The purpose of this study was to assess the influence of spine orthosis and sit-to-stand motor strategies on ground reaction force (GRF) and lower extremity muscle activity. Twenty healthy adult men participated, and subjects randomly performed sit-to-stand motions in three different conditions: Momentum-transfer strategy (MTS); MTS with spine orthosis; and zero-momentum strategy (ZMS) with spine orthosis. GRF data, onset time, and muscle activity were determined and compared using force plate and electromyography. Data were statistically analyzed by the SPSS version 13.0. One-way repeated analysis of variance (ANOVA) was used to determine the statistical significance, and least significant difference was used as a post hoc test. The level of significance was .05. The results of this study were as follows: 1. Peak GRF and relative time to peak GRF were not significantly different in the three different conditions (p>.05). 2. Onset time of four muscles, tibialis anterior, gastrocnemius, biceps femoris and rectus femoris, in the three different conditions were significantly different (p<.05). 3. The tibialis anterior and rectus femoris muscle activity before hip-off and tibialis anterior, gastrocnemius, and rectus fermoris muscle activity after hip-off were significantly different in the three different conditions (p<.05).
The purpose of this study was to determine the consequence of resistance strengthening exercise on the hip flexor and extensor performed to improve functional mobility in stroke patients more than six months post stroke. Seventeen patients were randomized into two groups. Both groups received conventional physical therapy for six weeks. In addition, the experimental group performed eccentric resistance strengthening exercise in the hip flexor and extensor using an isokinetic dynamometer. The hip flexor and extensor strength, stair up and down mobility, timed get up and go (TUG), 10 m gait velocity, and functional reach were repeatedly measured at baseline, three weeks, and six weeks after treatment. The results were as follows: 1. The experimental group improved more remarkably in the hip flexor and extensor strength, stair up and down mobility, and the 10 m gait velocity after three weeks and six weeks of treatment (p<.05), 2. The control group improved significantly in the hip flexor and extensor strength, and 10 m gait velocity after three weeks of treatment (p<.05), 3. At each three and six week point, the experimental group made greater gains in hip flexor and extensor strength, stair up and down mobility, and 10 m gait velocity than the control group (p<.05). In conclusion, it is desirable to perform resistance strengthening exercises combined with conventional physical therapy to improve functional mobility in chronic stroke patients.
The limited walking ability after a stroke restricts a patient's independent mobility at home and in the community. It also brings about significant social handicaps. Therefore, it is necessary to improve walking ability in community-dwelling persons with stroke. The purpose of this study was to evaluate the effectiveness of gait training and muscle strengthening exercise of lower extremities in persons with chronic stroke. Nineteen community-dwelling individuals with stroke participated in this program. The exercise program lasted for seven weeks, with a 1-hour program twice per week, and it consisted of balance training, gait training, and strengthening of lower extremities. The outcome of the program was assessed by the gait speed, Wisconsin Gait Scale (WGS), Berg Balance Scale (BBS), and Stroke Impact Scale (SIS). Significant effects were found for the WGS, BBS, and mobility and hand function domain of the SIS (p<.05). It was found that short-term gait training exercise could improve quality of gait, balance, and mobility. Therefore, a more effective exercise program is required for community-based persons with stroke.
Theoretical framework of motor learning is used to enhance perceptual motor skill in physical therapy intervention, which can be subdivided into two main types-explicit and implicit. The purpose of this study was to examine whether stroke patients with unilateral brain damage learn implicitly a motor skill using the arm ipsilateral to the damaged hemisphere. Speculation then followed as to the formation of therapeutic plans and instructions provided to patients with stroke. 20 patients with stroke and 20 normal participants were recruited. All the subjects practiced serial reaction time tasks for 30 minutes a day and retention tests on the following day. The tasks and tests involved pressing the corresponding buttons to 4 colored circles presented on a computer screen as quickly and accurately as possible. Patients with stroke responded more slowly than controls. However, both groups showed decreased reaction time in the experimental and retention periods. Also, there was no significant difference between both groups regarding explicit knowledge of consecutive order. Therefore, patients with stoke had the ability to learn implicitly a perceptual motor skill. Prescriptive instruction using implicit and explicit feedback may be beneficial for motor skill learning in physical therapy intervention for patients with brain damage.
