[Purpose] Interlimb coordination can be affected by the symptoms associated with Parkinson’s disease and may result in an increased risk of falls. The purpose of the current study was to compare changes in interlimb coordination in individuals with Parkinson’s disease to healthy older adults while systematically manipulating walking speed. [Subjects and Methods] Participants walked on a treadmill while systematically increasing and decreasing the walking speed between 0.22 and 1.30 m/s. Kinematic data were collected by means of a three dimensional motion capture system. Dependent variables included the phase relation between arm and leg movements as well as between pelvic and thoracic rotation. [Results] Compared to healthy controls, an increased variability in relative phase between left and right arm swing, and smaller amplitude with arm, leg as well as less variability for the phase relation between thoracic and pelvic rotations were shown in individuals with Parkinson’s disease. [Conclusion] The increased variability of phase relation between left and right arm swing may be related to the reduced out-of-phase forcing of the arm movements at the shoulders as a result of axial rigidity in Parkinson’s disease. It deserves further investigation whether the improvement of the coordination between arms could result in the normalization of parkinsonian gait.
[Purpose] There is a lack of information evaluating specific markers of performance in patients awaiting bariatric surgery. We aimed to assess the postural control, functional performance, strength and endurance performance for morbidly obese patients awaiting bariatric surgery compared to lean controls. [Subjects and Methods] All parameters were assessed by modified Y-balance test, timed-up-and-go-test, maximum strength testing on resistance exercise equipment and cardio-pulmonary exercise testing on a cycle ergometer in 10 morbidly obese patients awaiting bariatric surgery and 10 age- and sex-matched lean controls. [Results] It was found that significant differences existed for overall modified Y-balance test in morbidly obese patients awaiting bariatric surgery versus lean controls (0.37 ± 0.03 vs. 0.47 ± 0.02 cm.cm−1), timed-up-and-go-test (9.33 ± 1.23 vs. 7.85 ± 1.73 sec) and several variables of cardio-pulmonary exercise testing. Overall absolute strength expressed in kilogram was similar, yet when relativized to body weight strength differences were notable (0.4 ± 0.17 vs. 0.83 ± 0.32 kg.kg−1). [Conclusion] The results of this study demonstrate the need for comprehensive functional assessment prior to surgery with an identified demand for subsequent tailored physical training prescription that should begin before surgery.
[Purpose] An estimation model of the knee and ankle joint angles during the extension phase was proposed in the previous study. However, it had limited use because of the fixed initial lower limb angle before standing up. This study aimed to propose a new estimation model of the initial lower limb angle to improve the angle estimation during extension phase. [Subjects and Methods] Seven healthy male volunteers were enrolled. The new estimation model approximated the initial lower limb angle using a force sensor plate that measured the plantar pressure of the subjects. The estimated angle and force were compared to those obtained by a motion capture system and force plate. [Results] The new estimation model of initial lower limb angle showed no significant difference compared with the true values obtained by motion capture, except for the subject who had a greater foot-pressure measurement error compared with the force plate measurement, with maximum errors of 5.98° and 6.31°, respectively. [Conclusion] The proposed model in this study can estimate the initial lower limb angle before standing and can be applied to the angle estimation model during the extension phase of the standing-up movement.
[Purpose] Medial longitudinal arch (MLA) height is associated with various injuries and diseases and gender differences, if any. This study aimed to examine factors affecting the MLA height associated with gender differences in healthy subjects with no orthopedic disorders. [Subjects and Methods] This study included 36 healthy adults (19 males, 17 females; mean age, 21.8 ± 3.6 years; body mass index, 21.1 ± 2.0 kg/m2). Their height, body weight, foot length, muscle strength of the tibialis posterior muscle (TPM), toe-gripping strength, hallux valgus angle, inversion microdactylia angle, angle of leg–heel alignment, femoro-tibial angle, and navicular height were measured. Correlation between the ratio of arch height and other measurement parameters was examined. [Results] In females, the ratio of arch height was significantly positively correlated with muscle strength of the TPM and toe-gripping strength and negatively correlated with the hallux valgus angle and the leg-heel alignment, whereas in males, only a positive correlation between the ratio of arch height and muscle strength of the TPM was observed. [Conclusion] These results reveal that etiological mechanisms determining MLA height are different between males and females. Overall, the present results indicate that further studies identifying causes of MLA height variation must include gender-based analysis.
