Browse > Article
http://dx.doi.org/10.14474/ptrs.2021.10.2.225

Effect of Proprioceptive Neuromuscular Facilitation Stretching on Pain, Hip Joint Range of Motion, and Functional Disability in Patients with Chronic Low Back Pain  

Kim, Beomryong (Department of Physical Therapy, Design Hospital)
Kang, Taewoo (Department of Physical Therapy, College of Health and Welfare, Woosuk University)
Kim, Dahee (Department of Physical Therapy, Howon University)
Publication Information
Physical Therapy Rehabilitation Science / v.10, no.2, 2021 , pp. 225-234 More about this Journal
Abstract
Objective: We aimed to identify the effects of proprioceptive neuromuscular facilitation (PNF) stretching on pain, hip range of motion, and functional disability in patients with chronic low back pain. Design: Randomized controlled trial Methods: In total, 45 patients with chronic low back pain were randomly divided into a conventional stretching group (n=22) and a PNF stretching group (n=23). Both interventions were performed three times per week for 6 weeks. Assessments were made using the visual analog scale, Flexion-Abduction-External Rotation test, modified Thomas test, prone hip extension test, and Oswestry disability index before and after the 6-week intervention period. We conducted a paired t-test to compare the within-group findings before and after the intervention. An independent t-test was used to compare the between-group differences. The statistical significance level was set at α=0.05, for all variables. Results: Both groups showed significant improvements in pain, hip range of motion, and functional disability after the intervention (p<0.05). A significant difference was observed in pain, hip range of motion, and functional disability in patients belonging to the PNF stretching group (p<0.05). Conclusions: This study provides evidence that the application of PNF stretching can effectively reduce pain and improve hip range of motion and functional disability in patients with chronic low back pain.
Keywords
Chronic low back pain; Functional disability; Hip range of motion; Proprioceptive neuromuscular facilitation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. New York: Springer; 2007.
2 Puentedura EJ, Huijbregts PA, Celeste S, Edwards D, In A, Landers MR, et al. Immediate effects of quantified hamstring stretching: hold-relax proprioceptive neuromuscular facilitation versus static stretching. Phys Ther Sport. 2011;12:122-6.   DOI
3 Youdas JW, Garrett TR, Egan KS, Therneau TM. Lumbar lordosis and pelvic inclination in adults with chronic low back pain. Phys Ther. 2000;80:261-75.   DOI
4 Martin RL, Sekiya JK. The interrater reliability of 4 clinical tests used to assess individuals with musculoskeletal hip pain. J Orthop Sports Phys Ther. 2008;38:71-7.   DOI
5 Frank C, Page P, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. 1st ed. Illinois: Human kinetics; 2009.
6 Kim DW, Shim JH, Choung SD. The effect of deep friction massage, modified thomas's stretching and muscle energy technique on thickness of psoas major and pelvic angle. Arch Orthop Sports Phys Ther. 2016;12:1-7.
7 Clapis PA, Davis SM, Davis RO. Reliability of inclinometer and goniometric measurements of hip extension flexibility using the modified Thomas test. Physiother Theory Pract. 2008;24:135-41.   DOI
8 Lee J, Song B. The effects of the passive and active stretching exercises of iliopsoas muscles on low back pain patients. J Spec Educ Rehabil Sci. 2015;54:291-307.
9 Konrad A, Stafilidis S, Tilp M. Effects of acute static, ballistic, and PNF stretching exercise on the muscle and tendon tissue properties. Scand J Med Sci sports. 2017;27:1070-80.   DOI
10 Jeong WM, Kim BR. The effects of proprioceptive neuromuscular facilitation exercise on the pain and functional disability index of patients with chronic lower back pain. PNF & Mov. 2017;15:195-200.
11 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. J Exer Rehabil. 2017;13:486-90.   DOI
12 Decicco PV, Fisher MM. The effects of proprioceptive neuromuscular facilitation stretching on shoulder range of motion in overhand athletes. J Sports Med Phys Fitness. 2005;45:183-7.
