Comparative Effects of Proprioceptive Neuromuscular Facilitation and Conventional Exercise on Balance, Mobility, and Fall-Related Outcomes in Older Adults With Sarcopenia
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Enrollment
- 34
- Locations
- 2
- Primary Endpoint
- Change in Berg Balance Scale score
Study Overview
Brief Summary
Sarcopenia is an age-related skeletal muscle disorder characterized by reduced muscle strength, muscle mass, and physical performance. It may lead to impaired balance, reduced mobility, falls, loss of independence, and reduced quality of life. Exercise is a central component of sarcopenia management; however, the additional effects of proprioceptive neuromuscular facilitation exercises in older adults with sarcopenia remain unclear.
This study compared proprioceptive neuromuscular facilitation-based exercise with conventional exercise in adults aged 65 years or older with sarcopenia. A total of 34 participants were assigned to either a proprioceptive neuromuscular facilitation group or a conventional exercise group.
Both groups participated in supervised exercise sessions three times per week for 10 weeks, with each session lasting approximately 45 minutes. The conventional exercise program included lower-extremity strengthening, balance, functional mobility, sit-to-stand, gait, and stretching exercises. The proprioceptive neuromuscular facilitation group received the conventional exercise program together with proprioceptive neuromuscular facilitation techniques.
Participants were evaluated at baseline, during the first month, and during the third month after initiation of the exercise program. Outcomes included balance, functional mobility, walking capacity, lower-extremity functional performance, stair performance, fear of falling, and depressive symptoms. Assessments included the Berg Balance Scale, Timed Up and Go Test, 6-Minute Walk Test, Five Times Sit-to-Stand Test, stair ascent and descent test, Tinetti Falls Efficacy Scale, and Geriatric Depression Scale.
Detailed Description
Sarcopenia is a progressive skeletal muscle disorder characterized by reduced muscle strength, impaired muscle quantity or quality, and decreased physical performance. In older adults, sarcopenia is associated with impaired balance, mobility limitations, an increased risk of falls, reduced independence, and adverse health outcomes. Exercise-based interventions are central to the management of sarcopenia. However, evidence regarding the additional functional benefits of proprioceptive neuromuscular facilitation-based exercise in older adults with sarcopenia remains limited.
This prospective, single-center, two-arm randomized clinical study was conducted at the Physical Medicine and Rehabilitation Clinic of Uşak Training and Research Hospital. Adults aged 65 years or older who were diagnosed with sarcopenia and were able to participate safely in an exercise program were included in the study.
Participants were randomly allocated in a 1:1 ratio to the PNF group or the conventional exercise group using a computer-generated randomization sequence. The conventional exercise group received a therapeutic exercise program that included lower-extremity strengthening, balance training, functional mobility exercises, sit-to-stand practice, gait exercises, and stretching. The PNF group received the conventional exercise program together with proprioceptive neuromuscular facilitation techniques. These techniques included diagonal movement patterns, proprioceptive stimulation, coordinated neuromuscular activation, manual resistance, and task-oriented functional movement patterns.
Both groups participated in supervised exercise sessions three times per week for 10 consecutive weeks. Each session lasted approximately 45 minutes. Exercise intensity and progression were individually adjusted according to each participant's functional capacity, clinical tolerance, and improvement during the intervention period.
Participants were assessed at baseline, during the first month, and during the third month after initiation of the exercise program. Balance was evaluated using the Berg Balance Scale. Functional mobility was assessed using the Timed Up and Go Test. Walking capacity was evaluated using the 6-Minute Walk Test. Lower-extremity functional performance was assessed using the Five Times Sit-to-Stand Test and a stair ascent and descent test. Fear of falling was evaluated using the Tinetti Falls Efficacy Scale, and depressive symptoms were assessed using the Geriatric Depression Scale.
Study Design
- Study Type
- Interventional
- Allocation
- Randomized
- Intervention Model
- Parallel
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 65 Years to — (Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Adults aged 65 years or older.
- •Diagnosis of sarcopenia according to the European Working Group on Sarcopenia in Older People criteria.
- •Ability to participate safely in the prescribed exercise program.
- •Completion of the baseline clinical assessment.
- •Provision of written informed consent to participate in the study.
Exclusion Criteria
- •Parkinson's disease.
- •Previous stroke.
- •Multiple sclerosis.
- •Vestibular disorders or vertigo.
- •Other major neurological diseases that could affect balance, gait, mobility, or physical performance.
- •Severe musculoskeletal disorders that could independently affect balance, gait, mobility, or participation in exercise.
- •Uncontrolled cardiovascular disease.
- •Any medical condition that could preclude safe participation in the exercise program.
Outcomes
Primary Outcomes
Change in Berg Balance Scale score
Time Frame: Time Frame: Baseline, 1 month, and 3 months after initiation of the intervention
Balance function was assessed using the Berg Balance Scale. Scores were measured at baseline, at the first-month assessment, and at the third-month assessment after initiation of the exercise program. Changes over time and differences between the groups were analyzed.
Secondary Outcomes
- Change in Tinetti Falls Efficacy Scale score(Baseline, 1 month, and 3 months after initiation of the intervention)
- Change in Timed Up and Go Test performance(Time Frame: Baseline, 1 month, and 3 months after initiation of the intervention)
- Change in 6-Minute Walk Test distance(Time Frame: Baseline, 1 month, and 3 months after initiation of the intervention)
- Change in Five Times Sit-to-Stand Test time(Time Frame: Baseline, 1 month, and 3 months after initiation of the intervention)
- Change in stair ascent and descent test time(Time Frame: Baseline, 1 month, and 3 months after initiation of the intervention)
- Change in Geriatric Depression Scale score(Baseline, 1 month, and 3 months after initiation of the intervention)
Investigators
Nihal Yilmaz
Assistant Professor
Uşak University