• The Journal of Korean Physical Therapy
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• 제35권5호
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.

• 한국엔터테인먼트산업학회논문지
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• 제13권7호
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• pp.539-548
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• 2019

복합호흡운동과 넙다리네갈래근의 신경근전기자극 치료가 중증 만성폐쇄성폐질환 환자들의 폐기능과 대뇌겉질 활성도에 미치는 효과를 알아보고자 하였다. 60~80세 중증 만성폐쇄성폐질환 환자 20명을 대상으로 실험군은 복합호흡운동과 넙다리네갈래근의 신경근전기자극을, 대조군은 복합호흡운동만을 실시하였다. 사전 검사로 폐기능과 대뇌겉질 활성도를 측정하였고, 중재는 6주 간, 주 4일, 1일 1회, 30분씩 각 집단에 시행한 후, 사후검사를 사전검사와 동일하게 재측정하였다. 그 결과 집단 내 폐기능 변화는 실험군과 대조군 모두 1초간 노력성 날숨량에서 유의한 차이가 있었고(p<.001)(p<.05), 집단 간 폐기능 변화 비교에서 1초간 노력성 날숨량의 변화는 유의한 차이가 있었다(p<.05). 집단 내 대뇌겉질의 영역 별 알파파 변화 비교에서는 Fp1, Fp2, F3, F4 영역에서 대조군과 실험군 모두 유의한 차이가 있었다(p<.01)(p<.05). 따라서 6주 동안의 복합호흡운동과 넙다리네갈래근의 신경근전기자극은 중증 만성폐쇄성폐질환들의 폐기능을 향상시키고, 대뇌겉질 활성도에서 앞이마부 영역의 알파파가 증가되어 긍정적인 호흡의 변화가 나타났음을 알 수 있었다. 따라서 중증의 만성폐쇄성폐질환 환자들에게 복합호흡운동 뿐만 아니라 부가적으로 넙다리네갈래근에 신경근전기자극을 병행하면 보다 좋은 치료적 효과를 볼 수 있을 것으로 생각된다.

• 대한통합의학회지
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• 제8권4호
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• PNF and Movement
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• 제15권2호
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• pp.141-148
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• 2017

Purpose: This study attempts to identify the effects of abdominal strength training using proprioceptive neuromuscular facilitation (PNF) on the balance ability and pain level of patients with chronic lower back pain. Methods: A total of 30 patients with chronic lower back pain were randomly divided into either experimental group I (n=10), who received abdominal strength training using PNF, experimental group II (n=10), who received abdominal strengthening training, or the control group (n=10), who received conventional physiotherapy. The interventions were applied three times a week for six weeks. We measured Berg's balance scale (BBS) in order to investigate the change in balance ability, while we measured the visible analogue scale (VAS) to determine the severity of pain. We conducted a paired t-test to compare the within-group change before and after the intervention. For the comparison of the between-group difference, we used a one-way ANOVA test. Tukey's test was used as a post hoc test. The statistical significance level was set at ${\alpha}=0.05$ for all the variables. Results: Experimental group I and experimental group II showed a significant within-group change in BBS (p<0.01). A statistically significant between-group difference was observed in terms of the change in BBS (p<0.01). According to the results of the post hoc Tukey test, experimental group I and experimental group II showed a more effective change in BBS than the control group. Experimental group I, experimental group II, and the control group all showed a significant within-group change in the VAS (p<0.01). There was a statistically significant between-group difference in terms of the change in the VAS (p<0.01). According to the results of the post hoc Tukey test, the change in the VAS was more effective in experimental group I than in experimental group II and the control group. Conclusion: In this study, the application of abdominal strength training using PNF for subjects who complained of chronic lower back pain proved effective in improving their balance ability and reducing pain. We therefore believe that this training method could be applied as a useful program for patients with chronic lower back pain.

• The Journal of Korean Physical Therapy
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• 제26권4호
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• pp.249-256
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• 2014

Purpose: The aim of this study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) pattern exercise using sprinter and skater on balance and gait in the stroke patients. Methods: Twenty-two subjects were randomly assigned to the experimental group (n=11) and the control group (n=11). The experimental group performed PNF pattern exercise using sprinter and skater for 15 minutes with conventional physical therapy for 35 minutes (matt and gait training for 15 minutes + FES stimulation for 20 minutes), while the control group performed only conventional physical therapy for 50 minutes (matt and gait training for 30 minutes + FES stimulation for 20 minutes). Both groups performed therapeutic interventions for five days per week, for a period of four weeks. Functional Reach Test (FRT) and Berg Balance Scale (BBS) were used for assessment of balance, and Timed-Up and Go test (TUG) was used for testing of gait. Results: The experimental group showed significant improvements in the FRT and the BBS, while the control group did not show significant changes in two measurements. The experimental group also showed significant improvements, however, the control group did not show significant changes in the TUG. In post-values of three measurements, significant differences were observed between the two groups (p<0.05). Conclusion: This study demonstrated that PNF pattern exercise using sprinter and skater may be used to improve balance and gait function in stroke patients. Thus, we suggested that PNF pattern exercise using sprinter and skater would be a therapeutic intervention in stroke rehabilitation.

