The purpose of this study was to assess the effect of visual block (eyes open or closed), mental task type, and participation in an exercise program on static balance in the elderly. The subjects were 34 elderly (>65 years old) residents of a social welfare institute in Gyeonggi-do. We measured the following variables. Berg balance scale, mini mental state examination, balance performance monitor (sway area, path, and maximal sway velocity), age, weight, height and whether the subject participated in an exercise program. Scores for the Berg balance scale and mini mental state examination were evaluated to assess static balance ability either alone (single task paradigm) or while performing a mental task (dual task paradigm). Static balance variables that were measured included sway area, path, and maximal sway velocity. Each test was repeated three times. Multiple regressions analysis was used to examine the effect of each variable on static balance ability. For the dual task paradigm, static balance was affected by whether the subject participated in an exercise program. The Berg balance scale score for subjects with their eyes open was affected by whether they participated in an exercise program, while this variable in addition to the height and weight of subjects were determining variables in subjects with their eyes closed. As a result, whether subjects participated in an exercise program affected their static balance irrespective of whether their eyes open or closed. Therefore, regular exercise is recommended for elderly people and further research is needed to examine the relationship between static and dynamic balance while performing mental tasks such as cognition and attention.
Repetitive transcranial magnetic stimulation (rTMS) modulates cortical excitability beyond the duration of the rTMS trains themselves. Depending on rTMS parameters, a lasting inhibition or facilitation of cortical excitability can be induced. Therefore, rTMS of high or low frequency over motor cortex may change certain aspects of motor learning performance and cortical activation. This study investigated the effect of high and low frequency subthreshold rTMS applied to the motor cortex on motor learning of sequential finger movements and brain activation using functional MRI (fMRI). Three healthy right-handed subjects (mean age 23.3) were enrolled. All subjects were trained with sequences of seven-digit rapid sequential finger movements, 30 minutes per day for 5 consecutive days using their left hand. 10 Hz (high frequency) and 1 Hz (low frequency) trains of rTMS with 80% of resting motor threshold and sham stimulation were applied for each subject during the period of motor learning. rTMS was delivered on the scalp over the right primary motor cortex using a figure-eight shaped coil and a Rapid(R) stimulator with two Booster Modules (Magstim Co. Ltd, UK). Functional MRI (fMRI) was performed on a 3T ISOL Forte scanner before and after training in all subjects (35 slices per one brain volume TR/TE = 3000/30 ms, Flip angle , FOV 220 mm, matrix, slice thickness 4 mm). Response time (RT) and target scores (TS) of sequential finger movements were monitored during the training period and fMRl scanning. All subjects showed decreased RT and increased TS which reflecting learning effects over the training session. The subject who received high frequency rTMS showed better performance in TS and RT than those of the subjects with low frequency or sham stimulation of rTMS. In fMRI, the subject who received high frequency rTMS showed increased activation of primary motor cortex, premotor, and medial cerebellar areas after the motor sequence learning after the training, but the subject with low frequency rTMS showed decreased activation in above areas. High frequency subthreshold rTMS on the motor cortex may facilitate the excitability of motor cortex and improve the performance of motor sequence learning in normal subject.
The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.
The purpose of this study was to examine the effects of stroke patients' cognitive score on their the activities of daily living. The subjects of this study were 30 stroke patients who were admitted to Te-Bong hospital from November, 2002 to March, 2003. The subjects were administerd an MMSE as a cognitive assessment and an MBI as a functional assessment upon referral to physical therapy initially. The results were as follows: 1. The MMSE scores for the stroke patients were related to the patients' abilities to perform their activities of daily living. The changes of MBl scores significantly correlated with the changes of MMSE scores (p<.05). 2. The subjects with left hemispheric lesion scored higher in MMSE than those with right hemispheric lesions (p<.05). 3. The hemispheric lesions did not significantly affect the activities of daily living score (p>.05).
