Earticle

Purpose: The purpose of this study was to analyze the effects of proprioceptive neuromuscular facilitation (PNF) patterns on electromyography (EMG) activity in the rectus abdominis, internal abdominal oblique, external abdominal oblique, and erector spinae according to position changes. Methods: Ten healthy adults volunteered to participate in the study. The subjects were required to complete exercises that followed two PNF extremity patterns, namely, an upper extremity extension- adduction-internal rotation pattern and a lower extremity flexion-adduction-external rotation pattern. The exercises were applied in the supine, side-lying, and sitting positions. Repeated measure one-way ANOVA and post-hoc Bonferroni correction were used to determine the influence of the patterns on muscle activity for each muscle, and descriptive statistics were then used to determine the local/global muscle ratios. Results: The upper extremity pattern had a significant effect on the rectus abdominis and erector spinae in the supine position, and on the internal oblique and external oblique in the sitting position (p<0.05). The median value for the internal oblique/rectus abdominis showed a high ratio of 2.05, and a high ratio of 1.01 was shown for the internal oblique/external oblique in the sitting position. The lower extremity pattern had a significant effect on the rectus abdominis in the side-lying position and on the internal oblique, external oblique, and erector spinae in the sitting position (p<0.05). The median value for the internal oblique/rectus abdominis showed a high ratio of 2.83 in the sitting position and a high ratio of 1.30 for the internal oblique/external oblique in the side-lying position. Conclusion: The PNF pattern increases local muscle activation in an unstable position. Therefore, when the pattern is used for intervention purposes, trunk stability and varied position changes should be taken into account.

Purpose: The purpose of this study was to determine the effectiveness of direct and indirect methods of contract-relax techniques in proprioceptive neuromuscular facilitation (PNF) stretching for improving hamstring flexibility. Methods: Twenty-six subjects were randomly assigned to either a direct contract-relax technique group or an indirect contract-relax group. For each group, stretching intervention was performed three times a week for a period of two weeks, with 12 seconds for the contraction and 10 seconds for the relaxation per once. The direct contract-relax technique for hamstring flexibility was applied by asking the subject to press down on the shoulder of the trainer in the straight leg-raising position. Conversely, the indirect contract-relax technique was performed by raising the leg with resistance. To facilitate a comparative analysis of hamstring flexibility between the two groups before and after the stretching intervention, two- way repeated ANOVA was performed. Hamstring flexibility for each group was measured using a passive straight leg-raising test. Results: The results showed significant improvement in hamstring flexibility for all subjects in the two groups. However, there was no significant difference between the groups. Conclusion: In conclusion, both direct and indirect contract-relax techniques are confirmed to be useful for improving hamstring flexibility. The choice of suitable technique has to be made individually according to the condition of each subject.

Purpose: The purpose of the present study was to compare the effects of both general hold-relax techniques and hold-relax techniques using pumping on pain due to delayed muscle pain and on the range of motion (ROM) of joints. Methods: Thirty-nine young adult males and females were randomly assigned either to a hold-relax technique application group of 20 subjects or to a group of 19 subjects with hold-relax techniques applied using a pumping application. Tenderness thresholds, the ROM of joints, and pain intensities were measured on the biceps of the nondominant arm of the subjects in both groups before exercises were performed to induce delayed muscle pain. Tenderness thresholds were again measured 24hours, 48hours, and 72 hours after inducing delayed muscle pain. The relevant intervention methods were applied to the two groups after conducting the measurement at 48hours. As a statistical analysis method, repeated measure ANOVAs were conducted to examine the tenderness thresholds, ROMs of elbow joints, and pain intensities in the individual groups at the time points. Results: At 48 hours and 72 hours after application of the interventions, the general hold-relax technique application group showed greater changes in the tenderness thresholds, the ROMs of elbow joints, and the pain intensities than did the group applying hold-relax techniques using a pumping application (p>0.05). Conclusion: Based on the results of the present study, the application of hold-relax techniques is thought to have beneficial effects on pain resulting from delayed muscle pain and on limited ROMs of joints.

Purpose: The purpose of this study was to determine the effects of a coordinative locomotor training program on the functional movement screen (FMS) scores of badminton players. Methods: The participants consisted of 31 badminton players who were randomly assigned to either an experimental group (n=15) or a control group (n=16), and engaged in exercise five times per week for six weeks. The experimental group engaged in coordinative locomotor training and the control group engaged in general exercise. An FMS kit (USA) was used to measure the following: FMS score, deep squat, hurdle step, in-line lunge, shoulder mobility, active straight leg raise, trunk stability push up, and rotary stability. Results: The FMS score, deep squat, hurdle step, in-line lunge, active straight leg raise, and trunk stability push up showed significant improvement in the experimental group (p<0.05). Conclusion: The coordinative locomotor training program was able to produce confirmation that functional movement screen scores change in the case of effective exercise interventions in badminton players.

