The Effect of Proprioceptive Neuromuscular Facilitation Techniques on Pain, Motor Functions, Fatigue and Health Related Quality of Life in Individuals with Multiple Sclerosis: A Randomized, Single-Blind Study

Abstract

Purpose: This study aimed to evaluate the effects of PNF on pain, motor function, fatigue, and quality of life in MS patients. Method: A randomized, controlled, single-blind study was conducted. Forty-four patients were randomly assigned to either the PNF Group (PNFG, n = 22, 16 female) or the Control Group (CG, n = 22, 16 female). PNFG underwent supervised combined aerobic and PNF training thrice weekly for 8 weeks, while CG followed a home exercise regimen. Various measures were employed, including the Visual Analogue Scale (VAS) for pain, Timed Up and Go (TUG) test, Functional Reach Test (FRT), Six-Minute Walk Test (6-MWT), Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Dexterity Questionnaire-24 (DextQ-24) and Multiple Sclerosis Quality of Life-54 (MSQoL-54). Results: PNFG exhibited significant improvements in VAS (p = 0.000), FRT (p = 0.001), TUG (p = 0.000), 6-MWT (p = 0.000), FIS (p = 0.007), DextQ-24 (p = 0.033), MSQoL-54 scores (Physical Health Composite, Mental Health Composite, p = 0.005, p = 0.002, respectively) (p < 0.05). CG also showed improvements in VAS (p = 0.018), TUG (p = 0.000), 6-MWT (p = 0.000), FSS (p = 0.006), psychosocial function (p = 0.007), MSQoL-54 (Physical Health Composite, Mental Health Composite, p = 0.017, p = 0.001, respectively), DextQ-24 ADL scores (p = 0.045) (p < 0.05). PNFG outperformed CG in DextQ-24 (Dressing, p = 0.038) and MSQoL-54 subscales (emotional well-being, energy, health perception, p = 0.007, p = 0.037, p = 0.044, respectively) (p < 0.05). Conclusions: This is the first randomized controlled trial to show that PNF improves upper limb motor function (skill) and quality of life in MS patients. PNF and home physiotherapy effectively improved pain, motor function, fatigue and quality of life, with the PNF group achieving better outcomes. Both modalities offered accessible rehabilitation options.