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Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke

  • Lucyna Slupska
  • Tomasz Halski
  • Małgorzata Żytkiewicz
  • Kuba PtaszkowskiEmail author
  • Robert Dymarek
  • Jakub Taradaj
  • Malgorzata Paprocka-Borowicz
Part of the Advances in Experimental Medicine and Biology book series


This study focused on how pulmonary function is affected by proprioceptive neuromuscular facilitation (PNF) of accessory respiratory muscles in the chronic post-stroke phase. The study involved patients who had had ischemic stroke 6 months or more before the PNF treatment investigated. The objective was to define the effect of PNF on bioelectrical resting and maximum activity of the accessory muscles. Patients were randomly assigned to PNF treatment and just positioning treatment as a reference for comparison; 30 patients each. Electromyography of accessory muscles was investigated before and after physiotherapeutic treatments. We found that there was a greater reduction in EMG activity in all muscles investigated after PNF compared to positioning treatment alone. A reduction of muscle activity due to PNF concerned both affected and unaffected body side, but it was greater on the affected side. We conclude that a reduction of the accessory respiratory muscle activity due to PNF treatment could be of benefit in chronic stoke patients in that it would help normalize breathing pattern and thereby prevent the development of hypoxia.


Accessory respiratory muscles Electromyography Proprioceptive neuromuscular facilitation Pulmonary function Respiration Stroke 



The study was registered with the international clinical trials platform of the Australian and New Zealand Clinical Trials Registry (ACTRN 12613001315707). Funded in part by grant ST.E060.16.059 of Wroclaw Medical University in Wroclaw, Poland.

Conflicts of Interest

The authors report no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Medical University in Wroclaw, Poland (permit no. KB867/2012).

Informed Consent

Written informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lucyna Slupska
    • 1
  • Tomasz Halski
    • 1
  • Małgorzata Żytkiewicz
    • 1
  • Kuba Ptaszkowski
    • 2
    Email author
  • Robert Dymarek
    • 3
  • Jakub Taradaj
    • 4
    • 5
  • Malgorzata Paprocka-Borowicz
    • 2
  1. 1.Department of PhysiotherapyOpole Medical SchoolOpolePoland
  2. 2.Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health ScienceWroclaw Medical UniversityWroclawPoland
  3. 3.Department of Nervous System Diseases, Faculty of Health ScienceWroclaw Medical UniversityWroclawPoland
  4. 4.Department of Physiotherapy BasicsAcademy of Physical EducationKatowicePoland
  5. 5.College of Rehabilitation SciencesUniversity of ManitobaWinnipegCanada

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