Vol.7(No.1 2007)

Title Abstruct  Autor Page
The Original The immediacy effect of resistive pelvic exercise on the improvement of low back pain The purpose of this study was to investigate the immediate effects of a resistive sustained contraction using the Proprioceptive Neuromuscular Facilitation pattern of pelvic posterior depression (SCPD) as compared to a pelvic posterior tilt exercise (PPT) on the improvement of trunk flexibility in patients with low back pain. Eighteen subjects with low back pain were randomly assigned to either the PPT or the SCPD group. Measurements of the distance from "floor to index finger with trunk flexion" (FFD) were done before and immediately after treatment to determine the effects of each exercise. The results of a two-way ANOVA showed a more significant increase in the FFD for the SCPD group than for the PPT group. This result suggests that there is a possibility of a remote effect from the SCPD technique, which may trigger a reflex suppression of the lower trunk extensors and facilitate an increase in the excitability of the trunk flexors.

Key words: pelvic resistive exercise, low back pain, Proprioceptive Neuromuscular Facilitation (PNF) 
Satoshi Saya
Mitsuo Arai
Hajime Shimizu
Michele Eisemann Shimizu
Ken Yanagisawa
1~5
Effect of pelvic exercise on the shifting of the center of gravity laterally to increase weight bearing on the affected lower extremity in Hemiplegic patients The purpose of this study was to determine the effect of a resistive sustained contraction on the ability of five hemiplegic patients (mean age: 74.8 years) to laterally shift to the affected side, using the Proprioceptive Neuromuscular Facilitation pattern for pelvic posterior depression (SCPD) in the standing position. A single-subject experimental design was used in this study. A 5-day period of baseline measurements was taken as phase AI. Phase AI was followed by a 5-day period, phase BI. Phase BI was followed by a 5-day period, phase AⅡ. Phase AⅡ was followed by a 5-day period, phase BⅡ. In phases AI and AⅡ, the subject was treated by facilitating weight bearing to the affected side by shifting for 10 seconds. In phases BI and BⅡ, the subjects were treated with the SCPD technique at various intervals. We measured the amount of lateral displacement of the center of gravity, speed of lateral shifting, and pelvic retraction to evaluate the effects of each phase. The results showed that the SCPD technique produced more cumulative increments in each parameter as compared with the shifting exercise.

Key Words: hemiplegia, weight-shift, pelvic posterior depression, PNF
Kazue Masumoto
Mitsuo Arai
Tuneji Murakami
Yoshimi Tanaka
Michele Eisemann Shimizu Mayumi Kato
Ken Yanagisawa
6~16
Effects of hold relax and pelvic resistive exercise on the range of motion of the knee joints in normal young volunteers The purpose of this study was to determine the immediate effects of Proprioceptive Neuromuscular Facilitation (PNF) on the improvement of passive range of motion (PROM) of the knee joint in normal young volunteers. The exercise consisted of a resistive sustained contraction using the PNF pattern for pelvic posterior depression (SCPD), Hold Relax using the PNF pattern of flexion-adduction-external rotation (HR-PNF), Hold Relax in a plane parallel to the sagittal plane (HR-straight), and sustained stretching (SS). Thirty-five subjects were divided into 4 groups (SCPD, HR-PNF, HR-straight, and SS). The PROM of the knee joint measured before and after each exercise in the supine position was used to calculate changes in the PROM of each group and to determine the effect of each technique. The results of a two-way ANOVA for repeated measurements showed significant differences in the improvement rate between the groups (p<0.01). The Scheffe post hoc revealed that both the SCPD and HR-straight groups showed significant improvements as compared to the SS technique (p<0.05). A significant difference between the SCPD and HR groups could not be found. The remote facilitating effects of the SCPD technique in the improvement of the PROM of the knee joint may be an effective indirect therapy procedure, and may be as effective as the HR technique.

Key Words: PNF, Sustained Contraction of Posterior Depression (SCPD), Hold Relax, Range of Motion
Tomoko Shiratani
Tsuneji Murakami
Mitsuo Arai
Hajime Shimizu
Michele Eisemann Shimizu Mayumi Kato
Ken Yanagisawa
17~22
The effects of pelvic resistive exercise on the rising from supine to sitting in Hemiplegia The purpose of this study was to determine how resistive sustained contractions using the Proprioceptive Neuromuscular Facilitation pattern for pelvic posterior depression (SCPD) influences the ability of rising from supine to sitting for a hemiplegic patient (age: 63 years). A single-subject experimental design was used. A 4-day period of baseline measurements was taken four times in a week at various intervals in phase AI. Phase AI was followed by a 4-day period, phase BI . Phase BI was followed by a 4-day period,phase AⅡ. Phase AⅡwas followed by a 4-day period,phase BⅡ.In phase AI and AⅡ, the subjects repeated ADL exercises of rising from supine to sitting. In phases BI and BⅡ, the subjects were treated with the SCPD technique at various intervals. The measurement of the amount of time required to rise from supine to sitting was used to evaluate the effect of each phase. We found that, as compared to the ADL exercise, the SCPD technique had cumulative effects for the reduction of the amount of time required to rise from supine to sitting.

