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The Effects of Pressure Biofeedback Units in Lower-Limb PNF Pattern Training on the Strength and Walking Ability of Stroke Patients

압력 바이오피드백 제공에 따른 고유수용성신경근촉진법 하지패턴 적용이 뇌졸중 환자의 근력과 보행능력에 미치는 영향

  • Park, Jin (Department of Physical Therapy, Drim Sol Hospital) ;
  • Song, Myung-Soo (Dr. Song's Rehabilitation Institute of Science and Academy)
  • 박진 (드림솔병원 근골격계센터) ;
  • 송명수 (Dr. Song's 재활과학연구소)
  • Received : 2019.12.12
  • Accepted : 2020.01.31
  • Published : 2020.04.30

Abstract

Purpose: The purpose of this study was to compare the strength and walking ability of chronic stroke patients following either proprioceptive neuromuscular facilitation (PNF) pattern training with pressure biofeedback units (feedback group) or PNF pattern training without pressure biofeedback units (control group). Methods: Eighteen participants with chronic stroke were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n = 8) and a control group (n = 10). They all received 30 minutes of neurodevelopmental therapy and PNF training for 15 minutes five times a week for three weeks. Muscle strength and spatiotemporal gait parameters were measured. Muscle strength was measured by hand-held dynamometer; gait parameters were measured by the Biodex Gait trainer treadmill system. Results: After the training periods, the feedback group showed a significant improvement in hip abductor muscle strength, hip extensor muscle strength, step length of the unaffected limb, and step time of the affected limb (p<0.05). Conclusion: The results of this study showed that proprioceptive neuromuscular facilitation pattern training with pressure biofeedback units was more effective in improving hip muscle strength and walking ability than the proprioceptive neuromuscular facilitation pattern training without pressure biofeedback units. Therefore, to strengthen hip muscles and improve the walking ability of stroke patients, using pressure biofeedback units to improve trunk stability should be considered.

