Effects of muscle strengthening methods in open and closed kinetic chains on hip abductor muscles in patients with lower extremity fractures
Tomoko Shiratani, Mitsuo Arai, Rui Hobara, Natsuki Numao, Yasuhiro Harada, Ken Yanagisawa
Abstract: The purpose of this study was to examine whether stimulation of the hip abductor muscles by closed kinetic chain （CKC-abd） with the expectation of closed kinetic chain （CKC） by contact with the ball of the big toe would produce an augmentation effect on the hip abductor muscles in 10 patients with orthopedic diseases of the limbs. We compared whether there was a difference in the increase in maximum muscle strength （MVC） of the hip abductor muscle group after static contraction of the hip abductor muscle group by contact with the external hip joint （OKC-abd） using the open kinetic chain （OKC）, after CKC-abd, and after resting. The mean of the measured values before intervention and each intervention was 91.96 （48.23） N, the mean of the measured values after intervention was 96.02 （52.85） N for OKC-abd, 105.64 （50.91） N for CKC-abd, and 96.74 （48.56） N for rest. Multiple comparison tests showed significant differences between CKC-abd and OKC-abd, and between CKC-abd and rest （p<0.05）. The results suggest that CKC-abd in the supine position may be useful as a preparatory step for CKC training in the weight-bearing position, since contact with the plantar part of the affected lower limb causes joint compression and increases the strength of hip abductor muscles efficiently.
Key words: PNF, Closed kinetic chaine, Open kinetic chaine, Sustained contraction
The effect of resistive static contraction of lower trunk muscles on the gait speed with vertebral compression
Rui Hobara, Tomoko Shiratani, Yasuhiro Harada
Abstract: A single case study was conducted to evaluate the effects of resistive static contractions of pelvic posterior depression technique （SCPD） and knee extensor muscle training （CC） on walking speed in a patient with a spinal compression fracture who had back pain in the sitting posture due to weakness of the knee extensor muscles. The subject was a woman in her 70s with a compression fracture of the 12th thoracic vertebra. The CC procedure was performed during the basic level measurement phase （phase A）, and the SCPD procedure was performed during the operation introduction phase （phase B）. The results showed that the gait speed was worse than the baseline value in the A1 period and the CC procedure （A2 and A3 periods） was worse than the SCPD procedure （B1 and B2 periods） in the previous week. The SCPD technique may have improved gait speed by providing stability to the trunk muscles. Our results suggest that improving trunk muscle stability as well as risk management for pain may be important for improving walking ability in patients with spinal compression fractures.
Key words: SCPD, Knee extension strength, 5m walking speed, Vertebral compression fractures
The impact of a combination of scapula and pelvic in the proprioceptive neuromuscular facilitation movement pattern on patients with limited range of motion due to shoulder periarthritis
Yusuke Fujiwara, Takeshige Kanamori
Abstract: We performed a combination of posterior scapular lowering and anterior pelvic elevation, which is one of the approaches of proprioceptive neuromuscular facilitation （PNF）, on a patient with limited range of motion due to periarthritis of the shoulder. The patient was a male in his 50s. Based on the staging and functional anatomy of periarthritis of the shoulder, joint range of motion exercises and muscle strengthening exercises were performed step by step, but the difference in automatic flexion range of motion of the shoulder joint between supine and sitting position remained. Since muscle strengthening exercises and direct approaches to each muscle group were not effective, resistance exercises using a spiral pattern of combined posterior scapular lowering and anterior pelvic elevation were performed as an indirect approach. As a result, scapular abduction and upward rotation were induced, and the shoulder joint range of motion was improved. The results suggest that not only conventional treatment based on functional anatomy but also an indirect approach may lead to improvement of shoulder joint range of motion.
Key words: proprioceptive neuromuscular facilitation, shoulder periarthritis, combination of scapula and pelvic pattern