The aim of this study was to investigate the effect of hip external rotation angle on pelvis and lower limb muscle activity during prone hip extension. Sixteen healthy men were recruited for this study. Each subject performed an abdominal drawing-in maneuver (ADIM) in a prone position, and extended the dominant hip at three different hip external rotation angles (0°, 20°, 40°) with a 30° hip joint abduction. Activity of the gluteus maximus (G Max), gluteus medius (G Med), and hamstring (HAM) and the G Max/HAM and G Med/HAM ratios were determined with surface electromyography (EMG). The EMG signal was normalized to 100% maximum voluntary isometric contractions (MVICs) and expressed as %MVIC. Data were analyzed by one-way repeated analysis of variance (alpha level=.05) and the Bonferroni post hoc test. Significant differences in G Max and G Med muscle activity were noted among the three different hip external rotation angles. G Max muscle activity increased significantly at both 40° (p=.006) and 20° (p=.010) compared to a 0° hip external rotation angle. G Med muscle activity increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. The G Max/HAM activity ratio increased significantly at both 40° (p=.004) and 20° (p=.014) compared to a 0° hip external rotation angle. The G Med/HAM activity ratio increased significantly at 20° (p=.013) compared to a 40° hip external rotation angle. In conclusion, 40° and 20° hip external rotation angles are recommended to increase G Max activity, and 20° hip external rotation is advocated to enhance G Med muscle activity during prone hip extension with ADIM and 30° hip abduction in healthy subjects.
The purpose of this study was to investigate the activity of the transverse abdominal muscle resulting from changed posture by measuring the thickness of the transverse abdominal muscle in a supine posture, a slouched sitting posture, and an erect sitting posture. The subjects of the study were 28 patients with cerebral palsy. All their transverse abdominal muscles at the end of inhalation were measured at supine, slouched sitting (S sitting) and erect sitting (E sitting) postures by using ultrasonography, and then their dynamic sitting balance was measured at S sitting and E sitting postures by using BioRescue. For the statistical analysis, the Kruskal-Wallis test and the Wilcoxon signed-rank test were used to compare the differences among each the postures. The results were as follows. The thickness of the transverse abdominal muscle when comparing the supine posture and the S sitting posture showed no statistically significant difference. But the E sitting posture showed a statistically significant difference as compared with the others. In addition, the dynamic sitting balance in comparing the S sitting and E sitting postures showed a significant difference. In conclusion, the E sitting posture has a more positive effect on postural control and balance than generally taking the S sitting posture, for the sitting posture of a patient with cerebral palsy. It is suggested that patients with cerebral palsy mainly experiencing a sedentary life or being in a wheelchair should be seated in the E sitting posture during their daily life, and it may be necessary to continue to monitor and manage the proper E sitting posture.
The purpose of this study was to compare the intra-rater and inter-rater reliability of three methods for measuring iliotibial tract length in 40 knees of 20 subjects. The measurements were performed by two examiners and one assistant. The length of the iliotibial tract was measured using three methods: the first used a modified Ober test with an inclinometer, the second used a modified Ober test with a marker, and the third used active adduction test with a marker in the supine position. Each examiner used the three methods in two sessions. For the first method, the inclinometer value was recorded manually. For the second and third methods, Image J analysis software was used to analyze the photographs taken. The intra-rater and inter-rater reliability of the measured value was assessed by means of intra-class correlation coefficients [ICC (3,1)] and the standard error of measurement. The intra-rater reliabilities of the three methods were excellent (ICC=.97, .95, and .94, respectively), and the inter-rater reliabilities of the first and second methods were fair to good (ICC=.64 and .65, respectively). The inter-rater reliability of the third method was excellent (ICC=.88). Our results suggest that the active adduction test is an objective and qualitative measurement method for measuring iliotibial tract length. We recommend that the active adduction test be used for measuring iliotibial tract length in the clinical setting.