Key Words: hemiplegia, rising from supine to sitting, PNF, SCPD
Akiko Uehiro
Mitsuo Arai
Tuneji Murakami
Yoshimi Tanaka
Michele Eisemann Shimizu Mayumi Kato
Ken Yanagisawa
23~27
Effect of Soleus H-Wave amplitude on PNF low-extremity patterns movement By this research, PNF patterns movement on Low Extremity performed search by induction electromyogram H wave amplitude for the purpose which verifies the influence on α motor neuron of opposite side soleus. We divided 12 candidates into 3 groups of Cont group (a rest of five minutes in the supine position), Active group (low-extremity active shuttle movement in supine position), and PNF group (PNF pattern active shuttle movement with knee flexion and extension in supine position) at random, and measured the opposite side soleus H wave amplitude in before and after movement. Stimulus conditions were 1Hz in frequency about the rectangle wave of self-sustaining 1msec, made intensity about 1.5 times and carried out the electric stimulus of the tibial nerve percutaneously from the hollow of knee. The obtained waveform was performed 16 addition average processings. The amplitude rate of change was performed statistics processing by unitary arrangement distribution analysis and multiplex comparison official approval, and made the significant level less than 5% of rates of danger. Consequently, the PNF group reduced H wave amplitude intentionally compared with Cont group and Active group. As this nerve physiological factor, Synergy effect by two factors of Crossed Extension Reflex and the relaxation after contraction were able to be considered.

Key Words: PNF, H-Reflex, Crossed Extension Reflex, Relaxation
Koji Ishikuro
Yutaka Tokuda
Hiroshi Kawai
Tosiharu Sinde
Isao Matsushita
Ken Yanagisawa
28~32
The effect of pelvic anterior elevation influence to pelvic rotation of initial contact in opposite side during walking The purpose of this study is to examine the influence of proprioceptive neuromuscular facilitation (PNF) technique on pelvic rotation during walking. 2 trials were conducted using 7 healthy adult males, on the right side. Trial A: Walking before the pelvic anterior elevation (PAE) pattern of PNF execution. Trial B: Conducted immediately after the execution PAE. The pelvic rotation angle in the left initial contact is calculated by the use of the 3 dimensional operation analysis devices. The influence on the pelvic rotation conversion period before and after PAE. The difference from the left initial contact, to the beginning of the pelvic external rotation, (opposite side is anterior rotation), of each trials, was calculated and compared. therefore, trial B, showed the significant shortens from trial A (p<0.05). That is, in walking that executed PAE, it was thought that the pelvis began the external rotation at once, after the initial contact of the left limb, and, on the right limb change over to the swing phase at the early stage. It was concluded that PAE was a useful means, as an approach to an excessive posterior rotation of the pelvis, as a clinical application.

Key Words: PNF, pelvic anterior elevation, pelvic rotation, walking
Osamu Hasegawa
Takashi Nishibori
Tomoko Kimura
33~38
The influence of Replication on knee joint kinesthetic sense The purpose of this study was to investigation the influence on joint kinesthetic sense by the proprioceptive neuromuscular facilitation (PNF) techniques with replication. Eighteen healthy subjects were randomly assigned to the PNF group and the active movement group. Both the PNF group and the active movement group performed measurement and approach on knee joint kinesthetic sense in the sitting position. The PNF group performed replication techniques at PNF patterns of flexion-adduction-external rotation with knee extension in sitting repeated a pattern of exercises five times. The active movement group performed knee extension exercises five consecutive times. The results of a paired t-test analysis showed statistically significant improvement average of the error in both the PNF group and the active movement group. The results of a non paired t-test analysis showed statistically significant improvement its error of the PNF group versus the active movement group. The results of the study suggest that PNf techniques with the replication are an efficacious treatment option that can help to improvement of knee joint kinesthetic sense.

