[Purpose] To identify the risk factors and the stroke types in recurrent stroke patients of Madinah Al-Munawarah city. [Participants and Methods] A prospective research hospital based study was conducted through the year of 2014. The patients were entered in the study when they had recurrent cerebrovascular accident led to hospital admission. All details of patients were obtained include history, demographic data, risk factors and stroke types. [Results] Ninety-four (83.9%) ischaemic strokes, 12 (10.7%) intercerebral hemorrhage strokes and 6 (5.4%) undefined out of 112 patients had recurrent stroke found in this study. Hypertension was the most prevalent risk factors (90.2%) followed by diabetes mellitus (62.5%) and ischaemic heart disease (51.8%). [Conclusion] Hypertension, diabetes, and ischaemic heart disease in particular were exhibited to be crucial risk factors for stroke recurrence in this study. Future studies are needed for secondary prevention planning.
[Purpose] We hypothesized that an association exists between the nutritional state of elderly people and the deterioration in the swallowing function associated with sarcopenia, which is reflected by the strength of the tongue and suprahyoid muscles. Therefore, we conducted a comparative study of the nutritional state and swallowing muscle strength. [Participants and Methods] The participants in this study were 25 elderly people in need of support or nursing care, situated at a geriatric health service facility, who were able to understand instructions and ate three meals per day orally. We evaluated the strength of the tongue muscles using a tongue pressure measurement device and the strength of the suprahyoid muscles by measuring the jaw-opening force. The nutritional state was evaluated using the Mini Nutritional Assessment. [Results] There was a significant correlation between the Mini Nutritional Assessment score and the jaw-opening force. Conversely, no correlation was found between the Mini Nutritional Assessment score and the tongue pressure. [Conclusion] The significant correlation between the Mini Nutritional Assessment score and the jaw-opening force suggests that the strength of the suprahyoid muscles, which reflects the swallowing function and jaw-opening force, deteriorates with age and is affected by the nutritional state. This suggests that the nutritional state could be an important indicator for the evaluation of the swallowing function.
[Purpose] In this study, we aimed to analyze customer satisfaction as a tool to investigate the association among happiness, health status, and well-being using the Happiness & Health Feeling Scale. [Participants and Methods] We included 17 elderly participants and measured the happiness and health statuses using the Happiness & Health Feeling Scale. We analyzed customer satisfaction by correlating subjective well-being with the questionnaire scores. [Results] The results showed a negative correlation between subjective well-being and the score on each questionnaire (correlation coefficient= −0.476). The elderly participants showed lower scores associated with self-esteem, including external appreciation and self-love, whereas high scores associated with eating and pleasure. The Cronbach’s alpha was 0.814. [Conclusion] This study showed an inverse correlation between Happiness & Health Feeling Scale score and well-being, presumably because of low scores associated with self-esteem, which should be prioritized for improvement. The additional use of customer satisfaction analysis using the Happiness & Health Feeling Scale could be helpful to elucidate the subjective association between happiness and health-related factors.
[Purpose] To determine if pressure biofeedback unit readings are related to abdominal muscle activation and centre of pressure displacement as well as to test the effects of using it as a biofeedback tool to control lumbopelvic motion. [Participants and Methods] Eighteen volunteers with chronic nonspecific low back pain (21.28 ± 1.41 years old) who performed an active straight leg raising (dynamic postural challenge) with and without pressure biofeedback. Changes in the pressure biofeedback unit and on centre of pressure displacement were assessed, as well as bilateral electromyographic abdominal muscle activity. Participants were not allowed to use a Valsalva manoeuvre. [Results] Pressure variation was not significantly correlated with abdominal muscle activity or with mediolateral centre of pressure displacement. When used as a biofeedback instrument, there was a significant increase in almost all abdominal muscles activity as well as a significant decrease in pressure variation and in mediolateral centre of pressure displacement while performing an active straight leg raising with a normal breathing pattern. [Conclusion] Despite not being an indicator of abdominal muscle activity or mediolateral load transfer in the supine position, the pressure biofeedback unit could have great relevance when used in the clinic for biofeedback purposes in individuals with low back pain.
