• Journal of Korean Medicine Rehabilitation
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• v.33 no.2
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• pp.49-55
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• 2023

Objectives The purpose of this study is to analyze randomized controlled trials about neuromuscular electrical stimulation for muscle wasting with cancer patient and evaluate it's motor functionality effect. Methods Studies will be searched from 7 online databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure [CNKI], Korean studies Information Service System [KISS], Research Information Sharing Service [RISS], Oriental Medicine Advanced Searching Integrated System [OASIS]). Participants will be cancer patients with muscle loss, regardless of cause, gender, race or age, interventions will be neuromuscular electrical stimulation. Other treatments than interventions will be the control group and the main outcome will be reviewed by motor functionality effect. Results Randomized controlled trials about neuromuscular electrical stimulation for muscle wasting should be included in the study. Primary outcomes include motor functionality effect. Secondary outcomes evaluate adverse event. The data uses Review Manager Software 5.4. Conclusions The conclusion of this study will provide a basis for determining whether neuromuscular electrical stimulation treatment for muscle wasting with cancer patient treatment is an effective and safe treatment method in clinical practice.

• PNF and Movement
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• v.15 no.2
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• pp.201-208
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• 2017

Purpose: The purpose of this study is to determine the effects of visual biofeedback training on the recovery of balance function in stroke patients. Methods: A total of 30 patients with stroke were chosen as the subjects of this study. The subjects were randomly divided into either the visual biofeedback balance training group (experimental group; n=15) or the general balance training group (control group; n=15). The visual biofeedback balance training and general balance training were implemented for 30 minutes a day, three times a week, for a total of four weeks. The subjects' balance ability was measured before and after the interventions. Results: The shift length and surface area of the center of the body decreased in both the experimental group and the control group, with the difference being statistically significant. The shift length and surface area of the center of the body both decreased more in the experimental group than in the control group, and there was a statistically significant between-group difference. Conclusion: The experimental group showed a greater improvement in terms of the balance ability of patients with stroke than the control group. Therefore, we believe that visual biofeedback balance training can be effectively applied for the improvement of balance ability in patients with stroke.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.28-33
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• 2021

Purpose: This study examined the effects of heel raise exercises combined with neuromuscular electrical stimulation (NMES) on the muscle strength and postural control ability of subjects with functional ankle instability (FAI). Methods: Twenty-two subjects with FAI participated in this study. They were assigned randomly to two groups: 11 each in the NMES and the sham-NMES groups. Heel raise exercise was applied, and NMES electrodes were attached to the peroneus longus muscles. The NMES group applied NMES during the heel raise exercise. NMES was applied for 20 minutes during the heel raise exercise. The heel raise exercise was performed four times a week for five weeks. The muscle strength and balance error scoring system (BESS) were measured before and after the intervention. Results: A comparison of before and after the intervention within the groups revealed improved muscle strength in the NMES and Sham-NMES groups, but the BESS was improved under all conditions only in the NMES group. The Sham-NMES group showed no improvement in the unstable support surface. Furthermore, when comparing the amount of change before and after the intervention between the groups, there were significant differences in the total score and unstable support in the BESS and muscle strength. Conclusion: NMES had a positive effect on the functional activities of the functional ankle instability subjects, such as balancing on an unstable support surface during postural control and increasing muscle strength.

• The Journal of Korean Physical Therapy
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• v.26 no.5
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• pp.280-289
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• 2014

Purpose: This study was conducted in order to determine the stimulation variables which should be considered when neuromuscular electrical stimulation (NMES) is applied for a muscle under the normal innervation to minimize muscle fatigue and increase force-generating ability. Methods: A total of 23 healthy men participated in the study and all subjects were randomly assigned to the 1:1 group, 1:3 group, 1:5 group, and control group with on-off ratio of NMES. The subjects performed a fatigue task, consisting of 10 times of isometric contraction sustained by NMES. NMES using Russian current stimulation was applied to muscle fatigue and divided into three sessions by pulse frequency (10 bps, 30 bps, 90 bps). The EMG was recorded using an MP 100 system from the quadriceps femoris muscle in four groups. Results: The differences of delta MdF and delta MF of between on-off ratio groups of 10 bps, 30 bps, and 90 bps pulse frequencies were very significant (p<0.05). According to the results of post hoc of 10, 90 bps, it was greater in the 1:1 group and the 1:3 group compared with the 1:5 group, and no fatigue was observed in the control group. In 30 bps, it was greater in the 1:1 group compared with 1:3, 1:5, and control group (p<.05). Conclusion: Among NMES variables to minimize muscle fatigue, the larger on-off ratio by pulse frequency showed the lower muscle fatigue. Therefore, on-off ratio needs to be great enough, and will be more efficient with the frequency 30 bps rather than of 10 bps and 90 bps.

