UZUN SÜRELİ OTURMA POZİSYONUNA SAHİP BİREYLERDE KAS ESNEKLİĞİ ÜZERİNE ÇEŞİTLİ PROPRİOSEPTİF NÖROMUSKÜLER FASİLİTASYON (PNF) TEKNİKLERİNİN KARŞILAŞTIRMALI ANALİZİ

Yıl 2024, Cilt: 35 Sayı: 1, 20 - 28, 20.04.2024

Rahul Krishnan Kutty , Ong Sıew Chee Suvınlal Stalın Sonıa Dewan Nisha Vijayan Acharry

https://doi.org/10.21653/tjpr.1076651

Öz

Amaç: Bu araştırmanın amacı, hamstring kas gerginliği için farklı Propriyoseptif Nöromüsküler Fasilitasyon (PNF) germe tekniklerinin etkinliğini araştırmak ve hamstring esnekliğini geliştirmek için en iyi PNF tekniğini bulmaktır.
Yöntem: Bu yarı deneysel dizaynlı çalışmada 18-25 yaşında, günde >6 saat oturan ve Aktif Diz Ekstansiyon Testi (AKET) >20º olan 30 üniversite öğrencisi elverişlilik örnekleme yöntemiyle seçilmiş ve Grup A, B ve C'ye eşit olarak ayrılmıştır.. Sırasıyla tut-gevşe (HR), agonist kasılma (AC) ve kas-rahatla antagonist kas (CRAC) germe teknikleri verilmiş ve müdahaleler deneklere haftada üç seans, üç hafta süreyle uygulanmıştır.
Sonuçlar: Paired t-testi, HR, AC ve CRAC gruplarının hepsinde ön test ve son test AKET ölçümleri arasında anlamlı farklar olduğunu gösterdi (p<.001). Tek yönlü ANOVA testi, bu tekniklerin etkinlikleri arasında anlamlı bir farklılık olduğunu (F(2,27)=13,069, p<,001); Tukey Post-Hoc testi, etkinin CRAC (-20,033°±2,666°, p<,001) ve AC gruplarında (-17,516°±1,658º, p=,047) HR'den (-15,100°±2,025°) anlamlı olarak daha yüksek olduğunu ortaya koydu.. Ayrıca, CRAC'ın (p=,038) AC'den önemli ölçüde daha fazla etkiye sahip olduğu bulundu.
Tartışma: Bu çalışmada kullanılan PNF germe teknikleri, üniversite öğrencilerinde hamstring esnekliğini geliştirmede etkili olup, en etkili olan CRAC tekniğidir.

Anahtar Kelimeler

esneklik, hamstring, proprioseptif nöromuskuler fasilitasyon, germe, uzun süreli oturma pozisyonu

A COMPARATIVE ANALYSIS OF VARIOUS PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION (PNF) TECHNIQUES ON MUSCLE FLEXIBILITY AMONG EXTENDED SITTING POSTURE INDIVIDUALS

Öz

Purpose: The purpose of this research is to compare the effectiveness of different Proprioceptive Neuromuscular Facilitation (PNF) stretching techniques for hamstring muscle tightness, and to find out the best PNF technique for improving hamstring flexibility.
Methods: In this quasi-experimental designed study, 30 university students who were between 18-25 years-old, sitting >6 hours per day, and had a Active Knee Extension Test (AKET) >20º were recruited with convenience sampling and equally allocated into Group A, B and C, non-randomly. Hold-Relax (HR), Agonist Contraction (AC) and Contract-Relax-Antagonist-Contract (CRAC) stretching techniques were given respectively, 3 sessions/week, for three weeks.
Results: Paired t-test showed significant effect of each technique compared between pre-test value and post-test value of AKET measurements of Hold-relax (HR), AC and CRAC groups (p<.001). One-way ANOVA results showed significant difference between the effects of these techniques (F(2,27)=13.069, p<.001). Tukey Post-Hoc test revealed that effect was significantly greater in CRAC (-20.033°±2.666°, p<.001) and AC groups (-17.516°±1.658º, p=.047) than HR (-15.100°±2.025°). Furthermore, CRAC (p=.038) was found to have significantly greater effect than AC.
Conclusion: The PNF stretching techniques used in this study are effective in improving hamstring flexibility among university students. In addition, CRAC technique was found to be the most effective one.

