Browse > Article
http://dx.doi.org/10.12674/ptk.2015.22.1.069

Effect of Proprioceptive Neuromuscular Facilitation and Action Observation Training on Upper Extremity Motor Function in Stroke Patient: A Single-Subject Study  

Park, Hye-Ryoung (Dept. of Rehabilitation Center, Gwangju City Rehabilitation Hospital)
Lee, Moon-Kyu (Dept. of Rehabilitation Center, Gwangju City Rehabilitation Hospital)
Yun, Tae-Won (Dept. of Rehabilitation Center, Gwangju City Rehabilitation Hospital)
Publication Information
Physical Therapy Korea / v.22, no.1, 2015 , pp. 69-78 More about this Journal
Abstract
This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.
Keywords
Action observation training; Proprioceptive neuromuscular facilitation; Stroke; Upper extremity motor function;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Maeda F, Mazziotta J, Iacoboni M. Transcranial magnetic stimulation studies of the human mirror neuron system. International Congress Series. 2002;1232:889-894.   DOI
2 Mathiowetz V, Volland G, Kashman N, et al. Adult norms for the box and block test of manual dexterity. Am J Occup. 1985;39(6):386-391.   DOI
3 Morris DM, Uswatte G, Crago JE, et al. The reliability of the wolf motor function test for assessing upper extremity function after stroke. Arch Phys Med Rehabil. 2001;82(6):750-755.   DOI
4 Muthukumaraswamy SD, Johnson BW, McNair NA. Mu rhythm modulation during observation of an object-directed grasp. Brain Res Cogn Brain Res. 2004;19(2):195-201.   DOI
5 Oberman LM, Hubbard EM, McCleery JP, et al. EEG evidence for mirror neuron dysfunction in autism spectrum disorders. Brain Res Cogn Brain Res. 2005;24(2):190-198.   DOI   ScienceOn
6 Park BK, Yang JH. Motor recovery of the upper extremity following stroke. Korean J Stroke. 2003;5(1):89-95.
7 Pelosin E, Avanzino L, Bove M, et al. Action observation improves freezing of gait in patients with Parkinson's disease. Neurorehabil Neural Repair. 2010;24(8):746-752. http://dx.doi.org/10.1177/1545968310368685   DOI
8 Refshauge KM, Ada L, Ellis E. Science-Based Rehabilitation: Theories into practice. Oxford, Butterworth-Heinemann, 2005:1-3.
9 Rizzolatti G. The mirror neuron system and its function in humans. Anat Embryol (Berl). 2005;210(5-6):419-421.   DOI
10 Rizzolatti G, Craighero L. The mirror-neuron system. Annu Rev Neurosci. 2004;27:169-192.   DOI
11 Rizzolatti G, Fabbri-Destro M, Cattaneo L. Mirror neurons and their clinical relevance. Nat Clin Pract Neurol. 2009;5(1):24-34. http://dx.doi.org/10.1038/ncpneuro0990   DOI
12 Rizzolatti G, Fadiga L, Gallese V, et al. Premotor cortex and the recognition of motor actions. Brain Res Cogn Brain Res. 1996;3(2):131-141.   DOI
13 Shin YI, Lee HS. The effect of elastic band based of PNF pattern on the U/E function in the spinal cord injury patient. J Korean Soc Phys Ther. 2004;16(3):152-160.
14 Song MS. A study on comparison of proprioceptive neuromuscular facilitation and general exercise in the treatment of frozen shoulder. The Journal of Korean Academy of Physical Therapist. 1995;2(2):487-494.
15 Strafella AP, Paus T. Modulation of cortical excitability during action observation: A transcranial magnetic stimulation study. Neuroreport. 2000;11(10):2289-2292.   DOI
16 Tremblay C, Robert M, Pascual-Leone A, et al. Action observation and execution: Intracranial recordings in a human subject. Neurology. 2004;63(5):937-938.   DOI
17 Umilta MA, Kohler E, Gallese V, et al. I know what you are doing. A neurophysiological study. Neuron. 2001;31(1):155-165.   DOI
18 Wolf SL, Catlin PA, Ellis M, et al. Assessing wolf motor function test as outcome measure for research in patients after stroke. Stroke. 2001;32(7):1635-1639.   DOI
19 Wolf SL, Lecraw DE, Barton LA, et al. Forced use of hemiplegic upper extremities to reverse the effect of learned nonuse among chronic stroke and head-injured patients. Exp Neurol. 1989;104(2):125-132.   DOI
20 Adler SS, Beckers D, Buck M. PNF in Practice: An illustrated guide. 3rd ed. Heidelberg, Springer, 2008:2-3.
21 Andersen LL, Magnusson SP, Nielsen M, et al. Neuromuscular activation in conventional therapeutic exercises and heavy resistance exercises: Implications for rehabilitation. Phys Ther. 2006;86(5):683-697.