• PNF and Movement
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• 제17권3호
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• pp.451-461
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• 2019

Purpose: This study identified the effect of abdominal muscle contraction using changes in waist circumference for healthcare workers with back pain due to inadequate posture during working hours. Methods: In this study, we provided educational training focused on posture alignment and utilized waist circumference change sensors to induce the contraction of abdominal muscles as a method to address low back pain in healthcare workers. All 32 participants received the same training and then were assigned to two groups: wearing the keeping core band (CB) and not wearing the keeping core band (NCB). For the CB group, the waist circumference change sensor was applied for 6 weeks during working hours. Wilcoxon's signed-ranks test and paired t-tests were used to compare the differences between the groups. All statistical significance levels were set to α=0.05. Results: Trunk muscle endurance increased significantly in the CB group. There was no significant difference in stability index to evaluate static postural control, but active hip abduction tests, which evaluate dynamic postural control, showed significant decrease in the CB group. Conclusion: These results suggest that the induction of abdominal contraction using the waist circumference change sensor may improve the trunk muscle endurance and the postural control ability of the hip and pelvis of healthcare workers.

• Physical Therapy Rehabilitation Science
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• 제3권2호
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• PNF and Movement
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• 제16권3호
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• pp.461-473
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• 2018

Purpose: The purpose of this study was to evaluate and compare the effects of inspiratory muscle training with chest expansion exercises on pulmonary function, maximal inspiratory pressure, and gait in individuals with stroke. Methods: The participants in this study included 36 stroke patients. These patients were randomly divided into three groups: an inspiratory muscle training (IMT) with chest expansion (CE) group (n=12), an IMT group (n=12), and a control group (n=12). Participants in the IMT with CE group underwent IMT and CE exercises 5 times per week for 30 minutes over 4 weeks, whereas those in the CE group and the control group received IMT and conventional physical therapy, respectively, for the same duration. The investigator measured the patients' pulmonary function, maximal inspiratory pressure, and gait endurance. Results: After the intervention, the change values for the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow (PEF), maximal inspiratory pressure (MIP), and six-minute walk test (6MWT) in the IMT with CE group and the control group were significantly greater than those of the control group (p<0.05). Similarly, after the intervention, the change values of the FVC, FEV1, PEF, MIP, and 6MWT in the IMT with CE group were significantly greater than those in the IMT group (p<0.05). Conclusion: These findings suggest that IMT with CE could be used to increase pulmonary function, maximal inspiratory pressure, and gait endurance in stroke patients.

• Journal of Mechanical Science and Technology
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• 제18권4호
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• pp.649-663
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• 2004

While a great number of studies on human motor control have provided a wide variety of viewpoints concerning the strategy of the central nervous system (CNS) in controlling limb movement, none were able to reveal the exact methods how the movement command from CNS is mapped onto the neuromuscular activity. As a preliminary study of human-machine interface design, the characteristics of human leg motion and its underlying motor control scheme are studied through experiments and simulations in this paper. The findings in this study suggest a simple open-loop motor control scheme in leg motion. As a possible candidate, an equilibrium point control model appears consistent in recreating the experimental data in numerical simulations. Based on the general leg motion analysis, the braking motion by the driver's leg is modeled.

• 한국전문물리치료학회지
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• 제7권2호
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• pp.76-87
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• 2000

Delayed onset muscle soreness (DOMS) is a common problem that can interfere with rehabilitation as well as activities of daily living. The purpose of this study was to determine the effects of both transcutaneous electrical nerve stimulation (TENS) and microcurrent electrical neuromuscular stimulation (MENS) on DOMS, Twenty-seven untrained and male volunteer subjects were randomly assigned to one of three treatment groups: 1) a group that received TENS (7 Hz), 2) MENS (60 ${\mu}A$, .3 pps) or 3) a control group that received no treatment. Subjects performed repeated eccentric exercise of the non-dominant forearm flexor muscle with submaximal intensity by the simply designed eccentric exercise devices. Treatments were applied after 24 hours and 48 hours. Subjects attended on two consecutive days for treatment and measurement of elbow flexion, extension, resting angle (universal goniometer), and pain (visual analogue scale: VAS) on a daily basis. Measurements were taken after treatment. Analysis of results were as follows; 1) There were no significant differences between TENS and MENS by one-way repeated ANOVA, 2) The t-test for pain, resting, flexion and extension angle revealed significant differences within TENS group, 3) The t-test for resting angle revealed significant differences within MENS group.