• Title/Summary/Keyword: Neuromuscular balance approach

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Effects of Proprioceptive Neuromuscular Facilitation Program Combined with Dynamic Neuromuscular Stabilization Approach on Balance in Patient with Cerebellum Atrophy -Case Report- (동적 신경근 안정화 접근법과 결합한 PNF 중재 프로그램이 소뇌 위축 환자의 균형에 미치는 영향 -사례보고-)

  • Na, Eun-Jin;Moon, Sang-Hyun;Kim, Eun-Kyung;Park, Du-Jin
    • PNF and Movement
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    • v.14 no.3
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    • pp.237-244
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    • 2016
  • Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

Effect of Non-paralyzed side and Paralyzed side of Elastic Band Combined with Proprioceptive Neuromuscular Facilitation Lower Extremity Patterns on Balance in Chronic Stroke Patients (비 마비 측과 마비 측에 적용한 탄력밴드를 결합한 고유수용성 신경근 촉진법 하지패턴이 만성 뇌졸중 환자의 균형에 미치는 영향)

  • Lee, Young-Min;Ham, Min-Sik;Kim, Taek-Soo
    • PNF and Movement
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    • v.13 no.4
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    • pp.181-188
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    • 2015
  • Purpose: This study aimed to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower extremity patterns combined with elastic bands applied to stroke patients diagnosed with hemiplegia through self-training using the non-paralyzed side approach and the paralyzed side approach, and to investigate the differences in the effects. Methods: Nine chronic stroke patients who were being treated not more than twice a week at H, K, R, and C hospitals located in Gangwon-do, performed self-training for 16 minutes, two times per day for four weeks between August and October 2015. The subjects' balance ability was measured using the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and the Timed Up and Go (TUG) test before the experiment and four weeks later. Among the statistical methods, paired t-tests were conducted for intra-group comparison of the measurements taken before and after the experiment, and independent t-tests were conducted for inter-group comparison of the ex post facto values. The statistical significance level was set to 0.05. Results: When the lower extremity patterns were applied to the non-paralyzed side group and the paralyzed side group, significant intra-group differences were observed for the Tetrax stability index, the weight distribution index, the Berg Balance Scale (BBS), and Timed Up and Go (TUG) tests (p<0.05); however, the inter-group comparisons showed no significant differences. Conclusion: The non-paralyzed side approach was found to be easy for patients to participate in and it also affected the patients' paralyzed side. Although the paralyzed side approach produced good exercise effects in a short period of time, it could result in adverse effects, such as a decrease in motivation and self-confidence. Therefore, these approaches are considered to be more effective when they are selectively applied depending on the purpose of the intervention and the degree of a patients' participation.

Review of the approach in the PNF and Tai Chi on frail elders (허약한 노인을 위한 고유수용성 신경근 촉진법과 타이치의 적용에 관한 고찰)

  • Cho, Jeong-Sun;Bae, Sung-Soo;Park, Rae-Joon
    • PNF and Movement
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    • v.5 no.1
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    • pp.29-35
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    • 2007
  • Purpose : The purpose of this study was investigated to find the approach in the PNF and TC for frail elder Method : This is a literature study with books, articles, seminal note and books for PNF and TC international course. Result : Neural mechanisms contribute significantly to the gains that occur in the range of motion about a joint with stretching exercises. The participation in a stretch-training program decreases tonic reflex activity and increases flexibility and decreases in force production and muscle activation. Also the stretching-induced decreases may be due to a central nervous system inhibitory mechanism. PNF stretch techniques can increase ROM in older adults. These results may differ from those of studies performed with younger populations because of age-related physiologic changes. TC exercise improves balance control and muscle strength and were associated with reorganized lower extremity neuromuscular patterns. Conclusions : The stretch training program of the PNF and TC contribute to increase the balance and coordination for frail elder. Therefore, The frail elder prevent falling. Further study, The PNF and TC be introduced as the new therapeutic intervention for frail elder.

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Rehabilitation of the Throwing Athlete (던지기 선수에서의 재활)

  • Youn, Te-Hyun;Moon, Young-Lae
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.2
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    • pp.77-82
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    • 2007
  • The thrower's shoulders require a delicate balance between mobility and functional stability. First step to successful nonoperative management is an accurate diagnostic approach. Rehabilitation program follows a well-organized, multiphase approach with focus on controlling painful inflammation, restoring muscle balance, obtaining joint flexibility, improving proprioception and neuromuscular control, and effectively returning to competitive pitching. In this article, the typical musculoskeletal profile of the overhead thrower and various rehabilitation programs for specific injuries are discussed.

