Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty
[Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standa...
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| Published in | Journal of Physical Therapy Science Vol. 27; no. 11; pp. 3377 - 3380 |
|---|---|
| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
Japan
The Society of Physical Therapy Science
2015
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0915-5287 2187-5626 2187-5626 |
| DOI | 10.1589/jpts.27.3377 |
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| Abstract | [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term. |
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| AbstractList | [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term. [Abstract.] [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term. [Purpose] The aim of this longitudinal study was to examine the long term functional effectiveness of proprioceptive neuromuscular facilitation (PNF) after total knee arthroplasty. [Subjects and Methods] We included 30 patients and they were randomly assigned to two groups. In addition to the standard rehabilitation program the PNF group received proprioceptive neuromuscular facilitation therapy and the CPM group received continuous passive motion therapy. The outcome measures included range of motion using a goniometer, pain scores using a numeric pain rating scale, days to reach functional benchmarks, the Beck depression scale and isokinetic torque and isometric strength measurements. [Results] There were no significant differences between the two groups in terms of baseline demographic data, clinical findings and length of stay. Days to reach range of motion benchmarks were similar in the two groups. Pain at the 8th week was slightly higher in the PNF group. With the exception of walking with a walker, days to reach functional benchmarks were statistically significantly fewer in patients of the PNF group despite similar isokinetic measurements. Administration of PNF resulted in earlier functional gains in patients after total knee arthroplasty. These functional accomplishments were more pronounced in the PNF group despite it having isokinetic torque measurements similar to those of the CPM group. [Conclusion] PNF techniques can positively affect functional outcomes over the long term. |
| Author | Güven, Zeynep Alaca, Nuray Atalay, Ayçe |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26696702$$D View this record in MEDLINE/PubMed |
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| Keywords | Functional gains Total knee arthroplasty Proprioceptive neuromuscular facilitation |
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| References | 4) Brosseau L, Milne S, Wells G, et al.: Efficacy of continuous passive motion following total knee arthroplasty: a metaanalysis. J Rheumatol, 2004, 31: 2251–2264. 8) Pereira MP: Proprioceptive neuromuscular facilitation does not increase blood pressure of healthy elderly women. Physiother Theory Pract, 2012, 28: 412–416. 17) Mau-Moeller A, Behrens M, Finze S, et al.: The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study. Health Qual Life Outcomes, 2014, 12: 68. 16) Järvenpää J, Kettunen J, Kröger H, et al.: Obesity may impair the early outcome of total knee arthroplasty. Scand J Surg, 2010, 99: 45–49. 21) Konrad A, Gad M, Tilp M: Effect of PNF stretching training on the properties of human muscle and tendon structures. Scand J Med Sci Sports, 2015, 25: 346–355. 10) Denis M, Moffet H, Caron F, et al.: Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial. Phys Ther, 2006, 86: 174–185. 