PNF and Movement

  • 제16권3호
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  • Pages.451-460
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  • 2018
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  • 2508-6227(pISSN)
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  • 2508-6472(eISSN)
대한고유수용성신경근촉진법학회 (Korea Proprioceptive Neuromuscular Facilitation Association)
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고유수용성촉진법을 이용한 수정된 강제유도 운동치료가 아급성 뇌졸중 환자의 상지 기능과 일상생활수행능력에 미치는 영향

The Effects of mCIMT using PNF on the Upper Extremity Function and Activities of Daily Living in Patients with Subacute Stroke

  • 방대혁 (원광대학교 익산한방병원 물리치료실) ;
  • 송명수 (Dr. Song's 재활과학연구소) ;
  • 조혁신 (익산미소재활요양병원 재활센터)
  • Bang, Dae-Hyouk (Department of Physical Therapy, Ik-San Oriental Hospital, Wonkwng University) ;
  • Song, Myung-Soo (Dr. Song's Rehabilitation Institute of Science and Academy) ;
  • Cho, Hyuk-Shin (Rehabilitation center, Ik-San Miso Rehabilitation Hospital)
  • 투고 : 2018.11.02
  • 심사 : 2018.11.16
  • 발행 : 2018.12.31
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초록

Purpose: The purpose of this study was to investigate the effects of a modified constraint induced movement therapy (mCIMT) using proprioceptive neuromuscular facilitation (PNF) on the upper extremity function and activities of daily living (ADLs) in patients with subacute stroke. Methods: Fourteen participants with subacute stroke were randomly assigned to a group using both mCIMT and PNF or a group using mCIMT alone. Each group underwent twenty sessions (1 h/d, 5 d/wk) for 4 weeks. Patients were assessed with the action research arm test (ARAT), the Fugl-Meyer assessment for the upper extremities (FMA-UE), the Modified Barthel Index (MBI), and motor activity logs (MALs; amount of use [AOU] and quality of movement [QOM]). Results: Both the experimental group and the control group showed significant intragroup improvement in the ARAT, FMA-UE, MBI, and MAL-AOU (p<0.05). The group using both mCIMT and PNF exhibited greater improvement in the ARAT, FMA-UE, MBI, and MAL-AOU than did the group using mCIMT alone. Statistical analyses showed significant differences in the ARAT (p=0.01), FMA-UE (p=0.01), MBI (p=0.00), and MAL-AOU (p=0.01) between the groups. Conclusion: This study applied mCIMT combined with PNF for subacute stroke patients, and the results showed significant improvements in the patients' upper extremity function and ADLs. Therefore, mCIMT using PNF may be more effective than mCIMT alone in improving upper limb function and ADLs in patients with subacute stroke.

키워드

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Fig. 1. Task programs for upper extremity training.

Table 1. mCIMT using PNF

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Table 2. Demographic data of the participants

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Table 3. Descriptive measurements

