Browse > Article
http://dx.doi.org/10.18857/jkpt.2019.31.4.236

Effects of Aquatic Proprioceptive Neuromuscular Facilitation Pattern Exercise on Balance, Gait ability and Depression in Patients with Chronic Stroke  

Lee, Dong-Kyu (Department of Physical Therapy, Sunhan Hospital)
Hwang, Tae-Yeun (Department of Physical Therapy, Chunnam Techno University)
Publication Information
The Journal of Korean Physical Therapy / v.31, no.4, 2019 , pp. 236-241 More about this Journal
Abstract
Purpose: This study examined the effects of aquatic proprioceptive neuromuscular facilitation pattern exercise on the balance, gait ability, and depression in patients with chronic stroke. Methods: Thirty patients with chronic stroke were assigned randomly to an experimental (n=15) or control (n=15) group. The experimental group performed aquatic proprioceptive neuromuscular facilitation pattern exercise. The control group performed ground proprioceptive neuromuscular facilitation pattern exercise. Training was conducted once a day for 30 minutes, five days per week for six weeks. The balance ability was measured using the Berg balance scale. The gait ability was measured using the 10 Meter walk test. Depression was measured using the Beck depression inventory. Results: As a result of a comparison within groups, the experimental and control group showed a significant difference for balance, gait ability, and depression after the experiment (p<0.05). In a comparison between the two groups, the experimental group, in which aquatic proprioceptive neuromuscular facilitation pattern exercise was applied, showed more significant changes in balance, gait ability, and depression than the control group (p<0.05). Conclusion: Based on these results, aquatic proprioceptive neuromuscular facilitation pattern exercise effectively improved the balance, gait ability and depression in patients with chronic stroke.
Keywords
Aquatic proprioceptive neuromuscular facilitation; Balance; Gait; Depression;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Prange GB, Jannink MJ, Groothuis-Oudshoorn CG et al. Systematic review of the effect of robot-aided therapy on recovery of the hemiparetic arm after stroke. J Rehabil Res Dev. 2006;43(2):171-84.   DOI
2 Smania N, Picelli A, Gandolfi M et al. Rehabilitation of sensorimotor integration deficits in balance impairment of patients with stroke hemiparesis: a before/after pilot study. Neurol Sci. 2008;29(5):313-9.   DOI
3 Duncan PW, Samsa GP, Weinberger M et al. Health status of individuals with mild stroke. Stroke. 1997;28(4):740-5.   DOI
4 Wade DT, Wood VA, Hewer RL. Recovery after stroke-the first 3 months. J Neurol Neurosurg Psychiatry. 1985;48(1):7-13.   DOI
5 Bergamin M, Gobbo S, Zanotto T et al. Influence of age on postural sway during different dual-task conditions. Front Aging Neurosci. 2014;22(6): 1-7.
6 Horstman AM, Beltman MJ, Gerrits KH et al. Intrinsic muscle strength and voluntary activation of both lower limbs and functional performance after stroke. Clin Physiol Funct Imaging. 2008;28(4):251-61.   DOI
7 Tyson SF, Hanley M, Chillala J et al. Balance disability after stroke. Phys Ther. 2006;86(1):30-8.   DOI
8 Kelly J, Hunt BJ, Lewis RR et al. Anticoagulation or inferior vena cava filter placement for patients with primary intracerebral hemorrhage developing venous thromboembolism? Stroke. 2003;34(12):2999-3005.   DOI
9 Bohannon RW, Horton MG, Wikholm JB. Importance of four variables of walking to patients with stroke. Int J Rehabil Res. 1991;14(3):246-50.   DOI
10 Roth EJ, Lovell L, Harvey RL et al. Incidence of and risk factors for medical complications during stroke rehabilitation. Stroke. 2001;32(2):523-9.   DOI
11 Klein DA, William JS, Wayne TP et al. PNF training and physical function in assisted-living older adults. J Aging Phys Act. 2002;10(4):476-88.   DOI
12 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):683-97.   DOI
13 Ikai T, Kamikubo T, Takehara I et al. Dynamic postural control in patients with hemiparesis. Am J Phys Med Rehabil. 2003;82(6):463-9.   DOI
14 Kofotolis ND, Kellis E. Cross-training effects of a proprioceptive neuromuscular facilitation exercise programme on knee musculature. Phys Ther Sport. 2007;8(3):109-16.   DOI
15 Lim CG. The Effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using the sprinter and the skater on balance and gait function in the stroke patients. J Kor Soc Phys Ther 2014;26(4):249-56.
16 Choi SJ, Yoon SW. The effect of aquatic rotation exercise on balance maintenance. J Kor Soc Phys Ther 2010;22(1):27-32.