22 Aziz-Zadeh L, Koski L, Zaidel E, et al. Lateralization of the human mirror neuron system. J Neurosci. 2006;26(11):2964-2970.   DOI
23 Bellelli G, Buccino G, Bernardini B, et al. Action observation treatment improves recovery of postsurgical orthopedic patients: Evidence for a top-down effect? Arch Phys Med Rehabil. 2010;91(10):1489-1494. http://dx.doi.org/10.1016/j.apmr.2010.07.013   DOI   ScienceOn
24 Buccino G, Binkofski F, Fink GR, et al. Action observation activates premotor and parietal areas in a somatotopic manner: An fMRI study. Eur J Neurosci. 2001;13(2):400-404.   DOI
25 Buccino G, Riggio L. The role of the mirror neuron system in motor learning. Kinesiology. 2006;38(1):5-15.
26 Buccino G, Vogt S, Ritzl A, et al. Neural circuits underlying imitation learning of hand actions: An event-related fMRI study. Neuron. 2004;42(2):323-334.   DOI
27 Dobkin BH. Training and exercise to drive poststroke recovery. Nat Clin Pract Neurol. 2008;4 (2):76-85. http://dx.doi.org/10.1038/ncpneuro0709   DOI   ScienceOn
28 Celnik P, Webster B, Glasser DM, et al. Effects of action observation on physical training after stroke. Stroke. 2008;39(6):1814-1820. http://dx.doi.org/10.1161/STROKEAHA.107.508184   DOI
29 Chae J, Johnston M, Kim H, et al. Admission motor impairment as a predictor of physical disability after stroke rehabilitation. Am J Phys Med Rehabil. 1995;74(3):218-223.   DOI
30 Choi JH, Lee KM, Kim HJ, et al. Effects of supplemental PNF and weight training on the daily activity-related physical function and isokinetic muscular function of knee joint in the elderly. The Korean Journal of Physical Education. 2005;44(1):693-701.
31 Ertelt D, Small S, Solodkin A, et al. Action observation has a positive impact on rehabilitation of motor deficits after stroke. Neuroimage. 2007;36:T164-T173.   DOI   ScienceOn
32 Ewan LM, Kinmond K, Holmes PS. An observation- based intervention for stroke rehabilitation: Experiences of eight individuals affected by stroke. Disabil Rehabil. 2010;32(25): 2097-2106. http://dx.doi.org/10.3109/09638288.2010.481345   DOI
33 Franceschini M, Agosti M, Cantagallo A, et al. Mirror neurons: Action observation treatment as a tool in stroke rehabilitation. Eur J Phys Rehabil Med. 2010;46(4):517-523.
34 Gallese V, Fadiga L, Fogassi L, et al. Action recognition in the premotor cortex. Brain. 1996;119(Pt 2):593-609.   DOI
35 Garrison KA, Winstein CJ, Aziz-Zadeh L. The mirror neuron system: A neural substrate for methods in stroke rehabilitation. Neurorehabil Neural Repair. 2010;24(5):404-412. http://dx.doi.org/10.1177/1545968309354536   DOI
36 Iacoboni M, Woods RP, Brass M, et al. Cortical mechanisms of human imitation. Science. 1999;286(5449):2526-2528.   DOI   ScienceOn
37 Grafton ST, Arbib MA, Fadiga L, et al. Localization of grasp representations in humans by positron emission tomography. 2. Observation compared with imagination. Exp Brain Res. 1996;112(1):103-111.
38 Haslinger B, Erhard P, Altenmuller E, et al. Transmodal sensorimotor networks during action observation in professional pianists. J Cogn Neurosci. 2005;17(2):282-293.   DOI
39 Iacoboni M, Molnar-Szakacs I, Gallese V, et al. Grasping the intentions of others with one's own mirror neuron system. PLoS Biol. 2005;3(3):e79.   DOI   ScienceOn
40 Jette DU, Latham NK, Smout RJ, et al. Physical therapy interventions for patients with stroke in inpatient rehabilitation facilities. Phys Ther. 2005;85(3):238-248.
41 Jung HS, Bae SS, Jung YW. Effect on muscle questionnaire of knee osteoarthritis with lower extremity patterns of the proprioceptive neuromuscular facilitation. Korean Soc Phys Med. 2007;2(1):21-30.
42 Kawahira K, Shimodozono M, Ogata A, et al. Addition of intensive repetition of facilitation exercise to multidisciplinary rehabilitation promotes motor functional recovery of the hemiplegic lower limb. J Rehabil Med. 2004;36(4):159-164.   DOI
43 Kim DK. Change of walking and stair up in hemiplegia by proprioceptive neuromuscular facilitation techniques. J Korean Soc Phys Ther. 1999;11(3):57-64.
44 Kim JM, Yang BI, Lee MK. The effect of action observational physical training on manual dexterity in stroke patients. Phys Ther Korea. 2010;17(2):17-24.
45 Lee MK, Kim JM. The effect of action observational training on arm function in people with stroke. Phys Ther Korea. 2011;18(2):27-34.