[Purpose] The purpose of this study was to make a comparison of dynamic balance ability between dual and simple task conditions. [Subjects and Methods] Nine children with attention deficit hyperactivity disorder (9.00 ± 2.12 years) and 10 healthy children (9.67 ± 2.75 years) were recruited. Each group was asked to do an obstacle crossing alone and the obstacle crossing combined with a stimulus response task. The Qualisys motion capture system was used to capture full-body motion. The parameters measured included crossing speed, step width, and reaction time. [Results] Children with attention deficit hyperactivity disorder had greater problems than controls in performing the primary balance task while concurrently completing the auditory reaction time task and showed greater variability in step width and a longer reaction time. The balance scores assessed using the Movement Assessment Battery for Children test were significantly worse in the attention deficit hyperactivity disorder group and were significantly correlated to the crossing reaction time and variance of crossing speeds.[Conclusion] The attention deficit hyperactivity disorder group preferred to complete the obstacle crossings before responding to the stimulus. This resulted in a longer reaction time for the secondary task and also changed the gait strategy.
[Purpose] The aim of this study was to evaluate the intrarater and interrater reliabilities of a toe grip dynamometer. [Subjects] The subjects were 180 community-dwelling people and 20 university students. [Methods] We assigned 180 individuals to three groups based on age to determine the intrarater reliability. The groups consisted of young (age, 20 to 39 y), middle-aged (age, 40 to 59 y) and older adults (age, 60 to 79 y). Interrater reliability was investigated using 20 university students as subjects. We calculated intraclass correlation coefficients to assess the intrarater and the interrater reliability. The intrarater reliability was assessed for each group by gender. We calculated intraclass correlation coefficients for the interrater reliability by comparing the first measurements made by two testers. The Bland-Altman analysis was used to assess fixed and proportional bias. [Results] The intrarater reliability showed a substantial to almost perfect agreement in male and almost perfect agreement in female subjects. For the intrarater reliability, a fixed bias was found in most measurements, but proportional bias was not found at all. The interrater reliability showed almost perfect agreement. Fixed bias and proportional bias were not found for the interrater reliability. [Conclusion] The intrarater and the interrater reliabilities of the toe grip dynamometer were substantial, indicating its suitability for clinical use.
[Purpose] The purpose of this study was to investigate the effect of biofeedback-based balance training while performing cognitive tasks on gait of the elderly. [Subjects] Forty-one participants were selected from a fall prevention class and were randomly allocated to two groups: 20 to the experimental group (81.12 ± 7.24 years), and 21 to the control group (81.29 ± 6.19 years). [Methods] The experimental group received biofeedback-based balance training while performing cognitive tasks for 50 minutes a day, 3 days a week, for 8 weeks. Temporal and spatial parameters and stability were measured pre- and post-training. [Results] The experimental group showed significant improvements in all measures. [Conclusion] This study confirms that biofeedback-based balance training while performing cognitive tasks effectively improves the mobility of elderly people at risk of falling.
[Purpose] The purpose of this study was to examine the effect of a bridge exercise using the abdominal drawing-in maneuver (ADIM) on chronic stroke patients’ balance. [Subjects] In this study, 21 hemiplegia patients diagnosed with stroke were divided into a bridge exercise group using the abdominal drawing-in maneuver (BEGADM, n=10) and a bridge exercise group (BEG, n=11). [Methods] We examined subjects’ balance through sway area, sway path length, and sway max velocity. These values were compared and analyzed using a Balance Performance Monitor. [Results] At different points in time during the treatment period, the sway area (SA), sway path length (SPL), and sway max velocity (SMV) within the BEGADM and the BEG groups showed statistically significant differences. After 8 weeks of treatment, there were significant differences in the SA, SPL, and SMV between the two groups. [Conclusion] Bridge exercise using the abdominal drawing-in maneuver is an effective intervention for chronic stroke patients’ balance.
