Comparison of different neuromuscular facilitation techniques and conventional physiotherapy in knee osteoarthritis

Comparison of different neuromuscular facilitation techniques and conventional physiotherapy in knee osteoarthritis

Background/aim: This study was conducted to compare the effects of conventional physiotherapy and two different ‘proprioceptive neuromuscular facilitation’ (PNF) techniques on knee muscle strength, knee muscular endurance, and proprioception in knee osteoarthritis (KOA). Materials and methods: The study included 35 patients between the ages of 47 and 62 who were diagnosed with stage 1-2 KOA. The patients were divided into three groups with block randomization method as Repeated Stretching Group (N = 12) With Repeated Stretching Technique, Combined Isotonic Contraction Group (N = 11) With Combined Isotonic Contractions (CIC) Technique, And Conventional Physiotherapy Group (n = 12). PNF was applied to all patterns of the lower extremity in full pattern and patients in all groups were treated for 6 weeks, 3 days a week. Muscle strength, muscle endurance, and proprioception were evaluated with Biodex System Pro3 (Biodex Corp. Shirley NY, USA). Results: Knee extensor muscle strength showed more improvement at CIC group than the other groups, and CIC group showed more improvement compared to the conventional physiotherapy in terms of knee joint position sensation evaluated at 60° (p < 0.05). Conclusion: All methods were effective in patients with early-stage knee osteoarthritis; however, the most effective results were obtained by PNF using CIC technique.Key words: Osteoarthritis, knee, exercise, proprioception

