The purpose of this study was to compare the balance and gait between fallers and non-fallers in elderly. A brief questionnaire was used to obtain the fall history. Twenty-seven women subjects were evaluated in this study. Eleven subjects and a mean age of 84.5 years (SD=4.6) were designated as the faller group. Sixteen subjects and a mean age of 80.3 years (SD=5.3) were designated as the non-faller group. The fall-related factors (mental status, balance, range of motion and muscle strength of lower extremity, sensation of foot, and cadence, walking velocity, stride length) were compared between faller group and non-faller group and measured. The results showed that faller group had significantly less range of motion of the hip flexion and knee extension, and strength of the knee extensor and ankle dorsiflexor and plantar flexor than non-faller group. The scores of the Functional reach test and One leg standing were significantly less in faller group than in non-faller group. Faller group showed less walking velocity and stride length compared to non-faller group. However, there was no significant difference in cadence during comfortable waking and fast walking between two groups. There were no significant differences in pressure, position sensory between two groups. These results suggest that exercise for improving the flexibility, muscle strength of the lower extremity and balance may be useful strategies to prevent fall in elderly. Further studies are needed to identify which specific factors are related to fall in the elderly population.
The purpose of this study was to investigate the treatment effect of three interventions on the disuse atrophy of rat hindlimb after two weeks suspension. Forty-eight 11~12 weeks old female Sprague-Dawley white rats were divided into four intervention groups: 1) suspension only (S; n=10), 2) intensive weight bearing treadmill (IWBT; n=10), 3) electrical stimulation (ES; n=9), 4) 2)+3) (ES/IWBT; n=9). Another 10 rats received no intervention or hindlimb suspension and served as controls (C). After the interventions, 1) the cross-sectional area (CSA), 2) the ratio of white muscle fiber composition (WMFC), 3) isometric tetanic tension (ITT), and 4) muscle weights (MWs) were measured from the four calf muscle specimens. The results were as follows: 1. In all intervention groups, the CSAs of medial and lateral gastrocnemius (MG LG), soleus (SOL), and flexor digitorum superficialis (FDS) decreased when compared to the control (C) group (p<.05). The CSA increased in FDS and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group (p<.05). 2. The ratios of WMFC in MG, LG, SOL, and FDS increased compared to the C group for all interventions (p<.05). The ratios of WMFC decreased in SOL and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group, and decreased in SOL for the ES/IWBT group compared to the IWBT group (p<.05). 3. The ITT in the MG, LG, SOL, and FDS decreased compared to the C group for all interventions (p<.05). The ITT increased in MG LG/FDS, SOL, and the whole calf muscles (WCMs) in the IWBT, ES and ES/IWBT groups compared to the S only group (p<.05). 4. The MWs in MG LG/FDS, SOL, WCMs decreased compared to the C group for all interventions (p<.05). The MWs increased in MG LG/FDS and WCMs for the IWBT group, in SOL for the ES group, and in SOL for the ES/IWBT group compared to the S only group (p<.05). 5. In atrophied muscles, the IWBT group showed the best recovery and the ES/IWBT and ES groups followed in decreasing order. The most susceptible muscle to disuse atrophy was the SOL. But conversely, it showed the best recovery in the ES/IWBT group. After two weeks of hindlimb suspension, the calf muscles of rats atrophied and their isometric tension decreased. These changes were best reversed by hindlimb-focused treadmill activity. The next best results were achieved by electrical stimulation combined with the treadmill followed by only electrical stimulation. These findings indicate that full weight bearing treadmill activity alone or in combination with electrical stimulation are effective treatments for non-weight bearing induced muscle atrophy. Further study of the effect of different intensities of electrical stimulation and variations in the duration period of full weight bearing treadmill activity on disuse atrophy is recommended.
Physiological Cost Index (PCI) of walking has been widely used to predict oxygen consumption in healthy subjects or patients. The purpose of this study was to evaluate the predictability of physiological cost index of walking for the amount of exercise and cardiac function. Walking exercise was conducted in 67 healthy children (age 4-12) with a self-selected comfortable walking speed on the level surface. Walking speed was calculated, and heart rate was measured before and immediately after the walking. PCI was calculated for statistical analysis. The results were as follows; 1) The walking speed tends to increase and PCI of walking tends to decrease with age. There was significant difference in walking speed and PCI of walking among three age groups (p<.05). The change of walking heart rate tends to decrease with age, however, there was no significant difference among three age groups. 2) Linear regression equation between walking speed and age was 'Y (walking speed) = 2.124X (age) + 48.286' (=.337), (p=.00). 3) The walking heart rate tends to decrease with age. Linear regression equation between walking heart rate and age was 'Y (walking heart rate) = 143.346 - 2.63X (age)' (=.3425), (p=.00). 4) The walking heart rate decreased as body surface area (BSA) increased. Linear regression equation between walking heart rate and BSA was 'Y (walking heart rate) = 149.830 - 27.115X (BSA)' (=.3066), (p=.00). In conclusion, these equations and PCI could be useful to quantify the variation of energy expenditure of children with pathological gait when compared with age-matched healthy children.
The purpose of this study was to compare the body alignment during standing on level and wedge board. Twenty healthy college students (8 females, 12 males) were evaluated in this study. Diagnostic contourline potographic imaging system (Model JTC-1, Jodang Trading Co.) was used to measure body alignment. Sagittal and frontal plane images were used to analyze the body alignment. The result showed that the cervical and lumbar lordotic curve significantly decreased during standing on wedge board when compared with standing on level. On the other hand, thoracic kyphosis significantly increased during standing on wedge board. There was no significant difference in body alignment according to gender, weight, and height. Clinically, patients with low back pain and severe lordosis may be affected by heel wedge. Further study is needed to identify whether the standing on wedge board can change the body alignment in patients with low back pain and spinal deformity.
