The purpose of the study was to determine if there was a difference in the Functional Ambulation Performance score of senior adults with or without a history of falls during walking at a preferred velocity. Twelve subjects with a history of falling (mean age=73.8) and eight subjects with no history of falling (mean age=70.4) participated in the study. Temporal and spatial parameters of gait were analyzed using the computerized GAITRite system. The GAITRite system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance score. The Functional Ambulation Performance score is a Quantitative means of assessing gait based on specific temporal and spatial parameters. Statistical analysis of the two groups demonstrated a significant decrease in Functional Ambulation Performance score for those with a history of falls. They had lower values for step/extremity ratios, mean normalized velocity, and greater values for step times, percent in double support. These results indicate that the GAITRite system can be useful in detecting footfall patterns and selected time and distance measurements of persons with a history of falls and the Functional Ambulation Performance score can be used as indicators of gait performance for senior adults with a history of falls.
Therapeutic ultrasound is commonly applied for deep heating in physical therapy setting. However, it is difficult to determine the exact application dosage and to confirm the immediate heating effect. Microwave Radio-Thermometer (MRT) can measure the temperature by the electromagnetic energy in the microwave region of the object that emits above absolute zero temperature. MRT was used for early diagnosis of breast cancer since it was not harmful, non-invasive, and non-ionizing to the human body. The purposes of this study were to investigate how accurately 1.1 GHz RTM (RES Ltd. Russia) measures the change of average temperature in the tissue, and to determine the depth of temperature change measurement. Therapeutic ultrasound was applied (continuous wave for 5 minutes, 1 MHz, intensity of 1.5 [in vitro] and 1.0 [in vivo]) in four different conditions: (1) 30 cases of in vitro specimen of pork, (2) 30 cases of in vitro specimen of pork ankle joint, (3) 10 cases of in vivo canine thigh, and (4) 30 cases of in vivo human body. Intraclass Correlation Coeffients (ICC[3,1]) between average needle probe thermometer below surface and MRT temperature was revealed as followed: (1) Before ultrasound application ICCs ranges above .8 in specimen of pork (15 mm underneath the skin) and above .82 in specimen of pork ankle joint (10~30 mm underneath the skin). (2) After ultrasound application ICCs ranges above .7 in both specimens of pork and pork ankle joint. (3) Before ultrasound application ICCs ranges above .8 in canine thigh (20 mm underneath the skin). (4) After ultrasound application ICCs ranges above .82 in canine thigh. The temperature of the human body increased significantly with the mean of in muscle tissue and with the mean of in joint (p<.00). It was revealed that the average depth of temperature measurement of the tissue by MRT was in between 10 and 35 mm, and determined that the proper temperature measurement band was .
Body weight support treadmill training is a new and promising therapy in gait rehabilitation of patients with hemiplegia. The purpose of this study was to identify the effects of body weight support treadmill training on gait and standing balance in patients with hemiplegia. Eighteen patients with hemiplegia participated in the study. A 10 m-timed walk test, measurements of step length and standing balance score were administered. Intervention consisted of body weight support treadmill training five times a week for 2 weeks. The data were analyzed by paired t-test. Body weight support treadmill training scoring of standing balance, step length and 10 m-timed walk test showed a definite improvement. Body weight support treadmill training offers the advantages of task-oriented training with numerous repetitions of a supervised gait pattern. The outcomes suggest that patients with hemiplegia can improve their gait ability and standing balance through body weight support treadmill training.
The purpose of this study was to compare visual analogue scale (VAS), pain threshold (PT), , and EMG gaps before and after applying transcutaneous electrical nerve stimulation (TENS) on the upper trapezius muscle at the patients with myofascial pain syndrome (MPS). The subjects were 4 men and 10 women composed of both the inpatients and outpatients who were diagnosed as MPS at Wonju Medical Center. VAS and PT measurements were performed to assess the subjective pain level. The reference voluntary contraction (RVC) test was performed for 15 seconds for normalization on the bilateral trapezius muscle using surface electromyography (sEMG). After 3-minute resting time, the EMG signal was recorded while performing a typing activity for 2 minutes and then TENS was applicated with a comfortable intensity for 10 minutes. The EMG activity of the upper trapezius muscle was recorded during typing for 2 minutes. The results of study were as follows: 1) VAS score was significantly decreased on the more painful side after treatment, however, it was not significantly different on the less painful side. 2) PT was increased after treatment on both sides, however, it was not significantly different between before and after the TENS application. 3) The EMG activity during typing was significantly decreased after treatment, and 4) The EMG gaps were significantly increased after TENS treatment compared to before it. Consequently, the study showed that TENS was effective in decreasing VAS, , and in increasing EMG gaps. The EMG gap analysis could be a useful method to measure pain in patients with MPS in the upper trapezius.
The purpose of this study was to compare the relative accuracy of a range of computer-based analysis with respect to EMG onset determined visually by an experienced examiner. Ten healthy students (6 male, 4 female) were recruited and three times randomly selected trials of isometric contraction of wrist flexion and extension were evaluated using four technique. These methods were compared which varied in terms of EMG processing, threshold value and the number of samples for which the mean must exceed the defined threshold, and beyond 7% of maximum amplitude. To identify determination of onset time, ICCs(Intraclass Correlation Coefficients) was used and inter-rater arid intra-rater reliability ranged good in visually derived onset values. The results of this study present that in wrist flexion and extension, the reliability of the inter and intra-examiner muscle contraction onset times through visual analysis showed beyond .971 with ICCs. The reliability of the muscle contraction onset time decision through visual reading, tested with computer analysis, showed a relationship of all the selected analysis methods with ICCs .859 and .871. The objective computer-based analysis comparing with visual reading at the same time is the effective and qualitative data analysis method, considering the specificity of each study method.