[Purpose] To present a case of the complete correction of mild suspected adolescent idiopathic scoliosis in support of the argument that early aggressive treatment is superior to the traditional ‘watch & wait’ approach. [Subject and Methods] A 9-year-old female presented with a 14° thoracic curve indicative of early adolescent idiopathic scoliosis. The parents consented to immediate and early treatment with the SpineCor dynamic and corrective scoliosis brace. The brace was worn 20 hours per day and check-ups were performed every three months. [Results] The patient achieved complete correction of the thoracic curve within 9-months. The child was followed for 4.5 years until she approached near cessation of skeletal growth (Risser sign grade 4) at the age of 14 years, 4-months. The patient’s spine remained straight throughout the follow-up. [Conclusion] This report as well as others suggests that the SpineCor bracing system is a unique and effective intervention for mild scoliosis. Further, this case illustrates an ideal outcome and supports the argument that initiating treatment at the earliest indication of suspected idiopathic scoliosis should offer superior outcomes versus the traditional ‘watch & wait’ approach. Last, radiation exposures associated with radiography for scoliosis treatment and management are negligible and not harmful.
[Purpose] This study aimed to investigate the effects of circular gait training on balance and balance confidence in patients with stroke. [Subjects and Methods] Fifteen patients with stroke were randomly divided into either the circular gait training (CGT) group (n=8) or the straight gait training (SGT) group (n=7). Both groups had conventional therapy that adhered to the neurodevelopmental treatment (NDT) approach, for 30 min. In addition, the CGT group performed circular gait training, and the SGT group practiced straight gait training for 30 min. Each intervention was applied for 1 h, 5 days a week, for 2 weeks. Berg Balance Scale (BBS), Timed Up and Go (TUG) test, and Activities-specific Balance Confidence (ABC) scale were used to test balance and balance confidence. [Results] After the intervention, both groups showed significant increases in balance and balance confidence. Significant improvements in the balance of the CGT group compared with the SGT group were observed at post-assessment. [Conclusion] This study showed that circular gait training significantly improves balance in patients with stroke.
[Purpose] This study investigates two types of toe tapping, i.e., “closed,” with both feet on the floor, and “open,” in which the foot does not touch the ground, and evaluates their usefulness in combination with monitoring of muscle activity during toe tapping. [Subjects and Methods] The study enrolled 11 patients with Parkinson’s disease (PD) and 9 controls (Controls). The tibialis anterior (TA) and gastrocnemius (GS) muscle activity during toe tapping was measured using surface electromyography. [Results] In closed tapping, the minima in GS activation with the first tap was significantly higher in patients with PD than in Controls. In open tapping, the coefficient of variation (CV) of local maxima in TA activation was significantly higher in patients with PD than in Controls. In both types of tapping, the CV of extrema in GS activities increased with disease duration, but this may be due to the long-term administration of Levodopa, which itself tends to cause excessive GS activities. [Conclusion] Closed tapping is suitable for the assessment of GS activity and can detect excessive activities, which is observed as visible movement. Open tapping, on the other hand, is suitable for assessment of TA activity.
[Purpose] The purpose of this study was to examine the correlation between weight-bearing (WB) and non-WB ankle dorsiflexion (DF) range of motion (ROM) and ankle movement during gait, including heel-rise time and ankle DF at heel-rise. [Subjects and Methods] Thirty healthy male subjects were recruited for this study. Ankle DF ROM of both feet was measured under the WB and non-WB conditions. Heel-rise time and ankle DF at heel-rise in both feet during gait were measured using a motion analysis system. Pearson product moment correlations were used to identify correlation ankle DF ROM and ankle movement during gait. [Results] Heel-rise time and ankle DF at heel rise were significantly correlated with WB ankle DF ROM. However, no correlations were found between ankle movement during gait and non-WB ankle DF ROM. [Conclusion] These findings demonstrate that WB ankle DF ROM measurements can be used to predict heel-rise time and ankle DF at heel-rise.
[Purpose] The purpose of this study was to investigate the effect of chest expansion exercise with transcutaneous electrical nerve stimulation (TENS) on gait ability and trunk control of patient with stroke. [Subjects and Methods] The subjects were divided into 7 in the chest expansion exercise with TENS group (experimental group) and 7 in the chest expansion exercise with placebo TENS (control group). The gait ability and trunk contol were measured using Six-Minute Walk Test, Tinetti gait index and Trunk impairment scale (TIS). [Results] Both the experimental group and the control group showed significant improvement in the Six-Minute Walk Test, Tinetti gait index, and TIS total score. The dynamic sitting balance and coordination of TIS showed significant improvement only in the experimental group. In comparison between the two groups, the experimental group showed a more significant improvement in Tinetti gait index and TIS total score than the control group. [Conclusion] This study showed that chest expansion exercise with TENS was an effective method for improving gait ability and trunk control in chronic stroke patients.