The purpose of this study was to determine the effects On the lymphedema patients of sponge padding and the correlation between the rate of edema reduction and downward shifting of bandages. Fifty secondary lymphedema patients with no infection, active cancer, limitation of movement, pain or drugs were randomly assigned to two groups: a sponge padding group, and a cotton padding group. Complex decongestive therapy was applied for 2 weeks. In each group the volume of the ankle, mid-calf, knee, and mid-thigh and downward shifting of bandages at the thigh was measured with measuring tape. The reduction of volume and downward shifting of bandages were analyzed by the unrelated t-test and the Pearson Correlation Test. The results were as follows: 1. In comparison between the sponge padding group and the cotton padding group, there was no significant difference in volume except in the thigh area. The edema volume was reduced significantly to at the thigh with sponge padding after treatment (p<.05). 2. Bandage shifted 10.12 cm with cotton padding, but only shifted 2.85 cm when sponge padding was used. Sponge padding had an excellent effect in preventing the shifting of bandages. There was a significant difference in the amount of shifting that occurred with each type of padding (p<.05). 3. There was also a strong correlation between the reduction of edema and the shifting of bandage. These results suggest that short-stretch bandaging with sponge padding is more effective than bandaging with cotton padding. Further study on skin irritation and the comfort of sponge padding is needed to use padding materials safely and effectively.
The purpose of this study was to compare the difference of joint position sense between measurements. Fourteen healthy male subjects were recruited for this study. The elbow joint position senses were measured using angle reproduction test. The elbow joint position sense was assessed with three experimental conditions: ipsilateral reproduction test in open-chain condition, contralateral reproduction test in open-chain condition, ipsilateral reproduction test with weight in open-chain condition and ipsilateral reproduction test in closed-chain condition. The angular difference between stimulus position and the reproduced position (angular error) was calculated in all testing conditions to examine the accuracy of the joint position sense. One way ANOVA was used to compare the error angles in all experimental conditions. The error angles between measurements were significantly different in elbow joint. The error angles was smallest in ipsilateral reproduction test with weight in open-chain condition and was greatest in the contralateral reproduction test in open-chain condition. Findings of this study indicate that testing methods, types of task, existence of resistance should be considered in clinical assessment for the joint position sense.
Manual tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking training, using the paretic side, on gait in stroke patients. Nine patients with hemiplegia participated in the study. The timed 10 m gait speed test and tracking test were administrated. The tracking test was composed with ranges of to and to . The tracking training consisted of five times every week for 4 weeks. The data were analyzed by non-parametric paired sign test of Wilcoxon. The flexion/extension error of the tracking test was significantly reduced on the paretic side, while the nonparetic side was not statistically significant. The transfer of the skill to the functional activity was shown in the significant improvement at timed 10 m gait speed test. This study shows that individuals with chronic who have impaired knee movement can be trained to improve their knee control through intensive practice at a knee movement tracking task and that the skill learned from such training is transfered to a more functional gait speed.
This study was conducted to assess the effects of the gait training method in incomplete spinal cord injured persons using an auto-walking machine. Persons with incomplete spinal cord injury level C or D on the American Spinal Injury Association impairment scale participated for eight weeks in an auto-walking training program. The gait training program was carried out for 15 minutes, three times per day for 8 weeks with an auto-walking machine. The foot rests of the auto-walking machine can be moved forward, downward, backward and upward to make the gait pattern with fixed on crank. The patient's body weight is supported by a harness during waking training. We evaluated the gait speed, physiologic cost index, motor score of lower extremities and the WISCI (walking index for spinal cord injury) level before the training and after the forth and eighth week of walking training. 1. The mean gait speed was significantly increased from .22 m/s at pre-training to .28 m/s after 4 weeks of training and .31 m/s after 8 weeks of training (p=.004). 2. The mean physiologic cost index was decreased from 4.6 beats/min at pre-training to 3.0 beats/min after 4 weeks and 2.0 beats/min after 8 weeks of training, but it was not statistically significant (p=.140). 3. The mean motor score of lower extrernities was significantly increased from 29.8 to 35.8 after 8 weeks of training (p=.043). 4. The mean WISCI level was significantly increased from level 10 to level 19 after 8 weeks of training (p=.007). The results of this study suggest that the gait training program using the auto-walking machine increased the gait speed, muscle strength and galt pattern (WISCI level) in persons with incomplete spinal cord injury. A large, controlled study of this technique is warranted.
We processed meta-analysis to test if the effects of laser therapy and mobilization techniques are evidence-based practice for treating tennis elbow. By researching and collecting the results of previous studies on tennis elbow, we inquired into the difference in the effects of each treatment methods on pain, grip strength, and ROM. A total of 10 international and domestic articles on the treatments of tennis elbow were selected for this study, including 7 articles on the effect of laser therapy and 3 on mobilization techniques. According to the qualitative meta-analysis, all 7 of the articles on laser therapy and 1 of the mobilization technique were double-blinded and randomized the subjects, and all of the 10 studies were designed in a high quality research, using statistics. The results of the studies on laser therapy showed in terms of statistical significance: 4 out of 7 did not decrease pain after therapy, and 3 out of 5 did not increase grip strength after therapy. In the studies on the effects of mobilization technique, both the 2 studies significantly increased grip strength after therapy. For other studies which measured ROM and tension, the mobilization therapy increased ROM significantly, and decreased tension significantly. The results of our study are shown in a diverse form in terms of the effects of different therapy techniques. This is related to the accuracy of the measurement tools for assessments and diagnoses. Further qualitative studies on the evidence-based practice and researches on tennis elbow are needed.
