Journal of Biomedical Engineering Research (대한의용생체공학회:의공학회지)

The Korean Society of Medical and Biological Engineering (대한의용생체공학회)
권호 표지
DOI QR코드

DOI QR Code

Effects of Proprioceptive Neuromuscular Facilitation and Visual-Feedback based Joint Position Reproduction Training on the Level of Ankle Proprioception and One-leg Standing Balance Ability

고유 수용성 신경근 촉진법과 시각 되먹임 기반 관절재현 훈련이 발목관절의 고유 수용성 감각 수준과 한 발 서기 균형 능력에 미치는 영향

  • Ree, Jae Sun (Department of Physical Therapy, Graduate School of Hoseo University) ;
  • Kim, Jongho (Department of Physical Therapy, College of Life and Health Science, Hoseo University) ;
  • Kang, Minjoo (Department of Physical Therapy, College of Life and Health Science, Hoseo University) ;
  • Hwang, Jisun (Department of Physical Therapy, Graduate School of Hoseo University) ;
  • Hwang, Seonhong (Department of Physical Therapy, College of Life and Health Science, Hoseo University)
  • 이재선 (호서대학교 일반대학원 물리치료학과) ;
  • 김종호 (호서대학교 생명보건대학 물리치료학과) ;
  • 강민주 (호서대학교 생명보건대학 물리치료학과) ;
  • 황지선 (호서대학교 일반대학원 물리치료학과) ;
  • 황선홍 (호서대학교 생명보건대학 물리치료학과)
  • Received : 2022.01.17
  • Accepted : 2022.03.10
  • Published : 2022.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Proprioception training has been considered a secondary method to facilitate postural control ability. This study investigated the effects of two different proprioception training methods - the proprioceptive neuromuscular facilitation (PNF) and visual feedback-based joint position and force reproduction (VF) - on postural control advancements. Sixteen healthy people volunteered for this study, and they randomly grouped two. Each group participated in the PNF and VF training for three weeks. We evaluated each subject's proprioception levels and balance ability before and after the training. We used a clinometer and electromyogram (EMG) for VF training. The joint position reproduction test was also used to evaluate the position and force aspects of the proprioception level. We analyzed the trajectory of the center of pressure (COP) while subjects were standing on the firm floor and balance board with one leg using a pressure mat. The improvement of the position aspect of the proprioception level of the VF group (4.93±4.74°) was larger than that of the PNF group (-0.43±2.08°) significantly (p=0.012). The improvement of the anterior-posterior COP velocity of the PNF group (0.01±0.01 cm/s) was larger than that of VF group(0.002±0.01 cm/s) significantly (p=0.046). Changes of position error in the PNF group (rho=0.762, p=0.028) and tibialis anterior force reproduction error in the VF group showed a significantly strong relationship with balance ability variables. These results showed that different PNF and VF have different effects on improving two aspects of proprioception and their relationship with the balance ability. Therefore, these results might be useful for selecting proprioception or balance rehabilitation considering the clinical and patients' situation.

Keywords

Acknowledgement

이 논문은 2017년도 정부(교육부)의 재원으로 한국연구재단의 지원을 받아 수행된 기초연구사업임(2017R1D1A1B04034104).

