[Purpose] The purpose of this study was to determine the absolute reliability and relative reliability of the Pediatric Balance Scale (PBS) for children with Cerebral Palsy (CP). [Subjects] For the inter- and intra-rater reliability, 36 children with CP (20 boys, 16 girls) were recruited. For the test-retest reliability, 27 children with CP (16 boys, 11 girls) were recruited. [Methods] Seven pediatric physical therapists rated 36 video recordings of children with CP to test inter-rater reliability. Two therapists rescored each video recording to test intra-rater reliability after an interval of two weeks. To evaluate the test-retest reliability, one rater scored each of the 27 video clips on two occasions, two-weeks apart. Relative reliability was calculated using the intraclass correlation coefficient (ICC). Absolute reliability was assessed using the standard error of measurement (SEM) and the smallest real difference (SRD). [Results] The PBS showed high to very high relative reliability, and the absolute reliability was satisfactory for the inter- and intra-rater and test-retest reliability. [Conclusion] Excellent absolute reliability as well as relative reliability of the PBS was obtained, so the PBS is reliable for examining the functional balance of children with cerebral palsy.
[Purpose] This purpose of this study was to verify the effects on shoulder abduction ROM of Gong’s mobilization applied to patients in the sitting position and in the side-lying position. [Subjects] This study recruited male and female adults whose shoulder abduction range of motion (ROM) was 120 degrees or less and separated them into Gong’s Mobilization in the side-lying position group (side-lying group, n=20) and Gong’s Mobilization in the sitting position group (sitting group, n=20). [Methods] Gong’s mobilization was applied repetitively about 10–15 times on each individual in both the side-lying and sitting groups. A goniometer was used to measure the shoulder abduction ROM. [Results] In both the side-lying group and the sitting group shoulder abduction ROM increased, and the increase of ROM in the side-lying group was greater. [Conclusion] The treatment effect of Gong’s mobilization applied to patients in the side-lying position was greater than that of Gong’s mobilization applied to patients in the sitting position; thus, the side- lying position is the proper therapeutic position for Gong’s mobilization for patients whose abduction hypomobility.
[Purpose] The purpose of this study was to investigate the effect of the application of Rhythmic Auditory Stimulation (RAS) to the rehabilitation of stroke patients and its effect on gait symmetry. [Subjects] Twenty-five subjects with stroke performed walking under five conditions and the study progressed following a randomized single-blind cross-sectional design. [Methods] We evaluated the effects of a 5-minute session of RAS. Subjects walked under five conditions: (1) a comfortable speed without external rhythm; (2) non-paretic leg footfall with RAS matching the baseline speed; (3) non-paretic leg footfall with RAS 30% slower than the baseline speed; (4) paretic leg footfall with RAS beat frequency matching the baseline speed; (5) paretic leg footfall with RAS 30% faster than the baseline speed. The step time (paretic leg and non-paretic leg), velocity and cadence were measured before and after gait training with RAS [Results] Gait symmetry improved in conditions 4 and 5, but not in conditions 2 and 3. Gait ability was assessed with velocity and cadence. Velocity and cadence improved in conditions 4 and 5. [Conclusion] The results of the study demonstrate the ability of RAS to improve gait symmetry. Thus, RAS should be an effective method for the improvement of the gait symmetry of chronic stroke patients.
[Purpose] The objective of this study was to verify the immediate effects of Gong’s mobilization on the ankle dorsiflexion range of motion (ROM). [Subjects] The subjects of this study were 40 health adult males and females who were divided epuallt into a Gong’s mobilization group (Gong’s group) and mobilization with movement group (MWM group). [Methods] Gong’s mobilization and MWM were implemented about 10 times. The ankle dorsiflexion ROM was measured with a goniometer. [Results] Both Gong’s Mobilization and MWM were effective at increasing ankle dorsiflexion ROM. However, neither Gong’s Mobilization nor MWM can be said to better than the other at increasing ankle dorsiflexion ROM. [Conclusion] We recommend use of MWM to increase ankle dorsiflexion ROM in closed kinetic chains and use of Gong’s Mobilization to increase ankledorsi flexion ROM in open kinetic chains.
[Purpose] The purpose of this study was to show the effects of different bridge exercises for the elderly on trunk and gluteal muscles. [Subjects] Twenty elderly persons were recruited. [Methods] The EMG activities of the right side L5 paraspinal, external abdominal oblique (EO), and gluteus maximus (GM) muscles were measured during three bridge exercises: conditions 1, 2, and 3. [Results] The EMG activities of the for the L5 paraspinal, EO, and GM muscles showed significant differences among the 3 bridge exercise conditions. The EMG activity of the EO muscle significantly increased in the order of condition 1<2<3. The EMG activity of the GM muscle also significantly increased in the order of condition 1<2<3. [Conclusion] Bridge exercises with special boards are effective exercises because they help to strengthen and develop the EO and GM muscles that help to stabilize the spine of the elderly.
