PNF and Movement

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

DOI QR Code

Effect of an Ankle Strengthening Exercise that Uses PNF on the Balance and Walking Ability of Patients with Acute Disseminated Encephalomyelitis -A Single Case Study-

PNF를 이용한 발목 강화 운동이 급성파종성 뇌척수염 환자의 균형 및 보행 향상에 미치는 영향 -단일사례연구-

  • Jung, Du-Kyo (Department of Physical Therapy, Soon Chun Hyang University Seoul Hospital)
  • 정두교 (순천향대학교 서울병원 물리치료실)
  • Received : 2016.11.11
  • Accepted : 2017.02.01
  • Published : 2017.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

Keywords

References

  1. Adler S, Beckers D, Buck M. PNF in practice: An illustrated guide, 3rd ed. Heidelberg. Springer. 2008.
  2. Andrews AW, Bohannon RW. Short-term recovery of limb musclestrength after acute stroke. Archives of Physical Medicine Rehabilitation. 2003;84(1):125-130. https://doi.org/10.1053/apmr.2003.50003
  3. Bohannon RW, Larkin PA. Lower extremity weihg tbearing under various standing conditions in independently ambulatory patients with hemiparesis. Physical Theraphy. 1985;65(9):1323-1325. https://doi.org/10.1093/ptj/65.9.1323
  4. Bohannon RW, Andrews AW, Thomas MW. Walking speed: reference values and correlates for older adults. Journal Orthopaedic Sports Physical Therapy. 1996;24(2):86-90. https://doi.org/10.2519/jospt.1996.24.2.86
  5. Chang SM, Rincon D. Biofeedback controlled ankle foot orthosis for stroke rehabilitation to improve gait symmetry. FCRAR. European Journal of Physical and Rehabilitation Medicine. 2006;47(3):427-433.
  6. Damiano DL. Activity, activity, activity: rethinking our physical therapy approach to cerebral palsy. Physical Therapy. 2006;86(11):1534-1540. https://doi.org/10.2522/ptj.20050397
  7. Donald AN. Kinesiology of the musculoskeletal system : Foundations for physical rehabilitation. St. Louis. Mosby Publication. 2002.
  8. Dorsch S, Ada L, Canning CG, et al. The strength of the ankledorsiflexors has a significant contribution to walking speed in people who can walk independently after stroke: an observational study. Archives of Physical Medicine and Rehabilitation. 2012;93(6): 1072-1076. https://doi.org/10.1016/j.apmr.2012.01.005
  9. Engsberg JR, Ross SA, Collins DR. Increasing ankle strength to improve gaitand function in children with cerebralpalsy: a pilot study. Pediatric Physical Therapy. 2006;18(4):266-275. https://doi.org/10.1097/01.pep.0000233023.33383.2b
  10. Epperson LW, Whitaker JN, Kapila A. Cranial MRI in acute disseminated encephalomyelitis. Neurology. 1988; 38(2):332-3.
  11. Ferber R, Osternig LR, Gravelle DC. Effect of PNF stretch techniques on knee flexor muscle EMG activity in older adults. Journal of Electromyography and Kinesiology. 2002;12(5):391-397. https://doi.org/10.1016/S1050-6411(02)00047-0
  12. Geoffrey CB, Julie K, Geoff S, et al. Contributing factors to muscle weakness in children with cerebralpalsy. Developmental Medicine & Child Neurology. 2003; 45(8):542-550. https://doi.org/10.1111/j.1469-8749.2003.tb00954.x
  13. Hartung HP, Grossman RI. ADEM: distinct disease or part of the MS spectrum? Neurology. 2001;56(10): 1257-1260. https://doi.org/10.1212/WNL.56.10.1257
  14. Kendall FP, McCreary EK, Provance PG, et al. Muscles testing and function with posture and pain, 5th ed. Philadelphia. Lippincott Williams and Wilkins. 2005.
  15. Lamontagne A, Malouin F, Richards CL, et al. Mechanisms of disturbed motor control in ankle weakness during gait after stroke. Gait Posture. 2002;15(3):244-255. https://doi.org/10.1016/S0966-6362(01)00190-4
  16. Lee JS, Lee JS, Coe Cj. A case of acute disseminated encephalomyelitis. Journal of Korea child neurology society. 1994;2(1)191-199.
  17. Lin CH, Jeng JS, Hsieh ST. Acute disseminated encephalomyelitis: a follow-up study in Taiwan. Journal of Neurology, Neurosurgery & Psychiatry. 2007;78(2):162-167. https://doi.org/10.1136/jnnp.2005.084194
  18. Lin PY, Yang YR, Cheng SJ, et al. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Archives of Physical Medicine and Rehabilitation. 2006;87(4):562-568. https://doi.org/10.1016/j.apmr.2005.12.042
  19. Lord SR, Murray SM, Chapman K, et al. Sit-to-stand performance depends on sensation, speed, balance,and psychologicalstatus in addition to strength in older people. Journal Gerontology Series A: Biological Sciences Medical Sciences. 2002;57(8):539-543. https://doi.org/10.1093/gerona/57.8.M539
  20. Ma SY, Hwang YT. The effects of PNF on the temporal-Spatial gait parameters and lower limb joint in patients with stroke. Journal of rehabilitation research. 2009; 13(2):159-173.
  21. McNee AE, Gough M, Morrissey MC, et al. Increases in muscle volume after plantarflexor strength training in children with spastic cerebralpalsy. Developmental Medicine & Child Neurology. 2009;51(6):429-435. https://doi.org/10.1111/j.1469-8749.2008.03230.x
  22. Menge T, Hemmer B, Nessler S, et al. Acute disseminated encephalomyelitis: an update. Archives of Neurology. 2005;62(11):1673-1680. https://doi.org/10.1001/archneur.62.11.1673
  23. Menz, HB, Morris ME, Lord SR. Foot and ankle characteristics associated with impaired balance and functional ability in older people. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 2005;60(12):1546-1552. https://doi.org/10.1093/gerona/60.12.1546
  24. Noureddin NA, Soofia N, Parastoo Y, et al. Inter- and intrarater reliability of the modified Ashworth scale in patients with knee extensor poststroke spasticity. Physiotherapy Theory and Practice. 2008;24(3): 205-213. https://doi.org/10.1080/09593980701523802
  25. Shin KT. Steps to internal medicine. Seoul. Jung-Dam Publishing. 2002.
  26. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinicalpractice, 3rd ed. Philadelphia. Lippincott Williams & Wilkins. 2007.
  27. 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. Physical Therapy. 2002;82(2):128-137. https://doi.org/10.1093/ptj/82.2.128
  28. Sullivan SBO, Schmitz TJ. Physical rehabilitation, 5th ed. New Delhi. Jaypee Brothers Publication. 2007.
  29. Tenembaum S, Chitnis T, Ness J, et al. Acute disseminated encephalomyelitis. Neurology. 2007;68(16):23-36.
  30. Trueblood PR. Partialbody weight treadmill training in persons with chronic stroke. NeuroRehabilitation. 2001; 16(3):141-153.
  31. Tyson S, De Souza L. Development of the brunel balance assessment: a new measure of balance disability poststroke. Clinical Rehabilitation. 2004;18(7): 801-810. https://doi.org/10.1191/0269215504cr744oa
  32. Whitney SL, Poole JL, Cass SP. A review of balance instruments for older adults. American Journal Occupational Therapy. 1998;52(8):666-671. https://doi.org/10.5014/ajot.52.8.666