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Effect of PNF Leg Flexion Pattern on Muscle Activity of Ipsilateral Trunk and Leg with and without Abdominal Drawing-in Maneuver

PNF 다리 굽힘 패턴 시 복부 드로잉-인 기법 동시적용이 동측 몸통과 다리의 근활성도에 미치는 효과

  • Ahn, Su-Hong (Department of Biomedical Health Science, Graduate School, Dong-Eui University) ;
  • Lee, Su-Kyong (Department of Physical Therapy, College of Nersing and Healthcare Sciences, Dong-Eui University) ;
  • Jo, Hyun-Dai (Gonjiam Middle School)
  • 안수홍 (동의대학교 보건의과학대학원) ;
  • 이수경 (동의대학교 물리치료학과) ;
  • 조현대 (곤지암 중학교)
  • Received : 2019.11.15
  • Accepted : 2019.12.23
  • Published : 2020.04.30

Abstract

Purpose: The purpose of this study was to investigate the effect of the simultaneous abdominal drawing-in maneuver (ADIM) on the muscle activity of the ipsilateral trunk and leg during proprioceptive neuromuscular facilitation (PNF) leg flexion, adduction, and external rotation with knee flexion (D1) patterns. Methods: The participants were 20 healthy adult males and females (18 males and 2 females). The maneuvers were performed by a physical therapist who fully understands the PNF leg patterns (D1) and their application in clinical practice. The participants were trained and allowed to practice for 15 minutes prior to applying ADIM, to ensure adequate learning as evidenced by the pressure biofeedback unit. In this study, we measured the muscle activity of the trunk and leg when the PNF leg pattern (D1) was performed by the physical therapist either sustaining or releasing the ADIM. Muscle activity was measured on the right transverse abdominis muscle (TRA), the external abdominal oblique muscle (EO), the internal abdominal oblique muscle (IO), the erector spinae muscle (ES), the vastus medialis oblique muscle (VMO), the vastus lateralis oblique muscle (VLO), and the tibialis anterior muscle (TA) and compared using the mean values from averaging three repeated measurements. Results: The muscle activity of the transversus abdominis, the external abdominal oblique, the internal abdominal oblique, the vastus medialis oblique, and the vastus lateralis oblique was significantly greater (p < 0.05), and the muscle activity of the erector spinae was significantly less (p < 0.05) during PNF leg pattern (D1) when the ADIM contraction was sustained compared to when it was not. Conclusion: These results suggest that sustaining ADIM during PNF leg pattern (D1) training increases the trunk and leg muscle activity, resulting in more effective training.

