• 대한물리의학회지
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• 제16권3호
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• pp.55-64
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• 2021

PURPOSE: The purpose of this study was to apply dynamic neuromuscular stabilization (DNS) to subjects with forward head posture (FHP) and to compare its effects on respiratory function as against the conventional neck stabilization exercise and neck stretching and extensor strengthening exercises. METHODS: The whole-body posture measurement system was used to measure the degree of FHP, and a spirometer and a respiratory gas analyzer were used to measure the respiratory function. After the intervention was completed, the changes over time were analyzed in the DNS group, the neck stabilization exercise group, and the neck stretching and extensor strengthening exercise group. The inter-group difference in the changes was also analyzed. A repeated ANOVA was performed to compare the respiratory function according to the period between the three groups, and the least significant difference (LSD) method was used for the post hoc test. RESULTS: After the 6-week exercise period, respiratory functions, such as forced vital capacity (FVC), forced expiratory volume for 1 second (FEV1), forced expiratory volume for 1 sec/forced vital capacity (FEV1/FVC), maximum oxygen intake (VO₂max), and the volume of expired gas (VE), significantly improved according to the period (p < .05), but no inter-group differences were found. CONCLUSION: DNS is an effective training method, and can be applied along with neck stabilization exercise and neck stretching and extensor strengthening exercises, which are widely used in clinical practice, to people with FHP who cannot directly perform neck exercises to improve their respiratory function.

• PNF and Movement
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• 제5권2호
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• pp.37-46
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• 2007

Purpose : The purpose of this study was to examine the effects of combination of isotonic and rhythmic stabilization in proprioceptive neuromuscular facilitation on trunk stability and balance in elderly people with chronic low back pain. Subjects : Thirty-two elderly people ($73.78{\pm}8.49$ years of age) who had complaints of CLBP were randomly assigned to 2 groups: experimental group and control group. Methods : Subject trained with combination of isotonic and rhythmic stabilization in proprioceptive neuromuscular facilitation for 4weeks with aim of improving trunk stability and balance. Weight distribution, trunk muscle balance, static balance ability and dynamic balance ability were measured before, at the end of training. Results : Data were analyzed using two-way ANOVA. After the exercise programs, there were significant differences in the weight distribution, trunk muscle balance and dynamic balance ability between the experimental and control group. However there was no significant difference in the one leg stance test(p<.05). Conclusion : This study suggest that PNF programs may be appropriate for improving trunk stability and balance in elderly people with CLBP.

• PNF and Movement
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• 제14권3호
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• pp.237-244
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• 2016

Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

• 대한정형도수물리치료학회지
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• 제18권1호
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• pp.65-72
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• 2012

Background: The purpose of this study is on finding the effects of the lumbar stabilization exercise applied with the proprioceptive neuromuscular facilitation technique (PNF) to the balance and the gait of chronic stroke patients. Methods: An experiment was conducted using two sets of behavioral measures with 30 chronic stroke hospitalized patients in the rehabilitation center located in Incheon city. The 15 participants in group A were instructed to apply the traditional exercise therapy. And the other 15 participants were assigned to apply the lumbar stabilization exercise with the PNF technique. It was conducted for 30 minutes per three days for six weeks, which had eighteen times. Using the balance system, it was checked about the static and dynamic balance. Using the Gaitrite, it was checked about the ability of the gait. Results: There was a better effect on both groups especially with the static balance. Those who were applied the lumbar stabilization exercise with the PNF technique had a better result on the dynamic balance and the gait than those applied the traditional exercise therapy. Conclusion: This research shows that the Lumbar Stabilization Exercise applied with the PNF technique is more effective on dynamic balance and the gait performance ability of the chronic stroke patients.

• 한국전문물리치료학회지
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• 제26권4호
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• pp.1-9
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• 2019

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.215-224
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• 2022

