[Purpose] The purpose of this study was to compare the effects of shoulder stabilization exercise and shoulder isometric resistance exercise on maximum voluntary isometric contraction (MVIC) rate of change of shoulder stabilization muscles and hand function. [Method] The subjects of this study were nineteen healthy adults who had no problems with their musculoskeletal system. Group I performed shoulder stabilization exercise with a ball for 30 minutes. Group II performed shoulder isometric resistance exercise without a ball for 30 minutes. Electromyography recorded the MVIC rate of change of the upper trapezius, lower trapezius and serratus anterior in a manual muscle testing position after each exercise. All subjects were assessed for hand function (power and dexterity) using a dynamometer, pinch gauge, grooved pegboard and Purdue pegboard. The EMG data was compared using the independent t-test. Hand function was compared using the independent t-test and the paired t-test. [Results] The results of study were as follows: the MVIC rate of change showed significant difference between the shoulder stabilization exercise group and the shoulder isometric resistance exercise group for the upper trapezius and serratus anterior. In the shoulder stabilization exercise group, power grip, pinch, grooved pegboard test and Purdue pegboard test results were significantly increased post-intervention. In the shoulder isometric resistance exercise group, pinch was significantly increased post-intervention, but the other test results showed no significant differences. [Conclusion] We conclude that shoulder stabilization exercise is more effective than shoulder isometric resistance exercise for shoulder stability and hand function.
[Purpose] It is unknown what compensatory strategies are employed by amputees during standing at the initial stage of prosthesis wearing. This study examined the muscle activity during standing with different positions of center of gravity (COG) of healthy subjects wearing a simulated trans-femoral prosthesis on the right leg for the first time. [Subjects] Eight healthy subjects participated in this study. [Methods] Electromyograms of the left lower limb muscles were recorded during standing with different COG conditions. Center of pressure was also measured using a force platform. [Results] There were significant differences among the standing conditions for all the muscles. The tibialis anterior and gastrocnemius were mainly activated in weight shift backward and forward, respectively, which suggests that stiffness of ankle muscles, an ankle strategy, is related to maintaining balance. Significant activity of the semitendinosus, vastus medialis and lateralis also occurred, which indicates that an additional hip strategy was also employed for the sound leg during standing. In addition, there were significant differences of total sway path between shift backward and the other standing conditions. [Conclusion] Fear of falling and lack of sensory feedback may affect standing balance control, particularly in shift backward. Subjects will employ/develop a hip strategy as a compensatory mechanism due to peripheral dysfunction and fear of falling at the first experience of prosthetic standing.
[Purpose] The purpose of our study was to examine the reliability of a dual algometer and tissue hardness meter. [Subjects] Fourteen female American college students were used as test subjects for the tissue hardness meter, and 15 healthy Japanese adult males were used to test the algometer. All provided their informed consent. [Methods] Hardness of the rectus femoris muscle tissue was measured. Each subject sat in a resting position, with the knee bent at 60 degrees. The chair was fitted with a torque machine. Measurements were taken 3 times under each of the following conditions: No load (no muscle contraction) 10, 20, 30, 40 and 60 lbs and maximum load. Electromyograms of the rectus femoris were recorded simultaneously. The new algometer and a commercially available algometer (J-TECH) were tested for reliability. Pain threshold and pain tolerance were measured with both meters in the test subject's elbow joints and under the lateral epicondyle of the humerus. [Results] The correlation coefficient between tissue hardness and muscle contraction was high for each level of contraction, from no load to the maximum load of voluntary contraction; the reliability of the results was therefore high. The validity of the hardness measurement of the soft tissue for each load was also high. The reliability of both algometers was high. However, comparison of pain threshold and mean degree of tolerance revealed that the value was significantly lower with the new algometer. The new algometer was fitted with a switch for use by the test subject to end the test. The use of this switch resulted in highly accurate measurements. [Conclusion] This evaluation system will be useful in the future for providing objective evidence and making advances in rehabilitation medicine and other fields in the natural sciences.
