• 대한물리의학회지
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• 제14권2호
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• pp.107-115
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• 2019

PURPOSE: This study examined the effects of the chopping pattern of proprioceptive neuromuscular facilitation (PNF) on the neglect, balance ability, and activities of daily living in stroke patients with hemi-spatial neglect. METHODS: Twenty stroke patients with neglect volunteered for this study. The subjects were assigned randomly to either the experimental group (EG, n=10) or control group (CG, n=10). The chopping pattern of PNF and exercise therapy were applied in the EG and CG, respectively, for four weeks. Neglect, balance, and activities of daily living were evaluated at the pre-and post-intervention. The assessment tools included a line-bisection test, balance test using Space balance 3D, and modified Barthel index. The pre-and post-intervention values were compared in each group using a paired t-test and the between-group differences were assessed using an independent t-test. Statistical significance was set to ${\alpha}=.05$ for all variables. RESULTS: Significant differences were observed between the EG and CG in terms of neglect, balance, and activities of daily living (p<.05). Both groups showed significant improvement in neglect, balance, and activities of daily living (p<.05). CONCLUSION: These results suggest that the chopping pattern of PNF is effective in improving the hemi-spatial neglect, balance, and activities of daily living in stroke patients with neglect.

• 대한물리의학회지
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• 제14권2호
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• pp.125-135
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• 2019

PURPOSE: This study examined the effects of low frequency neuromuscular electrical stimulation (NMES) training on abdominal obesity in middle-aged women through electromyography and ultrasound. METHODS: Twenty-two middle aged women with abdominal obesity participated in the study. A low-frequency NMES device was used on the abdomen and waist of each subject for 20 minutes each (a total of 40 minutes) three times a week for eight weeks. The waist-hip ratio (WHR), weight and BMI (Body Mass Index) were measured. Electromyography (EMG) and ultrasound measurements were performed three times in total (pre-intervention, four weeks into the intervention, and eight weeks post-intervention) to examine the effects of low-frequency NMES on the abdominal muscle activity, muscle thickness, and subcutaneous fat. RESULTS: The results indicated a difference in the WHR and waist circumference before and after intervention (p<.05). The external oblique muscle (EO) showed a significant increase in muscle activity during all measurements taken post-intervention (p<.05). The abdominal subcutaneous fat thickness also showed a significant decrease between each measurement (p<.05). The test results showed that the abdominal subcutaneous fat thickness values taken eight weeks post-intervention were significantly lower than those taken pre-intervention and four weeks into the intervention (p<.05). CONCLUSION: These findings show that low-frequency NMES device training can be applied to middle-aged women with abdominal obesity to improve their body shape and exercise performance.

• PNF and Movement
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• 제17권1호
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• pp.11-18
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• 2019

Purpose: This study verifies the muscle activity around the amputation site during proprioceptive neuromuscular facilitation (PNF) pattern exercise for the upper extremities on the non-amputated part in upper extremity amputees and provides basic data on effective exercise around an amputation site. Methods: Manual resistance was applied to the PNF upper extremity pattern of the non-amputated part to generate muscle activity around the amputation site. The resistance was adjusted to an intensity that could cause maximal isometric contraction. The muscle activity of the amputation site and the non-amputated part was measured using a surface electromyogram for the upper trapezius, middle trapezius, infraspinatus, serratus anterior, and pectoralis major. Results: During the scapular exercise in the painless range, the amputated side showed significantly lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. During the PNF pattern exercise in the painless range, the amputated side showed lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. When the direct scapular exercise of the amputated side was compared with the PNF pattern exercise of the non-amputated side, their muscle contraction ratios were similar. Conclusion: This study confirmed the effectiveness of the PNF pattern exercise of the non-amputated part as a way to indirectly train the injured site with no pain for rehabilitation of patients with serious body injuries, such as amputation. It is necessary to develop effective exercise programs for the rehabilitation of the amputation site based on the results of this study.

• 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.