Purpose: The purpose of the present study was to examine the effects of the simultaneous application of the combination of isotonics (CI) in proprioceptive neuromuscular facilitation (PNF) and sport taping on the pain and grip strength of patients diagnosed with lateral epicondylitis among H badminton club members and to provide intervention methods for lateral epicondylitis. Methods: The subjects included 10 patients diagnosed with lateral epicondylitis. The CI technique in PNF as well as sport taping were applied to the subjects five times per week for two weeks. The visible analogue scale (VAS) was used to measure decreasing changes in pain, and a grip dynamometer was used to measure grip strength (GS). Paired sample t-tests were conducted to compare values measured before and after the experiment in order to determine differences. Results: The intensities of pain of the experimental groups changed significantly between the times before and after the experiment (p<0.05), and grip strength also changed significantly from the time before after the experiment (p<0.05). Conclusion: When the CI technique of PNF as well as sport taping were applied to patients with lateral epicondylitis, the patients showed significant improvements in pain and grip strength. Since the intervention had quite positive effects on the subjects that complained of lateral epicondylitis by reducing their pain and increasing their grip strength, studies of efficient exercise interventions will be continuously conducted to propose the development of intervention programs.

Purpose: In general, confabulation is defined as confusion of reality with past events without apparent prompting, in association with disruption of the capacity for retrieval and encoding of memory. We report on a patient who showed spontaneous confabulation associated with injury of the Papez circuit following middle cerebral artery (MCA) infarction. Methods: A 67-year-old female patient suffered cerebral infarct resulting from spontaneous MCA territory. After onset of the MCA infarct, she showed severe memory impairment and provoked confabulation. The Papez circuit was reconstructed for evaluation of part of it using diffusion tensor tractography (DTT). Fractional anisotropy (FA), mean diffusivity (MD), and tract volume were measured. Results: The right thalamocingulate tract showed a significant decrement of FA value and tract volume, and an increment of MD value by more than two standard deviations of that of normal control subjects. The tract volume in the left fornix and mammillothalamic tract decreased by more than two standard deviations of that of normal control subjects. Conclusion: Injuries of the Papez circuit were demonstrated in a patient who showed severe memory impairment and provoked confabulation following MCA infarct. We believe that analysis of the Papez circuit tract using DTT is useful in elucidating the cause of provoked confabulation in patients with MCA infarct.

Purpose: The purpose of the present study was to examine the effects of the area of the base of support formed by the human body on the maximal voluntary isometric contraction of upper limb muscles. Methods: The study was conducted with 20 normal adults. To identify changes in the base of support, the maximal voluntary isometric contraction of the biceps muscle was measured in a standing position, a sitting position, and a lying position for each subject. The sizes of the base of support formed in the standing, sitting, and lying positions were set to 1, 2, and 3 respectively, based on the sizes, to analyze the correlations. The maximal voluntary isometric contraction of the biceps muscle was measured using surface electromyograms (EMGs) (Noraxon DTS, Germany). Results: The results showed negative correlations in which, as the size of the base of support increased, the maximal voluntary isometric contraction of the biceps muscle decreased. Conclusion: Changes in the base of support of the body affect the maximal voluntary isometric contraction of the upper limbs. Therefore, when resistance exercises are applied for muscle strengthening, the positions should be changed considering the changes in muscle activity according to those positions. In addition, when EMGs are used to measure the maximal voluntary isometric contraction, the measurements should be conducted in the same positions, considering muscle activity that changes according to the base of support and positions, for data quantification.

Purpose: This study aimed to examine the correlation between the asymmetric ratio of occlusal force of the temporomandibular joint and the thickness of the middle scalene muscle. Methods: The study measured the occlusal force of the right and left temporomandibular joints in 30 subjects (12 males and 18 females). Pearson’s correlation analysis was performed to examine the effect of occlusal force on the asymmetric ratio of the thickness of their middle scalene muscles by measuring the force using ultrasound after the break. Results: The correlation between the asymmetric ratio of occlusal force and muscle thickness is 0.41, according to Pearson’s correlation coefficient. Therefore, the result shows a moderate correlation with the asymmetric ratio of the temporomandibular joint depending on differences in the thickness of the middle scalene muscle. Conclusion: Based on the above results, the asymmetric ratio of occlusal force was found to correlate with the thickness of the middle scalene muscle. Thus, therapeutic intervention is required for the middle scalene muscle in the case of temporomandibular joint disorder.

Purpose: The purpose of this study was to review articles in order to establish optimal contraction intensity and duration in the performance of relaxation techniques for maximal increase in range of motion. Methods: The Cochrane, EBSCO, Embase, Medline, ProQuest, PubMed, ScienceDirect, and Scopus databases were used to search articles from 1990 to January 2016. The search terms were "contract relax," "hold relax," "muscle energy technique (MET)," and "proprioceptive neuromuscular facilitation (PNF) stretching." Only experimental human studies (randomized controlled trials) that compared the effects of varying intensity and duration of isometric contraction were included. Non-English language and unpublished studies were excluded. Results: A total of 2,156 articles were initially identified, with only five eventually meeting the inclusion and exclusion criteria. Three studies compared the effects of varying intensity in isometric contraction and two studies compared the effects of varying duration in isometric contraction with regard to range of motion (ROM). Two articles suggested that submaximal voluntary isometric contraction was more effective than maximum voluntary isometric contraction (MVIC) in the improvement of ROM. One article showed that a longer contraction time led to greater increases in ROM. Conclusion: Submaximal voluntary isometric contraction was recommended during contract-relax exercises in healthy people. Lack of evidence makes it difficult to suggest the optimal duration of isometric contraction during relaxation techniques. For future research, high-quality evidence will be needed to establish the optimal contraction intensity for maximum improvement of ROM.