The purpose of this study was to compare the differences of weight-bearing distribution between subjects with low back pain and healthy subjects. Fifty-one subjects (22 men, 29 women; mean age = 42.9 years) with low back pain and 31 healthy subjects (11 men, 20 women; mean age = 35.4 years) were evaluated. The weight-bearing distribution was measured by two commercial scales during comfortable standing. The difference of weight-bearing distribution between right and left side was calculated for each subject. The differences of weight-bearing distribution in subjects with low back pain and healthy subjects were 6.0 kg and 4.5 kg, respectively. However, there were no significant differences in the weight-bearing distribution between subjects with low back pain and healthy subjects.
During therapy sessions, feedback is often provided concurrently by the physical therapist as the patient attempts to perform a movement and after the movement attempt. This feedback is provided to enhance the patient's balance abilities. However, recent studies in nondisabled populations have suggested that frequent feedback may be detrimental to retention or learning of motor skills. This study compared the effects of 100% relative frequency of knowledge of performance (KP) with 66% relative frequency of KP for motor learning on balance retraining in patients with hemiplegia. Twenty patients with hemiplegic were randomly assigned to one of two experimental groups. The acquisition phase consisted of 16 blocks of 5 trials for 2 days (80 total practice trials). The retention phase consisted of 2 blocks of a short-term retention test, one day after the end of the acquisition phase and a long-term retention test, one week after the end of the short-term retention test. In the 100% feedback condition, participants received feedback after every practice trial. A faded KP schedule was used in the 66% condition. No significant differences were found between the two groups during all experimental phases (acquisition and retention phases), (p>.05). However, there were significant decreases in balance index for both groups of acquisition phase (p<.05). These results suggest that 66% relative frequency of KP is not more effective than 100% relative frequency of KP with respect to retention over time when hemiparetic patients attempt to learn balance.
This paper presents the relevance between GMFM and the spatiotemporal parameters of gait in children with cerebral palsy. Twenty-one children ( months) with cerebral palsy participated in this study. GMFM was performed and spatiotemporal parameters of gait were measured by foot print gait analysis. A correlation analysis was used to investigate the correlation between GMFM scores and spatiotemporal parameters of gait. A linear regression analysis was employed to find how much each gait spatiotemporal parameters could be predicted from GMFM scores. The total GMFM scores was significantly correlated with walking speed, cadence, and stride length. Dimensions D (standing) and E (walking, running, and jumping) were more significantly correlated with gait spatiotemporal parameters than dimensions A (lying and rolling), B (sitting), and C (crawling and kneeling). The GMFM scores were useful for predicting spatiotemporal parameters. However, it is difficult to predict the status of gait development using GMFM scores because GMFM scores and gait spatiotemporal parameters are only measured as quantities not qualities. In the field, it is easily found that many children with cerebral palsy are unable to walk in any way. Consequently, gait analysis cannot be performed in many cases. Therefore, it is more reasonable to investigate the influence of GMFM on spatiotemporal parameters, rather than vice versa.
The purposes of this study were to investigate the therapeutic effects of an early exercise program after mastectomy and to provide the early exercise program protocol for patients who had undergone mastectomy. The subjects were seventy women who were diagnosed with breast cancer. They were randomly as signed either to a experimental group (n=35) that received early postoperative exercise program or to a control group (n=35) that received only education by nurses. Data were obtained for each patient from goniometric measurements of shoulder flexion, abduction, external rotation, 10 elements of functional performance, and subjective pain evaluation using visual analogue scale (VAS). All variables were measured preoperatively, three days postoperatively, and one month postoperatively. Data were compared by groups using independent t-test and Mann-Whitney U test for parametric or non-parametric data, respectively. There were no significant differences between the groups for all variables preoperatively and at three days postoperatively. But there were significant differences at one month postoperatively. The experimental group showed a statistically significant increases in shoulder flexion, abduction, and external rotation and in the pain VAS at one month postoperatively (p<.05). Also, at one month postoperatively, the experimental group had less difficulty with three elements of functional performance-doing up a 'back' zippered article of clothing, reaching the ipsilateral scapula, and contralateral scapula with the fingers on the operated side-than the control group (p<.05). The results of this study suggest that, after mastectomy, the early exercise program conducted by a well-trained physical therapist can make a significant contribution to the return of more normal shoulder function and activities of daily living and to an increased quality of life.