13 Lederman E. The science & practice of manual therapy. 2nd ed.Amsterdam: Elsevier Health Sciences; 2005.
14 Glard Y, Launay F, Viehweger E, Guillaume JM, Jouve JL, Bollini G. Hip flexion contracture and lumbar spine lordosis in myelomeningocele. J Ped Orthop. 2005;25:476-8.   DOI
15 Ryu BH. The effect of joint mobilization with PNF stretch exercise on ankle joint range of motion, plantar pressure, and balance in patients with stroke. J Int Acad Phys Ther Res. 2018;9:1642-50.   DOI
16 Malai S, Pichaiyongwongdee S, Sakulsriprasert P. Immediate Effect of Hold-Relax Stretching of Iliopsoas Muscle on Transversus Abdominis Muscle Activation in Chronic Non-Specific Low Back Pain with Lumbar Hyperlordosis. J Med Assoc Thai. 2015;98 Suppl 5:S6-11.
17 Chaitow L, Crenshaw K. Muscle energy techniques. 3rd ed. Amsterdam: Elsevier Health Sciences; 2006.
18 Gunn LJ, Stewart JC, Morgan B, Metts ST, Magnuson JM, Iglowski NJ, et al. Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial. J Man ManipTher. 2019;27:15-23.
19 Nadler SF, Malanga GA, Feinberg JH, Prybicien M, Stitik TP, DePrince M. Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study. Am J Phys Med Rehabil. 2001;80:572-7.   DOI
20 Volpato CP, Added MAN, Richter G, Tanaka V, Carvalho N, Freitas D. Influence of stretching and strengthening of the iliopsoas associated with lumbar segmental stabilization exercises in patients with low back pain: the pilot study. J Exerc Sports Orthop. 2014;25:27-32.
21 Birinci T, Razak Ozdincler A, Altun S, Kural C. A structured exercise programme combined with proprioceptive neuromuscular facilitation stretching or static stretching in posttraumatic stiffness of the elbow: a randomized controlled trial. Clin Rehabil. 2019;33:241-52.   DOI
22 Wagner DR, Tatsugawa K, Parker D, Young TA. Reliability and utility of a visual analog scale for the assessment of acute mountain sickness. High Alt Med Biol. 2007;8:27-31.   DOI
23 Bagwell JJ, Bauer L, Gradoz M, Grindstaff TL. The reliability of FABER test hip range of motion measurements. Int J Sports Phys Ther. 2016;11:1101-5.
24 Lee HJ, Shim JH, Kim JW, Kim KS. The fusion effect of deep transverse stroking, manual stretching exercise and active muscle release technique on psoas major muslce thickness and muscle tone and pelvic angle of non-specific low back pain patient. J Korea Converg Soc. 2018;9:137-44.
25 Tucker WS, Slone SW. The acute effects of hold-relax proprioceptive neuromuscular facilitation with vibration therapy on glenohumeral internal-rotation deficit. J Sport Rehabil. 2016;25:248-54.   DOI
26 Lewis CL, Sahrmann SA, Moran DW. Anterior hip joint force increases with hip extension, decreased gluteal force, or decreased iliopsoas force. J Biomech. 2007;40:3725-31.   DOI
27 Bruno PA, Millar DP, Goertzen DA. Inter-rater agreement, sensitivity, and specificity of the prone hip extension test and active straight leg raise test. Chiropr Man Therap. 2014;22:23.   DOI
28 Fairbank JC. Oswestry disability index. J Neurosurg Spine. 2014;20:239-41.   DOI
29 Kang TW, Kim BR. The effects of stretching and strengthening exercise on the pain, pelvic tilt, functional disability index, and balance ability of patients with chronic lower back pain. J Korean Phys Ther. 2019;31:7-12.   DOI
30 Cronin CG, Lohan DG, Meehan CP, Delappe E, McLoughlin R, O'Sullivan GJ, et al. Anatomy, pathology, imaging and intervention of the iliopsoas muscle revisited. EmergRadiol. 2008;15:295-310.
31 Akbari A, Mohammadi M. Effect of post isometric stretch duration on the hip joint extension in females with short iliopsoas muscle. J Shahrekord University Med Sci. 2007;9:68-75.
32 Penning L. Psoas muscle and lumbar spine stability: a concept uniting existing controversies. Eur Spine J. 2000;9:577-85.   DOI