StrokeNCT07808580
Effect of Transcranial Direct Current Stimulation and Pelvic Proprioceptive Neuromuscular Facilitation in Stroke Patient
A study testing Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy, Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy and Transcranial Direct Current Stimulation and Routine Physical Therapy in people with Stroke and Subacute Stroke, run by Lahore University of Biological and Applied Sciences at 1 site in Pakistan.
Trial summary
Stroke is a leading cause of long-term disability and commonly results in impaired trunk control, postural instability, balance deficits, and reduced functional mobility due to disrupted sensorimotor integration, impaired proprioceptive processing, and decreased cortical excitability. Read more about this study
- Who is it for?
- Ages 40 to 65 years
- Conditions the study is for
- Stroke, Subacute Stroke
- What is being tested?
- Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy, Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy and Transcranial Direct Current Stimulation and Routine Physical Therapy
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 36 participants
- Where
- 1 sitePakistan
- Study dates
- 23 Jul 2026to 1 Sep 2026
- Phase
- Interventional
- Are there results?
- None posted in the registry
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 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Both genders
- Middle Cerebral Artery Ischemic Stroke
- Subacute phase of stroke
- Patients experiencing their first ever stroke
- Brunnstrom stage 3
- Patients is capable to follow commands
Who cannot join
- Frequent seizures or epileptic disorder
- Contractures in the spine and lower limb
- Patients with uncontrolled medical conditions e.g. severe musculoskeletal pain, uncontrolled heart disease, uncontrolled hypertension
- Metallic implant
- History of brain tumor, orthopedic, neurosurgical surgery
- Concurrent participation in another clinical trial.
Trial locations and contacts
1 site in 1 country.
Pakistan1 site
Dr Salma Physiotherapy Department Psrd Hospital 042-37423455
Lahore, Punjab Province, 54000
About this study
Official title: Effects of Transcranial Direct Current Stimulation and Pelvic Proprioceptive Neuromuscular Facilitation on Trunk Control, Balance and Functional Mobility in Stroke Patients
Stroke is a leading cause of long-term disability and commonly results in impaired trunk control, postural instability, balance deficits, and reduced functional mobility due to disrupted sensorimotor integration, impaired proprioceptive processing, and decreased cortical excitability. Trunk control is a key determinant of balance, gait performance, and functional independence, making it a critical target in stroke rehabilitation. Transcranial Direct Current Stimulation (tDCS) enhances cortical excitability and promotes neuroplasticity through a top-down mechanism, while Pelvic Proprioceptive Neuromuscular Facilitation (PNF) improves trunk-pelvic control, weight shifting, and sensorimotor integration through a bottom-up proprioceptive facilitation mechanism. Emerging evidence suggests that combining tDCS with Pelvic PNF may improve trunk function and mobility in stroke survivors, supporting the concept of synergistic neuromodulation and motor facilitation. Despite the documented benefits of tDCS and Pelvic PNF individually, the combined application of these interventions remains insufficiently explored, particularly in subacute stroke patients. Most previous studies have focused on gait training, robotic rehabilitation, or other task-oriented interventions, with limited emphasis on trunk-focused pelvic PNF and postural control outcomes. Furthermore, few high-quality randomized controlled trials have evaluated whether simultaneous targeting of central neuroplasticity and peripheral proprioceptive facilitation provides superior improvements in trunk control, balance, and functional mobility. Therefore, this study aims to address this important clinical and methodological gap by investigate the combining effect of Pelvic PNF and tDCS, potentially establishing an evidence-based rehabilitation strategy that optimizes functional recovery after stroke.
