• PNF and Movement
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• v.15 no.1
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• pp.1-11
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• 2017

Purpose: The purpose of this study was to use an ICF tool in an intervention for anterior cruciate ligament reconstruction (ACLR) patients to examine and evaluate the patients' functional problems, measure the results of the intervention, and present the process of preparing proprioceptive neuromuscular facilitation (PNF) intervention strategies, thereby contributing to changes in and development of relevant future clinical practices. Methods: A PNF rehabilitation exercise program using an ICF tool was applied to ACLR patients five times per week for four weeks. To measure the resulting changes, the ICF evaluation display, the visual analog scale (VAS), the manual muscle test (MMT), the range of motion (ROM) test, the Lysholm knee score (LKS), and the muscle endurance test (MET) were used. Results: After the intervention was applied to the ACLR patients, improvements were achieved in all the tests: ICF evaluation display, VAS, MMT, ROM, LKS, and MET. Conclusion: Utilizing the ICF tool, this study identified functional problems of ACLR patients. When the intervention was applied, physical functions improved, and structural damage was reduced, leading to enhanced levels of functional activities such as postural changes, posture maintenance, gait, movements, and movements between different places. The patients were able to complete the teacher training, which was their goal.

• 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.18 no.1
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• pp.35-44
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• 2020

Purpose: The purpose of this study was to investigate the effect of the simultaneous abdominal drawing-in maneuver (ADIM) on the muscle activity of the ipsilateral trunk and leg during proprioceptive neuromuscular facilitation (PNF) leg flexion, adduction, and external rotation with knee flexion (D1) patterns. Methods: The participants were 20 healthy adult males and females (18 males and 2 females). The maneuvers were performed by a physical therapist who fully understands the PNF leg patterns (D1) and their application in clinical practice. The participants were trained and allowed to practice for 15 minutes prior to applying ADIM, to ensure adequate learning as evidenced by the pressure biofeedback unit. In this study, we measured the muscle activity of the trunk and leg when the PNF leg pattern (D1) was performed by the physical therapist either sustaining or releasing the ADIM. Muscle activity was measured on the right transverse abdominis muscle (TRA), the external abdominal oblique muscle (EO), the internal abdominal oblique muscle (IO), the erector spinae muscle (ES), the vastus medialis oblique muscle (VMO), the vastus lateralis oblique muscle (VLO), and the tibialis anterior muscle (TA) and compared using the mean values from averaging three repeated measurements. Results: The muscle activity of the transversus abdominis, the external abdominal oblique, the internal abdominal oblique, the vastus medialis oblique, and the vastus lateralis oblique was significantly greater (p < 0.05), and the muscle activity of the erector spinae was significantly less (p < 0.05) during PNF leg pattern (D1) when the ADIM contraction was sustained compared to when it was not. Conclusion: These results suggest that sustaining ADIM during PNF leg pattern (D1) training increases the trunk and leg muscle activity, resulting in more effective training.

• PNF and Movement
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• v.18 no.1
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• pp.11-22
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• 2020

Purpose: The purpose of this study was to investigate the effects of neck stabilization exercise with PNF for neck alignment, neck disability index, and sitting balance in adults with forward-head posture. Methods: Forty participants were randomly assigned to two groups. Patients in the neck stabilization exercise group (NSG, n = 20) and the proprioceptive neuromuscular facilitation neck pattern exercise group (PNFG, n = 20) were studied 30 minutes a day three times a week for four weeks. Outcomes were measured using cranial vertical angle (CVA), the Korean version of the neck disability index (KNDI), anterior limit of stability (ALOS), and posterior limit of stability (PLOS) before and after the intervention period. Results: There were significant effects in the CVA and the KNDI of both groups pre- and post-intervention. There were significant effects in ALOS and PLOS in the PNFG pre- and post-intervention compared with the NSG. Conclusion: The results of this study suggest that PNF with neck exercise could be beneficial to the static balance of adults with forward-head posture.

• PNF and Movement
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• v.13 no.3
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• pp.135-143
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• 2015

Purpose: The purpose of this study was to assess the effect of the proprioceptive neuromuscular facilitation (PNF) relaxation technique (hold relax; HR, contract relax; CR) and static stretch (SS) on hamstring flexibility and vertical jump performance in healthy adults over a four-week period. Methods: Twenty-four healthy adults volunteered to participate in PNF and static stretch sessions. The subjects were divided into three groups as follows: 8 subjects in the SS group, 8 subjects in the HR group, and 8 subjects in the CR group. In the HR and CR groups, contractions lasted 15 seconds per trial and consisted of 5 sets of 15 seconds of hamstring contraction immediately followed by 15 seconds of passive static hamstring stretching. For the static group, the participants were asked to stretch by hanging a leg over a table for 30 seconds. Subjects in all groups performed the exercises three days per week for 4 weeks. The active straight leg raising (ASLR) test, active knee extension (AKE) test, and vertical jump test were performed before the intervention and after 1, 2, and 4 weeks. Results: The SS, HR, and CR techniques effected positive improvement in hamstring flexibility and vertical jump performances but neither of the stretching methods had any statistically significant different effects according to group, although there were interactions (between group and time) in the ALSR group from 1 week to 2 week and in the AKE test from pretest to 1 week. Conclusion: Based on the results of the current study, SS, HR, and CR were shown to affect hamstring flexibility and vertical jump performance in healthy adults. In particular, it was determined that within a short period, hamstring flexibility could be attributed more to CR than to SS.

