2-Year Follow up of Balance in Stroke Patients after Myofascial Release using a Tennis Ball - Four Case Reports -

Young-In Hwang,Jang-Whon Yoon,Du-Jin Park 대한고유수용성신경근촉진법학회 2018 PNF and Movement Vol.16 No.1

Purpose: Myofascial release (MFR) is an effective treatment for improving muscle stiffness and balance in neurological patients. This study examined long-term effects of MFR on the balance ability of stroke patients. Methods: MFR using a tennis ball was applied to the lower extremity and sacroiliac joint of the affected side of four stroke patients. The four subjects performed the Berg balance scale (BBS) and Timed up and go (TUG) test at the beginning of an 8-week intervention, directly after the intervention, and 2 years later. Results: The BBS scores indicated a trend toward maintenance of balance (p=0.05), but there was no difference in the TUG time (p=0.47). Conclusion: MFR may be a clinically meaningful intervention to maintain balance in stroke patients over a long period. However, the sample size in this study was too small to draw general conclusions. A larger study with more participants is needed.

한 발 서기 시 복부 압박 벨트가 요통 환자의 정적 균형에 미치는 영향

주화평,최솔아,정다혜,한나린,우영근 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: This study aimed to measure static balance of low back pain patients while one-leg standing in abdominal compression belts. Methods: The study included 40 adult males and females at J university, divided into a low back pain patient group and a normal group through the Oswestry disability questionnaire (ODQ). The subjects were instructed to hold a one-leg standing posture for 15 seconds on a balance measurement plate while wearing an abdominal compression belt. Shifting distance (0.1 cm), mean velocity (cm/s), pressure, and contact area were analyzed using BioRescue (BioRescue, RMINGEIEIRIE, Rodez, France). The average value was used to measure the result 3 times for each condition. Results: Both normal and low back pain groups significantly decreased in the speed of sway while wearing the abdominal compression belt. Furthermore, the pressure of the center of motion significantly decreased in the low back pain groups while wearing abdominal compression belt. However, there were no significant differences in the speed of sway or the pressure of center of motion between groups after wearing the abdominal pressure belt. Conclusion: These results suggest that abdominal compression belts are one option for improving balance temporarily. However, balance after wearing abdominal compression vests depends on onset of back pain, age, and symptoms of pain in the groups with low back pain. Further research is needed to investigate muscle activity, dynamic balance, and the effect of the period of wearing abdominal compression belts in the variety of low back pain patients.

다양한 발목각도에 따른 스쿼트 시 오른쪽 다리의 근 활성도 비교

안수홍,이수경,이광준,박진성,황제웅 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: This study aimed to compare muscle activities in the right leg during squatting on an angle-adjustable inclined wooden plate at three different angles. Methods: The subjects were 19 healthy adult men and women. An angle-adjustable inclined wooden plate was used for the experiment, and the subjects performed squatting at three adjusted angles of 0° ankle angle, 10° ankle flexion, and 10° plantar flexion. Squatting was randomly performed without a sequence. The knee angle was set at 45°, and a goniometer was used to measure the angles accurately. Electromyography was employed to measure and compare muscle activity in the right leg in each condition. The measured data were converted to root mean square values to calculate the muscle activities. Results: This study showed no statistically significant difference at a 0° ankle angle, but a statistically significant difference was found in the vastus medialis at 10° of ankle flexion. Moreover, statistically significant differences were observed in the vastus medialis and lateralis at 10° of plantar flexion. Conclusion: This study showed a statistically significant difference in the vastus medialis at 10° of ankle flexion and statistically significant differences in the vastus medialis and lateralis at 10° of plantar flexion. Therefore, it may be effective to perform squatting at 10° of ankle flexion when intending to selectively strengthen the vastus medialis and at 10° of plantar flexion when intending to strengthen both the vastus medialis and lateralis.

음악을 병행한 목적있는 활동이 급성기 뇌졸중 환자의 상지기능, 치료동기와 기분에 미치는 효과

문종훈,김계호,이순현,원영식 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.

만성 뇌졸중 환자의 균형 및 보행 증진을 위한 체간 자가 훈련 프로그램 -예비연구-

나은진,우영근 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

닫힌사슬에서의 PNF 대각선 패턴을 이용한 몸통 전⋅후방 이동운동이 뇌졸중환자의 상지 기능 및 일상생활에 미치는 영향 -단일 사례 연구-

박시은,문상현 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

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.

