A bstract Background: Lacunar strokes, a subtype of ischemic stroke caused by small vessel occlusion, commonly lead to upper limb motor impairments, restricting daily activities. Early and targeted physiotherapy plays a crucial role in recovery. This case study reports the outcomes of combining proprioceptive neuromuscular facilitation (PNF) and neuromuscular electrical stimulation (NMES) for upper limb rehabilitation in a post lacunar stroke patient. Objectives: To evaluate the effectiveness of an early combined intervention using PNF and NMES in improving upper limb motor function following a lacunar stroke. Materials and Methods: A 59-year-old male presenting with the right upper limb weakness due to a left-sided lacunar infarct participated in a 10-day physiotherapy program, initiated on the 3 rd day post-admission, and once medically stable. Treatment included NMES targeting wrist extensors and PNF techniques to facilitate neuromuscular re-education, voluntary control, and functional movement. Results: Following the intervention, the patient showed notable improvements: Fugl-Meyer assessment scores increased from 2/12 to 11/12, muscle strength improved from Grade 1 to Grade 4, and tone advanced from hypotonia to Grade 3. Enhanced voluntary control enabled the patient to perform functional tasks more independently. Conclusion: This case highlights that early integration of NMES and PNF can significantly improve upper limb motor recovery after lacunar stroke. Prompt application of such combined interventions may accelerate neurological rehabilitation and enhance functional outcomes.
Pal et al. (Mon,) studied this question.