[Purpose] The purpose of this study was to determine the effects of non-paretic arm movement during the bridge exercise on trunk muscle activity in stroke patients. [Participants and Methods] In total, 18 stroke patients were recruited. Surface EMG electrodes were attached over the trunk muscles (rectus abdominis, RA; internal oblique, IO; erector spinae, ES), and three kinds of bridge exercises were performed: 1) ‘standard’ bridge, 2) bridge with unilateral isometric arm flexion, and 3) bridge with unilateral isometric arm horizontal abduction. [Results] According to the activity of the trunk muscles measured during bridge exercises, only the IO and ES showed significantly greater muscle activity during bridges with isometric arm horizontal abduction and flexion than during the standard bridge. Additionally, comparison of the paretic and non-paretic sides showed that muscle activity was higher on the paretic side. [Conclusion] This study showed that, as an exercise to heighten the activity of the trunk muscles in stroke patients, bridge exercises with accompanying non-paretic arm flexion and horizontal abduction were more effective clinically than a standard bridge.
[Purpose] The purpose of this study was to determine the effect of dry needling on tendon-pulley architecture, pain and hand function in patients with trigger finger. [Participants and Methods] A randomized controlled trial was conducted. Fifty eight patients having trigger finger were randomly assigned as either an experimental group that received a single session of dry needling over pulleyA1 and flexor tendon or a control group that received no intervention. Thickness of tendon-pulley, and pain-hand function (by disability arm-shoulder questionnaire score and pinch grip strength) were measured by a blinded assessor before and one week after intervention. [Results] The two way mixed ANOVA in the experimental group showed that the thickness of pulley-tendon decreased, pinch grip power increased and DASH questionnaire score was decreased in comparison to the control group. [Conclusion] This study results suggest that a single session of Dry Needling (DN) was effective in decreasing pain, DASH score, pulley-tendon thickness and improving pinch grip power in patients with trigger finger.
[Purpose] Cerebral palsy (CP) encompasses a group of disorders of movement and posture with wide ranges of impairments, activity limitations and participation restrictions. Guiding management of children with CP by the ICF model is important to deliver quality services. This study aimed to explore relationship between CP subtypes and the Gross Motor Function Classification System-Expanded and Revised (GMFCS-E&R) and to examine differences in distribution of impairments and activity limitations across CP subtypes and GMFCS-E&R levels. [Participants and Methods] 70 children with CP (mean age: 6.5 ± 2.9 years) were classified using CP subtypes and GMFCS-E&R. Research assistants examined impairments including: scoliosis, scissoring, and inability to bear weight. Parents described their children’s transfers and functional mobility. [Results] CP subtypes and GMFCS-E&R levels were significantly associated. Scissoring and scoliosis were predominant in children in levels IV and V of the GMFCS-E&R. Only scoliosis was predominant in children with quadriplegia. Transfer activities and functional mobility were more limited in children with quadriplegia and in level V of the GMFCS-E&R. [Conclusion] Impairments and activity limitations components of the ICF can be differentiated by CP subtypes and GMFCS-E&R. Clinicians can use the two classification in providing comprehensive and individualized services for children with CP and their families.
[Purpose] To investigate the characteristics and distributions of the myofascial trigger point (TrP) and pressure pain threshold (PPT) of the active TrP in individuals with chronic tension-type headache (CTTH). [Participants and Methods] Fifty-three CTTH patients and 53 age and gender-matched individuals without CTTH (CON) were recruited. The TrPs and tenderness points were first identified by manual palpation, and the PPTs of the active TrPs were determined by using a manual algometer. [Results] The active TrP, latent TrP and tenderness point totals per person in the head, neck, shoulder and upper back in CTTH were 4.3 ± 2.1, 0.6 ± 1.0 and 1.9 ± 1.8, respectively, while those in CON were 0, 0.7 ± 1.5 and 1.9 ± 1.8, respectively. The PPT levels of the active TrPs were 0.7 ± 0.2 to 1.2 ± 0.6 kg/cm2 in the muscles of the head, neck, shoulder and upper back. A larger number of active TrPs and lower PPT levels of the active TrPs were found in the head, neck and shoulder regions than in the upper back region. [Conclusion] Lower PPTs of the active TrPs in the head, neck and shoulder regions could influence the individuals with CTTH.
