• PNF and Movement
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• v.15 no.3
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• pp.237-246
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• 2017

Purpose: The purpose of this study was to investigate the effects of forward-and-backward shift trunk exercise using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern in a closed kinematic chain exercise on the upper limb function and activity of daily living (ADL) in a stroke patient. Methods: One subject participated in this study. The study used a reversal A-B-A' design, where A and A' were the baseline period (no intervention), and B was the intervention period. The intervention was a forward-and-backward trunk shift exercise, using a PNF diagonal pattern on both a stand-on-hand position and a quadruped position of closed kinematic chain exercises, for 20 min per day for 2 weeks. The range of motion (ROM) of the shoulder joint was measured and a Fugl-Meyer assessment of upper extremity (FMA-UE) and a functional independence measure (FIM) were performed to measure upper limb function and activity of daily living (ADL). Results: ROMs of shoulder joint (flexion, extension, abduction, and external rotation) increased in the intervention phase. The FMA-UE score increased (from 28 to 36) in the intervention phase. The FIM score increased (from 20 to 25) in the intervention phase. These increases were maintained after intervention (Baseline II). Conclusion: These results suggest that forward-and-backward shift trunk exercises using a PNF diagonal pattern in a closed kinematic chain exercise have a positive effect on stroke patients' upper limb function and ADL ability.

• The Journal of Korean Physical Therapy
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• v.23 no.3
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• pp.7-12
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• 2011

Purpose: The cane is one of the most popular assistive devices for stroke patients. Clinical complaints of sensorimotor functions on the ipsilateral upper limb were appealed in stroke patients who had used a cane for a long period. Therefore, we investigated whether cane usage for a long-term period affected sensoriomotor dysfunctions on the non-affected upper limb, in terms of pain presence, shoulder joint sense, a nine-hole pegboard test, and a tracking task. Methods: We recruited 12 stroke patients, who were divided into the cane-using (CU) group or the non-cane using (NCU) group, according to cane usage experience. We evaluated joint position sense for the integrity of proprioceptive reposition sense in the shoulder joint, used a nine-hole pegboard test for upper limb dexterity evaluation, and a tracking task for visuomotor coordination. Results: Four patients in the CU group had complained of shoulder pain none did in the NCU group. In addition, the CU group showed more reposition errors on the shoulder joint than the NCU group did. In addition, the CU group had more difficulty in proprioceptive sense perception and in performance of the nine-hole pegboard teat and tracking task, compared with the NCU group. Conclusion: Our findings suggest that cane usage for a long period in stroke patients could give rise to trigger joint pain and decrease proprioceptive sense. In addition, complex motor performance in the ipsilateral upper limb could deteriorate. In stroke patients who had used acane for long period, careful observation and proper intervention will be necessary.

• Physical Therapy Korea
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• v.15 no.1
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• pp.46-53
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• 2008

The aim of the present study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on the muscle activation of neck flexors. Twenty healthy subjects participated in this study. Each subject performed bilateral asymmetrical PNF leg patterns against manual resistance under four conditions: through the full range of motion toward the right side, left side, and the end range in the right side, left side. Electromyographic (EMG) data was collected from the sternocleidomastoid (SCM) muscles as neck flexors. The root mean square (RMS) value of the SCM was measured and normalized from maximal EMG activity of the SCM. The data were analyzed using the paired t-test and repeated analysis of variance (ANOV A) was used to compare the statistical significance. The results of this study are summarized as follows: Firstly, the RMS values of SCM were significantly higher in all four PNF leg patterns than in the resting condition (p<.05). Secondly, there was no significant difference in muscle activation according to the direction of PNF leg patterns (p>.05). Thirdly, there was no significant difference in muscle activation according to the point of range of the motion of leg patterns (p>.05). It is suggested that PNF bilateral asymmetrical leg patterns have a considerable effect on muscle activation of the SCM, regardless of the range of motion and direction of PNF bilateral asymmetrical leg patterns.

• PNF and Movement
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• v.14 no.2
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• pp.83-91
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• 2016

Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects' balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at ${\alpha}=0.05$. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects' gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients' gait and balance abilities.

• PNF and Movement
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• v.14 no.2
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• pp.105-112
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• 2016

