Vol.14(No.1 2014)

【The Original】 page 1-10

Effects of a resistive static contraction of the pelvic depressors technique on the active range of motion of the knee joints in patients with lower-extremity orthopedic conditions.


Shiratani Tomoko, Arai Mitsuo, Shimizu Michele Eisemann, 

Nitta Osamu, Masumoto Kazue, Yanagisawa Ken


Abstract:If an immediate stretching approach is difficult because of pain, we previously found that an indirect approach such as a remote after-effect (RAE) of a resistive static contraction of the pelvic depressors (SCPD) technique using a Proprioceptive Neuromuscular Facilitation (PNF) pattern in the mid-range of pelvic motion could improve the passive range of motion (PROM) of the shoulder joint [Arai 2002,] and knee joint [Shiratani, 2009, Shiratani, 2013] without a direct approach. In a previous study, the authors did determine that the RAE of the SCPD technique results in an improvement of the active range of motion (AROM) of knee extension in patients with lower-extremity orthopedics. However, the effects of the duration of the indirect RAE of the SCPD technique were not established with the improvement of the AROM of knee extension in the previous study. The purpose of this study was to determine the RAE of the SCPD technique as an indirect approach in comparison with direct approaches, such as a sustained stretch (SS) and hold relax (HR) techniques, for the improvement of the AROM of knee extension in patients with lower-extremity orthopedic problems considering the duration of intervention.

The source patients consisted of 30 outpatients (22 women, 8 men) with lower-extremity orthopedic conditions. Subjects were randomly assigned to one of six groups (20s-SCPD, 40s-SCPD, 20s-HR, 40s-HR, 20s-SS, or 40s-SS) in which the technique and duration of intervention were combined. The value change in the AROM of the knee joint after each technique was calculated in comparison with the AROM before the technique was performed.

A two-way non-repeated ANOVA for percentage change in the AROM showed that only the group factor produced a main effect (p<0.05). While the RAE of the SCPD on the AROM of knee extension technique did not differ in duration in this study, as well as in the PROM of the previous study (Shiratani, 2013), a Bonferroni post hoc testing revealed a significant difference only between the SCPD and SS group (p<0.05), reflecting a greater improvement in AROM in the SCPD group. The results of this study on orthopedic patients suggest that the indirect SCPD technique may be an effective approach to improve AROM as a RAE in patients with orthopedic conditions.

Key words:PNF, SCPD, stretch, hold relax, range of motion, remote after-effect

【The Original】 page 11-19

Comparison of the directional after-effects of static contractions in different positions of the upper extremity and different strengths of pinch force on the improvement of maximal active range of motion of the wrist joint in normal subjects 


Arai Mitsuo, Shiratani Tomoko, Shimizu Michele Eisemann,

Masumoto Kazue, Tanaka Yoshimi, Tsuboi Akio, Yanagisawa Ken


Abstract:To increase the maximal active range of motion (MAROM) of the wrist joint in normal volunteers, the diagonal position of the shoulder joint and a strong static contraction of the intrinsic hand muscles influenced the effect of improving the MAROM of wrist flexion as an after-effect (Arai et al., 2004). The purpose of this study was to assess the after-effect of a static contraction on the

directional dominance of the wrist movement. We hypothesized that the static contractions considering the shoulder position, the degree of strength of the fingertips, and the direction of wrist movement influence the improvement of MAROM that correlate with wrist agonist/antagonist IEMG activities as an after-effect. The participants were 20 neurologically intact volunteer subjects (9 males and 11 females) with no restricted wrist joints. The after-effects of a static contraction combined with different positions

of the shoulder joint, different strengths of the pinch force, and different directions of the wrist movement (extension/flexion) on both the MAROM change ratio of wrist movement extension/flexion)

and the wrist agonists and antagonists IEMG ratio were analyzed.

Three factor (2×2×2) analyses of variance (ANOVA) were used to determine the differences between the types of shoulder position, degrees of pinch force and movement direction on the effect of MAROM change ratio and IEMG ratio. Three factor ANOVA for the MAROM change ratio showed no significant main effects for shoulder position (F (1,72)=2.67, p=0.11) and pinch force (F (1,72)=0.00, p=1.00). Movement direction only showed a significant main effect (F (1,72)=4.42, p=0.04). The hypothesis of

the directional dominance of wrist movement after a static contraction was supported. However, because of the non-significant correlations between the MAROM change ratio and agonist IEMG ratio, the hypothesis that the use of facilitation of the agonist after the static contraction was not proven in this study.