[Purpose] To investigate the efficacy of pursed lips breathing with forced expiration techniques (PLB & FETs) and the active cycle of breathing technique (ACBT) on pulmonary mucus clearance in healthy subjects. [Methods] Three healthy subjects volunteered for the study. Pulmonary mucus clearance was measured over 70 minutes on three different days by a radioaerosol technique. Each subject attended three sessions, one each of control (normal breathing), PLB & FETs and ACBT. [Results] The efficacy of both airway clearance techniques was similar, but better than that of normal breathing. In the central lung zone, PLB & FETs demonstrated a slight enhancement of mucus clearance as compared with ACBT and normal breathing. In the intermediate and peripheral zones, PLB & FETs and ACBT resulted in a relatively high mucus clearance as compared with normal breathing. Overall mucus clearance of normal lungs was remarkably improved by PLB & FETs and ACBT. [Conclusion] Enhanced mucus clearance in healthy subjects, particularly in the intermediate and peripheral lung zone, can be achieved by PLB & FETs and ACBT.
[Purpose] This study attempted to examine the imbalance between the left and right side in standing and during gait among college students according to the way they wore their bags and the weight of the bag. [Subjects] The subjects were forty healthy Korean undergraduate students who were divided into two groups: a shoulder pack group and a backpack group. Five different weights were used for the bags: 0, 2, 5, 10 and 15 kg. [Methods] A Zebris FDM-T Treadmill (Zebris, Germany) was used for measuring plantar foot pressure. The plantar foot pressures in standing and during gait were measured using different bag types and weights. The paired t-test was used to compare plantar foot pressure between the left and right side. [Results] The backpack group did not show a significant difference between the left and right sides in standing and during gait regardless of the bag weight. Meanwhile, the shoulder pack group began to show differing plantar foot pressures between the left and right sides at a bag weight of 5 kg. However, no difference in plantar foot pressure was observed at any bag weight during gait. [Conclusion] The study results show that the plantar foot pressure differs between the left and right sides in standing when wearing shoulder packs heavier than 5 kg, while no such difference was observed during gait. Thus, walking while wearing a shoulder pack heavier than 5 kg is likely to cause musculoskeletal disorder due to the overuse of the muscle on the contralateral side.
[Purpose] We observed the action of muscles during gait using a Bluetooth Gait Analyzer (sampling frequency 1 kHz), by integrating electromyograms and performing power spectral analysis. Analyzer was described in the quantitative and qualitative evaluation of these muscles. [Subjects] The subjects were 15 healthy adult males. [Methods] A Bluetooth electromyography gait analyzer was used to observe the action of the vastus medialis muscle (Quad muscle) and the long head of the biceps femoris muscle (Hamstrings) during slow, medium, and fast gait. Electromyograms were subjected to integration and power spectral analysis evaluation. [Results] The integrated electromyograms of the Quad muscles and the Hamstrings increased significantly with increases in gait speed. Power spectral analysis showed the mean power frequency of the Quad muscles tended to decrease, and the high frequency component (81-250 Hz) was significantly reduced. The mean power frequency of the Hamstrings increased with increases in gait speed, but the high frequency component was significantly increased. [Conclusion] The observed tendencies might have resulted from the induction of positive action in type I muscle fibers in the Quad muscles with increased gait speed and of the muscle action of type II fibers in the Hamstrings. We suggest that, as the gait speed increases, the Quad muscles are forced to play the role of a braking muscle.
[Purpose] This study compared the activations of the upper trapezius (UT) and serratus anterior (SA) muscles and the SA/UT activation ratio during dynamic and isometric exercises on various support surfaces. [Subjects] We recruited 12 male subjects, all right-side dominant and with no congenital deformities in the upper extremities and no orthopedic or neurological disorders. [Methods] Push-ups and push-ups plus position maintenance exercises were performed on three different base surfaces: a wobble board, dual wobble boards, and a one-sided wobble board. Electromyography activities of the SA and UT muscles were recorded. [Results] The SA/UT ratio was significantly higher when dynamic exercises were performed using the one-sided wobble board than when they were performed on a normal wobble board or with dual wobble boards. The SA/UT ratio was significantly higher when isometric exercises were performed using a wobble board than when they were performed with a one-sided wobble board. [Conclusion] For clinical applications with a goal of selected SA muscle strengthening, greater benefit is achieved with isometric exercises performed on an unstable support surface and dynamic exercises performed on a stable support surface, as measured by the SA/UT ratio.
