The purpose of this study was to describe a rolling motion, which is common in normal adults and patients with motor disorder, and to try to understand the mechanism of the motion. Ten healthy young adults participated in the experiment and were requested to roll from supine to side-lying by pressing the floor with their contra-lateral foot. Their motions in the task were measured with a 3-D analysis system and a force platform. The hip abduction-adduction angle was at around the neutral position and was approximately constant throughout the rolling motion. The hip rotation angle was at a neutral or slightly internally rotated position at the beginning of the motion, and it externally rotated linearly toward the end of the rolling motion. These patterns were thought to be mechanically the most effective for the subjects to perform the motion as was also indicated by the kinetic analysis.
Falling due to unstable standing balance is considered to be the main cause of bone fractures, which lead elderly persons to becoming bedridden. Thus, the standing balance of elderly persons is being given increasingly greater attention. On the other hand, postural deformation caused by deformation in the spine and lower leg joints is considered to have an effect on standing balance. The objective of this study is to clarify the effect of postural deformation on the following three categories of standing balance; 1) the ability to immobilize Center of Gravity (COG) in standing statically, 2) the ability to control COG during movement and 3) the postural response induced by postural sway. Fifty elderly persons (age:77.7 ± 6.4 years old, fifty females) participated in this study. Postural deformation was measured using a Spinal Mouse, a device for non-invasive measurement of spinal curvature and photographic image in sagittal plane. In line with to Nakata's classification of postural deformation, subjects were classified by extension type, S-character deformation type, flexion type, hands on the knee type and normal group. In order to assess the ability to immobilize COG in static standing, Center of Pressure (COP) in static standing was measured for 30 sec. In order to assess the ability to control COG during movement, functional reach, maximal length of stride and the period of 10 m gait were measured. Postural response was induced by fore-aft perturbation of the platform on which the subjects stood. Postural responses were assessed by measuring both COP, and electromyography (EMG) of muscles in the lower legs. There was little significant difference among the five groups concerning postural deformation in every measured item, neither in the ability to immobilize COP in static standing, nor in the postural response induced by postural sway. However, the results of measured items concerning the ability to control COG during movement were significantly worse in flexion type and hands on the knee type compared with the normal group. It was suggested that postural deformation in elderly persons effects exclusively on the ability to control COG during movement in standing balance.
Even though many investigators have analyzed the functional difference of the three heads of triceps surae in human, none of them succeeded to clarify the distinctive functional difference of those three muscles. The aim of this study was to investigate whether the integrated EMGs (IEMGs) of the triceps surae muscle, gastrocnemius and soleus, were task dependent. IEMGs of the medial head of the gastrocnemius (GM), lateral head of the gastrocnemius (GL), and soleus (SO) were investigated at three different knee joint angles, at four different duration of ramp contraction, with the generation of a single ongoing force, from 0 to the maximum voluntary contraction (MVC). Three-way ANOVAs for repeated measures were used to estimate differences in IEMG values in each of the GM, GL, and SO, taken at four different durations of ramp contraction (5, 10, 15 and 20 s), at three different knee joint angles (0 deg, 30 deg and 90 deg), across ankle plantar flexion levels of force (10, 20, 30, 40, 50, 60 and 70% MVC). According to three-way ANOVAs for repeated measures, IEMG of the GM muscle showed a first-order interaction between force and knee joint angle. In addition, IEMG of the GL muscle showed first-order interactions between the level of force and knee joint angle, and between the level of force and duration of ramp contraction. Furthermore, IEMG of the SO showed a main effect only on level of force. These results suggest that the each head of the triceps surae may work task dependently.
The purpose of this study was to examine the intra-tester and inter-tester reliability of chest expansion (CE) using a tape measure, in people with ankylosing spondylitis (AS) and healthy subjects. Twenty-two subjects with AS with a mean age of 41.4 years and 25 healthy subjects with a mean age of 41.0 years were tested in two arm positions: hands on head and arms at the sides, the tape measure being placed at the level of xiphisternum. There were three testers for subjects with AS and two testers for healthy subjects. Three trials in both arm positions were recorded by each tester on two separate occasions which were 10 minutes apart. Results showed intraclass correlation coefficients (ICC) for intra-tester reliability good (0.85 to 0.97) across the occasions. Intraclass correlation coefficients for inter-tester reliability were also very good (0.93 to 0.97). As reliability is good it is suggested that CE can be used for monitoring disease progression and efficacy of intervention with confidence within tester and between testers.