[Purpose] The aim of this study was to evaluate the changes in reaching function during a reaching task in cervical spondylosis (CS) patients before and after surgery. [Participants and Methods] Nine patients participated in the study. Wrist acceleration peaks were monitored pre- and postoperatively using a tri-axial accelerometer, and the Japanese Orthopedic Association (JOA) score was recorded preoperatively. Additional upper extremity function tests were performed pre- and postoperatively. Multiple stepwise regression analysis was used to investigate the contribution of wrist acceleration peak to the severity of clinical symptoms. Moreover, we compared the acceleration peaks produced during the reaching task before and after surgery. [Results] Multiple regression analysis showed that wrist acceleration peak, grip strength and pinch strength were associated with the upper extremity function of the JOA score, explaining 61.0% of the variance. There was a significant improvement in x-axis acceleration peak after surgery. [Conclusion] Our results suggested that quantitative assessments of reaching function are useful to objectively evaluate the changes in reaching function in patients undergoing cervical decompression surgery.
[Purpose] This study aimed to evaluate the changes in leg-power generation that accompany competitive badminton, as simulated in a badminton field test (FT). [Participants and Methods] Fifteen male badminton players with 1–2 years of experience performed five repetitions of an FT involving rapid and randomly assigned shuttle-run movements between markers distributed around a badminton court. Repetitions were separated by a 1-minute rest period. Peak mechanical power, obtained from the serial vertical jump tests, was used to estimate fatigue and performance reduction. [Results] Decreases in distance and time were significantly different in each of the five FT repetitions while maintaining the same speed for the condition. The peak mechanical power and fatigue index significantly declined. The reduction in the peak mechanical power percentage (11.78–35.49%) was in the acceptable peak mechanical power range for each FT set. These results were confirmed by the significant increase in the participants’ blood lactate concentration levels, the rating of perceived exertion, and heart rate. [Conclusion] Leg-power generation could gradually be decreased in badminton competition as indicated by a badminton field test.
[Purpose] To explore the relationship between functional outcome measurements of spinal mobility, static balance and functional performance. [Participants and Methods] Fifty two healthy participants aged between 18–36 years participated. Spinal mobility included forward bending and side bending. Balance was tested via maintaining single-leg stance position with eyes open and with eyes closed. Functional testing included five times squat to stand, walking on heels and walking on tiptoes. [Results] Two-way mixed intraclass correlation coefficients (ICCs) consistency model average measure (ICC3,K) for single-leg standing with the eyes are open and closed was excellent (0.85) and very good (0.79) respectively. Mean forward spinal mobility score of the recreationally active group (M= 3.3 ± 5.7) was significantly lower (M= 9.5 ± 10.5) than inactive group. Regarding five times squat to stand, the mean score of the recreationally active group (10.4 ± 4.3) was not significantly different from the mean of the recreationally inactive group (9.5 ± 2.6). [Conclusion] Walking on heels significantly took more time and perceived with more exertion than tiptoes walking. Also, standing on one leg was harder when eyes are closed. Recreationally active had shown significant forward mobility but no difference between sidebending mobility. The relationships between different outcome measures need to be furtherly explored.
[Purpose] In clinical settings, patients with knee osteoarthritis often complain of pain at gait initiation. In the present study, we aimed to determine the differences in the center of foot pressure and lower extremity muscle activity at gait initiation in healthy volunteers compared to patients with medial knee osteoarthritis. [Participants and Methods] The study comprised of 10 females without medial knee osteoarthritis (healthy group) and 10 females with medial knee osteoarthritis (medial knee osteoarthritis group). We measured the center of foot pressure trajectory and muscle activity onset times of the tibialis anterior and internal gastrocnemius at gait initiation. Moreover, we examined the effects of insole use in the medial knee osteoarthritis group. [Results] The posterior center of foot pressure displacement was significantly smaller in the medial knee osteoarthritis group (barefoot and insole) than in the healthy group. The anterior center of foot pressure displacement significantly improved with insole use. The muscle activity onset time of the tibialis anterior was significantly delayed in the medial knee osteoarthritis group (barefoot) than in the healthy group. [Conclusion] Postural control decreased at gait initiation in the medial knee osteoarthritis group.
