PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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The Effect of Lower Trapezius Strengthening Exercise Using PNF on Pain, Range of Motion, and Disability in Patients with Chronic Neck Pain

PNF를 이용한 아래등세모근 강화 운동이 만성 목 통증 환자의 통증, 관절가동범위, 장애에 미치는 영향

  • Song, Min-Jeong (Department of Physical Therapy, Wonkwang Health Science University) ;
  • Kang, Tae-Woo (Department of Physical Therapy, College of Health and Welfare, Woosuk University) ;
  • Kim, Beom-Ryong (Department of Physical Therapy, Design Hospital)
  • 송민정 (원광보건대학교 물리치료과) ;
  • 강태우 (우석대학교 보건복지대학 물리치료학과) ;
  • 김범룡 (디자인병원 통합재활팀)
  • Received : 2020.12.02
  • Accepted : 2021.01.13
  • Published : 2021.04.30
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Abstract

Purpose: The study aimed to determine the effect of proprioceptive neuromuscular facilitation (PNF) lower trapezius muscle strengthening exercise on pain, cervical range of motion (ROM), and neck disability index (NDI) in patients with chronic neck pain. Methods: Following baseline measurements, the subjects (n = 30) with chronic neck pain were randomized into two groups: the PNF group (n = 15) that received PNF strength training of the lower trapezius muscles or a control group (n = 15) that received gentle palpation of the skin. Each group participated in the intervention for 30 min, three times per week for six weeks. The visual analogue scale for pain, ROM, and NDI of both groups were recorded at both pre- and post-intervention. Paired t-tests were used to determine significant changes in the post-intervention compared with pre-intervention, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the six-week intervention, both groups experienced significantly decreased pain and NDI (p < 0.05) and significantly increased cervical flexion, extension, lateral flexion, and rotation ROM (p < 0.05). The PNF group that received PNF strength exercise of the lower trapezius muscles showed greater improvements in pain and NDI and cervical rotation of ROM than those of the control group (p < 0.05). Conclusion: These results suggest that the PNF lower trapezius strengthening exercise reduces neck pain and disability level and enhances cervical ROM in patients with chronic neck pain.