To clarify whether exercise therapy in a water environment is appropriate therapy for hypertensive patients, we investigated oxygen saturation and hemoglobin level in the vastus medialis muscle using a laser tissue blood oxygen monitor. Seven hypertensive patients (52 to 77 years of age, hypertensive group) and five healthy volunteers (44 to 69 years of aged, control group) participated in this study. Subjects maintained resting postures for about 5 minutes each in a standing position, a sitting position on a chair, a lying position out of water, and a position in water below the navel and to the chest level. Subjects performed flexion/extension movement of the knee joint (30 times/min) in and out of water. Oxygen saturation level (SaO2), oxygenated hemoglobin level (HbO2), deoxygenated hemoglobin level (HbD), and total tissue hemoglobin level (HbT) were measured in the muscle tissue. Blood pressure (BP) and pulse rate (PR) were monitored simultaneously. In the hypertensive group, SaO2 in muscle tissue in water was significantly increased compared with that in a standing position out of water (p<0.05), and returned to the level in the control group. HbD in the hypertensive group was significantly reduced in the position in water to the chest level compared to that in a standing position (p<0.05). In both groups, the ratios of HbD and HbO2 (O2/D ratio) was significantly increased in water environment compared with that out of water (p<0.05). The O2 /D ratio, which indicates oxygenation within the tissue, increased during exercise in water in the hypertensive group. This study demonstrated that oxygen saturation in the muscles of the hypertensive group was lower than that in controls out of water, but the level was increased in water. Our findings suggest that water provides a good exercise environment for hypertensive patients from the perspective of oxygen saturation in hypertensive muscle tissue.
A variety of physiotherapeutic approaches have been tried out during the past 25 years to alleviate the plight of patients with peripheral facial nerve paresis. The objective of this review was to assess the effectiveness of physiotherapy in patients with facial nerve paresis. Trials were identified by computerised searches of biomedical databases, reference lists, and by contacting investigators. Selection criteria were randomised controlled trials of physiotherapy for the improvement of sequelae of facial nerve paresis, comparing the treatment with either another intervention or no intervention. Two reviewers independently assessed the trials using the PEDro scale. Two physiotherapy randomised controlled studies were identified. Interventions used for treatment of patients with facial nerve paresis in the included studies were relaxation, biofeedback and exercise therapy. Neither of the two randomised controlled studies showed scientific evidence of a physiotherapeutic approach in comparison with a control group. Both studies described benefits of the interventions. Further randomised controlled studies are required to determine the effectiveness of physiotherapy in patients with facial nerve paresis.
Falls are a major public health problem for older people. Recent research suggests that fear of falling may be a more pervasive and serious problem than falls among the elderly. The present study was conducted to determine whether frail elderly persons with fear of falling have lower physical function. A total of 47 subjects (aged 73 to 95) were recruited from a geriatric health services facility in Osaka. Physical function including balance, mobility, and muscular strength were measured using the following tests: Timed up & go test (TUG), functional reach test, single limb stance with eyes open, ten-meter walk, and knee extensor strength. Twenty-nine subjects (62%) had fear of falling and 18 (38%) had no fear of falling. There was no significant difference in age, sex, or the proportion using assistive devices. Results from the statistical tests showed that there were no differences in physical function, except in the functional reach test. The ratio of TUG to 10 m walk was used to determine the association between balance and mobility. In frail elderly persons with fear of falling and in those without fear of falling, the means of the ratios were 1.20 (SD=0.27) and 1.03 (SD=0.16), respectively. The ratios for frail elderly persons with fear of falling were higher (p=0.024) than the frail elderly without fear of falling. Our study suggests that even if frail elderly individuals walk slowly, they are not afraid of falling if there is a feasible balance function. We conclude that, in low-functioning frail elderly, fear of falling is associated with a combination of balance function and gait speed.