• PNF and Movement
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• 제12권2호
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• pp.107-113
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• 2014

Purpose: The objective of this study was to identify functional problems, including walking ability, of patients with strokes using the International Classification of Functioning, Disability, and Health (ICF) and to present a method that could solve functional problems, thereby determining the applicability of the ICF to increase the quality of evaluation and intervention in clinical fields in the future. Methods: Information on stroke patients who were admitted and treated in a hospital was collected. The authors conducted evaluations, interventions, and measurements of the results of the ICF tool in order to improve gait abilities of patients. The subjects were trained using proprioceptive neuromuscular facilitation (PNF) one hour a day and five times a week for four weeks. The result measurement variables were a six-minute gait test, 10 m velocity test, gait instability test, and measurements using the ICF sheet. Results: In the six-minute gait test, gait distance increased by 48 m, from 102 m to 150 m. The gait velocity test result showed an improvement from 0.36m/s to 0.44m/s. The subjects performed a gait instabilitytestwithacupfilledwith50mmwater. In the gait instability test, the amount of water was 38 mm before the intervention; however, it was 50 mm after the intervention. The gait velocity with a cup filled with water improved from 0.25m/s to 0.31m/s. Conclusion: An evaluation and intervention were designed with the ICF tool for stroke patients. Gait abilities improved when the PNF technique was used. The IFC method can be used for evaluation and intervention, and it could help improve gait abilities of stroke patients.

• PNF and Movement
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• 제18권3호
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• pp.435-444
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• 2020

Purpose: This study aimed to compare the elector spine muscle tone using the irradiation of the proprioceptive neuromuscular facilitation (PNF) arm pattern according to angular motion. Methods: Thirty subjects participated in this study. Elector spine muscle tone was measured using a Myotonpro device while in the sitting position according to the angular motion (70°, 100°, 130°) of the PNF arm pattern using a D1 flexion pattern. Each angular motion of the PNF arm pattern was performed with a continuous passive motion (CPM). The change in elector spine muscle tone was statistically evaluated using a repeated one-way ANOVA test. Post-hoc analysis was performed using the Bonferroni method. Results: The results revealed a significant change in elector spine muscle tone when performing the PNF arm pattern using D1 flexion pattern. Specifically, the elector spine muscle tone had significantly increased at 100° and 130° motion in the PNF arm pattern when compared to the initial muscle tone (p < 0.05). No significant muscle tone changes were noted for any of the angular motions of the PNF upper arm pattern (p > 0.05). Conclusion: The results of this study indicate a positive increase in elector spine muscle tone with irradiation of the PNF upper arm pattern exercise with 100° or 130° angular motion. The minimum angle at which the effect of the irradiation of the PNF arm pattern could be seen was 100°.

• The Journal of Korean Physical Therapy
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• 제34권5호
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• pp.278-281
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• 2022

Purpose: This study sought to compare the muscle activity of the deltoid muscle according to the range of motion during the proprioceptive neuromuscular facilitation (PNF) upper extremity D2 pattern exercise performed with an isokinetic exercise device. The aim was to provide basic data for selecting an exercise for the relevant segment of the range of motion to enhance function in clinical practice. Methods: In this study, the relevant measurements of the anterior and middle trapezius of 25 healthy adults were taken using a surface electromyography system. The upper extremity pattern exercise was performed in three ranges (0% to 50%, 50% to 100%, and 25% to 75%) using the upper extremity isokinetic device. Results: There was a statistically significant difference in the muscle activity ratios of the anterior and middle deltoid muscles according to the measurement conditions (p<0.05). There was a statistically significant difference in the activity ratio of the middle deltoid muscle according to the measurement conditions in the ratio from the start range to the end range (p<0.05). There was no significant difference in the muscle onset time difference according to the measurement conditions (p>0.05). Conclusion: The muscle activity of the anterior and middle deltoid muscles was analyzed according to the range of motion during the PNF upper extremity pattern exercise performed with an isokinetic device. The results could be used as a basis for selecting exercises for the relevant segment of the range of motion according to the function to be emphasized.