[Purpose] This study examined the validity of admission FIM scores as predictors of functional independence, of “early” and “late” elderly patients with stroke in a post-acute rehabilitation unit. [Subjects] After excluding stroke patients with recurrence and complications, the remaining 286 (150 males and 136 females) patients aged 65 to 84 with stays of more than one month . [Methods] According to the level of ADL independence, based on motor and cognitive admission FIM scores, the patients were divided into 3 groups: completely dependent/maximal assistance; moderate/minimal assistance; and supervision/completely independent. Subsequently, time-dependent changes in FIM scores were analyzed to compare the “early” and “late” elderly, score-based groups, and measurements. [Results] Total motor and cognitive FIM scores on and after admission did not overlap among the three ADL independence groups, and showed linear time-dependent changes. Such changes were not observed in individual FIM item, while differences were shown in the period and degree of ADL improvement between the age-based groups. [Conclusion] Motor and cognitive FIM scores were shown to be valid as predictors of functional independence, regardless of age. Scores of individual items were shown to be generally inappropriate as predictors. As the period and degree of ADL improvement varied between the age-based groups, it may be important to continuously provide approaches not only for motor, but also cognitive functions over a long period of time, while considering the age and type of ADL, as well as the individual needs of each patient.
[Purpose] This study was conducted to investigate the effect of mobilization of the ankle joint in elderly adults on range of motion and functional balance of elderly adults. [Methods] Thirty-three healthy elderly adults were randomly allocated to two groups: the mobilization (MT) group and the control (CT) group, comprised of 18 and 15 subjects respectively. Traction, anterior gliding and posterior gliding of the talocrural joint were performed in the MT group, whereas no intervention was made in the CT group. [Results] The average change of ankle ROM was 7.02° in the MT group and -0.08° in the CT group, showing a significant difference (F=52.67). The average change of execution time in the OLB test was 6.88 seconds in the MT group and -0.49 seconds in the CT group, showing a significant difference (F=107.33). The average change of execution time in the TUG test was -2.88 seconds in the MT group and -0.34 seconds in the CT group, showing a significant difference (F=36.44). The average change of reaching distance in the LR test was 13.61 mm in the MT group and 0.48 mm in the CT group, also showing a significant difference (F=11.13). [Conclusion] We presume that mobilization of the ankle joint of elderly adults increases range of motion and improves functional balance.
[Purpose] The purpose of this study was to investigate the intra- and inter-tester reliabilities of transverse arch length (TAL) standing position and lower leg maximum anterior tilting (LMAT) position. [Subjects] Eight subjects who were free from lower extremity injury at the time of testing and three testers participated in this study. [Methods] TAL was measured 3 times in each trial both in the standing position and the LMAT position. Three trial repetitions were performed at 1-hour intervals. Test–retest reliability was established using the ICC (1, k) model and data from the first to the third trials. Inter-tester reliability was established using the ICC (2, k) model and the averages of the first to third trials of each tester. [Results] In the standing position, intra-tester reliability was good or sufficient for use in a clinical setting. Inter-tester reliability was sufficient for use in a clinical setting. In the LMAT position, intra-tester reliability was excellent or sufficient for use in a clinical setting. Inter-tester reliability was good. [Conclusion] We suggest that it is possible to easily assess the flexibility of the transverse arch of the forefoot using the technique we describe here.
[Purpose] The main purpose of this study was to investigate the effects of Virtual Reality Reflection Therapy on motor recovery and motor function in the upper extremities of patients with chronic stroke. [Subjects] Nineteen participants patients with chronic stroke were randomly assigned to the experimental group (n=11) and the control group (n=8). [Methods] The experimental group performed a Virtual Reality Reflection Therapy program for 30 minutes a day, 5 days a week, during a 4 week period, in addition to conventional therapy. The control group received conventional therapy and performed sham program. All subjects were evaluated using by the Fugl-Meyer Assessment (upper limb section), the Modified Ashworth Scale (MAS), the Box and Block Test (BBT), the Jebsen-Taylor Hand Function Test and the Manual Function Test pre- and post-intervention. [Results] The experimental group and the control group effectively increased their upper-extremity motor recovery and motor function. Upper-extremity motor recovery and motor function of the experimental group showed more significant increases than those of the control group. [Conclusion] Virtual Reality Reflection Therapy (even as a home treatment) with a conventional program in the early stages of treatment might be beneficial for improving hand function. Future studies need to investigate the effectiveness of Virtual Reality Reflection Therapy with optimal patient selection or duration and intensity of training.
[Purpose] The purpose of this study was to investigate the effect on chronic stroke patient’s trunk control and dynamic balance ability in the sitting position of a dual motor task training program combined with a conventional training program. [Subjects] Twenty-eight subjects after twelve months post stroke participated. [Methods] The subjects were randomly divided into two groups: a dual motor task training group (n=14) and a control group (n=14). Both groups performed the conventional exercise program for 60 minutes per day, 5 times a week for six weeks. The dual motor task training group also performed dual motor task training in the sitting position for 30 minutes per day, 3 times a week for six weeks at a separate place from the control group. [Results] The dual motor task training group showed significant improvements in trunk control ability, and dynamic balance in the sitting position. [Conclusion] Dual motor task training combined with a conventional exercise program improves trunk control ability and sitting balance. These results suggest that dual motor task training is feasible and beneficial for individuals with chronic stroke.