[Purpose] Reportedly, males take fewer steps than females among frail older adults. The step count of frail older adults may be influenced by domestic roles in the instrumental activities of daily living. In this study, we aimed to investigate the association between instrumental activities of daily living and the number of steps in frail older females. [Participants and Methods] In this cross-sectional study, we included 27 frail older females aged 84.4 ± 6.5 years who attended a day-care center. We used the Fillenbaum’s instrumental activities of daily living screener and measured the number of steps using an accelerometer, functional independence measure, grip strength, and short physical performance battery. We investigated the association between instrumental activities of daily living and daily steps. Furthermore, we compared the outcomes of the differences in the independence using a subscale of instrumental activities of daily living. [Results] Instrumental activities of daily living and step counts showed a significant correlation. Participants dependent on meal preparation and housework took significantly fewer steps per day. The dependence of their activities also caused low functional independence measure and weak grip strength. [Conclusion] In frail older females, decreased ability for instrumental activities of daily living were associated with fewer steps. Domestic roles may increase the daily steps in frail older adults.
[Purpose] In this study, we aimed to investigate the effects of neck movement restriction on somatotopic mapping of the motor cortex. We restricted cervical extension for two weeks and investigated the effects on motor cortex somatic representation in rats. [Subjects and Methods] We placed six Wistar rats into each of three groups: (i) the experimental group, in which cervical extension was restricted; (ii) the sham group, in which cervical movement was not restricted, but a splint was placed in the shoulder girdle; and (iii) the control group. After cervical immobilization for two weeks, we evaluated the motor cortex somatic representation using intra-cortical micro-stimulation. [Results] In the experimental group, the areas of the cervical and vibrissal domains of the motor cortex decreased by approximately 50%, and the forelimb domain showed slight reduction. In addition, a trunk domain formed at the locus of the vibrissal area. There were no differences between the sham and control groups. [Conclusion] Restriction of cervical extension for two weeks resulted in changes in motor cortex somatic representation. Reversible changes occurred in cortical areas that controlled the neck and parts of the body involved in cervical movement.
[Purpose] It is important to accurately measure one-repetition maximum to determine the training load and number of repetitions. However, huge and expensive equipment, such as a torque machine and/or dynamometer, is needed to measure one-repetition maximum. Therefore, a more accessible and affordable method has been developed to predict one-repetition maximum. In this study, we aimed to investigate whether one-repetition maximum of the knee extensor could be predicted more accurately with a combination of muscle strength, measured using a handheld dynamometer, muscle thickness, and thigh circumference. [Participants and Methods] Participants were sixty-four non-athletic healthy adult volunteers (33 males and 31 females). Muscle strength of the knee extensor measured using one-repetition maximum, maximal voluntary isometric contraction measured using a handheld dynamometer, muscle thickness of the quadriceps and/or thigh circumference measured on ultrasonography. [Results] The stepwise regression analysis revealed that body mass, gender, muscle thickness at 15 cm above the patella, and maximal voluntary isometric contraction were the significant and independent determinants (R2=0.813). [Conclusion] One-repetition maximum could be predicted more accurately with a combination of maximal voluntary isometric contraction measured using a handheld dynamometer and muscle thickness.
[Purpose] Many clinicians believe that rehabilitation for patients with advanced cancer is futile. We determined factors affecting the performance of activities of daily living in patients with advanced cancer based on age, gender, marital status, living arrangement, rehabilitation intensity, type of cancer, impairment, metastasis, and active cancer treatment. [Participants and Methods] We assessed the Barthel Index to evaluate the performance of activities of daily living. Of the 120 adult patients with cancer who underwent inpatient rehabilitation, we analyzed the Barthel Index scores, consisting of 10 items, and reviewed the clinical characteristics from the medical records of 48 patients who completed supportive or palliative rehabilitation according to Dietz and showed an increased or maintained total Barthel Index score at final evaluation. [Results] The median total Barthel Index score increased from 45 (5–95) to 72.5 (5–100); the rehabilitation intensity was 320 (40–1,240) minutes. The analytical results showed that the increase of total Barthel Index score was positively associated with rehabilitation intensity (β=0.350) and negatively associated with the initial grooming score (β=−0.277). [Conclusion] Adequate rehabilitation positively affects performance of activities of daily living, especially in patients with advanced cancer who lost their grooming ability at the onset of rehabilitation. Importantly, rehabilitation may be beneficial for patients with advanced cancer.