The purpose of this study was to assess the effects of High-Voltage Pulsed Current (HVPC) and ultrasound on adjuvant-induced arthritis in rats. Adjuvant arthritis was induced in female Sprauge-Dawley rats by the subcutaneous injection of a single dose of 1 ㎖ of Complete Freund's Adjuvant (CFA) (1 mg of Mycobacterium Butyricum suspended in 1 ㎖ paraffin oil) into the right hind paw. A randomized, parallel-groups design of 24 subjects was used. All rats were randomly assigned to control (n=8), ultrasound (n=8), and HVPC (n=8) were compared with those of injured rats. The rats in the pulsed ultrasound group were treated at 1 MHz frequency with 5 W/㎠ intensity in 1:4 mode for 5 minutes per day. The rats in the HVPC group were treated at 120 pulses per second and 50 ㎲ phase duration, 20 mA intensity for 30 min per day. Treatment was done in the left and right hind limb for 2 weeks. We evaluated clinical, radiographic, hematologic and histopathologic findings before and after treatment and obtained the following results. 1. Edema of the right hind paw was more significantly reduced in the ultrasound and HVPC groups than the control group on days 9, 12, and 14 (p<.05). Edema of the left hind paw was more significantly reduced in ultrasound and HVPC groups than the control group on days 12, 14 (p<.05). 2. WBC counts of the ultrasound and HVPC groups as compared with the control group were becoming remarkably decreased after the treatment. 3. In radiologic findings, arthritis formation was seen according to the score of arthritis, which was the highest in the control group, upon the observation of radiographs of the left and right hind paws. However, no statistically significant difference was present in the score within three groups. 4. In the histopathologic findings, ultrasound and HVPC groups had effectively suppressed erosions of articular cartilage and inflammatory cell infiltrations. Therefore, the results of the study show that rats that were treated with the ultrasound and HVPC effectively suppressed adjuvant arthritis. However, no statistically significant difference was present between the ultrasound group and the HVPC group.
This study investigated therapeutic effects of pelvic tilt exercise (PTE) on weight bearing and body sway during sit-to-stand (STS) on 18 hemiplegic patients who had visited the Hanyang University Seoul Hospital and Injae University Sanggyebek Hospital physiotherapy rooms. The study compared the patients with 18 normal adults. The subjects were sampled out from those who could get up independently, maintain a standing posture more than 10 seconds, understand the movements of this study and have no difficulty in performing the tasks. By executing STS in a natural way with habitual movements before and after PTE, the weight bearing was measured by using Mediance II. In order to compare the difference of weight distribution, weight bearing and body sway on affected and nonaffected sides during STS before and after PTE, the Wilcoxon Signed Ranks Test was used. The statistical significance level was based on p<.05. The results revealed that the difference of weight distribution in the hemiplegic group was significantly decreased (p<.05), whereas there was no significant difference in the healthy group (p>.05). Weight bearing loaded on the affected side was 42.53±7.65% and 44.20±6.32%, respectively, in the hemiplegic group during STS before and after PTE. Weight bearing during STS after PTE is increased significantly, as compared with weight bearing before PTE (p<.05). Body sway in the hemiplegic group was significantly decreased (p<.05). As mentioned, PTE proved to be effective for improvement in weight bearing on the affected side during STS of hemiplegic patients.