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참고문헌

  1. Alder S, Becker D, Buck M. PNF in practice: an illustrated guide, 3rd ed. Heidelberg. Springer. 2008.
  2. Ali M, Atula S, Bath PM, et al. Stroke outcome in clinical trial patients deriving from different countries. Stroke. 2009;40(1):35-40. https://doi.org/10.1161/STROKEAHA.108.518035
  3. Bang DH, Shin WS, Choi HS. Effects of modified constraint-induced movement therapy with trunk restraint in early stroke patients: a single-blinded, randomized, controlled, pilot trial. NeuroRehabilitation. 2018;42(1):29-35. https://doi.org/10.3233/NRE-172176
  4. Bang DH, Shin WS, Choi SJ. The effects of modified constraint-induced movement therapy combined with trunk restraint in subacute stroke: a double-blinded randomized controlled trial. Clinical Rehabilitation. 2015;29(6):561-569. https://doi.org/10.1177/0269215514552034
  5. Brunner I, Skouen J, Strand L. Is modified constraint-induced movement therapy more effective than bimanual training in improving arm motor function in the subacute phase post stroke? A randomized controlled trial. Clinical Rehabilitation. 2012;26(12):1078-1086. https://doi.org/10.1177/0269215512443138
  6. Cirstea MC, Levin MF. Compensatory strategies for reaching in stroke. Brain. 2000;123(Pt 5):940-953. https://doi.org/10.1093/brain/123.5.940
  7. Cohen J. Stastistical power analysis for the behavioral science, 2nd ed. San diego. C.A. academic press, lawrence Erlbam. 2017.
  8. Corbetta D, Sirtori V, Castellini G, et al. Constraint-induced movement therapy for upper extremities in people with stroke. Cochrane Database Systematic Review. 2015;(10):CD004433.
  9. Corbetta D, Sirtori V, Moja L, et al. Constraint-induced movement therapy in stroke patients: systematic review and meta-analysis. European Journal of Physical Rehabilitation Medicine. 2010;46(4):537-544.
  10. Franceschini M, Agosti M, Cantagallo A, et al. Mirror neurons: action observation treatment as a tool in stroke rehabilitation. European Journal of Physical Rehabilitation Medicine. 2010;46(4):517-523.
  11. Fugl-Meyer AR, Jaasko L, Leyman I, et al. The post-stroke hemiplegic patient. 1. A method for evaluation of physical performance. Scandinavian Journal of Rehabilitation Medicine. 1975;7(1):13-31.
  12. Grimm F, Naros G, Gharabaghi A. Closed-loop task difficulty adaptation during virtual reality reach-to-grasp training assisted with an exoskeleton for stroke rehabilitation. Frontiers in Neuroscience. 2016;10:518.
  13. Hammer AM, Lindmark B. Effects of forced use on arm function in the subacute phase after stroke: a randomized, clinical pilot study. Physical Therapy. 2009;89(6):526-539. https://doi.org/10.2522/ptj.20080017
  14. Hobart JC, Thompson AJ. The five item barthel index. Journal of Neurology, Neurosurgery, and Psychiatry. 2001;71(2):225-230. https://doi.org/10.1136/jnnp.71.2.225
  15. Kim T, Kim S, Lee B. Effects of action observational training plus brain-computer interface-based functional electrical stimulation on paretic arm motor recovery in patient with stroke: a randomized controlled trial. Occupational Therapy International. 2016;23(1):39-47. https://doi.org/10.1002/oti.1403
  16. Lang CE, Edwards DF, Birkenmeier RL, et al. Estimating minimal clinically important differences of upperextremity measures early after stroke. Archives of Physical Medicine and Rehabilitation. 2008;89(9):1693-1700. https://doi.org/10.1016/j.apmr.2008.02.022
  17. Lyle RC. A performance test for assessment of upper limb function in physical rehabilitation treatment and research. International Journal of Rehabilitation Research. 1981;4(4):483-492. https://doi.org/10.1097/00004356-198112000-00001
  18. Nazzal M, Sa'adah MA, Al-Ansari D, et al. Stroke rehabilitation: application and analysis of the modified Barthel index in an arab community. Disability and Rehabilitation. 2001;23(1):36-42. https://doi.org/10.1080/09638280150211284
  19. Nijland R, van Wegen E, van der Krogt H, et al. Characterizing the protocol for early modified constraint-induced movement therapy in the explicit-stroke trial. Physiotheray Research International. 2013;18(1):1-15. https://doi.org/10.1002/pri.1521
  20. Portney L, Wakin M. Foundation of clinical research; applications to practice, 3rd ed. New Jersey. Prentice Hall. 2008.
  21. Sanford J, Moreland J, Swanson LR, et al. Reliability of the fugl-meyer assessment for testing motor performance in patients following stroke. Physical Therapy. 1993;73(7):447-454. https://doi.org/10.1093/ptj/73.7.447
  22. Schaechter JD, Kraft E, Hilliard TS, et al. Motor recovery and cortical reorganization after constraint-induced movement therapy in stroke patients: a preliminary study. Neurorehabilitation and Neural Repair. 2002; 16(4):326-338. https://doi.org/10.1177/154596830201600403
  23. Sirtori V, Corbetta D, Moja L, et al. Constraint-induced movement therapy for upper extremities in stroke patients. Cochrane Database Systematic Review. 2009;(4):CD004433.
  24. Taub E, Crago JG. Constrained-induced movement therapy: a new approach to treatment in physical rehabilitation. Rehabilitation Psychology. 1989;4(3):152-179.
  25. Taub E, Uswatte G, Pidikiti R. Constraint-induced movement therapy: a new family of techniques with broad application to physical rehabilitation-a clinical review. Journal of Rehabilitation Research and Development. 1999;36(3):237-251.
  26. Timmermans AA, Verbunt JA, van Woerden R, et al. Effect of mental practice on the improvement of function and daily activity performance of the upper extremity in patients with subacute stroke: a randomized clinical trial. Journal of the American Medical Directors Association. 2013;14(3):204-212. https://doi.org/10.1016/j.jamda.2012.10.010
  27. Zhu Y, Zhou C, Liu Y, et al. Effects of modified constraintinduced movement therapy on the lower extremities in patients with stroke: a pilot study. Disability and Rehabilitation. 2016;38(19):1893-1899. https://doi.org/10.3109/09638288.2015.1107775