[Purpose] We aimed to clarify whether demonstration and simulated experience help the ability of care-receivers to get transferred, such as from the bed to the commode. [Participants and Methods] Participants included 28 nurses and 17 caregivers (34 females and 11 males). We developed a total floor reaction force measurement device to quantify the total loading level of care-receivers and caregivers and force shoes to quantify the loading level of the caregivers. Using these instruments, we constructed a system to measure the load on the lower limbs of the care-receivers during partial assistance. We divided the participants into the control, demonstration, and simulated experience method groups. We examined the differences in the load on the lower limbs before and after the intervention. [Results] The loads on the lower limbs of care-receivers when their buttocks were lifted from the chair were 11.7 ± 69.6, 61.8 ± 79.4, and 101.0 ± 104.0 N in the control, demonstration, and simulated experience groups. [Conclusion] These data suggest that the simulated experience method could help make use of the ability of the care-receiver to get transferred. Even care workers for the sanatorium-type sickbeds could learn to utilize the physical ability of the care-receivers using simulated experience.
[Purpose] To present basic data for a health promotion plan tailored to the body function of Bolivians residing in different municipalities and altitudes by investigating their blood pressure and oxyhemoglobin saturation. [Participants and Methods] The participants were 589 Bolivians residing in different altitudes who voluntarily participated in health promotion activities. We measured the blood pressure, peripheral capillary oxygen saturation, height, and weight, and calculated the body mass index. We divided the participants into two groups based on the altitude (valley and lowland) and the participants of each altitude group into six age brackets (every 10 years) to investigate the effect of age on each value. [Results] The altitude affected the systolic and diastolic blood pressure, oxyhemoglobin saturation, and height. All average values in the valley group were lower than those in the lowland group. There were significant effects in all variables based on age. The body mass index values were significantly higher in participants aged 45–64 years compared to those aged 18–34 years; the average value was 29. [Conclusion] An anti-obesity initiative for health promotion is needed to reduce the risk of health impairment in Bolivians, especially lifestyle-related diseases, such as type 2 diabetes mellitus, cardiovascular diseases, and stroke.
[Purpose] In this study, we aimed to determine the components of activities of daily living that decline easily during hospitalization. [Participants and Methods] We performed a prospective cohort study of 2,819 inpatients who were hospitalized and discharged. We prospectively evaluated the Barthel Index at admission and discharge, age, length of hospital stay, clinical department, and rehabilitation type. We divided the inpatients into two groups based on the Barthel Index score at admission and compared the items of the index at admission and discharge to analyze the characteristics of decline in activities of daily living. [Results] Forty-nine inpatients (2.0%) had declined in activities of daily living. There were no significant between-group differences in age, length of hospital stay, clinical department, or ratio of individual rehabilitation. However, transfer and toilet use remarkably decreased in the group with Barthel Index scores at admission <85, and bathing and ascending/descending remarkably decreased in the group with Barthel Index at admission ≥85. [Conclusion] The characteristics of decrease in each activity of daily living vary, and our results suggested the components that easily declined when inpatients were divided based on their performance of activities of daily living at admission.
[Purpose] Somatic symptoms, such as hyposomnia and anorexia, can affect depression and result in decreased movement quality; however, the relationship between movement quality and somatic symptoms is unclear. The present study investigated the characteristics of this relationship using observable posture and movements. [Participants and Methods] Twenty healthy young adults (mean age 20.9 ± 0.4 years) participated in the study. First, we administered the Self-rating Depression Scale questionnaire to the participants. Second, a qualified physical therapist assessed the movement quality of the volunteers using the Body Awareness Rating Scale-Movement Quality and Experience. We classified the participants into high- and low-score groups based on their Self-rating Depression Scale scores and then analyzed the Body Awareness Rating Scale-Movement Quality and Experience scores in both groups. [Results] There was a significant difference in the movement quality between the Self-rating Depression Scale high- and low-score groups. The Self-rating Depression Scale total score ranged from 20 to 80, with higher scores indicating a greater severity of depression. The low-score group had higher scores for the Body Awareness Rating Scale-Movement Quality and Experience than the high-score group in all items. [Conclusion] The present study showed that movement quality was related to symptoms of depression, thereby suggesting that early detection and treatment interventions for depression are possible by an assessment of movement quality.
