Effect of a Proprioceptive Neuromuscular Facilitation-Based Physiotherapy Program on Nerve Function and Disability in Leprosy Patients with Peripheral Neuropathy: A Randomized Controlled Trial

Muhammad Tahir Akram; Fakher ud din; Rimsha taimuri; Dr. M Shahmir khan; Eraj Fatima; Israr Ali Haider; Dr. Umar Ali

doi:10.61919/frb8j139

Authors

Muhammad Tahir Akram Public health specialist and physiotherapist, Jinnah Post Graduate Medical Centre, Karachi, Pakistan Author
Fakher ud din Assistant professor, College of Physical Therapy, Jinnah Post Graduate Medical Centre, Karachi, Pakistan Author
Rimsha taimuri Student, Ziauddin College of Physical Therapy, Karachi, Pakistan Author
Dr. M Shahmir khan Physiotherapist, Moomal Group of Colleges, Karachi, Pakistan Author
Eraj Fatima Physiotherapy house officer, Jinnah Post Graduate Medical Centre, Karachi, Pakistan Author
Israr Ali Haider Physiotherapy house officer, Jinnah Post Graduate Medical Centre, Karachi, Pakistan Author
Dr. Umar Ali Physiotherapist, Jinnah Post Graduate Medical Centre, Karachi, Pakistan Author

DOI:

https://doi.org/10.61919/frb8j139

Keywords:

Leprosy; Peripheral Neuropathy; Proprioceptive Neuromuscular Facilitation; Physiotherapy; Disability; Pain

Abstract

Background: Leprosy-related peripheral neuropathy can persist after multidrug therapy and may result in sensory loss, muscle weakness, neuropathic pain, deformity, disability, and reduced functional independence. Proprioceptive Neuromuscular Facilitation (PNF) may enhance neuromuscular recruitment and functional movement control, but evidence in leprosy-related neuropathy remains limited. Objective: To evaluate the effect of a PNF-based physiotherapy program on nerve function, disability, and pain in patients with leprosy-related peripheral neuropathy. Methods: A multi-center, single-blinded, parallel-group randomized controlled trial was conducted in specialized leprosy and rehabilitation centers in Karachi, Pakistan. Eighty adults with leprosy-related peripheral neuropathy were randomized into a PNF-based physiotherapy group (n=40) or conventional physiotherapy group (n=40). The intervention was delivered for 12 weeks. Outcomes included motor strength using the Medical Research Council scale, disability using the SALSA scale, and pain using the Visual Analogue Scale. Results: At 12 weeks, the PNF group showed significantly better motor strength than controls (3.91 ± 0.74 vs 3.56 ± 0.53; mean difference 0.35; p=0.018), lower disability scores (32.75 ± 5.54 vs 41.44 ± 4.31; mean difference −8.69; p<0.001), and lower pain intensity (1.98 ± 0.62 vs 4.05 ± 0.69; mean difference −2.07; p<0.001). Conclusion: PNF-based physiotherapy produced superior improvements in motor strength, disability, and pain compared with conventional physiotherapy and may be integrated into leprosy rehabilitation protocols.

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