• PNF and Movement
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• v.15 no.2
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• pp.195-200
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• 2017

Purpose: This study attempts to identify the effects of stretching and core exercise using proprioceptive neuromuscular facilitation (PNF) on the pain and functional disability index of patients with chronic lower back pain. Methods: A total of 20 patients with chronic lower back pain were randomly divided into either the experimental group (n=10), who received PNF stretching and core exercise, or the control group (n=10), who received conventional physiotherapy. Both interventions were applied three times a week for six weeks. The visible analogue scale (VAS) was measured in order to determine the level of pain, while the Oswestry Disability Index (ODI) was used to measure the change in the functional disability index. We conducted a paired t-test to compare the within-group change before and after the intervention. To compare the between-group difference, we used an independent t-test. The statistical significance level was set at ${\alpha}=0.05$ for all the variables. Results: The experimental group showed a significant within-group change in both the VAS and the ODI (p<0.01). The control group also showed a significant change (p<0.01). A significant difference was observed between the experimental group and the control group with regard to the change in both the VAS and the ODI after the interventions (p<0.01). Conclusion: In this study, the application of stretching and core exercise using PNF for subjects who complain of chronic lower back pain proved effective in reducing both pain and functional disability. We therefore expect that this intervention can be applied in the future as a useful program for patients with chronic lower back pain.

• Physical Therapy Korea
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• v.14 no.1
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• pp.28-36
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• 2007

The aim of this study was to identify the effect of suspension unloading (SU) and electrical stimulation upon the development of neonatal muscular system. For this study, the neonatal rats were randomly divided into three groups: a control group, an experimental group I, and an experimental group II. The SU for experimental group I and II was applied from postnatal day (PD) 5 to PD 30. The electrical stimulation for soleus muscle of experimental group IIwas applied from PD 16 to PD 30 using neuromuscular electrical stimulation (NMES), which gave isometric contraction with 10 pps for 30 minutes twice a day. In order to observe the effect of SU and ES, this study observed myocyte enhancer factor 2C (MEF2C) and vascular endothelial growth factor (VEGF) immunoreactivity in the soleus muscles at PD 15 and PD 30. In addition, the motor behavior test was performed through footprint analysis at PD 30. The following is the result. At PD 15, the soleus muscles of experimental group Iand II had significantly lower MEF2C, VEGF immunoreactivity than the control group. It proved that microgravity conditions restricted the development of the skeletal muscle cells at PD 15. At PD 30, soleus muscles of the control group and experimental group II had significantly higher MEF2C, VEGF, immunoreactivity than experimental group I. It proved that the NMES facilitated the development of the skeletal muscle cells. At PD 30, it showed that SU caused the decrease in stride length of parameter of gait analysis and an increase in toe-out angle, and that the NMES decreased these variations. These results suggest that weight bearing during neonatal developmental period is essential for muscular development. They also reveal that NMES can encourage the development of muscular systems by fully supplementing the effect of weight bearing, which is an essential factor in the neonatal developmental process.

• Physical Therapy Rehabilitation Science
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• v.9 no.1
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• pp.1-9
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• 2020