Foot ulceration results in substantial morbidity in patients with peripheral neuropathy. The purpose of this study was to find the relationship of plantar foot pressures during walking to plantar ulceration in patients with Hansen's disease. The subjects were recuruited from two Welfare Clinic for Hansen's disease in Wonju and Uiwang city. Ten subjects (5 females, 5 males) with plantar ulceration and a mean age of 63 years were evaluated in this study. The mean duration of Hansen's disease in these subjects was 30 years. Plantar pressures were measured during self-selected comfortable walking speed by using MatScan system. Three subjects had plantar ulceration under the first metatarsal head. Five subjects had plantar ulceration under the second and third metatarsal head. Two subjects had plantar ulcers under the fifth metatarsal head. Eight of 10 subjects had plantar ulceration at highest pressure point that measured during walking. This result suggests that the abnormal high plantar pressure could be related factor to plantar ulceration in patients with Hansen's disease. Also the foot pressure measurement may be useful to evaluate the risk of plantar ulceration in patients with Hansen's disease.
Many pregnant women have experienced low back pain (LBP) during pregnancy and after delivery, and it has been an important component in women health. This study was designed to investigate the characteristics and management of the LBP in postpartum women. Eighty-five postpartum women were participated in this survey. Mean age of 85 women was 28.1 years. Of 85 postpartum women, 55.3% (n=47) had LBP after pregnancy. Thirty of 47 women had pain on lumbar region, 17 postpartum women had pain on sacroilium region. Of 85 postpartum women, 74% (n=54) had LBP before pregnancy and 71.8% (n=61) had LBP during pregnancy. Of 47 postpartum women who had LBP, 83% (n=39) had not received medical management for LBP, 12.8% (n=6) took medication, and 4.3% (n=2) performed self-exercise. None of postpartum women had received physical therapy during pregnancy and after delivery for treatment low back pain. The pain in SI region was more severe than in lumbar region after pregnancy according to VAS (visual analog scale) (p<.05). However, there was no significant difference in VAS scores between SI pain and lumbar pain before and during pregnancy (p>.05). Pain region after delivery was related to pain region of pre-pregnancy and during pregnancy (p<.01). Pain level after delivery was related to the pain and night pain level during pregnancy (p<.01).
The purpose of this research was to determine the effects on the healing of fibular fractures in rabbits of low-intensity pulsed ultrasound (50 and 500 ) applied for periods of 4, 14 and 24 days following fibular osteotomy. Thirty-six male Japanese white rabbits were randomly divided into three groups of twelve for three treatment protocols: (1) ultrasound treatment at intensities of 50 and 500 until the 4th day following fibular osteotomy, (2) ultrasound treatment at intensities of 50 and 500 until the 14th day following fibular osteotomy, and (3) ultrasound treatment at intensities of 50 and 500 until the 24th day following fibular osteotomy. The low-intensity pulsed ultrasound was applied to only one fibula of each rabbit (these served as the experimental group). The other fibula of each rabbit served as the control group. The selection of which fibula was to be treated was made randomly. The animals were sacrificed on the 4th, 14th and 24th day after the start of ultrasound treatments. Percent of trabecular bone area and fibular radiography were carried out to compare the degree of fibular bone healing. A microscope was also used to determine any histologic changes. For statistical differences in radiological changes due to length of treatment period (4, 14 and 24 days respectively), the Wilcoxon signed-ranks test was used to compare the experimental and control groups. For statistical differences in fracture healing due to differences in ultrasound intensity, radiological studies were compared using the Mann-Whitney Test. And, to compute percentage differences in areas of trabecular bone, Two-way analysis of variance (ultrasound intensity x each group) was used. Experiment results were as follows: 1. In animals sacrificed on the 4th day, no difference was found in the radiological studies of the fibulae in the experimental and control groups (p>.05). However, experimental groups showed more rapid bone repair than control group. 2. Both radiographic and percent of trabecular bone area studies showed significant differences in rabbits sacrificed after 14 days. Fracture healing was significantly increased in the experimental group (p<.05) 3. In the animals sacrificed on the 24th day, histologic study showed rapid bone repair but fibular radiologic studies did not show statistical differences between the two groups (p>.05). 4. On the 14th day, bone union on radiograph was significantly more rapid in the treatment group with pulsed ultrasound of 50 than the group with 500 (p<.05). Histologic studies showed that both the 14 and 24 days groups had more rapid bone repair in animals treated with 50 ultrasound intensity than those treated with 500 intensity. In conclusion, it has been shown that the low-intensity pulsed ultrasound has a positive effect on bone fracture healing in the early stage and the range of pulse ultrasound from 50 to 500 is effective for fracture healing. Further study is needed to investigate the influence of pulsed ultrasound on delayed union and non-union in bone fractures and also for the clinical use of low-intensity pulsed ultrasound for bone healing in humans.
The purposes of this study were to investigate the patient satisfaction with physical therapy services and find the related factors to patient satisfaction. In this study, three hospitals were selected at large, middle, small city. Ninety subjects (53 males, 37 females) who had received physical therapy service were participated in this survey. Survey data were collected by a written questionnaire. The patient satisfaction scale had a good reliability (Cronbachs alpha=.9134). The collected data were analyzed by t-test, ANOVA, and Kruskal-Wallis. The scores of patient satisfaction with physical therapy services at large, middle, and small city were 79.67, 76.23, and 86.33 respectively. The score of patient satisfaction at small city was significantly higher than middle and large city (p<.01). There was no significant difference in patient satisfaction with physical therapy services according to gender, age, education years, occupation, marital status, religion and average monthly income. Further studies are needed to identify which specific factors are related to patient satisfaction with physical services. This information will be useful in improving the patient satisfaction.