[Purpose] To determine whether position affects measured lung capacity of spinal cord injury patients. [Subjects] The study subjects were 45 patients with spinal cord injury (cervical level 15, thoracic level 15, lumbar level 15). Subjects were provided with a full explanation of the experimental procedures and all provided written consent signifying their voluntary participation. [Methods] We used a spirometer (Spirometer, Micromedical Ltd, UK) to measure pulmonary function in the supine and sitting positions (straightened upper body at an angle of 90°). Forced vital capacity (FVC), forced expiratory volume during the first second (FEV1), tidal volume (TV), and maximum insufflation capacity (MIC) were also measured. [Results] FVC, FEV1, TV, MIC (%) were greater in the supine than in the sitting position for those with injury at the cervical or thoracic injury level. On the other hand, FVC, FEV1, TV, MIC (%) were lower in the supine position for those with an injury at the lumbar level. [Conclusion] More attention should be paid to the effect of injury level on measured lung capacity.
[Purpose] The purpose of this study was to show the effects of the wearing of tight jeans on lumbar and hip movements during trunk flexion. [Subjects] Twelve male subjects were recruited. [Methods] The lumbar flexion angle and hip flexion angle were measured using a dual inclinometer during trunk flexion, with and without tight jeans. [Results] The lumbar flexion angle significantly increased when wearing tight jeans compared to not wearing and wearing of general jeans. The hip flexion angle significantly decreased when wearing tight jeans compared to not wearing and wearing of general jeans. [Conclusion] We suggest that tight jeans might limit normal lumbar and hip movements. So, abnormal lumbar and hip movements induced by tight jeans may be a cause of low back musculoskeletal disorders.
[Purpose] In response to the increase of Taiwan’s aging population, and to improve the daily living function and quality of life of the elderly, the government of Miaoli County has implemented a ten-year long-term care program providing home-based physical therapy services. The purpose of our study was to design an assessment form and analyze the effects of home-based physical therapy. [Subjects and Methods] Disabled elderly who received home-based physical therapy were identified, and therapists provided treatment and evaluated their functional improvement using the designed home-based assessment form. [Results] The results of our study show that the total correlation coefficient (r) of test-retest reliability was 0.89 and the internal consistency reliability had a Cronbach’s α was 0.91. The test-retest reliability was high as assessed by the intraclass correlation, and the home-based assessment form was highly correlated with the Barthel Index. Among the 255 subjects (age: 76.88 ± 9.69), 120 (47.1%) had cardiovascular diseases, and 108 (42.35%) had orthopedic diseases. Subjects received 4.54 ± 2.35 treatments, and the score of the home-based assessment form was 53.6 ± 23.8 before treatment, and 56.0 ± 21.0 after treatment. [Conclusions] After a clinical test for disability, the home-based assessment is a suitable assessment of improvement of function ability. However, the number of subjects was too small and the treatment time was too short, and further investigation of this issue is still needed.
[Purpose] The purpose of this study was to measure the effect of structural components on walking ability by conducting tests using subjects who used combined rollator-wheelchairs and walking aids in their daily lives. [Subjects] Ten residents living in a health care facility for the elderly who required walking aids participated in this study. [Methods] We measured maximum walking speed (MWS), step length, cadence and conducted the shuttle stamina walk test (SSTw), and the timed up-and-go test (TUG) under three conditions (rollator with forearm support, rollator with handgrip and cart). [Results] There were significant differences among the conditions with forearm support providing the best results in terms of MWS, step length, cadence, SSTw and TUG, showing in improved walking abilities of walking speed, endurance and dynamic balance. [Conclusion] These results show that therapists should advocate using rollators with forearm support as a safe method of expanding the range of walking activities for elderly who use walking aids or rollator-wheelchairs in their daily lives.
[Purpose] This study examined the feasibility of using an intervention of core stabilization exercises using a sling to control pain and muscle strength of patients with chronic low back pain. [Subjects] The subjects, 30 chronic low back patients, were divided randomly into two exercise groups: one group performed core stabilization exercises using a sling (n=15), and the other group performed mat exercises group (n=15). Each exercise program was performed three days per week for four weeks. Pain and muscle strength were measured before and after the intervention. Pain was assessed using a visual analogue scale (VAS) and muscle strength was measured with a Tergumed device. [Results] The differences in the VAS scores for the sling exercise and mat exercise program were statistically significant between pre and post intervention in both groups. Muscle strength increases were also statistically significant. However, the comparison of sling exercise and mat exercise program showed no statistically significant differences between the groups, post-intervention. [Conclusion] Both the sling exercise and the mat exercise program reduced chronic low back pain improved patients’ lumbar muscle strength, and decreased VAS scores; and the sling exercise was more effective than the mat exercise program. Further study is needed to develop the sling exercise for effective use in clinical practice for the treatment of chronic low back pain.