Keywords

References

  1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Heidelberg. Springer. 2016.
  2. Akuthota V, Nadler SF. Core strengthening. Archives of Physical Medicine and Rehabilitation. 2004;85(1):86-92. https://doi.org/10.1053/j.apmr.2003.12.005
  3. Bergkmak A. Stability of the lumbar spine: a study in mechanical engineering. Acta Orthopaedica Scandinavica. 1989;60(230):1-54.
  4. Bjerkefors A, Ekblom MM, Josefsson K, et al. Deep and superficial abdominal muscle activation during trunk stabilization exercises with and without instruction to hollow. Manual Therapy. 2010;15(5):502-507. https://doi.org/10.1016/j.math.2010.05.006
  5. Bong SY. Effects of the slashpipe exercise on trunk stability on balance.walking and quality of life in stroke patients. Nambu University. Dissertation of Doctorate Degree. 2019.
  6. Bong SY, Kim YJ, Kang MG, et al. Effects of proprioceptive neuromuscular facilitation exercise on forced expiratory volume at one second, pain, and functional disability index of chronic low back pain patients. PNF and Movement. 2016;14(3):185-193. https://doi.org/10.21598/JKPNFA.2016.14.3.185
  7. Cabanas-Valdes R, Bagur-Calafat C, Girabent-Farres M, et al. The effect of additional core stability exercises on improving dynamic sitting balance and trunk control for subacute stroke patients: a randomized controlled trial. Clinical Rehabilitation. 2016;30(10):1024-1033. https://doi.org/10.1177/0269215515609414
  8. Choi HS, Kwon OY, Yi CH, et al. The comparison of trunk muscle activities during sling and mat exercise. Journal of Korean Research Society of Physical Therapy. 2005;12(1):1-10.
  9. Chon SC, Chang KY, You JS. Effect of the abdominal draw-in manoeuvre in combination with ankle dorsiflexion in strengthening the transverse abdominal muscle in healthy young adults: a preliminary, randomised, controlled study. Physiotherapy. 2010;96(2):130-136. https://doi.org/10.1016/j.physio.2009.09.007
  10. Cram JR, Kasman GS, Holtz J. Introduction to surface electromyography. Gaithersburg. Aspen. 1998.
  11. De Troyer A, Estenne M, Ninane V, et al. Transversus abdominis muscle function in humans. Journal of Applied Physiology. 1990;68(3):1010-1016. https://doi.org/10.1152/jappl.1990.68.3.1010
  12. Haruyama K, Kawakami M, Otsuka T. Effect of core stability training on trunk function, standing balance, and mobility in stroke patients: a Randomized controlled trial. Neurorehabilitation Neural Repair. 2017;31(3):240-249. https://doi.org/10.1177/1545968316675431
  13. Hermens HJ, Freriks B, Disselhorst-Klug C, et al. Development of recommendations for SEMG sensors and sensor placement procedures. Journal of Electromyography and Kinesiology. 2000;10(5):361-374. https://doi.org/10.1016/S1050-6411(00)00027-4
  14. Hides JA, Wilson SJ, Stanton W, et al. An MRI investigation into the function of the transversus abdominis muscle during drawing-in of the abdominal wall. Spine. 2006;31(6):175-178.
  15. Hildenbrand K, Noble L. Abdominal muscle activity while performing trunk-flexion exercise using the Ab roller, AB-slide, Fit-ball, and conventionally performed trunk curls. Journal of Athletic Training. 2004;39(1):37-43.
  16. Hong EJ. Biomechanics analysis of EMT's trunk during CPR at abdominal drawing-in. Daegu University. Dissertation of Doctorate Degree. 2014.
  17. Hwang BJ, Kim JW. Effects of lumbar stabilization exercise on lumbar and lower extremity strength of the elderly women. Journal of the Korean Society of Physical Medicine. 2011;6(3):267-275.
  18. Jeon HJ, Lee MH. The effects of PNF technique versus trunk exercise program on the pain, disability, and balance in chronic LBP patients. Journal of Contents. 2009;9(12):665-673.
  19. Kim BR, Kang TW. Effectiveness of proprioceptive neuromuscular facilitation of chronic low back Pain: a systematic review and meta-analysis of studies in Korea. PNF and Movement. 2019;17(1):157-166.
  20. Kim CH, Kim BR. The effects of abdominal strength training using proprioceptive neuromuscular facilitation on the balance ability and pain of patients with chronic lower back pain. PNF and Movement. 2017;15(2):141-148.
  21. Kim CY. The effects of a trunk stability exercise on trunk strengthening, dynamic balance and walking in the persons with chronic stroke. Sahmyook University. Dissertation of Master's Degree. 2008.
  22. Kim EO. The influence of abdominal drawing-in maneuver on lumbar lordosis and trunk and lower extremity muscle activity during bridging exercise. Hanseo University. Dissertation of Master's Degree. 2008.
  23. Kim EO, Kim TH, Roh JS, et al. The influence of abdominal drawing-in maneuver on lumbar lordosis and trunk and lower extremity muscle activity during bridging exercise. Journal of Korean Research Society of Physical Therapy. 2009;16(1):1-9.
  24. Lee SK. The effects of abdominal drawing-in on muscle activity in the trunk and legs during ramp walking. PNF and Movement. 2019;17(1):137-144.