[Purpose] The purpose of this study was to investigate the effects of physical activity on the muscular strength of the lower extremities of mentally retarded adults. [Subjects] The subjects were ten adults with mental retardation, residents of a special institution, who took part in an aerobic and strength exercise program and ten others who did not perform any exercise for 24 weeks. [Methods] Participants in the exercise group performed the combined exercise therapy at 55–69% HRmax for an hour 3–4 days a week for 24 weeks. Leg muscular strength was measured before and after the training. The paired t-test was used analyze the difference between before and after training. [Results] The exercise group showed significantly improved leg muscular strength. [Conclusion] The findings imply that the physical activity over a long period has a significant effect on the muscular strength of the lower extremity of adults with mental retardation.
[Purpose] Changes in cardiopulmonary function during wheelchair propulsion on a treadmill were measured using wheelchairs according to backrest angle adjustment. [Methods] Twenty-two healthy male subjects were the subjects. Oxygen consumption (VO2, ml/min), heart rate (HR, beats/min), carbon dioxide emissions (VCO2, ml/min), oxygen uptake per body weight (VO2, ml/kg/min), and respiration frequency (Rf) were used as the measurement variables for cardiopulmonary data. [Results] The peak value, average value and value at rest were compared. When resting, the value did not differ except for VO2, and the peak value, did not differ except for VCO2. However, the average value in all except VO2/kg (at 13 degrees) was significantly lower than 3 degrees (93°). [Conclusion] A 13° wheelchair backrest angle (103°) provides a lower cardiopulmonary workload than the base angle (3°). A training program for good seating and posture needs to be provided
[Purpose] The fear of falling is a common problem among older people and it can lead to activity restriction and risk of future falls. A tool to assess the fear of falling in Thailand was not available; thus, it was essential to develop an appropriate questionnaire that can determine the severity of the fear of falling. [Subjects] Five hundred elderly subjects aged 60 years old or over participated in this study. [Methods] This study created a new questionnaire called the Thai Geriatric Fear of Falling Questionnaire consisting of 34 items with a 6-point Likert scale separated into 3 major domains: 15 physical and functioning items, 8 in environmental items and 11 psychosocial items. Then the psychometric properties of the new questionnaire were assessed. [Results] The reliability results show the internal consistency (r = 0.965) and test-retest reliability (r = 0.874) were excellent. The validity results for content (4 expert agreements), convergent (r = -0.910), and discriminative (r = 0.122) were satisfactory. The best cut-off score of 66 was also identified from the acceptable area under the curve, sensitivity, and specificity (0.794, 90.1%, and 100%, respectively). [Conclusion] The Thai Geriatric Fear of Falling Questionnaire can be used as an instrument to assess the fear of falling. Utilizing this tool, health personnel can become aware of and better able to manage the problems associated with activity restriction from the fear of falling.
[Purpose] The aim of this study was to analyze the effect of muscle tightness and joint range of motion on the kicking motion based on measurements of physical functions obtained by a medical check and simple analysis of kicking motion. [Subjects] The subjects of this study were 21 senior high school students who belonged to a soccer club. [Methods] We measured the tightness of the iliopsoas, quadriceps, hamstrings, and triceps surae, and the angle of external rotation of the hip joint in the upright position. Also, images in the sagittal plane were taken of the kicking motion. [Results and Conclusion] A tendency was observed of muscle tightness in the quadriceps and triceps surae, affecting the kicking motion. The angle of external rotation of the hip joint in the upright position also affected kicking motion by decreasing anterior inclination of the lower supporting leg and backward shift of the upper trunk at the time of foot impact on the ball.
[Purpose] This study examined the effects of Gong’s mobilization on the cervical lordosis, forward head posture (FHP), cervical range of motion (ROM), and the resting and concentration states of the brain. [Subjects]Forty college students who had problems with cervical posture and ROM were divided into a Gong’s mobilization group (n=20) (an experimental group) and a control group (n=20). [Methods] We performed Gong’s mobilization on the experimental group three times per week for four weeks and looked at the effects of Gong’s mobilization on cervical lordosis, FHP, and cervical ROM. We also examined the effects of Gong’s mobilization on the brain’s activation levels by analyzing brain waves during the brain’s resting and concentrating states using neuro-feedback equipment. [Results] Gong’s mobilization increased cervical lordosis, cervical extension ROM (CER), and the ranges of flexion and extension motion (RFEM). It also decreased FHP and enhanced the brain’s resting state, rest-α, low rest-β, and high rest-β waves; and during concentration, it increased high β waves. [Conclusion] Gong’s mobilization improved FHP and increased the ROM of the cervical spinal area. These improvements in dynamic parts are effective at enhancing the brain’s resting state, which indicates that Gong’s mobilization may affect the maximization of the brain’s steady state and attention and concentration.