PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
권호 표지
DOI QR코드

DOI QR Code

Immediate Effects of Using the PNF Contract-Relax Technique in the Close Kinetic Chain Position on the Gait Ability and Gastrocnemius Muscle Tone of Stroke Patients

닫힌 사슬 자세에서의 PNF 수축-이완 기법이 뇌졸중 환자의 장딴지 근육 긴장도와 보행능력에 미치는 즉각적 효과

  • Received : 2016.11.17
  • Accepted : 2016.11.28
  • Published : 2017.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to determine the immediate effects of using the proprioceptive neuromuscular facilitation (PNF) contract-relax technique in the close kinetic chain position on the gait ability and gastrocnemius muscle tone of stroke patients. Methods: The subjects were patients who had strokes due to cerebrum infarction and hemorrhage. The subjects participated in exercise with the PNF contract-relax technique in the standing-on-elbow position with a high table, and the affected lower leg was placed in the posterior position. The PNF contract-relax technique was applied at the position in which the ankle plantar-flexors were in a sufficiently elongated position. After performing twice in each range, while the muscle was elongated, the affected side was moved further back and a new range was set. In each session, the time of contraction was set to 8 seconds, and the resting time was set to 5 seconds; however, if the patient felt tired, they received more resting time during the intervention. The Myoton Pro and 10 m walking test were used to measure the muscle tone and gait ability both pre- and post-intervention. Results: After participating in the program, the muscle tone decreased and the gait ability improved in the ankle plantar-flexors, as determined by the Myoton Pro and 10 m walking test. Conclusion: The PNF contract-relax technique can help to decrease muscle tone in ankle plantar-flexors with hypertonus and increase the gait ability in stroke patients.

Keywords

References

  1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Heidelberg. Springer. 2014.
  2. Barnes M. Upper motor neuron syndrome and spasticity: clinical management and neurophysiology. Cambridge. Cambridge University Press. 2001.
  3. Brouwer B, Davidson LK, Olney SJ. Serial casting in idiopathic toe-walkers and children with spastic cerebral palsy. Joural of Pediatric Orthopaedics. 2000;20(2): 221-225.
  4. Chaitow L, Muscle energy techniques, 3rd ed. New York. Churchill Livingston. 2007.
  5. Chuang LL, Wu CY, Lin KC. Reliability, validity, and responsiveness of myotonometric measurement of muscle tone, elasticity, and stiffness in patients with stroke. Archives Physical Medicine Rehabilitation. 2012;93(3):532-540. https://doi.org/10.1016/j.apmr.2011.09.014
  6. Chung SG, Van Rey E, Bai Z, et al. Biomechanic changes in passive properties of hemiplegic ankles with spastic hypertonia. Archives Physical Medicine Rehabilitation. 2004;85(10):1638-1646. https://doi.org/10.1016/j.apmr.2003.11.041
  7. Feland JB, Myrer JW, Merrill RM. Acute changes in hamstring flexibility: PNF versus static stretch in senior athletes. Physical therapy in sports. 2001;2(4):186-193. https://doi.org/10.1054/ptsp.2001.0076
  8. Neumann DA. Kinesiology of the musculoskeletal system: foundations for physical rehabilitation. St. Louis. Mosby. 2002.
  9. Kisner C, Colby LA. Therapeutic exercise: foundations and techniques, 5th ed. Philadelphia. F.A. Davis Co. 2007.
  10. Lance J. Pathophysiology of spasticity and clinical experience with baclofen. Chicago. Year Book. 1980.
  11. Lee JH, Kim JH. Effect of exercise program using mirrors for stroke patients. International Journal of Contents. 2013;9(1):60-64. https://doi.org/10.5392/IJoC.2013.9.1.060
  12. Lucas RC, Koslow R. Comparative study of static, dynamic, and proprioceptive neuromuscular facilitation stretching techniques on flexibility. Perceptual and motor skills. 1984;58(2):615-618. https://doi.org/10.2466/pms.1984.58.2.615
  13. Moon SH, Boo JA, Park SE. Effects of ankle plantar flexors stretching with closed kinetic chain on pelvic movements and gait speed in hemiplegia patients: a case study. Jourmal of Physical Therapy Science. 2016;28(1):309-313. https://doi.org/10.1589/jpts.28.309
  14. Olney SJ, Richards C. Hemiparetic gait following stroke. Part I: characteristics. Gait Posture 1996;4(2):136-148. https://doi.org/10.1016/0966-6362(96)01063-6
  15. Perry J. Gait analysis: normal and pathological function. New York. McGraw-Hill. 1992.
  16. Selles RW, Li X, Lin F, et al. Feedback-controlled and programmed stretching of the ankle plantarflexors and dorsiflexors in stroke: effects of a 4-week intervention program. Archives Physical Medicine Rehabilitation. 2005;86(12):2330-2336. https://doi.org/10.1016/j.apmr.2005.07.305
  17. Stone JA, Leuken JS, Partin NB, et al. Closed kinetic chain rehabilitation for the glenohumerla joint. Journal of Athletic Traning. 1993;28:(1):34-37.
  18. Tsai KH, Yeh CY, Chang HY, et al. Effects of a single session of prolonged muscle stretch on spastic muscle of stroke patients. Proceedings of the Natlional Science Council, Republic of China Part B. 2001;25(2):76-81.
  19. Vattanasilp W, Ada L, Crosbie J. Contribution of thixotropy, spasticity, and contracture to ankle stiffness after stroke. Jourmal of Neurology, Neurosurgery & Psychiatry. 2000;69(1):34-39. https://doi.org/10.1136/jnnp.69.1.34
  20. Watson MJ. Refining the ten metre walking test for use with neurologically impaired people. Physiotherapy. 2002;88(7):386-397. https://doi.org/10.1016/S0031-9406(05)61264-3
  21. Winter DA. Biomechanics and motor control of human movement. New York. John Wiley & Sons. 2004.
  22. Yoon JS, Jung HI. The influence of treatment in patients with should a adhesive capsulitis for the proprioceptive neuromuscular facilitation and self-assistive ROM exercise. Journal of the Korean Society of Physical Medicine. 2013;8(2):219-229. https://doi.org/10.13066/kspm.2013.8.2.219