Read the detailed description
Stroke is a neurological disorder caused by a disruption of blood supply because of cerebral infarction or hemorrhage. Stroke is a leading cause of long-term disability worldwide, with balance impairment recognized as one of the most disabling sequel affecting functional independence and quality of life. In Pakistan, the annual incidence of stroke is estimated at 250 per 100,000 people, and stroke is the second leading cause of death with a mortality rate of about 9.3%. Postural control and balance impairment are common issues among patients with stroke. It has been estimated that approximately 83% of patients with stroke experience difficulties in maintaining balance. Effective trunk control, often referred to as core stability, is therefore a fundamental component of motor performance and postural control. Selective trunk exercises designed to improve trunk coordination and control can boost balance and gait parameters among stroke subjects. Transcranial direct current stimulation (tDCS) is one of the most used noninvasive brain stimulation techniques. Transcranial direct current stimulation (tDCS) is a means of increasing cortical excitability by promoting synaptic plasticity in the cerebral cortex. A new "top-down" approach to enhance stroke rehabilitation outcomes. The Pelvic Proprioceptive Neuromuscular Facilitation facilitates the control of trunk and lower extremity motion and provide mobility and stability to trunk. The use of Pelvic PNF facilitates neuromuscular coordination through specific movement patterns, which enhance trunk stability and postural control. The Pelvic PNF facilitates the trunk and lower extremity motion and also provides the stability to trunk. It also promotes the exploration of postural reflexes and prioritizes eccentric muscle contraction, stimulating agonist activity. Pelvic Proprioceptive Neuromuscular Facilitation (PNF) improves trunk-pelvic control, weight shifting, and sensorimotor integration through a bottom-up proprioceptive facilitation mechanism. This study will contribute to knowledge by providing evidence regarding the combined effects of Pelvic PNF and tDCS on trunk control, balance, and functional mobility in subacute stroke patients. The findings will contribute to the existing body of knowledge by providing evidence regarding synergistic effect of these interventions. Clinically the results may help physiotherapist develop more effective, evidence-based treatment protocols for improving trunk control and functional independence. By comparing these groups, the study will determine whether adding tDCS to Pelvic PNF provides better functional recovery by enhancing both cortical excitability and peripheral proprioceptive input. This is important because stroke rehabilitation currently lacks clear evidence on the most effective combination of top-down (neuromodulation) and bottom-up (sensorimotor facilitation) approaches. The findings may help establish a more effective, evidence-based intervention strategy for trunk control and mobility impairments, which are key determinants of independence after stroke. At the community level, improved balance and mobility can reduce fall risk, decrease dependency on caregivers, enhance participation in daily and social activities, and better quality of life. Additionally, effective rehabilitation may reduce long-term disability and healthcare burden, making stroke management more cost-effective and accessible for the community. Experimental Group A will receive Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy while Experimental Group B will receive Pelvic PNF and Routine Physical Therapy and Experimental Group C Transcranial Direct Current Stimulation and Routine Physical Therapy. . Therefore, this study aims to address this important clinical and methodological gap by investigate the combining effect of Pelvic PNF and tDCS, potentially establishing an evidence-based rehabilitation strategy that optimizes functional recovery after stroke.
- Conditions
- Stroke, Subacute Stroke
- Being tested
- Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy, Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy, Transcranial Direct Current Stimulation and Routine Physical Therapy
- Keywords
- transcranial direct current stimulation, pelvic proprioceptive neuromuscular facilitation, trunk control, balance and functional mobility
- Medical subject headings
- Stroke
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical TherapyOther
The patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair. For the groups receiving tDCS, a wireless rechargeable tDCS device will use. This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline. The electrodes will be carefully wrap around the patient's head. The brain remains excited for up to 20 min following tDCS. The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation. The PNF will be perform at 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks. Each session lasted 20 min. Pelvic PNF pattern as anterior elevation and posterior elevation using rthymic initiation and slow reversal. RPT include ROM, trunk flexion, bridging and swiss ball exercises.
Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical TherapyOther
The PNF treatment will be perform at a dosage of 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks. Each session lasted 20 minutes, depending on the participant's endurance and response to therapy. The treatment will performed on the affected side, with the hips flexed to 100° and the knees flexed to 45°. For anterior elevation, the therapist's hands will placed just on the subject's anterior iliac spine, and for posterior depression, they will placed on the patient's ischial tuberosity. "Pull up" for anterior elevation, and "push down" and "sit into my hands" for posterior depression. Rhythmic initiation, Slow reversal and stabilizing reversal will used. routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left. Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting.
