Effects of PNF and Static Stretching on Architecture and Viscoelastic Properties of Hemiplegic Elbow

The patients who were diagnosed with stroke in governmental/university/private hospitals, and who needed rehabilitation because of the increased flexor tone in the elbow joint, decreased range of motion and/or decreased function of the upper extremity will be invited to the study in accordance with the criteria that are given in inclusion and exclusion part. Participants will be randomly assigned to one of two parallel groups, either the PNF Stretching Group (n=17) or the Prolonged Stretching Group (n=17), according to the order of participation in the study by simple randomization. An online computer program will be used to assign participants (https://www.randomizer.org/). Exercises that will increase proximal stabilization and control will be applied to both groups for 4 weeks, 5 days a week. In addition to the exercises, prolonged stretches for 10 minutes will be applied to the Prolonged Stretching Group, and PNF stretching will be applied to the PNF Stretching Group. At the beginning and the end of the study, muscle architecture, muscular viscoelastic properties, range of motion, proprioception, upper extremity motor performance and function and posture will be evaluated.

Inclusion Criteria:Stroke diagnosed by magnetic resonance imaging or computed tomography, regardless of ischemic or hemorrhagic origin;Hemiplegia caused only by stroke;At least 3 months have passed since the diagnosis of stroke;At least 1+ spasticity according to Modified Ashworth Scale in the elbow flexors of the affected side;Ability to maintain sitting balance for at least 20 seconds without support;Being older than 18 years old;Being voluntary to participate in the study.Exclusion Criteria:Having a history of multiple strokes or bilateral involvement;Botox application to any/all of the Biceps, Brachialis or Brachioradialis muscles within the last 6 months;Changes in pharmacological treatment in the last 6 months;Muscle involvement on the affected side that completely prevents the elbow joint range of motion;Presence of conditions that may affect the level of spasticity (infection, febrile illness, etc.)Mini Mental State Assessment Test score below 24;Presence of neurological diagnosis other than stroke;Insufficient vision, hearing and/or understanding ability to administer assessments and treatments.