【The Original】 page 13-20
Reproducibility of the neurophysiological remote rebound effects of a resistive static contraction using a Proprioceptive Neuromuscular Facilitation pattern in the mid-range of pelvic motion of posterior depression on the flexor carpi radialis H-reflex
Arai Mitsuo, Shiratani Tomoko, Michel Eisemann Shimizu, Tanaka Yoshimi, Yanagisawa Ken
Abstract：Background: With respect to the ascending effects of a resistive static contraction of the pelvic depressors technique (RSCPDT) using a proprioceptive neuromuscular facilitation pattern in the mid-range of pelvic motion of posterior depression, we found that the neurophysiological remote rebound effects (RRE) induced by RSCPDT on the extensor digitorum H-reflex initially caused reflexive inhibition during RSCPDT, followed by a gradual excitation after RSCPDT in one case (Arai et al., 2002).
However, to the best of our knowledge, few studies have provided the reproducibility of the neurophysiological effects on remote parts induced by a static contraction of lower trunk muscles, such
as RSCPDT. Aim: The purpose of this study was to clarify the reproducibility of the RRE of RSCPDT on the excitability of the remote flexor carpi radialis (FCR) H-reflex of the upper extremities by a repetitive stimulation. Methods: The subjects were randomly assigned to (1) the handgrip group (n = 6), who participated in contralateral submaximal isometric handgrip exercises, or (2) the RSCPDT group (n = 5), who participated in RSCPDT (One subject in the RSCPDT group was excluded because of failure to induce a FCR H-reflex). To determine the reproducibility of the excitability of the FCR H-reflex, we measured the FCR H-reflex during and after each exercise by a repetitive stimulation.
Results: Two-way repeated ANOVA for the H-reflex showed significant effects of both the time-course and group. The interaction between group and time-course was also significant (P < 0.05). Post-hoc analysis revealed significant effects on the H-reflex. Conclusion: RSCPDT-induced RRE on the FCR Hreflex caused a large degree of reflexive inhibition during RSCPDT followed by a gradual excitation after RSCPDT by a repetitive stimulation.
Key words： PNF, H-reflex, static contraction, remote rebound effect, remote after effects
【The Original】 page 21-25
The effects of static contraction facilitation techniques on gait-time in patients with orthopedic conditions using a Proprioceptive Neuromuscular Facilitation pelvic posterior depression pattern
in the middle range
Mitsuo Arai, Tomoko Shiratani, Michele Eisemann Shimizu, Ken Yanagisawa
Abstract：Background: The use of a proprioceptive neuromuscular facilitation pattern in the mid-range of posterior elevation pelvic motion（SCPD）as a resistive static contraction facilitation technique may have immediate effects for increasing the gait speed of stroke patients. Aim: The purpose of this study was to investigate the immediate effects of SCPD on the gait ability of orthopedic patients. Design: Twenty-two orthopedic patients without neurological deficits（mean age = 64.0 years, SD = 15.3）
were randomly assigned to the SCPD group or to the repeated gait exercise group. SPSS for Windows, version 12.0, was used for statistical analyses. Results: The 10 m gait-time（ICC（1,1）= 0.99）, which was highly reliable, was measured before and after each exercise. The percentage change of gait-time （PCG）after each exercise was calculated in comparison with the gait-time before each exercise. The mean PCG（SD）was － 4.3（4.3）% for the SCPD group and 2.0（5.4）% for the repeated gait exercise group．The result of the unpaired t-test revealed that the SCPD showed significant improvements（p<0.05）. Conclusion: This result suggests that SCPD may have immediate effects for increasing the ability of gait in orthopedic patients.