The purpose of this study was to investigate the effects of smartphone use on muscle fatigue and tenderness in the cervical erector spinae (CES) and the upper trapezius (UT) and on the cervical range of motion among subjects with and without neck muscle pain. The subjects were 30 smartphone users in their 20 s who -were assigned to either an experimental group with neck muscle pain or a control group without neck muscle pain. Muscle fatigue and tenderness in the CES and the UT as well as the subjects’ cervical range of motion were measured before and after 20-min smartphone sessions in a sitting position. In a between-group comparison of muscle fatigue, the experimental group showed a significantly greater decrease in median frequency in the CES and the right UT after smartphone use (p<.05). Regarding the assessment of muscle tenderness after smartphone use, the experimental group showed a statistically significant decrease in the pressure-pain threshold (PPT) in all muscles (p<.05), whereas the control group showed a significantly decreased PPT in the right CES and the UT (p<.05). The assessment of the cervical range of motion revealed a statistically significant reduction in the cervical flexion-extension and left lateral flexion in the experimental group (p<.05) after smartphone use. However, there was no significant change in the cervical range of motion in the control group (p>.05) after smartphone use. When compared with the control group, the experimental group demonstrated greater changes in cervical extension, lateral flexion, and rotation, except for cervical flexion (p<.05). In conclusion, when smartphone users have pre-existing neck muscle pain, the use of a smartphone further increased muscle fatigue and tenderness in the neck and reduced PPT and the cervical range of motion.
The aim of this study was to investigate the effects of different postural correction in the electromyographic (EMG) activity of the trunk and hip muscles during bridging exercises. Twenty-four healthy subjects volunteered for this study. The muscle activity was recorded with surface electrodes over the erector spinae, multifidus, gluteus maximus (GM), and hamstring (Ham) muscles; it was measured by using surface EMG equipment under the following 3 experimental conditions: manual postural correction, verbal correction, and no correction. The maximal voluntary isometric contraction (MVIC) was determined for each muscle group in order to represent each exercise as a percentage of MVIC and allow for standardized comparison between subjects. A one-way analysis of variance was used to determine significant differences in the EMG activities of each muscle between the 3 experimental groups. During bridging exercises, the manual postural correction on normalized EMG activity of the GM muscle during manual guiding was significantly higher than during verbal guiding and without guiding (p<.05). Furthermore, the GM/Ham ratio was significantly higher during manual guiding than during verbal guiding and without guiding (p<.05). These findings suggest that the activities of the hip and trunk muscles may be favorably modified with manual guiding during bridging exercises.
Fall is one of the most intimidating health conditions in elders. Comprehensive assessment is necessary to understand the individual and environmental aspects of the falls such as balancing abilities, depression, and quality of life. The purpose of this study was to compare the balancing ability, depression, and quality of life between elderly fallers and elderly non-fallers. Thirty-two community-dwelling elders (fifteen males and seventeen females between 65 and 83 years old), who have experienced fall on walking during last twelve months, were involved in the elderly fallers group. And twenty-four males and twenty-two females between 65 and 83 years old of community-dwelling elders, who have no experienced fall on walking during last twelve months, were involved in the elderly non-fallers group. Berg balance scale (BBS), timed up and go test (TUG), and functional reach test (FRT), were used to evaluate the ability of the physical balance. ‘Beck depression scale in Korean’ questionnaire was used to assess the depression. ‘Korean version of World Health Organization Quality of Life Assessment Instrument-Bref’ questionnaire was used to assess the quality of life. The results were as follows: 1) Balancing abilities measured by the BBS, TUG in the elderly fallers group were meaningfully lower than that of the elderly non-fallers group (p<.05), whereas no significant difference in the FRT was found (p>.05). 2) Depression level in the elderly fallers group was significantly higher than that of the elderly non-fallers group (p<.05). 3) Quality of life in the elderly fallers group was significantly lower than that of the elderly non-fallers group, excluding environment domain (p<.05). Therefore, in order for clinical evaluation of the community-dwelling elders those with reduced balancing ability, it is necessary to evaluate and understand the fall experience, depression, and quality of life.
This study investigated the relationship between function classification systems and the Pediatric Evaluation of Disability Inventory (PEDI) functional skills in children with cerebral palsy (CP). Two hundred and eleven children with CP participated in this study. The Korean-Gross Motor Function Classification System (K-GMFCS), Korean-Manual Ability Classification System (K-MACS), Korean-Communication Function Classification System (K-CFCS), and self-care, mobility, and social function domains of the Korean-Pediatric Evaluation of Disability Inventory (K-PEDI) functional skills were measured by physical therapists or occupational therapists. All of the function classification systems were significantly correlated with PEDI functional skills (rs=-.549 to -.826) (p<.05). Especially, K-GMFCS, K-MACS, and K-CFCS were correlated significantly with mobility, self-care, and social function, respectively. Using stepwise multiple regression analysis, we established that K-GMFCS, K-MACS, and K-CFCS were predictors of self-care skills (74.3%) and mobility skills (79.5%) of the K-PEDI (p<.05). In addition, K-CFCS and K-MACS were predictors of social function (65.9%) of the K-PEDI (p<.05). The information gathered in this study using the levels measured in the function classification systems may be useful to clinicians for estimating the PEDI functional skills in children with CP.