[Purpose] The purpose of this study was to determine the relationship between the Timed Up and Go (TUG) test score and the physical performance of women aged 75 years and over according to orthopedic status. [Subjects] The participants were 832 elderly women (mean age, 78.6 ± 2.7 years) who carried out their daily activities independently in their own homes and did not have histories of stroke or osteoarthritis of the hip. [Methods] Maximal voluntary contractions of the knee extensor and ankle plantar flexor muscle groups were measured using a hand-held dynamometer. One-leg standing time and usual walking speed were assessed as balance and walking performances. [Results] The TUG score was more strongly correlated with walking speed (r = -0.776) than the other measures of physical performance (r = -0.228 to -0.399). Correlations between the TUG score and walking speed were strongest for participants with knee osteoarthritis (r = -0.824) and fractures after 60 years of age (r = -0.809). A linear regression model of data from all participants showed that all performance scores and age were determinants of the TUG score (R2 = 0.634). The determinants of the TUG score for participants with osteoarthritis or fractures were walking speed and one-leg standing score, and age (R2 = 0.701) and walking speed, age, and knee strength (R2 = 0.688). Beta estimates of walking speed for all participants and for the subgroups were higher (-0.69 to -0.76) than those for the other determinants (-0.06 to 0.14). [Conclusion] Walking speed is a stronger determinant of the TUG score than muscle strength or balance for elderly women.
[Purpose] We attempted to investigate changes in motor function and C-reactive protein level according to amounts (length of time) of exercise in patients with cerebral infarct. [Method] Forty-six consecutive chronic hemiparetic patients with cerebral infarct were randomly assigned to two groups: Group 1 (exercise time 100 minutes/day) and Group 2 (exercise time 200 minutes/day). Types of exercise included static bicycle, isokinetic exercise, and standing or gait exercise on a treadmill. We also evaluated motor recovery using the Fugl-Meyer Scale (FMS) and the Modified Motor Assessment Scale (MMAS). Assessment of CRP levels and motor recovery were performed 3 times for 12 weeks at pre-treatment, 8 weeks and 12 weeks. [Results] The CRP level was decreased at post-treatment compared with pre-treatment; however, there were no significant differences. The FMS in both groups showed improvement at post-treatment compared with pre-treatment; however, there were no significant differences. The MMAS in both groups showed improvement at post-treatment compared with pre-treatment; however, there were no significant differences. [Conclusion] The exercise program improved the motor function and decreased the elevated CRP levels in chronic patients with cerebral infarct. Also, an increase in the duration of the exercise was correlated with decrease in the CRP level and increase in motor recovery.
[Purpose] The purposes of this study were to examine whether the asymmetrical tonic neck reflex affects the dominant-hand grip strength in healthy adults and to compare the results with the degree of grip strength achieved when Kinesio tape was applied to the flexor muscles of the dominant hands. [Subjects] The subjects were 20 men and 20 women who agreed to participate in the study. [Methods] Grip strength was measured using a Jamer dynamometer under 3 conditions: the neutral position, the head-neck system rotating toward the nondominant hand in the transverse plane, and after applying Kinesio tape to the flexor muscles of the dominant hand. [Results] In the neutral position, the grip strength of the dominant hand was significantly greater after applying Kinesio tape to the flexor muscles than that of the untaped dominant hand in the neutral position or the head-neck rotation condition in both males and females. [Conclusion] These results suggest that the muscle strength of the upper extremity in subjects with upper-extremity muscle weakness may be improved by clinical application of Kinesio taping as a supplementary measure.
[Purpose] The purpose of this study was to investigate the degree of muscle activation of the upper limb muscles during reaching movements in patients recovering from stroke. [Subjects] Nineteen hemiplegic patients participated in low-reaching and high-reaching tasks. [Methods] Changes in muscle activation resulting from performing low-reaching (reaching toward an object at the height of the knee) and high-reaching (reaching toward an object at the height of the shoulder) were measured using surface EMG. The surface electrodes were attached to the trapezius upper fibers, the deltoid anterior fibers, the deltoid middle fibers, the biceps, the triceps, the extensor carpi radialis and the flexor carpi radialis of both the paretic upper limb and the non-paretic upper limb. The independent t-test was used to compare muscle activation. [Results] Based on the results of measurements of muscle activation of the paretic upper limb, the muscle activation of the trapezius upper fibers and that of the deltoid anterior/middle fibers showed significant increases in high-reaching compared to low-reaching. However, for the non-paretic upper limb, significant increases were shown only in the trapezius upper fibers. These results indicate that, there is no difference between the muscle activation of the paretic side and that of the non-paretic side in high reaching while in low-reaching, the muscle activation values of the deltoid anterior fibers and the triceps of the non-paretic side are larger than those of the paretic side. [Conclusion] Muscle activation in reaching movements differs depending on the height of the target and we consider that these differences should be considered when therapeutic interventions are prescribed.
