Background: Proprioceptive neuromuscular facilitation (PNF) has been proven effective in a myriad of clinical fields as a treatment to restore function in patients with musculoskeletal disorders, damage to the central nervous system, or sports injuries. Objectives: The purpose of this study was to investigate the effect of a 2-week PNF exercise intervention on the degree of calcification, pain perception, and shoulder joint function in persons with calcific tendinitis (CT) of the supraspinatus. Design: Matched pairs design. Methods: This study was classified into a PNF group (n=8) and a control group (n=7) through a matched pairs design. Filmed x-rays, Visual Analogue Scale (VAS), Simple Shoulder Test (SST), and Constant-Murley Scale (CMS) were used to assess the long and short axis of calcified deposits, self-awareness of pain, and shoulder joint function of the subjects. 8 participants in the PNF group received a scapular and upper extremity PNF exercise intervention for 30 minutes per session, 10 times/week for 2 weeks while no intervention in the control group. Results: Two-way repeated analysis of variance (ANOVA) showed a significant improvement after the 2-week PNF exercise intervention on calcified deposits, pain, and shoulder joint function (P<.05), whereas no changes in the control. Conclusion: These findings suggest that the intensive 2-week PNF exercise may maximize intervention effects to reduce calcified deposits and pain in a relatively short period time and is effective for restoring shoulder function without combining other treatments or exercises in patients with supraspinatus CT.

Background: A functional movement screen (FMS) can be used as an intervention method as well as a test method. Compensatory action due to a faulty functional movement result in imbalance of the body, and decrease in proprioceptive sensation and flexibility. However, the benefits of exercise using FMS on proprioceptive sensation and flexibility are unclear. Objectives: This study aimed to investigate the effect of exercise using FMS on the proprioceptive sensation and flexibility. Design: Pretest-posttest control group experimental design. Methods: Fifty-two young adults in their 20s were divided into an FMS exercise group (FEG, n=26) and a control group (CG, n=26). The FEG conducted FMS exercise intervention for 12 days, and CG did not implement any intervention. Each group evaluated proprioceptive sensation and flexibility before and after exercise. To measure proprioceptive sensation, the angles were measured at both shoulder joints, elbow joints, hip joints, and knee joints using the active joint sensory position test method. To measure flexibility, situp forward bending evaluation was performed. Results: In the FEG, bilateral proprioceptive sensation and flexibility improved significantly after intervention (all P<.01). There were no significant differences in the CG (all P>.05). After the intervention, there were significant differences between the groups in both proprioceptive sensation and flexibility (all P<.05). Conclusion: The findings suggest that exercise using FMS can significantly improve proprioceptive sensation and flexibility. Therefore, it is suggested to consider exercise using FMS as an intervention to increase joint proprioceptive sensation and flexibility.

Background: This study evaluated the effectiveness of upper thoracic manipulation (UTM) and proprioceptive training versus proprioceptive training alone on forward head posture (FHP) and cervicocephalic joint position sense (CJPS) in asymptomatic university students during a short interval of time. Objectives: To evaluate whether the suggested combination would provide greater benefit, and be superior to proprioceptive training alone in improving proprioceptive acuity and head posture. Design: A single-blind randomized controlled trial. Methods: Thirty-three university student volunteers with asymptomatic FHP were recruited. Subjects were randomly assigned to a manipulation group (n=16) receiving UTM combined with proprioceptive training or a proprioception group (n=17) receiving proprioceptive training only. The intervention period lasted 5 weeks in total, and consisted of one 15 to 20-minute session per week. FHP and CJPS were assessed before and after the intervention. Results: A significant pre- to post-intervention decrease in FHP and joint position error was identified in both groups (P<.05). Subjects in the manipulation group demonstrated greater improvements in CJPS and head posture compared to the proprioception group (P<.05). Conclusion: These findings support employing either intervention for treating asymptomatic students with FHP. However, the addition of UTM to proprioceptive training was more effective than proprioceptive training alone in reducing joint position errors and improving head posture.

Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint. Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions. Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions. Results: There were significant improvements in the weight-bearing (p = 0.002) and nonweight- bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions. Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.

Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

The purpose of this study was to identify the effects of cervical alignment, pain, and physique to apply proprioceptive neuromuscular facilitation( PNF) techniques in patients with forward head posture (FHP). The subjects of this study were 24 patients diagnosed with FHP. They were randomly divided into two groups: a PNF group(n=12) and a control group(n=12). The intervention was performed a total of 24 times, 30 min a day, six times a week for four weeks. Data on cervical alignment(forward head displacement, FHD), pain(visual analog scale, VAS), and physique(height, weight, and body mass index) were obtained pre- and post-intervention. Two-way repeated measures ANOVA was used to compare the groups and time. For FHD, the VAS, and physique(height and BMI), there was an interaction effect for the groups and time(p<.001, BMI: p<.05) and main effects for time(p<.001, BMI: p<.05). For weight, there were main effects of time(p<.01). For FHD(p<.01) and the VAS(p<.05), there were main effects for the groups. In the PNF group, there were significant improvements in FHD, VAS, and physique. In the control group, there was a significant increase in FHD. The results of this study indicated that PNF intervention using scapular and upper extremity patterns effective in FHP positively. The use of a therapeutic intervention on physique changes may also be effective in improving poor posture and help to better patients’ quality of life.

목 적: Maindot 검사의 외안근의 고유수용감각 수준 평가의 적합성 유무를 알아보고자 한다. 방 법: 평균나이 15.48(±3.23)세, 교정시력이 0.9 이상이고 양안시 및 조절기능이 정상인 14명의 정위 안(남 8명, 여 6명)과 교정시력과 조절기능은 정상이나 원, 근거리 편위량이 10PD를 초과하고, 시기능훈련 을 10주간 성실히 수행한 훈련자 19명의 간헐성 외사시안(남 11명, 여 8명)을 대상으로 훈련 전, 종료직후 및 종료 후 6, 12개월 간의 타각 및 자각증상 그리고 고안한 Maindot 검사를 실시하였다. 결 과: Maindot 검사와 자각증상의 상관관계 분석에 있어 고유수용감각 능력이 높을수록 자각증상(복시) 은 감소되는 경향을 나타내었으며(p<0.001), 타각검사값의 상관관계 분석에서 양안시 고유수용감각 능력이 향상될수록 편위량은 줄고, PRC의 복시점은 증가되는 경향을 나타내어 상관관계가 있음을 검정하였다 (p<0.001). 결 론: 운동 및 자각증상과 상관성을 가지는 양안시 고유수용감각능력검사인 Maindot 검사는 시기능 훈련 성공유무 판단 및 예후 그리고 자각증상 예측에 있어 검사자에게 매우 유용한 정보를 제공하리라 생각된다.

The effects of Proprioceptive Neuromuscular Facilitation (PNF) and elastic band exercise on the physical functions and blood lipids of obese elderly women were investigated. The experimental group (n1=16) patients underwent PNF for 12 weeks, and the control group (n2=15) patients performed elastic band exercises. SPSS 21.0 was used to compute the means and standard deviations. After the 12-week PNF, both the experimental and control groups showed statistically significant differences in the physical functions (cardiovascular endurance, strength of the lower extremity, muscular endurance, flexibility, balance, and agility) (p<.05), but the difference in the experimental group was more significant than that in the control group (p<.05). In terms of the changes in the blood lipid levels (total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein), the experimental group showed significant changes (p<.05). In conclusion, PNF was confirmed as more effective than elastic band exercise in improving the physical functions and blood lipid levels of obese elderly women.