Transcranial Direct Current Stimulation and Routine Physical TherapyOther
The patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair. For the groups receiving tDCS, a wireless rechargeable tDCS device will use. This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline. The electrodes will be carefully wrap around the patient's head. The brain remains excited for up to 20 min following tDCS. The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation. routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left. Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting for 20 min duration
| Study group | Role | What they receive |
|---|---|---|
| Experimental: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical therapy | Experimental | group A will receive pelvic propriceptive neuromuscualar facilitation and transcranial direct current stimulation with routine physical therapy. The participants will receive 20 min session of transcranial direct current stimulation with intensity of 2 mA in which anodal tDCS applied over ipsilateral side. Then 20 min session of pelvic PNF will perform with 10 repitition per set for 3 set. pelvic PNF pattern perform as anterior elevation and posterior elevation using rthymic initiation, slow reversal and stabilizing reversal will perform, Then perform routine therapy as ROM, Bridging, trunk flexion and swiss ball perform for 20 minutre. Receives: Other: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy |
| Experimental: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy | Experimental | Group B will receive pelvic proprioceptive neuromuscular facilitation with routine physical therapy. In this group patient receive 20 min session of pelvic PNF with 10 repititions per set for 3 set per session apply moderate manual resistance according to patient tolerance. Patient should be in side lying position then apply PNF pattern as anterior and posterior elevation using rthymic initiation , slow reversal and stabilizing reversal. the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball. Receives: Other: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy |
| Experimental: Transcranial Direct Current Stimulation and Routine Physical Therapy | Experimental | Group C will receive transcranial direct current stimulation and routine physical therapy. The participants will receive 20 min session. tDCS pads will soaked in saline and then apply to patients head. Anodal tDCS apply over ipsilesional side with current of 2mA with 30 second ramp up and down in the begining and end of stimulation. the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball. Receives: Other: Transcranial Direct Current Stimulation and Routine Physical Therapy |
What is being measured
The primary outcome is the main question the study is designed to answer.
Trunk impairement scale
Trunk impairment scale evaluates static and dynamic trunk balance and trunk coordination. These tasks are design to reflect the patient's ability to activate trunk musculature, which is often impaired after stroke. It evaluates three components: static sitting balance (score range 0-7), dynamic sitting balance (0-10), and trunk coordination (0-6). The total score ranges from 0 to 23, with higher scores indicating better trunk performance.
Measured: [Time Frame: baseline, week 6 and week 12]
Berg Balance Scale
The BBS is a 14-item ordinal scale that measures balance performance during functional tasks such as sitting, standing, and weight shifting. Each item is rate on a 5-point scale (0-4), with a maximum total score of 56. Higher scores indicate better balance ability. It has excellent inter-rater reliability, with ICC values of 0.989. Concurrent validity (r = 0.970). Interpretation of 0 to 20 (High Risk): Severe balance impairment; patients typically require a wheelchair for mobility and significant assistance. 21 to 40 (Moderate Risk): Increased fall risk; these individuals typically require walking aids and environmental modifications. 41 to 56 (Low Risk): Good balance function with minimal fall risk.
Measured: baseline, week 6 and week 12
Time up and go test
This test measures functional mobility and fall risk by timing the patient as they rise from a chair, walk a short distance, turn around, return, and sit down. The time taken is record in seconds and categorized into normal mobility, low, moderate, or high fall. Reliability ICC for the TUG were 0.998 and 0.992
Measured: baseline, week 6 and week 12
Fugl-Meyer Assessment (FMA) for the lower extremity
This scale measure the motor control in stroke patients. FMA consists of 17 items, with a maximum total score of 34 points. Each task is rate on a 3-point ordinal scale. 0: Movement cannot be performed, 1: Movement can be performed partially, 2: Movement can be performed fully. The higher the score, the better your motor recovery. The scores indicate: 0-10: Severe motor impairment, 11-23: Moderate motor impairment, 24-33: Mild motor impairment, 34: Minimal to no impairment (full motor recovery). Reliability, with Intra-class Correlation Coefficient (ICC) values 0.90 to 0.97 high inter-and intra-rater reliability (ICC > 0.90) for the total FMA-LL score.