[Purpose] The purposes of this study were to investigate the age-related differences in balance ability of elderly individuals and to verify the clinical usefulness of the Functional Reach Test (FRT) in comparison with the Sensory Organization Test (SOT) for balance evaluation of this subject group. [Subjects] The subjects were 46 community-dwelling elderly people aged over 65 years old. [Methods] Balance was measured using the FRT and the six sub-equilibrium sessions and composite equilibrium score of the SOT. Pearson’s correlation coefficient was used to evaluate the relationships among these balance measures. [Results] The <75 years old group showed significantly better balance ability than the ≥75 years old group. Significant positive correlations were found between the FRT and both the eyes-closed sway-surface (EC/SS) section (r=0.79) and the composite equilibrium score (r=0.55) of the SOT. [Conclusion] It is possible to use the FRT as a quantitative measure of balance for elderly individuals rather than the SOT, which is more expensive and complicated to evaluate.
[Purpose] We examined whether monoaminergic brain stem centers contribute to reflexive soleus (Sol) activity when vibration is applied to ankle joints on a moving platform. [Methods] Ten male subjects (23–35 years) stood with their eyes closed on a movable platform. Vibrators (92 Hz) were applied to the malleolus and Achilles’ tendon. Sol electromyographic (EMG) responses of short- (SLR) and medium-latency reflexes (MLR) during platform movement were collected under the control, Sol vibration (SV), and malleolus vibration (MV) conditions. The SLR, MLR areas and their latencies were measured. [Results] The Sol SLR and MLR onsets were significantly delayed under the SV and MV conditions compared to the control condition. The intercept of the regression line under the MV conditions was significantly greater than under the SV condition. [Conclusion] Delays of SLR and MLR onset under the SV and MV conditions might correspond to the length of time required for temporal summation of α-motoneurons due to inhibition of afferent fibers. A rise in the intercept of the regression line under the MV condition means an increase of MLR area. That is, the monoaminergic brain stem centers compensated for stimulation of the group II interneuron via ankle joint afferents acting against the inhibition of the stimulation of Sol α-motoneurons.
[Purpose] This study investigated the effect of a simple underwater training program on ambulatory functions of patients with peripheral vascular disease. [Subjects and Methods] Seven male patients participated in supervised underwater exercise training for twelve weeks to determine the effect of the program on their ambulatory capacity through comparison of their pre- and post-training values of their ambulatory indices, including toe pressure, maximum ambulatory distance, and ankle brachial index. [Results] We show that twelve weeks of underwater training improved the ambulatory functions and quality of life of patients with peripheral vascular disease. [Conclusion] This program should be considered as an effective conservative treatment for low risk patients with intermittent claudication.
[Purpose] The purpose of this study was to examine the effects of respiratory muscle training using feedback on respiration to prevent or mitigate the effects of a variety of respiratory disorders. [Subjects] The subjects of this study were 34 male undergraduates in their 20s (experimental group, 17; control group, 17). [Subjects and Method] The respiratory muscle training was performed for about 60 minutes, three times per week for 6 weeks. Measurements were made of forced vital capacity (FVC), peak expiratory flow (PEF), and forced expiratory volume at one second (FEV1). [Results] Prior to the exercise, the FVC value of the experimental group was lower than that of the control group. The FVC and other values of the the smokers group showed increases after the exercise. The FVE1 value of the non-smokers group showed an increase after the exercise. [Conclusions] The respiratory muscle training was proven to be effective at improving pulmonary function.