This research was performed to compare spinal segment motion angle between low back pain (LBP) group and painless group during trunk flexion-extension and to investigate the effect of transversus abdominis strengthening exercise on spinal segment motion angle in LBP group. Nine subjects with LBP and ten subjects without LBP participated. Transversus abdominis strengthening exercise was performed in LBP group for three weeks, and spinal segment motion angles were compared before and after the exercise performance. Spinal segment motion angles were measured both in sitting and standing position. Results were as followed: 1) Subjects' average age was 24.79 years, height was 167.84 cm, and weight was 59.95 kg. 2) Spinal segment motion angle of T10/l1 was significantly higher in LBP group compared with painless group (p<.05) in sitting position during trunk flexion-extension. 3) In sitting position, whereas entire lumbar segment motion angles were lower in LBP group compared with painless group (p<.05), angle of L4/5 was higher in LBP group compared with painless group (p<.05). 4) There was no significant difference in thoracic segment motion angle in standing position. 5) After three weeks of transversus abdominis strengthening exercise, thoracic segment motion angle increased both in sitting and standing position (p<.05). 6) In painless group, there was no significant difference in entire spinal segment motion angles in sitting and standing position (p>.05). When spinal segment motion angles were compared between sitting and standing position, there were slight differences. In sitting position, there was no difference in spinal segment motion angle between LBP group and painless group while hip joint motion angle and sacral inclination angle of LBP group was lower than those of painless group (p<.05). In standing position, lumbar segment motion angle was significantly lower in LBP group than that of painless group. Transversus abdominis strengthening exercise influenced thoracic segment motion angle more significantly than lumbar segment motion angle.
Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.
Slipping during various kinds of movement often leads to potentially dangerous incidents of falling. The purpose of this paper was to review some of the research performed in the field including such topics as rating scales for balance, kinematics and kinetics of slipping, adaptation to slippery conditions, postural and balance control, and protective movement during falling. Controlling slipping and fall injuries requires a multifaceted approach. Environmental conditions (state of floor surface, tidiness, lighting, etc), work task (walking, carrying, pushing, lifting, etc), and human behavior (anticipation of hazards, adaptation to risks, risk taking, etc) must be accounted for in the assessment of slip and fall-related risks. Future directions of research must deal with modeling of basic tribophysical, biomechanical, and postural control process involved in slipping and falling.
This study tested whether repeated measurement of median frequency (MDF)-related variables could express the muscle power changes during a 12-week DeLome strengthening program, by using consecutive overlapping FFT (Fast Fourier transformation) and integrated EMG (IEMG) from surface EMG data for isometric and isotonic exercise. To evaluate the effect of training, the following were recorded every 3 weeks for the elbow flexors and knee extensors of 5 healthy male volunteers: MVC, lRM, limb circumference, and surface EMG during isometric MVC or isotonic contraction at 10RM load. From the EMG data, IEMG and variables from a regression analysis between MDF and time were obtained. MVC, lRM, IEMG, and initial MDF increased linearly over the training period. The fatigue index and slope of the regression line increased temporarily until the 6th week and decreased thereafter. From these results, there appeared to be enhanced neural recruitment of fast twitch fibers in the first 6 weeks and continued enhancement in the recruitment and hypertrophy of fast twitch fibers, which led to increased fatigue resistance, over the last 6 weeks. Accordingly, the MDF and IEMG analysis technique could demonstrate the effect of the program detected significant changes in both isometric and isotonic contractions. EMG analysis methods can be used to estimate the electrophysiological and histological changes in skeletal muscles during a strengthening program.
A single subject experimental design (alternating treatment design) was used to compare the effects of only ultrasound and ultrasound combined with stretching of the joint capsule on the ROM increase and pain reduction in patients with frozen shoulder. Two subjects were included in each group. In the only ultrasound treatment sessions, ultrasound was applied at the pain point of the shoulder joint in supine position. In the ultrasound combined with stretching treatment sessions, ultrasound was applied at the pain point of the shoulder joint positioned in external rotation and abduction in sitting position. Only ultrasound treatment and ultrasound combined with stretching treatment were alternately performed on each patient. Pain and disability was measured by shoulder pain and disability index (SPADI), and range of motion (ROM) was measured by scratch test. The results of this study showed that ultrasound combined with stretching treatment were more effective than only ultrasound treatment in ROM increase and pain reduction. However, disability score was not significantly different.
This study evaluated the community-based rehabilitation services provided by the Wonju Public Health Center from Jan. 2000 to Dec. 2002. Ninety-four persons with disabilities dwelling in the community participated and the surveys were completed in an interview during home visits. The respondents' demographic, socio-economic, and medical characteristics, rehabilitation service received, willingness to receive home-visit rehabilitation services, and satisfaction with the rehabilitation services were analyzed by frequency and percentage. A Likert scoring system consisting of five agreement-disagreement categories was applied to each item, consisting of Very Satisfied, Satisfied, So-So, Poorly Satisfied, and Very Poorly Satisfied. The major findings were as follows: 1) The rehabilitation services used included medical rehabilitation (26.9%), followed by social assistance (23.5%), diagnosis by a physician at home (17.3%), medical examination (12.3%), housekeeping services (6.2%), and vocational and educational rehabilitation (3.5%). 2) Of the medical services, the respondents desired physical therapy at home and free rental of rehabilitation equipment, such as wheelchairs, canes, walkers, the most, followed by home visit occupational therapy, nursing services, and oriental medicine service in descending order. 3) Some of the respondents expressed so-so satisfaction (50.0%) or dissatisfaction (16.9%) with the rehabilitation services provided by the Wonju Public Health Center. These findings should prove useful when planning or extending community-based rehabilitation programs for the homebound disabled in the community.