The purpose of this study was to investigate the effects of Proprioceptive Neuromuscular Facilitation (PNF) on the swallowing function of stroke patients. Twelve-week PNF (facial, tongue, and breathing exercise) was applied in the experimental group consisting of 12 subjects, and a general swallowing exercise program was applied to the control group consisting of 12 subjects. In addition, the signs of improvement in the stroke patients (N=24) swallowing function were examined by conducting a video fluoroscopic swallowing study. The data were analyzed using the SPSS ver. 21.0 program, which was also utilized to gain statistical information (percentage, mean, and standard deviation), and paired t-test was conducted. As a result of the analyses, the following conclusions were arrived at. The 12-week PNF significantly improved the functional dysphagia scale, penetration-aspiration scale, pharyngeal transit time, swallowing response time, residue in valleculae, and residue in pyriform sinuses enhanced swallowing functions of the stroke patients (p<.05). In conclusion, the PNF intervention in the swallowing function of the stroke patients was found to be an effective exercise program.
The purposes of the current study were to (1) estimate the inter-rater agreement for visual assessment of scapular downward rotation (SDR), (2) develop the scapular downward rotation index (SDRI) as a method to measure SDR objectively and quantitatively, and (3) analyze the intra- and inter-rater reliability of the SDRI. Twenty subjects with scapular downward rotation syndrome (SDRS) were recruited for this study. The visual assessment and the measurement for the SDRI were conducted by two examiners in two sessions each. The SDRI [(a-b)÷a×100] is calculated with the measurement of two linear distances: One is a perpendicular distance from the root of the scapular spine to the thoracic mid-line (a), and the other is a perpendicular distance from the inferior angle of the scapula to the thoracic mid-line (b). Cohen’s kappa coefficient was calculated to estimate the inter-rater agreement for visual assessment. Intra-class correlation coefficients (ICCs) with a 95% confidence interval (CI), the standard error of measurement, and minimal detectable differences were calculated to assess intra- and inter-rater reliability of SDR measurement using the SDRI. The results indicated that the kappa coefficient of inter-rater agreement for visual assessment was fair (κ=.21). The intra-rater reliability of SDR measurement using the SDRI was excellent for examiner 1 (ICC=.92, 95% CI=.78∼.97) and good for examiner 2 (ICC=.82, 95% CI=.55∼.93). The inter-rater reliability was moderate (ICC=.73, 95% CI=.32∼.89). These findings showed that SDR measurement using the SDRI for subjects with SDRS may be considered reliable and better than the visual assessment.
Previous studies have reported that decreased cognitive ability has been consistently associated with significant declines in performance of one or both tasks under a dual-task walking condition. This study examined the relationship between specific cognitive abilities and the dual-task costs (DTCs) of spatio-temporal gait parameters in stroke patients. The spatio-temporal gait parameters were measured among 30 stroke patients while walking with and without a cognitive task (Stroop Word-Color Task) at the study participant's preferred walking speed. Cognitive abilities were measured using Computerized Neuropsychological Testing. Pearson's correlation coefficients (r) were calculated to quantify the associations between the neuropsychological measures and the DTCs in the spatio-temporal gait parameters. Moderate to strong correlations were found between the Auditory Continuous Performance test (ACPT) and the DTCs of the Single Support Time of Non-paretic (r=.37), the Trail Making A (TMA) test and the DTCs of Velocity (r=.71), TMA test and the DTCs of the Step Length of Paretic (r=.37), TMA test and the DTCs of the Step Length Non-paretic (r=.36), the Trail Making B (TMB) test and the DTCs of Velocity (r=.70), the Stroop Word-Color test and the DTCs of Velocity (r=-.40), Visual-span Backward (V-span B) test and the DTCs of Velocity (r=-.41), V-span B test and the DTCs of the Double Support Time of Non-paretic (r=.38), Digit-span Forward test and the DTCs of the Step Time of Non-paretic (r=-.39), and Digit-span Backward test and the DTCs of the Single Support Time of Paretic (r=.36). Especially TMA test and TMB test were found to be more strongly correlated to the DTCs of gait velocity than the other correlations. Understanding these cognitive features will provide guidance for identifying dual- task walking ability.