[Purpose] This study investigated the effects of low-level laser phototherapy on hand and forearm fractures. [Subjects and Methods] This was a one-group pretest-posttest design study. We recruited 9 patients with hand or forearm fracture, and they received diode laser treatment (808 nm, 10 Hz, 60 mW). Evaluation of pain on a visual analog scale (VAS) and radiographic assessments were made pre-intervention, post-intervention, and at two weeks of follow-up. [Results] There were significant differences in VAS scores between pre-intervention and post-intervention and between pre-intervention and 2 weeks of follow up. In the radiographic assessment, the percentage of detectable cortical bridging also increased significantly after phototherapy. [Conclusions] We consider that low-level laser phototherapy is effective for human bone healing and pain relief.
[Purpose] This research investigated whether fatigue of intrinsic muscles plays an important role in support of the medial longitudinal arch, affecting foot pressure and balance. [Subjects] The study subjects were 20 adults with flatfoot who did not exhibit musculoskeletal disorders, disease of the lower limbs, or lower back pain. [Methods] The subjects were instructed to perform 75 isotonic contractions of the intrinsic foot muscles, flexing the metatarsophalangeal joints through the full range of motion with an elastic band. This exercise was repeated until a drop in median frequency (MedF) of at least 10% was observed. Before and after exercise, balance and foot pressure were measured with the subject standing on one leg. [Results] After the exercise, the middle forefoot area and midfoot medial area showed a significant difference in foot pressure. In the middle forefoot area, the pressure increased from 21.83 ± 4.56 psi to 25.95 ± 2.92 psi. In the midfoot medial area, the pressure increased from 5.52 ± 1.97 psi to 12.75 ± 2.56 psi. Although the anterior/posterior index, medial/lateral index, and overall stability index of balance increased significant differences were not observed. [Conclusion] Increased pronation of the subtalar joint was seen in people with flatfoot after intrinsic muscle fatigue.
[Purpose] We investigated the effects of changing the resistance direction using an elastic tubing band on abdominal muscle activities during isometric upper limb exercises in a seated position. [Subjects] Twenty able-bodied volunteers (10 males, 10 females) were recruited for the study. [Methods] All subjects performed isometric upper limb exercises with an elastic tubing band involving three different shoulder movements (extension, flexion, and horizontal abduction). Surface electromyography (EMG) signals were recorded from the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) bilaterally during isometric upper limb exercises. [Results] There were significant differences in EMG activity of the bilateral RA during shoulder extension, shoulder horizontal abduction, and shoulder flexion. The EMG activities of the bilateral EO and IO were significantly higher in shoulder extension and horizontal abduction than in shoulder flexion when the subjects performed the arm exercise in the seated position. There was no significant difference between shoulder extension and horizontal abduction. [Conclusions] We suggest that upper limb extension and horizontal abduction using an elastic tubing band could be effective at improving abdominal muscle activities without trunk movement during isometric upper limb exercises.
[Purpose] The purpose of this study was to compare the immediate changes in patients with chronic lower-back pain (LBP) following LBP exercises and direct stretching (DS) of the tensor fasciae latae, the hamstrings and the adductor magnus. [Subjects] Five females and five males patients with chronic LBP participated in the study. [Method] Exercise therapy of proven effectiveness was performed as the control intervention and DS of the tensor fasciae latae, the hamstrings and the adductor magnus was performed as the experimental intervention in a randomized controlled trial. Pain on a - Visual Analogue Scale (VAS), Finger Floor Distance (FFD), maximum pelvic anterior inclination, maximum pelvic posterior inclination, pelvic range of motion (ROM) and posterior lumbar flexibility (PLF) - were measured before and after the intervention. The six items measured were evauated in a random order, and analysed using Student’s t-test with significance accepted at less than 5%.[Results] Significant improvements in VAS, FFD, maximum pelvic anterior inclination, maximum pelvic posterior inclination, pelvic ROM and PLF were observed after the DS intervention. However, the only improvement observed after the control intervention was in VAS. [Conclusion] The results study has suggest that DS may have an immediate effect on chronic LBP.