Key words：PNF, static contraction, gait, orthopedic patients
【The Original】 page 26-32
Comparison of unilateral and bilateral hip joint rotator muscles power
Takashi Ito, Ken Yanagisawa, Keita Shimura, Shingo Tomoshige, Kumiko Sumiya
Abstract：The purpose of this study was to determine the influence which it has on the contralateral hip joint rotator muscles power in a bilateral hip joint rotator synchronously muscle contraction
compared with the unilateral hip joint rotator muscles contraction. The subjects were twenty five healthy adults' olunteers（fourteen men, eleven women, ean age 25.6）. The synchronously contraction in each combination of a hip joint internal rotation and external rotation and the unilateral contraction were measured by the maximum isometric contraction using CYBEX and a Handheld-
Dynamometer. In the result of this study, the bilateral symmetry hip joint rotator muscles power showed significant the higher strength measurement than unilateral hip rotator muscle and bilateral asymmetry hip rotator muscle in internal rotation and external rotation. It was thought that this result had the effect
of irradiation to the contralateral lower extremity by symmetry movement larger than asymmetric movement in hip joint rotator muscles. And by asymmetric movement, since the trunk was unstable, it was thought that the effect of the strength reinforcement was not accepted.
Key Word：Cross education, hip rotator contraction, bilateral movement, irradiation
【The Original】 page 33-38
The effects of scapular and pelvic resistive exercises on the improvement of shoulder internal rotation range of motion
Satoshi Saya, Mitsuo Arai, Takuya Hukushima, Hiroaki Mizuno, Mitsuaki Kanei, Terumasa Hayashi, Michele Eisemann Shimizu
Abstract：The purpose of this study was to determine the remote effect of resistive static contractions of the scapular and pelvic depressors on the improvement of active range of motion（AROM）of
shoulder internal rotation after exercise. The exercises included a sustained stretching of shoulder internal rotation（SS）and static contractions using the proprioceptive neuromuscular facilitation
（PNF）patterns for posterior depression of the scapula（SCPD-S）and posterior depression of the pelvis（SCPD-P）. Thirty healthy subjects（27 men；3 women）, with a mean average age（SD）of
23.4（6.3）years, were randomly assigned to one of three exercise groups. The result of a one way ANOVA showed significant differences between the groups. Tukey's HSD post-hoc test revealed that the SCPD-P showed significant improvements as compared with the SS group, and the SCPD-S showed significant improvements as compared with the SS and SCPD-P groups. The remote facilitating effects on the AROM of shoulder internal rotation may be an effective indirect approach for increasing the AROM of shoulder internal rotation in healthy persons.
Key words：remote effect, resistive static contraction, range of motion, proprioceptive neuromuscular facilitation（PNF)
【The Original】 page 39-45
Brain activity during a static contraction of posterior depression using the proprioceptive neuromuscular facilitation technique：An fMRI study
Tomoko Shiratani, Osamu Nitta, Mitsuo Arai, Tadamitsu Matsuda, Yuuichi Tada, Atsushi Senoo, Michele Eisemann Shimizu, Ken Yanagisawa
Abstract：The remote effects on the hand of a static contraction of posterior depression（SCPD）using the proprioceptive neuromuscular facilitation technique（PNF）may be related to brain activities.
However, the relationship is not known yet. Aim：A functional magnetic resonance imaging（fMRI） was used to define brain activity associated with an SCPD and was compared with an exercise of holding a ball in the palm of the hand（Hold）. Methods： Four healthy right-handed subjects（mean age ＝ 25.3, SD ＝ 3.38）were asked to exercise while taking an fMRI. fMRI scans were performed in whole body MRI systems operating at 3.0 T（Gyroscan Intera, Philips Medical Systems, Best, The Netherlands）. Areas of significant change in the brain were estimated by preprocessing, and statistical analyses of the fMRI data were done by using the SPM8 software implemented in MATLAB. Block design fMRIs were obtained under two conditions, each replicated 3 times. All results are height thresholded at P value ＝ 0.05, adjusted to control for the family-wise error. fMRI studies showed significantly increased activation of the left sensorimotor cortex（SMC）during both the SCPD and Hold. The region of significant overlap between these 2 exercises（SCPD and Hold）projected onto the left sensorimotor
cortex（SMC）. We believe that the results provide evidence of the remote effects of SCPD on hand activities.
