The Effect of Scapular Proprioceptive Neuromuscular Facilitation (PNF) Exercises

The Effect of Scapular Proprioceptive Neuromuscular Facilitation (PNF) Exercises on Posture, Upper Extremity Strength and Dexterity in University Students.

Posture is generally defined as the sitting or standing position of a person's body. Repetitive or prolonged positioning in an atypical posture may also occur as a risk factor for the development of musculoskeletal diseases. Race, gender, seasons, nutrition, socio-economic status, profession and occupations, psychological state, hygiene, sleep patterns, exercise habits, fatigue, fractures, soft tissue disorders, disorders in the normal alignment angles of the joints, and emotional states such as joy, grief, and distress. It affects posture. Creating professional awareness among physiotherapy and rehabilitation students is very important for the physiotherapy profession, which has a very important role in protecting and improving public health, to achieve its professional goals. On the other hand, physiotherapists and physiotherapy students are at great risk of musculoskeletal disorders due to their working conditions and working postures.

The basic principle of proprioceptive neuromuscular facilitation techniques, defined as facilitating the responses of the neuromuscular mechanism by stimulating the proprioceptors and briefly referred to as PNF, is based on the principle that physiological movements in the human body have rotational and oblique characters and that a greater response can be achieved with movements performed against maximum resistance. The shoulder girdle serves purposes beyond stabilization and movement of the extremities. The clavicle and scapula cooperate as a single unit in the shoulder girdle. The scapula is not a weight-bearing structure during normal functions; rather, it supports the attachment of skeletal muscles.

Study Overview

• Status: Completed
• Conditions: Postural Kyphosis
• Intervention / Treatment: Other: strength exercises; Other: PNF EXERCISES

Detailed Description

Posture is generally defined as the sitting or standing position of a person's body. Repetitive or prolonged positioning in an atypical posture may also occur as a risk factor for the development of musculoskeletal diseases. Race, gender, seasons, nutrition, socio-economic status, profession and occupations, psychological state, hygiene, sleep patterns, exercise habits, fatigue, fractures, soft tissue disorders, disorders in the normal alignment angles of the joints, and emotional states such as joy, grief, and distress. It affects posture. Creating professional awareness among physiotherapy and rehabilitation students is very important for the physiotherapy profession, which has a very important role in protecting and improving public health, to achieve its professional goals. On the other hand, physiotherapists and physiotherapy students are at great risk of musculoskeletal disorders due to their working conditions and working postures.

The basic principle of proprioceptive neuromuscular facilitation techniques, defined as facilitating the responses of the neuromuscular mechanism by stimulating the proprioceptors and briefly referred to as PNF, is based on the principle that physiological movements in the human body have rotational and oblique characters and that a greater response can be achieved with movements performed against maximum resistance. The shoulder girdle serves purposes beyond stabilization and movement of the extremities. The clavicle and scapula cooperate as a single unit in the shoulder girdle. The scapula is not a weight-bearing structure during normal functions; rather, it supports the attachment of skeletal muscles.Scapula patterns are activated by upper extremity patterns, and all upper extremity patterns occur together with scapula patterns. The therapeutic purposes of scapula patterns are as follows:

mobility and stabilization of the scapula,

• Trunk muscles and movements, rotation, etc. functional activities,
• Cervical movements and stability, to increase upper-extremity movements and stabilization. Strengthening exercises for posture problems are frequently included in literature studies. However, the results of scapular-pattern PNF exercises specific to the shoulder girdle muscles are unknown. In this study, which we planned in light of this information, the findings obtained from scapular PNF exercises will serve to fill this gap in the literature.

Our hypotheses in this project are:

Hypothesis 1: Scapular PNF applications will show superiority in the development of muscle strength compared to upper extremity strengthening exercises in university students who receive 6-week training.

Hypothesis 2: Scapular PNF applications will be superior to upper extremity strengthening exercises in correcting shoulder girdle posture in university students who receive 6-week training.

Hypothesis 3: Scapular PNF applications will be superior to upper extremity strengthening exercises in the development of hand skills in university students who receive 6-week training.

