【論文摘要】The Immediate Effect of Rhythmic Initiation Technique in Affected Pelvis on Stride Length in a Patient With Chronic Stroke: A Case Report

【論文摘要】患側骨盆做節律性起始在中風患者步幅的立即效果：個案報告

黃于瑄(Yu-Syuan Huang) ； 洪嘉洵(Chia-Hsun Hung)

《物理治療》 45卷4期 (2020/12) Pp. 327-328

https://doi.org/10.6215/FJPT.202012.P19

摘要

Background and Purpose: The proprioceptive neuromuscular facilitation (PNF) is a method of facilitation, in which rhythmic initiation (RI) is the technique aiding in initiating movement and increasing range of motion. The pelvic mobility plays an important role in gait cycle due to its direct linkage between trunk and lower extremities. The pelvic pattern of PNF includes anterior elevation, anterior depression, posterior elevation and posterior depression. The purpose was to investigate the immediate effect of RI in affected pelvis on stride length in a patient with stroke. Method: This is a 73-year-old female with right hemiplegia. She could walk with moderate assistance three years post stroke. Her Brunnstrom's stage was V in lower extremity of right side, but she had difficulty in initiating walking. She felt hard to lift her right leg and step forward, and was fear of falling. The intervention was specific to pelvic patterns of PNF with RI technique on right side in side-lying. The PT guided the arc movement of right pelvis from anterior elevation to posterior depression back and forth. Following, the arc movement was changed the direction from anterior depression to posterior elevation back and forth. Each movement repeated was performed 3 set each direction, 20 times per set. Outcome measure was stride length. Putting the stickers on the ground that was a point of heel contact measured the length of each stride. Result: She only received one-day treatment. Before intervention, the stride length was 33 cm in right side and was 28.3 cm in left side. Passive range of motion of both sides was within normal limit. After intervention, the stride length was 46 cm (39.3% of improvement) in right side and was 38cm (35.7% of improvement) in left side. The patient could lift the leg of affected side easier and step longer. Conclusion: Application of RI in affected pelvis could increase stride length of the affected side in a patient with stroke. Clinical Relevance: The pelvic pattern of PNF by using RI technique may provide a potential strategy on increasing walking speed and distance in stroke patients.