  25. Kim HW. Effects of the abdominal draw-in maneuver in combination with ankle dorsiflexion in transverse abdominis and balance in patients with chronic stroke. Daegu University. Dissertation of Master's Degree. 2014.
  26. Kim JW. The effect of various exercises for strengthening lumbar muscles on the function of lumbar and extremities muscles. Keimyung University. Dissertation of Doctorate Degree. 2009.
  27. Kisner C, Colby LA. Therapeutic exercise: foundation and techniques, 5th ed. Philadelphia. F.A. Davis Company. 2010.
  28. Lee HO, Park DJ. Understanding and clinical application of abdominal hollowing exercise: a literature review. PNF and Movement. 2011;9(2):9-19.
  29. Lee NY, Kim SH, Kim TY. The effect of proprioceptive neuromuscular facilitation and traditional trunk stabilization training on the rectus abdominis muscle contraction. Journal of the Korean Academy of Clinical Electrophysiology. 2009;7(1):43-48. https://doi.org/10.5627/KACE.2009.7.1.043
  30. Macedo LG, Maher CG, Latimer J, et al. Motor control exercise for persistent, nonspecific low back pain: a systematic review. Physical Therapy. 2009;89(1):9-25. https://doi.org/10.2522/ptj.20080103
  31. Marshall PW, Murhpy BA. Core stability exercise on and off a swiss ball. Archives of Physical Medicine and Rehabilitation. 2005;86(2):242-249. https://doi.org/10.1016/j.apmr.2004.05.004
  32. Nachemson A. Lumbar intradiscal pressure. In: Jayson MIV (ed). The lumbar spine and back pain. Edinburgh. Churchill Livingstone. 1987.
  33. Nourbakhsh M, Arab A. Relationship between mechanical factors and incidence of low back pain. Journal of Orthopedic and Sports Physical Therapy. 2002;32(9):447-460. https://doi.org/10.2519/jospt.2002.32.9.447
  34. Oh JS, Cynn HS, Won JH, et al. Effects of performing an abdominal drawing-in maneuver during prone hip extension exercises on hip and back extensor muscle activity and amount of anterior pelvic tilt. Journal of Orthopaedic & Sports Physical Therapy. 2007;37(6):320-324. https://doi.org/10.2519/jospt.2007.2435
  35. O'sullivan, PB. Twomey L, Allison GT. Dynamic stabilization of the lumbar spine. Critical $Reviews^{TM}$ in Physical and Rehabilitation Medicine. 1997;9(3-4):315-330. https://doi.org/10.1615/CritRevPhysRehabilMed.v9.i3-4.70
  36. Park KN, Cynn HS, Kwon OY, et al. Effects of the abdominal drawing-in maneuver on muscle activity, pelvic motions, and knee flexion during active prone knee flexion in patients with lumbar extension rotation syndrome. Archives of Physical Medicine and Rehabilitation. 2011;92(9):1477-1483. https://doi.org/10.1016/j.apmr.2011.03.020
  37. Park SD, Yu SH. The effects of abdominal draw-in maneuver and core exercise on abdominal muscle thickness and Oswestry disability index in subjects with chronic low back pain. Journal of Exercise Rehabilitation. 2013;9(2);286-291. https://doi.org/10.12965/jer.130012
  38. Ralston SH, Urquhart GD, Brzeski M, et al. Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis. The BMJ. 1990;300(6724):563-565. https://doi.org/10.1136/bmj.300.6724.563
  39. Rone-Adams S, Shamus E, Hileman M. Physical therapists evaluation of the trunk flexors in patients with low back pain. The Internet Journal of Allied Health Sciences and practice. 2004;2(2):1-9.
  40. Sahrmann. Diagnosis and treatment of movement impairment syndromes. St Louis. Elsevier Mosby. 2002.
  41. Shin MG. The effect of abdominal muscle contraction on center of gravity moving and lumbar lordosis: in low back pain patients with pelvic anterior shift. Kyonggi University. Dissertation of Master's Degree. 2011.
  42. Sim YH. The effects of abdominal muscle drawing-In exercise and MFR application on back pain, flexibility and balance in elderly women. Hanyang University. Dissertation of Master's Degree. 2015.
  43. Soderberg GL, Cook TM. An electromyographic analysis of quadriceps femoris muscle setting and straight leg raising. Physical Therapy. 1983;63(9):1434-1438. https://doi.org/10.1093/ptj/63.9.1434
  44. Stevens VK, Bouche KG, Mahieu NN, et al. Trunk muscle activity in healthy subjects during bridging stabilization exercises. BMC Musculoskeletal Disorders. 2006;7(75):1-8. https://doi.org/10.1186/1471-2474-7-1
  45. Stuge B, Laerum E, Kirkesola G, et al. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnacy: a randomized controlled trial. Spine. 2004;29(4):351-359. https://doi.org/10.1097/01.BRS.0000090827.16926.1D
  46. Sung SW. The spinal flexibility and response time of erector spinae muscle following stabilization exercise. Journal of Korean Academy of Orthopaedic Manual Therapy. 2000;6(1):35-49.
  47. von Garnier K, Koveker K, Rackwitz B, et al. Reliability of a test measuring transversus abdominis muscle recruitment with a pressure biofeedback unit. Physiotherapy. 2009;95(1):8-14. https://doi.org/10.1016/j.physio.2008.10.003
  48. Yoo BH. The effects of simultaneous application of trunk stabilization exercise on the activation of contralateral lower-limb muscles during PNF lower-limb pattern. Silla University. Dissertation of Master's Degree. 2013.