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Effects of Proprioceptive Neuromuscular Facilitation Exercise on Forced Expiratory Volume at One Second, Pain, and Functional Disability Index of Chronic Low Back Pain Patients

고유수용성신경근촉진법 운동이 만성허리통증환자의 1초간 노력성 날숨량과 통증 및 기능장애지수에 미치는 영향

  • Received : 2016.10.24
  • Accepted : 2016.11.16
  • Published : 2016.12.31

Abstract

Purpose: The purpose of this study was to investigate the effects of neck patterns in proprioceptive neuromuscular facilitation (PNF) for neck movement and the neck disability index (NDI) among adults with forward head posture. Methods: Thirty-nine subjects were randomly assigned into two groups. Subjects in the proprioceptive neuromuscular facilitation exercise group (PNFG, n = 20) received 20 minutes of PNF neck pattern (flexion-Rt. lateral flexion-Rt. rotation followed by extension-Lt. lateral flexion-Lt. rotation) 3 times weekly for 4 weeks. Outcomes were measured using absolute rotation angle (ARA), anterior weight bearing (AWB), range of flexion and extension motions (RFEM), and neck disability index (NDI) methods before and after the 4-week intervention period. Results: There were significant effects for the PNFG, pre- and post-intervention, in ARA, AWB, RFEM, and NDI. There were significant differences in ARA, AWB, RFEM, and NDI compared with CG. Conclusion: The results of this study suggest the PNF neck pattern could be beneficial for adults with forward head posture.Purpose: This study investigates how abdominal muscular exercise based on proprioceptive neuromuscular facilitation (PNF) can affect chronic low back pain patients in terms of their pulmonary function, pain, and functional disability indexes. Methods: Fourteen target subjects with chronic low back were randomly assigned to the control group (n = 7) that performed abdominal muscle exercises and the experimental group (n = 7) that performed PNF abdominal muscular exercises. The exercises were performed five times a week for six weeks. To check the change in pulmonary function, the forced expiratory volume at one second (FEV1) and visible analogue scale (VAS) were measured to check the pain level. The disability level caused by back pain was measured by the Oswestry Disability Index (ODI). A paired t-test was applied to compare the differences between the groups before and after the intervention, and an independent t-test was used to compare the differences between the groups. The level of statistical significance was set as ${\alpha}=0.05$. Results: Before and after the intervention, the experimental group showed a significant change in FEV1 (p < 0.01), and both the experimental and the control groups showed significant changes in VAS and ODI (p < 0.01). A comparison of the differences between the groups indicated that the experimental group showed more significant changes in FEV1 (p < 0.05). Conclusion: According to the study results, PNF abdominal muscular exercise effectively improved pulmonary function, pain, and functional disability indexes in subjects with chronic back pain. The proposed program can be applied to chronic back pain patients as a useful therapy.

