PNF 목 패턴을 이용한 목 운동이 경추척수증 환자의 균형, 양팔의 저린감 및 목의 움직임에 미치는 영향 - 단일 사례 연구 -

The Effects of a Neck Exercise using a PNF Neck Pattern on the Balance and Numbness of Both the Upper Extremities and Neck Motions in Patients with Cervical Myelopathy - Single Subject Design -

Abstract

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A') was used. The A and A' were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline II). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

Fig. 1-1. Neck exercise using PNF pattern.

Fig. 2. Mean values of right one leg stand of each sessions.

Fig. 3. Mean values of left one leg stand of each sessions.

Fig. 4. Value of right visual analogue scale of each sessions.

Fig. 5. Value of left visual analogue scale of each sessions.

Fig. 6. Value of range of motion in neck flexion of each sessions.

Fig. 1-2. Neck exercise using PNF pattern.

Fig. 1-3. Neck exercise using PNF pattern.

Table 1. Patient information, ROM and MMT of cervical vertebrae

Table 2. Program of PNF neck pattern exercise

Table 3. Changes of one leg stand, VAS, neck flexion ROM for 16 weeks