References

  1. Lee JA., Kim DH, Shin HK, Choi KH, Kwon OY. Difference of proprioceptive sense at elbow joint according to measurement methods. Physical Therapy Korea. 2003;10(3):63-70.
  2. Martin J, Jessell T. Modality coding in the somatic sensory system. In: Kandel E, Schwartz J, Jessell T, editors. Principles of neural science. London: Prentice-Hall International Inc.; 1991;341-52.
  3. Rothwell J, Lennon S. Control of human voluntary movement. Physiotherapy. 1994;80(12):869. https://doi.org/10.1016/S0031-9406(10)60176-9
  4. Sherrington CS. The integrative action of the nervous system. Cambridge: Cambridge University Press; 1906.
  5. Krewer C, Van de Winckel A, Elangovan N, Aman JE, Konczak J. Commentary on: "Assessing proprioception: A critical review of methods" by Han et al. Journal of sport and health science. 2016;5(1):91. https://doi.org/10.1016/j.jshs.2015.11.001
  6. Riemann BL, Lephart SM. The sensorimotor system, part II: the role of proprioception in motor control and functional joint stability. Journal of athletic training. 2002;37(1):80.
  7. Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: a critical review of methods. Journal of Sport and Health Science. 2016;5(1):80-90. https://doi.org/10.1016/j.jshs.2014.10.004
  8. Han J, Waddington G, Adams R, Anson J, Liu Y. Assessing proprioception: What do you really want to know?-Response to Krewer et al. Journal of sport and health science. 2016;5(1):93. https://doi.org/10.1016/j.jshs.2015.11.002
  9. Phillips D, Karduna A. No relationship between joint position sense and force sense at the shoulder. J Mot Behav. 2018;50(2):228-234. https://doi.org/10.1080/00222895.2017.1327415
  10. de Vet HC, Bouter LM, Bezemer PD, Beurskens AJ. Reproducibility and responsiveness of evaluative outcome measures. Int J Technol Assess Health Care 2001;17(04):479-487. https://doi.org/10.1017/S0266462301107038
  11. Dover G, Powers ME. Reliability of joint position sense and force-reproduction measures during internal and external rotation of the shoulder. Journal of athletic training, 2003;38(4):304.
  12. Arvin M, Hoozemans MJ, Burger BJ, Verschueren SM, van Dieen JH, Pijnappels M. Reproducibility of a knee and hip proprioception test in healthy older adults. Aging clinical and experimental research, 2015;27(2):171-177. https://doi.org/10.1007/s40520-014-0255-6
  13. Shumway-Cook A, Anson D, Haller S. Postural sway biofeedback: its effect on reestablishing stance stability in hemiplegic patients. Arch Phys Med Rehabil. 1988;69(6):395-400.
  14. Nashner LM, Peters JF. Dynamic posturography in the diagnosis and management of dizziness and balance disorders. Neurol Clin. 1990;8(2):331-49. https://doi.org/10.1016/s0733-8619(18)30359-1
  15. Han-suk Lee, Houng-sik Choi, Oh-yun Kwon. A Literature Review on Ba1ance Control Factors. Phys Ther Korea. 1996;3(3):86.
  16. Runge CF, Shupert CL, Horak FB, Zajac FE. Ankle and hip postural strategies defined by joint torques. Gait Posture. 1999;10(2):161-70. https://doi.org/10.1016/S0966-6362(99)00032-6
  17. Donald AN. Kinesiology of the Musculoskeletal System. 3rd ed. Mosby; 2002.
  18. Niam Susan. et al. Balance and physical impairments after stroke. Arch Phys Med Rehabil. 1999;80(10):1227-33 https://doi.org/10.1016/S0003-9993(99)90020-5
  19. Michaelson P, Michaelson M, Jaric S, Latash ML, Sjolander P, Djupsjobacka M. Vertical posture and head stability in patients with chronic neck pain. J Rehabil Med. 2003;35(5):229-35. https://doi.org/10.1080/16501970306093
  20. Muehlbauer T, Roth R, Mueller S, Granacher U. Intra and intersession reliability of balance measures during one-leg standing in young adults. J Strength Cond Res. 2011;25(8):2228-2234. https://doi.org/10.1519/JSC.0b013e3181fb393b
  21. Matsuda S, Demura S, Uchiyama M. Centre of pressure sway characteristics during static one-legged stance of athletes from different sports. J Sport Sci. 2008;26(7):775-779. https://doi.org/10.1080/02640410701824099
  22. Klein DA, Stone WJ, Phillips WT, Gangi J, Hartman S. PNF training and physical function in assisted-living older adults. J Aging Phys Activ. 2002;10(4):476-488. https://doi.org/10.1123/japa.10.4.476
  23. Rhyu HS, Kim SH, Park HS. The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity. J Exerc Rehabil. 2015;11(1):36-40. https://doi.org/10.12965/jer.150189
