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The Effect of Proprioceptive Neuromuscular Facilitation Exercise on the Range of Motion, Pain, and Functional Activity of Total Knee Arthroplasty Patients

고유수용성신경근촉진법 운동이 무릎관절 전치환술환자의 관절가동범위와 통증 및 기능적 활동에 미치는 영향

  • 김창헌 (대자인병원 재활센터) ;
  • 강태우 (원광대학교병원 물리치료실) ;
  • 김범룡 (대자인병원 재활센터)
  • Received : 2018.01.03
  • Accepted : 2018.02.09
  • Published : 2018.04.30

Abstract

Purpose: This study investigated the effects of proprioceptive neuromuscular facilitation (PNF) exercise on the range of motion (ROM), pain, and functional activity of patients who received total knee arthroplasty (TKA). The purpose of this study was to provide fundamental data regarding the use of PNF exercise among patients with musculoskeletal disease. Methods: Fourteen patients who received TKA were randomly divided into an experimental group (n=7) that took part in PNF exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 2 weeks. For the measurement of ROM, the range of knee flexion was measured using a clinometer smartphone application. A visual analogue scale (VAS) was used for the measurement of the level of pain. The timed up and go test (TUG) was conducted to measure functional activity. A paired t-test was performed to compare within-group changes before and after the PNF exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at ${\alpha}=0.05$. Results: After the exercise, there was a significant within-group change in VAS and TUG scores in the experimental group and control group (p<0.01). There was also a significant between-group difference in VAS and TUG scores after the intervention (p<0.05). Conclusion: General rehabilitation exercise is commonly applied as a treatment for TKA patients and is relatively effective. The application of PNF exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.