[Purpose] This study tested the clinical feasibility of using fast-tempo auditory stimulation (FTAS) incorporated into self-adopted walking training for improving walking function in patients with post-stroke hemiparesis. [Subjects] A total of 26 patients volunteered for the study and were randomly allocated to either the experimental group (EG) or the control group (CG), with 13 patients in each group. [Methods] The patients in the EG received 30-minute self-adopted walking training with FTAS twice a day, five days a week for two weeks. Walking speed, number of steps, and Wisconsin gait scale were measured before and after intervention. [Results] Significant differences between pre-test and post-test were found for all variables in the EG; however, only the number of steps was affected in the CG. A post-test comparison of the 2 groups revealed significant differences in all variables. The improvement rate for all variables was significantly higher for the EG than the CG. [Conclusion] These findings support the clinical use of FTAS integration into walking training as an efficient option for improving walking function in patients with post-stroke hemiparesis.
[Purpose] The aim of the present study was to measure the interrater and intrarater reliabilities of spinal motions using a skin-surface device (SpinalMouse; Idiag, Voletswil, Switzerland). [Methods] Spinal motion was measured in upright standing, trunk flexion, and trunk extension in 38 healthy adults. Intraclass correlation coefficients (ICCs) and Pearson's correlation coefficient were used to examine between-day and interrater reliabilities for spinal motion. [Results] For intrarater reliability of Raters 1 and 2, Pearson's correlation coefficient was 0.76-0.98, and ICC was 0.73-0.98, indicating high reliability in all cases except for extension of the sacral/hip. For interrater reliability on days 1 and 2, Pearson's correlation coefficient was 0.75-0.97 and ICC was 0.77-0.97 for all cases except for extension of the sacral/hip. [Conclusion] The reliability of SpinalMouse was demonstrated to be fair or higher but the measurement for extension of the sacral/hip needs further investigation.
[Purpose] The purpose of this study was to identify effects of exercise therapy on Heat Shock Protein (HSP70) in obese individuals. [Subjects] This study compared pre- and post-intervention levels of HSP70 between two obesity groups (obese exercise therapy n=7, obese control n=7). [Methods] Exercise therapy subjects were treated on a treadmill for 50 minutes at 55-80% of maximal heart rate for eight weeks. The HSP levels were measured prior to exercise at rest, exhaustion and 30 minutes after exercise therapy. Baseline HSP levels were also measured in seven controls, at rest, exhaustion and 30 minutes after exercise therapy. [Results] The findings show HSP levels in the long-term exercise therapy subjects were significantly lower than those of the control group at exhaustion. In this study, HSP70 levels may have increased significantly after exercise. [Conclusion] We conclude that the lower levels of baseline HSP70 expression in exercise therapy subjects might be the results of chronic adaptation to training.
[Purpose] This study examined the effect of balance training on an unstable surface on patients with spinal cord injury (SCI). [Methods] Twelve inpatients, 7 in the experimental group and 5 in the control, at a rehabilitation hospital in Seoul were enrolled as subjects. The experimental group was treated with conventional physical therapy, and allowed to exercise on an unstable surface for 4 weeks (30 minutes a day, 5 times a week. reaching forward, to the right and left, and over the head holding a ball with both hands. The following variables were measured before and after training; Modified Functional Reach Test (MFRT), sway area, and sway velocity using a Balance Performance Monitor (BPM). [Results] There was a significant increase in the MFRT distance in the experimental group. The experimental group also showed a significant decrease in sway area with both opened and closed eyes after training. The experimental group showed a significant difference before and after training compared to the control, as shown by MFRT distance and swaying area. [Conclusion] Exercise on an unstable surface improves the sitting balance of patients with a spinal cord injury. This treatment can be recommended as an effective treatment program for patients with spinal cord injury.
