Cross Training Effect Of Pnf Health Essay
Cross Training Effect Of Pnf Health Essay
Among all the neurologic diseases of grownup life, the cerebrovascular 1s clearly rank foremost in frequence and importance. At least 50 per centum of the neurologic upsets in a general infirmary are of this type.
The term shot is applied to a sudden focal neurologic syndrome, specifically the type due to cerebrovascular disease. The term cerebrovascular disease designates any abnormalcy of the encephalon ensuing from a diseased procedure of the blood vass. Pathologic procedure is given an inclusive significance viz. , occlusion of the lms by embolus or thrombus, rupture of a vas, an altered permeableness of the vas wall, or increased viscousness or other alteration in the quality of the blood fluxing through the intellectual vass. Cross Training Effect Of Pnf Health Essay.
The neurologic shortage reflects both the location and the size of the infarct or bleeding. Cross Training Effect Of Pnf Health Essay. Hemiplegia stands as the authoritative mark of all cerebrovascular diseases, whether in the cerebral hemisphere or brain-stem, but there are many other manifestations, happening in big but extremely recognizable combinations. ( Allen and Robert, 2005 )
Voluntary motion control is typically impaired after a shot. Stroke by and large induces negative effects to life along with damages and the neurological symptoms after the damaged intellectual arteria chiefly causes the harm to one cerebral hemisphere and to the organic structure and limbs in the other side.
In the upper appendage, after a period of flabbiness, a common class of recovery includes the development of an uncontrolled flexure synergism. This pathological synergism is observed in the hemiparetic limb during attempts to utilize the arm for functional undertakings. ( Stein, 1998 )
”Hemiparesis ” is a corporate term that lumps together the positive and negative motor symptoms that occur after shot. It can be ventured that most brain doctors, despite frequent usage of the term ”hemiparesis, ” have small involvement in the physiological mechanisms of the paretic shortage. This is reflected in a penchant for nominal and ordinal disablement and quality- of-life graduated tables in clinical tests instead than physiological measurings of damage. ( Krakauer, 2005 ) Up to 85 % of shot patients show an initial shortage in the upper limb, and the recovery of the upper-limb map is frequently hapless and merely seen in less than half of the patients.
Badness of arm paresis in the first month after shot remains the strongest forecaster of result and likely reflects the grade of harm done to cortical motor countries and the corticospinal piece of land. It is to be hoped that the impact of initial badness can be lessened with new rehabilitation techniques in the first 6 months post shot. Cortical and subcortical shots may necessitate different rehabilitative attacks. Finally, it is now known that chronic shot patients ( & gt ; 6 months ) respond to rehabilitation, and so it is imaginable that the patients who do non demo important responses by 6 months may necessitate more drawn-out periods of rehabilitation. ( Kwakkel et al, 2003 ) Cross Training Effect Of Pnf Health Essay.
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Of all damages that result from shot, possibly the most serious and most in demand of rehabilitation effectivity surveies is hemiparesis of the upper limb. Population-based statistics indicate that between 73 % and 88 % of first-time shots ( infarctions merely ) consequence in an acute hemiparesis of the upper and/or lower limbs. ( Foulkes et al, 1988 ; Duncan et Al, 1994 ) The upper limbs are of particular concern because the impact of upper-extremity damages on disablement and wellness is so pronounced, merely limited attending has been given to upper-extremity rehabilitation after shot, and functional recovery of the arm and manus are by and large limited compared with that for the lower appendages. ( Wade et Al, 1983 ; Nakayama et Al, 1994 )
In the intercessions of physical therapy, functional recovery is the top precedence intent. The study consequences on the symptoms following the harm including inability to utilize the custodies musculus failing, decrease of the sensory-motor map, hypertonicity, decrease of the coordination and many others ( Swinnen et al, 2002 ) .
The rehabilitation of the upper limb is a challenge. Many curative attacks are presently available. However, considerable contention exists about their effectivity. Controlled surveies designed to compare neurophysiological intervention attacks, such as proprioceptive neuromuscular facilitation, neurodevelopmental intervention, and the Brunnstrom technique with conventional intervention, failed to observe any differences in general result ( Dickstein et al, 1986 ; Lord & A ; Hall, 1986 ; Wagenaar et Al, 1990 ) and in upper limb map. ( Logigian et Al, 1983 ; Basmajian et Al, 1987 ) Although no curative advantage could be demonstrated for one attack over another, decisions should be carefully interpreted in the visible radiation of some methodological defects.