Purpose: The purpose of this study was to examine the effects of proprioceptive neuromuscular facilitation (PNF) wrist taping, after the application of a rhythmic stabilization (RS) technique, on the decrease of pain and the increase of grip strength in physical therapists who complained of wrist pain and to provide basic data on interventions for wrist pain patients. Methods: The subjects were 15 peoples in their 20s who complained of pain with a visual analogue scale (VAS) at five points or higher due to overuse of their wrists. They were randomly assigned to a control group, to which PNF wrist taping was applied after stretching (n=7), or to an experimental group (n=8), to which PNF wrist taping was applied after application of the RS technique of PNF. The experiment was conducted for four weeks, five times per week. VAS was measured in order to measure pain decrease, and grip strength (GS) was measured using a dynamometer. In order to compare within-group differences before and after the intervention, a paired t-test was performed, and in order to compare differences between the two groups, the analysis of covariance (ANCOVA) was used. All statistically significant levels were set at ${\alpha}=0.05$. Results: There were significant differences in changes of VAS and GS within each group before and after the intervention (p<0.01), but there was no significant difference between the two groups. Conclusion: This study applied PNF wrist taping after the application of stretching or PNF RS to patients who complained of pain beyond a sense of discomfort; these interventions resulted in a decrease in pain and an increase in the grip strength of the subjects. Taping and therapeutic techniques using PNF are considered to be usefully applied as one of the programs to improve wrist pain patients' pain and grip strength.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.96-104
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• 2017

Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

• PNF and Movement
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• v.4 no.1
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• pp.9-18
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• 2006

Purpose: The purpose of this study was to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) applied to the unilateral upper extremity on the muscle activation of contralateral lower extremity. Twenty-two healthy subjects (mean age of 23.7 years) participated in this study. Method : PNF patterns applied on the unilateral upper extremity in all subjects were the flexion/abduction/external rotation and lifting pattern. The hold and appoximation techniques for the irradiation were applied to end range of both patterns. Muscle activations in four patterns were measured in vastus medialis, tibialis anterior, rectus femoris, and gastrocnemius medial muscles of contralateral lower extremity using surface EMG system. Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed by one factor analysis of variance with repeated measure test. Result : There were significant differences in the between-subject effect (muscles) and within-subject effect (patterns) in comparison of muscle activation by application of PNF patterns (p<.05). The irradiation led to higher activation in the flexion/abduction/external rotation pattern than that of lifting pattern in all muscles (p<.05). The approximation techniques revealed more activations than these of hold technique in all muscles (p<.05). Conclusion : These results suggest that the application of PNF patterns to the unilateral upper extremity affect on the muscle activation of contralateral lower extremity and increase according to the intensity of resistance. This mechanism of contralateral effect might provide a help to the development of treatment method for the affected side and functional improvement for the patients who have damages of central nervous system or musculoskeletal problems by orthopedic injury.

• PNF and Movement
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• v.16 no.1
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• pp.27-32
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• 2018

Purpose: This study examined changes in gait speed and stride length after an intervention involving simultaneous scapular and pelvic patterns of proprioceptive neuromuscular facilitation in a hemiplegic patient. Methods: A 58-year-old woman with left hemiplegia who had complained of slowness of gait speed and weakness of leg strength took part in an intervention involving scapular postdepression patterns on the affected side and pelvic postdepression patterns on the nonaffected side. The intervention was performed with the patient lying on her left side, in a half kneeling position, and in a standing posture. Rhythmic initiation was used for teaching the movements to the patient and improvement of kinesthesia, and a combination of isotonic was employed for increasing strength and irradiation of the scapula and pelvic movement. The intervention took place for 30 min. It was implemented twice a day, 5 days a week, for 3 weeks. After three repetitions, the average time taken to complete the 10-m walk test (10 MWT), in addition to stride length, was measured to determine gait speed. Results: After the 3-week program, the patient's performance in the 10 MWT improved from 21.7sec to 17.1sec, and her stride length improved from 31.4cm to 38.7cm. Conclusion: The results showed that trunk movement exercise, especially coordinative movements of the scapula and pelvis can improve gait speed and stride length by increasing trunk stability and mobility. A combination of pelvic and scapular patterns can facilitate trunk rotation, thereby improving gait speed and stride length.

• Physical Therapy Korea
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• v.27 no.1
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• pp.30-37
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• 2020

Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

• PNF and Movement
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• v.15 no.1
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• pp.35-40
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• 2017

Purpose: The purpose of this study was to determine the immediate effects of using the proprioceptive neuromuscular facilitation (PNF) contract-relax technique in the close kinetic chain position on the gait ability and gastrocnemius muscle tone of stroke patients. Methods: The subjects were patients who had strokes due to cerebrum infarction and hemorrhage. The subjects participated in exercise with the PNF contract-relax technique in the standing-on-elbow position with a high table, and the affected lower leg was placed in the posterior position. The PNF contract-relax technique was applied at the position in which the ankle plantar-flexors were in a sufficiently elongated position. After performing twice in each range, while the muscle was elongated, the affected side was moved further back and a new range was set. In each session, the time of contraction was set to 8 seconds, and the resting time was set to 5 seconds; however, if the patient felt tired, they received more resting time during the intervention. The Myoton Pro and 10 m walking test were used to measure the muscle tone and gait ability both pre- and post-intervention. Results: After participating in the program, the muscle tone decreased and the gait ability improved in the ankle plantar-flexors, as determined by the Myoton Pro and 10 m walking test. Conclusion: The PNF contract-relax technique can help to decrease muscle tone in ankle plantar-flexors with hypertonus and increase the gait ability in stroke patients.