• PNF and Movement
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• v.21 no.1
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• pp.87-94
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• 2023

Purpose: The present study aims to investigate the effects of a diagonal exercise pattern on selective activation of the upper extremity muscles using both normalization and isolation methods. Methods: In total, 17 asymptomatic subjects participated in this study. During the two diagonal patterns of exercise (diagonals 1 and 2), muscular activities of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), anterior deltoid (AD), and infraspinatus (IS) were measured. The collected data were analyzed in two ways, according to the dominance of muscle activities (%Isolation) and according to normalized activities (%MVIC). Results: There were significant differences in LT, SA, AD, and IS between %MVIC and %Isolation (p<0.05), and the diagonal 1 pattern of exercise showed significantly more LT activities compared with the diagonal 2 pattern (p<0.05). Further, except for LT, there were no significant differences in muscle activities between the diagonal 1 and 2 exercises. Conclusion: The present study suggests that a diagonal pattern of exercise is advantageous for strengthening shoulder muscles, but caution is needed when applying to patients requiring selective strengthening. Regarding both the concentric and eccentric phases of exercise, there was no significant difference in muscular activation, except in LT, between the two diagonal patterns of exercises.

• Physical Therapy Korea
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• v.7 no.2
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• pp.88-95
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• 2000

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$. The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle $0^{\circ}$, $45^{\circ}$, and $90^{\circ}$ (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.1
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• pp.1-7
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• 2015

PURPOSE: The aim of this study was to investigate the effects of distal movement on shoulder muscle activation during diagonal pattern of exercises. METHODS: Seventeen healthy male participants volunteered to participate. Five muscles of shoulder were investigated during standing performance of diagonal shoulder exercises with and without visual trace. Two patterns of the diagonal exercises were used as diagonal 1 flexion and extension (D1F-E), and diagonal 2 flexion and extension (D2F-E). Two way repeated measures analysis of variance was used, which the factor was the presence of distal movement and exercise variations. RESULTS: The average muscle activity values of the lower trapezius and anterior deltoid are higher with the D2F-E, compared to the D1F-E (p<.05). The distal movement effect was observed within included all muscles except the lower trapezius, which the values are significantly greater in exercise with distal movement (P<.05). All significant increase of the muscles during the exercise with distal movement condition showed over 0.9 for the observed power in present study. CONCLUSION: Present result suggested that the diagonal pattern of exercise with distal movement has additional advantages of activating the scapulothoracic muscle as well as glenohumeral muscles. In addition, the D2F-E exercise pattern is effective for activating lower trapezius and anterior deltoid muscles.

• Physical Therapy Korea
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• v.4 no.2
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• pp.66-76
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• 1997

The purpose of this study was to compare the integrated electromyographic activity ratios of vastus lateralis(VL); rectus femoris lateral portion (RFL); rectus femoris medial portion(RFM); and vastus medialis(VM) muscles of 30 healthy subjects under three proprioceptive neuromuscular facilitation(PNF) techniques. Each subject was randomly assigned to one of 3 PNF techniques groups : slow reversal(SR), slow reversal hold(SRH) and rhythmic stabilization (RS). Each person was positioned in supine with the right hip flexed to $45^{\circ}$ and the knee fully extended and received a total of 6 sessions. Each technique was applied to the right lower extremity in two diagonal patterns while electrical activity was monitored from the ipsilateral muscles VL, RFL, RFM, and VM, respectively. Comparison of normalized mean EMG magnitudes from VL, VM showed that RS demonstrated significantly greater activity than that of SR or SRH and that RFL and RFM did not demonstrate any greater relative EMG activity with the three PNF techniques than did VL or VM.

• PNF and Movement
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• v.20 no.3
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• pp.321-329
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• 2022

Purpose: The purpose of this study was to compare the immediate effect on the change in muscle stiffness in the common extensor muscle (CEM) when using the spiral taping method to promote proprioception. Methods: There were 18 participants in this study. CEM stiffness was measured using a MyotonePRO device with the subject in a sitting position and according to the proprioceptive neuromuscular facilitation (PNF) arm pattern. Elastic tape was used as the material for the three taping methods employed in the study: kinesiotaping (KT), right spiral taping (RST), and left spiral taping (LST). The taping methods were applied to the wrist extensor muscle with elongation position. Additionally, when performing PNF arm patterns, spiral taping in diagonal and spiral directions was used to promote CEM proprioceptors. The change in CEM stiffness was compared with the initial data values. Results: The results of this study were obtained by comparing and measuring changes in CEM stiffness using three different tapings. It was found that the stiffness change of the CEM was significant compared to the initial value, and the increase in stiffness of the CEM after RST application was also significant. Conclusion: The results of this study show that by affecting the strength and activation of the extensor muscle, taping performed through the RST method had the most positive effect on the change in CEM stiffness.