[Purpose] One promising strategy for workplace wellness programs is to emphasize functional mobility screening and coaching to promote suitable physical activity and reduce musculoskeletal risks. This study examined intra-rater reliability, test-retest reliability, concurrent validity, known-groups validity and minimal detectable change for a new Two Square Agility Test (TSAT) designed as a functional mobility measure to promote workplace health. [Participants and Methods] Two hundred forty eight non-disabled participants (ages 18–69) were measured for body size, physical activity and 3 trials of the Two Square Agility Test. 78 participants were tested a week later on the Two Square Agility Test and other functional mobility tests. [Results] Intra-rater reliability was excellent (ICC=0.94) and test-retest reliability was good (ICC=0.87). Two Square Agility Test correlated moderately with Timed Up and Go (r=0.63), Five Times Sit to Stand (r=0.62), and Maximum Step Length (r= −0.54), supporting its concurrent validity. Performances for Two Square Agility Test were better in males, younger age, higher physical activity, and non-obese groups. The minimal detectable change at a 95% confidence level (MDC95) was 1.37 s. [Conclusion] Preliminary results supported reliability and validity of Two Square Agility Test as a functional mobility measure to promote workplace health.
[Purpose] The aim of this literature review was to detect the factors associated with pelvic girdle pain persisting for over 3 months in the postpartum period. [Methods] We performed a broad literature search for eligible studies published before May 1, 2018 using electronic databases and processed the data using a review process. [Results] In the initial online search, we identified 12,174 potential studies. Finally, 22 studies met the specified criteria and were included for examination of risk factors for persistent pelvic girdle pain after delivery. Pain intensity and disability during pregnancy were risk factors for pelvic girdle pain persisting for over 6 months after delivery. The active straight leg raising test predicted the risk of persistent pelvic girdle pain after delivery. Dysfunction of the pelvic floor muscles was also a risk factor for persistent pelvic girdle pain. [Conclusion] Pain intensity and disability during pregnancy, positive provocation tests, active straight leg raising test, and musculoskeletal mechanics were positively associated with pelvic girdle pain persisting for over 3 months after delivery.
[Purpose] To present the structural improvement of an excessive junctional thoracolumbar kyphosis and related biomechanical parameters in an adolescent. [Participant and Methods] A 16 year old female presented with chronic back pains. Radiographic assessment revealed excessive posterior sagittal balance and thoracolumbar kyphosis and reduced lumbar lordosis and sacral inclination. Chiropractic BioPhysics® technique including mirror image®, anterior thoracic translation and thoracolumbar hyperextension traction was performed as well as spinal manipulation and postural exercises over an 8-week period. [Results] After 24 in-office treatments and a daily home program the patient reported a minimization of back pains and a better mood. Follow-up X-rays demonstrated a 48 mm reduction of posterior sagittal balance, a 22° reduction of thoracolumbar kyphosis, an 11° increase in lumbar lordosis, and a 10° increase in sacral inclination. [Conclusion] This is the first case documenting the non-surgical reduction of excessive thoracolumbar junctional kyphosis and related biomechanical parameters in an adolescent. Precise analysis of radiologic assessment for adolescents presenting with back pains is advised and are safe for the screening of postural disorders. There is a growing evidence base for the Chiropractic BioPhysics® technique approach in the correction of lumbar spine disorders; more research is encouraged to further evaluate this unique treatment.
