【The Original】 page 1-6
Inﬂuence of resistive exercise as an indirect-approach on the unexercised soleus H-reﬂex
Shigeta Yuki, Shiratani Tomoko, Hobara Rui, Ide Natsuki,
Masumoto Kazue, Arai Mitsuo
Abstract: When direct approach is difﬁcult to use for improving the active and passive range of motion of severely restricted joints because of agonist muscle pain or weakness, indirect approaches can be useful in clinical practice. Indirectapproaches often use resistive static contraction of pelvic posterior depressors（RSCPD）as descending remote effects and/or contralateral resistive static contraction（CRSC）as Cross-education. The purpose of this study was to compare the neurophysiological effects and after-effects of the right RSCPD, left CRSC, and resistive static contraction of the right plantar ﬂexors（RSCPF）with different degrees of load on the right unexercised soleus H-reﬂex. The effects of order were controlled by randomly assigning numbers taken from a table of random numbers for the order of the resistive exercise （RSCPD, CRSC, and RSCPF）with different degrees of load（10%: light, 30%: heavy）for 17 normal subjects. The right soleus H-reﬂex was measured at rest（condition-BE）, during resistive exercise phase（condition-DE）, and rest phase after resistive exercise（condition-AE）. The H-reﬂex amplitude was normalized to the corresponding maximal M-wave （Mmax）H-reflex, which was expressed by the ratio H/Mmax. The results of four-way analysis of variance showed signiﬁcant interaction between the resistive exercise and degrees of load for H/Mmax. Post-hoc analysis revealed that CRSC×heavy in the condition-DE had signiﬁcant facilitatory effects on the H-reﬂex compared with the other resistive exercises in the condition-DE. However, inhibitory effects were revealed as after-effects in the condition-AE compared with the condition-BE in RSCPD, CRSC, and RSCPF. These results indicated that CRSC×heavy induced contralateral effects as cross-education on the soleus H-reﬂex, which initially caused reﬂexive facilitation during CRSC×heavy followed by gradual inhibition after CRSC.
Key words: resistive static contraction, degrees of load, cross-education, pelvic posterior depressors, Soleus H-reﬂex
【The Original】 page 7-12
The different effects of resistive static contraction in mid-range pelvic motion and Cross-education with different degrees of resistance on the unexercised soleus H-reﬂex
Takezawa Miho, Arai Mitsuo, Ide Natsuki, Shigeta Yuki,
Shiratani Tomoko, Hobara Rui, Masumoto Kazue
Abstract: When direct approach is difﬁcult to use for improving the active and passive range of motion of severely restricted joints because of agonist muscle pain or weakness, indirect approaches can be useful in clinical practice. Indirect approaches often use a resistive static contraction of the pelvic anterior elevators（RSCAE）as descending effects or a contralateral resistive static contraction（CRSC）as Cross-education. The purpose of this study was compare the neurophysiological remote effect and after-effects of right RSCAE and CRSC with different degrees of load on the unexercised soleus H-reﬂex. Ordering effects were controlled for by randomizing the order of the resistive static contraction（RSCAE and CRSC）with different degrees of load［light（10%）or heavy（30%）］ for each of the 16 normal subjects. The right soleus H-reﬂex was measured at rest（condition-BE）, during resistive static contraction phase（condition-DE）, and rest phase after resistive static contraction（condition-AE）. Each H-reﬂex amplitude was normalized to the corresponding maximum M-waves（Mmax）and H-reflexes, which was expressed as the ratio of H/Mmax. The results of four-way analysis of variance showed signiﬁcant interaction between the resistive static contraction and the H/Mmax time course. Post-hoc analysis revealed that CRSC in condition-DE showed signiﬁcantly greater effects on H-reﬂex than RSCAE in conditionDE. However, inhibitory effects occurred as remote after-effects in condition-AE compared to those in both CRSC and RSCAE in condition-BE. These results indicated that CRSC induced contralateral effects act as Cross-education on the soleus H-reﬂex, which initially caused a reﬂexive facilitation during CRSC followed by a gradual inhibition after CRSC.
Key words: soleus H-reﬂex, degrees of load, resistive exercise, cross-education, descending remote effects
【The Original】 page 13-16
Remote after-effects of resistive static contractions of the lower trunk depressors on strength of the plantar ﬂexor muscle after ankle fracture
Shiratani Tomoko, Arai Mitsuo, Kuruma Hironobu, Hobara Rui,
Ide Natsuki, Masumoto Kazue
Abstract: Previous studies have shown that application of resistive static contraction with manual resistance using proprioceptive neuromuscular facilitation in mid-range pelvic posterior depression（RSCPD）improves temporary loss of functioning motor units. The purpose of this study was to investigate the after-effects of RSCPD on the strength of the plantar ﬂexor muscle compared with static stretch（SS）of the plantar ﬂexor after ankle fracture. The subjects were 5 patients with ankle fractures（2 men and 3 women, mean（SD）45.8（72.8）years）who underwent RSCPD and SS in a random order. The mean percentage changes of the maximal ankle plantar ﬂexors（SD）were 4.60（13.66）% after RSCPD and -6.60（8.73）% after SS. Two-way ANOVA showed a signiﬁcant difference between the techniques based on the percentage improvement in the strength of the plantar ﬂexor muscle（F（1, 56）=22.53, p =0.01）. RSCPD showed a significant improvement compared to SS in patients with ankle fracture, which suggests a remote after-effect on impairment of the ability to activate motor units.