[Purpose] This study aimed to clarify the reliability and validity of the impact force and knee joint sway measurement during single-leg drop landing by using a motion sensor with two built-in accelerometers. [Participants and Methods] Ten healthy college students (4 males and 6 females) who joined a basketball club participated in this study. Peak vertical acceleration, time between initial contact and peak vertical acceleration, and knee joint mediolateral sway were measured using the accelerometer during the landing motion. Reliability of the measurement with the accelerometer and the criterion-related validity between the accelerometer and force plate data were examined. [Results] The intraclass correlation coefficients indicated a peak vertical acceleration of 0.88, time between initial contact and peak vertical acceleration of 0.96, and knee joint mediolateral sway of 0.62. The magnitude and timing of the peak values between both measurement instruments showed high validity. [Conclusion] The measurement method using a motion sensor for the evaluation of the impact force and knee joint sway during landing has a moderate to high reliability and criterion-related validity. A motion sensor measurement might be a useful and easy method for evaluating landing impact force and knee joint stability.
[Purpose] Considering that respiratory muscle fatigue is a cause of respiratory failure, we aimed to clarify the characteristics of respiratory muscle fatigue under inhalation load and investigate its impact on individual respiratory muscles. [Participants and Methods] The study included 14 healthy adult male volunteers. Maximal inspiratory and expiratory mouth pressures were measured under inhalation load and while at rest. The statuses of the trapezius, sternocleidomastoid, pectoralis major, diaphragm, rectus abdominis, and external and internal abdominal oblique muscles were also assessed using electromyographic frequency analysis. [Results] The maximal inspiratory and expiratory mouth pressures decreased over time and recovered after rest. The median power frequency decreased significantly in the sternocleidomastoid and rectus abdominis muscles at maximal inspiratory and expiratory mouth pressures, respectively, under inhalation load. [Conclusion] As a characteristic of respiratory muscle fatigue, there is a possibility that decreases in maximal inspiratory and expiratory mouth pressures as a result of the inhalation load affect muscle fatigue in the sternocleidomastoid and rectus abdominis muscles.
[Purpose] This study aimed to examine the direct and indirect effects of factors influencing the risk of life space assessment using path analysis. [Participants and Methods] A sample of 212 elderly residents (at least 65 years old) with no clear indications of cognitive dysfunction, visual impairment, and physical dysfunction were recruited for the study. Data on these factors were collected from the participants at a community gathering using measures of life space assessment, skeletal muscle mass, lower extremity muscle strength, mobility, cognitive function, and fear of falling. Correlational and path analyses were used to investigate the relationships between these variables. [Results] The final path model satisfied the requisite statistical criteria, and subsequently, the relationships between the physiological and psychological factors associated with life space assessment were structured and represented visually. Age, skeletal muscle mass, fear of falling, and mobility had a direct effect on life space assessment, whereas lower extremity muscle strength and cognitive function affected it indirectly. [Conclusion] In this study, direct and indirect effects of physiological and psychological factors related to risk of life space assessment of the elderly were clarified using path analysis.
[Purpose] This study aimed to investigate sport climbing injuries among users of a climbing gym to identify the characteristics of the injuries and preventive measures. [Participants and Methods] Participants with at least 6 months of sport climbing experience at least once a week were included in the study. They provided basic information with regard to climbing, medical history, and self-care of climbing-related injuries. [Results] Of 113 validated respondents, 85 reported a history of climbing-related injuries. The injury occurrence rate by location was highest in the fingers, followed by the wrist, shoulder and ankle, knee, and elbow. All the ankle injuries had sudden onset. Moreover, the occurrence rates of the injuries with both sudden and gradual onsets tended to be higher in the fingers and wrists. With regard to the self-care status, warming up was performed by 88.5% of the participants; and cooling down, by only 25.7%. [Conclusion] This study found a high incidence of injuries involving the fingers, wrists, and ankles, which suggests the need for prevention by self-care.