• Clinical Pain
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• 제20권2호
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• pp.127-130
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• 2021

Ultrasound (US)-guided hydrodissection (HD) is a widely applied therapeutic method to release the entrapped peripheral nerve. However, this therapy has only been studied for the nerve entrapments such as carpal tunnel syndrome, and there are no reports of its effect on direct nerve injuries with incomplete axonal damage. Here, we report a case of direct traumatic injury of a median nerve with incomplete axonal injury in a 28-year-old man. He presented hypoesthesia and weakness along with the median nerve territory of the left hand after a laceration wound of the wrist. The patient underwent a surgical procedure, but did not experience prominent improvement for the next six months. Symptoms improved after we performed the US-guided HD with dextrose. We propose this procedure as one of the new treatment methods for direct axonal injury of nerves including the median nerve.

• 한국전문물리치료학회지
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• 제29권4호
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• pp.269-273
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is used for muscle strengthening. While voluntary muscle contraction follows Henneman et al.'s size principle, the NMES-induced muscle training disrespects the neurophysiology, which may lead to unwanted changes (i.e., declined balance ability). Objects: We examined how the balance was affected by abdominal muscle training with the NMES. Methods: Fifteen young adults (10 males and 5 females) aged between 21 and 30 received abdominal muscle strengthening with NMES for 23 minutes. Before and after the training, participants' balance was measured through one leg standing on a force plate with eyes open or closed. Outcome variables included mean distance (MDIST), root mean square distance (RDIST), total excursion (TOTEX), mean velocity (MVELO), and 95% confidence circle area (AREA) of center of pressure data. Two-way repeated measures analysis of variance was used to test if these outcome variables were associated with time (pre and post) and vision. Results: All outcome variables were not associated with time (p > 0.05). However, all outcome variables were associated with vision (p = 0.0001), and MVELO and TOTEX were 52.4% (45.5 mm/s versus 95.6 mm/s) and 52.4% (364.1 mm versus 764.5 mm) smaller, respectively, in eyes open than eyes closed (F = 55.8, p = 0.0005; F = 55.8, p = 0.0005). Furthermore, there was no interaction between time and vision (F = 0.024, p = 0.877). Conclusion: Despite the different neurophysiology of muscle contraction, abdominal muscle strengthening with NMES did not affect balance.

• 한국전문물리치료학회지
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• 제29권3호
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• pp.187-193
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• 2022

Background: Neuromuscular electrical stimulation (NMES) is a physical modality used to activate skeletal muscles for strengthening. While voluntary muscle contraction (VMC) follows the progressive recruitment of motor units in order of size from small to large, NMES-induced muscle contraction occurs in a nonselective and synchronous pattern. Therefore, the outcome of muscle strengthening training using NMES-induced versus voluntary contraction might be different, which might affect balance performance. Objects: We examined how the NMES training affected balance and proprioception. Methods: Forty-four young adults were randomly assigned to NMES and VMC group. All participants performed one-leg standing on a force plate and sat on the Biodex (Biodex R Corp.) to measure balance and ankle proprioception, respectively. All measures were conducted before and after a training session. In NMES group, electric pads were placed on the tibialis anterior, gastrocnemius, and soleus muscles for 20 minutes. In VMC group, co-contraction of the three muscles was conducted. Outcome variables included mean distance, root mean square distance, total excursion, mean velocity, 95% confidence circle area acquired from the center of pressure data, and absolute error of dorsi/plantarflexion. Results: None of outcome variables were associated with group (p > 0.35). However, all but plantarflexion error was associated with time (p < 0.02), and the area and mean velocity were 37.0% and 18.6% lower in post than pre in NMES group, respectively, and 48.9% and 16.7% lower in post than pre in VMC group, respectively. Conclusion: Despite different physiology underlying the NMES-induced versus VMC, both training methods improved balance and ankle joint proprioception.