  24. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. Springer Science & Business Media. 2007.
  25. Seo KC, Park HS, Park KY. The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients' dynamic balance ability. J Phys Ther Sci. 2015;27(5):1459-1462. https://doi.org/10.1589/jpts.27.1459
  26. Kim JJ, and Park SY. Immediate effects of the trunk stabilizing exercise on static balance parameters in double-leg and one-leg stances. J Phys Ther Sci. 2016;28(6):1673-1675. https://doi.org/10.1589/jpts.28.1673
  27. Borges MD, Medeiros DM, Minotto BB, Lima CS. Comparison between static stretching and proprioceptive neuromuscular facilitation on hamstring flexibility: systematic review and meta-analysis. Eur J Physiother. 2018;20:12-19. https://doi.org/10.1080/21679169.2017.1347708
  28. Takasaki H, Okubo Y, Okuyama S. The Effect of Proprioceptive Neuromuscular Facilitation on Joint Position Sense: A Systematic Review. J Sport Rehabil. 2019;29(4):488-497. https://doi.org/10.1123/jsr.2018-0498
  29. Giggins OM, Persson UM, Caulfield B. Biofeedback in rehabilitation. J Neuroeng Rehabil. 2013 18;10:60.
  30. Tate JJ, Milner CE. Real-time kinematic, temporospatial, and kinetic biofeedback during gait retraining in patients: a systematic review. Phys Ther. 2010;90(8):1123-34. https://doi.org/10.2522/ptj.20080281
  31. Semblantes PA, Andaluz VH, Lagla J, Chicaiza FA, Acurio A. Visual feedback framework for rehabilitation of stroke patients. Informatics in Medicine Unlocked 2018;13:41-50. https://doi.org/10.1016/j.imu.2018.10.002
  32. Karnath HO, Broetz D. Understanding and treating "pusher syndrome". Phys Ther. 2003;83(12):1119-25. https://doi.org/10.1093/ptj/83.12.1119
  33. Gallery PM, Forster AL. Human movement, 2nd ed. 1985. New York, Churchill Livingstone.
  34. Woollacott MH, Shumway-Cook A, Nashner LM. Aging and posture control: changes in sensory organization and muscular coordination. Int J Aging Hum Dev. 1986;23(2):97-114. https://doi.org/10.2190/VXN3-N3RT-54JB-X16X
  35. Sackley CM, Baguley BI, Gent S, Hodgson P. The use of a balance performance monitor in the treatment of weight-bearing and weight-transference problems after stroke. Phyiotherapy. 1992;78(12):907-913.
  36. Sackley CM, Baguley BI. Visual feedback after stroke with the balance performance monitor: two single-case studies. Clin Rehab. 1993;7(3):189-195. https://doi.org/10.1177/026921559300700302
  37. Winstein CJ, Gardner ER, McNeal DR, Barto PS, Nicholson DE. Standing balance training: effect on balance and locomotion in hemiparetic adults. Arch Phys Med Rehabil. 1989;70(10):755-62.
  38. Han D. Muscle activation of paraspinal muscles in different types of high heels during standing. J Phys Ther Sci. 2015;27(1):67-69. https://doi.org/10.1589/jpts.27.67
  39. Hof AL. The relationship between electromyogram and muscle force. Sportverletzung.Sportschaden. 1997;11(03):79-86 https://doi.org/10.1055/s-2007-993372
  40. Bogey RA, Perry J, Gitter AJ. An EMG-to-force processing approach for determining ankle muscle forces during normal human gait. IEEE Trans Neural Syst Rehabil Eng. 2005;13(3):302-10. https://doi.org/10.1109/TNSRE.2005.851768
  41. Staudenmann D, Kingma I, Daffertshofer A, Stegeman DF, van Dieen JH. Improving EMG-based muscle force estimation by using a high-density EMG grid and principal component analysis. IEEE Trans Biomed Eng. 2006;53(4):712-9. https://doi.org/10.1109/tbme.2006.870246
  42. Turker KS, Miles TS. Surface electromyography, force and single motor-unit data for inhibitory reflex responses in human masseter at two levels of excitatory drive. Arch Oral Biol. 1989;34(9):731-7. https://doi.org/10.1016/0003-9969(89)90080-0
  43. Werner BC, Holzgrefe RE, Griffin JW, Lyons ML, Cosgrove CT, Hart JM, Brockmeier SF. Validation of an innovative method of shoulder range-of-motion measurement using a smartphone clinometer application. J Shoulder Elbow Surg. 2014;23(11):e275-82. https://doi.org/10.1016/j.jse.2014.02.030
  44. Benjaminse A, Sell TC, Abt JP, House AJ, Lephart SM. Reliability and precision of hip proprioception methods in healthy individuals. Clin J Sport Med. 2009;19(6):457-63. https://doi.org/10.1097/JSM.0b013e3181bcb155