Measured: baseline, week 6 and week12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted9 Sep 2026
- Study start23 Jul 2026
- Primary completion1 Sep 2026
- Study completion1 Sep 2026
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for StrokeStudies of the same condition, open and under way.
- More trials run by Lahore University of Biological and Applied SciencesThe sponsor's other registered studies.
- 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
- Model description
- This study will use a parallel-group design, with participants randomly allocated into three intervention groups. Group A receive Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy for 20 minutes. Group B receive Pelvic PNF and Routine Physical Therapy for 20 minute. Group C receive Transcranial Direct Current Stimulation and Routine Physical Therapy for 20 minute. 3 sessions per week for 12 weeks. .Participants will be randomly allocated into three parallel groups to ensure an unbiased comparison, with each group receiving its specific intervention protocol throughout the study period without crossover to the other groups intervention
- Masking
- Single blind
- Who is masked
- Outcomes assessor
- Enrolment
- 36 participants (actual)
Sponsor and investigators
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- psrd hospital, Principal investigator, Pakistan Society for Rehabilitation of Disabled Hospital Lahore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07808580
- Sponsor's protocol ID
- UBAS/ERB/26/07/080
- Status last verified
- Sep 2026
- First submitted
- 2 Sep 2026
- Last updated
- 9 Sep 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
El-Sherbini AEIEM, Elgayar SL, Elhamrawy MY, Youssef TM. Unlocking trunk potential after stroke: a novel approach combining transcranial direct current stimulation and core stability exercise: a randomized controlled trial. J Neuroeng Rehabil. 2026 Apr 10;23(1):128. doi: 10.1186/s12984-026-01949-0.
PubMed 41964055Boob MA, Kovela RK. Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Chronic Stroke Patients: A Randomized Clinical Trial. Cureus. 2022 Oct 24;14(10):e30630. doi: 10.7759/cureus.30630. eCollection 2022 Oct.
PubMed 36426303
Study at a glance
From the registry record, last updated by the sponsor on 9 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Effects of Transcranial Direct Current Stimulation and Pelvic Proprioceptive Neuromuscular Facilitation on Trunk Control, Balance and Functional Mobility in Stroke Patients
- ClinicalTrials.gov ID
- NCT07808580
- Acronym / sponsor ID
- UBAS/ERB/26/07/080
- Conditions
- Stroke, Subacute Stroke
- Keywords
- transcranial direct current stimulation, pelvic proprioceptive neuromuscular facilitation, trunk control, balance and functional mobility
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 36 participants (actual)
- Lead sponsor
- Lahore University of Biological and Applied SciencesUniversity, hospital or other
- Study start
- 23 Jul 2026 (actual)
- Primary completion
- 1 Sep 2026 (actual)
- Study completion
- 1 Sep 2026 (actual)
- First posted
- 9 Sep 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.
Stroke is a leading cause of long-term disability and commonly results in impaired trunk control, postural instability, balance deficits, and reduced functional mobility due to disrupted sensorimotor integration, impaired proprioceptive processing, and decreased cortical excitability. Trunk control is a key determinant of balance, gait performance, and functional independence, making it a critical target in stroke rehabilitation. Transcranial Direct Current Stimulation (tDCS) enhances cortical excitability and promotes neuroplasticity through a top-down mechanism, while Pelvic Proprioceptive Neuromuscular Facilitation (PNF) improves trunk-pelvic control, weight shifting, and sensorimotor integration through a bottom-up proprioceptive facilitation mechanism. Emerging evidence suggests that combining tDCS with Pelvic PNF may improve trunk function and mobility in stroke survivors, supporting the concept of synergistic neuromodulation and motor facilitation. Despite the documented benefits of tDCS and Pelvic PNF individually, the combined application of these interventions remains insufficiently explored, particularly in subacute stroke patients. Most previous studies have focused on gait training, robotic rehabilitation, or other task-oriented interventions, with limited emphasis on trunk-focused pelvic PNF and postural control outcomes. Furthermore, few high-quality randomized controlled trials have evaluated whether simultaneous targeting of central neuroplasticity and peripheral proprioceptive facilitation provides superior improvements in trunk control, balance, and functional mobility. Therefore, this study aims to address this important clinical and methodological gap by investigate the combining effect of Pelvic PNF and tDCS, potentially establishing an evidence-based rehabilitation strategy that optimizes functional recovery after stroke.