[Purpose] Integrated volitional control electrical stimulation (IVES) is a type of electrical stimulation therapy that promotes agonist muscle contraction in limbs with motion paralysis. This case study describes the improvement in the paretic hand with stroke hemiplegia, eight years after the onset, with IVES for one month in the extrinsic and intrinsic muscles, including change of mode of stimulation based on the degree of improvement. [Participant and Methods] A 76 year-old male with hemiplegia for eight years. The patient was evaluated for two weeks and performed IVES in the right flexor pollicis brevis, abductor pollicis brevis, and extensor carpi ulnaris with the change of mode of IVES. [Results] The upper limb function improved in a short period of time. The hemiplegia test showed Brunnstrom stages II–III and II–IV for the right upper limb and right hand and fingers, respectively, 28 days after IVES initiation. [Conclusion] After one month of undergoing IVES, the patient showed improvement in hand and finger motor function, which was maintained even after IVES was completed. In this case, there was improvement with a short-term intervention using appropriately combined IVES modes.
[Purpose] A young female with first-time traumatic shoulder dislocation showed a good outcome at the 1 year follow-up in returning to work and sports after undergoing a combination of exercise therapy and psychological intervention. [Participant and Methods] A 24-year-old female who worked as an occupational therapist and played badminton for recreation had dislocated her shoulder in a fall. We evaluated her compliance with home-exercise, range of motion, return to work, fear of movement, sports activity level, and instability of shoulder joint using the modified Rowe score at each timepoint necessary. During early sessions of the physical therapy, the range of motion and instability score for the shoulder joint were poor. We treated her using a phase-based approach, and subsequently, added the Watson program to restore normal kinematics. Because of a psychological problem during middle sessions of the physical therapy, we provided psychological education and support. [Results] At the final session of the therapy, her compliance with home-exercise was good. She had achieved almost a full range of motion. The fear of movement decreased, and she could play sports again. The modified Rowe score improved from 5 to 85. [Conclusion] As a conservative treatment for patients with first-time traumatic shoulder instability, a combination of therapeutic exercise and psychological intervention may be useful.
[Purpose] The aim of this study was to analyze changes in thoracic and lumbar spinal motions during running in a female athlete with scoliosis. [Participant and Methods] A female with scoliosis who was a member of a college track team was recruited for this study. On 1.5-T magnetic resonance imaging, angles between bodies of adjacent vertebrae in the frontal plane were calculated. We measured real-time spine movement while running using a three-dimensional motion analysis system, wherein the running speed was altered (6, 9, and 12 km/h). [Results] We observed a Cobb angle of 29.0° and the right convex curvature of the thoracolumbar spine on magnetic resonance imaging. As the running speed increased, during the right stance phase, the participant increased the lateral bending angle of the thoracic spine to the left and the lumbar spine to the right. However, during the left stance phase, the runner bent the thoracic spine to the right and the lumbar spine to the left, indicating a decreased convex curvature of the spine. [Conclusion] As the running speed increased, the convex curvature of the spine was corrected during the left stance phase but was uncorrected during the right stance phase.
[Purpose] To present the reduction of both lumbar spine hyperlordosis and anterior sagittal balance in a symptomatic patient as treated by Chiropractic BioPhysics® technique. [Participant and Methods] A 46 year old reported with low back and hip pains for six years. Oswestry disability index scored 28%. Radiographic assessment revealed pronounced anterior sagittal balance with lumbar hyperlordosis. The patient was treated by Chiropractic BioPhysics technique to reverse the spinal deformity subluxation via mirror image corrective exercises and spinal traction, as well as spinal manipulative therapy. [Results] Assessments after 36 and 74 treatments corresponding to the 4-month and 13-month check-ups demonstrated a continuous structural improvement in lumbar spine biomechanical parameters. There was a near complete resolution in low back and hip pains with an Oswestry score of 4%. [Conclusion] This case documents the reduction of lumbar spine hyperlordosis and forward sagittal balance by contemporary spine rehabilitation methods. It is essential to screen spinal subluxation patterns via standing radiography which obviously, as demonstrated in this case determines treatment approach as most low back pain patients present with lumbar hypolordosis. Routine initial and repeat radiography is safe in the screening and monitoring of treatment efficacy and is the standard for evidence-based, patient-centred structural rehabilitation.