2-Year Follow up of Balance in Stroke Patients after Myofascial Release using a Tennis Ball - Four Case Reports -

Young-In Hwang,Jang-Whon Yoon,Du-Jin Park 대한고유수용성신경근촉진법학회 2018 PNF and Movement Vol.16 No.1

Purpose: Myofascial release (MFR) is an effective treatment for improving muscle stiffness and balance in neurological patients. This study examined long-term effects of MFR on the balance ability of stroke patients. Methods: MFR using a tennis ball was applied to the lower extremity and sacroiliac joint of the affected side of four stroke patients. The four subjects performed the Berg balance scale (BBS) and Timed up and go (TUG) test at the beginning of an 8-week intervention, directly after the intervention, and 2 years later. Results: The BBS scores indicated a trend toward maintenance of balance (p=0.05), but there was no difference in the TUG time (p=0.47). Conclusion: MFR may be a clinically meaningful intervention to maintain balance in stroke patients over a long period. However, the sample size in this study was too small to draw general conclusions. A larger study with more participants is needed.

고유수용성신경근촉진법을 적용한 상하지 협응 운동이 뇌졸중 환자의 균형 및 보행능력에 미치는 효과

조혁신,차현규,신효섭,Cho, Hyuk-Shin,Cha, Hyun-Gyu,Shin, Hyo-Seop 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: This study examined the effects of upper- and lower-limb coordinated exercise with proprioceptive neuromuscular facilitation (PNF) on stroke patients' recovery of their balancing and walking abilities. Methods: This study was conducted with 30 patients aged at least 60 years and diagnosed with stroke. The patients were randomly assigned to either a PNF upper- and lower-limb coordinated exercise group of 15 patients or an aero-step balance exercise group of 15 patients. To test the subjects' balancing and walking abilities, balancing ability tests and 10-m walking speed tests were conducted before and after the interventions. The patients performed their respective exercises for 30 minutes per session, three times per week for four weeks. The PNF exercise group performed six stages of exercise consisting of a combination of PNF patterns such as sprinting, skating, and striking. The six stages (right striking, right skating, right sprinting, left striking, left skating, and left sprinting) were performed continuously with a rest period of 1 min. after training for 4 min. The exercises for the aero-step balance group consisted of balancing in a two-leg standing position, weight shifting in a two-leg standing position, one-leg standing, squat exercises, marching in place, and squatting on an aero step. Results: The PNF exercise group showed significant improvements in their balancing ability evaluations compared to the aero-step balance group and also showed significant improvements in their 10-m walking speed tests. Conclusion: Based on the results of this study, PNF upper- and lower-limb coordinated exercise resulted in clinical improvements of stroke patients' balancing and walking abilities. Therefore, this type of exercise is recommended as a clinical intervention for the recovery of stroke patients' lower-limb function. Future studies should be conducted with longer intervention periods and more subjects to generalize the study results.

기능에서 신체분절의 협응과 기여

채정병,Chae, Jung-Byung 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: This study investigated the coordination and contribution of body segments during functioning. Methods: The relevant literature related to body segments and function were reviewed. Results: Efficient control of function is considered with regard to a participant's ability to perform a sequence of movements in body segments, which progresses from the head to the arm, trunk, pelvis, and leg segments. Each segment performs a specific role, which environment explorer using visual information for the head, reaching and grasping for the arms, a stabilizer for the trunk, and the distribution of COM in the pelvis and leg. Conclusion: During any of the movements, the momentum generated by the proximal segments is transferred to the adjacent distal segments in an appropriate sequence. In assessing function for clinical intervention strategies, the segment coordination, segment sequence, transfer of the center of body mass, asymmetrical ratio, muscle activity, and compensatory strategies should be considered.

닫힌 사슬 자세에서의 PNF 수축-이완 기법이 뇌졸중 환자의 장딴지 근육 긴장도와 보행능력에 미치는 즉각적 효과

문상현,Moon, Sang-Hyun 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: The purpose of this study was to determine the immediate effects of using the proprioceptive neuromuscular facilitation (PNF) contract-relax technique in the close kinetic chain position on the gait ability and gastrocnemius muscle tone of stroke patients. Methods: The subjects were patients who had strokes due to cerebrum infarction and hemorrhage. The subjects participated in exercise with the PNF contract-relax technique in the standing-on-elbow position with a high table, and the affected lower leg was placed in the posterior position. The PNF contract-relax technique was applied at the position in which the ankle plantar-flexors were in a sufficiently elongated position. After performing twice in each range, while the muscle was elongated, the affected side was moved further back and a new range was set. In each session, the time of contraction was set to 8 seconds, and the resting time was set to 5 seconds; however, if the patient felt tired, they received more resting time during the intervention. The Myoton Pro and 10 m walking test were used to measure the muscle tone and gait ability both pre- and post-intervention. Results: After participating in the program, the muscle tone decreased and the gait ability improved in the ankle plantar-flexors, as determined by the Myoton Pro and 10 m walking test. Conclusion: The PNF contract-relax technique can help to decrease muscle tone in ankle plantar-flexors with hypertonus and increase the gait ability in stroke patients.