19) Minshull C, Eston R, Bailey A, et al.: The differential effects of PNF versus passive stretch conditioning on neuromuscular performance. Eur J Sport Sci, 2014, 14: 233–241. 20) Stanziano DC, Roos BA, Perry AC, et al.: The effects of an active-assisted stretching program on functional performance in elderly persons: a pilot study. Clin Interv Aging, 2009, 4: 115–120. 22) Higgs F, Winter SL: The effect of a four-week proprioceptive neuromuscular facilitation stretching program on isokinetic torque production. J Strength Cond Res, 2009, 23: 1442–1447. 1) MacDonald SJ, Bourne RB, Rorabeck CH, et al.: Prospective randomized clinical trial of continuous passive motion after total knee arthroplasty. Clin Orthop Relat Res, 2000, 380: 30–35. 15) Koca I, Boyacı A, Tutoglu A, et al.: The relationship between quadriceps thickness, radiological staging, and clinical parameters in knee osteoarthritis. J Phys Ther Sci, 2014, 26: 931–936. 3) Salter RB, Simmonds DF, Malcolm BW, et al.: The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am, 1980, 62: 1232–1251. 23) González-Ravé JM, Sánchez-Gómez A, Santos-García DJ: Efficacy of two different stretch training programs (passive vs. proprioceptive neuromuscular facilitation) on shoulder and hip range of motion in older people. J Strength Cond Res, 2012, 26: 1045–1051. 18) Weng MC, Lee CL, Chen CH, et al.: Effects of different stretching techniques on the outcomes of isokinetic exercise in patients with knee osteoarthritis. Kaohsiung J Med Sci, 2009, 25: 306–315. 12) Bello M, Mesiano Maifrino LB, Gama EF, et al.: Rhythmic stabilization versus conventional passive stretching to prevent injuries in indoor soccer athletes: a controlled clinical trial. J Bodyw Mov Ther, 2011, 15: 380–383. 9) James DA, Nigrini CM: Total knee replacement protocol. In: Brotzman SB, Manske RC eds. Clinical Ortopaedic Rehabilitation. Philadelphia: Elsevier Mosby. pp 386–390. 14) Lauermann SP, Lienhard K, Item-Glatthorn JF, et al.: Assessment of quadriceps muscle weakness in patients after total knee arthroplasty and total hip arthroplasty: methodological issues. J Electromyogr Kinesiol, 2014, 24: 285–291. 7) Chow TP, Ng GY: Active, passive and proprioceptive neuromuscular facilitation stretching are comparable in improving the knee flexion range in people with total knee replacement: a randomized controlled trial. Clin Rehabil, 2010, 24: 911–918. 5) Lenssen TA, van Steyn MJ, Crijns YH, et al.: Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty. BMC Musculoskelet Disord, 2008, 9: 60. 24) Nakata K, Kougo M, Huo M, et al.: The immediate effect of Neuromuscular Joint Facilitation (NJF) treatment for knee osteoarthritis. J Phys Ther Sci, 2012, 24: 69–71. 11) Adler S, Beckers D, Buck M: PNF in practice: an illustrated guide. Verlag Berlin Heidelberg: Springer, 2008. 2) Devers BN, Conditt MA, Jamieson ML, et al.: Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? J Arthroplasty, 2011, 26: 178–186. 6) Postel JM, Thoumie P, Missaoui B, et al. French Physical Medicine and Rehabilitation Society: Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines. Ann Readapt Med Phys, 2007, 50: 244–257. 13) Jakobsen TL, Christensen M, Christensen SS, et al.: Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?Physiother Res Int, 2010, 15: 126–134. 20413247 - J Arthroplasty. 2011 Feb;26(2):178-86 19560995 - Kaohsiung J Med Sci. 2009 Jun;25(6):306-15 7440603 - J Bone Joint Surg Am. 1980 Dec;62(8):1232-51 16445331 - Phys Ther. 2006 Feb;86(2):174-85 20685725 - Clin Rehabil. 2010 Oct;24(10):911-8 11064970 - Clin Orthop Relat Res. 2000 Nov;(380):30-5 22007735 - Physiother Theory Pract. 2012 Jul;28(5):412-6 19503774 - Clin Interv Aging. 