  45. Dover G, Powers ME. Reliability of joint position sense and force-reproduction measures during internal and external rotation of the shoulder. J Athl Train. 2003;38(4):304.
  46. O'Leary SP, Vicenzino BT, Jull GA. A new method of isometric dynamometry for the craniocervical flexor muscles. Phys Ther. 2005;85(6):556-64. https://doi.org/10.1093/ptj/85.6.556
  47. Lephart SM, Warner JJ, Borsa PA, Fu FH. Proprioception of the shoulder joint in healthy, unstable, and surgically repaired shoulders. J Shoulder Elbow Surg. 1994;3(6):371-80. https://doi.org/10.1016/S1058-2746(09)80022-0
  48. Lee D, Kim H, An H, Jang J, Hong S, and Jung S, et al. Comparison of ostural sway depending on balance pad type. J Phys Ther Sci. 2018;30(2):252-7. https://doi.org/10.1589/jpts.30.252
  49. Qiu H, Xiong S. Center-of-pressure based postural sway measures: Reliability and ability to distinguish between age, fear of falling and fall history. Int J Ind Ergonom. 2015;47:37-44. https://doi.org/10.1016/j.ergon.2015.02.004
  50. Mukaka MM. Statistics corner: a guide to appropriate use of correlation coefficient in medical research. Malawi Med J. 2012;24:69-71.
  51. Overholser BR, Sowinski KM. Biostatistics primer: part 2. Nutr Clin Pract. 2008;23:76-84. https://doi.org/10.1177/011542650802300176
  52. Kim B, Kang T. Effect of balance exercise using a combination of isotonics for proprioceptive neuromuscular facilitation on balance and walking ability in patients with hemiplegia due to stroke. Phys Ther Rehabil Sci. 2021;10(4):470-478. https://doi.org/10.14474/ptrs.2021.10.4.470
  53. Song Q, Zhang X, Mao M, Sun W, Zhang C, Chen Y, Li L. Relationship of proprioception, cutaneous sensitivity, and muscle strength with the balance control among older adults. J Sport Health Sci. 2021;10(5):585-593. https://doi.org/10.1016/j.jshs.2021.07.005
  54. Lee HM, Cheng CK, Liau JJ. Correlation between proprioception, muscle strength, knee laxity, and dynamic standing balance in patients with chronic anterior cruciate ligament deficiency. Knee. 2009;16(5):387-91. https://doi.org/10.1016/j.knee.2009.01.006
  55. Wang H, Ji Z, Jiang G, Liu W, Jiao X. Correlation among proprioception, muscle strength, and balance. J Phys Ther Sci. 2016;28(12):3468-3472. https://doi.org/10.1589/jpts.28.3468
  56. Pereira MP, Goncalves M. Proprioceptive neuromuscular facilitation improves balance and knee extensors strength of older fallers, Int Sch Res Notices. 2012;402612.
  57. Sharma V, Kaur J. Effect of core strengthening with pelvic proprioceptive neuromuscular facilitation on trunk, balance, gait, and function in chronic stroke. J Exerc Rehabil. 2017;13(2):200-205. https://doi.org/10.12965/jer.1734892.446
  58. Cayco CS, Gorgon EJR, Lazaro RT. Effects of proprioceptive neuromuscular facilitation on balance, strength, and mobility of an older adult with chronic stroke: A case report. J Bodyw Mov Ther. 2017;21(4):767-774. https://doi.org/10.1016/j.jbmt.2016.10.008
  59. Kingma H, Felipe L, Gerards MC, Gerits P, Guinand N, Perez-Fornos A, Demkin V, vand de Berg R. Vibrotactile feedback improves balance and mobility in patients with severe bilateral vestibular loss. J Neurol 2019;266:19-26. https://doi.org/10.1007/s00415-018-9133-z
  60. Cayco CS, Gorgon EJR, Lazaro RT. Effects of proprioceptive neuromuscular facilitation on balance, strength, and mobility of an older adult with chronic stroke: A case report. J Bodyw Mov Ther. 2017;21(4):767-774. https://doi.org/10.1016/j.jbmt.2016.10.008
  61. Lakhani B, Mansfield A. Visual feedback of the centre of gravity to optimize standing balance. Gait&Posture. 2015;41(2):499-503. https://doi.org/10.1016/j.gaitpost.2014.12.003
  62. Kennedy MW, Crowell CR, Striegel AD, Villano M, Schmiedeler JP. Relative efficacy of various strategies for visual feedback in standing balance activities. Exp Brain Res. 2013;230:117-125. https://doi.org/10.1007/s00221-013-3634-x
  63. Bowman T, Gervasoni E, Arienti C, Lazzarini SG, Negrini S, Crea S, Cattaneo D, Carrozza MC. Wearable Devices for Biofeedback Rehabilitation: A Systematic Review and Meta-Analysis to Design Application Rules and Estimate the Effectiveness on Balance and Gait Outcomes in Neurological Diseases. Sensors. 2021;21(10):3444. https://doi.org/10.3390/s21103444