Key Words: Replication, joint kinesthetic sense, proprioceptive neuromuscular facilitation
Takashi Ito
Toshiaki Saito
Hitoshi Sato
Mai Shinoda
39~43
The remote effects of the isometric resistance exercise for PNF upper extremity pattern The purpose of this syudy was to clarify the remote effect of proprioceptive neuromuscular facilitation (PNF). We studied the opposite left lower extremity in performing the isometric resistance exercise at the start, the middle and the final positions of right upper extremity PNF flexion-abduction-external rotation pattern (PNF group: PNFG), and shoulder flexion movement (shoulder flexion group: SFG). Subjects were 20 right-handed healthy men (age, 20.9 ± 1.1 years). The Hand-Held-Dynamometer was attached to the left heel. The force of left lower extremity by the resistance exercise in PNFG were 4.36±4.32kgf, 6.08±4.10kgf, 9.84±4.76kgf at the start, the middle and the final positions respectively. In the same way, the force of left lower extermity by the resistance exercise in SFG were 0.67±1.21kgf, 2.51±3.17kgf, 7.86±3.62kgf at the start, the middle and the final positions respectively. In both groups, the resistance exercise to the final position of right upper extremity as for the force of left extremity was highest (p<0.05). In upper extremity the start and the middle positions, by statistical analysis both groups difference was significant, but the final position, both groups difference was no significant. The ratios of the left lower extremity maximum voluntary isometric contraction of PNFG were 26.0%MVC, 36.3%MVC, and 58.7%MVC at the start, the middle and the final positions respectively. The flexion movement of one side upper extremity occurred continuing movement to trunk and lower extremities. And, the isometric resistance exercise of one side upper extremity occurred irradiation to the opposite lower extremity. Therefore, it can propose using PNF as remote approach from the one side upper extremity to the opposite lower extremity.

Key Words: PNF approach, indirect approach, remote effects
 
Hitoshi Sato
Takashi Ito
44~49
Effects of resistive exercise of shoulder joint on the ROM of hip joint on their supine position We investigated the immediate effects of a resisitive sustained contraction of the shoulder muscles on the active range of motion (AROM) of the hip joint in 15 healthy people (mean age=24.1). All subjects underwent 5 seconds of sustained contraction of the shoulder extensors (about 70% of the maximum contraction) in three different shoulder positions; flexed, extended, and extended with internal rotation (PNF), in the supine position. Bilateral AROM of hip joint flexion was measured with the knee both flexed and extended (Straight Leg raising(SLR)) after a short rest period following each resistive shoulder exercise to determine the effect of each sustained contraction position. The results of a two-way ANOVA showed statistically significant differences in AROM hip measurements (knee flexed and extened) with each sustained contraction of the shoulder. The results showed that the shoulder PNF position accounted for greater hip AROM increase in comparison to the shoulder flexed position (p<0.05). The measured SLR hip AROM of the contralateral leg showed a greater improvement than hip flexion with the knee flexed on either side (p<0.01), and the SLR of the ipsilateral leg showed a greater improvement than hip flexion with the knee flexed on either side (p<0.01). These results suggest that there is a possibility for a remote effect from the sustained contraction of the shoulder PNF position, which may trigger a reflex suppression of the hamstrings and encourage an increase in reflex excitability of the hip flexors.

Key Words: PNF, sustained contraction, remote effect
Kenzo Nishiura
Mituo Arai
Eiichi Shigematsu
Ken Yanagisawa
Michele Eisemann Shimizu
50~55
The effects of resistive pelvic exercise on the rising from supine to sitting and gait speed in Hemiplegia The purpose of this study was to determine how a resistive sustained contraction using the Proprioceptive Neuromuscular Facilitation pattern for pelvic posterior depression (SCPD) influences the ability of rising from supine to sitting for five hemiplegic patients. A single-subject experimental design was used. A 3-day period of baseline measurements was taken in phase AI. Phase AI was followed by a 3-day period, phase BI. Phase BI was followed by a 3-day period, phase AⅡ. Phase AⅡ was followed by a 3-day period, phase BⅡ. This program was conducted for four weeks. In phase AI and AⅡ, the subjects were treated by repeated ADL exercise of rising from supine to sitting. In phases BI and BⅡ, the subjects were treated with the SCPD technique at various intervals. The amount of time required to rise from supine to sitting and gait speed were calculated to evaluate the effects of each phase. We found that, as compared to the ADL exercise, the SCPD technique had more cumulative effects in reducing the amount of time required to sit-up from supine and to walk.

Key Words: hemiplegia, rising from supine to sitting, PNF, SCPD
Toshiyuki Tanaka
Mitsuo Arai
56~60
Research and Reporting The effects of resistive pelvic exercise on the rising from supine to sitting in hemiplegia The purpose of this study was to determine how a resistive sustained contraction using the Proprioceptive Neuromuscular Facilitation pattern for pelvic posterior depression (SCPD) influences the ability of rising from supine to sitting for hemiplegic patients. A single-subject experimental design was used for hemiplegic patients. Following a 7-day period of baseline measurements (Phase AI) , a 7-day period of Phase BI was done, which was then followed by a 7-day period of Phase AⅡ and then a 7-day period of Phase BⅡ. In Phase AI and AⅡ, the subjects were treated with repeated ADL exercises of rising from supine to sitting. In Phase BI and BⅡ, the subjects were treated with the SCPD technique at various intervals. The amount of time required to rise from supine to sitting was measured to determine the effect of each exercise. The results showed that the SCPD technique was more effective than the ADL exercise in reducing the amount of time required to sit up from supine.