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  • 1. Adler SS, Beckers D, Buck M. PNF in practice: an illustrated guide. Berlin, Germany: Springer; 2007.
  • 2. Livanelioğlu A, Erden Z, Günel MK. Proprioseptif Nöromusküler Fasilitasyon Teknikleri. 6 ed. Ankara: Hipokrat Kitabevi; 2018.
  • 3. Shrestha Y. A systematic literature review on the use of proprioceptive neuromuscular facilitation in neuromuscular rehabilitation. MsC, Satakunta University, Finland, 2013.
  • 4. Gul S, Khan DA, Rahman MU. Effectiveness of Proprioceptive Neuromuscular Facilitation versus Conventional Therapeutic Exercises in Knee Osteoarthritis. Annals of Allied Health Sciences. 2015;1(1):16-19.doi: 10.1016/j.isjp.2020.09.002
  • 5. Kofotolis N, Kellis E. Effects of two 4-week proprioceptive neuromuscular facilitation programs on muscle endurance, flexibility, and functional performance in women with chronic low back pain. Physical Therapy. 2006;86(7):1001-1012.doi: 10.1093/ptj/86.7.1001
  • 6. Westwater-Wood S, Adams N, Kerry R. The use of proprioceptive neuromuscular facilitation in physiotherapy practice. Physical Therapy Reviews. 2010;15(1):23-28.doi: 10. 1179/174328810X12647087218677
  • 7. Takasaki H, Okubo Y, Okuyama S. The Effect of Proprioceptive Neuromuscular Facilitation on Joint Position Sense: A Systematic Review. Journal of Sport Rehabilitation. 2019;1:1- 10.doi: 10.1123/jsr.2018-0498
  • 8. Pocock SJ. Clinical trials: a practical approach. West Sussex, England: John Wiley & Sons; 2013.
  • 9. Davies GJ, Durall CJ, Matheson JW, Wilder P. Isokinetic testing and exercise. In: Placzek JD, Boyce DA, editors. Orthopaedic Physical Theraphy Secrets. 2 ed. Philadelphia, PA, USA: Elsevier; 2006. p. 284-292.
  • 10. Erden Z, Otman S, Atılla B, Tunay VB. Relationship between pain intensity and knee joint position sense in patients with severe osteoarthritis. The Pain Clinic. 2003;15(3):293-297.doi: 10.1163/156856903767650826
  • 11. Park J-Y, Lee J-C, Bae J-J, Cheon M-W. The effect of proprioceptive exercise on knee active articular position sense using Biodex System 3pro®. Transactions on Electrical and Electronic Materials. 2014;15(3):170-173.doi: 10.4313/ TEEM.2014.15.3.170
  • 12. Taş S, Erden Z, Bek N. Diz Osteoartritli Hastalarda Farklı Esnek Bant Uygulamalarının Ağrı, İzokinetik Kas Kuvveti, Eklem Pozisyon Hissi ve Fiziksel Performans Üzerine Anlık Etkileri: Plasebo Kontrollü, Çift-Kör Çapraz Çalışma. Turkiye Klinikleri Sağlık Bilimleri Dergisi. 2016;1(1):16-23.doi: 10.5336/healthsci.2015-44437
  • 13. Cesário DF, Mendes GBdS, Uchôa ÉPBL, Veiga PHA. Proprioceptive neuromuscular facilitation and strength training to gain muscle strength in elderly women. Revista Brasileira de Geriatria e Gerontologia. 2014;17:67-77.doi: 10.1590/s1809-98232014000100008
  • 14. de Andrade Mesquita LS, de Carvalho FT, de Andrade Freire LS, Neto OP, Zângaro RA. Effects of two exercise protocols on postural balance of elderly women: a randomized controlled trial. BioMed Central Geriatrics. 2015;15(1):1-9.doi: 10.1186/ s12877-015-0059-3
  • 15. Soundarya N. A comparative study on the effectiveness of PNF stretching versus static stretching on Pain and Hamstring flexibility in osteoarthritis knee patients. International Journal of Research in Pharmaceutical Sciences. 2019;10(3):1789-1794. doi:10.26452/ijrps.v10i3.1312
  • 16. Jung DK, Chung Y. The effect of hip joint strengthening exercise using proprioceptive neuromuscular facilitation on balance, sit to stand and walking ability in a person with traumatic brain injury: a case report. Physical Therapy Rehabilitation Science. 2017;6(2):96-104.doi: 10.14474/ptrs.2017.6.2.96
  • 17. Harput G. Kuvvet Eğitim Yaklaşımları. In: Tunay VB, Erden Z, Yıldız C, editors. Alt Ekstremite Yaralanmalarında Rehabilitasyon. 1 ed. Ankara: Hipokrat Yayınevi; 2017. p. 577- 588.
  • 18. Ünlü G, Çevikol C, Melekoglu T. Comparison of the Effects of Eccentric, Concentric, and Eccentric-Concentric Isotonic Resistance Training at Two Velocities on Strength and Muscle Hypertrophy. The Journal of Strength & Conditioning Research. 2020;34(2):337-344.doi: 10.1519/JSC.0000000000003086
  • 19. Roig M, O’Brien K, Kirk G, Murray R, McKinnon Pet al. The effects of eccentric versus concentric resistance training on muscle strength and mass in healthy adults: a systematic review with meta-analysis. British Journal of Sports Medicine. 2009;43(8):556-568.doi: 10.1136/bjsm.2008.051417
  • 20. Dursun E. Diz ekleminde osteoartriti olan hastalarda egzersiz programının etkinliği. MsC, Hacettepe Üniversitesi, Ankara, Türkiye, 2007.
  • 21. Cesário DF, Mendes GBdS, Uchôa ÉPBL, Veiga PHA. Proprioceptive neuromuscular facilitation and strength training to gain muscle strength in elderly women. Revista Brasileira de Geriatria e Gerontologia. 2014;17(1):67-77.doi: 10.1590/S1809-98232014000100008
  • 22. Lazarou L, Kofotolis N, Malliou P, Kellis E. Effects of two proprioceptive training programs on joint position sense, strength, activation and recurrent injuries after ankle sprains. Isokinetics and Exercise Science. 2017;25(4):289-300.doi: 10.3233/IES-171146
  • 23. Higgs F, Winter SL. The effect of a four-week proprioceptive neuromuscular facilitation stretching program on isokinetic torque production. Journal of Strength and Conditioning Research 2009;23(5):1442-1447.doi: 10.1519/ JSC.0b013e3181a392c4
  • 24. Rhyu H-S, Kim S-H, Park H-S. The effects of band exercise using proprioceptive neuromuscular facilitation on muscular strength in lower extremity. Journal of Exercise Rehabilitation. 2015;11(1):36-40.doi: 10.12965/jer.150189
  • 25. Ferber R, Osternig L, Gravelle D. Effect of PNF stretch techniques on knee flexor muscle EMG activity in older adults. Journal of Electromyography and Kinesiology. 2002;12(5):391- 397.doi: 10.1016/s1050-6411(02)00047-0
  • 26. Pereira MP, Gonçalves M. Proprioceptive neuromuscular facilitation improves balance and knee extensors strength of older fallers. International Scholarly Research Network Rehabilitation. 2012;2012.doi:10.5402/2012/402612
  • 27. Baert IA, Mahmoudian A, Nieuwenhuys A, Jonkers I, Staes Fet al. Proprioceptive accuracy in women with early and established knee osteoarthritis and its relation to functional ability, postural control, and muscle strength. Clinical Rheumatology. 2013;32(9):1365-1374.doi: 10.1007/s10067- 013-2285-4
  • 28. Kofotolis N, Vrabas I, Vamvakoudis E, Papanikolaou A, Mandroukas K. Proprioceptive neuromuscular facilitation training induced alterations in muscle fibre type and cross sectional area. British Journal of Sports Medicine. 2005;39(3):e11.doi: 10.1136/bjsm.2004.010124
  • 29. Vincent KR, Vincent HK. Resistance exercise for knee osteoarthritis. The Journal of Injury, Function and Rehabilitation. 2012;4(5):S45-S52.doi: 10.1016/j. pmrj.2012.01.019
  • 30. Knoop J, Steultjens M, Van der Leeden M, Van der Esch M, Thorstensson Cet al. Proprioception in knee osteoarthritis: a narrative review. Osteoarthritis and Cartilage. 2011;19(4):381- 388.doi: 10.1016/j.joca.2011.01.003
  • 31. Hortobágyi T, Garry J, Holbert D, Devita P. Aberrations in the control of quadriceps muscle force in patients with knee osteoarthritis. Arthritis Care & Research. 2004;51(4):562-569. doi: 10.1002/art.20545
  • 32. Erduran M, Akseki D, Karaoğlan O, Pınar H. Gonartrozlu hastalarda patellofemoral eklem dinamiği. Eklem Hastalıkları ve Cerrahisi Dergisi. 2009;20(1):18-24
Turkish Journal of Medical Sciences-Cover
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  • Yayın Aralığı: Yılda 6 Sayı
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