[Purpose] This study was performed to investigate the balance of the stance limb of hemiplegic stroke patients during the crossing of obstacles of different heights. [Subjects] Twenty stroke patients (right hemiplegia) crossed obstacles of different heights (0 cm, 10 cm, 20 cm). [Methods] Stance time and muscle activity of the stance limb were measured during obstacle crossing. Two-way ANOVA was used to compare the stance time and muscle activities of the stance limb at the various obstacle heights. [Results] The results show that the stance time of the unaffected lower limb was significantly longer than that of the paretic lower limb and obstacle height increased, the stance time of the unaffected lower limb increased significantly. The participants exhibited increase in electromyography of the unaffected limb with increasing obstacle height. Particularly, the rectus femoris and gastrocnemius of the unaffected limb showed significant increases, and the tibialis anterior of the unaffected limb showed a significant difference between heights of 10 cm and 20 cm. Finally, the tibialis anterior and gastrocnemius showed significant difference between paretic and unaffected limb at all obstacle hights. [Conclusion] The results suggest that training the gastrocnemius of the paretic limb is an effective therapy for hemiplegic stroke patients.
[Purpose] Examine the age-related deterioration of attentional capacity and predictive validity of multi-tasking performances for falls in adults aged 75 and older. [Methods] This study involved 45 elderly individuals and 15 healthy and young volunteers. Reaction times to a visual stimulus were measured under three different conditions: 1) stepping in place (dual-tasking condition with dynamic balance demands); 2) counting backwards during quiet standing (dual-tasking condition with cognitive demands); and 3) counting backwards while stepping in place (triple-tasking condition). The participating elderly individuals reported subsequent falls after a 5-month follow-up period. [Results] Elderly adults demonstrated significantly longer reaction time responses in all task conditions in comparison to young adults. There were statistically significant differences in reaction times between fallers and non-fallers during dual-tasking conditions, but not during triple-tasking conditions. The slower reaction times during dual-tasking conditions with dynamic balance demands were significantly related to the occurrence of subsequent falls, whereas there was only a weak association in model-adjusted physical performance tests. [Conclusions] Attentional capacity in multi-tasking conditions decreases with aging. Slow reaction time response during dual-tasking conditions with dynamic balance demands may be a predictor of falls in adults aged 75 and older.
[Purpose] The purpose of this study was to give task-oriented training to stroke patients in water and on land and compare their static balance and dynamic balance. A total of 10 types of task-oriented training were given in water and on land. [Subjects] A total of 34 patients received training for 50 minutes, three times a week, for 12 weeks. [Methods] The 34 patients were randomly divided into an in-water training group and an on-land training group. The patients received the same task-oriented training for 12 weeks. [Results] When the groups' static balance was compared, the in-water training group showed significant improvements in anteroposterior velocity (mm/s) and mediolateral velocity (mm/s) with eyes open (EO) and eyes closed (EC). The on-land training group showed significant improvements in values other than anteroposterior velocity (mm/s) with EC. When the groups' dynamic balance was compared, there was a statistically significant difference between the groups at 12 weeks. The in-water training group showed significant reductions in the time and distance taken to implement a task. [Conclusion] According to the results, task-oriented training received by chronic stroke patients in water was more effective at improving static balance and dynamic balance than on-land training.
[Purpose] In this study, we quantitatively evaluated how the positioning program influenced the movement patterns of preterm infants in the neonatal intensive care unit (NICU). [Subjects and Methods] Spontaneous movements of 12 low-risk preterm infants were video-recorded at 38 or 39 postmenstrual weeks of age (PMA). Six of them (positioning group) received a positioning program from birth to 35-36 weeks of PMA while the other 6 (non-positioning group) did not. We attached reflective markers on the infant's wrists and ankles in the supine position and filmed them from above. By using a two-dimensional image analysis system, we digitized the wrist and ankle trajectories and analyzed the data by calculating several statistics. [Results] Infants in the positioning group brought their hands to the midline or crossed their hands over the midline and showed more variation in velocity of movements than those in the non-positioning group. We also noticed that infants in the positioning group exhibited and maintained a movement pattern similar to that of full-term infants at 1 month after the positioning program was terminated. [Conclusions] These results suggest that appropriate positioning of preterm infants facilitates flexion posture and movement patterns toward the centre of the body similar to foetuses in the uterus.