The Journal of Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회지)

Korean Academy of Orthopedic Manual Physical Therapy (대한정형도수물리치료학회)
권호 표지

The Comparison of the Effects of Joint Mobilization, Incline Board and PNF stretching to Increase the Dorsiflexion of the Ankle Joint on Ankle Dosiflexion and the Muscle Tone of the Plantar Flexor the Ankle in Subjects with Stroke

발등 굽힘 관절가동범위를 증가시키기 위한 관절가동술과 경사대, PNF 스트레칭이 뇌졸중 환자의 발등 굽힘 및 발바닥 굽힘근의 근 긴장도에 미치는 효과 비교

  • 유병호 (더원요양병원 재활치료센터) ;
  • 홍현표 (종로정형외과 물리치료실)
  • Received : 2020.04.22
  • Accepted : 2020.06.08
  • Published : 2020.06.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: This study was conducted to compare the effects of an incline board, proprioceptive neuromuscular facilitation (PNF) stretching, and joint mobilization on the dorsiflexion of the ankle joint and muscle tone of the plantar flexor and ankle in stroke patients. Methods: Forty-five stroke subjects were randomly divided into three groups: each JMG (Joint Mobilization Group), IBG (Inclined Board Group) and PSG (PNF Stretching Group). The experiment was performed for eight weeks between August 1 and October 31, 2018. Results: The dorsiflexion of the ankle joint was significant between the groups and by period (p<.05). JMG had a significant change by period (p<.05). Differences between groups by period increased after 8 weeks in the PSG and the JMG (p>.05). The gastrocnemius lateral muscle tone was significant between the groups (p<.05), and medial muscle tone was interacted between groups and time (p<.05). Conclusion: An effective intervention method to increase the dorsiflexion of the ankle joint and decrease the muscle tone when performing PNF stretching, and joint mobilization in stroke patients was confirmed. Future studies are recommended to variety research of PNF stretching and joint mobilization.