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References

  1. Adler SS, Beckers D, Buck, M. PNF in practice: an illustrated guide. Berlin. Springer. 2007.
  2. Arlotta M, LoVasco G, McLean L. Selective recruitment of the lower fibers of the trapezius muscle. Journal of Electromyography and Kinesiology. 2011;21(3):403-410. https://doi.org/10.1016/j.jelekin.2010.11.006
  3. Aruin AS, Latash ML. Directional specificity of postural muscles in feed-forward postural reactions during fast voluntary arm movements. Experimental Brain Research. 1995;103(2):323-332.
  4. Bae SS, Lee HO, Goo BO, et al. Change and development of proprioceptive neuromuscular facilitation. PNF and Movement. 2003;1(1):27-32.
  5. Barry M, Jenner J. ABC of rheumatology: pain in neck, shoulder, and arm. BMJ. 1995;310(6973):183-186. https://doi.org/10.1136/bmj.310.6973.183
  6. Bush KW, Collins N, Portman L, et al. Validity and intertester reliability of cervical range of motion using inclinometer measurements. Journal of Manual & Manipulative Therapy. 2000;8(2):52-61. https://doi.org/10.1179/106698100790819546
  7. Chen X, Treleaven J. The effect of neck torsion on joint position error in subjects with chronic neck pain. Manual Therapy. 2013;18(6):562-567. https://doi.org/10.1016/j.math.2013.05.015
  8. Choi YJ, Hwang R. Effect of cervical and thoracic stretching and strengthening exercise program on forward head posture. The Journal of the Korea Contents Association. 2011;11(10):293-300. https://doi.org/10.5392/JKCA.2011.11.10.293
  9. Coakwell MR, Bloswick DS, Moser R. High-risk head and neck movements at high G and interventions to reduce associated neck injury. Aviation, Space, and Environmental Medicine. 2004;75(1):68-80.
  10. Codine P, Bernard P, Pocholle M, et al. Influence of sports discipline on shoulder rotator cuff balance. Medicine & Science in Sports & Exercise. 1997;29(11):1400-1405. https://doi.org/10.1097/00005768-199711000-00002
  11. Eltayeb S, Staal JB, Hassan A, et al. Work related risk factors for neck, shoulder and arms complaints: a cohort study among Dutch computer office workers. Journal of Occupational Rehabilitation. 2009;19(4):315-322. https://doi.org/10.1007/s10926-009-9196-x
  12. Gong WT, Lee SY, Lee YM. The effects of cervical ROM and muscle endurance on cervical joint mobilization of normal adults. Journal of the Korean Society of Physical Medicine. 2010;5(1):7-13.
  13. Grant R. Physical therapy of the cervical and thoracic spine. Churchill Livingstone. Edinburgh. Elsevier. 2002.
  14. Ha SM, Kwon OY, Yi CH, et al. Effects of passive correction of scapular position on pain, proprioception, and range of motion in neck-pain patients with bilateral scapular downward-rotation syndrome. Manual Therapy. 2011;16(6):585-589. https://doi.org/10.1016/j.math.2011.05.011
  15. Hanten WP, Olson SL, Russell JL, et al. Total head excursion and resting head posture: normal and patient comparisons. Archives of Physical Medicine and Rehabilitation. 2000;81(1):62-66. https://doi.org/10.1016/S0003-9993(00)90223-5
  16. Hoving JL, De Vet HC, Twisk JW, et al. Prognostic factors for neck pain in general practice. Pain. 2004;110(3):639-645. https://doi.org/10.1016/j.pain.2004.05.002
  17. Jull G, Falla D, Vicenzino B, et al. The effect of therapeutic exercise on activation of the deep cervical flexor muscles in people with chronic neck pain. Manual Therapy. 2009;14(6):696-701. https://doi.org/10.1016/j.math.2009.05.004
  18. Jull G, Sterling M, Falla D, et al. Whiplash, headache, and neck pain: research-based directions for physical therapies. Elsevier Health Sciences. Edinburgh. Elsevier. 2008.
  19. Kang TW. The effect of proprioceptive neuromuscular facilitation rehabilitation exercise on range of motion, pain, and function of breast cancer patients after surgery. PNF and Movement. 2018;16(1):133-141.
  20. Ki HS, Kwon OY, Yi CH, et al. Effects of the scapular taping on the muscle activity of the scapula rotators and pain in subjects with upper trapezius pain. Physical Therapy Korea. 2010;17(1):77-85.
  21. Kim BR, Lee HJ. Effects of proprioceptive neuromuscular facilitation-based abdominal muscle strengthening training on pulmonary function, pain, and functional disability index in chronic low back pain patients. Journal of Exercise Rehabilitation. 2017;13(4):486-490. https://doi.org/10.12965/jer.1735030.515
