DOI QR코드

DOI QR Code

The effect of hip joint strengthening exercise using proprioceptive neuromuscular facilitation on balance, sit to stand and walking ability in a person with traumatic brain injury: a case report

  • Jung, Du Kyo (Department of Physical Therapy, Soon Chun Hyang University Seoul Hospital) ;
  • Chung, Yijung (Department of Physical Therapy, College of Health Science and Social Welfare, Sahmyook University)
  • 투고 : 2017.05.15
  • 심사 : 2017.06.13
  • 발행 : 2017.06.30

초록

Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

키워드

참고문헌

  1. Effgen SK. Meeting the physical therapy need of children. 2nd ed. Philadelphia: F.A. Davis Company; 2013.
  2. Chaplin D, Deitz J, Jaffe KM. Motor performance in children after traumatic brain injury. Arch Phys Med Rehabil 1993;74: 161-4.
  3. Katz-Leurer M, Rotem H, Lewitus H, Keren O, Meyer S. Relationship between balance abilities and gait characteristics in children with post-traumatic brain injury. Brain Inj 2008;22: 153-9. https://doi.org/10.1080/02699050801895399
  4. Kirkwood M, Janusz J, Yeates KO, Taylor HG, Wade SL, Stancin T, et al. Prevalence and correlates of depressive symptoms following traumatic brain injuries in children. Child Neuropsychol 2000;6:195-208. https://doi.org/10.1076/chin.6.3.195.3157
  5. Fay GC, Jaffe KM, Polissar NL, Liao S, Rivara JB, Martin KM. Outcome of pediatric traumatic brain injury at three years: a cohort study. Arch Phys Med Rehabil 1994;75:733-41.
  6. Bowen JM, Clark E, Bigler ED, Gardner M, Nilsson D, Gooch J, et al. Childhood traumatic brain injury: neuropsychological status at the time of hospital discharge. Dev Med Child Neurol 1997;39:17-25.
  7. Carr JH, Shepherd RB. Neurological rehabilitation: optimizing motor performance. 2nd ed. Edinburgh: Churchill Livingstone; 2010.
  8. Eng JJ, Winter DA. Kinetic analysis of the lower limbs during walking: what information can be gained from a three-dimensional model? J Biomech 1995;28:753-8. https://doi.org/10.1016/0021-9290(94)00124-M
  9. Liu MQ, Anderson FC, Pandy MG, Delp SL. Muscles that support the body also modulate forward progression during walking. J Biomech 2006;39:2623-30. https://doi.org/10.1016/j.jbiomech.2005.08.017
  10. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. 3rd ed. Heidelberg: Springer; 2008.
  11. Kendall FP, McCreary EK, Provance PG, Rodgers MM, Romani WA. Muscles: testing and function, with posture and pain. 5th ed. Baltimore: Lippincott Williams and Wilkins; 2005.
  12. Ansari NN, Naghdi S, Younesian P, Shayeghan M. Inter- and intrarater reliability of the Modified Modified Ashworth Scale in patients with knee extensor poststroke spasticity. Physiother Theory Pract 2008;24:205-13. https://doi.org/10.1080/09593980701523802
  13. O'Sullivan SB, Schmitz TJ. Physical rehabilitation. 5th ed. Philadelphia: F.A. Davis; 2007.
  14. Berg KO, Maki BE, Williams JI, Holliday PJ, Wood-Dauphinee SL. Clinical and laboratory measures of postural balance in an elderly population. Arch Phys Med Rehabil 1992;73:1073-80.
  15. Lord SR, Murray SM, Chapman K, Munro B, Tiedemann A. Sit-to-stand performance depends on sensation, speed, balance, and psychological status in addition to strength in older people. J Gerontol A Biol Sci Med Sci 2002;57:M539-43. https://doi.org/10.1093/gerona/57.8.M539
