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Purpose : The purpose of this study was to investigate the effect of the sprinter and skater combined patterns on muscle contraction onset time and muscle activation of body stabilizing muscles. Method : Our study included young and healthy men in their 20s. The participants used the sprinter and skater combined patterns of the proprioceptive neuromuscular facilitation (PNF) methods to measure muscle activation and muscle contraction onset time of the trunk muscles. To measure muscle contraction onset time and muscle activation, electrodes were attached to the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinalis (ES) regions. Significant differences were identified using a paired t-test and a one-way analysis of variance (ANOVA) analysis. Result : In the sprinter combined pattern, the muscle with the fastest onset time of contraction was the RES, and that with the slowest was the RRA (p<.001). In the skater combined pattern, the muscle with the fastest onset time of contraction was the LES, and that with the slowest was the LRA (p<.001). In the sprinter combined pattern, the REO and LIO presented medium muscle contraction onset times (p<.001). In the skater combined pattern, the LEO and RIO presented medium muscle contraction onset times (p<.001). Conclusions: Based on these results, these patterns could be used as exercise methods for the elderly with delayed proactive response speeds of the body stabilization methods due to imbalances in body stabilizing muscles or limbs movement.

This study analyzed the brain wave data of central cortical areas (C3, C4) during both action observation and motor execution of proprioceptive neuromuscular facilitation (PNF) upper extremity (U/E) patterns in normal young adults. We measured suppression of the electroencephalographic (EEG) Mu rhythm, a reliable indicator of mirror-neuron activity,in central cortical areas during both action observation and motor execution of PNF U/E patterns. In all subjects, Mu-rhythm suppression was observed above C3 and C4 regions during both action observation and motor execution of the PNF U/E pattern and significant differences were observed in three experimental tasks when compared with that noted for the baseline (Wilcoxon signed rank test). Friedman test results indicated no significant differences in the suppression of Mu rhythm in the three experimental conditions. These results suggest that action observation and PNF U/E pattern can activate the mirror neuron system in central cortical areas, particularly in the form of Mu-rhythm suppression. These findings can prove useful ina clinical therapeutic intervention program and the practice of combining action observation and PNF U/E pattern could improve health and enhance physical performance in young adults.

Purpose : This study was to figure out the Effects of Lower Extremity Pattern of PNF on the Pain and ROM in Patients with TKA. Methods : The subjects were consisted of 13 women patients with TKA. All subjects were randomly assigned to PNF group. Each group had a treatment for 30 minutes per day and three times a week during 2 weeks period. Was used to measure recovery or worse of patient's condition, resting pain, moving pain, ROM. Results: This stud results in following conclusons. 1. The stable hour tube cung to after treatment criminal record 1, after 2 and after 3 and after 3 and after 4 it considered and it was under diminishing(p<.05), to after 1 and after. 2 there was not a difference which considers(p>.05). 2. Moving pain score was significantly decreased in PNF group(p<.05). 3. ROM score was significantly decreased in PNF group(p<.05). Conclusion : From this result the PNF treatment retrogression characteristic will be effective in treatment of patient, with the TKA and widely may be applied at a therapist.

Purpose: This study verifies the muscle activity around the amputation site during proprioceptive neuromuscular facilitation (PNF) pattern exercise for the upper extremities on the non-amputated part in upper extremity amputees and provides basic data on effective exercise around an amputation site. Methods: Manual resistance was applied to the PNF upper extremity pattern of the non-amputated part to generate muscle activity around the amputation site. The resistance was adjusted to an intensity that could cause maximal isometric contraction. The muscle activity of the amputation site and the non-amputated part was measured using a surface electromyogram for the upper trapezius, middle trapezius, infraspinatus, serratus anterior, and pectoralis major. Results: During the scapular exercise in the painless range, the amputated side showed significantly lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. During the PNF pattern exercise in the painless range, the amputated side showed lower muscle activity and a lower muscle contraction ratio compared with the non-amputated side. When the direct scapular exercise of the amputated side was compared with the PNF pattern exercise of the non-amputated side, their muscle contraction ratios were similar. Conclusion: This study confirmed the effectiveness of the PNF pattern exercise of the non-amputated part as a way to indirectly train the injured site with no pain for rehabilitation of patients with serious body injuries, such as amputation. It is necessary to develop effective exercise programs for the rehabilitation of the amputation site based on the results of this study.

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 analyze the effect of normal timing according to angular motion in PNF patterns on electromyography (EMG) activity in rectus abdominis, internal oblique abdominal muscle, external oblique abdominal muscle, and erector spinae. Methods: Ten healthy adults volunteered to participate in this study. The participants were required to complete following two PNF extremity patterns; upper extremity extension- adduction-internal rotation pattern with 180°, 90°, 30°and lower extremity flexion- adduction-external rotation pattern with 0°, 60°, 90°. A paired t-test was used to determine the influence of the two PNF patterns on muscle activity in each muscle. Descriptive statistics were used to determine the ratio of local muscle activity to global muscle activity. Results: In terms of their effect on applied normal timing, the upper and lower extremity pattern significantly affected the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). The upper extremity pattern (at an extension angle of 30°) and the lower extremity pattern ((at a flexion angle of 90°) influenced the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). Conclusion: The effect of the upper and lower extremity patterns on applied normal timing was significant in that these patterns increased trunk muscle activation. The upper extremity pattern (at an extension angle of 30°) and the lower extremity pattern (at a flexion angle of 90°) increased trunk muscle activation. Normal timing is required to increase trunk muscle strength and extremity movement.