Proprioceptive neuromuscular facilitation ( PNF ) is a curative exercising method introduced by Dr. Herman Kabat in 1940s, which recognizes and embodies the mass motion based on neurophysiological land such as Sherrington ‘s mutual nervus excitations and suppression every bit good as advancement of irradiation, and the features of coiling and diagonal forms ( Moon et al, 2010 ) . Cross Training Effect Of Pnf Health Essay.
Exercise flood is by and large defined as the consequence of exercising in one country of the organic structure on the musculus activity in another country of the organic structure. This response can be seen as increased facilitation ( contraction ) or suppression ( relaxation ) in the interactive musculuss and forms of motion. The response increases as the stimuli addition in strength or continuance ( Sherrington 1947 ) . Kabat ( 1961 ) wrote that it is opposition to gesture that produces irradiation, and the spread of the muscular activity will happen in specific forms. ( susan alder, 2008 ) .
This irradiated exercising flood is sometimes used as a curative technique by physical or occupational healers concerned with the rehabilitation of patients with motor shortages ensuing from a cerebrovascular accident ( CVA ) . The principle for the application of this technique in rehabilitation has been mostly based on positive consequences which were found with healthy topics. ( Panin et al, 1961 ; Podivinsky, 1964 ; Hellebrandt et Al. 1962 ; Wellock et Al, 1958 )
The literature has revealed two possible accounts for forms of contralateral effects. One theory is based on the flood of urges from the musculuss that are straight being exercised. The urges are thought to be directed to musculuss matching to the agonists or adversaries of the limb undergoing resisted exercising. The other theory is based on biomechanics: the effects are due to stabilisation of the contralateral side when opposition is applied to the exercised limb.
Most exercising flood surveies have demonstrated additions in strength in either the upper or lower appendage through resistive exercising of the contralateral homologous appendage. Studies affecting EMG monitoring of all four appendages have shown that the effects of exercising flood that vary straight with the strength of the exercising. They are widespread over the organic structure addition with musculus weariness, and most apparent in musculuss used to stabilise the organic structure.
A survey of Davis ( 1942 ) found the association of voluntary active motion in one appendage with muscular activity in all four limbs. Panin et Al ( 1961 ) found that when we exercise an upper or lower appendage, widespread activity occurs throughout the organic structure affecting ipsilateral and contralateral musculuss in the upper and lower appendages.
The qualitative analysis of EMG overflow consequences of eight patients with CVAs studied by Russell indicated an evident addition in electrical activity in the flexor musculus groups of the affected nonexercised upper appendage. This activity occurred when either flexure or extension proprioceptive neuromuscular facilitation exercisings of the uninvolved appendage were performed. These consequences may propose that overflow effects in patients with CVAs could happen in musculuss associated with strong interactive motion forms and he besides suggested for farther probe in this respect.
There are many surveies explains the form of flood in hemiplegic patients, but none utilised this technique to happen out the effectivity in shot patients. Cross Training Effect Of Pnf Health Essay. Thus the intent of the survey is to happen out the effectivity of proprioceptive neuromuscular facilitation induced irradiation technique on contra sidelong hemiplegic upper appendage recovery in topics with acute shot.
Need FOR THE STUDY
Though upper limb rehabilitation is a ambitious portion in shot, it ‘s really of import to recover the upper limb map to transport out maximal independence in activities of day-to-day life. Among assorted facilitation techniques, proprioceptive neuromuscular rehabilitation technique has been proved its capacity to ease and bring forth electrical activity in the peretic limb by executing exercising to the unaffected limb. There are many surveies explains the form of flood in hemiplegic patients, but none utilised this technique to happen out the effectivity in shot patients. Finding out the effectivity of this PNF induced irradiation technique will assist us to border a good protocol for speed uping the upper limb recovery procedure and this can be used for regular clinical pattern.
STATEMENT OF THE PROBLEM
A survey to analyze the effectivity of proprioceptive neuromuscular facilitation induced irradiation technique on contra sidelong hemiplegic upper appendage recovery in topics with acute shot.
1.3 Cardinal Wordss:
Stroke
Upper limb
Proprioceptive neuromuscular facilitation
Irradiation
Cross preparation
1.4 OBJECTIVES OF THE STUDY
To measure the upper appendage motor recovery of patients with acute shot.