Objective: This study aimed to investigate the immediate effects of intervention using neuromuscular control, self-stretching (SS), and neck stabilization exercises (NSEs) on neck pain, range of motion (ROM), and proprioception of position sense in adults with neck discomfort. Design: Three-group pretest-posttest design. Methods: Forty-four adults who complained of neck pain participated in the experiment. They were randomly assigned to the following groups: neuromuscular control exercise (NMCE) group (n=15), SS group (n=14) and NSE group (n=15). The NMCE group did rolling with only upper limb pattern on both sides. The SS group performed neck stretching on each side, 3 sets of 30 seconds for each muscle. The NSE group had the pressure biofeedback applied with increases in pressure by 2 mmHg at a time from 20-30 mmHg while in the hook-lying position. All groups performed exercises for 10 minutes. Neck pain, ROM, and proprioception were measured to determine differences between the intervention methods. Results: Intra-group comparisons showed significant improvement after exercise in pain, ROM, and proprioception in the NMC group (p<0.05). In the comparison between groups, the NMC group had a significant decrease in pain compared to the other two groups (p<0.05). There was no difference in ROM between the groups but the NMC group showed significant improvement in left rotation compared to the stabilization exercise group (p<0.05). For proprioception, the NMC group had significantly lower error than the other two groups (p<0.05). Conclusions: NMCEs through upper extremity pattern rolling exercise is effective in improving neck pain, ROM, and proprioception.

• PNF and Movement
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• v.15 no.1
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• pp.57-65
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• 2017

Purpose: The purpose of this study was to examine the effects of resistant gait training with proprioceptive neuromuscular facilitation (PNF) on the walking and balancing abilities of chronic stroke patients. Methods: Twelve chronic stroke patients were randomly assigned to either a control group (n = 6) that underwent treadmill gait training or an experimental group (n = 6) that underwent resistant gait training using PNF. The interventions were performed five times per week for four weeks. Gait variables were measured using a GAITRite system (CIR System Inc, Clifton, NJ, USA) to examine changes in walking ability; the Berg balance scale (BBS) was used to measure changes in balance; and the activity-specific balance confidence scale (ABC) was measured to examine changes in confidence about balance. A Wilcoxon signed-rank test was used to examine intragroup differences before and after the interventions, and a Mann-Whitney U-test was used for intergroup comparisons of the effects of the interventions. All statistical significance levels were set to ${\alpha}=0.05$. Results: Both the experimental group and the control group showed significant intragroup improvement in walking speed, the number of steps per minute, stride length, double support time, balance, and confidence about balance after the interventions (p < 0.05). In intergroup comparisons after the interventions, the experimental group showed significant improvements over the control group in walking speed, the number of steps per minute, stride length, balance, and confidence about balance (p < 0.05). No significant difference in double support time was seen in the intergroup comparison after training (p > 0.05). Conclusion: This study applied resistant gait training using PNF to chronic stroke patients, and the results showed significant improvements in the patients' walking and balancing abilities. Therefore, resistant gait training using PNF is thought to be applicable as an intervention method for chronic stroke patients.

• PNF and Movement
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• v.5 no.2
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• pp.73-88
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• 2007

Purpose : The purpose of this study was to find out The effect of Low back pain on the total pattens of Proprioceptive neuromuscular facilitation(PNF). Methods : The subjects of the study were 62 low back pain patients. They were divided into two groups: 31 in the experimental group and 31 in the control group. the experimental group performed modalities and PNF total patterns three times for a week. the control group performed only modalities and ROM exercise three times for a week. Back muscle strength was measured by a back muscle strength measuring machine, the intensity of pain was measured by the Visual Analogue Scale (VAS), and the level of disability was measured by Oswestry low back pain disability index. Study measurements were compared before and after 6 weeks exercise program. The two groups of subjects were assessed by utilizing two different balance measurement: Static standing balance was measured by balance performance monitor (BPM) and Dynamic standing balance was measured by one leg standing(OLS). The scale for static standing balance was measured by using, sway area, sway path, max velocity. Results : The results of this study were as follow: 1) The score on visual analogue scale shows statistically significant increase on PNF group of post test(p<.05). 2) The score on Oswestry low back pain disability index. shows statistically significant decrease on PNF group of post test(p<.05). 3) The change sway area was statistically significant on pre-test and post-test(p<.05). 4) The change sway path was statistically significant on pre-test and post-test(p<.05). 5) The change max velocity was statistically significant on pre-test and post-test(p<.05). 6) The score on one leg standing shows statistically significant increase on PNF group of post test(p<.05). Conclusion : These results of this study indicated that Proprioceptive Neuromuscular Facilitation Total patterns which performed for six weeks had a statistically significant influence on low back pain. If the exercise for muscle strength is performed along with therapeutic stabilizing exercise, a better effect can be expected on low back pain. We hope that this study will provide a basic data for further research with a bigger group and on a long-term effect.