PNF and Movement

  • 제18권1호
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  • Pages.1-10
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  • 2020
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  • 2508-6227(pISSN)
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  • 2508-6472(eISSN)
대한고유수용성신경근촉진법학회 (Korea Proprioceptive Neuromuscular Facilitation Association)
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탄력밴드를 이용한 PNF 운동이 유방암 절제술에 속발한 상지 림프부종 환자의 부종, 관절가동범위 및 통증에 미치는 영향 -열린 홀딩과 닫힌 홀딩의 차이-

The Effects of Proprioceptive Neuromuscular Facilitation (PNF) Using Elastic Bands on Edema, Range of Motion, and Pain in Post-Mastectomy Patients with Upper Limb Lymphedema: Differences between Open-Hand and Closed-Hand Grips

  • 조예진 (경성대학교 대학원 물리치료학과) ;
  • 이상열 (경성대학교 물리치료학과)
  • Jo, Ye-Jin (Department of Physical Therapy, Graduated school of Kyungsung University) ;
  • Lee, Sang-Yeol (Department of Physical Therapy, Kyungsung University)
  • 투고 : 2019.10.22
  • 심사 : 2019.12.04
  • 발행 : 2020.04.30
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초록

Purpose: This study was conducted to examine the effects of a PNF intervention using elastic bands on edema, range of motion (ROM), and pain in post-mastectomy patients with upper limb lymphedema, according to their hand grip type. Methods: The subjects were 14 female patients who were at Stage II lymphedema after undergoing mastectomy for Stage II breast cancer. They were randomly divided into an experimental group (n =7) and a control group (n = 7). Both groups participated in a treatment program four times (one time under the therapist's instructions and three times as self-exercise) a week for 4 weeks. Both groups repeated an upper limb PNF pattern exercise for 30 min using elastic bands after receiving a manual lymph drainage treatment for 1 hour. Here, subjects in the experimental group performed the PNF exercise with an open-hand grip by putting their hands into the loops of elastic bands and keeping their fingers spread out. Subjects in the control group performed the PNF exercise with a closed-hand grip by holding the loops of elastic bands with their fingers. In both groups, the subjects' edema, ROM, and pain levels were measured before the intervention and 2, 3 and 4 weeks after the intervention. Results: As a result of the experiment, both groups demonstrated edema reductions, ROM increases, and pain reductions in four areas of the upper limbs. Notably, the experimental group exhibited larger ROM increases in flexion, extension, and abduction as well as greater edema and pain reductions than the control group. In particular, the most significant effects were found in the elbow of the four upper limb areas for edema reductions and in extension for ROM increases. Conclusion: The present study indicates that exercise therapy-based approaches using elastic bands in post-mastectomy patients with upper limb lymphedema can have different effects depending on the type of hand grip (open or closed), which is the body's most distal part. Therefore, these approaches should be based on the conditions of the distal parts of the patient's body for their effective applications in clinical practice.

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참고문헌

  1. Anthony WB, Stanton AE, Stephanie Modi AE, Lymphatic drainage in the muscle and subcutis of the arm after breast cancer treatment. Breast Cancer Research and Treatment. 2009;117:549-557. https://doi.org/10.1007/s10549-008-0259-z
  2. Bumpers HL, Best IM, David N, et al. Debiliatating lymphedema of the upper extremity after treatment of breast cancer. American Journal of Clinical Oncology. 2002;25(4):365-367. https://doi.org/10.1097/00000421-200208000-00009
  3. Franzeck UK, Spiegel I, Fischer M, et al. Combined physical therapy for lymhedema evaluated by fluorescence microlymphograpy and lymph capillary pressure measurements. Journal of Vasular Research. 1997;34(4):306-311. https://doi.org/10.1159/000159238
  4. Ha KJ, Kim DK, Hwang SK. The impact of shoulder flexion angle on hand grip strength in male and female undergraduate students. Journal of Korea Proprioceptive Neuromuscular Facilitation Association. 2011;10(1):9-16.
  5. Han JT, Bae SS. Literature review of PNF application for improvement of fitness in the elderly. Journal of the Korean Proprioceptive Neuromuscular Facilitation Association. 2008;6(1):27-32.
  6. Harris SR, Hugi MR, Olivotto IA, et al. Clinical practice guidelines for the care and treatment of breast cancer: follow-up after treatment for breast cancer. Canadian Medical Association Journal. 2005;172(10):1319-1320. https://doi.org/10.1503/cmaj.045062
  7. Hutnick NA, Williams NI, Kraemer WJ, et al. Exercise and lymphocyte activation following chemotherapy for breast cancer. Medicine & Science in Sports and Exercise. 2005;37(11):1827-1835. https://doi.org/10.1249/01.mss.0000175857.84936.1a
  8. Karki A, Simonen R, Malkia E, et al. Postoperative education concerning the use of the upper limb, and exercise and treatment of the upper limb: cross-sectional survey of 105 breast cancer patients. Supportive Care in Cancer. 2004;12(5):347-354. https://doi.org/10.1007/s00520-004-0612-7
  9. Kim DK, Ha KJ. The effects of PNF techiques on lymphoma in the upper limbs. Journal of the Korean Proprioceptive Neuromuscular Facilitation Association. 2012;10(2):1-8.
  10. Kim SJ. Lymphedema. Seoul. Jungdam media. 2002.
  11. Kim YH, Lee KK, Lee MK. Effect of scapulothoracic joint movement and resistance training intensity on shoulder complex muscle activation during bench press exercise. Korean Journal of Sport Biomechanics. 2013;23(2):141-148. https://doi.org/10.5103/KJSB.2013.23.2.141
  12. Mock V, Pickett M, Ropka M, et al. Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Practice. 2001;9(3):119-127. https://doi.org/10.1046/j.1523-5394.2001.009003119.x
  13. Moseley A, Piller PM. The assessment and care of the patient with secondary limb lymphedema. America Journal of Nursing. 2002;53:1-4.
  14. Palmer ML, Epler ME. Fundamentals of musculoskeletal assessment techniques, 2nd ed. Philadelphia. Lippincott Williams & Wilkins. 2001.
  15. Portenoy RK. Cancer-related fatigue: an immense problem. Oncologist. 2000;5(5):350-352. https://doi.org/10.1634/theoncologist.5-5-35
  16. Rebegea L, Firescu D, Dumitru M, et al. The incidence and risk factors for occurrence of arm lymphedema after treatment of breast cancer. Chirurgia (Bucur). 2015;110(1):33-37.
  17. Sporrong H, Palmerud G, Herbert P. Hand grip increases shoulder muscle activity. An EMG analysis with static hand contractions in 9 subjects. Acta Orthopaedica Scandinavica. 1996;67(5):485-490. https://doi.org/10.3109/17453679608996674
  18. Sakakibara Y, Honda Y. Cardiopulmonary responses to static exercise. The Annals of Physiological Anthropology. 1990;9(2):153-161. https://doi.org/10.2114/ahs1983.9.153