Use of
PNF induced irradiation technique to patients with acute shot and analysing the result.
Conventional therapy preparation to patients with acute shot and analysing the result.
Analyzing of effectivity of PNF induced irradiation technique in the betterment of upper appendage motor recovery in patients with acute shot.
1.5 HYPOTHESES
1.5.1 NULL HYPOTHESIS
There is no important betterment in upper limb voluntary control and motor recovery in capable with acute shot when treated with PNF induced irradiation technique.
1.5.2 ALTERNATE HYPOTHESIS
There is a important betterment in upper limb voluntary control and motor recovery in capable with acute shot when treated with PNF induced irradiation technique. Cross Training Effect Of Pnf Health Essay.
Abstract
[Purpose] The purpose of this study was to determine the effects of proprioceptive neuromuscular facilitation integration pattern (PIP) and Swiss ball training on balance and pain in elderly patients with chronic low back pain. [Subjects] Participants were randomly assigned to a PIP training (n=24) and a Swiss ball training group (n=24). [Methods] The training was performed for 30 minutes per day, three times a week for 6 weeks. Outcome measures included the mean velocity in the X and Y directions using the Good Balance System®, functional reach test, timed up and go test, and visual analogue scale.Cross Training Effect Of Pnf Health Essay. [Results] After completion of training, mean velocity in the X and Y direction, and the functional reach test, timed up and go test, and visual analogue scale results showed statistically significant improvements in the PIP and Swiss ball training groups. However, there was no significant difference in the functional reach test, timed up and go test, and visual analogue scale results between the two groups. [Conclusion] This study indicated that PIP training improved the balance ability of elderly patients with chronic low back pain.
Bed rest; treatment using heat, ultrasound, electrical simulation, or traction; joint mobilization; manipulation; massage; and exercise therapy can be used as conservative treatment for back pain2). However, passive treatments have been used less frequently in recent years. Instead, exercise treatment, which is an active treatment, has become a mainstream therapy for promoting early recovery and preventing recurrence or slowing progress toward chronic pain3).
Most treatments for back pain in elderly individuals are based on the use of medications such as analgesics, anti-inflammatories, and muscle relaxants to relieve pain. Considering that the major cause of back pain is an imbalance of posture and muscles, such drug treatments may be helpful to temporarily relieve pain, but an exercise program that can help to correct posture in daily living should also be utilized for ultimate back pain management4).
Balance is the ability to maintain the line of gravity within the base of support of the body weight, and can be divided into static and dynamic balance5). Static balance refers to the ability to stand without postural sway on a fixed surface6). Balance ability is affected by various factors, including age, gender, cognition ability, musculoskeletal disorders, sensory disturbances, and muscle tone. A reduction in balance ability restricts the range of daily activities that patients can perform and increases the risk of falling7). Cross Training Effect Of Pnf Health Essay.
A proprioceptive neuromuscular facilitation integration pattern (PIP) is a proprioceptive neuromuscular facilitation (PNF)-applied cross training program that stimulates the proprioceptors in the muscles and tendons to improve their functions, as well as muscle activity, flexibility, and stability8). If various patterns are applied simultaneously, more force can be used, thereby affecting muscle strength and stability further. Dietz proposed gait analysis and treatment by integrating individual patterns of PNF into the exercise pattern and motions occurring during the gait period9). PIP improves trunk stability and the proprioceptive senses of the limbs; moreover, it can improve static balance when it is applied for normal healthy persons10). This study aimed to determine the effect of a PIP exercise program on pain relief and improvement in the balance ability of elderly persons with chronic back pain, as well as its applicability as a clinical therapeutic exercise program.
SUBJECTS AND METHODS
The subjects of this study were 48 elderly persons with chronic back pain who were admitted to an aged care hospital in G City. It was approved by the hospital, and all the participants provided written informed consent. The 48 subjects were randomly assigned to the PIP and Swiss ball training groups. The selection criteria were as follows: back pain for six months or longer, no back pain-related diseases or complications, no serious cardiopulmonary problems, and ability to exercise for 30 min or longer and walk 30 m or more without assistance. Table 1 summarizes the general characteristics of the study subjects who participated in the present research.
