeks following NMES. | Procedure or surgery | Rood's Facilitatory Techniques Group |
| Proprioceptive Neuromuscular FacilitationPNF sequential training with upper limb diagonal functional patterns (D1 and D2). Techniques include rhythmic initiation, dynamic reversals, repetitive contractions, and combination of isotonic contractions with moderate resistance according to patient's capabilities. Each session includes 8-12 repetitions per pattern over 20-30 minutes, three times per week for eight weeks. | Procedure or surgery | PNF Sequential Pattern Group |
Primary outcome
Upper Limb Motor Function
Time frame: Baseline and 8 weeks (post-intervention)
Fugl-Meyer Assessment for Upper Extremity (FMA-UE). A standardized 66-point scale assessing motor recovery after stroke based on Brunnstrom stages. Evaluates shoulder, elbow, wrist, hand, and coordination functions. Higher scores indicate better motor function.
1 secondary outcome
Muscle Tone
Time frame: Baseline and 8 weeks (post-intervention)
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 1 Jun 2026.
- Individual participant dataSharing planned: No
Related trials for Stroke
Recruiting
Delay AvoIding Primary Evaluation for ThRombectomy of Acute StrokE Patients With Large Vessel OCclusion in the Angiography SuiTe
Stroke, Acute
RecruitingPhase 4
Xeomin® and Gait Related Mobility After Stroke
Stroke
RecruitingObservational study
Implementing Transcranial Direct Current Stimulation in a Rehabilitation Setting
Aphasia, Stroke
Not yet recruiting
EEG Feedback-Based Vagus Nerve Stimulation for Post-Stroke Dysphagia
Ischemic Stroke, Post-stroke Dysphagia
RecruitingObservational study
Development and Validation of Risk Prediction Models for Stroke and Cognitive Impairment in Moyamoya Disease and Moyamoya Syndrome
Moyamoya Disease, Moyamoya Syndrome
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Neuromuscular Electrical Stimulation, Rood's Facilitatory Techniques and Proprioceptive Neuromuscular Facilitation in people with Stroke and Middle Cerebral Artery Infarction, run by University of Faisalabad at 1 site in Pakistan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 6 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: enrolling by invitation, as of the sponsor's last update on 1 Jun 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Pakistan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Upper Limb Motor Function (time frame: Baseline and 8 weeks (post-intervention)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 1 Jun 2026.