PNF and Movement

Korea Proprioceptive Neuromuscular Facilitation Association (대한고유수용성신경근촉진법학회)
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Effects of Pectoralis Minor Stretching and Lower Trapezius Strengthening Exercise using PNF on Posture Change, Shoulder Range of Motion, and Pain in Rotator Cuff Repair Patients with Rounded Shoulder Posture

PNF를 이용한 작은가슴근 신장과 아래등세모근 강화 운동이 둥근 어깨 자세를 가진 돌림근띠 복원술 환자의 자세변화와 어깨 관절가동범위 및 통증에 미치는 영향

  • Beom-Ryong Kim (Department of Physical Therapy, Design Hospital) ;
  • Tae-Woo Kang (Department of Physical Therapy, College of Health and Welfare, Woosuk University)
  • 김범룡 (대자인병원 통합재활팀) ;
  • 강태우 (우석대학교 보건복지대학 물리치료학과)
  • Received : 2023.02.15
  • Accepted : 2023.03.07
  • Published : 2023.04.30
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Abstract

Purpose: This study aims to determine the effect of proprioceptive neuromuscular facilitation (PNF) pectoralis minor stretching and lower trapezius strengthening exercise on posture change, shoulder range of motion (ROM), and pain in rotator cuff repair patients with a rounded shoulder posture (RSP). Methods: Following baseline measurements, the subjects (n = 25) with rotator cuff repair were randomized into two groups: the PNF group (n = 13), which engaged in PNF pectoralis minor stretching and lower trapezius strengthening exercise, and the control group (n = 12), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The RSP values for the postural changes, flexion and abduction ROM, and visual analogue scales (VASs) of both groups were recorded at both pre- and post-intervention. In addition, before and after the intervention, a paired t-test was conducted to compare the within-group changes and an independent t-test to compare the between-group differences. Results: After the two-week intervention, both groups experienced significantly decreased RSP and VAS values (p < 0.05) and a significantly increased ROM (p < 0.05). Meanwhile, the PNF group showed greater improvements in RSP, ROM, and VAS than the control group (p < 0.05). Conclusion: These results suggest that PNF pectoralis minor stretching and lower trapezius strengthening exercise reduce posture and shoulder pain and enhance ROM in rotator cuff repair patients with RSP.