• Physical Therapy Korea
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• v.26 no.1
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• pp.19-27
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• 2019

Background: Compared to healthy people, patients with chronic lower back pain have reduced balance abilities which may cause proprioception problems, patients with chronic lower back pain avoid physical activities due to pain, and reduced activity levels lead to muscle weakening, which can further exacerbate pain. Recently, there have been many studies on the use of sensory stimulation; and among these studies, interventions that use vibrational stimulation have shown functional improvements in the patients. Objects: This study examined the effects of a stabilization exercise with vibration stimulation on the balance ability and disability in patients with chronic back pain. Methods: The subjects of the study were 30 persons who were randomly assigned to the experimental group and the control group, with 15 subjects in each. The subjects were evaluated before and after intervention via a balance ability test, the Korean Oswestry disability index (KODI) test, a pain test, and a proprioceptive sensory test. Both groups received general physical therapy. The experimental group performed the stabilization exercise with vibration stimulation, and the control group performed a general stabilization exercise, three times a week for six weeks. Results: After the intervention, both groups showed significant improvements in the balance ability test, the KODI test, the pain test, and the proprioceptive sensory test. The experimental group showed statistically significant, higher improvements than the control group in the balance ability test, the KODI test, and the proprioceptive sensory test. Conclusions: The stabilization exercise with vibration stimulation for patients with chronic back pain has been reported to provide greater functional improvements than the conventional intervention method. Therefore, the stabilization exercise in a vibration stimulation environment could be a useful intervention for patients with chronic back pain.

• PNF and Movement
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• v.16 no.3
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• pp.441-449
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• 2018

Purpose: This study aimed to compare the impact of proprioceptive neuromuscular facilitation leg patterns emphasizing hallux abduction (PNF-LPHA) on the intrinsic foot muscles of participants with hallux valgus (HV) using the toe-spread-out exercise (TSO). Methods: The present study recruited 12 individuals with HV. All the participants voluntarily agreed to participate in the study after hearing explanations of its purpose and process. All participants performed the TSO, PNF-LPHA 1, and PNF-LPHA 2. The participants' abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activity was measured, and the ratio of AbH:AdH was measured during the three interventions using electromyography. Additionally, the participants' AbH thickness was measured by ultrasonography. An intraclass correlation coefficient (ICC) was used to verify the intra-rater reliability of ultrasonography at rest and during contraction. Results: The intra-rater reliability was excellent at rest and during contraction ($ICC_{3,1}=0.90$ and $ICC_{3,1}=0.83$, respectively). There were no statistically significant differences in the activity of the AbH, the ratio of AbH: AdH, and the thickness of AbH between the TSO and PNF-LPHA2 groups. Additionally, EHL activity was significantly higher in the PNF-LPHA2 group than in the TSOgroup. Conclusion: PNF-LPHA 2 can be recommended as a method to optimize AbH and EHL activity, the ratio of AbH:AdH, and the thickness of AbH in individuals with HV.

• PNF and Movement
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• v.16 no.3
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• pp.365-376
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• 2018

Purpose: This study investigates research trends in the Proprioceptive Neuromuscular Facilitation (PNF) and Movement journal. Methods: This study analyzes the frequency of keywords and their coincidences with medical subject headings (MeSH) over 15 years in 315 papers from volume 1, issue 1 to volume 15, issue 3 of a journal published by the Korean Proprioceptive Neuromuscular Facilitation Association. The research types and levels are also analyzed, and the journals are classified by subject, diagnosis, application of PNF, and technique used when PNF is applied. All of the variables are classified in five-year units and their trends are examined. Results: A total of 315 papers were published in 40 issues, and 1190 keywords were used over 15 years. The most frequently used keyword was "PNF." For the keywords that coincided with the MeSH, there were 235 (19.74%) complete coincidence words, 167 (14.03%) incomplete coincidence words, and 788 (66.21%) complete incoincidence words. Thus, the number of complete incoincidence words was the largest. For research types, there were 196 (61.90%) experimental studies, which was the most studied research type. For research levels, there were 155 (49.21%) Level 3 studies (non-randomized trial), which was the research level with the largest number of papers. Normal people were the most common subjects (121 cases, 38.41%), and the number of papers that did not use PNF was 187 (59.37%), which was larger than those that used PNF. The most frequently used combination technique was isotonics when PNF was used. Conclusion: Basic data on PNF-related research was obtained by analyzing papers published over the past 15 years. This information can be used to suggest future directions for PNF research.

• PNF and Movement
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• v.16 no.3
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• pp.317-332
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• 2018

Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

• PNF and Movement
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• v.17 no.2
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• pp.263-274
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• 2019

Purpose: This article was conducted to determine the immediate effects of unilateral contract-relax (CR) stretching on contralateral knee extension range and to compare both sides of the knee extension range between experimental and control groups. Methods: This study recruited 16 adult males and females with straight leg raising abilities below $90^{\circ}$. The subjects were randomly divided into an experimental group and a control group comprising 8 subjects each. The experimental group performed direct CR stretching on the right hamstring muscles with straight hip extension adduction, and the control group performed indirect CR stretching on the right hamstring muscles with straight hip flexion abduction. Each group performed CR stretching 4 times with 4 repetitions comprising 10 sec of contraction and a 10 sec break between repetitions. Before and after the CR stretching exercises, the subjects' passive knee extensions were measured at the hip in a $90^{\circ}$ flexed position. The subjects' peak force on the right leg and peak pressure on the left leg during each CR stretching exercise were also measured. Results: After doing CR stretching 4 times, each group showed a significantly increased passive knee extension range on both sides, and there was no difference in the passive knee extension ranges between the groups. The peak force on the right leg was significantly higher in the experimental group than the control group. There was no difference in peak pressure between the groups. Conclusion: After applying unilateral CR stretching, the study subjects experienced a significantly increased passive knee extension range on the contralateral side. For patients who find it difficult to apply stretching techniques to knee joints directly, the use of the proprioceptive neuromuscular facilitation technique of CR stretching may be useful in improving the range of the knee joint on the contralateral side without direct treatment.