Key words:PNF, SCPD, range of motion, after-effect, static contraction

【The Original】 page 20-28

The effects of pelvic resistive exercise on sitting balance and

blood pressure variability in acute stroke patients


Shinichi Watanabe, Koji Ishiguro,Akitoshi Mizuno,Yuma Yamada, Keisuke Mizutani, Makoto Nakagawa, Hisashi Okada, Fujiko Someya     

Abstract:The purpose of this study was to determine how a resistive sustained contraction using a Proprioceptive Neuromuscular Facilitation pattern for pelvic posterior depression (SCPD) influences improvement in sitting balance and blood pressure variability for 10 acute stroke patients (mean age: 73.2 years). All subjects received 2 random sessions of each intervention. The exercises included endurance training for sitting and SCPD with endurance training for sitting. Both interventions

incorporated the amount of lower limb loading force on the ability to maintain sitting. Systolic blood pressure, diastolic blood pressure and pulse rate were measured. The results of a t-test indicated that

there were significant differences between both the amount of lower limb loading force and the ability to maintain sitting and systolic blood pressure (p<0.05). These results suggest that SCPD may have positive effects for increasing the improvement of sitting balance and blood pressure variability.

Key words:Proprioceptive Neuromuscular Facilitation (PNF), acute stroke patient, endurance training for sitting, SCPD

【The Original】 page 29-34

The immediate effects of a sustained contraction facilitation technique in the middle range of motion using flexion-abduction-external rotation pattern on the forward reaching task in sitting in hemiplegic patients


Yugi Morikawa, Mituo Arai, Sachie Shimmizu, Akiko Takahashi, Kazue Masumoto, Kousuke Hashiguchi, Kentaro Yamanaka, Toshiyasu Honjo, Ken Yanagisawa


Abstract:The purpose of this study was to compare the immediate effect of a resistive sustained contraction facilitation technique in the middle range of motion (SCF) using the Proprioceptive

Neuromuscular Facilitation for flexion-abduction-external rotation pattern for increasing the reaching distance (RD) toward the affected side while using the unaffected upper extremity of hemiplegic patients. Eleven subjects with hemiplegia (mean age = 73.1) were randomly assigned to the SCF or the repetition of the forward reaching task in sitting or control group. RD were measured three times before each exercise and five times after each exercise. The results of a one way ANOVA calculated between

the groups using the percentage improvement in RD showed a significant difference between the groups (p<0.05). The Sheffé's post hoc revealed that the SCF group showed a significant improvement as compared to the control group. These results indicated that the immediate effect of SCF for increasing RD might increase postural stability and ability to control postural sway.

Key words:Proprioceptive neuromuscular facilitation, flexion-abduction-external rotation, static contraction facilitation technique, after effect, sitting forward reaching test

【The Original】 page 35-39

The after-effects of a resistive static contraction of the pelvic depressors on the improvement of full-weight-bearing in orthopedic patients


Ayumi Shimizu, Kazue Masumoto, Satoko Akagi, Mitsuo Arai, Ken Yanagisawa, Michele Eisemann Shimizu


Abstract:The purpose of this study was to determine the remote after-effects (RAE) of a resistive static contraction of the pelvic depressors (SCPD) or anterior elevators (SCAE) technique as an indirect approach in comparison with a weight-shift exercise toward the affected side as tolerated by orthopedic patients who were prescribed full-weight-bearing by the surgeon. Eight orthopedic patients had difficulty in bearing weight due to pain. Subjects (mean age=74.2 years, SD=14.7) were randomly assigned to the SCPD group, SCAE group, or a repeated weight-shift exercise

as tolerated (WSE) group. The result of a one-way ANOVA analysis calculated between the groups using the percentage improvement in weight-shift showed a significant difference between the groups

(p<0.01). Scheffé's post hoc testing revealed that the SCPD group showed significant improvements as compared to both the WSE group (p<0.01) and SCAE group (p<0.05). These results suggest that SCPD may have immediate after-effects for increasing the weight-bearing load of orthopedic patients.

