Vol.18(No.1 2018)

【The Original】 page 1-6

Influence of resistive exercise as an indirect-approach on the unexercised soleus H-reflex

Shigeta Yuki, Shiratani Tomoko, Hobara Rui, Ide Natsuki,

Masumoto Kazue, Arai Mitsuo

Abstract: When direct approach is difficult to use for improving the active and passive range of motion of severely restricted joints because of agonist muscle pain or weakness, indirect approaches can be useful in clinical practice. Indirectapproaches often use resistive static contraction of pelvic posterior depressors（RSCPD）as descending remote effects and/or contralateral resistive static contraction（CRSC）as Cross-education. The purpose of this study was to compare the neurophysiological effects and after-effects of the right RSCPD, left CRSC, and resistive static contraction of the right plantar flexors（RSCPF）with different degrees of load on the right unexercised soleus H-reflex. The effects of order were controlled by randomly assigning numbers taken from a table of random numbers for the order of the resistive exercise （RSCPD, CRSC, and RSCPF）with different degrees of load（10%: light, 30%: heavy）for 17 normal subjects. The right soleus H-reflex was measured at rest（condition-BE）, during resistive exercise phase（condition-DE）, and rest phase after resistive exercise（condition-AE）. The H-reflex amplitude was normalized to the corresponding maximal M-wave （Mmax）H-reflex, which was expressed by the ratio H/Mmax. The results of four-way analysis of variance showed significant interaction between the resistive exercise and degrees of load for H/Mmax. Post-hoc analysis revealed that CRSC×heavy in the condition-DE had significant facilitatory effects on the H-reflex compared with the other resistive exercises in the condition-DE. However, inhibitory effects were revealed as after-effects in the condition-AE compared with the condition-BE in RSCPD, CRSC, and RSCPF. These results indicated that CRSC×heavy induced contralateral effects as cross-education on the soleus H-reflex, which initially caused reflexive facilitation during CRSC×heavy followed by gradual inhibition after CRSC.

Key words: resistive static contraction, degrees of load, cross-education, pelvic posterior depressors, Soleus H-reflex

【The Original】 page 7-12

The different effects of resistive static contraction in mid-range pelvic motion and Cross-education with different degrees of resistance on the unexercised soleus H-reflex

Takezawa Miho, Arai Mitsuo, Ide Natsuki, Shigeta Yuki,

Shiratani Tomoko, Hobara Rui, Masumoto Kazue

Abstract: When direct approach is difficult to use for improving the active and passive range of motion of severely restricted joints because of agonist muscle pain or weakness, indirect approaches can be useful in clinical practice. Indirect approaches often use a resistive static contraction of the pelvic anterior elevators（RSCAE）as descending effects or a contralateral resistive static contraction（CRSC）as Cross-education. The purpose of this study was compare the neurophysiological remote effect and after-effects of right RSCAE and CRSC with different degrees of load on the unexercised soleus H-reflex. Ordering effects were controlled for by randomizing the order of the resistive static contraction（RSCAE and CRSC）with different degrees of load［light（10%）or heavy（30%）］ for each of the 16 normal subjects. The right soleus H-reflex was measured at rest（condition-BE）, during resistive static contraction phase（condition-DE）, and rest phase after resistive static contraction（condition-AE）. Each H-reflex amplitude was normalized to the corresponding maximum M-waves（Mmax）and H-reflexes, which was expressed as the ratio of H/Mmax. The results of four-way analysis of variance showed　significant interaction between the resistive static contraction and the H/Mmax time course. Post-hoc analysis revealed that CRSC in condition-DE showed significantly greater effects on H-reflex than RSCAE in conditionDE. However, inhibitory effects occurred as remote after-effects in condition-AE compared to those in both CRSC and RSCAE in condition-BE. These results indicated that CRSC induced contralateral effects act as Cross-education on the soleus H-reflex, which initially caused a reflexive facilitation during CRSC followed by a gradual inhibition after CRSC.

Key words: soleus H-reflex, degrees of load, resistive exercise, cross-education, descending remote effects

【The Original】 page 13-16

Remote after-effects of resistive static contractions of the lower trunk depressors on strength of the plantar flexor muscle after ankle fracture

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

Ide Natsuki, Masumoto Kazue

Abstract: Previous studies have shown that application of resistive static contraction with manual resistance using proprioceptive neuromuscular facilitation in mid-range pelvic posterior depression（RSCPD）improves temporary loss of functioning motor units. The purpose of this study was to investigate the after-effects of RSCPD on the strength of the plantar flexor muscle compared with static stretch（SS）of the plantar flexor after ankle fracture. The subjects were 5 patients with ankle fractures（2 men and 3 women, mean（SD）45.8（72.8）years）who underwent RSCPD and SS in a random order. The mean percentage changes of the maximal ankle plantar flexors（SD）were 4.60（13.66）% after RSCPD and -6.60（8.73）% after SS. Two-way ANOVA showed a significant difference between the techniques based on the percentage improvement in the strength of the plantar flexor muscle（F（1, 56）=22.53, p =0.01）. RSCPD showed a significant improvement compared to SS in patients with ankle fracture, which suggests a remote after-effect on impairment of the ability to activate motor units.