Key words：fMRI, PNF, Pelvic resistance exercise, Static contraction
【The Original】 page 46-51
Effect of hold relax involved passive stretching of the target muscle and sustained contraction facilitation technique in the middle range of motion of PNF on the passive range motion of the knee joint in orthopedic patients
Kazue Masumoto, Mitsuo Arai, Satoko Akagi, Ayumi Shimizu, Ken Yanagisawa, Michele Eisemann Shimizu
Abstract：Background：The effect on the flexibility of the hamstring muscles of a sustained contraction facilitation（SCF）technique in the middle range of motion using a Proprioceptive Neuromuscular Facilitation（PNF）pattern for the extremities without stretching compared to the hold relax（HR）technique utilizing a shortening contraction of the opposing muscle placing the target muscle on stretch， followed by a static contraction of the target muscle， has not been studied for orthopedic patients. Aim： The purpose of this study was to investigate the immediate effects of HR and SCF using a lower extremity pattern（extension-abduction-internal rotation）for the improvement of hamstring flexibility in the passive range of motion（PROM）of the knee joints. Design：Randomized
design. Methods： Fifteen subjects with orthopedic knee joint disability（mean age ＝ 78.5 years， SD ＝ 9.4）were randomly assigned to a sustained stretch（SS）（control）group， HR group or SCF group. The PROM of knee extension with the hip stabilized at 90 degrees was measured in the supine position as a parameter of hamstring flexibility before and after each exercise. The percentage of improvement in PROM before and after each exercise was calculated. Result： The result of a one-way ANOVA calculated between groups using the percentage improvement in PROM showed a significant difference between the groups（p＜0.05）. A post hoc Sheff test revealed that the HR and SCF groups showed significant improvement as compared to the SS group（P＜0.05）. Conclusion：These results suggest that a SCF technique used in the middle range of motion as well as the HR passive stretching of the target muscle may have immediate effects for increasing the PROM
of the hamstrings.
Key words：PNF，Orthopedic，Hold relax，Sustained contraction facilitation technique in the middle range of motion，Passive range of motio
【The Original】 page 52-57
Effects of sustained contraction of the upper extremity PNF pattern
on the active range of motion of the knee joints
－ Comparison of the effect of sustained stretch techniques and PNF techniques for increasing the extensibility of the hamstrings－
Yasuhiro Harada, Mitsuo Arai, Yutaka Hukushima, Ken Yanagisawa, Michele Eisemann Shimizu
Abstract：Aim：The purpose of this study was to investigate the immediate effects of aresistive static
contraction to the upper extremities using the Proprioceptive Neuromuscular Facilitation（PNF） pattern on the improvement in the active range of motion（AROM）of the knee joints．Design： Randomized design．Methods：Twenty healthy volunteers（mean age＝ 23.2years，SD＝ 4.6）were randomly assigned to the sustained stretch（control）（SS）group or PNF（extension-abductioninternal rotation）group．The AROM of knee extension with the hip stabilized at90degrees was measured in supine position before and after each exercise to determine hamstrings flexibility．
Results：Unpaired t－ test analysis revealed that the PNF group showed significant improvements as compared to the SS group（p＜ 0.05）．Conclusion：PNF group have an immediate remote effect
compared to SS group for increasing the extensibility of the hamstrings,the irradiation of pass downward in propriospainal reflex may facilitatethe agonist muscles of knee extension and inhibit the
hamstrings in normal young volunteers.
Key Word：PNF, Hamstrings，Sustained contraction，Active range of motion
【Case Report】 page 58-66
PNF approach on acute phase of stroke：a case report
Keizo Yoshimura, Hideaki Fukudome, Yoko Tamura
Abstract：We had experienced of a good outcome by using proprioceptive neuromuscular facilitation （PNF）approach．The case was 74 years old man who suffered from cerebral infarction in left
thalamus． We facilitated activities of trunk and extremities by approaches based on PNF philosophy． 60－ min session each，6 times in total．As a result，increased the ability of roll-over and supine to sit in bed immediately and toilet activities were enabled by less assistance．（toilet activities which was his demand）．These indicate that PNF approach is effective and efficient for after acute phase of stroke patient．
Key Word：stroke，early ambulation，acute phase rehabilitaion，PNF