Key words:Proprioceptive Neuromuscular Facilitation (PNF), Sustained contraction facilitation technique in the middle range of motion, after-effect, weight-shift

【The Original】 page 40-46

Effects of muscle contraction in ipsilateral lower extremity

on muscle activities in the contralateral ankle joint


Hiroshi Tomita, Osamu Nitta, Masayoshi Shibata, Sumikazu Akiyama, Ken Yanagisawa 


Abstract:The purpose of this study was to verify that the muscle activity in the contralateral tibialis anterior and gastrocnemius was correlatively affected by the muscle contraction in the ipsilateral lower extremity (hip/knee/ankle joints), its motion (e.g. extension, flexion), and its loading intensity. Twenty-one healthy male subjects were assigned to perform eight types of static contractions: extension, flexion, abduction and adduction in the right hip joint, extension and flexion in the right knee joint, and dorsiflexion and plantar flexion in the right ankle joint, with 20%, 40%, 60% and 80% of maximal voluntary contraction (MVC) in order to comprehensively analyze the myoelectric activities caused in the muscles of the left tibialis anterior and the left gastrocnemius. Higher muscular activities in the left anterior tibialis muscle were generated when the right hip joint was abducted. Similarly, higher muscular activities in the left gastrocnemius muscle were generated when the right hip joint was flexed. These results indicate that as the loading intensity in the muscles of the

right lower extremity increased, the muscle activities of the left lower extremity also increased. Also, in the gastrocnemius muscle, when a static contraction (80%MVC) was performed in the ipsilateral lower extremity, a muscle contraction was generated which was sufficient to maintain muscle strength in the contralateral lower extremity.

Key words:muscle contraction, ipsilateral lower extremity, contralateral ankle joint, irradiation, electromyography

【Research】 page47-51

Effects of changing unilateral hip flexion position on the muscle

strength of contralateral ankle plantar flexors in healthy subjects




Abstract:The purpose of this study was to examine the effects of position changing in unilateral hip flexion on the contralateral muscle strength of the ankle plantar flexors. Eighteen healthy male subjects (mean age 28.3 years old) who had no neurologic or orthopedic diseases participated in this study. The subjects lay supine on a torque table (BIODEX System 3) with their left ankle joint plantar flexed at a 20-degree angle. Then the examiner held the right hip joint passively at 0, 15, 30, 45, 60-degree angles

by the original attachment. Subjects were tested for the maximum isometric plantar flexion strength of the left ankle joint in these testing positions. Three trials were measured for each testing position. The isometric peak muscle torque of ankle plantar flexion (Nm) was recorded, and its percent body mass (Nm/kg) was calculated. A repeated measure ANOVA was used to identify significant effects. A data analysis was performed using IBM SPSS statistics 20 for Windows. The results showed that there were 

no significant effects on the isometric peak muscle torque of the ankle plantar flexors and its percent body mass. We also investigated the effects of the cross extension reflex on voluntary movement, but our results were negative. In a previous study, it was shown that the effect of the cross extension reflex is stronger on the proximal joints in a spinal dog. Our results were the same as in this previous study, and an effect of the cross extension reflex on the contralateral muscle torque in the distal joint was not found. The results suggest that a further study on the proximal joints is needed to determine the effects of changing the position of a unilateral hip joint on contralateral muscle torque.

Key words:position of hip joint, muscle strength of ankle joint, crossed extension reflex

Research and Report】 page 52-57

Research trends in the PNF Society of Japan Journal


Sumikazu AKIYAMA, Hiroshi TOMITA


Abstract:The research trends in "The PNF Research" journal were reviewed from 2001 to 2012. For the total number of 122 papers, there were 62 original articles and 49 research reports. In a breakdown of the diseases studied, 26 papers involved brain blood vessel syndromes and 15 papers involved patients with orthopedic diagnoses. Hemi-paralysis from a cerebral vascular disorder was mostly used, but seven papers involved a stroke, and three papers involved matched hemi-paralytic diagnoses. The subject's measurements were usually expressed numerically by using an inexpensive, handy tool, e.g., a goniometer, stopwatch, etc., which tends to suggest that the clinician has the possibility of performing

research. In the future, we expect to see an increase in case reports by 3% of the total number of 122 papers over 12 years. The journal should promote case study reports from the viewpoint of advancing clinical medicine.

Key Words:PNF research, reserach direction, CVA, case report