  22. Kim BR, Yi DH, Yim JE. Effect of the combined isotonic technique for proprioceptive neuromuscular facilitation and taping on pain and grip strength in patients with lateral epicondylitis: a randomized clinical trial. Journal of Exercise Rehabilitation. 2019;15(2):316-321. https://doi.org/10.12965/jer.1938078.039
  23. Kim HY, Kim SY, Jang HJ, et al. Effect of scapular stabilization exercise on patients with neck pain classified according to passive scapular elevation test. Physical Therapy Korea. 2012;19(3):51-60. https://doi.org/10.12674/ptk.2012.19.3.051
  24. Kim KY, Kim SY. The effect of lower trapezius strengthening exercises on pain, disability, cervical range of motion and strength of lower trapezius in patients with unilateral neck pain: a controlled randomized trial. Physical Therapy Korea. 2015;22(1):58-68. https://doi.org/10.12674/ptk.2015.22.1.058
  25. Klein DA, Stone WJ, Phillips WT, et al. PNF training and physical function in assisted-living older adults. Journal of Aging and Physical Activity. 2002;10(4):476-488. https://doi.org/10.1123/japa.10.4.476
  26. Krekoukias G, Gelalis ID, Xenakis T, et al. Spinal mobilization vs conventional physiotherapy in the management of chronic low back pain due to spinal disk degeneration: a randomized controlled trial. Journal of Manual & Manipulative Therapy. 2017;25(2):66-73. https://doi.org/10.1080/10669817.2016.1184435
  27. Lee EW, Shin WS, Jung KS, et al. Reliability and validity of the neck disability index in neck pain patients. Physical Therapy Korea. 2007;14(3):97-106.
  28. Lee HJ, Kim SY. Effects of thoracic mobility exercise on cervicothoracic function, posture and pain in individuals with mechanical neck pain. Physical Therapy Korea. 2019;26(3):42-56.
  29. Lee HS, Yoo JH. The effects of stretching and isometric exercise for chronic neck pain patient in strength and pain. Journal of Korean Society of Physical Medicine. 2012;7(3):329-337. https://doi.org/10.13066/kspm.2012.7.3.329
  30. Lee H, Nicholson LL, Adams RD. Cervical range of motion associations with subclinical neck pain. Spine. 2004;29(1):33-40. https://doi.org/10.1097/01.BRS.0000103944.10408.BA
  31. Lingjaerde O, Foreland AR. Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity. Psychiatry Research. 1998;81(3):387-392. https://doi.org/10.1016/S0165-1781(98)00119-X
  32. Mottram SL, Woledge RC, Morrissey D. Motion analysis study of a scapular orientation exercise and subjects' ability to learn the exercise. Manual Therapy. 2009;14(1):13-18. https://doi.org/10.1016/j.math.2007.07.008
  33. Park IW, Park KN, Yi CH, et al. The inter-rater reliability of measurements of active craniocervical range of motion with smartphone in patients with stroke. Physical Therapy Korea. 2019;26(1):8-18. https://doi.org/10.12674/ptk.2019.26.1.008
  34. Park SH, Lee MM. Effects of lower trapezius strengthening exercises on pain, dysfunction, posture alignment, muscle thickness and contraction rate in patients with neck pain: randomized controlled trial. Medical Science Monitor. 2020;26(1):1-9.
  35. Petersen SM, Wyatt SN. Lower trapezius muscle strength in individuals with unilateral neck pain. Journal of Orthopaedic & Sports Physical Therapy. 2011;41(4):260-265. https://doi.org/10.2519/jospt.2011.3503
  36. Pietrobon R, Coeytaux RR, Carey TS, et al. Standard scales for measurement of functional outcome for cervical pain or dysfunction: a systematic review. Spine. 2002;27(5):515-522. https://doi.org/10.1097/00007632-200203010-00012
  37. Sahrmann SA. Diagnosisand treatment of movement impairment syndromes. St Louis. Mosby. 2001.
  38. Sarig-Bahat H. Evidence for exercise therapy in mechanical neck disorders. Manual Therapy. 2003;8(1):10-20. https://doi.org/10.1054/math.2002.0480
  39. Sjolander P, Michaelson P, Jaric S, et al. Sensorimotor disturbances in chronic neck pain-range of motion, peak velocity, smoothness of movement, and repositioning acuity. Manual Therapy. 2008;13(2):122-131. https://doi.org/10.1016/j.math.2006.10.002
  40. Song GB, Kim JJ, Kim KR, et al. The effects of neck stabilization exercise and proprioceptive neuromuscular facilitation on neck alignment, NDI, and static balance in adults with forward-head posture in a sitting position. PNF and Movement. 2020;18(1):11-22.