경사로 횡단 보행 시 경사로 각도에 따른 안⋅바깥쪽 장딴지근의 활성 비율 변화

이상열,안수홍,김용훈 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: This study was conducted to predict the risks that arise while standing on mediolateral ramps at various ramp angles by identifying the ratio of medial to lateral gastrocnemius muscle activities. Methods: The subjects were 20 healthy adult men. Seven mediolateral ramp angles (0°, 2°, 5°, 10°, 15°, 20°, and 25°) were applied for the experiment. The ratio of medial to lateral gastrocnemius muscle activities in each condition was measured using electromyography, and the measured data were converted to root mean square values to calculate the activity ratios. Results: The study results showed statistically significant differences in the ratio of mediolateral gastrocnemius muscle activities according to the selected mediolateral ramp angles. The results of a post hoc test confirmed that the multifidus muscles were asymmetrically used on the two sides at mediolateral ramp angles of 5° or higher. Conclusion: This study found that an asymmetric use of the multifidus muscles began at a mediolateral ramp angle of 5°, and the provision of propulsion using the ankle joints on mediolateral ramps at 5° or steeper was maneuvered differently from that on flat ground. This suggests that individuals with balance control disorder have the risk of falling due to ankle sprains and unstable balance control. Therefore, patients and elderly people are required to exercise caution when crossing 5° or steeper ramps.

목과 몸통 안정화 운동이 노인의 몸통근 수축 개시 시간에 미치는 영향

박은초,송귀빈 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The purpose of this study was to describe the effects of neck and trunk stabilization exercise on the onset time of trunk muscle contraction in the elderly. Methods: Elderly subjects were divided into 2 groups: a neck and trunk stabilization exercise group (NTSG) and a control group (CG). The NTSG performed both neck and trunk stabilization exercises and the CG performed gait training on a treadmill, at 30 min per session, 3 times per week, over 8 weeks. Surface electromyography was employed to measure the onset times of trunk muscle contractions in the right anterior deltoid, rectus abdominis, external oblique abdominis, internal oblique abdominis, and erector spinae muscles. Results: The NTSG subjects showed earlier and statistically significant onset of contraction in trunk muscles as compared to the CG. Conclusion: The combination of neck and trunk stabilization exercises may more effectively improve the onset of muscle contractions in the elderly than other types of exercise. The present study’s findings may be used as basic data for the development of exercise programs suitable to the elderly, specifically for the design of home exercise programs.

협응이동훈련이 척추 측만증 고객의 족저압과 균형에 미치는 효과 -단일사례연구

김진철,김태윤,이정아 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: The purpose of this study was to investigate the effects of coordinative locomotor training (CLT) on the foot pressure and balance of patients with scoliosis. Methods: This was a single-case A-B-A study involving two patients with scoliosis. The study was designed to perform repeated measurements as follows: 5 times at baseline (A), 10 times during intervention (B), and 5 times after intervention (A). The study period was 5 weeks, and the CLT program was divided into warm up, CLT program, and cool down stages, at 50 min per stage. For the primary outcome measure, Gait View AFA-50 was used to determine the foot pressure and balance ability. For the secondary outcome measure, the SRS-22 questionnaire was used to assess the quality of life of the patients with scoliosis. Descriptive statistics and visual analysis using graphs were used to compare the rates of change. Results: The results of this study showed that the foot pressure and balance ability of the two subjects improved during the intervention period and remained improved even during the baseline period. However, their quality of life did not change after the intervention. Conclusion: CLT may have a positive effect on foot pressure and balance ability in patients with scoliosis. Also, this body function improvement may have positive effects on the performance of daily activities which employ the upright position.

무게부하를 이용한 교각운동이 건강한 성인 남성의 몸통 및 다리 근육의 활성화에 미치는 영향

이수경 대한고유수용성신경근촉진법학회 2017 PNF and Movement Vol.15 No.3

Purpose: This study observed the activity of trunk and lower limb muscles during a modified bridging exercise with various weight loads. Methods: The participants in this study consisted of 15 male adults. The muscle activity of the elector spinae, rectus abdominis, gluteus maximus, gluteus medius, vastus medialis, vastus lateralis, tibialis anterior, and soleus muscles was measured with an EMG-8 system during a modified bridging exercise performed with various weight loads (indicated as percentage of body weight). Differences in muscle activity during the bridging exercise according to the weight load applied were analyzed using a one-way ANOVA, and post hoc analysis was performed using LSD. Statistical significance was accepted at a p-level of 0.05. Results: When the subjects performed the modified bridging exercise with various weight loads, the muscle activity of the gluteus maximus and vastus medialis peaked at a load of 0.5%. The activity of the gluteus medius showed a remarkable difference when the modified bridging exercise was performed at loads of 0% and 0.5%, 0% and 1%. In addition, the activity of the vastus medialis showed a remarkable difference between modified bridging exercises performed at a load of 0% and that performed at a load of 0.5%. Conclusion: The results suggest that performing modified bridging exercises with a load of 0.5% of body weight results in significant differences in the activity of the gluteus medius and vastus medialis muscles. Thus, it is suggested that performing the modified bridging exercise at 0.5% of body weight may selectively strengthen the gluteus medius and vastus medialis muscles.