This study was designed to examine, using Rasch analysis, the rating scale performance of the Korean version of the Berg Balance Scale (BBS). The subjects were 95 elderly people at community dwelling. Subjects (19 men, 76 women) ranged in age from 65 to 91 years. Rasch analysis was then done by means of the Winsteps program to determine the validity and reliability of the Korean version of the BBS evaluation tools for elderly people. The results were as follows: Twenty-one elderly people were excluded for misfit persons. Three items were found to be misfits and the order of item difficulty of the remaining 11 items was arranged. Elderly people BBS ability is indicated by -.94~7.41 logit, and the transformation formula is score=(logit score+.94)/. This transformation formula can be applied to Korean elderly people for balance ability. In the order of difficulty of evaluation items, the most difficult item was "Standing on one foot" and the easiest item was "Standing to Sitting". In conclusion, the Korean version of BBS evaluation tool for the elderly people has been proved valid and will be useful in clinical practice and research in Korea.
Ischemic stroke results from a transient or permanent reduction in cerebral blood flow that is restricted to the territory of a major brain artery. Thus, this study was performed to examine (1) the effects of swimming exercise on the improvement of muscle atrophy, and (2) exercise and HSP 70 expression in an ischemic stroke model induced by middle cerebral artery occlusion. The results of this study were as follows: One week after ischemic stroke was induced, changes appeared in the muscle weight of the gastrocnemius muscle due to muscle atrophy in the affected side. Group II showed statistically significant difference from group III eight weeks after ischemic stroke was induced. (p<.05). One week and eight weeks after ischemic stroke was induced there was significant decrease in the relative muscle weight of the gastrocnemius muscle in each group except Group IV, while there was statistically significant increase in group II eight weeks after ischemic stroke was induced, compared to group III (p<.05). For neurologic exercise behavior tests, Group II generally had the highest score, compared to other groups. In immunohistochemical observations, Group II showed a decrease in HSP 70. The above results suggest that swimming exercise improved muscle atrophy, changed the HSP 70 expression of ischemic stroke in rats, and contributed to the improvement of exercise function.
The purpose of this study was to investigate the effects of walking aid on hemiplegic gait of chronic stroke patients. Twelve stroke patients participated in this study. Physiological cost index (PCI), gait speed, and climbing stairs with and without walking aid were measured and analyzed. The results showed that walking with walking aid significantly improved gait speed and reduced physiological cost index and time needed to climb stair (height 7 cm) in comparison with a walking without walking aid. In conclusion, walking aid may improve the speed and efficiency of hemiplegic gait in chronic stroke patients.
The purpose of this study was to examine the isokinetic moment of quadriceps and hamstring strength ratio among women of different ages. The study population consisted of 1,184 women referred to the Health Promotion Center at the S district. All subjects were aged 20 to 69 years old and divided into 5 groups; 20s (n=248), 30s (n=255), 40s (n=248), 50s (n=228), and 60s (n=205). The strength of the knee extensor and flexor, quadriceps, and hamstring of all the participants were assessed at 60 degrees/second with an isokinetic machine. We calculated the peak torque, peak torque %BW (%Body Weight), deficit of peak torque and hamstring/quadriceps ratio of the knee. The data were analyzed by one way ANOVA to investigate statistical differences in strength variation between different age groups and were computed by ⊿% difference from women in their 20's. The results were obtained as follows: 1. Peak torque of the knee extensor, quadriceps, were significantly reduced in women older than 30, but peak torque of the knee flexor, hamstring, were significantly reduced in women older than 50 compared to women in their 20's. (p<.05). 2. Peak torque %BW of the knee extensor, quadriceps, were significantly reduced in women older than 20, but peak torque %BW of knee flexor, hamstring, were significantly reduced in women older than 40 compared to women in their 30's (p<.05). 3. Compared to the women in their 20's, there was no significant difference among any of the age groups in the deficit of peak torque of the knee extensor and flexor, but the deficit of peak torque of knee extensor among women between 30 and 50showed significant difference within the normal range of deficit. 4. Compared to the women in their 20's, there was no significant difference among any of the age groups in the hamstring/quadriceps ratio These results showed that peak torque, peak torque %BW, deficit of peak torque, and hamstring/quadriceps ratio of the knee were reduced in each age group, but especially among the women over 50. Further longitudinal study may be needed to see if volume of muscle mass and intervention of exercise affect knee strength in spite of aging.