This study was designed 10 investigate the effects of therapeutic gymnastic ball exercise on pain, flexibility, lumbar disability level and daily activity levels in male patients of the armed forces medical hospital who complain of chronic low back pain. Twenty-three males were placed in the experimental group and twenty-nine males were placed in the control group. All of the subjects were chosen on the basis of availability among in-patients who were diagnosed with low back pain. The control patients were matched to the experimental group and they were selected considering gender, pain duration and age. Gymnastic ball exercise therapy was developed by the author with the assistance of a rehabilitation specialist. Gymnastic ball exercise therapy includes muscle relaxation, flexibility, muscle strength and posture development exercises. The gymnastic ball exercise therapy was carried out by the experimental group three times a week for eight weeks. Before and after the experiments, the intensity of pain, the lumbar joint mobility (flexibility), the lumbar disability levels, and the daily activity levels of the subjects were measured, respectively. The intensity of pain and the lumbar disability levels were measured by the Visual Analogue Scale, the level of flexibility by a measurement ruler, and the level of disability by the Oswestry Low Back Pain Disability Scale. Data were analysed using a t-test, a paired t-test and an unpaired t-test. The results were as follows: 1. The intensity of pain in the lumbar spine in the experimental group was significantly decreased compared with that of the control group during the 4th week and 8th week. 2. The flexibility of the lumbar spine in the experimental group was significantly increased compared with that of the control group during the 4th week and 8 week. 3. The level of pain caused by anterior, posterior, left lateral and right lateral bending and by rotation in experimental group was significantly decreased compared with that of the control group. 4. The Oswestry Disability score of the experimental group was significantly increased compared with that of control group. These findings indicate that gymnastic ball exercise therapy could be effective in decreasing pain and lumbar disability, and increasing the daily activity levels and lumbar flexibility in patients with chronic low back pain. The study also suggests that gymnastic ball exercise therapy could be an essential factor for effective nursing intervention for patients suffering from chronic low back pain.
The purpose of this study was to determine the factors affecting on the home treatment stress in the CP (cerebral palsy) children's mothers. Direct interviews were conducted from March 17 with April 4, 2003 with 97 mothers of CP children. The average level of stress from home treatment felt by mothers with CP children was . Stress-levels were especially high in mothers who were not satisfied with the treatment outcome (p<.05) and whose acceptance of disability was low (p<.01). Stress felt by mothers was low when their health status was high (p<.05). A physical burden was shown to have a significant correlation with the stress of the mothers during the home treatment (p<.01). Mothers with a child of Level 2 disability had lower levels of stress than those with a child of Level 4 or 5 disability (p<.01). The level of stress was higher in mothers who lagged in acquiring technical sufficiency (p<.05). Multiple regression analysis showed that one factor affecting the stress felt by mothers with CP children was the degree of acceptance of the disability (p<.01). Programs that can reduce the stress levels of mothers with CP children through home treatment and secure social systems such as professional help and economic compensation, need to be developed. Active policies should be established and executed for these mothers since stress felt by mothers significantly affects the consistency and effectiveness of treatment provided at home.
Median frequency can be regarded as a valid indicator of local muscle fatigue. As local muscle fatigue develops, the muscle fiber conduction velocity decreases, the fast twitch fibers are recruited less, and consequently the median frequency shifts toward the lower frequency area. The aim of this study was to test the characteristics of the median frequency according to exercise load (30% and 60% of MVC on the biceps brachii, 40% and 80% of MVC on the vastus lateralis) during the fatiguing isometric exercise. Thirteen healthy male volunteer students of Yonsei University were recruited. After the testing maximal voluntary isometric contraction, three variables (initial median frequency, regression slope, fatigue index) from the regression line of MDF data were measured in each exercise load. The results showed that the regression slope and fatigue index were significantly different for the biceps brachii, but not for the vastus lateralis initial MDF was not significant difference according to the exercise load on both muscles. The regression slope and fatigue index could monitor physiologic muscle change during fatiguing isometric exercise. The results showed that two MDF variables reflect the local muscle fatigue according to the exercise load.