  16. Bohannon RW, Andrews AW, Thomas MW. Walking speed: reference values and correlates for older adults. J Orthop Sports Phys Ther 1996;24:86-90. https://doi.org/10.2519/jospt.1996.24.2.86
  17. Steffen TM, Hacker TA, Mollinger L. Age- and gender-related test performance in community-dwelling elderly people: Six- Minute Walk Test, Berg Balance Scale, Timed Up & Go Test, and gait speeds. Phys Ther 2002;82:128-37. https://doi.org/10.1093/ptj/82.2.128
  18. Wallen MA, Mackay S, Duff SM, McCartney LC, O'flaherty SJ. Upper-limb function in Australian children with traumatic brain injury: A controlled, prospective study. Arch Phys Med Rehabil 2001;82:642-9. https://doi.org/10.1053/apmr.2001.22620
  19. Carr JH, Shepherd RB. Stroke rehabilitation: guidelines for exercise and training to optimize motor skill. Edinburgh: Butterworth- Heinemann; 2003.
  20. Clark JM, Haynor DR. Anatomy of the abductor muscles of the hip as studied by computed tomography. J Bone Joint Surg Am 1987;69:1021-31. https://doi.org/10.2106/00004623-198769070-00010
  21. Neumann DA. Kinesiology of the musculoskeletal system. St. Louis: Mosby; 2002.
  22. Dalstra M, Huiskes R. Load transfer across the pelvic bone. J Biomech 1995;28:715-24. https://doi.org/10.1016/0021-9290(94)00125-N
  23. Schmitz RJ, Riemann BL, Thompson T. Gluteus medius activity during isometric closed-chain hip rotation. J Sport Rehabil 2002;11:179-88. https://doi.org/10.1123/jsr.11.3.179
  24. Canning CG, Shepherd RB, Carr JH, Alison JA, Wade L, White A. A randomized controlled trial of the effects of intensive sit-tostand training after recent traumatic brain injury on sit-to-stand performance. Clin Rehabil 2003;17:355-62. https://doi.org/10.1191/0269215503cr620oa
  25. Gajdosik CG. Ability of very young children to produce reliable isometric force measurements. Pediatr Phys Ther 2005;17:251-7. https://doi.org/10.1097/01.pep.0000186507.74151.78
  26. Kawahira K, Shimodozono M, Ogata A, Tanaka N. Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemiplegic lower limb. J Rehabil Med 2004;36:159-64. https://doi.org/10.1080/16501970410029753
  27. Massagli TL, Jaffe KM, Fay GC, Polissar NL, Liao S, Rivara JB. Neurobehavioral sequelae of severe pediatric traumatic brain injury: a cohort study. Arch Phys Med Rehabil 1996;77:223-31. https://doi.org/10.1016/S0003-9993(96)90102-1
  28. Rossi C, Sullivan SJ. Motor fitness in children and adolescents with traumatic brain injury. Arch Phys Med Rehabil 1996;77: 1062-5. https://doi.org/10.1016/S0003-9993(96)90069-6
  29. Parham LD, Fazio LS. Play in occupational therapy for children. 2nd ed. St. Louis: Mosby; 2008.
  30. LaForme Fiss AC, Effgen SK, Page J, Shasby S. Effect of sensorimotor groups on gross motor acquisition for young children with Down syndrome. Pediatr Phys Ther 2009;21:158-66. https://doi.org/10.1097/PEP.0b013e3181a3dec7

피인용 문헌

  1. Comparison of rhythmic and non-rhythmic aerobic exercises on depression and balance in the elderly vol.6, pp.3, 2017, https://doi.org/10.14474/ptrs.2017.6.3.146
  2. Effects of foot pressure using the elastic band with rings during sit-to-stand in persons with stroke vol.6, pp.4, 2017, https://doi.org/10.14474/ptrs.2017.6.4.159
  3. Effects of functional training on strength, function level, and quality of life of persons in intensive care units vol.8, pp.3, 2017, https://doi.org/10.14474/ptrs.2019.8.3.134