Detailed description
Stroke is a neurological disorder caused by a disruption of blood supply because of cerebral infarction or hemorrhage. Stroke is a leading cause of long-term disability worldwide, with balance impairment recognized as one of the most disabling sequel affecting functional independence and quality of life. In Pakistan, the annual incidence of stroke is estimated at 250 per 100,000 people, and stroke is the second leading cause of death with a mortality rate of about 9.3%. Postural control and balance impairment are common issues among patients with stroke. It has been estimated that approximately 83% of patients with stroke experience difficulties in maintaining balance. Effective trunk control, often referred to as core stability, is therefore a fundamental component of motor performance and postural control. Selective trunk exercises designed to improve trunk coordination and control can boost balance and gait parameters among stroke subjects. Transcranial direct current stimulation (tDCS) is one of the most used noninvasive brain stimulation techniques. Transcranial direct current stimulation (tDCS) is a means of increasing cortical excitability by promoting synaptic plasticity in the cerebral cortex. A new "top-down" approach to enhance stroke rehabilitation outcomes. The Pelvic Proprioceptive Neuromuscular Facilitation facilitates the control of trunk and lower extremity motion and provide mobility and stability to trunk. The use of Pelvic PNF facilitates neuromuscular coordination through specific movement patterns, which enhance trunk stability and postural control. The Pelvic PNF facilitates the trunk and lower extremity motion and also provides the stability to trunk. It also promotes the exploration of postural reflexes and prioritizes eccentric muscle contraction, stimulating agonist activity. Pelvic Proprioceptive Neuromuscular Facilitation (PNF) improves trunk-pelvic control, weight shifting, and sensorimotor integration through a bottom-up proprioceptive facilitation mechanism. This study will contribute to knowledge by providing evidence regarding the combined effects of Pelvic PNF and tDCS on trunk control, balance, and functional mobility in subacute stroke patients. The findings will contribute to the existing body of knowledge by providing evidence regarding synergistic effect of these interventions. Clinically the results may help physiotherapist develop more effective, evidence-based treatment protocols for improving trunk control and functional independence. By comparing these groups, the study will determine whether adding tDCS to Pelvic PNF provides better functional recovery by enhancing both cortical excitability and peripheral proprioceptive input. This is important because stroke rehabilitation currently lacks clear evidence on the most effective combination of top-down (neuromodulation) and bottom-up (sensorimotor facilitation) approaches. The findings may help establish a more effective, evidence-based intervention strategy for trunk control and mobility impairments, which are key determinants of independence after stroke. At the community level, improved balance and mobility can reduce fall risk, decrease dependency on caregivers, enhance participation in daily and social activities, and better quality of life. Additionally, effective rehabilitation may reduce long-term disability and healthcare burden, making stroke management more cost-effective and accessible for the community. Experimental Group A will receive Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy while Experimental Group B will receive Pelvic PNF and Routine Physical Therapy and Experimental Group C Transcranial Direct Current Stimulation and Routine Physical Therapy. . Therefore, this study aims to address this important clinical and methodological gap by investigate the combining effect of Pelvic PNF and tDCS, potentially establishing an evidence-based rehabilitation strategy that optimizes functional recovery after stroke.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Single blind (outcomes assessor)
- Number of arms
- 3
- Model description
- This study will use a parallel-group design, with participants randomly allocated into three intervention groups. Group A receive Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy for 20 minutes. Group B receive Pelvic PNF and Routine Physical Therapy for 20 minute. Group C receive Transcranial Direct Current Stimulation and Routine Physical Therapy for 20 minute. 3 sessions per week for 12 weeks. .Participants will be randomly allocated into three parallel groups to ensure an unbiased comparison, with each group receiving its specific intervention protocol throughout the study period without crossover to the other groups intervention
| Arm | Type | Receives |
|---|---|---|
| Experimental: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical therapy | Experimental | Other: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapygroup A will receive pelvic propriceptive neuromuscualar facilitation and transcranial direct current stimulation with routine physical therapy. The participants will receive 20 min session of transcranial direct current stimulation with intensity of 2 mA in which anodal tDCS applied over ipsilateral side. Then 20 min session of pelvic PNF will perform with 10 repitition per set for 3 set. pelvic PNF pattern perform as anterior elevation and posterior elevation using rthymic initiation, slow reversal and stabilizing reversal will perform, Then perform routine therapy as ROM, Bridging, trunk flexion and swiss ball perform for 20 minutre. |