This study evaluated and compared the effectiveness on upper motor extremity function between proprioceptive neuromuscular facilitation which has been frequently used in clinical practice, and action observation training in terms of improving upper motor extremity function. A study with a single-subject design (A-B-C-A') was conducted with a patient who was diagnosed with left hemiplegia. A repeated-measure analysis was conducted to assess results of the Wolf Motor Function Test (WMFT), Box and Block Test (BBT), and grip and pinch strength test performed daily in the study for 4 weeks. The results of the analysis indicated that the WMFT score, BBT score, grip strength, and pinch strength were improved from 29.60 to 39 (24.10%), from 1.67 to 4.93 each (EA) (66.22%), from 2.06 to 2.66 libras (lbs) (22.61%), and from 1.57 to 1.93 lbs (18.94%), respectively, from the baseline period to treatment period B. The values were improved from 29.60 to 42.20 (29.86%), from 1.67 to 7 EA (76.21%), from 2.06 to 3.47 lbs (40.57%), and from 1.57 to 1.67 lbs (6.12%), respectively, from the baseline period to treatment period C. From treatment period B to treatment period C, the WMFT score, BBT score, and grip strength were improved from 39 to 42.20 (7.58%), from 4.93 to 7 EA (29.56%), and from 2.66 to 3.47 lbs (23.20%), respectively, but pinch strength was decreased from 1.93 to 1.67 lbs (15.83%). In conclusion, proprioceptive neuromuscular facilitation and action observation training both have positive effects on upper extremity motor function. However, we suggest that the posttreatment effect of action observation training was better than that of proprioceptive neuromuscular facilitation.

The purpose of this study was to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF) on the swallowing function of stroke patients. Twelve-week PNF (facial, tongue, and breathing exercise) was applied in the experimental group consisting of 12 subjects, and a general swallowing exercise program was applied to the control group consisting of 12 subjects. In addition, the signs of improvement in the stroke patients (N=24) swallowing function were examined by conducting a video fluoroscopic swallowing study. The data were analyzed using the SPSS ver. 21.0 program, which was also utilized to gain statistical information (percentage, mean, and standard deviation), and paired t-test was conducted. As a result of the analyses, the following conclusions were arrived at. The 12-week PNF significantly improved the functional dysphagia scale, penetration-aspiration scale, pharyngeal transit time, swallowing response time, residue in valleculae, and residue in pyriform sinuses enhanced swallowing functions of the stroke patients (p<.05). In conclusion, the PNF intervention in the swallowing function of the stroke patients was found to be an effective exercise program.

The purpose of this study was to implement a program of combined muscle stregth and proprioceptive exercises and to examine the impacts of these exercises on functional ankle instability(FAI). Experiments were conducted with 30 adult males and females in their 20s, and the exercise programs were implemented three days per week for four weeks. FAI was defined as a feeling of giving way after an ankle sprain and having a Cumberland ankle instability tool score of 24 points or less. The study subjects were randomly assigned to either a control group, a muscle-strengthening exercise group, or a combined muscle-strengthening and proprioceptive exercise group consisting of 10 subjects each. A Biodex isokinetic dynamometer was used to assess the subjects’ankle strength at selected speeds of 60°/sec and 120°/sec. The peak torque % body weight showed significant differences in plantar flexion, dorsiflexion, inversion, and eversion. There were also significant differences in proprioception. The results suggest that applying combined muscle-strength and proprioceptive exercises to subjects with FAI is a more effective intervention than applying only muscle-strengthening exercises.

The present study examined the effects of functional electrical stimulus( group 1), proprioceptive neuromuscular facilitation(group 2) and combined training of functional electrical stimulus and proprioceptive neuromuscular facilitation(group 3) with scapula adductor muscles on scapula movement, upper limb function and gait in fifteen subjects stroke patients. The training was thirty minutes a day, five times a week for six weeks, obtained result as follow, upper limb function was significant difference in the group 2(p<.05) but no significant difference in other groups. The change of weight bearing were significant difference in all the groups(p<.05), and increase of gait velocity were significant difference in all the group(p<.05). In conclusion, when applied with functional electrical stimulus, proprioceptive neuromuscular facilitation and combined training to the scapular adductor muscles, it was oberved in the course of the experiment that proprioceptive neuromuscular facilitation was the most effective treatment among the three methods applied to the scapula adductors.