2009;4:115-20 22373895 - J Strength Cond Res. 2012 Apr;26(4):1045-51 24886619 - Health Qual Life Outcomes. 2014 May 09;12:68 20024893 - Physiother Res Int. 2010 Sep;15(3):126-34 19620921 - J Strength Cond Res. 2009 Aug;23(5):1442-7 24290027 - J Electromyogr Kinesiol. 2014 Apr;24(2):285-91 24716522 - Scand J Med Sci Sports. 2015 Jun;25(3):346-55 15517640 - J Rheumatol. 2004 Nov;31(11):2251-64 21665116 - J Bodyw Mov Ther. 2011 Jul;15(3):380-3 25013299 - J Phys Ther Sci. 2014 Jun;26(6):931-6 17412445 - Ann Readapt Med Phys. 2007 May;50(4):244-57 23688197 - Eur J Sport Sci. 2014;14(3):233-41 18442423 - BMC Musculoskelet Disord. 2008 Apr 29;9:60 20501358 - Scand J Surg. 2010;99(1):45-9 |
| References_xml | – reference: 4) Brosseau L, Milne S, Wells G, et al.: Efficacy of continuous passive motion following total knee arthroplasty: a metaanalysis. J Rheumatol, 2004, 31: 2251–2264. – reference: 17) Mau-Moeller A, Behrens M, Finze S, et al.: The effect of continuous passive motion and sling exercise training on clinical and functional outcomes following total knee arthroplasty: a randomized active-controlled clinical study. Health Qual Life Outcomes, 2014, 12: 68. – reference: 11) Adler S, Beckers D, Buck M: PNF in practice: an illustrated guide. Verlag Berlin Heidelberg: Springer, 2008. – reference: 7) Chow TP, Ng GY: Active, passive and proprioceptive neuromuscular facilitation stretching are comparable in improving the knee flexion range in people with total knee replacement: a randomized controlled trial. Clin Rehabil, 2010, 24: 911–918. – reference: 21) Konrad A, Gad M, Tilp M: Effect of PNF stretching training on the properties of human muscle and tendon structures. Scand J Med Sci Sports, 2015, 25: 346–355. – reference: 1) MacDonald SJ, Bourne RB, Rorabeck CH, et al.: Prospective randomized clinical trial of continuous passive motion after total knee arthroplasty. Clin Orthop Relat Res, 2000, 380: 30–35. – reference: 2) Devers BN, Conditt MA, Jamieson ML, et al.: Does greater knee flexion increase patient function and satisfaction after total knee arthroplasty? J Arthroplasty, 2011, 26: 178–186. – reference: 10) Denis M, Moffet H, Caron F, et al.: Effectiveness of continuous passive motion and conventional physical therapy after total knee arthroplasty: a randomized clinical trial. Phys Ther, 2006, 86: 174–185. – reference: 23) González-Ravé JM, Sánchez-Gómez A, Santos-García DJ: Efficacy of two different stretch training programs (passive vs. proprioceptive neuromuscular facilitation) on shoulder and hip range of motion in older people. J Strength Cond Res, 2012, 26: 1045–1051. – reference: 18) Weng MC, Lee CL, Chen CH, et al.: Effects of different stretching techniques on the outcomes of isokinetic exercise in patients with knee osteoarthritis. Kaohsiung J Med Sci, 2009, 25: 306–315. – reference: 3) Salter RB, Simmonds DF, Malcolm BW, et al.: The biological effect of continuous passive motion on the healing of full-thickness defects in articular cartilage. An experimental investigation in the rabbit. J Bone Joint Surg Am, 1980, 62: 1232–1251. – reference: 14) Lauermann SP, Lienhard K, Item-Glatthorn JF, et al.: Assessment of quadriceps muscle weakness in patients after total knee arthroplasty and total hip arthroplasty: methodological issues. J Electromyogr Kinesiol, 2014, 24: 285–291. – reference: 22) Higgs F, Winter SL: The effect of a four-week proprioceptive neuromuscular facilitation stretching program on isokinetic torque production. J Strength Cond Res, 2009, 23: 1442–1447. – reference: 16) Järvenpää J, Kettunen J, Kröger H, et al.: Obesity may impair the early outcome of total knee arthroplasty. Scand J Surg, 2010, 99: 45–49. – reference: 5) Lenssen