Background: The method of measuring the walking function of patients with chronic stroke differs depending on patients walking capability and environmental conditions. Objects: This study aimed to demonstrate the influences of walking capacity and environmental conditions on the results of short- and long-distance walk tests in patients with chronic stroke. Methods: Forty patients with chronic stroke volunteered for this study, and allocated to group-1 (<.4㎧, household walking, n1=13), group-2 (.4∼.8㎧, limited community ambulation, n2=16), and group-3 (>.8㎧, community ambulation, n3=11) according to their walking capacity. The 10-meter walk test (10MWT) and 6-min walk tests, (6MWT) were used to compare the short- and long-distance walk tests results, which were randomly performed under indoor and outdoor environmental conditions. Results: The comparison of the results obtained under the indoor and outdoor conditions revealed statistically significant differences between the groups in the 6MWT and 10MWT (p<.05). Post-hoc tests’ results showed significant differences between groups-1 and -2 and between groups-1 and -3 in the 10MWT, and between group-1 and -3 in the 6MWT. Furthermore, in group-2 the 10MWT and 6MWT results significantly differed between the indoor and outdoor conditions, and the values measured under the indoor and outdoor conditions significantly differed between 10MWT and 6MWT (p<.05). Group-3 showed a significant difference in 10MWT results between the indoor and outdoor conditions (p<.05). Conclusion: These findings suggest that the results of the short- and long-distance walk tests may differ depending on the walking capacity of patients with chronic stroke and the environmental condition under which the measurement is made, and these effects were greatest for the patients with the limited community ambulation capacity.
Background: Patients with chronic stroke often shows decreased trunk muscle activity and trunk performance. To resolve these problems, many trunk stabilizing techniques including the abdominal drawing-in maneuver (ADIM) and the diaphragmatic breathing maneuver (DBM) are used to improve trunk muscle strength. Objects: To compare the effects of the ADIM and the DBM on abdominal muscle thickness, trunk control, and balance in patients with chronic stroke. Methods: This was a randomized controlled trial. Nineteen patients were randomly allocated to the ADIM (n1=10) and DBM (n2=9) groups. The ADIM and DBM techniques were performed three times per week for 4 weeks. The thicknesses of the transversus abdominis (TrA), internal oblique muscle, and external oblique muscles on the paretic and non-paretic sides, Trunk Impairment Scale (TIS) score, and Berg Balance Scale (BBS) score were used to assess changes in motor development after 4 weeks of training. Results: After the training periods, the TrA thickness on the paretic side, TIS score, and BBS score improved significantly in both groups compared to baseline (p<.05). TIS score was significantly greater in the DBM group than in the ADIM group (p<.05). Conclusion: This study demonstrated that ADIM and DBM are beneficial for improving TrA muscle thickness in the paretic side, trunk control, and balance ability. Intergroup comparison revealed that TIS score was significantly improved in the DBM group versus the ADIM group. Thus, DBM may be an effective treatment for low trunk muscle activity and performance in patients with chronic stroke.
Background: The measurement of the strength of the shoulder muscles is an important element of the overall assessment of patients with various shoulder disorders. However, the clinical utilization of this measurement is dependent on its reproducibility. Objects: To explore the reproducibility of the measurements derived from testing of the isokinetic strength of shoulder muscles in patients with tendinitis of the rotator cuff. Methods: A total of 20 patients with tendinitis of the rotator cuff participated in this study and were assessed twice in 1 week. Isokinetic testing was performed concentrically for shoulder flexors, abductors, and external rotators and eccentrically for the shoulder extensors, adductors, and internal rotators. The relative and absolute reproducibility of the peak torque (PT) and ratios were assessed using intra-class correlation coefficients (ICC), standard error of measurement (SEM), and minimal clinically important difference (MCID), respectively. Results: Overall, high to excellent ICC, clinically acceptable SEM and MCID values were obtained for the PT (ICC: .83-.95, SEM: 1.2%-9%, MCID: 3.4%-25%) and ratios (ICC: .85-.93, SEM: 5.1%-10%, MCID: 14.2%-27.6%). Conclusion: These findings suggest that isokinetic tests may be effectively utilized for the determination of shoulder strength profiles and appropriate position are recommended to perform test without pain in patients with tendinitis of the rotator cuff.