Keywords

References

  1. Bach JR, Smith WH, Michaels J, et al. Airway secretion clearance by mechanical exsufflation for post-poliomyelitis ventilator-assisted individuals. Archives of Physical Medicine and Rehabilitation. 1993;74(2):170-177.
  2. Fairbank JC. Oswestry disability index. Journal of Neurosurgery Spine. 2014;20(2):239-241. https://doi.org/10.3171/2013.7.SPINE13288
  3. Hildenbrand K, Noble L. Abdominal muscle activity while performing trunk-flexion exercises using the Ab roller, ABslide, FitBall, and conventionally performed trunk curls. Journal of athletic training. 2004;39(1):37-43.
  4. Izzo A, Perrotta F, Cennamo A, et al. Spirometry in elderly laryngectomized patients: a feasibility study. International Journal of Surgery. 2016;33(1):4-8. https://doi.org/10.1016/j.ijsu.2016.05.058
  5. Jeon HJ, Lee MH. The effects of PNF technique versus trunk exercise program on the pain, disability, and balance in chronic LBP patients. The Korea Contents Association. 2009;9(12):665-673. https://doi.org/10.5392/JKCA.2009.9.12.665
  6. Kang JI, Choi H. The effect of pelvic stability exercise program on pain and hip joint of patients with chronic low back pain involving sacroiliac joint pain. Journal of Digital Convergence. 2013;11(4):331-338.
  7. Kang JI, Kim BR, Park SK, et al. Effects of deep abdominal muscle strengthening exercises on pulmonary function and the ability to balance in stroke patients. The Journal of Korean Physical Therapy. 2015;27(4):258-263. https://doi.org/10.18857/jkpt.2015.27.4.258
  8. Kang TW, Park YS. Effect of sling exercise with PNF basic procedure for pain and balance ability of patients with chronic low back pain. Journal of the Korean Proprioceptive Neuromuscular Facilitation Association. 2013;11(1):1-6.
  9. Kim GD, Lee YJ, Choi WS, et al. Effects of lumbar stabilization exercise using PNF techniques on thickness of lumbar deep muscle and functional activity in chronic low back pain patients. The Korea Contents Association. 2012;12(3):233-243.
  10. Kim GY, Ahn CS, Kim SS. The effects of 3-dimensional lumbar stabilization exercise have an effect on the improvement of pain and static or dynamic balance ability in 20's age group with low back pain. Journal of the Korean Society of Physical Medicine. 2011;6(2):235-246.
  11. Kim K, Kim EK, Lee DK. Effects of PNF patterns exercise on pain, functional disability and fear avoidance belief in chronic low back pain patients. The journal of Korean Society of Physical Therapy. 2014;26(2):110-116.
  12. Kim KS, Kwon OY, Yi CH. Effect of abdominal drawing-In maneuver on peak expiratory flow, forced expiratory volume in 1 second and pain during forced expiratory pulmonary function test in patients with chronic low back pain. Korean Research Society of Physical Therapy. 2009;16(1):10-17.
  13. Kisner C, Colby LA. Therapeutic exercise: foundations and techniques, 4th ed. Philadelphia. F.A. Davis Company. 2002.
  14. Kofotolis N, Vrabas IS, Kalogeropoulou E, et al. Proprioceptive neuromuscular facilitation versus isokinetic training for strength, endurance and jumping performance. Journal of Human Movement Studies. 2002;42(2):155-165.
  15. Lee BG, Jee YS, Ko IG, et al. Effects of combined exercises of walking and lumber stabilization on pulmonary function and lumbar deep muscles of patients with chronic low back pain. Korean Journal of Health Promotion. 2008;8(3):168-177.
  16. Lee BK. The effect of the forced pulmonary function of young female, by changes in lung function related to postures and by transverse abdominis activation in standing position. Journal of the Korean Society of Physical Medicine. 2012;7(3):267-274. https://doi.org/10.13066/kspm.2012.7.3.267
  17. Lee CW, Kim JS, Lee IS. The effects of combination patterns of proprioceptive neuromuscular facilitation and ball exercise on pain and balance in chronic low back pain patients. Journal of the Korean Society of Physical Medicine. 2012;7(1):1-9. https://doi.org/10.13066/kspm.2012.7.1.001
  18. Lee CW, Kim HS, Lee IS. The effect of horse-riding exercise on the balance ability in the chronic low back pain patients. Journal of The Korean Society of Integrative Medicine. 2014;2(1):101-108. https://doi.org/10.15268/ksim.2014.2.1.101
  19. Lee P, Helewa A, Goldsmith CH, et al. Low back pain: prevalence and risk factors in an industrial setting. The Journal of Rheumatology. 2001;28(2):346-351.
  20. Lee SJ, Lee GC, Bae WS, et al. The effect of transverse abdominal exercise for 3weeks for lumbar muscle strength and pain relief on chronic low back pain patients. Korean Society of Integrative Medicine. 2013;1(3):9-17.
  21. Lingjaerde O, Foreland AR. Direct assessment of improvement in winter depression with a visual analogue scale: high reliability and validity. Psychiatry Research. 1998;81(3):387-392. https://doi.org/10.1016/S0165-1781(98)00119-X
  22. Nachemson AL. Disc pressure measurements. Spine. 1981;6(1):93-97. https://doi.org/10.1097/00007632-198101000-00020
  23. Nourbakhsh MR, Arab AM. Relationship between mechanical factors and incidence of low back pain. The Journal of orthopaedic and sports physical therapy. 2002;32(9):447-460. https://doi.org/10.2519/jospt.2002.32.9.447
  24. O'Sullivan PB. Lumbar segmental 'instability': clinical presentation and specific stabilizing exercise management. Manual Therapy. 2000;5(1):2-12. https://doi.org/10.1054/math.1999.0213
  25. Panjabi M, Abumi K, Duranceau J, et al. Spinal stability and intersegmental muscle forces. A biomechanical model. Spine. 1989;14(2):194-200. https://doi.org/10.1097/00007632-198902000-00008
  26. Ralston SH, Urquhart GD, Brzeski M, et al. Prevalence of vertebral compression fractures due to osteoporosis in ankylosing spondylitis. British Medical Journal. 1990;300(6724):563-565. https://doi.org/10.1136/bmj.300.6724.563
  27. Rone-Adams SA, Shamus E, Hileman M. Physical therapists evaluation of the trunk flexors in patients with low back pain. The Internet Journal of Allied Health Sciences and Practice. 2004;2(2):1-9.
  28. Yun JH, Kim TS, Lee BK. The effects of combined complex exercise with abdominal drawing-in maneuver on expiratory abdominal muscles activation and forced pulmonary function for post stroke patients. Journal of the Korean Society of Physical Medicine. 2013;8(4):513-523. https://doi.org/10.13066/kspm.2013.8.4.513