[Purpose] The purpose of this study was to investigate whether the recovery period of joint contractures differ between treatments with joint fixation with unweighting of the hind limbs and joint fixation alone. [Subjects and Methods] Twelve 10-week-old male Wistar rats were divided into a group with joint fixation of the right ankle joints in full plantar flexion for 1 week (F) and a group with joint fixation and hind limb suspension (FS). Thereafter, the rats were removed from the joint fixation and hind limb suspension for 2 weeks. The ankle dorsiflexion angles during the recovery process of the joint contractures were measured. [Results] The ankle dorsiflexion angles of the F group from the day joint fixation was removed to the seventh recovery day were significantly lower than the pre-experiment values. The ankle dorsiflexion angles of the FS group from the day joint fixation and hind limb suspension were removed to the 10th recovery day were significantly lower than the pre-experiment values. [Conclusion] We found that the period required for the recovery of joint contractures treated with joint fixation with unweighting of the hind limbs was longer than that with joint fixation alone.
[Purpose] Determining the thickness of the intercostal muscle with ultrasound imaging would be a useful parameter in evaluating respiratory muscle activity in patients with tetraplegia and neuromuscular weakness. However, it has not been clarified whether ultrasound imaging can measure changes in intercostal muscle thickness during breathing. This study aimed to measure contractions of the human intercostal muscle in the anterior, lateral, and posterior parts with ultrasound imaging during maximal breathing. [Participants and Methods] The participants were 12 healthy males. Intercostal muscle thickness was measured using ultrasound at rest and at maximal breathing. The measurement sites were the anterior, lateral, and posterior portions of the right intercostal spaces. Statistical analysis was performed using a paired t-test comparing intercostal muscle thickness at rest and maximal breathing. [Results] The thickness of the intercostal muscle showed significant increases in the first, second, third, fourth, and sixth intercostal spaces of the anterior portions. There were no significant differences in the lateral or posterior portions between rest and maximal breathing. [Conclusion] Human intercostal muscle thickness can be measured with ultrasound and increases only in the anterior portions during maximal breathing.
[Purpose] This study aimed to classify the plantar contact condition during forward stepping by focusing on the medial and lateral toes and to elucidate the relationship between the classification and turning movement. [Participants and Methods] The participants were 38 females. The plantar contact condition during forward stepping was evaluated for all participants, and the results were used for the group classification. In all the classified participants, the ground reaction force (GRF) during turning movement was measured. [Results] At sidestep (SS) and cross-step (CS), the peak medial-lateral GRF was significantly smaller in the medial floating toe (MFT) group than in the contact toe (CT) group. At SS, the peak times of the medial-lateral GRF in the MFT and lateral floating toe groups were significantly lesser than those in the CT group. At CS, the push-off peak time of the anterior-posterior GRF was significantly lesser in the MFT group than in the CT group. [Conclusion] The results of this study confirmed that each group classified according to the floating toe classification during forward stepping has different characteristics with respect to the ground reaction force during the turning movement, particularly the medial-lateral ground reaction force and its peak time.
[Purpose] This study aimed to evaluate the movement characteristics of sport climbing on the basis of the difference in basic movements between experienced climbers and beginners. [Participants and Methods] Eighteen healthy men participated in this study, including 9 experienced climbers and 9 beginners. A two-dimensional motion analysis was conducted with two digital cameras. The motion tasks were the counter-movements, including before and after each movement, which was classified into 5 phases. In each phase, the joint angles of the shoulder, elbow, hip, knee, and trunk were calculated. In the frontal plane, the center of gravity (COG) trajectory, motion speed, and motion time were calculated, which were compared between the climbers and the beginners in each phase. [Results] A significant difference was observed in the horizontal direction of the COG movement width. The beginners tended to have smaller shoulder flexion and abduction, and larger elbow flexion on the supporting side, and smaller hip flexion and abduction and knee flexion on the support side than the climbers. [Conclusion] This study suggests that climbers adopt a strategy to reduce the burden on the upper extremities by efficiently using the trunk and lower extremities to move their COG.