Background: The presence of the lumbopelvic-hip neuromuscular chain is essential for dynamic spinal stabilization; its therapeutic effects on dynamic movements of the distal extremity segment and underpinning motor mechanism remain unknown and warrant further study on participants with low back pain (LBP). Objects: We aim to compare the effects of the broken chain exercise (BCE) and connected chain exercise (CCE) on electromyography (EMG) amplitude and onset time in participants with and without LBP. Methods: Randomized controlled clinical trial. A convenience sample of 40 nonathletic participants (mean age: 24.78 ± 1.70) with and without LBP participated in this study. All participants underwent CCE for 30 minutes, 30-minute daily. We measured EMG amplitude and onset times on bilateral erector spinae (ES), gluteus maximus (GM), hamstring (HAM), transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) during the prone hip extension (PHE) test before and after the BCE and CCE. We used multivariate analysis of variance (MANOVA) to analyze the amplitude and onset time difference between exercises (BCE and CCE) and Pearson's correlations to determine any synergistic relationship among the HAM, GM, bilateral TrA/IO, and ES muscles. The statistical analyses were used at p < 0.05. Results: MANOVA showed that CCE was more decreased on EMG amplitude in HAM and bilateral ES, while increased GM and contralateral TrA/IO than BCE (p < 0.05). MANOVA EMG onset time data analyses revealed that the main effect of the conditions was significant for all HAM, GM, and bilateral ES muscles, whereas the main effect for the group was significant only for GM and contralateral ES in healthy and LBP groups. Pearson's correlation coefficient was computed to assess the relationship between BCE and CCE on dependent variables. In most of the muscles, there was a strong, positive correlation between the two variables, and there was a significant relationship (p < 0.001). Conclusion: CCE produced more effective and coordinated core stabilization and motor control mechanism in the lumbopelvic-hip muscles in participants with and without LBP during PHE than BCE.

• PNF and Movement
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• 제11권1호
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• pp.7-16
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• 2013

Purpose : The purpose of this study is to analyze the effect of the proprioceptive exercise program on balance performance in order to the suggest hemiplegic patients the therapeutic intervention. Methods : In this study, Proprioceptive exercise program was applied to 11 hemiplegic patients for 6 weeks as follows: First of all, hemi leg flexion-extension pattern was applied in a supine position. Secondly, alternated leg flexion pattern was applied in a standing posture with one hand support on the unstable platform. Thirdly, rhythmic stabilization techniques were applied in a standing posture on the unstable platform. Results : Significant differences were observed the chronic low back pain patient for VAS, BBS. Chronic low back pain patient improved all test. The results of this study were summarized as follows: 1. After intervention, there was a statistically significant change in the dynamic balance (FSST, TUG, FRT) performance(p<.05). 2. After intervention, there was also a statistically significant change in the static balance (FICSIT-4) performance(p<.05). Conclusion : The result of the study suggests that muscle strength exercise by the intervention of proprioceptive exercise program improves the hemiplegic patients' static and dynamic balance performance.

• PNF and Movement
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• 제13권2호
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• pp.73-80
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• 2015

Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.

• The Journal of Korean Physical Therapy
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• 제16권3호
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• pp.205-216
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• 2004

The purpose of this study is to find application of combination of insotonic(CI) in clinical approach. This is a literature study with books and clinical experience. CI was developed after Margaret Knott that is very useful in clinically. CI has two lever system. It has class II lever system for eccentric contraction and class III lever system for concentric contraction. Therefore it make two different contraction that is not only magnitude of motion and speed increase of motion but also biomechanical advantage. Application of CI has much variety by patient position and treatment position. Especially, it is very effectable on mat activities and training for mid stance period. CI apply in supine position on treatment table, mat or high mat activities, bridging activities, all fourth activities and sit on chair activities. CI apply serially with different techniques. These are rhythmic initiation, dynamic reversal, approximation, rhythmic stabilization and replication.

• PNF and Movement
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• 제15권3호
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• pp.353-360
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• 2017

Purpose: This study aimed to measure static balance of low back pain patients while one-leg standing in abdominal compression belts. Methods: The study included 40 adult males and females at J university, divided into a low back pain patient group and a normal group through the Oswestry disability questionnaire (ODQ). The subjects were instructed to hold a one-leg standing posture for 15 seconds on a balance measurement plate while wearing an abdominal compression belt. Shifting distance (0.1 cm), mean velocity (cm/s), pressure, and contact area were analyzed using BioRescue (BioRescue, RMINGEIEIRIE, Rodez, France). The average value was used to measure the result 3 times for each condition. Results: Both normal and low back pain groups significantly decreased in the speed of sway while wearing the abdominal compression belt. Furthermore, the pressure of the center of motion significantly decreased in the low back pain groups while wearing abdominal compression belt. However, there were no significant differences in the speed of sway or the pressure of center of motion between groups after wearing the abdominal pressure belt. Conclusion: These results suggest that abdominal compression belts are one option for improving balance temporarily. However, balance after wearing abdominal compression vests depends on onset of back pain, age, and symptoms of pain in the groups with low back pain. Further research is needed to investigate muscle activity, dynamic balance, and the effect of the period of wearing abdominal compression belts in the variety of low back pain patients.