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Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke

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Advances in Pulmonary Medicine: Research and Innovations

Part of the book series: Advances in Experimental Medicine and Biology ((NR,volume 1160))

Abstract

This study focused on how pulmonary function is affected by proprioceptive neuromuscular facilitation (PNF) of accessory respiratory muscles in the chronic post-stroke phase. The study involved patients who had had ischemic stroke 6 months or more before the PNF treatment investigated. The objective was to define the effect of PNF on bioelectrical resting and maximum activity of the accessory muscles. Patients were randomly assigned to PNF treatment and just positioning treatment as a reference for comparison; 30 patients each. Electromyography of accessory muscles was investigated before and after physiotherapeutic treatments. We found that there was a greater reduction in EMG activity in all muscles investigated after PNF compared to positioning treatment alone. A reduction of muscle activity due to PNF concerned both affected and unaffected body side, but it was greater on the affected side. We conclude that a reduction of the accessory respiratory muscle activity due to PNF treatment could be of benefit in chronic stoke patients in that it would help normalize breathing pattern and thereby prevent the development of hypoxia.

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References

  • Andrews AW, Bohannon RW (2000) Distribution of muscle strength impairments following stroke. Clin Rehabil 14(1):79–87

    Article  CAS  Google Scholar 

  • Arya KN, Pandian S, Verma R, Garg RK (2011) Movement therapy induced neural reorganization and motor recovery in stroke: a review. J Bodyw Mov Ther 15(4):528–537

    Article  Google Scholar 

  • Badics E, Wittmann A, Rupp M, Stabauer B, Zifko UA (2002) Systematic muscle building exercises in the rehabilitation of stroke patients. NeuroRehabilitation 17(3):211–214

    CAS  PubMed  Google Scholar 

  • Britto RR, Rezende NR, Marinho KC, Torres JL, Parreira VF, Teixeira-Salmela LF (2011) Inspiratory muscular training in chronic stroke survivors: a randomized controlled trial. Arch Phys Med Rehabil 92(2):184–190

    Article  Google Scholar 

  • Chan DY, Chan CC, Au DK (2006) Motor relearning programme for stroke patients: a randomized controlled trial. Clin Rehabil 20(3):191–200

    Article  Google Scholar 

  • Cohen E, Mier A, Heywood P, Murphy K, Boultbee J, Guz A (1994) Diaphragmatic movement in hemiplegic patients measured by ultrasonography. Thorax 49(9):890–895

    Article  CAS  Google Scholar 

  • CONSORT (2010) The CONSORT 2010 statement. https://www.consort-statement.org/consort-2010. Accessed on 1 Nov 2018

  • de Almeida IC, Clementino AC, Rocha EH, Brandão DC, Dornelas de Andrade A (2011) Effects of hemiplegy on pulmonary function and diaphragmatic dome displacement. Respir Physiol Neurobiol 178(2):196–201

    Article  Google Scholar 

  • Ezeugwu VE, Olaogun M, Mbada CE, Adedoyin R (2013) Comparative lung function performance of stroke survivors and age-matched and sex-matched controls. Physiother Res Int 18(4):212–219

    Article  Google Scholar 

  • Guissard N, Duchateau J (2004) Effect of static stretch training on neural and mechanical properties of the human plantar-flexor muscles. Muscle Nerve 29(2):248–255

    Article  Google Scholar 

  • Hindle KB, Whitcomb TJ, Briggs WO, Hong J (2012) Proprioceptive neuromuscular facilitation (PNF): its mechanisms and effects on range of motion and muscular function. J Hum Kinet 31:105–113

    Article  Google Scholar 

  • Houston JG, Fleet M, Cowan MD, McMillan NC (1995a) Comparison of ultrasound with fluoroscopy in the assessment of suspected hemidiaphragmatic movement abnormality. Clin Radiol 50(2):95–98