Anahtar Kelimeler

extended sitting posture, flexibility, hamstring, Proprioceptive Neuromuscular Facilitation, streching

Kaynakça

• Al-Kumaim, N.H., Alhazmi, A.K., Mohammed, F., Gazem, N.A., Shabbir, M.S. And Fazea, Y. (2021) Exploring The Impact Of The Covid-19 Pandemic On University Students’ Learning Life: An Integrated Conceptual Motivational Model For Sustainable And Healthy Online Learning. Sustainability. Mdpi 13 (5). P.2546.
• Borges, M.O., Medeiros, D.M., Minotto, B.B. And Lima, C.S. (2017) Comparison Between Static Stretching And Proprioceptive Neuromuscular Facilitation On Hamstring Flexibility: Systematic Review And Meta-Analysis. European Journal Of Physiotherapy. P.12-19.
• Burgess, T., Jelsma, J. And Buchholtz, K. (2019) The Effect Of The Contract-Relax-Antagonist-Contract (Crac) Stretch Of Hamstrings On Range Of Motion, Sprint And Agility Performance In Moderately Active Males: A Randomised Control Trial. South African Journal Of Sports Medicine. [Online] Academy Of Science Of South Africa 31 (1). P.1-5.
• Cayco, C., Labro, A. And Gorgon, E.J. (2016) Effects Of Proprioceptive Neuromuscular Facilitation On Hamstrings Flexibility In Adults: A Systematic Review With Meta-Analysis. Physiotherapy.P.190 Chellapillai, Fmd., Wijayalath, Wpld., Safinaz, Zmfz., Ihsan, An., Neranjan, Epl., Ariyasinghe, As. And Kariyawasam, Ap. (2019) Predisposing Factors For Hamstring Tightness Among University Students. Journal Of Physiotherapy And Physical Rehabilitation. 4 (2). P.1-3.
• Cowgill, B. O., Et Al. (2020) Get Up, Stand Up, Stand Up For Your Health! Faculty And Student Perspectives On Addressing Prolonged Sitting In University Settings. Journal Of American College Health.
• Dafda, R. (2019) A Study To Compare Efficacy Of Hold-Relax And Agonist Contraction Of Proprioceptive Neuromuscular Facilitation Technique On Hamstring Muscle Flexibility In Healthy Female-An Interventional Study. Indian Journal Of Physiotherapy And Occupational Therapy - An International Journal. [Online] Diva Enterprises Private Limited 13 (1). P.43.
• Davis, D.S., Ashby, P.E., Mccale, K.L., Mcquain, J.A., And Wine, J.M. (2005) The Effectiveness Of 3 Stretching Techniques On Hamstring Flexibility Using Consistent Stretching Parameters. The Journal Of Strength And Conditioning Research. [Online] Ovid Technologies (Wolters Kluwer Health) 19 (1). P.27.
• Diaz Km, Et Al. Patterns Of Sedentary Behavior And Mortality In U.S. Middle-Aged And Older Adults: A National Cohort Study. Annals Of Internal Medicine. 2017;167:465
• Etnyre, B. And Abraham, L. (1986) H-Reflex Changes During Static Stretching And Two Variations Of Proprioceptive Neuromuscular Facilitation Techniques. Electroencephalography And Clinical Neurophysiology. P.174- 179.
• Ferber, R., Osternig, L.R. And Gravelle, D.C. (2002) Effect Of Pnf Stretch Techniques On Knee Flexor Muscle Emg Activity In Older Adults. Journal Of Electromyography And Kinesiology. P.391-397.
• Fornramdee, J., Srungboonmee, K., Kaimook, P. And Panich, K. (2018) Chronic Effect Of Proprioceptive Neuromuscular Facilitation Stretching On Flexibility And Strength. Journal Of Sports Science And Technology. 18 (2). P.9-20.
• Ghanbari, A., Ebrahimian, M., Mohamadi, M. And Najjar-Hasanpour, A. (2013) Comparing Hold Relax - Proprioceptive Neuromuscular Facilitation And Static Stretching Techniques In Management Of Hamstring Tightness. Indian Journal Of Physiotherapy & Occupational Therapy. 7 (1). P.126-130.
• Haji Hasani, A., Bakhtiary, A.H. And Amoozadeh Khalili, M. (2014) Comparative Study Of Static Stretch And Hold Relax On Increasing The Motion Range Of Knee Extension And Flexibility Of Shortened Hamstring Muscles Of Male Students In Semnan. Middle East Journal Of Rehabilitation And Health. P.1-5.
• Hansberger, B.L., Loutsch, R., Hancock, C., Bonser, R., Zeigel, A. And Baker, R.T. (2019) Evaluating The Relationship Between Clinical Assessments Of Apparent Hamstring Tightness: A Correlational Analysis. International Journal Of Sports Physical Therapy. P.253-263.
• Hindle, K.B., Whitcomb, E.J., Briggs, W.O. And Hong, J. (2012) Proprioceptive Neuromuscular Facilitation (Pnf): Its Mechanisms And Effects On Range Of Motion And Muscular Function. Journal Of Human Kinetics. P.105-113.
• Juren, Y. U., Soh, K.G., Ong, S.L., Siswantoyo, M.K. And Sunardi, J. (2020) Comparing Sitting Time Between Male And Female Undergraduate Students During Weekdays And Weekends. European Journal Of Molecular & Clinical Medicine. 7 (3). P.79-87.
