The purpose of this study was to determine whether aromatherapy massages with manual lymph drainage (MLD) are significantly more effective than sham massages with MLD in reducing edematous limb volume in lymphedema. This study was performed on 46 patients who had developed unilateral upper or lower lymphedema. Twenty-three patients served as the experimental group and were treated with complex decongestive physiotherapy (CDP) applications including aroma massages with MLD, multi layered compression bandages, remedial exercises and skin care. Twenty-three patients in the control group were treated with CDP applications including sham massages with MLD, bandages, exercises and skin care. Patients undergo a therapy program once a day; 5 days a week for 2 weeks. Percentage excess volume (PEV) and body mass index (BMI) were recorded before and after treatment. PEV and BMI were significantly decreased before and after treatment in the experimental as well as in the control groups (p<.05). However, the percentage excess volume and BMI were not significantly improved after treatment between the two groups (p>.05). This study there suggests that aroma massages is not effective in the edema of patients with lymphedema.
The purpose of this study was to investigate electromyographic activities of the flexor digitorum superficialis (FDS) and the flexor carpi ulnaris (FCU) by the shape of the ultrasound head. Twelve healthy subjects participated and performed ultrasound therapy with a round head and a long handled head during each 5-minute application. Electromyographic activities of the FDS and FCU were recorded by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. There was no difference in the muscular fatigue of FDS and FCU as determined by the shape of the ultrasound head (p>.05). Without the shape of head, the mean power frequency decreased with the time. There also was no difference in %MVIC of the FDS and FCU as determined by the shape of the ultrasound head (p>.05), but the force exerted exceeded 20%MVIC. There was however a significant difference in the amount of cumulative workload of the FDS and FCU as determined by the shape of ultrasound head (p<.05). The workload was however not affected by the shape of the ultrasound head. Constant static grasp of ultrasound transducer head during ultrasound therapy is considered a high risk factor of work-related musculoskeletal disease.
The purpose of this study was to determine the influence of muscle fatigue in elbow flexors on the sense of force reproduction. Fifteen healthy subjects were recruited for this study. Maximum voluntary force (MVF) of elbow flexor muscles was measured by a digital tensiometer. Force errors were measured to test accuracy of the sense of force reproduction in elbow flexors. The subject was required to flex the elbow joint, to maintain and concentrate on about 20% of the MVF target force under visual feedback for 3 seconds. After a 5 second period rest, the subject was asked to duplicate the target force actively. Muscle fatigue was evoked with isometric contraction of the elbow flexors. Isometric contraction was continued until a 50% drop in MVF. The difference, in kilogram between the target force and the reproduced force was calculated for measuring force error. Force errors were compared between the non-fatigued condition and the fatigued condition by the paired t-test. Force errors were significantly increased in the fatigued condition compare to non-fatigued condition. This result suggests that the sense of force reproduction can be disturbed by localized muscle fatigue.
The purpose of this study was to determine the influence of high-heeled shoes on walking of obese women as it was already proven an extrinsic factor of knee osteoarthritis in women with normal weight. In this study the aimed therefore in particular was to utilize high-heeled shoes in proving it's causal influence on knee osteoarthritis by measuring the angle and torque of the knee joint. Fifteen obese women (BMI>25 ) were measured in their twenties. Each angle and torque of their knee joints during walking on 6.5 cm high-heeled shoes and with a bare feet, were compared with each other and analyzed with a 3D motion analysis system. There was no significant difference in walking speed, cadence and stride length between the two conditions. However, there was a significant increase in a double limb support time and the stance phase when walking on high-heeled shoes as when walking with bare feet. The peak knee flexion angle and peak knee varus torque was higher when walking on high-heeled shoes than with bare feet. On the contrary, the peak knee flexion angle in the swing phase was not statistically different. The prolongation of peak knee varus torque was also proven. There was a significant increase in peak knee varus torque in the initial and last stance phases during walking on high-heeled shoes as compared to walking on bare feet. Through the above results, it was proven that when obese women walked on high-heeled shoes, rather than with bare feet, peak knee flexor and varus torque increased along with the changes of the in knee joint angle. Therefore, the influence of high-heeled shoes might be a significant intrinsic factor in knee osteoarthritis of obese women.
Although many children with cerebral palsy have problems with their eye movements available data on its intervention is minimal. The purpose of the study was to determine the effectiveness of the postural movement normalization and eye movement program on the oculomotor ability of children with cerebral palsy. Twenty-four children with cerebral palsy (12 male and 12 female), aged between 10 and 12, were invited to partake in this study. The subjects were randomly allocated to two groups: an experimental group received the postural movement normalization and eye movement program and a control group which received conventional therapy without the eye movement program. Each subject received intervention three times a week for twelve weeks. The final measurement was the ocular motor computerized test before and after treatment sessions through an independent assessor. Differences between the experimental group and control group were determined by assessing changes in oculomotor ability using analysis of covariance (ANCOVA). The changes of visual fixation (p<.01), saccadic eye movement (p<.01) and pursuit eye movement (p<.01) were significantly higher in the experimental group than in the control group. These results show that the postural movement normalization and eye movement program may be helpful to treat children with cerebral palsy who lose normal physical and eye movement.