The purpose of this study was to investigate the effect of submerged relaxation therapy for the spasticity on the affected side in three subjects with post-stroke hemiparesis. A single-subject alternating design with multiple baselines across individuals was employed in this study. Each subject alternately participated in a range of motion exercises on the mat and in the pool, and relaxation exercises in the pool. The muscle tone of the affected side was measured using the tone assessment scale (TAS). Measurements were made immediately and one hour following the intervention. The findings showed a therapeutic effect of submerged relaxation exercise on reducing spasticity for all subjects. The effect of submerged relaxation exercise on decreasing muscle tone was maintained for one hour measurements after the submerged relaxation exercise, although the mean TAS score assessed one hour after intervention was higher than that assessed immediately. The results of this study suggest that submerged relaxation exercise has a positive effect on decreasing spasticity on the affected side in persons suffering from post-stroke hemiparesis. Future research on submerged relaxation exercise should focus on objective evaluation and functional the aspects relevant to activities of daily living.
The purpose of this study was to investigate the characteristics and the current condition of musculoskeletal pain sufferers among fitness center users. The investigation used self-reporting questionnaire with the 797 subjects. On average, the subjects were 30.6 years old, 168.8 cm in height and 65.2 kg in weight. Among them, 423 were male (53.1%) and 374 were female (46.9%). Out of them, 276 suffered from pain, (35.2%). More men felt muscle aches than women (p<.05). In terms of pain, lower back area topped the list with 44.9%, followed by the lower extremities (30.1%), the neck (17.8%) and the upper part of the body (17.8%). Dieters suffered the most from pain (86.2%) while those exercising to build strength suffered the least with 26.8%. There was a significant relationship between the purpose for exercising and the amount of pain suffered (p<.05). By kind of exercise, pain stroke aerobic exercisers disproportionately with 42.4% while it almost steered clear of exercisers for strengthening with 26.9%. There was significant relationship between the kind of exercise and pain suffered (p<.05). The type of suffering differed by body shape. A significantly higher number of overweight people experienced pain than underweight people (p<.05). 32.8% of pain sufferers commented that the pain affects their workout, and on this issue there was no gender difference (p>.05). The pain caused more difficulties in doing activities of daily living for overweight or obese peoples than underweight peoples (p<.05). More than a third of health club and fitness center users are experiencing musculoskeletal pains. Measures such as professional training or information provision is required to prevent injury or disorder caused by improper exercise.
To improve trunk stability, various exercise protocols were introduced into the clinical field. Trunk and lumbar stability exercises on unstable surfaces are especially recommended to improve lumbar stability. The purpose of this study was to compare abdominal oblique muscle activity during leg raising in hook-lying position among 3 different type of surface conditions (on floor (F), vestibular board (VB), and foam roll (FR)). Sixteen able-bodied volunteers, who had no medical history of lower extremity or lumbar spine disease, were recruited for this study. Surface electromyography (EMG) activity was recorded from the internal and external oblique muscles of both sides. The normalized EMG activity was compared using a one-way repeated ANOVA. The results showed that the EMG activities of the internal oblique and external oblique of the lifted leg side during straight leg raising significantly increased under the FR condition when compared to the F condition. There was no significant difference of the EMG activity in abdominal oblique muscles between the VB and the FR conditions. The EMG activity of the internal oblique of supported leg side during the straight leg raising was significantly greater under the FR condition than the VB and F conditions (p<.05). The composition ratio of EMG activity of internal oblique muscles during straight leg raising was significantly increased under the FR condition. Therefore, straight leg raising exercise on foam roll in hook lying position could be beneficial to improve trunk and lumbar stability.