Keywords

References

  1. Aird L, Samuel D, Strokes M. Quadriceps muscletone, elasticity and stiffness in older males: reliability and symmetry using the myotonPRO. Arch Gerontol Geriat. 2012;55(2):31-39. https://doi.org/10.1016/j.archger.2012.03.005
  2. Andrew A, Bohannon R. Short-term recovery of limb muscle strength after acute stroke. Arch Phy Med Reh. 2003;84:125-130. https://doi.org/10.1053/apmr.2003.50003
  3. Cruz-Diaz D, Lomas-Vega R, Osuna-Perez MC, et al. Effects of joint mobilization on chronic ankle instability: a randomized controlled trial. Disabil Rehabil. 2015;37(7):601-610. https://doi.org/10.3109/09638288.2014.935877
  4. Denegar C, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys. 2002;32(4):166-173. https://doi.org/10.2519/jospt.2002.32.4.166
  5. Gao F, Ren Y, Roth J, et al. Effects of repeated ankle stretching on calf muscle. tendon and ankle biomechanical properties in stroke survivors. Clin Bio. 2011;11(3):159-164. https://doi.org/10.1016/j.clinbiomech.2010.12.003
  6. Gross JM, Fetto J. Rosen E. Musculoskeletal Examination. John Wiley & Sons. 2015.
  7. Hoch MC, McKeon PO. Joint mobilization improves spatiotemporal postural control and range of motion in those with chronic ankle instability. J Orthop Res. 2011;29(3):326-332. https://doi.org/10.1002/jor.21256
  8. Hong WS, Kim KW. Reliability of measurement devices for measuring the ankle joint motion. J Korean Aca Orthop Man Ther. 2009;15(1);1-8.
  9. Hsu A, Tang P, Jan M. Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke. Arch of Phys Med and Rehabil. 2003;84(8):1185-1193. https://doi.org/10.1016/S0003-9993(03)00030-3
  10. Kim BJ, Lee SK, Kim MK. The effects of ankle strength exercise and functional electrical stimulation on the ability of balance control and gait in stroke Patients. J Sport Leisure Studies. 2007;31:921-931. https://doi.org/10.51979/KSSLS.2007.11.31.921
  11. Kim JS, Lee HO, Ahn SY, et al. Characteristics change of spatial and temporal parameters of gait in spastic hemiplegic patients by reciprocal inhibition. J Kor Phys Ther. 2004;16(4):645-660. https://doi.org/10.2514/5.9781600862403.0645.0660
  12. Klein D, William J, Wayne T. PNF training and physical function in assisted-living older adults. J Aging Phys Act. 2002;41(10):476-488. https://doi.org/10.1123/japa.10.4.476
  13. Kwah L, Herbert R, Harvey L, et al. Passive mechanical properties of gastrocnemius muscles of people with ankle contracture after stroke. Arch Phy Med Reh. 2012;93:1185-1190. https://doi.org/10.1016/j.apmr.2012.02.009
  14. Landrum F, Kelln B, Parente W, et al. Immediate effects of anterior-to-posterior talocrural joint mobilization after prolonged ankle immobilization: A preliminary study. J Man. Manip Ther. 2008;16(2):100-105. https://doi.org/10.1179/106698108790818413
  15. Lee HS, Park SE, Lee SB, et al. Effect of ankle joint mobilization and FES on change of ankle movement and the quality of gait in patients with hemiplegia. J Int Acad Phys Ther Res.2014;5(2):738-742. https://doi.org/10.5854/jiaptr.2014.10.31.738
  16. Manca M, Ferraresi G, Cosma M, et al. Gait patterns in hemiplegic paients with equinus foot deformity. BioMed Res Int. 2014;939316:1-7. https://doi.org/10.1155/2014/939316
  17. Maitland G. The treatment of joint by passive movement. Aust J Physiother. 1986;20:129-135. https://doi.org/10.1016/s0004-9514(14)61190-9
  18. Muscolino JE. Kinesiology: The skeletal system and muscle function, 2nd edition. 2011.
  19. Neumann DA. Kinesiology of the Musculoskeletal System: Foundations for Rehabilitation, 3rd edition. 2017.
  20. Park KH, Kim WB. The effects of ankle strategy exercise on balance of patients with hemiplegia. J Soc Korean Phys Med. 2014;9(1):75-82. https://doi.org/10.13066/kspm.2014.9.1.75
  21. Park JW, Nam KS, Back MY. The relationship between the plantar center of pressure displacement and dynamic balance measures in hemiplegic gait. Phys Thra Korea. 2005;12(1):1-21.
  22. Park SJ. The effects of Kaltenborn orthopedic manual therapy with Evjenth-hamberg stretching on range of motion of ankle joint and balance ability in patients with chronic stroke. J Korean Soc Phys Med. 2018;13(2):43-51. https://doi.org/10.13066/kspm.2018.13.2.43
  23. Patrick D, Ronald M. Textbook of pain II. Churchill Livingstone. 2002.
  24. Patterson K, Brooks GW, Black D, et al. Changes in gait symmetry and velocity after stroke: A cross-sectional study from weeks to years after stroke. NNR. 2010;24(9):783-790. https://doi.org/10.1177/1545968310372091
  25. Perez Parra JE, Henao Lema CP. Efecto de la movilizacion articular sobre la amplitud del Reflejo H enpersonas con espasticidad. Rev Cienc Salud. 2011;9(2):125-140.
  26. Rosa MC, Marques A, Demain S, et al. Lower limb co-contraction during walking in subjects with stroke: A systematic review. J Electromyogr Kines. 2014;24:1-10. https://doi.org/10.1016/j.jelekin.2013.10.016
  27. Sim YB. The Effects of Combination with Evjenth-hamberg Stretching and Dynamic Stretching on Balance and Gait in with Stroke Patients. Doctoral Dissertation. Yong-in University. 2015.
  28. Sue R, Linzi M, Mary L. Bobath Concept: Therapy and Clinical Practice in Neurological Rehabilitation. Wiley Blackwell. 2013.
  29. Voss D, Knott M. Patterns of motion for proprioceptive neuromuscular facilitation. British J Phys Med. 1954;17(9):191-198.
  30. Wang JS, Lee SB, Moon SH. The immediate effect of PNF pattern on muscle tone and muscle stiffness in chronic stroke patient. J of Phys Ther Sci. 2016;28(3):967-970. https://doi.org/10.1589/jpts.28.967
  31. Yildizgoren MT, Velioglu O, Demetgul O, et al. Assessment of the anterior talofibular ligament thickness in patients with chronic stroke: An Ultrasonographic Study. J Med Ultrasound, 2017;25(3):145-149. https://doi.org/10.1016/j.jmu.2017.03.001
  32. Yilmaz B, Demir Y, Ozyoruk E, et al. The effect of knee joint loading and immobilization on the femoral cartilage thickness in paraplegics. SC. 2016;54(4):283. https://doi.org/10.1038/sc.2015.151
  33. Yuk GC. The acute effects of 15 minutes plantarflexor static stretch in quite stance. J Korean Soc Phys Med. 2012;7(2):191-197. https://doi.org/10.13066/kspm.2012.7.2.191