[Purpose] The purpose of this study was to develop an assessment tool that reflects the ankle function during the terminal stance of gait using an inertial sensor. [Participants and Methods] Thirteen healthy males (20 limbs) participated in this study. All the participants were required to perform five straight-line walking trials along a 10-m level walkway. During the terminal stance phase, both the anterior-posterior and vertical accelerations were measured with an inertial sensor mounted on the fibular head. The Pythagorean theorem was used to calculate the acceleration vector. A three-dimensional gait analysis system was used for movement data acquisition. All statistical analyses were performed using IBM SPSS Statistics 24.0 for Windows. [Results] Results were obtained using the following multiple regression equation for the estimation of ankle plantar flexion power: Estimated Ankle Power=−4.689 + 0.269 × vertical acceleration + 0.104 × body weight. [Conclusion] Our novel method for gait analysis using an inertial sensor can assess the ankle power during the terminal stance phase of gait.
[Purpose] Oswestry Disability Index includes an item (Oswestry Disability Index-8) aiming to assess sexual disability associated to low back pain. The aim of this study is to investigate the percentage of participants who answered the Oswestry Disability Index-8, and the relevance and characteristics of sexual disability due to low back pain in Italian patients. [Participants and Methods] Design: multicenter retrospective analysis. Population: six hundred and ninety-seven outpatients with non-specific low back pain. Variables: pain characteristics (amount, localization, and duration of perceived pain), disability, and psychological variables (anxiety, depression, catastrophizing, kinesiophobia, pain acceptance, and pain vigilance and awareness). [Results] Seventy-seven participants (11.05%) did not answer the Oswestry Disability Index-8. The odds of being not responding to the Oswestry Disability Index-8 item appeared related to age (odds=7.50 for over 60), gender (odds=2.65 for females), and marital status (odds=2.33 for not married). Concerning the psychological variables, Activity Avoidance (coefficient=0.071), Depression (coefficient=0.068), and Rumination (coefficient=0.031) showed a positive impact on sexual disability. [Conclusion] In Italian patients, the percentage of not-responding to Oswestry Disability Index-8 was relatively low. In addition, sexual disability was related to depression, activity avoidance, and rumination.
[Purpose] We report a case of an elderly patient with rheumatoid arthritis who underwent hip disarticulation because of necrotizing fasciitis and regained the ability to walk independently with a prosthetic limb. [Participant and Methods] A 61-year-old female patient underwent right hip disarticulation due to severe necrotizing fasciitis of the right lower limb. Her chief complaint was that she was not able to walk inside her house or outdoors to perform instrumental activities of daily living. We applied a Canadian-type hip disarticulation prosthesis to the stump. The patient received in-hospital physical therapy, occupational therapy, and clinical psychology counselling for 145 days. As her hands and fingers were weakened by rheumatism, we made several modifications to the prosthesis to enable the patient to attach and detach it independently. [Results] The patient was able to use the prosthesis to walk continuously for 45 m, perform various housework duties, drive a car, and go out, thus accomplishing the desired daily activities. [Conclusion] Our patient, an elderly hip disarticulation amputee with rheumatoid arthritis, was able to walk independently using a prosthetic limb. The application of prosthetic limbs may be appropriate even for hip disarticulation amputees with comorbidities that make it difficult to acquire a prosthetic gait.
[Purpose] The aim of this study was to determine the highest electromyography (EMG) amplitude of the gluteus maximus from closed and open kinetic gluteal maximal voluntary isometric contractions (MVICs). [Participants and Methods] Ten healthy male rugby players performed three MVIC techniques that included, in random order: single leg squat, prone hip extension and standing gluteal squeeze. EMG signals were recorded from the inferior and superior regions of gluteus maximus of the dominant leg, and were normalized to the prone hip extension. [Results] For statistical analysis the EMG of both gluteus maximus regions were pooled together. The standing gluteal squeeze revealed a significantly lower EMG compared to single leg squat and prone hip extension. However, there was no significant difference in gluteal EMG activity between single leg squat and prone hip extension. [Conclusion] There is no distinct advantage for either single leg squat or prone hip extension in eliciting maximum EMG activity. Future research should compare the present positions with other MVICs that are commonly prescribed or have been demonstrated to produce high EMG amplitudes.