Dance movements consist of combinations of movements such as jumping, rotation, maintaining balance, leg lifts, and plantar flexion with toe shoes. Dance movements require great muscle strength of lower extremities as well as muscular endurance. The purposes of this study were to investigate correlation between the anthropometric variables and the peak torque in young female dancers and to identify variables that affect isokinetic peak torque. Twenty-six female dancers (19.7±1.2 years of age) performed concentric maximum force efforts on the knee extensors and flexors at 60°/sec and 120°/sec, the ankle plantar flexors (PF) and dorsiflexors (DF) at 30°/sec and 120°/sec. Antropometric variables such as age, height, weight, body mass index (BMI), thigh girth, calf girth and duration of dance training were measured. To identify antropometric variables related to muscle strength, Pearson correlations were computed and a stepwise multiple regression analysis was performed. Pearson correlation coefficients of Knee extensor at 60°/sec and 120˚/sec revealed moderate positive associations with BMI and thigh girth. Pearson correlation coefficients of ankle PF revealed low-to-moderate positive associations with height. Ankle DF also revealed moderate positive associations with BMI and calf girth. The main predictor variables of knee extensor at 60/sec, were stepwise multiple regression, age, height, thigh and girth.
Environmental Enrichment (EE) alone is not capable of enhancing the fine digit and the forelimb functions. Therefore, we applied modified constraint-induced movement therapy (mCIMT) under the influence of EE to assess its effect on promoting improved forelimb sensorimotor functions. Focal ischemic brain injury was produced in Sprague-Dawley rats (60 rats, 250±50 g) through middle cerebral artery occlusion (MCAO). Before MCAO induction, all rats were trained in modified limb placing tests and reaching tasks for 1 week. Then they were randomly divided into three groups: Group I: application of standard environment (SE) after MCAO induction (n=20), Group II: application of EE after MCAO induction (n=20), Group III: MCAO+EE, mCIMT and task-oriented training that was initiated at 10th day after MCAO induction (n=20). We also applied mCIMT (between 9 AM and 5 PM/daily) which included restraining the forelimb ipsilateral to the lesion using the 'Jones & Schallert' method. We assessed the change of modified limb placing, single pellet reaching test and the immunoreactivity of BDNF by immunohistochemistry (pre, 1st, 5th, 10th and 20th day). Group I showed no improved outcome, whereas group II and III significantly improved on the use of the forelimb and the immunoreactivity. The qualitative analysis of the skilled reaching test, of group III showed the greatest improvement in the fine digit and the forelimb function. These results suggest that EE combined with mCIMT is more functional in promoting enhanced fine digit and forelimb functional movements.
The purpose of this study was to evaluate inter-rater reliability of the amplitude and first knee extension angles in deep tendon reflex test by using an electrical hammer. Twenty-five healthy adults participated in the study. Compound muscle action potential is elicited by tapping the knee tendon with an electrical hammer in deep tendon reflex tests. The amplitude and knee extension angle were simultaneously measured. The mean value of the amplitude and the knee extension angles through three time trials for each tester, are used for determining the inter-rater and Intra-class Correlation Coefficients (ICCs) reliabilities. According to the results, the ICCs of the amplitude is .280 and that of the knee extension angle is .789. Pearson correlation coefficients of the amplitude of the action potential and the knee extension angles are .685, showing significant statistically moderate correlation. Inter-rater reliability in the amplitude was not significant. More objective and quantitative deep tendon reflex tests should be done to obtain higher reliability in further studies.
The purposes of this study were to determine correlations between the Berg Balance Test (BBS), Timed -UP & Go Test, Fugl Meyer-L/E, Balance, Sensory (FM-L/E, B, S), Motor Assessment Scale-Gait (MAS-G), Comfortable maximal Gait Speed (C MGS), and the Modified Barthel Index (MBI). The subjects were 40 stroke patients of the Korea National Rehabilitation Center in Seoul. Main outcome measures were Balance control (BBS, FM-B), Gait (TUG, C MGS, MAS-G), ADL (MBI) and Motor Function of Lower Extremities (FM-L/E, S). The data were analyzed using Pearson product correlation. FM scales between other clinical and instrumental indexes and multiple stepwise regression analyses were performed to identify prognostic factors for Balance, Gait and ADL Motor Function of Lower Extremity inclinations. The results of this study were as follows: The BBS, FM-L/E, balance, sensory and MBI showed positive correlation relations, but TUG and C MGS showed negative correlations. The sensory factor of the FM-scale showed the strongest variance in predicting BBS. However the FM-balance showed the strongest variance in predicting TUG, MAS-G and C MGS. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general clinical performance of the patients.