Key words: PNF, ankle fracture, pelvic posterior depression, static contraction

【The Original】 page 17-21

The after-effects of resistive static contraction facilitation technique using Proprioceptive Neuromuscular Facilitation in the middle range of pelvic motion on the improvement of time to ascend stairs in orthopedic patients

Tanaka Toshiyuki, Arai Mitsuo, Sakino Yugo, Shiratani Tomoko

Abstract: The purpose of this study was to determine the after-effects of resistive static contractions of pelvic anterior elevation （SCAE）and pelvic posterior depression（SCPD）using proprioceptive neuromuscular facilitation（PNF）in the middle range of pelvic motion on the time to ascend stairs in orthopedic patients. The subjects were 13 patients（mean（SD） age, 64.3（22.3）years）with various levels of motor impairment who were randomly assigned to the SCPD, SCAE, or control groups. Effects were examined within 1 hour. The participants stood one foot from the bottom of a 12-step flight of stairs. They were instructed to walk as quickly as possible（but not to run）and to take one step at a time. In this procedure, a significant difference was found between each procedure and the control. In a multiple comparison test, SCAE and SCPD both significantly reduced the ascending time compared with the control, and subjects had less pain after SCPD compared to SCAE. These results suggest that the procedures may have influenced the extension phase of the lower limbs, as in hemiplegic patients after stroke, and that SCPD may have an immediate after-effect for improving the time to ascend stairs in orthopedic patients.

Key words: Orthopedic patients, Static contraction, Speed of ascending stairs, Mobilization PNF

【Research and Report】 page 22-27

The effect of resistive static contraction of PNF scapular pattern on the improvement ROM of restricted ankle dorsiflexion

Sakino Yugo, Shiratani Tomoko, Arai Mitsuo, Harada Yasuhiro,

Ueda Ryo

Abstract: The purpose of this study was to determine the after-effects of resistive static contraction of scapular posterior depression（SCPD）and scapular anterior elevation（SCAE）using proprioceptive neuromuscular facilitation（PNF） in the mid-range of scapular motion or sustained stretch（SS）on restricted ankle dorsiflexion and subjective fatigue in elderly patients. SCPD, SCAE and SS were performed in a random order for 14 subjects with 9 orthopedic diseases and 5 central nervous system diseases（average age（SD）, 81.7（7.6）years）as outpatient rehabilitation. Significant differences among the techniques were found in two-way ANOVA. Ankle dorsiflexion AROM significantly increased after SCPD and SCAE compared with SS in multiple comparison（P<0.05）. Subjective fatigue did not show any significant differences. SCPD and SCAE increased ankle dorsiflexion AROM over time to a greater extent than SS. Therefore, these results suggest that SCPD and SCAE have indirect effects on AROM without affecting fatigue.

Key words: Ankle dorsiflexion, Scapular posterior depression, Scapular anterior elevation, Static Contraction, Mobilization PNF

【Research and Report】 page 28-32

Effect of resistive static contraction of the upper and lower trunk muscles on lumbar pain and knee extension range of motion in patients with an osteoporotic lumbar vertebral body compression fracture

Murasaki Yukiko, Shiratani Tomoko, Arai Mitsuo

Abstract: Vertebral body compression fractures（VCFs）can cause chronic pain and new techniques are needed for reducing acute pain. The purpose of this study was to determine the after-effects of 10-second static contraction of muscles in scapular posterior depression（S-SCPD）and pelvic posterior depression（P-SCPD）in the middle range of motion using proprioceptive neuromuscular facilitation in patients with an osteoporotic lumbar VCF. Three subjects of mean（SD） age 74.7（5.5）years were randomly given P-SCPD or S-SCPD using a sustained contraction facilitation technique in the middle range of motion on the unaffected pelvic side, and static contraction of the knee extensors（KE）. One-way ANOVA showed a significant difference between the exercises based on the percentage improvement in active range of motion（AROM）, grasp power, and visual analogue scale （VAS）pain score. A Scheffé post hoc test showed that P-SCPD resulted in significant improvements compared with KE（P < 0.05）. This suggests that P-SCPD may show immediate after-effects for reducing acute lumbar pain in patients with an osteoporotic lumbar VCF.

Key words: lumbar compression fracture, mobilization PNF, pain, range of motion