Vol.15(No.1 2015)

【Special Lecture】page 1-23

PROPRIOCEPTIVE NEUROMUSCULAR ELECTRICALLY STIMULATED FACILITATI ON INTEGRATING NMES INTO YOUR PNF PRACTICE

Cindy Wederich

Abstract ：Both Proprioceptive Neuromuscular Facilitation (PNF) and Neuromuscular Electrical Stimulation (NMES) use the same underlying physiological principles to evoke amot or response .

Therapists can utilize NMES to tap into these principles when manual techniquesal one are not enought to elicit an optimal motor

contraction. While many PNF techniques depend on the patient ' s ability to voluntarily contract a muscle , NMES does not require

voluntary effort . Like manual contacts , electrodes can be thought

of as ' electrical contacts ' that increase the therapists ' ability to maximize proprioceptive facilitation. The stronger the muscle

contraction, the stronger the facilitation, and NMES provids the

ability to induce st ronger contractions , and thus , greater

facilitation in the weak patient . With advances in the understanding of neural plasticity, the brain is now of ten the

target of treatment, rather than muscles . NMES has traditionally be enused to reduce secondary peripheral impairments , but it can also be used to help reactivate existing neural pathways in the

brain that were temporarily rendered inaccessible , or to encour age cortical reorganization in the case of permanent brain damage.

While NMES can be used alone , when combined with PNF, the two together are better able to drive the be havioral signals that are

 thought to promote neural plasticity and result in increased

function. This paper be gins by revie wing NMES principles to

provide the basis for discussing the combined use of NMES and PNF. The paper then presents : 1) the use of NMES to manage

peripheral dysfunction to address secondary impairments ; 2) the

use of NMES integrated with PNF procedures and techniques to manage central issues ; 3) research on combining PNF and NMES;

 4) augmenting PNF manual therapy with NMES; and f inally, 5)

adescription of neuroplasticity research and its application to

integrating PNF and NMES.

Key words：Proprioceptive Neuromuscular Facilitation (PNF) ,

Electrical Stimulation (NMES) , Neural Plasticity.

【The Original】 page 24-32

Neurophysiological remote rebound effects of are resistive static

contraction using a Proprioceptive Neuromuscular Facilitation

pattern in the midrange of pelvic motion of posterior depression on the soleus H-reflex 

Shiratani Tomoko, Arai Mitsuo, Kuruma Hironobu, Hobara Rui,  

Yanagisawa Ken

Abstract:

1. Introduction/ Background

With respect to the ascending effects of a resistive static

contraction of a pelvic depressors technique (RSCPD) using a

proprioceptive neuromuscular facilitation pattern in the mid-range

of pelvic motion of posterior depression, we found that the

neurophysiological remote rebound effects (RRE) induced by RSCPD on the he flexor carpi radialis H-reflex initially caused

reflexive inhibition during RSCPDT, followed by a gradual excitation after RSCPD in one case (Arai et al . ,2002) . The purpose of this

study was to compare the neurophysiological effects of descending remote after effects (RAE) of the RSCPD on the soleus (SOL)

H-reflex compared with the contralateral resistive exercise (RCE)

of the upper ankle plantar muscles in the side-lying position.

2. Materials and Methods

The effects of order were controlled by randomly assigning

numbers taken from a table of random numbers for the order of

the resistive static contraction (RCE, RSCPD) for each of fifteen normal subjects . The SOL H-reflex was measured at rest , during

each resistive exercise and after each resistive exercise . For

comparison, each H-reflex amplitude were normalized to the

corresponding a max M-waves (Mmax ) H-reflexes , which was

expressed by the ratio of H/Mmax (H/Mmax) .

3. Results

A three way ANOVA for the H/Mmax showed that the technique

and time course produced a main effect ( exercise ; F ( 1, 132) =1. 88 p<0. 05; time course ; F ( 11, 132) =54. 53 p<0. 01) . RSCPD was significantly facilitated compared with the RCE. The interaction between technique and time course was also significant for the

H/Mmax( F ( 11, 132) =1. 94, p< 0. 01) . The relationship between

the H/Mmax and the time course in the RSCPD was best fitted by a single or derpolynomial equation ( y=0. 012x＋ 0. 162 ( p=0. 049). Gradual escalati on trend was observed RSCPD. Significant polynomial was not observedin RCE. A three way ANOVA f or the

H/Mmax showed t hat the technique and time course produced a main effect ( exercise ; F ( 1, 132) =1. 88 p<0. 05; time course ; F ( 11, 132) =54. 53 p<0. 01) . RSCPD was significantly facilitated

compared with the RCE. The interaction between technique and time course was also significant for the H/Mmax ( F ( 11, 132)

 =1. 94, p< 0. 01) .

4. Conclusion

According to the significant facilitation of the RSCPD compared with the RCE of the right right plantar flexors , descending effects was

larger than the cross-education in this study.