[Purpose] This study aims to identify the effect of respiratory exercise on trunk control, pulmonary function, and trunk muscle activity in chronic stroke patients. [Subjects and Methods] The study included 24 chronic stroke patients who were randomly assigned, 12 each, to the experimental and control groups, and received neurodevelopmental treatment. Moreover, the experimental group underwent respiratory exercise. In each patient, the trunk control was measured using the Trunk Impairment Scale (TIS); muscle activity of the trunk, through the surface electromyogram; and pulmonary function, using the pneumatometer. [Results] The intragroup comparison showed significant differences in TIS, Forced vital capacity (FVC), Forced expiratory volume at one second (FEV1), Rectus Abdominis (RA), Internal Oblique (IO) and External Oblique (EO) in the experimental group. The intergroup comparison showed that the differences in TIS, FVC, FEV1, RA, IO and EO within the experimental group appeared significant relative to the control group. [Conclusion] Based on these results, this study proved that respiratory exercise was effective in improving trunk control, pulmonary function, and trunk muscle activity in patients with chronic stroke.
[Purpose] This study aims to identify the immediate effects of taping therapy on knee pain and depression among patients with degenerative arthritis. [Subjects and Methods] In total, 32 patients with degenerative arthritis were randomly assigned to one of two groups: the experimental group that underwent taping therapy and the control group that underwent regular treatment (16 patients per group). In the experimental group, therapeutic tape was wrapped all around the knee joint. Pain and depression were measured using the visual analogue scale (VAS) and the Beck Depression Inventory (BDI), respectively. [Results] The intra-group comparison showed significant differences in VAS and BDI for the experimental group. The intergroup comparison showed that the differences in VAS and BDI within the experimental group appeared significant relative to the control group. [Conclusion] It was observed that taping therapy showed an immediate effect in decreasing knee pain and depression among patients with degenerative arthritis.
[Purpose] This study investigated the frequency effect of physical and occupational therapy on activities of daily living performance in children with cerebral palsy. [Subjects and Methods] A total of 162 children with cerebral palsy who attended a convalescent or rehabilitation center for disabled individuals or a special school for physical disabilities in South Korea participated in this study. The Pediatric Evaluation Disability Inventory was used to collect data on activities of daily living performance according to physical therapy frequency based on neurodevelopmental therapy for 1 year. [Results] The relationships between physical therapy frequency and activities of daily living performance (mobility, social function, and total functional skill) and between occupational therapy frequency and activities of daily living performance (social function and total functional skill) were significant. There was no significant difference in activities of daily living performance according to physical therapy frequency. The difference in the activities of daily living performance according to occupational therapy frequency was significant for social function. [Conclusion] Intensive occupational therapy was more effective in improving activities of daily living performance in children with cerebral palsy. In particular, their social function further improved with intensive physical therapy.
[Purpose] The purposes of this study were to assess and explore the gender-based differences in gross motor skill development of 5-year-old Japanese children. [Subjects and Methods] This cross-sectional study recruited 60 healthy 5-year-old (third-year kindergarten, i.e., nencho) children (34 boys, 26 girls) from one local private kindergarten school in Otawara city, Tochigi Prefecture, Japan. Gross motor skills, including six locomotor and six object control skills, were assessed using the test of gross motor development, second edition (TGMD-2). All subjects performed two trials of each gross motor skill, and the performances were video-recorded and scored. Assessment procedures were performed according to the standardized guidelines of the TGMD-2. [Results] The majority of subjects had an average level of overall gross motor skills. Girls had significantly better locomotor skills. Boys had significantly better object control skills. [Conclusion] The gross motor skill development of 5-year-old Japanese children involves gender-based differences in locomotor and object control skills. This study provided valuable information that can be used to establish normative references for the gross motor skills of 5-year-old Japanese children.
[Purpose] This study evaluated the effects of repetitive peripheral magnetic stimulation of the soleus muscle on spinal cord and peripheral motor nerve excitability. [Subjects and Methods] Twelve healthy adults (mean age 22 years) who provided written informed consent were administered repetitive peripheral magnetic stimulation for 10 min. Pre-and post-stimulation latencies and amplitudes of H- and M-waves of the soleus muscle were measured using electromyography and compared using paired t-tests. [Results] Pre- and post-stimulation latencies (28.3 ± 3.3 vs. 29.1 ± 1.3 ms, respectively) and amplitudes (35.8 ± 1.3 vs. 35.8 ± 1.1 mV, respectively) of H-waves were similar. Pre-stimulation latencies of M-waves were significantly higher than post-stimulation latencies (6.1 ± 2.2 vs. 5.0 ± 0.9 ms, respectively), although pre- and post-stimulation amplitudes were similar (12.2 ± 1.4 vs. 12.2 ± 1.3 mV, respectively). Motor neuron excitability, based on the excitability of motor nerves and peripheral nerve action, was increased by M-waves following magnetic stimulation. [Conclusion] The lack of effect of magnetic stimulation on the amplitude and latency of the H-reflex suggests that magnetic stimulation did not activate sensory nerve synapses of α motor neurons in the spinal cord. However, because motor nerves were stimulated together with sensory nerves, the increased H-wave amplitude may have reflected changes in peripheral rather than in α motor nerves.