[Purpose] Cervicogenic headache is a major problem in patients with upper cervical dysfunction. However, its physical therapy management is a topic of debate. This study aims to determine the effect of C1-C2 Mulligan sustained natural apophyseal glide mobilizations on cervicogenic headache and associated dizziness. [Participants and Methods] This study included 48 patients with cervicogenic headache, who were randomly assigned to three equal groups: Group A (Headache SNAG), group B (C1-C2 SNAG rotation), and group C (combined). Neck Disability Index was used to examine neck pain intensity and cervicogenic headache symptoms. The 6-item Headache Impact Test scale was used to examine headache severity and its adverse effects on social life and functions. Flexion-Rotation Test was used to assess rotation range of motion at the level of C1-C2 and confirmed by a cervical range of motion device. Dizziness Handicap Inventory scale was used to evaluate dizziness. The evaluation was done pre- and post-treatment and compared between the groups. [Results] Group C showed significant improvement in all variables compared with groups A and B. [Conclusion] Sustained natural apophyseal glide mobilizations used in the study were effective in reducing cervicogenic headache and dizziness in all groups with a greater improvement in the combined group. The use of cervical SNAG mobilizations is encouraged as a noninvasive intervention depending on the therapist’s assessment, findings, and clinical reasoning.
[Purpose] The purpose of this secondary analysis of data from the validation phase of National Institutes of Health Toolbox study was to describe the relationship between grip strength, dexterity, fine hand use, and age. [Participants and Methods] Children 3 to 13 years (n=132) contributed data. Grip strength was measured bilaterally with a Jamar dynamometer. Dexterity was measured bilaterally with the Nine-hole Peg Test. Fine hand use was characterized using 5 items of the Bruininks Oseretsky Test of Motor Proficiency. [Results] All grip strength and dexterity and fine hand use measures were correlated moderately to highly with one another and with age. The Cronbach’s alpha for all measures was 0.88. Factor analysis suggested that all measures loaded strongly on a single component with the first factor explaining 75.6% of the total variance. Nevertheless, correlations between grip strength and dexterity and fine hand use measures were mostly negligible after controlling for age. [Conclusion] As moderate to strong relationships between grip strength and dexterity and fine hand use are attenuated by age in children of 3 to 13 years, we cannot recommend the use of any one measure over others to characterize motor function of the hand.
[Purpose] Wearing shoes can be difficult for people who experience movement difficulties. This study aimed to compare young adults and senior adults while wearing shoes in order to quantify kinematic, physiological, and ergonomic points of variance. [Participants and Methods] Nine young adults (mean age, 21 years) and nine senior adults (mean age, 70 years) were included in the study. We investigated four postural combination of using hand and crossing legs used while wearing shoes: 1) time required to wear shoes, 2) the center of pressure point, 3) muscle activation within the right sartorius, the left rectus femoris, the gluteus maximus, and the internal oblique, and 4) the perceived ease of task performance via a numerical rating scale. [Results] The activities of the internal oblique and the gluteus maximus were significantly higher in senior adults than in young adults. Wearing shoes without using hands was associated with the highest value for the ease of performance among the four patterns for both groups. [Conclusion] Our results suggested that the muscles analyzed in this study were important for safety and postural maintenance while performing activities of daily living tasks in leg-raising processes in the sitting position, with lower level of muscle activity.