Table 1.
| PIP group (n=24) | Swiss ball group (n=24) | ||||
|---|---|---|---|---|---|
|
|
|
||||
| Pre-test | Post-test | Pre-test | Post-test | ||
| NSEO | X axis (mm/s) | 7.65 (1.63) | 6.14 (1.44)*† | 9.28 (2.60) | 8.30 (2.49)* |
| Y axis (mm/s) | 9.56 (3.00) | 7.82 (3.10)* | 9.87 (1.74) | 8.47 (2.79)* | |
| Velocity moment (mm2/s) | 18.57 (6.75) | 15.77 (6.57)* | 27.30 (16.02) | 26.43 (17.53) | |
| NSEC | X axis (mm/s) | 8.77 (1.92) | 6.83 (1.54)* | 11.53 (3.30) | 10.67 (4.28) |
| Y axis (mm/s) | 12.57 (2.84) | 10.50 (2.18)*† | 16.40 (5.27) | 15.42 (5.42)* | |
| Velocity moment (mm2/s) | 39.17 (24.33) | 34.28 (22.32)*† | 49.77 (24.60) | 47.84 (24.85) | |
| SSEO | X axis (mm/s) | 13.33 (4.31) | 10.35 (3.50)* | 16.47 (5.62) | 13.87 (6.94)* |
| Y axis (mm/s) | 16.26 (6.03) | 13.57 (5.45)* | 15.38 (4.83) | 13.51 (5.00)* | |
| Velocity moment (mm2/s) | 57.80 (26.22) | 50.30 (24.46)*† | 63.02 (25.83) | 59.63 (26.42) | |
| SSEC | X axis (mm/s) | 23.78 (7.13) | 18.78 (5.50)*† | 31.54 (9.63) | 28.45 (9.51)* |
| Y axis (mm/s) | 25.80 (9.10) | 21.48 (8.95)*† | 33.24 (12.28) | 30.64 (12.52)* | |
| Velocity moment (mm2/s) | 152.94 (92.40) | 139.18 (85.81)*† | 148.82 (67.35) | 146.59 (68.63) | |
| Functional reaching test (cm) | 21.97 (4.97) | 23.76 (5.21)* | 24.93 (7.05) | 27.18 (6.90)* | |
| Timed up and go test (s) | 21.49 (8.93) | 18.60 (7.43)* | 21.82 (8.21) | 20.15 (8.70)* | |
| Visual analogue scale | 4.30 (1.26) | 3.48 (1.12)* | 4.00 (1.38) | 3.40 (1.26)* | |
aMeans (SD), *Significant difference within group, †Significant difference between group. PIP: proprioceptive neuromuscular facilitation integration pattern, NSEO: normal standing eyes open, NSEC: normal standing eyes closed, SSEO: semi-tandem standing eyes open, SSEC: semi-tandem standing eyes closed.
Subjects in the PIP training group were given pattern and return pattern training prior to the experiment by a specialized therapist who understood the integration pattern well. Cross Training Effect Of Pnf Health Essay. The Swiss ball exercise group carried out balance training on a Swiss ball. The sessions were 50 min long and were held three times a week for 6 weeks.
For static balance ability, the Good Balance System® (Metitur Oy, Palokka, Finland, 2003) was employed. Indexes that can represent static balance ability such as a shift in the center of pressure (COP) in the anterior-posterior direction, a shift of COP in the medial-lateral direction, and shift in the path of COP, were used to measure postural sway.
For the dynamic balance test, the functional reach test (FRT) and timed up and go (TUG) test were conducted. The FRT can measure an individual’s balance and flexibility while performing tasks11). Meanwhile, the TUG test measures the time it takes for an individual to rise from sitting in a standard arm chair, walk 3 m, turn, walk back to the chair, and sit down12). The visual analogue scale (VAS) was used to measure pain.
The data collected in this study were analyzed using SPSS statistical program for Windows version 18.0. A paired t-test was used to measure balance significance within groups, and analysis of covariance (ANCOVA) was used for comparison between groups. The level of statistical significance, α, was set at 0.05.