Key words: PNF, ankle fracture, pelvic posterior depression, static contraction
【The Original】 page 17-21
The after-effects of resistive static contraction facilitation technique using Proprioceptive Neuromuscular Facilitation in the middle range of pelvic motion on the improvement of time to ascend stairs in orthopedic patients
Tanaka Toshiyuki, Arai Mitsuo, Sakino Yugo, Shiratani Tomoko
Abstract: The purpose of this study was to determine the after-effects of resistive static contractions of pelvic anterior elevation （SCAE）and pelvic posterior depression（SCPD）using proprioceptive neuromuscular facilitation（PNF）in the middle range of pelvic motion on the time to ascend stairs in orthopedic patients. The subjects were 13 patients（mean（SD） age, 64.3（22.3）years）with various levels of motor impairment who were randomly assigned to the SCPD, SCAE, or control groups. Effects were examined within 1 hour. The participants stood one foot from the bottom of a 12-step ﬂight of stairs. They were instructed to walk as quickly as possible（but not to run）and to take one step at a time. In this procedure, a signiﬁcant difference was found between each procedure and the control. In a multiple comparison test, SCAE and SCPD both signiﬁcantly reduced the ascending time compared with the control, and subjects had less pain after SCPD compared to SCAE. These results suggest that the procedures may have inﬂuenced the extension phase of the lower limbs, as in hemiplegic patients after stroke, and that SCPD may have an immediate after-effect for improving the time to ascend stairs in orthopedic patients.
Key words: Orthopedic patients, Static contraction, Speed of ascending stairs, Mobilization PNF
【Research and Report】 page 22-27
The effect of resistive static contraction of PNF scapular pattern on the improvement ROM of restricted ankle dorsiﬂexion
Sakino Yugo, Shiratani Tomoko, Arai Mitsuo, Harada Yasuhiro,
Abstract: The purpose of this study was to determine the after-effects of resistive static contraction of scapular posterior depression（SCPD）and scapular anterior elevation（SCAE）using proprioceptive neuromuscular facilitation（PNF） in the mid-range of scapular motion or sustained stretch（SS）on restricted ankle dorsiﬂexion and subjective fatigue in elderly patients. SCPD, SCAE and SS were performed in a random order for 14 subjects with 9 orthopedic diseases and 5 central nervous system diseases（average age（SD）, 81.7（7.6）years）as outpatient rehabilitation. Signiﬁcant differences among the techniques were found in two-way ANOVA. Ankle dorsiﬂexion AROM signiﬁcantly increased after SCPD and SCAE compared with SS in multiple comparison（P<0.05）. Subjective fatigue did not show any signiﬁcant differences. SCPD and SCAE increased ankle dorsiﬂexion AROM over time to a greater extent than SS. Therefore, these results suggest that SCPD and SCAE have indirect effects on AROM without affecting fatigue.
Key words: Ankle dorsiﬂexion, Scapular posterior depression, Scapular anterior elevation, Static Contraction, Mobilization PNF
【Research and Report】 page 28-32
Effect of resistive static contraction of the upper and lower trunk muscles on lumbar pain and knee extension range of motion in patients with an osteoporotic lumbar vertebral body compression fracture
Murasaki Yukiko, Shiratani Tomoko, Arai Mitsuo
Abstract: Vertebral body compression fractures（VCFs）can cause chronic pain and new techniques are needed for reducing acute pain. The purpose of this study was to determine the after-effects of 10-second static contraction of muscles in scapular posterior depression（S-SCPD）and pelvic posterior depression（P-SCPD）in the middle range of motion using proprioceptive neuromuscular facilitation in patients with an osteoporotic lumbar VCF. Three subjects of mean（SD） age 74.7（5.5）years were randomly given P-SCPD or S-SCPD using a sustained contraction facilitation technique in the middle range of motion on the unaffected pelvic side, and static contraction of the knee extensors（KE）. One-way ANOVA showed a signiﬁcant difference between the exercises based on the percentage improvement in active range of motion（AROM）, grasp power, and visual analogue scale （VAS）pain score. A Scheffé post hoc test showed that P-SCPD resulted in signiﬁcant improvements compared with KE（P < 0.05）. This suggests that P-SCPD may show immediate after-effects for reducing acute lumbar pain in patients with an osteoporotic lumbar VCF.
Key words: lumbar compression fracture, mobilization PNF, pain, range of motion