• The Journal of Korean Physical Therapy
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• v.13 no.1
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• pp.115-125
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• 2001

The purpose of this study was to determine the relationship between rotation of the humerus and the shoulder movement in the sagital, coronal, and diagonal planes. Thirty normal subjects(15 male. 15 female)were tested using Cybex NORMTM Testing & Rehabilitation System (CYBEX Division of LUMEX, Inc., Ronkinkoma, New York). The subjects performed active shoulder flexion, abduction and PNF patterns. The range of motion(ROM) of the glenohumeral joint was measured three times. In order to assure the statistical significance of the results. the independent t-test. and a pearson's correlation were applied of the .05 and .01 level of significant. The results of this study were as follow ;1. There were statistically significant differences between shoulder flexion with humerus medial rotation and shoulder flexion with humerus lateral rotation(p <.01). 2. There were statistically significant differences between shoulder abduction with humerus medial rotation and shoulder abduction with humerus lateral rotation(p <.01). 3. There were statistically significant differences between PNF pattern(flex-abd-ext rot) with humerus medial rotation and PNF pattern with humerus lateral rotation(p < .01).For effective rehabilitation of the shoulder, physical therapists must have correct knowledge of shoulder movements. Physical therapists should consider these results when the goal of treatment is to increase ROM of the shoulder.

• The Journal of Korean Physical Therapy
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• v.5 no.1
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• pp.109-114
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• 1993

The originator of the proprioceptive neuromuscular facilitation method was Dr. Herman Kabat, a man who received the bachelor of science degree from New York University in 1932. In 1936 he moved to the University of Minnesota where he served as instructor in physiology and also studies medicine. He received his medical doctorate in 1942. When Dr. Karbat meet Sister Kenny suggested that certain change. She does not receptive his ideas. So that he decided to pursure the treatment of patients. Upon the establishment of the Karbat- kaiser Institute to be opened in 1946. Margaret Knott, the first physical therapist to be employed by him and to become his head physical therapist. In 1948 Vallejo center was opened. Dr. Kabat developed the PNF method combined motions to ascertain the effectiveness of maximal resistance and stretch in facilitating the response of a weak distal muscle. He identified mass movement patterns that were spiral and diagonal in character in 1965. Margaret Knott presented lecture at tile APTA Annual Conference in Las Vegas. The title was In the groove. On December 18, 1978 she passed away at her home in Vallejo. Marie-Louise Mangold is director of the Kaiser Foundation Rehabilitation Center now. She is the Vice President of International Proprioceptive Neuromuscular facilitation Association. About 20 physical therapist working teaching and study at KFRC in Vallejo. PNF neuromuscular mechanism becomes integrated and efficient without awareness of individual muscle action, reflex and a multitude of other neurophysiological reactions. The principles of PNF are visual consideration, verbal consideration, and proprioceptive input consideration with tactile stimulation, joint receptors, appropriate facilitation, stretch reflex normal timing, irradiation, pattern of movement.

• PNF and Movement
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• v.15 no.1
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• pp.77-84
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• 2017

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

• PNF and Movement
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• v.19 no.3
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• pp.423-433
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• 2021

Purpose: Proprioceptive neuromuscular facilitation (PNF) is a method for promoting functional movements by facilitating neuromuscular responses through the stimulation of proprioceptors in the body using spiral and diagonal patterns. Irradiation, a basic principle of PNF, is a phenomenon in which the muscle activity of a body part caused by resistance is increased or spread into muscles in other parts via their connected muscles. Resistance training can be divided by body alignment into closed and open chain exercises. Methods: In this study, 19 healthy men in their 20s and 30s were selected as subjects. They performed PNF hip flexion, abduction, and internal rotation motions on their dominant side in an open chain exercise posture in which the nondominant sole was away from the wall, and in a closed chain exercise posture in which the sole was fixed to the wall. The nondominant leg's muscle activity was measured while resistance was maintained with applied pressure at 0%, 25%, 50%, 75%, and 100% of the maximum muscle strength in the last range of motions. A two-way analysis of variance (ANOVA) was conducted for a comparative analysis of the contralateral leg's muscle activity according to the chain exercise postures and the intensity of resistance intensity during PNF hip flexion, abduction, and internal rotation. In addition, an independent sample T-test was conducted for a comparative analysis of each chain exercise posture according to the intensity of resistance. A one-way ANOVA and a Scheffe post-hoc test were also performed to analyze the contralateral leg's muscle activity according to the intensity of resistance in the closed and open chain exercise postures. Results: Results of the two-way ANOVA found that the gluteus medius and the biceps femoris had statistically significant differences in both the chain exercise postures and resistance intensity (p<0.05), and that the vastus medialis and the gastrocnemius did not exhibit statistically significant differences in the chain exercise postures (p>0.05) but showed statistically significant differences in resistance intensity (p<0.05). As a result of the independent sample T-test, the application of the PNF hip flexion-abduction-internal rotation pattern led to a statistically significant difference in the contralateral gluteus medius during the closed chain exercise posture (p<0.05). According to the results of the one-way ANOVA and the Scheffe post-analysis, statistically significant differences were observed in the gluteus medius at 50%, biceps femoris at 75%, vastus medialis at 100%, and gastrocnemius at 100% during the closed chain exercise posture based on a resistance intensity of 0% (p<0.05). In the open chain exercise posture, statistically significant differences were found in the gluteus medius at 50%, biceps femoris at 50%, and vastus medialis at 75% based on the resistance intensity of 0% (p<0.05). In the same posture, there was no significant difference in the gastrocnemius's resistance intensity (p>0.05). Conclusion: When the PNF leg pattern is applied, each muscle requires effective chain exercise postures and resistance intensity to generate the contralateral leg muscle's irradiation.