Keywords

References

  1. Ada L, Dean CM, Lindley R, et al. Improving community ambulation after stroke: the ambulate trial. BMC Neurology. 2009;9(1):8. https://doi.org/10.1186/1471-2377-9-8
  2. Akuthota V, Nadler SF. Core strengthening. Archives of Physical Medicine and Rehabilitation. 2004;85(3 Suppl 1):86-92. https://doi.org/10.1053/j.apmr.2003.12.005
  3. Alder SS, Beckers D, Buck M. PNF in practice: an illustrated guide, 4th ed. Berlin. Springer-Verlag. 2014.
  4. Bolgla LA, Uhl TL. Electromyographic analysis of hip rehabilitation exercises in a group of healthy participants. Journal of Orthopaedic & Sports Physical Therapy. 2005;35(8):487-494. https://doi.org/10.2519/jospt.2005.35.8.487
  5. Chaitow L. Muscle energy techniques, 4th ed. London. Churchill Livingstone. Elsevier Health Sciences. 2013.
  6. Cynn HS, Oh JS, Kwon OY, et al. Effects of lumbar stabilization using a pressure biofeedback unit on muscle activity and lateral pelvic tilt during hip abduction in sidelying. Archives of Physical Medicine and Rehabilitation. 2006;87(11):1454-1458. https://doi.org/10.1016/j.apmr.2006.08.327
  7. Distefano LJ, Blackburn JT, Marshall SW, et al. Gluteal muscle activation during common therapeutic exercises. Journal of Orthopaedic & Sports Physical Therapy. 2009;39(7):532-540. https://doi.org/10.2519/jospt.2009.2796
  8. Dwyer MK, Boudreau SN, Mattacola CG, et al. Comparison of lower extremity kinematics and hip muscle activation during rehabilitation tasks between sexes. Journal of Athletic Training. 2010;45(2):181-190. https://doi.org/10.4085/1062-6050-45.2.181
  9. Earl JE. Gluteus medius activity during 3 variations of isometric single-leg stance. Journal of Sport Rehabilitation. 2005;14(1):1-11. https://doi.org/10.1123/jsr.14.1.1
  10. Eng JJ, Tang PF. Gait training strategies to optimize walking ability in people with stroke: a synthesis of the evidence. Expert Review of Neurotherapeutics. 2007;7(10):1417-1436. https://doi.org/10.1586/14737175.7.10.1417
  11. Friel K, McLean N, Myers C, et al. Ipsilateral hip abductor weakness after inversion ankle sprain. Journal of Athletic Training. 2006;41(1):74-78.
  12. Geurts AC, de Haart M, van Nes IJ, et al. A review of standing balance recovery from stroke. Gait & Posture. 2005;22(3):267-281. https://doi.org/10.1016/j.gaitpost.2004.10.002
  13. Gharib NM, El-Maksoud GM, Rezk-Allah SS. Efficacy of gait trainer as an adjunct to traditional physical therapy on walking performance in hemiparetic cerebral palsied children: a randomized controlled trial. Clinical Rehabilitation. 2011;25(10):924-934. https://doi.org/10.1177/0269215511400768
  14. Kim JH, Chung Y, Kim Y, et al. Functional electrical stimulation applied to gluteus medius and tibialis anterior corresponding gait cycle for stroke. Gait & Posture. 2012;36(1):65-67. https://doi.org/10.1016/j.gaitpost.2012.01.006
  15. Kofotolis ND, Kellis E. Cross-training effects of a proprioceptive neuromuscular facilitation exercise programme on knee musculature. Physical Therapy in Sport. 2007;8(3):109-116. https://doi.org/10.1016/j.ptsp.2007.02.004
  16. Lee YM, Ham MS, Ki TS. Effect of non-paralyzed side and paralyzed side of elastic band combined with proprioceptive neuromuscular facilitation lower extremity patterns on balance in chronic stroke patients. Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2015;13(4):181-188.
  17. Lin PY, Yang YR, Cheng SJ, et al. The relation between ankle impairments and gait velocity and symmetry in people with stroke. Archives of Physical Medicine and Rehabilitation. 2006;87(4):562-568. https://doi.org/10.1016/j.apmr.2005.12.042
  18. McBeth JM, Earl-Boehm JE, Cobb SC, et al. Hip muscle activity during 3 side-lying hip-strengthening exercises in distance runners. Journal of Athletic Training. 2012;47(1):15-23. https://doi.org/10.4085/1062-6050-47.1.15
  19. Mentiplay BF, Perraton LG, Bower KJ, et al. Assessment of lower limb muscle strength and power using hand-held and fixed dynamometry: a reliability and validity study. PLos One. 2015;10(10):e0140822. https://doi.org/10.1371/journal.pone.0140822
  20. Mercer VS, Chang SH, Williams CD, et al. Effects of an exercise program to increase hip abductor muscle strength and improve lateral stability following stroke: a single subject design. Journal of Geriatric Physical Therapy. 2009;32(2):6-15. https://doi.org/10.1519/00139143-200932020-00003
  21. Neumann DA. Kinesiology of the musculoskeletal system: foundations for physical rehabilitation. St. Louis. Mosby. 2002.
  22. Park IS, Lee SY. Effects of proprioceptive neuromuscular facilitation leg patterns on activity of gluteus medius at opposite side. Journal of Korean Proprioceptive Neuromuscular Facilitation Association. 2016;14(3):195-202.
  23. Peurala SH, Kononen P, Pitkanen K, et al. Postural instability in patients with chronic stroke. Restorative Neurology and Neuroscience. 2007;25(2):101-108.
  24. Pizzi A, Carlucci G, Falsini C, et al. Gait in hemiplegia: evaluation of clinical features with the Wisconsin gait scale. Journal of Rehabilitation Medicine. 2007;39(2):170-174. https://doi.org/10.2340/16501977-0026
  25. Sahrmann S. Diagnosis and treatment of movement impairment syndrome. St. Louis. Mosby. 2002.
  26. Selkowitz DM, Beneck GJ, Powers CM. Which exercises target the gluteal muscles while minimizing activation of the tensor fascia lata? Electromyographic assessment using fine-wire electrodes. Journal of Orthopaedic & Sports Physical Therapy. 2013;43(2):54-64. https://doi.org/10.2519/jospt.2013.4116
  27. Yoo B, Park H, Heo K, et al. The effects of abdominal hollowing in lower limb PNF pattern training on the activation of contralateral muscles. Journal of Physical Therapy Science. 2013;25(10):1335. https://doi.org/10.1589/jpts.25.1335