• Kamalakannan, M., Hemamalini, P. And Divya, T. (2021) Hamstring Tightness Causing Low Back Pain Among College Going Students - A Cross-Sectional Study. Indian Association Of Biomedical Scientists.P.531-534.
• Kanishka, G.K., Sandamali, H., Weerasinghe, I., Binduhewa, L., Dilshara, C., De Silva, C., Silva, D. And Balasuriya, A. (2020) Prevalence Of Hamstring Tightness And Associated Factors Among Sewing Machine Operators. Ceylon Journal Of Medical Science.P.23-29.
• Kaur, M. (2014) Effects Of Contract Relax Antagonist Contract Pnf And Dynamic Stretching Techniques On Performance Measures Of Long Distance Runners. International Journal Of Current Research. 6 (7). P.7498-7503.
• Moore, M.A. And Kukulka, C.G. (1991) Depression Of Hoffmann Reflexes Following Voluntary Contraction And Implications For Proprioceptive Neuromuscular Facilitation Therapy. Physical Therapy.P.321-329.
• Naga, V. (2015) Static Versus Pnf Stretching In Hamstringflexibility-A Comparitive Study. International Journal Of Physiotherapy. P.513-517.
• Nagarwal, A.K., Zutshi, K., Ram, C.S., Zafar, R. And Jamia, H. (2009) Improvement Of Hamstring Flexibility: A Comparison Between Two Pnf Stretching Techniques. International Journal Of Sports Science And Engineering. P.25-33.
• Oh, T. (2013) Effect Of Hold-Relax Technique For College Students With Hamstring Shortening. Journal Of The Korean Society Of Physical Medicine.. P.433-441.
• Qamar, M.M., Fatima, G., Ul Hassan, J., And Basharat, A. (2017) Extended Sitting Can Cause Hamstring Tightness. Saudi Journal Of Sports Medicine. P.110.
• Rajendran, K., Thiruvevenkadam, I.A. And Nedunchezhiyan, A. (2016) Static Stretching Vs Hold Relax (Pnf) On Sustainability Of Hamstring Flexibility In Sedentary Living College Students. International Journal Of Physiotherapy And Research. P.1436-1443.
• Ramachandran, S., Jibi, P., Senthilkumar, N., Selvaraj, S. And Tamilselvi. (2018) Comparative Effect Of Pnf Stretching Techniques On Hamstring Flexibility. International Journal Medical And Exercise Science. P.443-447.
• Regima, S.E., Balakrishnan, R. And Sinnasamy, T. (2015) A Comparative Study On The Effects Of Autogenic Mechanism And Reciprocal Mechanism On Hamstring Flexibility Among Amu Students. International Journal Of Physical Education, Sports And Health. 3 (1). P.281-292.
• Rizvi, F., Rasheed, N., Simon, N. And Chatterjee, A. (2020) The Effect Of Static Stretching And Pnf Hold-Relax Stretching On Increasing Flexibility Of Shortened Hamstring Muscle Among Sedentary Living Female Students - Randomized Controlled Trial. International Journal Of Science And Research. 9 (11). P.157-161.
• Romero-Blanco, C., Rodriguez-Almagro, J., Onieva-Zafra, M.D., Parra-Fernandez, M.L., Prado-Laguna, M.D.C. And Hernandez-Martinez, A. (2020) Physical Activity And Sedentary Lifestyle In University Students: Changes During Confinement Due To The Covid-19 Pandemic. International Journal Of Environmental Research And Public Health. [Online] Mdpi Ag 17 (18). P.6567.
• Sagat, P., Bartik, P., Prieto Gonzalez, P., Tohanean D.I. And Knjaz, D. (2020) Impact Of Covid-19quarantine On Low Back Pain Intensity, Prevalence, And Associated Risk Factors Among Adult Citizens Residing In Riyadh (Saudi Arabia): A Cross-Sectional Study. International Journal Of Environmental Research And Public Health. P.7302.
• Scott, G.S., Timothy, L.U., Brent, L.A. And Bruce, M.G. (2001) Duration Of Maintained Hamstring Flexibility After A One-Time, Modified Hold-Relax Stretching Protocol. Journal Of Athletic Training. 36 (1). P.44-48.
• Sumer, S., Sharath, U.R., Sridhar, S., Pradeep, K. And Baghyashree, S. (2020) Comparing The Effect Of Static, Ballistic And Contract-Relax Stretching On Hamstring Muscle Flexibility In Yong Individuals. International Journal Of Physical Education, Sports And Health. 8 (1). P.9-15.
• Sundaram, M. And Arun, B. (2016) Comparing The Effects Of Various Pnf Stretching In Improving The Hamstrings Flexibility In Athletes. Indian Journal Of Physiotherapy And Occupational Therapy - An International Journal.P.43
• Yadav, H. And Lehri, A. (2019) Effectiveness Of Proprioceptive Neuromuscular Facilitation On Flexibility In Males With Hamstring Tightness. International Journal Of Health Sciences And Research. 9 (5). P.191-195.