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Kinetic analysis of the foot and ankle (발과 족관절의 운동학적 분석)

  • Kim, Jae-Hun
    • PNF and Movement
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    • v.6 no.3
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    • pp.29-35
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    • 2008
  • Purpose : To describes the important aspects of the foot and ankle movement and function used when git and balance strategy. Method : The foot and ankle was a very important roles in the lower limb movement and gait. This study summarizes the physiologic movement of knee to the PNF lower extremity patterns. Result : The ankle joint composed of the talocural joint, the subtalarl joint, transverse tarsal joint, talocalcaneonavicular joint. The onset of dorsiflexion muscle activity starts in pre swing gait patterns. First contract muscle is the extensor hallucis. Activity of tibialis anterior and extensor digitorum longus quickly follows in mid swing gait phase. During stance phase, the soleus and gastrocnemius muscle provided plantar flexor torque, which muscle reacts quickly to restrain ankle dorsiflexion, and contributes modulated control of the ankle motion in gait patterns. Conclusions : The understanding of ankle kinematics, could provide a good therapeutic approach for improving gait patterns in patients with various pathological condition.

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Treatment of Edentulous Patient with Neutral Zone Technique : A Clinical Case (무치악 환자 에서 Neutral Zone 방법을 적용한 임상 증례)

  • Kim, Yongsik;Lee, Byunguk
    • Journal of Dental Rehabilitation and Applied Science
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    • v.17 no.2
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    • pp.107-112
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    • 2001
  • The prosthodontic treatment of severely resorbed edentulous patients has been one of the frustrating areas due to extensive loss of tissues. The integrated neuromuscular balance among tongue, lip, and cheek is compromised. The retention, stability, and support are the three major factors to influence the clinical outcome. Fish described a denture as having three surface, with each surface playing an independent and important role in the over all fit, stability, and comfort of the denture. He recommended that the polished surface should be a series of inclines so that pressure from muscular activity will retain dentures. Within the denture space there is an area that has been termed the neutral zone. The neutral zone is that area in the mouth where, during function, the forces of the tongue pressing outward are neutralized by the forces of the cheeks and lips pressing inward. According to Jacobson and Krol, neuromuscular control interacts to provide retention and the relationship of polished surface of denture base to the surrounding muscular structure of orofacial capsule facilitates the stability and retention. This neutral zone concept has been demonstrated with various modification by a number of authors. The theory used to develop the denture base contours is based on the belief that the muscle should functionally mold not only the border but the entire polished surface. Lott and Walsh reported the clinical success on complete mandibular dentures with application of neutral zone concept. A number of studies demonstrated that denture stability and retention are more dependent on correct position of the teeth and correct contour of external surfaces of the denture in a severely resorbed alveolar ridge. This article presents a prosthodontic approach to treatment of a edentulous patient using neutral zone technique to improve the retention and stability of the prosthesis.

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Analysis of Neurophysiological Approaches to the Intervention of Hemiplegia (편마비 중재에 신경생리학적 접근기법의 분석)

  • Shin, Hong-Cheul;Kang, Jung-Koo;Hwang, Hwan-Ick;Oh, Jeong-Guk
    • Journal of Korean Physical Therapy Science
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    • v.7 no.2
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    • pp.427-437
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    • 2000
  • 편마비 환자의 물리치료는 장애 결과를 완화시키는 것에 초점을 두고 있다. 본 연구는 신경생리학적 개념을 기초로 한 중재 접근 방법 중 편마비 환자에게 신경 발달 치료와 신경근 균형 접근 기법의 중재 효과를 비교 하였다. 연구 대상은 서울특별시와 전라북도에 소재한 종합병원 및 정형외과 의원에 입원 및 통원하고 있는 47-71세의 연령 범위에 있는 편마비 환자 30명 이다. 중재 집단의 기능적 능력 향상을 평가하기 위해 편마비 환자를 위한 운동 평가 척도와 수정된 바델 척도를 평가도구로 사용하였다. 편마비 환자의 기능적 능력 향성을 평가도구에 의해 측정된 결과를 분석한 바 운동평가 척도 항목중 바로누운 자세에서 옆으로 눕기와 앉아서 균형 취하기 영역에서, 수정된 바델 척도 항목 중 식사하기 영역에서 통계적으로 유의한 차이를 보였다(P<.05). 편마비 환자의 손상 부위, 손상 형태, 마비 부위 등의 손상의 본질에 따른 대상의 선정과 운동 조절 형태에 관한 지식 그리고 신경학적 결함 정도를 심도있게 다루어 기능적 능력 향상의 임상적 효과를 검증하는 것이 중요하다.

