Purpose : The purpose of this research was to determine the effects of Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined on gait ability in hemiplegic gait. Methods : The subjects of this study were 13 hemiplegic patients. Each subjects was taken PNF pattern and FES of combined with 5 times per week for 4weeks. Pre- and Post-intervention change in gait ability were measured using an Timed up and Go test, stride length of the affected side, step length of the affected side. The data were analyzed using the paired t-test. Results : The results of this study were showed significantly improvement in TUG, stride length of the affected side, step length of the affected side after intervention. Conclusion : These results suggest that the Proprioceptive Neuromuscular Facilitation(PNF) and Functional Electrical Stimulation(FES) of combined exercise is an effective way of improving gait ability for hemiplegic patients.
Purpose : The purpose of present study was to investigate the effects of proprioceptive neuromuscular facilitation (PNF) lifting on contralateral leg muscle activities in a seated position. Methods : Twenty healthy subjects were recruited for this study. Lifting was performed from each of the three position. An surface electromyogram (EMG) was used to record the EMG activities from vastus medialis (VM), biceps femoris (BF), tibialis anterior (TA), and gastrocnemius medialis (GM) in contralateral leg muscle. The data were analyzed using a repeated measures of one-way analysis of variance (ANOVA) with post-hoc Bonferroni's correction to determine the statistical significance. Results : The results of this study were summarized as follows: In comparison to the start position, percentage maximal voluntary isometric contraction (%MVIC) values of the VM, TA and GM demonstrated a significantly higher activities in the end position(p<.05). Conclusion : The result shows that contralateral leg muscles activities significantly more increase in the end position when PNF lifting was applied. Therefore, this study will be used to prove effect of indirect approach for the stability and strengthening in patients with leg impairments.
Journal of International Academy of Physical Therapy Research
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v.12
no.2
/
pp.2365-2369
/
2021
Background: Patients with dysphagia after stroke are treated with neuromuscular electrical stimulation (NMES), but its effect on masseter muscle thickness and bite force in the oral phase is not well known. Objectives: To investigated the effect of NMES on masseter muscle thickness and occlusal force in patients with dysphagia after stroke. Design: Two group, pre-post design. Methods: In this study, 25 patients with dysphagia after stroke were recruited and allocated to either the experimental or the control groups. Patients in the experimental group were treated with NMES to the masseter muscle at the motor level for 30 minutes and were additionally treated with traditional swallowing rehabilitation for 30 minutes. In contrast, patients in the control group were only treated with traditional swallowing rehabilitation for 30 minutes. Masseter muscle thickness was measured using ultrasonography before and after intervention, and bite force was measured using an bite force meter. Results: The experimental group showed significant improvement in masseter muscle thickness and bite force compared to the control group. Conclusion: NMES combined with traditional dysphagia rehabilitation is effective in improving masseter muscle thickness and bite force in patients with dysphagia after stroke.
Objective: We aimed to identify the effects of proprioceptive neuromuscular facilitation (PNF) stretching on pain, hip range of motion, and functional disability in patients with chronic low back pain. Design: Randomized controlled trial Methods: In total, 45 patients with chronic low back pain were randomly divided into a conventional stretching group (n=22) and a PNF stretching group (n=23). Both interventions were performed three times per week for 6 weeks. Assessments were made using the visual analog scale, Flexion-Abduction-External Rotation test, modified Thomas test, prone hip extension test, and Oswestry disability index before and after the 6-week intervention period. We conducted a paired t-test to compare the within-group findings before and after the intervention. An independent t-test was used to compare the between-group differences. The statistical significance level was set at α=0.05, for all variables. Results: Both groups showed significant improvements in pain, hip range of motion, and functional disability after the intervention (p<0.05). A significant difference was observed in pain, hip range of motion, and functional disability in patients belonging to the PNF stretching group (p<0.05). Conclusions: This study provides evidence that the application of PNF stretching can effectively reduce pain and improve hip range of motion and functional disability in patients with chronic low back pain.
Journal of the Korean Society of Physical Medicine
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v.16
no.3
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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.
Jeong, Hui Su;Kim, Hye Jin;Kim, Deok-Ho;Chung, Ki Wha;Choi, Byung-Ok;Lee, Ji Eun
Molecules and Cells
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v.45
no.4
/
pp.231-242
/
2022
The neuromuscular junction (NMJ), which is a synapse for signal transmission from motor neurons to muscle cells, has emerged as an important region because of its association with several peripheral neuropathies. In particular, mutations in GARS that affect the formation of NMJ result in Charcot-Marie-Tooth disease and distal hereditary motor neuropathy. These disorders are mainly considered to be caused by neuronal axon abnormalities; however, no treatment is currently available. Therefore, in order to determine whether the NMJ could be targeted to treat neurodegenerative disorders, we investigated the NMJ recovery effect of HDAC6 inhibitors, which have been used in the treatment of several peripheral neuropathies. In the present study, we demonstrated that HDAC6 inhibition was sufficient to enhance movement by restoring NMJ impairments observed in a zebrafish disease model. We found that CKD-504, a novel HDAC6 inhibitor, was effective in repairing NMJ defects, suggesting that treatment of neurodegenerative diseases via NMJ targeting is possible.