[Purpose] This study aimed to clarify the effects of Capacitive and Resistive electric transfer (CRet) on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise. [Subjects and Methods] Twenty-two healthy males were assigned into either the CRet (n=11) or control (n=11) group. Fatiguing exercise and CRet intervention were applied at the quadriceps muscle of the participants’ dominant legs. The Ely test, pelvic tilt, lumbar lordosis, and superficial temperature were measured before and after exercise and for 30 minutes after intervention. Statistical analysis was performed using one-way analysis of variance, with Tukey’s post-hoc multiple comparison test to clarify within-group changes and Student’s t-test to clarify between-group differences. [Results] The Ely test and pelvic tilt were significantly different in both groups after exercise, but there was no difference in the CRet group after intervention. Superficial temperature significantly increased in the CRet group for 30 minutes after intervention, in contrast to after the exercise and intervention in the control group. There was no significant between-group difference at any timepoint, except in superficial temperature. [Conclusion] CRet could effectively improve muscle flexibility and lumbopelvic alignment after fatiguing exercise.
[Purpose] The purpose of this review was to summarize available methods and equipment which are administered to evaluate the balance in anterior cruciate ligament reconstruction. [Subjects and Methods] A literature search was performed and reviewed using the narrative approach. This study reviewed English articles concerning balance assessment methods in anterior cruciate ligament reconstruction subjects from 1985 to 2015 using the following key words: Anterior Cruciate Ligament Injury, Anterior Cruciate Ligament Reconstruction, Postural Control, Equilibrium, Balance and Stability. [Results] This review included 44 studies out of 117 initially retrieved articles. These articles were discussed in balance measurement procedure without comparing the effect of various surgical, medical or rehabilitation approaches. [Conclusion] Biodex and EquiTest, functional dynamic tests are of choice in the evaluation and tracking of anterior cruciate ligament reconstruction subjects. Force plate parameters provide information regarding strategies of static postural control and is not sensitive enough to challenge postural control system in physical activities.
[Purpose] To present the successful treatment of posttraumatic dizziness and neck pains that were initiated in a patient following a whiplash event. [Subject and Methods] A 46 year old male suffered a whiplash event that initiated neck pain and dizziness symptoms. The patient had many positive orthopedic findings and demonstrated a forward head posture and cervical hypolordosis. The patient was treated by Chiropractic BioPhysics® technique including cervical extension traction, extension exercises and spinal manipulative therapy initially three times a week for 16-weeks, and once a month thereafter. [Results] The patient had a resolution of daily dizziness and neck pain with a concomitant reduction of forward head translation and increase in cervical lordosis. The postural measures were further improved after one year of mostly home-care. [Conclusion] The cervical spine alignment may be an important biomarker for those with dizziness. The correction of cervical lordosis may be an essential requirement for superior clinical outcomes for those with posttraumatic dizziness.
[Purpose] To establish the reliability and feasibility of a novel pinch aperture device to measure proprioceptive joint position sense. [Subjects and Methods] Reliability of the pinch aperture device was assessed in 21 healthy subjects. Following familiarization with a 15° target position of the index finger and thumb, subjects performed 5 trials in which they attempted to actively reproduce the target position without visual feedback. This procedure was repeated at a testing session on a separate date, and the between-session intraclass correlation coefficient (ICC) was calculated. In addition, extensor tendon vibration was applied to 19 healthy subjects, and paired t-tests were conducted to compare performance under vibration and no-vibration conditions. Pinch aperture proprioception was also assessed in two individuals with known diabetic neuropathy. [Results] The pinch aperture device demonstrated excellent reliability in healthy subjects (ICC 0.88, 95% confidence interval 0.70–0.95). Tendon vibration disrupted pinch aperture proprioception, causing subjects to undershoot the target position (18.1 ± 2.6° vs. 14.8° ± 0.76, p<0.001). This tendency to undershoot the target position was also noted in individuals with diabetic neuropathy. [Conclusion] This study describes a reliable, feasible, and functional means of measuring finger proprioception. Further research should investigate the assessment and implications of pinch aperture proprioception in neurological and orthopedic populations.