Hip Abductor Strengthening With Proprioceptive Neuromuscular Facilitation

Study Overview
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Brief Summary
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Objectives: To compare effectiveness of strengthening hip abductors with Proprioceptive Neuromuscular Facilitation (PNF) technique and Range Of Motion (ROM) exercises on core endurance and functional performance in healthy adults using theraband. Methods: 66 sedentary healthy, male volunteers between ages 20-26 (mean age 21,68± 1,37 years) participated in study. PNF, ROM exercises applied with theraband include intervention groups. Theraband strengthening exercises were applied 3 days a week for 6 weeks, a total of 18 sessions. Intervention groups were compared with healthy control group. Participants hip abductor muscle strength was assessed with hand held dynamometer, lower extremity balance with y test, core endurance with flexor, extensor, right, left side endurance tests, global core stability with single leg squat test at baseline and at 6 weeks after exercise program.

Detailed Description
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This study was designed as a randomized controlled trial and conducted according to the Declaration of Helsinki and was approved by the Ethics Committee of Clinical Trials (21.05.2019/10). All participants were informed about the study and their written consent was obtained. Participants were randomly divided into three groups using the sealed envelope method (on the evaluation day, participants chose one of the sealed envelopes and determined the treatment group). Group I comprised the Proprioceptive Neuromuscular Facilitation (PNF) group, Group II the Range of Motion(ROM) group, and Group III the Control (CG) group. Evaluations were made at baseline and at sixth week. Male participants between the ages of 20 and 26 years, were included in the study. Participants age, body mass index (BMI), dominant extremity were recorded as descriptive data. Muscle strength assessment: Bilateral hip abductor isometric strength was assessed using a Hand-held Dynamometer (HHD) (Commander Power Track II; JTECH Medical Industries, Salt Lake City, UT) using the maximal isometric strength standard protocol. The participant was asked to 30 degree hip abduct by stabilizing the pelvis in the side lying position. Three measurements were made by placing the dynamometer pad 10 cm proximal to the lateral epicondyle of the femur, and the average value was recorded in kilograms. Balance assesment: It was done with Y balance test. While maintaining their balance on the dominant extremity on the test platform, the participants were asked to reach out in 3 directions (anterior-posterior, postero-medial and postero-lateral) with the tip of the other foot. 3 repetitions were made for each direction, and rest intervals of 15 seconds were given. The mean score was recorded in cm. The lower extremity length of the participants was determined by measuring the distance between the anterior superior spina iliaca and the medial malleolus with a tape measure in the supine position. Composite scoring was obtained by multiply with one hundred the reach in all directions and dividing by three leg lengths. Global (functional) core assessment: It was done with the single leg squat test. Participants were asked to perform one-leg squats at 45 degree knee flexion in 30 seconds, and the number of squats was recorded. Core endurance assessment: Participants were evaluated with trunk flexion endurance, extension endurance and lateral bridge endurance tests, and the results were recorded in seconds.

Official Title
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The Effect of Hip Abductor Strengthening With Proprioceptive Neuromuscular Facilitation and Elastic Resistive Band Exercises on Core Endurance and Functional Performance ın Healthy Adults

Conditions
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Sports Physical Therapy

Intervention / Treatment
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* Other: Proprioceptive Neuromuscular Facilitation exercises
* Other: The Range Of Motion exercises


Participation Criteria
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Eligibility Criteria
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inclusion criteria: Not having any known and diagnosed health problems Not exercising regularly Not having a lower/upper extremity injury in the last three months Volunteering to participate in the study exclusion criteria: Not to participate in exercise training more than three sessions Want to leave the training voluntarily Have experienced serious orthopedic/systemic discomfort during the training

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 26 Years

Sexes Eligible for Study
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Male

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants were randomly divided into three groups using the sealed envelope method (on the evaluation day, participants chose one of the sealed envelopes and determined the treatment group). Group I comprised the Proprioceptive Neuromuscular Facilitation (PNF) group, Group II the Range of Motion(ROM) group, and Group III the Control (CG) group. Evaluations were made at baseline and at sixth week.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Proprioceptive Neuromuscular Facilitation (PNF) Exercise Group<br>The PNF group performed flexion-abduction-internal rotation and extension-abduction-internal rotation patterns as 15 repetitions, 2 sets. The metronome was used to fix the construction speed of the exercises (50bpm). PNF exercises were performed with EB at a metronome speed of 50bpm at a ratio of 1:2 sec. In other words, while transition from the antagonist to agonist pattern in 3 clicks, there was return from agonist to antagonist in 6 clicks. | Other: Proprioceptive Neuromuscular Facilitation exercises<br>* The PNF group performed flexion-abduction-internal rotation and extension-abduction-internal rotation patterns as 15 repetitions, 2 sets. The metronome was used to fix the construction speed of the exercises (50bpm). PNF exercises were performed with EB at a metronome speed of 50bpm at a ratio of 1:2 sec. In other words, while transition from the antagonist to agonist pattern in 3 clicks, there was return from agonist to antagonist in 6 clicks.<br>|
| Experimental: Range Of Motion (ROM) Exercise Group<br>The ROM group performed hip flexion abduction, neutral abduction and extension abduction exercises with an EB at 50bpm metronome speed in 3 sets of 10 repetitions. In both groups, 30 seconds of rest was given between exercises. | Other: The Range Of Motion exercises<br>* The ROM group performed hip flexion abduction, neutral abduction and extension abduction exercises with an EB at 50bpm metronome speed in 3 sets of 10 repetitions. In both groups, 30 seconds of rest was given between exercises.<br>|
| No Intervention: Control Group<br>No exercise practice was done | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change from baseline in Muscle strength with different exercises(PNF and ROM) at week 6 | Bilateral hip abductor isometric strength was assessed using a Hand-held Dynamometer(HHD) (Commander Power Track II; JTECH Medical Industries, Salt Lake City, UT) using the maximal isometric strength standard protocol. The participant was asked to 30 degrees hip abduct by stabilizing the pelvis in the side lying position. Three measurements were made by placing the dynamometer pad 10 cm proximal to the lateral epicondyle of the femur, and the average value was recorded in kilograms. | 6 weeks | 
| Change from baseline in balance with different exercises(PNF and ROM) at week 6 | It was done with Y balance test. While maintaining their balance on the dominant extremity on the test platform, the participants were asked to reach out in 3 directions (anterior-posterior, postero-medial and postero-lateral) with the tip of the other foot. 3 repetitions were made for each direction, and rest intervals of 15 seconds were given. The mean score was recorded in cm. The lower extremity length of the participants was determined by measuring the distance between the anterior superior spina iliaca and the medial malleolus with a tape measure in the supine position. Composite scoring was obtained by multiply with one hundred the reach in all directions and dividing by three leg lengths. | 6 weeks | 
| Change from baseline in global(functional) core with different exercises(PNF and ROM) at week 6 | It was done with the single leg squat test. Participants were asked to perform one-leg squats at 45 degrees knee flexion in 30 seconds, and the number of squats was recorded. | 6 weeks | 
| Change from baseline in core endurance with different exercises(PNF and ROM) at week 6 | Participants were evaluated with trunk flexion endurance, extension endurance and lateral bridge endurance tests, and the results were recorded in seconds. | 6 weeks | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Exercise, Muscle strenght, Balance