The purpose of this study was to verify the effects on fine motor, muscle strength (hand-grip), explosive muscular strength (vertical jump) and muscular endurance (sit-up) after ingesting coffee. Hence this study targeted a sample group of 38 healthy men in their twenties, without cardiac disorders and muscle disorders and none of them were hypersensitive to caffeine with symptoms such as palpitation and dyspnea. Nineteen of them ingested coffee, whereas the other nineteen men ingested decaffeinated coffee at the same amount. The amount of coffee was controlled by weight so as to regulate intake to 6 mg caffeine per kg. Research material was evaluated through O'Conner's finger dexterity test, hand-grip strength test, vertical jump test and sit-up test. The data were analyzed by means of paired t-test and ANCOVA. The material was then, analyzed by means of two-way ANOVA in order to verify the effect of one or two cups of coffee on fine motor and hand-grip strength. All parameters were measured by an independent observer. The results were as follows: There were no significant differences to fine motor, hand-grip strength, vertical jump, sit-up before and after drinking decaffeinated coffee, but there was a difference to those before and after drinking caffeine coffee. There was no significant difference to hand dexterity and hand-grip strength in one or two cups of coffee. Intake of a certain dosage of caffeine effects activation of muscles working in a short period based on the results. As a consequence, intake of certain dosages of caffeine was beneficial to enhance efficiency of activity during exercises, but it is will be difficult to obtain the desired result with only one or two cups of coffee.
The purpose of this study was to utilize the K-MBI (Korean Modified Barthel Index) and subscales of K-MBI in predicting the length of hospital stay (LOS) and the discharge destinations for stroke patients. The study population consisted of 97 stroke patients (57 men and 40 women) admitted to the Seoul National University at the Bundang Hospital. All participants were assessed by K-MBI at admission and discharge after rehabilitation therapy and the information available was investigated at admission. The data were analyzed by using the Mann-Whitney U test, the stepwise multiple regression and the logistic regression. The median LOS was 30 days (mean, 32.8 days; range, 22 to 43 days). The K-MBI score at initiation of rehabilitation therapy (p<.001), the type of stroke and living habits before a stroke were the main explanatory indicators for LOS (p<.05). Within the parameters of K-MBI measured at initiation for rehabilitation, feeding and chair/bed transfer were the explanatory factors for LOS prediction (p<.01). Confidence in the prediction of LOS was 20%. Significant predictors of discharge destination in a logistic regression model were the discharge K-MBI score, sex and hemiplegic side. Dressing in items of discharge K-MBI was the significant predictor of discharge destination. The K-MBI score was the most important factor to predict LOS and discharge destination. Knowledge of these predictors can contribute to more appropriate treatment and discharge planning.
The purpose of this study was to compare the joint position sense at the knee joint at 3 different surface conditions by using the active knee joint angle reproduction test in the standing position. Twenty healthy volunteers (10 males and 10 females) age 20~29 years were recruited for this study. The knee joint position senses were assessed at three different surface conditions: on the floor (stable condition), TOGU (soft condition), and seat fit (unstable condition) in a closed kinetic chain. Testing orders were selected randomly. The absolute angle error was defined as the absolute difference between target angles (30°～45° knee flexion) and subject perceived angle of the knee flexion. One way ANOVA was used to compare the absolute angle of error among 3 different conditions. The Independent t-test was used to compare the absolute angle of error between male and female. The error angles were significantly different among surface conditions (1.3°±1.2° for the floor, 2.1°±0.9° for the TOGU, and 4.4°±1.8° for the seat fit, p<.05). There was no significant difference in error angle between male and female. In conclusion, the joint position sense of the knee joint in the closed kinetic chain decreased at unstable surface conditions. The result of this study indicates that surface conditions should be considered when assessing and training the joint position sense of the knee joint in clinical setting.
The purpose of this study was to determine reliability and validity of the Neck Disability Index (NDI) now in use for the first time in neck pain patients of Korea. Fifty subjects (26 males and24 female) with neck pain enrolled in the study. They completed a standardized self-administered questionnaire that include pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. Reliability was determined by intra-class correlation coefficient (ICC) and Cronbach's alpha by internal consistency. Validity was examined by correlating the NDI scores to the Visual Analog Scale (VAS) score. The Test-retest reliability of the translated versions of the NDI was good ICC (2,1) = .90 (95%CI .85 .95). Cronbach's alpha value for NDI was found to be .95 and this was statistically significant (p<.05). The criterion-related validity coefficients was .72 (p<.01). We conclude that the Korean version of NDI has shown to be a reliable and valid instrument for the assessment of neck pain.