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Review of Various Treatments Applied to Patients with Chronic Low Back Pain (만성 요통환자들에게 적용하는 다양한 치료법들에 대한 고찰)

  • Ma, Sang-Yeol;Kim, Eun-Mi;Kim, Hye Lee;Lee, Jae-Hong
    • PNF and Movement
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    • v.10 no.2
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    • pp.47-54
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    • 2012
  • Purpose : The purpose of this study was investigated to find the approach in the various method for patients with chronic low back pain. Methods : For research purposes that meet the search was focused papers. Treatments include PNF, chiropractic, joint mobilization, microcurrent, electroacupuncture, stabilizing exercise, resistance exercise, aquatic rehabilitation exercise, lumbar flexion and extension exercise were included as Gymball exercise. Results : Treatment with the three major manual therapy, electrical therapy and therapeutic exercise were divided. The result of applying manual therapy increased balance, increased strength, stability increased and decreased pain. The result of applying the electrical therapy increased flexibility, and decreased pain. The result of applying therapeutic exercise increases muscle strength, reduced pain, and decreased body fat. Conclusion : Previous studies by examining the effects of chronic low back pain treatment was intended to help in the selection and application Aquatic therapy, manual therapy, electrical therapy for patients with chronic low back pain with pain reduction was found to be effective.

The Correlation between Physical Function and Lower Limb Tactile Sense in Children with Spastic Cerebral Palsy (경직형 뇌성마비 아동의 신체기능과 하지 촉각의 상관관계 연구)

  • Hye-Lyeong Yun;Na-Yeon YE;Eun-Ju Lee
    • PNF and Movement
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    • v.21 no.2
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    • pp.265-272
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    • 2023
  • Purpose: The purpose of this study was to investigate tactile sense perception of the lower extremities according to physical function in children with spastic cerebral palsy. Methods: This study was conducted on 15 children diagnosed with spastic cerebral palsy. Physical function measurement items included dynamic balance ability, gross motor function level, and lower extremity ankle spasticity. The lower extremity tactile sensation uses a monofilament to measure the sole of the first metatarsal head, the sole of the fifth metatarsal head, the heel, the anterior part of the shin midway between the patella and the ankle joint, the kneecap, the upper anterior iliac spine, and the knee. A total of six measurements were taken in the mid-femoral region of the bone. Spearman correlation analysis was performed to determine the degree of body function and lower extremity tactile perception. Results: As the physical function of children with spastic cerebral palsy deteriorated, there was a decrease in tactile sensation in the thigh area corresponding to the proximal lower extremity. (p <.05). Conclusion: Children with spastic cerebral palsy and poor physical function have sensory loss not only in the distal part but also in the proximal part, so a treatment approach that recognizes and improves it is necessary.

Lower Extremity Muscle Activity on the Obstacle Gait in Older Parkinson Diseases (파킨슨 환자들의 장애물 보행 향상을 위한 하지의 근육 활동 규명)

  • Lim, Bee-Oh;Kim, Mi-Young
    • Korean Journal of Applied Biomechanics
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    • v.17 no.4
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    • pp.141-148
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    • 2007
  • Falls associated with tripping over an obstacle can be dangerous, yet little is known about the strategies used for stepping over obstacles in older Parkinson disease. The purpose of this study was to investigate the lower extremity muscle activity on the obstacle gait according to obstacle height in older Parkinson diseases. The obstacle gait of 7 older Parkinson disease was examined during a 5.0 m approach to, and while stepping over, obstacles of 0, 25, 52, and 152mm. Seven pairs of surface electrodes(Noraxon MyoResearch, USA) were attached to the right-hand side of the body to monitor the adductor longus(AL), gluteus medius(GME), gluteus maximus(GMA), biceps femoris(BF), rectus femoris(RF), gastrocnemius(GA), tibialis anterior(TA). Electromyography data were filtered using a 10Hz to 350 Hz Butterworth band-pass digital filter and normalized to the maximum value in the analyzed phases. A one-way ANOVA for repeated measures was employed for selected electromyography variables to analyze the differences of the height of four obstacles. The results showed significant differences between 0.0mm and 25, 52, and 152mm obstacle height in TA and GA activities during the second phase(swing phase). But the more increase obstacle height, the more not increase the muscle activities. This means that the Parkinson disease stepping over obstacle inefficiency. To prevent and reduce the frequency of falls, elderly Parkinson disease maintained and improved their balance, muscular strength, neuromuscular control and mobility.