[Purpose] The present study investigated the influence of a plantar perceptual learning task on brain activity using functional near-infrared spectroscopy. [Subjects] Ten healthy volunteers participated in this study. [Methods] Seated subjects performed a hardness discrimination task using the soles of their feet to discriminate between sponges with 5 different levels of hardness over a period of 10 days. Brain activity was measured using fNIRS during the discrimination task on the first and final days. A cap with optical fibers covered to cover the frontal and parietal lobes, as well as the temporal and occipital lobes. [Results] On Day 1 of the task, oxyhemoglobin (oxyHb) increased significantly in the prefrontal and premotor areas, and the parietal association and motor-speech areas. On Day 10 of the task, oxyHb levels increased significantly in the supplemental motor area, and the parietal association and motor-speech areas. [Conclusion] Activation of the brain was noted in the prefrontal, premotor, and supplemental motor areas as well as the parietal association and motor-speech areas during the plantar perceptual learning task.
[Purpose] Previous studies have reported that physical activity is increasingly being encouraged as an essential part of a healthy lifestyle; thus, sports and preventable injury are becoming an important public health issue. Using an isokinetic test, we evaluated muscular activities and dynamic stability of the knee joint of skilled female athletes. [Methods] The subjects were 42 females aged 24.5 ± 0.9 years old, weighing 61.5 ± 1.1 kg; they were 169.6 ± 1.3 cm in height and had a body mass index (BMI) of 18.2 ± 0.5. We used a Biodex 3 System Pro® as the isokinetic dynamometer. [Results] The extensor in the dominant leg of the jumping group showed significantly higher strength than its counterpart in the cutting group. However, knee flexors showed no significant difference between groups. Furthermore, the H:Q ratios of the jumping group (ND: 45.4 ± 2.3%, D: 45.0 ± 1.2%) and the cutting group (ND: 48.1 ± 1.9%, D: 51.5 ± 1.6%) were lower than 60%. In addition, the ratio of dominance in the jumping group was significantly lower than in the cutting group. [Conclusion] These results suggest that skilled female athletes who perform excessive and repetitive jumping actions need to be more aware of their risk of developing anterior cruciate ligament (ACL) injury, and they need a more specific therapeutic program for this injury.
[Purpose] The aim of this study was to investigate whether the muscle metaboreflex is attenuated in subjects with type 2 diabetes. [Subjects] Ten subjects with type 2 diabetes and 10 age-matched, healthy control subjects participated in the study. [Methods] We compared cardiovascular responses between the diabetic and control subjects during a static handgrip exercise at 30% maximal voluntary contraction, followed by periods of post-exercise ischemia. [Results] During post-exercise ischemia, mean blood pressure and total peripheral resistance were not maintained at significantly higher levels than resting values in the diabetic subjects, whereas they remained elevated in the control subjects. [Conclusion] These findings indicate that the muscle metaboreflex is attenuated in subjects with type 2 diabetes.
[Purpose] The purpose of this study was to determine the physical fitness performance and health-related quality of life of patients with nonspecific low back pain (LBP) after a 4-week supervised fitness exercise intervention in addition to routine physical therapy. [Subjects] Twenty-four patients with nonspecific LBP participated in this study. [Methods] All participants completed either an additional supervised fitness exercise along with conventional physiotherapy twice a week for 4 weeks, or conventional physiotherapy only. Physical fitness, visual analogue scale of pain, the modified Roland–Morris Disability scale, and SF-36 assessments were made before and after the intervention. [Results] Significant improvements were found in physical fitness, including trunk flexors/extensors endurance, lower extensor strength, reaction time of the upper extremity, and the body pain domain of SF-36 after fitness exercise compared to the conventional physiotherapy alone. Decreases in pain intensity were found after treatment in both groups. [Conclusions] A 4-week supervised fitness exercise program was effective at reducing pain intensity and alleviating disability. It also improved trunk muscle endurance, lower extensor strength, and the body pain domain in health related quality of life of patients with nonspecific LBP.
Abstract. [Purpose] This study investigated the effects of velocity and gradient changes on cardiopulmonary functions during treadmill walking. [Subjects] The subjects were eleven physically fit female participants, 20 to 22 years of age. [Methods] Treadmill workload protocol was set at 4, 5, 6, 7 and 8 m/s and 0, 2.5, 5, 7.5, and 10% for velocity and gradient loading. A portable gas analyzer (COSMED K4b2, Italy) and portable heart rate analyzer (GBR. A, Finland) measured VO2, VCO2, EE, and HR. A treadmill with control of velocity and gradient was used for walking. Each of the average values used in the analysis was calculated from a 3 to 5 minute use of the treadmill. [Results] During treadmill walking, VO2, VCO2, EE and HR increased as the velocity increased. Also, as the gradient increased, VO2, VCO2, EE and HR increased. A comparison revealed that changes in velocity had a greater effect on VO2, VCO2, EE and HR gradient. [Conclusion] The results show that cardiopulmonary functions are affected by changes in velocity and gradient during walking. In particular, velocity has a greater effect on cardiopulmonary functions than gradient.