Background: Scapular posterior tilt (SPT) is important in the prevention of abnormal scapular movement and pain during elevation of the arm. However, previous studies have overlooked increased upper trapezius (UT) muscle activity interrupting the normal force couple of scapular motion and compensation of levator scapulae (LS) muscle activated simultaneously with UT during SPT exercise. Objects: The purpose of this study was to compare the effects of modified SPT with depression exercise versus SPT exercise on serratus anterior (SA), lower trapezius (LT), UT, and LS muscle activities and the clavicular tilt angle, in subjects with rounded shoulder posture (RSP) and myofascial pain in the UT muscle region. Methods: Eighteen subjects with RSP were recruited and randomly allocated to 2 groups; 9 in the SPT group and 9 in the SPT with depression group. All subjects met the specific RSP criteria and had myofascial pain of UT region. Depending on the allocated group, subjects performed the assigned SPT exercise and EMG data were recorded during the each exercise. Clavicular tilt angle was defined as the angle between the line joining the medial and lateral end of the clavicle and a horizontal line. Results: The SA muscle activity was significantly greater in SPT with depression than with SPT exercise (p<.05). The UT, LS muscle activity and the clavicular tilt angle was significantly lower in SPT with depression than with SPT exercise (p<.05). Conclusion: These findings were insightful because the potential risk of pain from overactivation of the UT and LS was considered, in contrast with SPT exercise. SPT with depression exercise can be implemented as an effective method to facilitate scapular muscle activity for stability and to prevent myofascial pain in the neck and shoulder.
Background: The active knee extension (AKE) test commonly used to assess the flexibility of the hamstring muscles. Many researchers have tested the reliability of the AKE test; however, no published studies have examined the intrarater and interrater reliability of the AKE test using a PBU. Objects: The purpose of this study was to determine the intrarater and interrater reliability of the AKE test performed with a pressure biofeedback unit (PBU) on healthy subjects. Methods: Sixteen healthy male participants volunteered and gave informed consent to participate in this study. Two raters conducted AKE tests independently with a PBU. Each knee was measured twice, and the AKE testing was repeated one week after the first round of testing. Results: The interrater reliability’s intraclass correlation coefficients (ICC2,1) were .887∼.986 for the right knees and .915∼.988 for the left knees. In addition, the intrarater (test-retest) reliability (ICC3,1) values ranged between .820∼.915 and .820∼.884 for Raters 1 and 2, respectively. The values for the standard error of mesurement were low for all tests (.81∼2.97˚); the calculated minimum detectable change was 2.24∼8.21˚. Conclusion: These findings suggest that the AKE test performed with a PBU had excellent interrater and intrarater reliability for assessing hamstring flexibility in healthy young males.
Background: Given the potential benefits of wellness programs promoting physical activity of the community-dwelling frail elderly, it is recommended that comprehensive wellness programs combined with the component of physical activity. This may improve overall health and potentially lower the health care cost of the frail elderly. In general, the frail elderly residing in community or those after being discharged from hospitals are often committed to enhancing the status of participation in physical activity. Objects: The purposes of this study were to identify specific shortcomings of current wellness programs as part of continuum of community rehabilitation services and to propose alternatives for the care of the community-dwelling frail elderly. Through this study, geriatric health care professionals may be able to implement assessments and programs to successfully promote an effective continuum of care for the frail elderly. Methods: Article reviews were summarized and evaluated. Results: A model elaborating the relationship between components of successful wellness program and participation in physical activities for the community-dwelling frail elderly are recommended. First, periodic monitoring the levels of physical activity by the use of online measurement system should be considered. Second, individualized adaptive technologies for selecting optimal physical activities for the elderly may be better fit to individuals’ current status of physical activity. Conclusion: The current status of physical activity in community-dwelling frail elderly can be monitored by online assessment systems. Through the innovative measurement system, elderly may assess his/her physical activity status overtime, select optimal physical activities matching the status, and create the elderly’s own adaptive wellness programs that match to the status while residing in his/her community.