Key Words: hemiplegia, rising from supine to sitting, PNF, SCPD
Kouichi Nakama
Mitsuo Arai
61~65
The cumulative effects of pelvic anterior elevation technique on reaching activity by using unaffected upper extremity in hemiplegic patients The purpose of this study was to compare the cumulative effects of a resistive sustained contraction using the Proprioceptive Neuromuscular Facilitation pattern for pelvic anterior elevation (SCAE) with the repetition of a reaching task exercise (RT) for increasing the reaching distance (DR) towards the affected side with the unaffected upper extremity of hemiplegic patients. The DR toward the affected side with the unaffected upper extremity in the sitting position was used to determine the effect of each exercise. Eight subjects with hemiplegia were randomly assigned to the SCAE or the RT group. Both SCAE and RT were performed regularly two days per week for four weeks. Measurements of the DR were done before and after each exercise in the first session of each week. The results of a repeated measure ANOVA indicated that the DR measured both before and after exercise in the four weeks showed more significant increases in the SCAE group than in the RT group (p<0.05). These results suggests that the cumulative effect of the SCAE for increasing DR may increase postural stability and ability to control postural sway.

Key Words:hemiplegia, PNF, sitting position, reaching
Yoshimi Tanaka
Mitsuo Arai
Hajime Shimizu
Michele Eisemann Shimizu Ken Yanagisawa
66~72
The effect of movable of pelvic to the lateral reaching in sitting position The purpose of this study was to examine how passive movement of the pelvis with a Proprioceptive Neuromuscular Facilitation (PNF) pattern (PM-PNF) influences the lateral reaching task in a sitting position. Sixteen healthy subjects were divided into two groups at random. Group1 (n=5) rested for three minutes and served as the control group. Group2 (n=11) received pelvic anterior elevation (AE) and posterior depression (PD) PM-PNF with the lumbar spine stabilized. For the PM-PNF group, measurement of the reaching distance (DR) and active pelvic AE and PD movements were measured before and after the PM-PNF. For the control group, DR and active pelvic AE and PD movements were measured before and after resting. The results of a one-way ANOVA showed significant differences between the PM-PNF group and control group in DR (p<0.01) and between pre and post PM-PNF in active pelvic AE and PD movements (p<0.01). Significant correlates were found between the active pelvic DR movement and the range of ipsilateral active pelvic PD movement and between the DR and the range of contralateral active pelvic AE movement. These results suggest that PM-PNF may be effective for increasing active movement of the pelvis and spine.

Key Words: Pelvis,movement, reaching, PNF
Keizo Yoshimura
Mitsuo Arai
Yutaka Watanabe
Akinori Makii
Hiroyuki Sano
Kae Kimura
73~78
Effects of hold relax and pelvic resistive exercise on the range of motion of the knee joints in geriatric patients The purpose of this study was to determine the immediate effects of Proprioceptive Neuromuscular facilitation (PNF) on the improvement in range of motion (ROM) of the knee in patients with orthopedic knee joint disabilities. The exercises included a resistive sustained contraction of the PNF pattern of posterior depression (SCPD), hold relax (HR) and sustained stretching (SS) techniques. Ten subjects with orthopedic knee joint disabilities received 3 random sessions of each exercise. The active and passive ROM of the knee joint was evaluated before and immediately after each exercise in the supine position to calculate the improvement rate in active and passive ROM as parameters of the effects of each technique. The results of a two-way ANOVA showed significant differences between the exercises in improving active and passive ROM (p<0.01). Tukey's post hoc revealed that the SCPD and HR techniques showed significant improvements in the active and passive ROM as compared with the SS technique (p<0.01). Significant differences in the improvement of ROM between the SCPD and HR techniques could not be found. The remote facilitating effects on the knee joint by the SCPD technique may be an effective indirect approach, and may be as effective as the HR technique, for therapy in patients with orthopedic knee joint disabiliries.

Key Word: PNF, Sustained Contraction of Posterior Depression (SCPD), Hold Relax, Range of Motion
Chiho Shimizu
Mitsuo Arai
Gouichi Kuroda
Ritsuko Ishibashi
Taizo Ishikawa
Ken Yanagisawa
79~84