【The Original】 page 33-38

The after effects of resistive static contraction facilitation on

improvement of restricted hip extension in or thopedic patients

Tetsuaki Sumida, Chihiro Sumida, Yasuhiro Harada

Abstract ：The purpose of this study was to determine the

aftereffects of resistive static contraction of the pelvic depressors (SCPD) or the anterior elevators (SCAE) using a proprioceptive

neuromuscular facilitation (PNF)  pattern in the midrange of pelvic

motion to i mprove restricted hip extension. Thirty six or thopedic

disease patients (mean age : 70. 4 years , SD: 12. 9) at one 

hospital were randomly as signed to the sustained stretch (SS) of

the hip flexors group, the SCPD group, or the SCAE group. The

change active range of motion (AROM) after each intervention was

calculated incomparison with AROM before the intervention. A one way ANOVA for the change in AROM revealed a significant differene

between the groups ( p<. 05) . Scheffé ' s test revealed that the

SCPD group and SCAE group showed signific ant improvements

compared to the SS group ( p<. 05) . The results of this study

suggest that use of the SCPD and SCAE may be effective approaches to improve the AROM of hipextension in the or thopedic

patients .

Key Words：PNF, Sustained contraction, Active range of motion of

hipextension

【The Original】 page 39-45

The after-effects of static contraction facilitation techniques of the

pelvic depressors while in the different sidelying position on the

improvement of the weight bearing of the affected side in the

standing posture in orthopedic patients

Kazue Masumoto, Mitsuo Arai, Satoko Akagi, Tomoko Shiratani,

Ken Yanagisawa, Michele Eisemann Shimizu

Abstract： The purpose of this study was to determine the after- effects of resistive static contraction of the pelvic depressos ( SCPD) on the unaffected or affected side while indifferent side-lying positions in orthopedic patients who were asked to shift to full weight bearing on the affected side in the standing posture . Eighteen subjects (mean age =79. 0 years , SD=12. 4) were randomly as signe d to the SCPD ( unaffected) , SCPD ( affected) or repeated weight shift exercise ( RWSE) groups where possible .

One way ANOVA demonstrated a significant difference between

groups based upon the percentage improvement in weight bearing.

Scheffé ' s post hoc test revealed that the SCPD for the unaffected and affected groups showed significant improvements compared with the RWSE group ( p<0. 05) . With respect to the weight bearing pain and feeling of unease , there were no significant differences between the three groups . These results suggest that SCPD may have immediate after-effects for increasing weight bearing of the affected side, and does not cause pain or a feeling of

unease on the affected side despite increased weight bearing.

Key Wor ds：PNF, Sustained contraction facilitation technique in the

middle range of motion, Weight bearing, After-effect

【Study Report】 page 46-53

Effects of resistive static contraction of the upper trunk muscles on the soleus H-reflex

Yoshimi Tanaka, Chiho Shimizu, Keisuke Kuwada, Yasuhiro Harada

Abstract：The purpose of this study was to investigate the effects of resistive static muscle contraction using a Proprioceptive

Neuromuscular Facilitation pattern in the mid-range of scapular anterior elevation ( SSCAET) or posterior depression ( SSCPDT) in

side-lying one xcitability of the upper soleus H-reflex . Forty healthy subjects ( mean age =30. 5 years ,SD=8. 0) were randomly as signed to the SSCAET group, SSCPDT group, Handgrip ( HG) group, or the Rest group. H-reflex amplitudes before, during and after each technique were measured every 20 seconds for 3 minutes . The results of repeated ANOVA in comparison of the amplitudes of the H-reflexes showed significant effects of both the

timecourse and group ( p<0. 05) . The interaction between group and timecourse was significant ( p<0. 05) . Post hoc analyis revealed significant effects on H-reflex during SSCAET and SSCPDT compared with the Rest group. The results of this study suggest that facilitation of the central nervous system occurs during resistive static contraction of the ipsilateral upper trunk muscles .

Key Wor ds ： PNF, H-reflex , Scapular anterior elevation, Scapular posterior depression, Static contraction

【Study Report】 page 54-61

Effects of resistive static contraction in the mid-range pelvic motion on the soleus H-reflex

Chiho Shimizu, Yoshimi Tanaka, Keisuke Kuwada, Yasuhiro Harada

Abstract：Previous studies have reported that the application of resistive static muscle contraction with manual resistance using a Proprioceptive Neuromuscular Facilitation pattern in the mid-range pelvic posterior depression technique ( SCPDT) have improved the range of motion. However, the detailed mechanism remains unclear. The purpose of this study was to investigate the effects of

SCPDT based upon detection of changes of the H-reflex amplitude in the ipsilateral soleus muscle . Thirty one healthy subjects without neurological deficits were randomly as signed to SCPDT, sustained stretch ( SS) , or rest groups . The H-reflex amplitude of

the resisted side soleus muscle of each subject using an evoked pot ential measuring system ( mode lMEB9102) was measured. The H-reflex amplitudes before , during and after each technique were measured every 20 seconds for three minutes . The results of repeated ANOVA for the amplitude of the H-reflex showed significant group effects( p<0. 05) . The interaction between the group and timecourse was significant ( p<0. 01) .Post hoc analysis revealed significant effects on H-reflex during SCPDT compared with the SS and rest groups ( p<0. 01) . These results suggest that

the neurophysiological effects of the remote parts were evident during static contraction of the lower trunk.

Key wor ds： PNF, H-reflex , Pelvic posterior depression, Static contraction