Addition of Proprioceptive Neuromuscular Facilitation to Cardio Respiratory Training Post Stroke
Addition of Proprioceptive Neuromuscular Facilitation to Cardio Respiratory Training Post Stroke
Post-stroke hemiparesis causes sequelae in the limbs and also in the trunk and abdomen
 structures. The level of physical activity decreases and cardiorespiratory training(CRT) is
 indicated to this population to improve the functions of several systems (respiratory,
 cardiovascular, muscular). The application of Proprioceptive Neuromuscular Facility(PNF)
 would imply in the awareness and greater harmony of the functions performed by the trunk of
 this individual. The objective of this study is to evaluate the effects of respiratory and
 trunk characteristics of the PNF associated with Cardiorespiratory training in quality of
 life, gait, distance traveled, peak oxygen consumption, respiratory muscle strength, thoracic
 cavity volumes, mobility and diaphragmatic thickness of individuals with post stroke.
Clinical, randomized, blind and allocation. Forty individuals post-stroke will be randomized
 into four groups: Experimental Lower Limbs(submitted to LL's CRT associated with PNF); Group
 control Lower Limbs (submitted LL's CRT associated with respiration). Experimental Upper
 Limbs (submitted to UP's CRT associated with PNF) and Group control Upper Limbs (submitted to
 UP's CRT associated with respiration). Individuals will be assessed before and immediately
 after 20 program sessions and one month after the end of treatment. Outcome measures shall be
 measured by: Stroke Specific Quality of Life Scale; Inertial gear sensor; Maximum volume of
 oxygen; Spirometry and manovacuometry; Ultrasound of mobility and thickness diaphragmatic;
 compartmental volumes of the rib cage with opto plethysmography electronics.

 For the four groups, the treatment program will have the total duration of one hour
 including: ten minutes of stretching (five minutes before and five minutes after the
 therapeutic intervention), ten minutes of rest and 40 minutes of aerobic treatment associated
 to PNF or to respiration, being performed in 20 Sessions three times a week. The order of
 application of the techniques will be random, being held until the end of the intervention
 period. For therapy with the CRT used the cycle ergometer for lower or upper limbs, Based on
 the criteria of the American College of Sports Medicine and monitoring constant blood
 pressure, oxygen saturation and perceived exertion. The PNF patterns will be performed in
 seated, dorsal, ventral and side. The breathing exercises will be performed at the same time
 and in the positions of the PNF. To analyze the data and to achieve the objectives
 appropriate statistical tests shall be used, according to the normality of and
 characteristics of the variables.
Inclusion Criteria:

 -  Have clinical diagnosis of ischemic or hemorrhagic stroke,

 -  primary for more than six months resulting in hemiparesis;

 -  Have mental competence assessed through the Mini-Exam of the Mental State-MMSE;

 -  Be able to walk 10 meters independently, with or without assistive device;

 -  Absence of other neurological or orthopedic deficiencies unrelated to stroke;

 -  Without report of associated pulmonary pathology and not be smoker or ex-smoker.

 Exclusion Criteria:

 -