[Purpose] To investigate the reliability of novice and experienced physiotherapists using the normalized navicular height truncated and the foot posture index-6 for classifying foot posture in healthy adults. [Participants and Methods] Thirty asymptomatic adults participated in this study. After brief training, inter-rater reliability was performed by an expert and inexperienced rater (the novice physiotherapist). On the same day, both raters independently performed the normalized navicular height truncated and the foot posture index-6. For intra-rater reliability, the inexperienced rater repeated data collection on the 8th day after the first assessment. Intraclass correlation coefficients (ICCs) and Cohen’s Weighted Kappa (Kw) were used for continuous and categorical data, respectively. [Results] The normalized navicular height truncated and the Rasch-converted foot posture index-6 scores demonstrated an excellent inter- and intra-rater reliability (ICCs=0.98–0.99). For classifying foot posture, the normalized navicular height truncated and the total foot posture index-6 scores represented more than 90% inter- and intra-rater agreement with Kw values ranging from 0.92–0.94, while each item of foot posture index-6 demonstrated inter- and intra-rater agreement ranging from substantial to almost perfect (Kw=0.71–0.94). [Conclusion] The normalized navicular height truncated and the foot posture index-6 are simple and reliable methods that can be used by the inexperienced rater.
[Purpose] We investigated whether the activities of daily living and instrumental activities of daily living independence in patients with Alzheimer’s disease are positively affected by the main nursing caregiver consciously aiming to provide only minimal nursing care. [Participants and Methods] The participants comprised 105 patients (men: 46, women: 59, mean age: 80.1 ± 6.7 years). We conducted interviews to establish whether the main nursing caregivers consciously aimed to provide only minimal nursing care (care consciousness), and participants were thus divided into two groups. Hyogo Activities of Daily Living Scale scores of the groups with and without care consciousness were compared by dementia severity. [Results] In patients with mild Alzheimer’s disease, activities of daily living and instrumental activities of daily living independence in the group with care consciousness were significantly higher than in the group without care consciousness. In patients with moderate Alzheimer’s disease, instrumental activities of daily living independence was significantly higher in the group with care consciousness than in the group without care consciousness. [Conclusion] Thus, positive effects on the activities of daily living and instrumental activities of daily living independence are observed when the main nursing caregivers consciously aim to provide only minimal nursing care to patients with Alzheimer’s disease.
[Purpose] To describe the effect of a physical therapy program in function improvement and pain reduction in patients older than 60 years with complex regional pain syndrome (CRPS) type I after distal radius fracture (DRF) treated conservatively. [Participants and Methods] Fifty-four patients received a 6 weeks physical therapy program that included in hydrotherapy, manual therapy, and exercises based on motor skill training. Two evaluations were performed, the wrist/hand function was assessed with Patient-Rated Wrist Evaluation (PRWE) questionnaire, the upper extremity function with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire, grip strength with Jamar Dynamometer, and pain intensity with the Visual Analog Scale (VAS). [Results] At the end of the treatment, PRWE showed a decrease of 30.9 points, DASH 34.7 points, and the VAS, 3.4 cm. The grip strength showed an increase of 14.4%. [Conclusion] A physical therapy program based on hydrotherapy, manual therapy, and exercises in a short term improves the function and reduces the pain in patients older than 60 years with CRPS I after DRF treated conservatively.
[Purpose] Little is known about the effectiveness of daily physical activity on depression biomarkers in older adults. This study aimed to investigate the effects of increased daily physical activity for 8 weeks on depression biomarkers in postmenopausal women. [Participants and Methods] Thirty-eight postmenopausal females were randomly assigned into a control or an active group and were asked to wear a uniaxial accelerometer for 8 weeks. Blood samples were obtained at baseline and at the end of the intervention. During the intervention, the active group was asked to increase their physical activity level above their usual lifestyle whereas those in the control group maintained their daily lifestyle. [Results] After the 8-week intervention, the step counts of the participants in the active group increased. The serum concentration of the brain-derived neurotrophic factor and serotonin increased significantly in the active group, but not in the control group, as compared with baseline values. The serum concentration of derivatives of reactive oxygen metabolites and biological antioxidant potential did not change after the intervention in either group. [Conclusion] These findings may suggest that promotion of daily physical activity in postmenopausal women has a positive impact on depression without any change in oxidative stress.