Keywords

References

  1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. Berlin. Springer. 2007.
  2. Ahn SJ, Choi EH, Kim MK. The effects of kinesiology taping and pectoralis minor self-stretching on posture change and muscle tone in adults with rounded shoulder posture. Journal of the Korean Society of Physical Medicine. 2019;14(4):81-91. https://doi.org/10.13066/kspm.2019.14.4.81
  3. An S, Kim B. The effect of rehabilitation exercise programs on recoverability of muscle functions following the arthroscopy surgery performed on rotator cuff tear. The Korean Journal of Sport. 2013;11(1):301-309.
  4. Bang H, Lee H. Difference of early muscle strengthening exercises on pain, function and sleep quality for rotator cuff partial tear patients. Journal of The Korean Society of Integrative Medicine. 2016;4(3):1-15. https://doi.org/10.15268/ksim.2016.4.3.001
  5. Boes MT, McCann PD, Dines DM. Diagnosis and management of massive rotator cuff tears: the surgeon's dilemma. Instructional Course Lectures. 2006;55(1):45-57.
  6. Boissonnault WG, Beth Badke M, Wooden MJ, et al. Patient outcome following rehabilitation for rotator cuff repair surgery: the impact of selected medical comorbidities. Journal of Orthopaedic & Sports Physical Therapy 2007;37(6):312-319. https://doi.org/10.2519/jospt.2007.2448
  7. Brodie DJ, Burnett JV, Walker JM, et al. Evaluation of low back pain by patient questionnaires and therapist assessment. Journal of Orthopaedic & Sports Physical Therapy. 1990;11(11):519-529. https://doi.org/10.2519/jospt.1990.11.11.519
  8. Burbank KM, Stevenson JH, Czarnecki GR, et al. Chronic shoulder pain: part II. treatment. American Family Physician. 2008;77(4):493-497.
  9. Franceschi F, Ruzzini L, Longo UG, et al. Equivalent clinical results of arthroscopic single-row and double-row suture anchor repair for rotator cuff tears: a randomized controlled trial. The American Journal of Sports Medicine. 2007;35(8):1254-1260. https://doi.org/10.1177/0363546507302218
  10. Hayes K, Walton JR, Szomor ZL, et al. Reliability of five methods for assessing shoulder range of motion. Australian Journal of Physiotherapy. 2001;47(4):289-294. https://doi.org/10.1016/S0004-9514(14)60274-9
  11. Im GE, Jeong YW, Seo TH. The effects of muscle energy technique on the shoulder complex range of motion and posture alignment of female college students in their twenties with a round shoulder. The Journal of Korean Academy of Orthopedic Manual Physical Therapy. 2021;27(2):17-25.
  12. Janda V. Muscle and motor control in cervicogenic disorders: assessment and management. New York. Churchill Livingstone. 1994.
  13. Jensen MP, Chen C, Brugger AM. Interpretation of visual analog scale ratings and change scores: a reanalysis of two clinical trials of postoperative pain. The Journal of Pain. 2003;(7):407-414.
  14. Jung J, Chung Y. Effects of combining both mobilization and hold-relax technique on the function of post-surgical patients with shoulder adhesive capsulitis. Physical Therapy Rehabilitation Science. 2020;9(2):90-97. https://doi.org/10.14474/ptrs.2020.9.2.90
  15. Kang TW, Song GB, Kim BR. The effect of the lower trapezius strengthening exercise using PNF on pain, range of motion, and disability in patients with frozen shoulder. PNF and Movement. 2021;19(3):401-412. https://doi.org/10.21598/JKPNFA.2021.19.3.401
  16. 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
  17. Kim BR, Kang TW. 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. Physical Therapy Rehabilitation Science. 2021; 10(4):470-478. https://doi.org/10.14474/ptrs.2021.10.4.470
  18. Kim BR, Song GB, Kang TW. Effects of extra thoracic mobilization exercises on shoulder range of motion, pain, and disability index in patients with rotator cuff repair. PNF and Movement. 2022;20(2):223-233. https://doi.org/10.21598/JKPNFA.2022.20.2.223
  19. Kim JH. Rehabilitation of rotator cuff repair. Journal of the Korean Arthroscopy Society. 2008;12(2):82-86.
  20. Kim JS, Woo YK, Ki KI. The effects of hold-relax techniques after inducing delayed muscle pain on the pain and range of motion of joints. PNF and Movement. 2016;14(1):15-21. https://doi.org/10.21598/JKPNFA.2016.14.1.15
  21. Kwon GI, Cho YH. Effects of exercise using PNF chopping and lifting pattern on the respiratory function of chronic stroke patients. Journal of the Korean Society of Physical Medicine. 2021;16(4):77-83. https://doi.org/10.13066/kspm.2021.16.4.77
  22. Lee BG, Cho NS, Rhee YG. Effect of two rehabilitation protocols on range of motion and healing rates after arthroscopic rotator cuff repair: aggressive versus limited early passive exercises. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012;28(1):34-42. https://doi.org/10.1016/j.arthro.2011.07.012
  23. Lee D. The effects of balance exercise and stretching exercise on forward head posture. Daegu University. Dissertation of Doctorate Degree. 2011.
  24. Lee T, Yoon J. The effects of repeated hold and relax exercise on frequency, stiffness and decrement of forward head posture syndrome. Archives of Orthopedic and Sports Physical Therapy. 2021;17(2):17-28. https://doi.org/10.24332/aospt.2021.17.2.03
  25. Lim WS, Shin HS, Kim IS, et al. The effects of scapular pattern and hold-relax technique of PNF on the ROM and VAS in frozen shoulder patients. The Journal of Korean Physical Therapy. 2002;14(1):15-26.
  26. 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
  27. Ludewig PM, Cook TM. Alterations in shoulder kinematics and associated muscle activity in people with symptoms of shoulder impingement. Physical Therapy. 2000;80(3):276-291.
  28. Lynch SS, Thigpen CA, Mihalik JP, et al. The effects of an exercise intervention on forward head and rounded shoulder postures in elite swimmers. British Journal of Sports Medicine. 2010;44(5):376-381. https://doi.org/10.1136/bjsm.2009.066837
  29. Nam SM, Kim K, Lee IG, et al. The immediate effects of pectoralis minor self-stretching exercise on muscle length and acromio-humeral distance in normal adults. Journal of the Korea Academia-Industrial cooperation Society. 2019;20(7):380-386.
  30. Nguyen PT, Chou LW, Hsieh YL. Proprioceptive neuromuscular facilitation-based physical therapy on the improvement of balance and gait in patients with chronic stroke: a systematic review and meta-analysis. Life. 2022;12(6):882-899. https://doi.org/10.3390/life12060882
  31. Ostor A, Richards C, Prevost A, et al. Diagnosis and relation to general health of shoulder disorders presenting to primary care. Rheumatology. 2005;44(6):800-805. https://doi.org/10.1093/rheumatology/keh598
  32. Sahrmann S. Diagnosis and treatment of movement impairment syndromes. St Louis. Mosby. 2002.
  33. Sbardelotto GAEB, Weisshahn NK, Beninca IL, et al. Hold-relax PNF is more effective than unilateral lumbar mobilization on increasing hamstring flexibility: a randomized clinical trial. Journal of Bodywork and Movement Therapies. 2022;32(1):36-42. https://doi.org/10.1016/j.jbmt.2022.04.003
  34. Seo T, Kim M, Jeong Y. Correlation between pectoralis minor, shoulder mobility and neck range of motion on rounded shoulder posture for life-care increase in women university student. Journal of the Korea Entertainment Industry Association. 2019;13(5):239-246. https://doi.org/10.21184/jkeia.2019.7.13.5.239
  35. 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.
  36. Song MJ, Kang TW, Kim BR. The effect of lower trapezius strengthening exercise using PNF on pain, range of motion, and disability in patients with chronic neck pain. PNF and Movement. 2021;19(1):137-146. https://doi.org/10.21598/JKPNFA.2021.19.1.137
  37. Spernoga SG, Uhl TL, Arnold BL, et al. Duration of maintained hamstring flexibility after a one-time, modified hold-relax stretching protocol. Journal of Athletic Training. 2001;36(1):44-48.
  38. Wong CK, Coleman D, Song J, et al. The effects of manual treatment on rounded-shoulder posture, and associated muscle strength. Journal of Bodywork and Movement Therapies. 2010;14(4):326-333. https://doi.org/10.1016/j.jbmt.2009.05.001
  39. Yang H, Bae S. Effects of shortening of pectoralis minor muscle on muscle activity of trapezius and pectoralis major muscles. Journal of The Korean Society of Integrative Medicine. 2013;1(4):85-92. https://doi.org/10.15268/ksim.2013.1.4.085
  40. Yang H, Jeong C, Yoo Y, et al. Effects of three exercise programs on the length of pectoralis minor and forward head posture. Journal of The Korean Society of Integrative Medicine. 2017;5(3):21-28.