    Article  CAS  Google Scholar 

  • Houston JG, Morris AD, Grosset DG, Lees KR, McMillan N, Bone I (1995b) Ultrasonic evaluation of movement of the diaphragm after acute cerebral infarction. J Neurol Neurosurg Psychiatry 58(6):738–741

    Article  CAS  Google Scholar 

  • Howard RS, Rudd AG, Wolfe CD, Williams AJ (2001) Pathophysiological and clinical aspects of breathing after stroke. Postgrad Med J 77(913):700–702

    Article  CAS  Google Scholar 

  • Hwang IS, Tung LC, Yang JF, Chen YC, Yeh CY, Wang CH (2005) Electromyographic analyses of global synkinesis in the paretic upper limb after stroke. Phys Ther 85(8):755–765

    PubMed  Google Scholar 

  • Khedr EM, El Shinawy O, Khedr T, Aziz Ali YA, Awad EM (2000) Assessment of corticodiaphragmatic pathway and pulmonary function in acute ischemic stroke patients. Eur J Neurol 7(5):509–516

    Article  CAS  Google Scholar 

  • Konrad A, Gad M, Tilp M (2015) Effect of PNF stretching training on the properties of human muscle and tendon structures. Scand J Med Sci Sports 25(3):346–355

    Article  CAS  Google Scholar 

  • Laghi F, Tobin MJ (2003) Disorders of the respiratory muscles. Am J Respir Crit Care Med 168(1):10–48

    Article  Google Scholar 

  • Lanini B, Gigliotti F, Coli C, Bianchi R, Pizzi A, Romagnoli I, Grazzini M, Stendardi L, Scano G (2002) Dissociation between respiratory effort and dyspnoea in a subset of patients with stroke. Clin Sci (Lond) 103(5):467–473

    Article  Google Scholar 

  • Lanini B, Bianchi R, Romagnoli I, Coli C, Binazzi B, Gigliotti F, Pizzi A, Grippo A, Scano G (2003) Chest wall kinematics in patients with hemiplegia. Am J Respir Crit Care Med 168(1):109–113

    Article  Google Scholar 

  • Mahoney FI, Barthel D (1965) Functional evaluation: the Barthel index. Md State Med J 14:56–61

    Google Scholar 

  • Merletti R (1999) Standards for Reporting EMG Data. J Electromyogr Kinesiol 9(1):III–IIV

    Google Scholar 

  • Merletti R, Hermens H (2000) Introduction to the special issue on the SENIAM European concerted action. J Electromyogr Kinesiol 10(5):283–286

    Article  CAS  Google Scholar 

  • Merletti R, Botter A, Troiano A, Merlo E, Minetto MA (2009) Technology and instrumentation for detection and conditioning of the surface electromyographic signal: state of the art. Clin Biomech (Bristol, Avon) 24(2):122–134

    Article  Google Scholar 

  • Morris SL, Dodd KJ, Morris ME (2004) Outcomes of progressive resistance strength training following stroke: a systematic review. Clin Rehabil 18(1):27–39

    Article  Google Scholar 

  • Patten C, Condliffe EG, Dairaghi CA, Lum PS (2013) Concurrent neuromechanical and functional gains following upper-extremity power training post-stroke. J Neuroeng Rehabil 10:1

    Article  Google Scholar 

  • Ratnovsky A, Elad D, Halpern P (2008) Mechanics of respiratory muscles. Respir Physiol Neurobiol 163(1–3):82–89

    Article  Google Scholar 

  • Reis Eda F, Pereira GB, de Sousa NM, Tibana RA, Silva MF, Araujo M, Gomes I, Prestes J (2013) Acute effects of proprioceptive neuromuscular facilitation and static stretching on maximal voluntary contraction and muscle electromyographical activity in indoor soccer players. Clin Physiol Funct Imaging 33(6):418–422

    PubMed  Google Scholar 

  • Roh J, Rymer WZ, Perreault EJ, Yoo SB, Beer RF (2013) Alterations in upper limb muscle synergy structure in chronic stroke survivors. J Neurophysiol 109(3):768–781