Piriformis muscle syndrome is a condition that causes direct muscle pain around piriformis muscle or sciatica from irritated sciatic nerve and the diagnosis remains debatable. The main treatment is symptomatic relief from conservative therapy such as medication and piriformis stretching exercise, and various therapeutic injections including local anesthetic, corticosteroid, botulinum toxin can be considered for diagnostic and therapeutic purposes. In this case, a 54-year-old male who had sciatica and gait disturbance showed piriformis muscle hypertrophy in the pelvis MRI. From imaging studies, electrodiagnostic study and physical examination, he was diagnosed with piriformis muscle syndrome. He underwent trigger point injection and botulinum toxin injection into the piriformis muscle, and pain and gait disturbance significantly improved. This case reports a case of piriformis muscle syndrome with clinical symptom of gait disturbance, which was improved by botulinum toxin injection.
Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.
Purpose : The purpose of this study was to find out The effect of Low back pain on the total pattens of Proprioceptive neuromuscular facilitation(PNF). Methods : The subjects of the study were 62 low back pain patients. They were divided into two groups: 31 in the experimental group and 31 in the control group. the experimental group performed modalities and PNF total patterns three times for a week. the control group performed only modalities and ROM exercise three times for a week. Back muscle strength was measured by a back muscle strength measuring machine, the intensity of pain was measured by the Visual Analogue Scale (VAS), and the level of disability was measured by Oswestry low back pain disability index. Study measurements were compared before and after 6 weeks exercise program. The two groups of subjects were assessed by utilizing two different balance measurement: Static standing balance was measured by balance performance monitor (BPM) and Dynamic standing balance was measured by one leg standing(OLS). The scale for static standing balance was measured by using, sway area, sway path, max velocity. Results : The results of this study were as follow: 1) The score on visual analogue scale shows statistically significant increase on PNF group of post test(p<.05). 2) The score on Oswestry low back pain disability index. shows statistically significant decrease on PNF group of post test(p<.05). 3) The change sway area was statistically significant on pre-test and post-test(p<.05). 4) The change sway path was statistically significant on pre-test and post-test(p<.05). 5) The change max velocity was statistically significant on pre-test and post-test(p<.05). 6) The score on one leg standing shows statistically significant increase on PNF group of post test(p<.05). Conclusion : These results of this study indicated that Proprioceptive Neuromuscular Facilitation Total patterns which performed for six weeks had a statistically significant influence on low back pain. If the exercise for muscle strength is performed along with therapeutic stabilizing exercise, a better effect can be expected on low back pain. We hope that this study will provide a basic data for further research with a bigger group and on a long-term effect.
Amyotrophic lateral sclerosis (ALS) is a degenerative neuromuscular disease of unknown etiology in which the upper and lower motor neurons are progressively destroyed. Recent evidences support the role of autoimmune mechanisms in the pathogenesis of ALS. This study investigated the effects of sera from ALS patients on neuromuscular transmission in phrenic nerve-hemidiaphragm preparations and on calcium currents of single isolated dorsal root ganglion (DRG) cells in mice. Mice were injected with either control sera from healthy adults or ALS sera from 18 patients with ALS of sporadic form, for three days. Miniature end plate potential (MEPP) and nerve-evoked end plate potential (EPP) were measured using intracellular recording technique and the quantal content was determined. Single isolated DRG cells were voltage-clamped with the whole-cell configuration and membrane currents were recorded. Sera from 14 of 18 ALS patients caused a significant increase in MEPP frequency in normal Ringer's solution $(4.62{\pm}0.14\;Hz)$ compared with the control $(2.18{\pm}0.15\;Hz).$ In a high $Mg^{2+}/low\;Ca^{2+}$ solution, sera from 13 of 18 ALS patients caused a significant increase in MEPP frequency, from $2.18{\pm}0.31$ Hz to $6.09{\pm}0.38$ Hz. Sera from 11 of 18 patients produced a significant increase of nerve-evoked EPP amplitude, from $0.92{\pm}0.05$ mV to $1.30{\pm}0.04$ mV, while the other seven ALS sera did not alter EPP amplitude. In the ALS group, EPP quantal content was also elevated by the sera of 14 patients (from $1.49{\pm}0.07$ to $2.35{\pm}0.07).$ MEPP frequency and amplitude in wobbler mouse were $4.03{\pm}0.53$ Hz and $1.37{\pm}0.18$ mV, respectively, which were significantly higher than those of wobbler controls (wobblers without the symptoms of wobbler). Sera from ALS patients significantly reduced HVA calcium currents of DRG cells to 42.7% at -10 mV. Furthermore, the inactivation curve shifted to more negative potentials with its half-inactivation potential changed by 6.98 mV. There were, however, significant changes neither in the reversal potential of $I_{Ca}$ nor in the I-V curve. From these results it was concluded that: 1) The serum factors of sporadic ALS patients increase neuromuscular transmission and can alter motor nerve terminal presynaptic function. This suggests that ALS serum factors may play an important role in the early stage of ALS, and 2) Calcium currents in DRG cells were reduced and rapidly inactivated by ALS sera, suggesting that in these cells, ALS serum factors may exert interaction with the calcium channel.
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