RESULTS
The results before and after the intervention are summarized in Table 1. In the normal standing eyes open (NSEO) posture, the PIP training group exhibited differences in mean velocity along the X and Y axes and velocity moment (p<0.05). Meanwhile, the Swiss ball training group demonstrated a difference in mean velocity along the X and Y axes (p<0.05). In the normal standing eyes closed (NSEC) posture, the PIP training group exhibited differences in mean velocity along the X and Y axes and velocity moment (p<0.05), while the Swiss ball training group showed a difference in mean velocity along the Y axis (p<0.05). In the semi-tandem standing eyes open (SSEO) posture, the PIP training group demonstrated differences in mean velocity along the X and Y axes and velocity moment (p<0.05). Furthermore, the Swiss ball training group exhibited a difference in mean velocity along the X and Y-axes (p<0.05). Cross Training Effect Of Pnf Health Essay. In the semi-tandem standing eyes closed (SSEC) posture, the PIP training group demonstrated differences in mean velocity along the X and Y axes and velocity moment (p<0.05), while the Swiss ball group exhibited a difference in mean velocity along the X and Y axes (p<0.05).
There were significant differences in the FRT, TUG, and VAS results before and after the PIP and Swiss ball exercises in both groups (p<0.05). A comparison within groups showed that there were significant differences in mean velocity along the X axis in the NSEO posture, mean velocity along the Y axis in the NSEC posture, velocity moment in the SSEO posture, and mean velocity along the X and Y axes and velocity moment in the SSEC posture (p<0.05).
DISCUSSION
After 6 weeks of PIP and Swiss ball exercise treatment for elderly patients with chronic back pain, improvements in balance ability and reduction in pain were achieved. In a study on the application of a PNF integration pattern to stroke patients13), 18 training sessions were conducted over 6 weeks. The results indicated a greater improvement in static and dynamic balance after PNF integration pattern exercises than after general exercise treatment. A study on 18 applications of a sprinter pattern lasting 30 min in patients with hemiplegia showed that a course of sprinter pattern exercise improved balance ability significantly more than in the control group, which carried out general exercise treatment14). A study on back muscle strengthening training for 12 weeks also showed that the experimental group experienced a reduction in pain and the Oswestry Disability Index, as well as an increase in back muscle strength, in comparison to the control group15). A study on PIP training and Swiss ball training applied to 40 patients with chronic back pain showed that the PIP training group experienced reduced pain and improved muscle activities to a greater extent than the Swiss ball training group16). A study comparing PNF training and a trunk exercise program for chronic back pain patients showed that both groups improved in terms of balance ability, but the PNF group improved significantly more than the trunk exercise group.Cross Training Effect Of Pnf Health Essay.
For the Swiss ball exercise group, the FRT results were 24.93±7.05 cm and 27.18±6.90 cm before and after the exercise program, respectively, while for the PIP training group, the FRT results were 21.97±4.97 cm and 23.76±5.21 cm before and after the exercise. This indicates that both groups exhibited a significant difference in increases in distance, but no significant difference was shown between groups. A study on elderly persons divided into a PNF lower extremity pattern group and a control group for 4 weeks showed that the PNF group had a significantly higher FRT result, indicating that balance training using muscle strength enhancement was more effective in this group than in the control group, which is consistent with the present study result17).
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In the comparison of TUG results, the PIP and Swiss ball exercise groups exhibited a significant difference in reduced TUG time before and after the exercise, but no significant difference between groups was observed. In a study using TUG in stroke patients divided into trunk stabilization and general balance exercise groups, both groups exhibited a significant difference before and after the exercise program, but no significant difference between groups was found18). However, it reported that stroke patients’ time to stand and walk was reduced significantly, thereby improving their dynamic balance ability. Geiger and Allen19) reported that the TUG result reduced from 23.08±13.7 sec before the exercise to 14.62±11.18 sec after the exercise, which was consistent with the present study result. A study by Song et al.20) reported that PIP training improved gait velocity in elderly persons who experienced a fall, and improved fall efficacy, indicating a positive effect of PIP training on these parameters.
The PIP and Swiss ball exercise group exhibited a significant reduction in the VAS score from before to after the exercise, but no significant difference between groups was observed. Based on the above results, PIP can induce significant improvements in balance ability and pain for elderly persons with chronic back pain.
In this study, psychological and physiological factors that can affect balance ability and pain, as well as daily activities, could not be controlled for completely, and within-subject factors that can influence balance ability and pain cannot be completely excluded. Thus, it is a limitation of this study that the results cannot be generalized to all elderly patients with chronic back pain. Nevertheless, the present findings showed that PIP training as a self-exercise program can provide foundational data for clinical use in both self-exercise programs and group exercise programs.
Cross Training Effect Of Pnf Health Essay