This study investigated the irradiation pattern of muscles on the affected side in stroke patients after application of diagonal 2 extension (D2 ex) proprioceptive neuromuscular facilitation in the unaffected upper extremity. Seven stroke patients participated. Electromyographic activities were recorded in the iliopsoas, biceps brachii, and triceps brachii were recorded by surface electrodes at rest, D2 ex with knee extension, and D2 ex with knee 90 flexion, normalized by maximal voluntary isometric contraction (MVIC) values. The medial frequencies of biceps brachii in both sides were also measured to compare muscle type recruited. %MVIC of biceps brachii and triceps brachii were significantly higher in D2 ex than at rest (p<.05). There was no difference in median frequency of biceps brachii between the affected and unaffected side (p>.05). This suggests that proprioceptive neuromuscular facilitation using D2 ex may improve muscle activities of the paretic side and that the irritation pattern of the affected side may respond to maintain body equilibrium according to movement of the sound side.

The aim of the present study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on the muscle activation of neck flexors. Twenty healthy subjects participated in this study. Each subject performed bilateral asymmetrical PNF leg patterns against manual resistance under four conditions: through the full range of motion toward the right side, left side, and the end range in the right side, left side. Electromyographic (EMG) data was collected from the sternocleidomastoid (SCM) muscles as neck flexors. The root mean square (RMS) value of the SCM was measured and normalized from maximal EMG activity of the SCM. The data were analyzed using the paired t-test and repeated analysis of variance (ANOV A) was used to compare the statistical significance. The results of this study are summarized as follows: Firstly, the RMS values of SCM were significantly higher in all four PNF leg patterns than in the resting condition (p<.05). Secondly, there was no significant difference in muscle activation according to the direction of PNF leg patterns (p>.05). Thirdly, there was no significant difference in muscle activation according to the point of range of the motion of leg patterns (p>.05). It is suggested that PNF bilateral asymmetrical leg patterns have a considerable effect on muscle activation of the SCM, regardless of the range of motion and direction of PNF bilateral asymmetrical leg patterns.

This study is aimed at investigating the influence of different quantitative knowledge of results on the measurement error during lumbar proprioceptive sensation training. Twenty-eight healthy adult men participated and subjects were randomly assigned into four different feedback groups(100% relative frequency with an angle feedback, 50% relative frequency with an angle feedback, 100% relative frequency with a length feedback, 50% relative frequency with a length feedback). An electrogoniometer was used to determine performance error in an angle, and the Schober test with measurement tape was used to determine performance error in a length. Each subject was asked to maintain an upright position with both eyes closed and both upper limbs stabilized on their pelvis. Lumbar vertebrae flexion was maintained at for three seconds. Different verbal knowledge of results was provided in four groups. After lumbar flexion was performed, knowledge of results was offered immediately. The resting period between the sessions per block was five seconds. Training consisted of 6 blocks, 10 sessions per one block, with a resting period of one minute. A resting period of five minutes was provided between 3 blocks and 4 blocks. A retention test was performed between 10 minutes and 24 hours later following the training block without providing knowledge of results. To determine the training effects, a two-way analysis of variance and a one-way analysis of variance were used with SPSS Ver. 10.0. A level of significance was set at .05. A significant block effect was shown for the acquisition phase (p<.05), and a significant feedback effect was shown in the immediate retention phase (p>.05). There was a significant feedback effect in the delayed retention phase (p<.05), and a significant block effect in the first acquisition phase and the last retention phase (p<.05). In conclusion, it is determined that a 50% relative frequency with a length feedback is the most efficient feedback among different feedback types.