| Experimental: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy | Experimental | Other: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical TherapyGroup B will receive pelvic proprioceptive neuromuscular facilitation with routine physical therapy. In this group patient receive 20 min session of pelvic PNF with 10 repititions per set for 3 set per session apply moderate manual resistance according to patient tolerance. Patient should be in side lying position then apply PNF pattern as anterior and posterior elevation using rthymic initiation , slow reversal and stabilizing reversal. the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball. |
| Experimental: Transcranial Direct Current Stimulation and Routine Physical Therapy | Experimental | Other: Transcranial Direct Current Stimulation and Routine Physical TherapyGroup C will receive transcranial direct current stimulation and routine physical therapy. The participants will receive 20 min session. tDCS pads will soaked in saline and then apply to patients head. Anodal tDCS apply over ipsilesional side with current of 2mA with 30 second ramp up and down in the begining and end of stimulation. the routine physical therapy involve 20 repetition with moderate intensity with 3 sessions per week it involve the ROM, bridging, trunk flexion and exercise on swiss ball. |
Who may qualify
- Ages
- 40 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (6 listed)
- Both genders
- Middle Cerebral Artery Ischemic Stroke
- Subacute phase of stroke
- Patients experiencing their first ever stroke
- Brunnstrom stage 3
Key exclusion criteria (6 listed)
- Frequent seizures or epileptic disorder
- Contractures in the spine and lower limb
- Patients with uncontrolled medical conditions e.g. severe musculoskeletal pain, uncontrolled heart disease, uncontrolled hypertension
- Metallic implant
- History of brain tumor, orthopedic, neurosurgical surgery
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 |
|---|---|---|
| Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical TherapyThe patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair. For the groups receiving tDCS, a wireless rechargeable tDCS device will use. This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline. The electrodes will be carefully wrap around the patient's head. The brain remains excited for up to 20 min following tDCS. The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation. The PNF will be perform at 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks. Each session lasted 20 min. Pelvic PNF pattern as anterior elevation and posterior elevation using rthymic initiation and slow reversal. RPT include ROM, trunk flexion, bridging and swiss ball exercises. | Other | Experimental: Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical therapy |
| Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical TherapyThe PNF treatment will be perform at a dosage of 10 repetitions per set, with 3sets per session, conducted 3 sessions per week over a duration of 12 weeks. Each session lasted 20 minutes, depending on the participant's endurance and response to therapy. The treatment will performed on the affected side, with the hips flexed to 100° and the knees flexed to 45°. For anterior elevation, the therapist's hands will placed just on the subject's anterior iliac spine, and for posterior depression, they will placed on the patient's ischial tuberosity. "Pull up" for anterior elevation, and "push down" and "sit into my hands" for posterior depression. Rhythmic initiation, Slow reversal and stabilizing reversal will used. routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left. Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting. | Other | Experimental: Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy |
| Transcranial Direct Current Stimulation and Routine Physical TherapyThe patients will sit comfortably on a chair, with their hip and knee joints positioned at 90 degrees and their forearms resting on a table in front of the chair. For the groups receiving tDCS, a wireless rechargeable tDCS device will use. This device use two 5-7 cm-long sponge electrodes that will soak in 0.9% saline. The electrodes will be carefully wrap around the patient's head. The brain remains excited for up to 20 min following tDCS. The tDCS will administered at a intensity of 2 mA, for 20 min, with a 30 sec ramp-up and ramp-down at the beginning and end of stimulation. routine physical therapy involve Sitting posture exercises as controlled forward flexion, trunk rotation to right and left. Supine position exercises as hip roll to both sides, bridging exercise Dynamic sitting exercise on swiss ball as controlled lateral weight shifting for 20 min duration | Other | Experimental: Transcranial Direct Current Stimulation and Routine Physical Therapy |
Primary outcome
Trunk impairement scale
Time frame: [Time Frame: baseline, week 6 and week 12]
Trunk impairment scale evaluates static and dynamic trunk balance and trunk coordination. These tasks are design to reflect the patient's ability to activate trunk musculature, which is often impaired after stroke. It evaluates three components: static sitting balance (score range 0-7), dynamic sitting balance (0-10), and trunk coordination (0-6). The total score ranges from 0 to 23, with higher scores indicating better trunk performance.