ICF 도구를 적용한 앞십자인대 재건술 환자의 고유수용성신경근촉진법 중재전략의 증례

송명수,김범룡,김창헌,노현정,강미경,Song, Myung-Soo,Kim, Beom-Ryong,Kim, Chang-Heon,Noh, Hyun-Jeong,Kang, Mi-Gyeong 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

편평발과 정상발의 무게중심한계 비교

한진태 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: Flatfeet are one of the risk factors of foot dysfunction and postural imbalance. The purpose of this study was to compare the limitation of stability (LOS) for the center of gravity (COG) between flatfeet and neutral feet on stable and unstable support surfaces. Methods: The study included 26 healthy, adult male participants: 14 with normal feet and 12 with flatfeet. The subjects were asked to incline the trunk maximumly to the left, right, anterior, and posterior directions and were asked to keep their feet on the floor with the knee extension. The subjects had 30 seconds of rest time between the tasks. The LOS (anterior, posterior, left, right) of COG was measured by Balance Trainer (BT4, Hur-labs, Tampere, Finland). An independent t- test was used to compare the LOS of COG between flatfeet and normal feet on stable and unstable support surfaces, respectively. Results: The LOS of the flatfeet group was generally decreased on stable support surfaces as compared to that of neutral feet, but it was not significantly different (p>0.05), while the LOS of the flatfeet group was significantly decreased compared to that of neutral feet on unstable support surfaces (p<0.05). Conclusion: This study suggested that the LOS of individuals with flatfeet may be decreased on unstable support surfaces and the postural balance of the flatfeet group may easily be disturbed on an unstable support surface.

수정된 복부 드로우-인 기법이 만성요통 환자의 몸통 안정성과 기능, 통증에 미치는 영향 -사례연구-

김창범 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The purpose of this study was to determine the effects of a modified abdominal draw-in maneuver on trunk stability and functional capacity as well as pain in patients with chronic low back pain. Methods: The study included 3 patients with chronic low back pain who volunteered to participate. The modified abdominal draw-in maneuver included a posterior pelvic tilt, a traditional abdominal draw-in maneuver, and a vibration sensory feedback device. Voluntary abdominal contraction using the vibration sensory feedback device was performed by the subjects for more than 1 hour per day, 5 times per week, for 6 weeks along with common low back pain treatment. Electromyographic signals in the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were measured to compare muscle activation. The degree of pain was measured using the visual analogue scale (VAS), and functional capacity was measured using the Korea Oswestry Disability Index (K-ODI). All results were compared to the means before and after intervention. Results: After the intervention, the RA, EO, and IO showed increased muscle activation and the ES showed decreased muscle activation. The visual analogue scale decreased after intervention and the K-ODI decreased after intervention. Conclusion: Modified abdominal draw-in maneuvers in daily life combined with therapeutic exercises may be effective in relieving pain and dysfunctions in chronic low back pain patients.

아급성기 뇌졸중 환자의 이중 과제 수행이 보행의 시⋅공간적 변수에 미치는 영향

장영민 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

리듬청각자극을 동반한 경사 트레드밀 보행 훈련이 뇌졸중 환자의 균형 및 보행에 미치는 영향

윤성경,이영민,Yoon, Sung-Kyeung,Lee, Young-Min 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: This study aimed to determine how inclined-treadmill walking training with rhythmic auditory stimulation affects balance and gait in stroke patients. Methods: Ten chronic stroke patients, admitted to B hospital in Gangwon-do between August and October 2015, were trained 5 times per week for 4 weeks; each session lasted 30 minutes. To assess balance and gait before and after the training, the timed up and go (TUG) test, Berg balance scale (BBS), six minute walking test (6MWT), and three-dimensional spatiotemporal gait ability were used to measure the relevant variables. The data were analyzed using the paired t-test, and the statistical significance level was 0.05. Results: There were significant differences in the TUG, BBS, 6MWT, gait speed, cadence, single limb support (SLS), and symmetric index (SI) before and after training (p < 0.05). Conclusion: The results showed that the inclined-treadmill walking training with rhythmic auditory stimulation was effective at improving the balance and walking ability of stroke patients. Hearing training, using one of the basic procedures of proprioceptive neuromuscular stimulation, is considered to be an important aspect.

고관절에 적용한 PNF 안정화 기법과 교각운동이 요부안정화 근육에 미치는 영향

김용훈,정주현,Kim, Yong-Hun,Jung, Ju-Hyeon 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.1

Purpose: The purpose of this study was to examine the effects of the PNF stabilization technique for the hip joint and the bridging exercise on the trunk stabilizer muscles in healthy adults. Methods: Twenty-eight healthy adults were randomly allocated to either a PNF stabilization exercise group (n = 12) or a bridging exercise group (n = 16). The outcome measures included the contraction thickness ratio in the transversus abdominis (TrA), internal oblique (IO), and external oblique (EO), and the TrA lateral slide was assessed during the abdominal drawing-in maneuver using b-mode ultrasound. The researcher measured the abdominal muscle thickness of each participant before the therapist began the intervention and at the moment that the intervention was applied. Between-group comparisons were performed using the Mann-Whitney U test. The level of statistical significance was set at 0.05. Results: The PNF intervention program showed a significant increase in the trunk stabilizer muscle. The percentage of change in the TrA thickness showed a significant interaction between intervention. However, there were no significant differences in the IO and EO between the two groups. Conclusion: The PNF stabilization technique for the hip joint can be used effectively to improve the IO and TrA muscles in healthy adults.