The most common posture problem seen in university students is the deterioration of shoulder girdle posture. In this project,

1. Purpose: To examine the effects of scapular PNF training on the strength of upper extremity muscles.
2. Purpose: To examine the effects of scapular PNF training on shoulder girdle posture.

Purpose: To examine the effects of scapular PNF training on manual skills.

• Study Type: Interventional
• Enrollment (Actual): 40
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Gaziantep, Turkey
    • Gaziantep Islam Science and Technology University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

1. Being between the ages of 18-35
2. Volunteering to participate in the study

Exclusion Criteria:

1. Having a systemic disease that prevents exercise,
2. Having a history of orthopedic problems in the upper extremity (fracture, trauma, etc.)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Control Group; STRENGTH EXERCISE TRAINING	Other: strength exercises; Upper limb exercise training (6 Weeks) 3 days/week 60% of 1 repetition maximum 5 minute warm up 20 min exercise training 5 min cool down Upper extremity movements - Scapular retraction - Shoulder flexion - Shoulder extension - Shoulder abduction - Shoulder adduction Resistant exercise training with Theraband and weights
Experimental: Study Group; PNF EXERCISE TRAINING	Other: PNF EXERCISES; Scapular PNF exercise training (6 Weeks) Exercise Frequency 3 days/week Exercise Intensity 60% of 1 maximum repetition Exercise Duration: 5-minute warm-up 20 minutes (2 sets of 15 repetitions) exercise training 5 min cool down Exercise Type Scapular patterns; Anterior elevation-Posterior depression; Anterior depression-Posterior elevation PNF techniques; Repetitive stretching; Rhythmic stabilization

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Muscle Strength	Lower extremity muscle strength will be measured with a digital muscle dynamometer. Lower extremity muscles will be evaluated using a digital dynamometer (Knect). With this device, muscle force values are expressed in Newton (N). Muscle strength will be recorded by making 3 measurements with a digital dynamometer, on the right and left extremities, without allowing the patients to compensate, and the average values will be used.	Baseline and after 6 weeks
Posture	It will be done with the PostureScreen Mobile (PSM) application. Using the phone's camera application, participants will be photographed from 4 directions: front, back (coronal plane), right and left (sagittal plane). After the photo is taken, after marking the anatomical points specified in the application, the function of the application is started and the right or left shift and tilt angles of the head, shoulders, rib cage, hips from the front, the tilt angles of the head, shoulders, hips, knees from the side and the head, shoulders, rib cage from the back are displayed. , right and left tilt and shift angles of the midpoint of the hip, T1-T4, T4-T8, T8-T12, T12-L3 vertebrae, L3 and SIPS will be determined and recorded. The application is a valid and reliable method and its ICC score is between 0.71-0.99.	Baseline and after 6 weeks
Manual skills	Will be evaluated with Purdue-Peg board test (PPBT). It is one of the tests frequently used in personnel selection for jobs requiring motor skills and coordination. It is a test that also measures the fingertip dexterity required for assembly work. Washers, rings and small nails are used in this test. The completion time of the test is recorded in seconds. The test is valid and reliable.	Baseline and after 6 weeks

Collaborators and Investigators

• Sponsor: Kahramanmaras Sutcu Imam University
• Investigators: Principal Investigator: Zekiye İpek Katırcı Kırmacı, Gaziantep Islam Science and Technology University

Study record dates

Study Major Dates

• Study Start (Actual): November 15, 2023
• Primary Completion (Actual): March 1, 2024
• Study Completion (Actual): March 15, 2024

Study Registration Dates

• First Submitted: December 27, 2023
• First Submitted That Met QC Criteria: December 27, 2023
• First Posted (Actual): January 10, 2024

Study Record Updates

• Last Update Posted (Actual): April 16, 2024
• Last Update Submitted That Met QC Criteria: April 15, 2024
• Last Verified: April 1, 2024

More Information

Terms related to this study

• Keywords: PNF; Scapular exercise
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Spinal Diseases; Bone Diseases; Spinal Curvatures; Kyphosis
• Other Study ID Numbers: ZİKK

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No