Objective：The purpose of this study was conducted to find the change of shoulder flexion by degree of freedom between the Proprioceptive Neuromuscular Facilitation(PNF) pattern, the flexion- abduction- external rotation, and not PNF pattern, the flexion- exteral rotation(except abduction)movement. Method：PNF pattern applied on the unilateral upper extremity in all subjects were the flexion- abduction- external rotation, and not PNF pattern, and twenty-six normal subjects(13 male, 13 female) were tested by Cybex Norm Testing & Rehabilitation System. Results：PNF pattern showed significant increase of flexion than not PNF pattern, the flexionexteral rotation(except abduction)movement, and also the female group was significantly increased than male group. Conclusion：The results suggested that the application of PNF pattern to the unilateral upper extremity had affected on the shoulder flexion by degree of freedom.

Purpose：The purpose of this study was to investigate the effect of aquatic exercise applied PNF patterns on body composition and balance performance in people who have had a stroke. Methods：Forteen candidates who have all experienced a stroke were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 10 consecutive weeks. Subjects were tested with body composition and 5 items of Berg’s balance test at pre-training and post-training. Total balance indexes in 3 conditions were measured by K.A.T. 3000. The aquatic exercise applied PNF patterns was consisted of PNF patterns and various aquatic activities. Results：After ten weekends of aquatic exercise training, there were not significant difference in body composition(p>.05) except of muscular weight of affected lower extremity(p<.05). But edema index increased more than pre-training (p<.05). Subjects showed significant difference in Berg’s balance test results except of 2 items of Berg’s balance test (p<.05). Total balance index score when subjects opened their eyes and didn’t hold the handle was decreased less than pre-training(p<.05). Conclusion：The results of this study showed that intervention of this aquatic exercise program applied PNF patterns could increase edema index and muscular weight of affected lower extremity and improve the balance performance in people who have had a stroke.

Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.

Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P <0.05). Significant differences between the PWBV and WBV groups were found (P <0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.

Purpose: The purpose of this study was to demonstrate the effects of a stepwise proprioceptive neuromuscular facilitation (PNF) pattern therapy in weightbearing positions on the balance and walking functions of a patient with subacute stroke. Methods: The patient was a 78-year-old man with right post-stroke hemiparesis who had decreased balance and gait function. During the baseline and withdrawal phases, no intervention was applied; however, in the intervention phase, the patient received a stepwise PNF pattern therapy in weight-bearing positions. Results: During the intervention phase, the LOS improved by 296.51% (from 2482.13 ㎟ to 626 ㎟), and walking speed improved by 18.70% (from 0.75 ㎧ to 0.64 ㎧). The LOS and 10MWT values appeared to be clinically significantly improved after the intervention. In addition, the scores of the BBS and ABC scales improved by 100% (from 36 points to 18 points) and 56.52% (from 720 points to 460 points), respectively. Conclusion: These findings suggest that a stepwise PNF pattern therapy may be helpful in enhancing the balance and walking function of a patient with subacute stroke. Further studies are required to validate the results of this study.

Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.

Purpose: The purpose of this study was to compare the strength and walking ability of chronic stroke patients following either proprioceptive neuromuscular facilitation (PNF) pattern training with pressure biofeedback units (feedback group) or PNF pattern training without pressure biofeedback units (control group). Methods: Eighteen participants with chronic stroke were recruited from a rehabilitation hospital. They were divided into two groups: a feedback group (n = 8) and a control group (n = 10). They all received 30 minutes of neurodevelopmental therapy and PNF training for 15 minutes five times a week for three weeks. Muscle strength and spatiotemporal gait parameters were measured. Muscle strength was measured by hand-held dynamometer; gait parameters were measured by the Biodex Gait trainer treadmill system. Results: After the training periods, the feedback group showed a significant improvement in hip abductor muscle strength, hip extensor muscle strength, step length of the unaffected limb, and step time of the affected limb (p<0.05). Conclusion: The results of this study showed that proprioceptive neuromuscular facilitation pattern training with pressure biofeedback units was more effective in improving hip muscle strength and walking ability than the proprioceptive neuromuscular facilitation pattern training without pressure biofeedback units. Therefore, to strengthen hip muscles and improve the walking ability of stroke patients, using pressure biofeedback units to improve trunk stability should be considered.