Hemiplegic patients usually present with difficulty maintaining balance. Balance retraining is the major component of rehabilitation program for patients with neurological impairment. The purpose of this study was to investigate the effects of prorpioceptive exercise program on the improvement of balance in the patients with chronic hemiplegia. Thirty subjects (mean age ) were recruited and the subjects were divided into a proprioceptive group and a visual group. The subjects for the proprioceptive group were participated in the proprioceptive exercise program for 4 weeks, and the visual group were treated visual feedback training using Balance Master. At 4 week follow-up test, Berg Balance Scale significantly improved 1.1 points (p<.01), Timed Up & Go test improved 4.2 second (p<.01), and weight distribution during sit to stand also improved 5.0% (p<.01). As a result of this study, the proprioceptive control approach improved dynamic balance in the patients with chronic hemiplegia. It is suggested that there was no benefit of visual feedback training like as Balance Master when administrated in combination with other physical therapy interventions, compared with physical therapy alone using proprioceptive control approach to hemiplegia.

The purpose of this study was to compare the difference of joint position sense between measurements. Fourteen healthy male subjects were recruited for this study. The elbow joint position senses were measured using angle reproduction test. The elbow joint position sense was assessed with three experimental conditions: ipsilateral reproduction test in open-chain condition, contralateral reproduction test in open-chain condition, ipsilateral reproduction test with weight in open-chain condition and ipsilateral reproduction test in closed-chain condition. The angular difference between stimulus position and the reproduced position (angular error) was calculated in all testing conditions to examine the accuracy of the joint position sense. One way ANOVA was used to compare the error angles in all experimental conditions. The error angles between measurements were significantly different in elbow joint. The error angles was smallest in ipsilateral reproduction test with weight in open-chain condition and was greatest in the contralateral reproduction test in open-chain condition. Findings of this study indicate that testing methods, types of task, existence of resistance should be considered in clinical assessment for the joint position sense.

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in , , and . The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle , , and (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

The purpose of this study was to compare the integrated electromyographic activity ratios of vastus lateralis(VL); rectus femoris lateral portion (RFL); rectus femoris medial portion(RFM); and vastus medialis(VM) muscles of 30 healthy subjects under three proprioceptive neuromuscular facilitation(PNF) techniques. Each subject was randomly assigned to one of 3 PNF techniques groups : slow reversal(SR), slow reversal hold(SRH) and rhythmic stabilization (RS). Each person was positioned in supine with the right hip flexed to and the knee fully extended and received a total of 6 sessions. Each technique was applied to the right lower extremity in two diagonal patterns while electrical activity was monitored from the ipsilateral muscles VL, RFL, RFM, and VM, respectively. Comparison of normalized mean EMG magnitudes from VL, VM showed that RS demonstrated significantly greater activity than that of SR or SRH and that RFL and RFM did not demonstrate any greater relative EMG activity with the three PNF techniques than did VL or VM.

The purpose of this study was to compare the effects of one proprioceptive neuromuscular facilitation technique and static stretching on calf muscle tightness. The subjects consist of 9 hemiplegics, and 9 quadriplegics. The eighteen subjects were randomly divided into 3 groups: prorioceptive neuromuscular facilitation(6 persons), static stretching(6 persons) and control(6 persons). Contract relax antagonist contract and static stretching techniques were applied continuously for twenty minutes each. Of the many proprioceptive neuromuscular facilitation techniques, only the contract relax antagonist contract technique was applied. The static stretching technique was applied with the subject placed in standing on a seventy degree inclined tilt table for twenty minutes. A wedge was placed under the feet to obtain maximum dorsiflexion. Wedge thickness varied with each subject. Results revealed: (1) a significant difference between the experimental and the control groups(p<0.05). (2) a significant difference between contract relax antagonist contract and static stretching groups(p<0.05). (3) At day five, the final increments were: contract relax antagonist contract , static stretching (meanstandard deviation).