Keywords

References

  1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Heidelberg. Springer. 2016.
  2. Bae CH, Jung YW, Lee DW, et al. The effect of sling exercise on muscular strength and range of motion in female patients who received total knee replacement. Journal of the Korea Academia-Industrial cooperation Society. 2014;15(7):4395-4403. https://doi.org/10.5762/KAIS.2014.15.7.4395
  3. Bae CH, Kim SI, Cho SH, et al. Effect of early exercise therapy on proprioception and pain scale after total knee replacement. The Journal of Korean Society of Health Sciences. 2013;10(2):69-78.
  4. Bong SY, Kim YJ, Kang MG, et al. Effects of proprioceptive neuromuscular facilitation exercise on forced expiratory volume at one second, pain, and functional disability index of chronic low back pain patients. PNF and Movement. 2016;14(3):185-193. https://doi.org/10.21598/JKPNFA.2016.14.3.185
  5. Capdevila X, Barthelet Y, Biboulet P, et al. Effects of perioperative analgesic technique on the surgical outcome and duration of rehabilitation after major knee surgery. Anesthesiology. 1999;91(1):8-15. https://doi.org/10.1097/00000542-199907000-00006
  6. Cho WS, Youm YS, Yang BS. The causes of revision total knee arthroplasty. The Journal of the Korean Orthopaedic Association. 2007;42(2):216-220. https://doi.org/10.4055/jkoa.2007.42.2.216
  7. Cornelius WL, Hands MR. The effects of a warm-up on acute hip joint flexibility using a modified PNF stretching technique. Journal of Athletic Training. 1992;27(2):112-114.
  8. Jeong WM, Kim BR, Kang MG. Effect of treadmill training and proprioceptive neuromuscular facilitation lower leg taping on balance and gait ability in stroke patients. PNF and Movement. 2016;14(2):83-91. https://doi.org/10.21598/JKPNFA.2016.14.2.83
  9. Jeong WM, Kim BR. The effects of proprioceptive neuromuscular facilitation exercise on the pain and functional disability index of patients with chronic lower back pain. PNF and Movement. 2017;15(2):195-200.
  10. Jogi P, Zecevic A, Overend TJ, et al. Force-plate analyses of balance following a balance exercise program during acute post-operative phase in individuals with total hip and knee arthroplasty: A randomized clinical trial. SAGE Open Medicine. 2016;4(1):1-9.
  11. Jo H. The effects of neuromuscular electrical stimulation on quadriceps muscle strengthening and balance in patients with total knee arthroplasty. Daegu University. Dissertation of Master's Degree. 2016.
  12. Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. Journal of Exercise Rehabilitation. 2017;13(4):486-490. https://doi.org/10.12965/jer.1735030.515
  13. Kim CH, Kim BR, Kang MG. Effect of rhythmic stabilization technique, before proprioceptive neuromuscular facilitation wrist taping, on grip strength and pain in wrist pain patients. PNF and Movement. 2016;14(2):105-112. https://doi.org/10.21598/JKPNFA.2016.14.2.105
  14. Kim CH, Kim BR. The effects of abdominal strength training using proprioceptive neuromuscular facilitation on the balance ability and pain of patients with chronic lower back pain. PNF and Movement. 2017;15(2):141-148.
  15. Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of aging and physical activity. 2002;10(4):476-488. https://doi.org/10.1123/japa.10.4.476
  16. Lee KM, Lee JH, Kwok CS, et al. Effect of closed chain exercise on strength of vastus medialis obliquus muscle and functional activities in patients with total knee replacement. The Korean Academy of Neural Rehabilitation. 2017;7(1):29-35.
  17. Lee SH. The effects of physical therapy intervention methods on range of motion, muscular strength, and balance after total knee replacement. Kwangju Women's University. Dissertation of Master's Degree. 2014.
  18. Lingjaerde O, Foreland AR. Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity. Psychiatry Research. 1998;81(3):387-392. https://doi.org/10.1016/S0165-1781(98)00119-X
  19. MacDonald SJ, Bourne RB, Rorabeck CH, et al. Prospective randomized clinical trial of continuous passive motion after total knee arthroplasty. Clinical Orthopaedics and Related Research. 2000;(380):30-35.
  20. Min HS, Jung YH, Kim ES, et al. Effects of muscle strengthening exercise program on pain, fatigue, physical function in elderly women with total knee arthroplasty. Journal of muscle and joint health. 2011;18(2):203-214. https://doi.org/10.5953/JMJH.2011.18.2.203
  21. Mizner RL, Petterson SC, Snyder-Mackler L. Quadriceps strength and the time course of functional recovery after total knee arthroplasty. Journal of Orthopaedic and Sports Physical Therapy. 2005;35(7):424-436. https://doi.org/10.2519/jospt.2005.35.7.424
  22. Moffet H, Collet JP, Shapiro SH, et al. Effectiveness of intensive rehabilitation on functional ability and quality of life after first total knee arthroplasty: a single-blind randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2004;85(4):546-556. https://doi.org/10.1016/j.apmr.2003.08.080
  23. Noh EK. The study of functional training in static and dynamic balance after total knee arthroplasty in elderly patients. Eulji University. Dissertation of Master's Degree. 2016.
  24. Oh SK. The influence of interferential current therapy, laser on the pain and functional recovery after total knee replacement. Nambu University. Dissertation of Master's Degree. 2014.
  25. Park SK, Kim JH. Effects of EMG-biofeedback training on total knee replacement patients' lower extremity muscle activity and balance. The Journal of Korean Physical Therapy. 2013;25(2):81-87.
  26. Podsiadlo D, Richardson S. The timed "Up & Go": a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society. 1991;39(2):142-148. https://doi.org/10.1111/j.1532-5415.1991.tb01616.x
  27. Puentedura EJ, Huijbregts PA, Celeste S, et al. Immediate effects of quantified hamstring stretching: hold-relax proprioceptive neuromuscular facilitation versus static stretching. Physical Therapy in Sport. 2011;12(3):122-126. https://doi.org/10.1016/j.ptsp.2011.02.006
  28. Rahmann AE, Brauer SG, Nitz JC. A specific inpatient aquatic physiotherapy program improves strength after total hip or knee replacement surgery: a randomized controlled trial. Archives of Physical Medicine and Rehabilitation. 2009;90(5):745-755. https://doi.org/10.1016/j.apmr.2008.12.011
  29. Song MS, Kim BR, Kang MG. The effect of CI technique in PNF and sport taping on pain and grip strength in patients with lateral epicondylitis. PNF and Movement. 2016;14(1):33-39. https://doi.org/10.21598/JKPNFA.2016.14.1.33
  30. Song MS, Kim BR, Kim CH, et al. A case report of a proprioceptive neuromuscular facilitation intervention strategy applied with an ICF tool in a patient with anterior cruciate ligament reconstruction. PNF and Movement. 2017;15(1):1-11. https://doi.org/10.21598/JKPNFA.2017.15.1.1
  31. Werner BC, Holzgrefe RE, Griffin JW, et al. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. Journal of Shoulder and Elbow Surgery. 2014;23(11):275-282. https://doi.org/10.1016/j.jse.2014.02.030
  32. Yun JY, Lee JK. Effects of a thera-band exercise program on pain, knee flexion ROM, and psychological parameters following total knee arthroplasty. Journal of Korean Academy of Nursing. 2016;45(6):823-833. https://doi.org/10.4040/jkan.2015.45.6.823
  33. Zhou Z, Yew KS, Arul E, et al. Recovery in knee range of motion reaches a plateau by 12 months after total knee arthroplasty. Knee Surgery Sports Traumatology Arthroscopy. 2015;23(6):1729-1733. https://doi.org/10.1007/s00167-014-3212-1