Purpose: This study compared and analyzed the effect of the proprioceptive neuromuscular facilitation (PNF) arm extension pattern and leg flexion pattern on the contralateral lower extremity muscles when the patterns were applied to the same subject. Methods: In the study, 35 healthy men and women who understood the PNF patterns were selected as participants. The participants completed the PNF arm extension-abduction-internal rotation pattern and leg flexion- adduction-external rotation with knee flexion pattern in the supine position. While the patients’ completed each pattern, the contralateral leg muscle activity was measured to examine the irradiation effect. The maximum isometric contraction time of the muscles to be measured was kept for 5 seconds, and the mean value was obtained by repeating the pattern three times. Results: When the leg flexion-adduction-external rotation with knee flexion pattern was completed, the muscle activity in the vastus lateralis, vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius of the contralateral lower extremity was significantly greater than that found in the PNF arm extension-abduction-internal rotation pattern. Conclusion: The PNF leg flexion pattern showed greater muscle activity on the contralateral lower extremity than the arm extension pattern. Thus, the PNF leg extension pattern is more effective in the activation of the muscles associated with weight-bearing activity.

Purpose: This study investigated the effects of neck pattern of proprioceptive neuromuscular facilitation (PNF) on balance and walking ability in patients with chronic stroke. Methods: Fourteen participants with chronic stroke were randomly assigned to vestibular rehabilitation and then divided into two groups: the neck pattern group or treadmill group. Each group underwent 20 sessions (20 minutes/day, five days/week, for four weeks). Patients were assessed with the Berg balance scale (BBS) and gait parameters (gait speed, cadence, step length, and double-limb support period) using a GAITRite system. Results: Vestibular rehabilitation for the neck pattern group and the treadmill group showed significant intragroup improvement on the BBS and in terms of gait speed, cadence, step length, and double-limb support period (p < 0.05). Vestibular rehabilitation was more effective for the neck pattern group than for the treadmill group in terms of the BBS (p = 0.00; 95% CI, 1.49–5.94), gait speed (p = 0.01; 95% CI, 0.05–0.16), cadence (p = 0.02; 95% CI, 0.54–4.99), and step length (p = 0.00, 95% CI, 1.55–4.62). Conclusion: This study used the neck pattern of PNF for vestibular rehabilitation in patients with chronic stroke. The results showed significant improvement in the patients’ balance and walking ability. Therefore, the neck pattern of PNF for vestibular stimulation may be more effective than treadmill training to improve balance and walking ability in patients with chronic stroke.

Purpose: The purpose of this study was to investigate the effects of a neck exercise using a proprioceptive neuromuscular facilitation (PNF) neck flexion and extension pattern on body balance in a progressive range of positions (supine, prone on elbow, and sitting), on numbness in the upper extremities, and on neck flexion motions in cervical myelopathy patients. Methods: One participant who was diagnosed with cervical myelopathy participated in this study. A reversal design (A-B-A’) was used. The A and A’ were the baseline period (no intervention), and B was the intervention period. The intervention used a neck extension pattern with a hold-relax technique and a neck flexion pattern with a combination of isotonic techniques in the supine position. Then, neck flexion and extension patterns were applied together with a reversal technique for stabilization, followed by a neck extension pattern with a combination of isotonic techniques in the prone position on the elbows. Finally, a neck flexion and extension pattern was used with a stabilizing reversal technique, and a neck extension pattern was applied with a combination of isotonic techniques in the sitting position for 60 minutes per day, 3 times per week for 8 weeks. To measure balance, numbness, and neck motion during neck flexion, the one-leg stand test and the visual analogue scale were used. Results: The right and left one-leg stand tests showed increased balance ability in the intervention phase. Upper extremity numbness was decreased in the intervention phase, and neck flexion motion was increased in the intervention phase. These increases were maintained after the intervention (Baseline Ⅱ). Conclusion: These results suggest that a neck exercise using a PNF neck pattern with additional techniques in a progressive range of positions has a positive effect on cervical myelopathy patients for balance, numbness, and neck motion.

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey’s multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

Purpose: This study aimed to determine the most effective way to facilitate the abductor hallucis muscle during PNF leg pattern-emphasized hallux abduction. Methods: The study recruited 18 healthy adults. All participants agreed voluntarily to take part in the study following an explanations of its purpose and procedures. They randomly performed the PNF leg pattern-emphasized hallux abduction variations in a hook-lying or sitting position. Activation of the abductor hallucis (AbH), adductor hallucis (AdH), extensor hallucis longus (EHL), and tibialis anterior (TA) muscles, and the ratio of AbH/AdH, were measured during PNF exercises using electromyography. One-way repeated ANOVA was used to compare the activation of foot intrinsic and extrinsic muscles during the four PNF exercises. Results: PNF leg pattern-emphasized hallux abduction using normal timing was significantly higher in TA compared to PNF leg pattern-emphasized hallux abduction using timing for emphasis, regardless of the starting position. The PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position was significantly higher in AbH than in other exercises. Although there was no statistically significant difference in the ratio of AbH/AdH, it was higher in the hook-lying position. Conclusion: PNF leg pattern-emphasized hallux abduction using timing for emphasis in the hook-lying position can be recommended as a method to optimize the activation of AbH and the ratio of AbH/AdH.