[Purpose] The purpose of this study was to compare the measurements of an electrogoniometer with those of the Fisi Metrix program to investigate the reliability and validity of Fisi Metrix assessments of wrist ROM. [Methods] The subjects were eighteen healthy young females. Wrist deviation was measured on images by three raters for measurement of wrist ROM using the Fisi Metrix program. [Results] Radial and ulnar deviation of the wrist between the methods showed a significant correlation, r > 0.80, and intra-rater reliability was even higher, ICC(1,1)>0.90. [Conclusion] We consider measurements of ROM by the Fisi Metrix program will be useful in the field of clinical and rehabilitation.
[Purpose] The purpose of this study was prospectively investigated whether recognitive factors and general balance of the elderly influence recurrent falls. [Subjects] The participants were 85 elderly, cared for at day care centers, who were followed for one year. [Methods] At baseline, we evaluated fall-related self-efficacy using the Modified Falls Efficacy Scale (MFES), and measured the gap between the actual reach distance and the estimated reach distance (GAE) as a recognitive factor. We also evaluated balance using the Timed Up and Go Test (TUG). For the follow-up, we interviewed the participants about the number of times they had fallen in the past year. We assigned whether the participants had fallen more than twice at follow-up to a dependent variable, and with MFES, GAE and TUG at baseline as independent variables, we performed a multiple logistic regression analysis to explore the factors which were related to recurrent falls. [Results] Fourteen participants had fallen more than twice, and it was found that GAE was related to recurrent falls. [Conclusion] GAE could be used as a factor for predicting the risk of recurrent falls.
[Purpose] The purpose of this study was to evaluate the impact of home exercise on acute myocardial infarction (AMI) patients undergoing percutaneous coronary intervention (PCI). [Subjects] A total of 46 AMI patients undergoing PCI were randomly divided into an experimental group and a control group. [Methods] The experimental group (n = 22) received education and home exercise training (walking exercise at home five times per week). Diet control and daily life were performed in the control group (n = 24). The lipid profile and high-sensitivity C-reactive protein (hs-CRP) were evaluated at baseline and at 12 weeks follow-up. [Results] From baseline to 12 weeks follow-up, the experimental group had significant improvements in total cholesterol, low-density lipoprotein (LDL), and hs-CRP. The control group showed significant improvements in total cholesterol and LDL, but there were no significant differences between the experimental and control groups. [Conclusion] Our results suggest that home exercise training is advantageous for patients with acute myocardial infarction who have undergone PCI. More clinical applications and studies of home exercise training will be needed in the future.
[Purpose] The “10-second Open-Close Stepping Test” (OCS-10) is simple, can be conducted anywhere, and requires no special equipment. In order to use the OCS-10 for the elderly, its reliability and characteristics for younger individuals and the elderly were examined. [Subjects] Younger subjects were 27 individuals (young group). Elderly subjects were 29 individuals under age 75 (young old group) and 34 individuals over age 75 (old old group) who could walk without assistance. [Methods] The OCS-10 was performed twice with an interval of 30 seconds between, and the measurement values were recorded. To compare measurement values among the young group, young old group and old old group, the best results from the 2 rounds of testing were used in analysis. The test duration was 10 seconds. [Results] The ICCs for each group were 0.93, 0.89, and 0.84 for the young group, young old group, and old old group, respectively. [Conclusion] The OCS-10 provides consistent measurement values for both younger individuals and the elderly, though the results are more consistent in younger individuals. In addition, the OCS-10 should allow accurate discernment of a decline in physical functions due to aging and accompanying loss of agility.