TA, van Steyn MJ, Crijns YH, et al.: Effectiveness of prolonged use of continuous passive motion (CPM), as an adjunct to physiotherapy, after total knee arthroplasty. BMC Musculoskelet Disord, 2008, 9: 60. – reference: 8) Pereira MP: Proprioceptive neuromuscular facilitation does not increase blood pressure of healthy elderly women. Physiother Theory Pract, 2012, 28: 412–416. – reference: 9) James DA, Nigrini CM: Total knee replacement protocol. In: Brotzman SB, Manske RC eds. Clinical Ortopaedic Rehabilitation. Philadelphia: Elsevier Mosby. pp 386–390. – reference: 12) Bello M, Mesiano Maifrino LB, Gama EF, et al.: Rhythmic stabilization versus conventional passive stretching to prevent injuries in indoor soccer athletes: a controlled clinical trial. J Bodyw Mov Ther, 2011, 15: 380–383. – reference: 19) Minshull C, Eston R, Bailey A, et al.: The differential effects of PNF versus passive stretch conditioning on neuromuscular performance. Eur J Sport Sci, 2014, 14: 233–241. – reference: 6) Postel JM, Thoumie P, Missaoui B, et al. French Physical Medicine and Rehabilitation Society: Continuous passive motion compared with intermittent mobilization after total knee arthroplasty. Elaboration of French clinical practice guidelines. Ann Readapt Med Phys, 2007, 50: 244–257. – reference: 20) Stanziano DC, Roos BA, Perry AC, et al.: The effects of an active-assisted stretching program on functional performance in elderly persons: a pilot study. Clin Interv Aging, 2009, 4: 115–120. – reference: 13) Jakobsen TL, Christensen M, Christensen SS, et al.: Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?Physiother Res Int, 2010, 15: 126–134. – reference: 15) Koca I, Boyacı A, Tutoglu A, et al.: The relationship between quadriceps thickness, radiological staging, and clinical parameters in knee osteoarthritis. J Phys Ther Sci, 2014, 26: 931–936. – reference: 24) Nakata K, Kougo M, Huo M, et al.: The immediate effect of Neuromuscular Joint Facilitation (NJF) treatment for knee osteoarthritis. J Phys Ther Sci, 2012, 24: 69–71. – reference: 17412445 - Ann Readapt Med Phys. 2007 May;50(4):244-57 – reference: 19560995 - Kaohsiung J Med Sci. 2009 Jun;25(6):306-15 – reference: 23688197 - Eur J Sport Sci. 2014;14(3):233-41 – reference: 15517640 - J Rheumatol. 2004 Nov;31(11):2251-64 – reference: 20024893 - Physiother Res Int. 2010 Sep;15(3):126-34 – reference: 18442423 - BMC Musculoskelet Disord. 2008 Apr 29;9:60 – reference: 11064970 - Clin Orthop Relat Res. 2000 Nov;(380):30-5 – reference: 24716522 - Scand J Med Sci Sports. 2015 Jun;25(3):346-55 – reference: 24886619 - Health Qual Life Outcomes. 2014 May 09;12:68 – reference: 19620921 - J Strength Cond Res. 2009 Aug;23(5):1442-7 – reference: 21665116 - J Bodyw Mov Ther. 2011 Jul;15(3):380-3 – reference: 16445331 - Phys Ther. 2006 Feb;86(2):174-85 – reference: 20501358 - Scand J Surg. 2010;99(1):45-9 – reference: 7440603 - J Bone Joint Surg Am. 1980 Dec;62(8):1232-51 – reference: 19503774 - Clin Interv Aging. 2009;4:115-20 – reference: 20413247 - J Arthroplasty. 2011 Feb;26(2):178-86 – reference: 20685725 - Clin Rehabil. 2010 Oct;24(10):911-8 – reference: 22373895 - J Strength Cond Res. 2012 Apr;26(4):1045-51 – reference: 22007735 - Physiother Theory Pract. 2012 Jul;28(5):412-6 – reference: 24290027 - J Electromyogr Kinesiol. 2014 Apr;24(2):285-91 – reference: 25013299 - J Phys Ther Sci. 2014 Jun;26(6):931-6 |
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| Title | Comparison of the long-term effectiveness of progressive neuromuscular facilitation and continuous passive motion therapies after total knee arthroplasty |
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