17 Kim CH, Kim YN. Effects of proprioceptive neuromuscular facilitation and treadmill training on the balance and walking ability of stroke patients. J Kor Phys Ther 2018;30(3):79-83.   DOI
18 Matsumoto S, Uema T, Ikeda K et al. Effect of underwater exercise on lower-extremity function and quality of life in post-stroke patients: a pilot controlled clinical trial. J Altern Complement Med. 2016;22(8):635-41.   DOI
19 Masumoto K, Shono T, Hotta N et al. Muscle activation, cardiorespiratory response, and rating of perceived exertion in older subjects while walking in water and on dry land. J Electromyogr Kinesiol. 2008;18(4): 581-90.   DOI
20 Clement G, Gurfinkel VS, Lestienne F et al. Adaptation of postural control to weightlessness. Exp Brain Res, 1984;57(1):61-72.
21 Kim SH, Lee DK, Kim EK. Effect of aquatic exercise on balance and depression of stroke patients. J Kor Soc Phys Ther 2014;26(2):104-9.
22 Kim EK, Lee DK, Kim YM. Effects of aquatic PNF lower extremity patterns on balance and ADL of stroke patients. J Phys Ther Sci. 2015;27(1):213-5.   DOI
23 Kim K, Lee DK, Jung SI. Effect of coordination movement using the PNF pattern underwater on the balance and gait of stroke patients. J Phys Ther Sci. 2015;27(12):3699-701.   DOI
24 Berg KO, Wood-Dauphinee SL, Williams JI et al. Measuring balance in the elderly: validation of an instrument. Can J Public Health. 1992;83(2): 7-11.
25 Dean CM, Richards CL, Malouin F. Task-related circuit training improves performance of locomotor tasks in chronic stroke: a randomized, controlled pilot trial. Arch Phys Med Rehabil. 2000;81(4):409-17.   DOI
26 Toulotte C, Fabre C, Dangremont B et al. Effects of physical training on the physical capacity of frail, demented patients with a history of falling: a randomised controlled trial. Age Ageing. 2003;32(1):67-73.   DOI
27 Geiger RA, Allen JB, O'Keefe J et al. Balance and mobility following stroke: effects of physical therapy interventions with and without biofeedback/forceplate training. Phys Ther. 2001;81(4):995-1005.   DOI
28 Park SE, Min KO, Lee SB et al. Effect of eye movements and proprioceptive neuromuscular facilitation on balance and head alignment in stroke patients with neglect syndrome. J Phys Ther Sci. 2016;28(2):596-601.   DOI
29 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):200-5.   DOI
30 Song JM, Kim SM. The effect of aquatic exercise applied PNF patterns on body composition and balance performance in stroke patients. J. of the Korean Proprioceptive Neuromuscular Facilitation Association. 2008; 6(2):1-10.
31 Kim YN, Lee DK. Comparison between aquatic and ground environments of rhythmic initiation for postural control. J Phys Ther Sci, 2012; 24(12):1269-71.   DOI
32 Gusi N, Tomas-Carus P, Hakkinen A et al. Exercise in waist-high warm water decreases pain and improves health-related quality of life and strength in the lower extremities in women with fibromyalgia. Arthritis Rheum. 2006;55(1):66-73.   DOI
33 Mirek E, Filip M, Banaszkiewicz K et al. The effects of physiotherapy with PNF concept on gait and balance of patients with Huntington's disease-pilot study. Neurol Neurochir Pol. 2015;49(6):354-7.   DOI
34 Carpenter JE, Blasier RB, Pellizzon GG. The effects of muscle fatigue on shoulder joint position sense. Am J Sports Med. 1998;26(2):262-5.   DOI
35 Hanh HM, Yum TH, Shin YW et al. A Standardization Study of Beck Depression Inventory in Korea. Psychiatry Investig. 1986;25(3):487-500.
36 Wang TJ, Belza B, Elaine Thompson F et al. Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs. 2007;57(2):141-52.   DOI
37 Kim K, Lee DK, Kim EK. Effect of aquatic dual-task training on balance and gait in stroke patients. J Phys Ther Sci. 2016;28(7):2044-7.   DOI
38 Arnold CM, Busch AJ, Schachter CL et al. A randomized clinical trial of aquatic versus land exercise to improve balance, function, and quality of life in older women with osteoporosis. Physiother Can. 2008;60(4):296-306.   DOI
39 Volaklis KA, Spassis AT, Tokmakidis SP. Land versus water exercise in patients with coronary artery disease: effects on body composition, blood lipids, and physical fitness. Am Heart J. 2007;154(3):560-6.
40 Song GB. Effects of indirect cross training on strengthening, balance, gait and depression in patients with stroke. Daegu University. Dissertation of Doctorate Degree. 2015.
41 Yohannes AM, Caton S. Management of depression in older people with osteoarthritis: A systematic review. Aging Ment Health. 2010;14(6):637-51.   DOI
42 Bherer L, Erickson KI, Liu-Ambrose T. A review of the effects of physical activity and exercise on cognitive and brain functions in older adults. J Aging Res. 2013:1-8.
43 Jung T, Lee D, Charalambous C et al. The influence of applying additional weight to the affected leg on gait patterns during aquatic treadmill walking in people poststroke. Arch Phys Med Rehabil. 2010;91(1):129-36.   DOI