[Purpose] This study investigated the effect of vibratory stimulation on tissue compliance and muscle activity in stroke patients with elbow flexor spasticity. [Subjects and Methods] Twenty patients who were grade 2 on the Modified Ashworth Scale (MAS) were evaluated before and after vibratory stimulation. This evaluation was done using MAS (change of clinical characteristic), a myotonometer (change in muscle tissue compliance), and surface electromyography (sEMG) (change in muscle activity). [Results] MAS results showed significant decreases immediately and three weeks after the start of vibratory stimulation. Tissue compliance significantly increased immediately (0.75, 1, and 1.25 kg) and three weeks (0.5, 0.75, 1, 1.25, and 1.5 kg) after the start of vibratory stimulation, and muscle tone decreased. Muscle activity significantly increased immediately (1 and 1.25 kg) and three weeks (0.75, 1, 1.25, and 1.5 kg) after the start of vibratory stimulation. [Conclusion] Using a myotonometer and sEMG, we demonstrated that vibratory stimulation was an effective form of therapeutic stimulation. Vibratory stimulation can be used as a non-pharmacological therapy for the neurorehabilitation of patients with spasticity.
[Purpose] This study examined the therapeutic effects of functional electrical stimulation (FES) with augmented reality (AR) during treadmill gait training on the muscle strength, balance and gait of stroke patients. [Subjects] Twenty-eight subjects with chronic stroke were divided into three groups: FES with AR during treadmill gait training (AR-FES group, n=9), gait training with FES on a treadmill (FES group, n=10), treadmill group (n=9). [Methods] All these groups were given 8 weeks of gait training 3 times a week, 20 minutes per session. To identify the effect of AR-FES, muscle strength was measured with a dynamometer, and the Berg balance scale (BBS) and timed upandgo (TUG) test were also assessed. [Results] The muscle strength increased significantly in the AR-FES and FES groups. The BBS showed a significant increase in all groups but there was no difference among the three groups. The TUG also improved significantly in all groups. The AR-FES group showed a better result than the treadmill group. [Conclusion] Although more study of gait training with FES on a treadmill and gait training with AR-FES will be needed, AR-FES improved the muscle strength and gait of stroke patients. These results suggest a variety of applications in clinical trials of conservative therapeutic methods.
[Purpose] Thoracic deformity (TD) secondary to severe kyphoscoliosis occurs frequently in adults with severe cerebral palsy (CP) and can eventually result in pneumonia. To determine the severity of TD, we used two protocols to examine and compare the anteroposterior (AP) and laterolateral (LL) diameters of the thorax in the transverse plane among adults with severe CP. [Subjects and Method] The study examined 20 adults with severe CP. Computed tomographic scans were acquired at the level of the xiphisternal junction in each patient, and two protocols were used to measure the AP and LL diameters. The largest AP diameters were measured along the gravity line (protocol 1) and along the line where the middle point of the sternum connects with the spinous process of the vertebra (protocol 2). The largest LL diameters were measured along the lines perpendicular to each AP diameter. The ratios of the AP to LL diameters were calculated. [Results] The AP diameter of protocol 1 was significantly shorter than that of protocol 2, and the LL diameter of protocol 1 was significantly longer than that of protocol 2. There was a significant difference in the ratio of AP to LL between the protocols. [Conclusions] Our results suggest that differences between protocols in the AP and LL diameters show the severity of TD.
[Purpose] We examined the characteristics of lower limb muscles of the elderly in climbing stairs as a fall prevention study. [Methods] This study selected 40 elderly people aged 60 or older who could walk independently. The activity of climbing stairs was divided into four stages: standing, knee flexion, touching the stair, and ascending. Muscle activities of the lower limbs were measured by electromyography. [Results] There were significant differences in the activities of four muscles in the four stages of climbing stairs. The right leg showed significant differences in onset times of the four muscles, activities, but the left leg showed no significant differences. [Conclusion] Activity of the tibialis anterior and medial gastrocnemius muscles were different at each stage of climbing stairs. We also found that the tibialis anterior was activated first to prevent dragging of the right leg, and the left leg muscles worked simultaneously to provid stability.