In children with cerebral palsy, bone density is decreased by disturbance of bone remodelling due to lack of normal weight bearing and muscle contraction through physical activity. Loss of bone density cause fracture, delays treatment with immobilization, and leads to functional limitation. The purpose of this study was to investigate bone mineral density of lumbar spine in children with spastic quadriplegia and diplegia. Six spastic quadriplegia and 14 spastic diplegia were evaluated in this study. QDR 4500 X-ray densitometer was used to measure bone density at lumbar spine (L1~L4). Children with cerebral palsy showed lower bone density than that of normal children. Bone density in children with spastic quadriplegia and diplegia was , , respectively. However, there was no significant differences in bone density between children with spastic quadriplegia and diplegia. There was no significant difference in bone density relation to motor development level, height, and weight. Further study is needed to find the appropriate interventions for preventing loss of bone density in children with cerebral palsy.
The purposes of this study were to investigate risk factors of low back pain in civil airmen and to use this information as basis for the back rehabilitation. Subjects of this study were randomly selected 276 civil airmen who had been employed at four airports in Seoul. These data were analyzed by test, t-test, ANOVA, and multiple logistic regression using SAS. The results were as follows: 1) The prevalence of low back pain among 276 civil airmen was 64.9%. 2) The most common cause of low back pain was load lifting (stewardess), long sitting (aircrew A), and long sitting plus training (aircrew B). 3) There were no statistically significant associations among age, height, body weight, and low back pain. 4) No statistically significant relationships were found among the average monthly working time, total working time, average monthly rest time, working year and low back pain. 5) There was statistically significant relation ship between abnormal posture and low back pain (p<.01). 6) There was statistically significant relation ship between fatigue and low back pain among stewardess and aircrew B. 7) There was a statistically significant relationship between job satisfaction and job-related stress (p<.05). 8) In stewardess, higher satisfaction score was associated with less likelihood of low back pain (odds ratio = .80). The results of this study indicate that civil airmen developed chronicity of low back pain due to unfit seat, poor habitual posture, fatigue symptom, and stress or other risk factors. Therefore, there is a need to improve the working environment for the prevention of posture-related low back pain.
Back extension exercises have been used for rehabilitation of the injured low back, prevention of injury, and fitness training programs. However, excessive loading on low back can exacerbate existing structural weakness. The purpose of this study was to compare muscle activity of low back muscles during back extension exercises. Twenty healthy male subject s were evaluated. Electromyographic (EMG) activities of low back muscles at L1 and L5 level were recorded during seven different back extension exercises and two reference tasks by surface EMG and saved for data analysis. Reference tasks of lifting 20% and 40% of their body weight were included for comparison. The result were as follows: 1) Single-arm extension and single-leg extension exercises on quadruped position appeared to constitute a low-risk exercise for initial extensor strengthening. 2) When arm extension was combined with contralateral leg extension on quadruped position, EMG activities of low back muscles were increased. 3) EMG activity of low back muscles was highest during the trunk extension exercises on prone position. 4) EMG activities of low back muscles during arm and leg extension exercises on quadruped position were less than those of reference task of lifting 40% of their body weight. These result s have important implications for progressive back extensor muscle strengthening exercises in patients with back pain.
This study addresses the effects of treadmill training on hyperextended knee and cadence in patients with hemiplegia. A single subject research design with multiple baselines across individuals was used for the study. Two patients with hemiplegia participated in the experiment. The experiment consisted of interventions where the patients were asked to ambulate for 15 minutes at a comfortable walking speed on the treadmill with 11% slope grade and were allowed to rest for 10 minutes. Patients, then, were asked to ambulated 20 meters at walkway. The number of occurrences of knee hyperextension and the total number of steps were recorded. The results showed that the occurrence of knee hyperextension decreased by approximately 30% after the first session of the treadmill training and continued to gradually decrease during the following sets of treadmill training. Meanwhile, there was a slight increase in the cadence to a negligible extent. These results suggest that the gait training on the sloped treadmill may be helpful for correcting the knee hyperextension in patients with hemiplegia.
Physical therapists should under stand motor control models and apply various models to evaluation and treatment of neurologically impaired patients. Thus, this paper reviews motor control models and applications in clinical settings. Assumptions and limitations of reflex models, hierarchical models, and systems models are presented. This paper also delineates goals and dissatisfaction of neurologic rehabilitation approaches for neurologically impaired patients. Muscle reeducation approach, neurotherapeutic facilitation approach, and contemporary task-oriented approach are explained.