Berg Balance Scale
Time frame: baseline, week 6 and week 12
The BBS is a 14-item ordinal scale that measures balance performance during functional tasks such as sitting, standing, and weight shifting. Each item is rate on a 5-point scale (0-4), with a maximum total score of 56. Higher scores indicate better balance ability. It has excellent inter-rater reliability, with ICC values of 0.989. Concurrent validity (r = 0.970). Interpretation of 0 to 20 (High Risk): Severe balance impairment; patients typically require a wheelchair for mobility and significant assistance. 21 to 40 (Moderate Risk): Increased fall risk; these individuals typically require walking aids and environmental modifications. 41 to 56 (Low Risk): Good balance function with minimal fall risk.
Time up and go test
Time frame: baseline, week 6 and week 12
This test measures functional mobility and fall risk by timing the patient as they rise from a chair, walk a short distance, turn around, return, and sit down. The time taken is record in seconds and categorized into normal mobility, low, moderate, or high fall. Reliability ICC for the TUG were 0.998 and 0.992
Fugl-Meyer Assessment (FMA) for the lower extremity
Time frame: baseline, week 6 and week12
This scale measure the motor control in stroke patients. FMA consists of 17 items, with a maximum total score of 34 points. Each task is rate on a 3-point ordinal scale. 0: Movement cannot be performed, 1: Movement can be performed partially, 2: Movement can be performed fully. The higher the score, the better your motor recovery. The scores indicate: 0-10: Severe motor impairment, 11-23: Moderate motor impairment, 24-33: Mild motor impairment, 34: Minimal to no impairment (full motor recovery). Reliability, with Intra-class Correlation Coefficient (ICC) values 0.90 to 0.97 high inter-and intra-rater reliability (ICC > 0.90) for the total FMA-LL score.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 9 Sep 2026.
- Background: PubMed 41964055El-Sherbini AEIEM, Elgayar SL, Elhamrawy MY, Youssef TM. Unlocking trunk potential after stroke: a novel approach combining transcranial direct current stimulation and core stability exercise: a randomized controlled trial. J Neuroeng Rehabil. 2026 Apr 10;23(1):128. doi: 10.1186/s12984-026-01949-0.
- Background: PubMed 36426303Boob MA, Kovela RK. Effectiveness of Pelvic Proprioceptive Neuromuscular Facilitation Techniques on Balance and Gait Parameters in Chronic Stroke Patients: A Randomized Clinical Trial. Cureus. 2022 Oct 24;14(10):e30630. doi: 10.7759/cureus.30630. eCollection 2022 Oct.
- Individual participant dataSharing planned: No
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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. This study is not recruiting at the moment.
psrd hospital principal investigator
Pakistan Society for Rehabilitation of Disabled Hospital Lahore
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Pelvic PNF and Transcranial Direct Current Stimulation and Routine Physical Therapy, Pelvic Proprioceptive Neuromuscular Facilitation and Routine Physical Therapy and Transcranial Direct Current Stimulation and Routine Physical Therapy in people with Stroke and Subacute Stroke, run by Lahore University of Biological and Applied Sciences 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 6 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: finished, as of the sponsor's last update on 9 Sep 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?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
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?
Trunk impairement scale (time frame: [Time Frame: baseline, week 6 and week 12]). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT07808580, which also lists 2 linked publications.
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 9 Sep 2026.