[Purpose] This study examined the changes in the electrophysiologic response of the tibialis anterior during repeated contraction training. [Methods] We recruited 16 normal adult women without musculoskeletal or neurological disorders for this research. They were divided into an electrical stimulation training group and an electrical/voluntary group. and for electrical stimulation analysis at the 5th, 10th, 15th, 20th, 25th and 30th contraction time electrical stimulations. Maximum voluntary contraction for 6 sec followed by a rest break of 3 sec was performed, repeatedly. The non-dominant tibialis anterior was measured using electromyography and a dynamometer. [Results] MVIC (maximal voluntary isometric contraction), RMS (root mean square), IEMG (intergrated electromyograms) and MDF (median frequency) showed no statistically significant differences in interaction between contraction time and group or main effects between groups, but changes in the main effect of contraction time were significantly different between the groups. The electrical stimulation training group showed a significant difference after 15, 20, 25, and 30 stimulations compared to the first contraction. Group combining voluntary exercise and electrical stimulation showed significant differences after 15, 20, 25, and 30 stimulations compared to the first contraction. [Conclusion] There was decline in electrophysiologic response after repeated contraction training of the tibialis anterior by electrical stimulation and by electrical stimulation and voluntary repeated contraction training and timing that significant decrease was found by the number of repeated contraction trainings of MVIC, RMS, IEMG, and MDF was different.
[Purpose] The purpose of this study was to examine the effect of home-based auditory stimulation on walking performance and to determine its clinical feasibility for chronic hemiparetic stroke patients. [Subjects] The subjects of this study were 20 chronic stroke patients. [Methods] The subjects were randomly divided into two groups: the experimental group (n=10) used over the ground gait training with a metronome beat, and the control group (n=10) which performed over the ground gait training. [Result] The affected side single support time, affected side single support time ratio, and gait velocity of both groups were significantly improved when compared with their respective values before the experiment. Affected side stride length, non-affected side stride length, and stride length ratio of the experimental group were significantly different between before and after the experiment. Comparison of the spatial-temporal gait parameters and symmetry ratios between the experimental group and the control group after the exercise showed a significant difference in affected stride length, non affected stride length, stride length ratio, affected single support time, non affected single support time, single support time ratio, and gait velocity. [Conclusion] These findings suggest that the home-based auditory stimulation training more effectively improves the walking performance of chronic stroke patients than gait training without auditory stimulation.
[Purpose] The purpose of this study was to investigate the effect of cognitive function on Activities of Daily Living (ADL) of post-stroke patients. [Subjects] This study examined 60 stroke patients admitted to a rehabilitation department in Korea between January 2010 and October 2011. All patients were evaluated using the Modified Barthel Index (MBI), Mini-Mental State Examination (MMSE), and the Loewenstein Occupational Therapy Cognitive Assessment for Geriatric Population (LOTCA-G) upon admission. One-way ANOVA, correlation, and multiple regression analyses were used to analyze the data. [Results] There were significant differences between groups categorized by MMSE scores in MBI. Significant correlations were observed between MBI and area subscores of LOTCA-G, with the exception of memory. Regression analysis showed that perception was the primary explanatory variable of ADL performance. [Conclusion] Perception had the strongest correlation with and the highest explanatory power of ADL performance. Therefore, the LOTCA-G area of perception may be a useful indicator of the level of ADL performance of stroke patients.
[Purpose] The aim of the study was to investigate the effect of Vojta therapy on motor improvement in an older child with cerebral palsy. [Subjects] Vojta therapy was performed for a 12 year-old child with cerebral palsy who had significantly arrested motor development during the first years of life. [Methods] The treatment was applied in two separate therapeutic units of 14 and 6 weeks, respectively, which were separated by an 8-month Vojta-free period. Therapeutic progress was gauged by the gross motor function measure, the gross motor function classification system, and the manual ability classification system. [Results] The gross motor function measure improved significantly following the first therapeutic unit, then decreased during the interval, but improved again following the second therapeutic unit. In the gross motor function classification system, the patient was classified as level III and this remained unchanged, despite great progress in specific motor functions. In the manual ability classification system assessment the child was classified as level III during the entire assessment period. [Conclusion] Using Vojta therapy can achieve dynamic locomotor and gross motor development in older cerebral palsy patients.