    Article  Google Scholar 

  • Scillia P, Cappello M, De Troyer A (2004) Determinants of diaphragm motion in unilateral diaphragmatic paralysis. J Appl Physiol 96(1):96–100

    Article  Google Scholar 

  • Sezer N, Ordu NK, Sutbeyaz ST, Koseoglu BF (2004) Cardiopulmonary and metabolic responses to maximum exercise and aerobic capacity in hemiplegic patients. Funct Neurol 19(4):233–238

    PubMed  Google Scholar 

  • Similowski T, Catala M, Rancurel G, Derenne JP (1996) Impairment of central motor conduction to the diaphragm in stroke. Am J Respir Crit Care Med 154(2. Pt 1):436–441

    Article  CAS  Google Scholar 

  • Teixeira-Salmela LF, Parreira VF, Britto RR, Brant TC, Inácio EP, Alcântara TO, Carvalho IF (2005) Respiratory pressures and thoracoabdominal motion in community-dwelling chronic stroke survivors. Arch Phys Med Rehabil 86(10):1974–1978

    Article  Google Scholar 

  • Tomczak CR, Jelani A, Haennel RG, Haykowsky MJ, Welsh R, Manns PJ (2008) Cardiac reserve and pulmonary gas exchange kinetics in patients with stroke. Stroke 39(11):3102–3106

    Article  Google Scholar 

  • Tomich GM, França DC, Diório AC, Britto RR, Sampaio RF, Parreira VF (2007) Breathing pattern, thoracoabdominal motion and muscular activity during three breathing exercises. Braz J Med Biol Res 40(10):1409–1417

    Article  CAS  Google Scholar 

  • Voyvoda N, Yücel C, Karataş G, Oğuzülgen İ, Oktar S (2012) An evaluation of diaphragmatic movements in hemiplegic patients. Br J Radiol 85(1012):411–414

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The study was registered with the international clinical trials platform of the Australian and New Zealand Clinical Trials Registry (ACTRN 12613001315707). Funded in part by grant ST.E060.16.059 of Wroclaw Medical University in Wroclaw, Poland.

Conflicts of Interest

The authors report no conflicts of interest in relation to this article.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Bioethics Committee of the Medical University in Wroclaw, Poland (permit no. KB867/2012).

Informed Consent

Written informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of Physiotherapy, Opole Medical School, Opole, Poland

    Lucyna Slupska, Tomasz Halski & Małgorzata Żytkiewicz

  2. Department of Clinical Biomechanics and Physiotherapy in Motor System Disorders, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland

    Kuba Ptaszkowski & Malgorzata Paprocka-Borowicz

  3. Department of Nervous System Diseases, Faculty of Health Science, Wroclaw Medical University, Wroclaw, Poland

    Robert Dymarek

  4. Department of Physiotherapy Basics, Academy of Physical Education, Katowice, Poland

    Jakub Taradaj

  5. College of Rehabilitation Sciences, University of Manitoba, Winnipeg, Canada

    Jakub Taradaj

Authors
  1. Lucyna Slupska
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  2. Tomasz Halski
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  3. Małgorzata Żytkiewicz
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  4. Kuba Ptaszkowski
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  5. Robert Dymarek
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  6. Jakub Taradaj
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  7. Malgorzata Paprocka-Borowicz
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Corresponding author

Correspondence to Kuba Ptaszkowski .

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Editors and Affiliations

  1. Opole Medical School, Opole, Poland

    Mieczyslaw Pokorski

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Slupska, L. et al. (2019). Proprioceptive Neuromuscular Facilitation for Accessory Respiratory Muscles Training in Patients After Ischemic Stroke. In: Pokorski, M. (eds) Advances in Pulmonary Medicine: Research and Innovations. Advances in Experimental Medicine and Biology(), vol 1160. Springer, Cham. https://doi.org/10.1007/5584_2018_325

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