This study compared the stability of the cervical spine according to the presence of neck pain and deep neck flexor performance. Thirty subjects with neck pain, and thirty subjects without neck pain were recruited for this study. The Cranio-cervical flexion (CCF) test was applied using a pressure biofeedback unit to classify the subjects into four subgroups; no cervical pain and good deep neck flexor performance (NG group), no cervical pain and poor deep neck flexor performance (NP group), cervical pain and good deep neck flexor performance (PG group), and cervical pain and poor deep neck flexor performance (PP group). The head sway angle was measured using a three-dimensional motion analysis system. A 3-kg weight was used for external perturbation with the subject sitting in a chair in the resting and erect head positions with voluntary contraction of the deep neck flexors. A one-way analysis of variance (ANOVA) was performed with a Bonferroni post hoc test. The deep neck flexor performance differed significantly among the four groups (p<.05). The NG group had significantly greater deep neck flexor performance than NP and PP groups. The stability of the cervical spine also differed significantly among the four groups in the resting head position (p<.05). The head sway angle was significantly smaller in NG group as compared with the other groups. The PP group had the greatest head sway angle in the resting head position. However, there was no significant difference in the stability of the cervical spine among the groups in the erect head position with voluntary contraction of deep neck flexors (p=.57). The results of this study suggest that the deep neck flexor performance is important for maintaining the stability of cervical spine from external perturbation.
The aim of this study was to analyze the relationship between physical impairments and daily activities on the basis of the outcome measurements in stroke patients. Seventy-six stroke patients participated in this study. Two physical therapists evaluated 3 clinical common measurements, i.e., the Fugl-Meyer Assessment (FMA), the Berg Balance Scale (BBS), and the Functional Independence Measure (FIM). Multiple regression analysis was used, as the dependent variables were the BBS and FIM; the independent variables were post-stroke duration, FMA of Upper Extremity (FMU), and FMA of Lower Extremity (FML). In the regression equation of the BBS, the coefficient of determination () was .383, and the FML was found to be the most important variable for determining the BBS score. In the regression equation of the FIM, was .531, and the FML was found to be the most important variable for determining the FIM. These results suggest that there is a need to determine the function of activities on the basis of the physical impairments of stroke patients. More variable measurement tools on the levels of body function and structure, as well as activity limitations are required.
The aims of this study were to investigate the correlation between the electromyographic (EMG) activity of the abductor hallucis (AbdH) and the amount of pressure measured by a pinch gauge (PG), and to compare the EMG activity of AbdH and the pressure measured by the PG during short foot (SF) exercise in subjects with pes planus and in subjects with a neutral foot alignment. Fourteen subjects were recruited for this study (pes planus group=7; neutral foot alignment group=7). A surface EMG was used to collect AbdH activity, and a PG was positioned under the first metatarsophalangeal joint to measure the pressure produced by the first metatarsal head during the SF exercise. The AbdH activity and the pressure measured by the PG showed a positive good correlation (r=.80, p<.05). The EMG activity of the AbdH and the pressure measured by the PG were significantly lower for subjects with pes planus than for subjects with a neutral foot alignment (p<.05). Based on these findings, the PG can be recommended as an effective instrument for evaluating the performance of the AbdH. It may also be beneficial for monitoring how well the SF exercise is performed, and for providing visual feedback to patients with pes planus during SF exercise in a clinical setting.
The aim of this study was to investigate the effects of respiratory muscle training (RMT) with abdominal drawing-in maneuver (ADIM) on pulmonary function. Twenty-two subjects with restrictive breathing participated in this study. All the subjects were randomly assigned to three groups (7 subjects in RMT group, 7 subjects in RMT with ADIM group, 8 subjects in control group). The first group performed the RMT by using incentive respiratory spirometer (IRS). The second group performed the RMT by using IRS and the ADIM by using a Stabilizer. The exercises were conducted over four days. The pulmonary function was evaluated using the spirometer to measure the force exploratory volume in 1 second () and forced vital capacity (FVC). Measurements were conducted on the first day and the last day. A paired-t test was used for pre-post changes and the change rates in FVC and among each group were investigated by a one-way ANOVA. The findings of the the study were as follows: 1) There were significant differences of FVC and between pre and post in the two training groups (p<.05) 2) There was no significant difference of the change ratio the FVC and between the RMT group and RMT with ADIM group. Therefore, it is concluded that respiratory muscle and ADIM training, combined with two methods of treatment would suggest positive evidence for improving pulmonary function.
The lumbrical muscles contribute to the intrinsic plus position, that is simultaneous metacarpophalangeal (MCP) flexion and interphalangeal (IP) extension. The strength of the lumbrical muscles is necessary for normal hand function. However, there is no objective and efficient method of strength measurement for the lumbrical muscles. In addition, previous studies have not investigated the measurement of the cross-sectional area (CSA) of the lumbrical muscles using ultrasonography (US) and the relationship between lumbrical muscle strength in the intrinsic plus position and the CSA. Therefore, the purpose of this study was to identify the measurement method of the CSA of the lumbrical muscles using US and to examine the relationship between maximal isometric strength and the CSA of lumbrical muscles. Nine healthy males participated in this study. Maximal isometric strength of the second, third, and fourth lumbrical muscles was assessed using a tensiometer in the intrinsic plus position which isolated MCP flexion and IP extension. The CSA of the lumbrical muscles was measured with an US. The US probe was applied on the palmar aspect of the metacarpal head with a transverse view of the hand in resting position. There was no significant difference between maximal isometric strength of the lumbrical muscles, but the fourth lumbrical muscle was stronger than the others. The CSA of the lumbrical muscles was significantly different and the fourth lumbrical muscle was significantly larger than the second lumbrical muscle. There was moderate to good correlation between maximal isometric strength and the CSA of the lumbrical muscles. Therefore, we conclude that maximal isometric strength of the lumbrical muscles was positively correlated to the CSA of the lumbrical muscle in each finger, while the measurement of the CSA of the lumbrical muscles, using US protocol in this study, was useful for measuring the CSA of the lumbrical muscles.
The purpose of this study was to investigate the changes in the flexicurve kyphosis index (KI), the flexicurve lordosis index (LI) and the distance from the inferior angle of the scapula to the nearest vertebral spinous process (DS), as a dependent variable of scapular protraction, after applying of adolescents with thoracic hyperkyphosis using three different garments. A repeated measures design was used. Ten adolescents ( years) with thoracic hyperkyphosis ( Cobb angle) were recruited from a university hospital. A flexicurve ruler was used to measure KI and LI and a scoliometer was used to measure DS under three different conditions: wearing-a hospital garment (HG), wearing-a sham garment (SG), and wearing-an experimental garment (EG). KI under EG condition was significantly decreased compared with that wearing the HG. However, there was no significant difference between wearing the SG and HG. LI when wearing the EG was significantly increased compared with that when wearing HG. However, there was no significant difference under SG and HG conditions. DS when wearing the EG was significantly decreased compared with wearing HG. However, there was no significant difference between the SG and HG. The results of this study show that the EG was effective in decreasing KI, but not effective in decreasing LI. Hence, the effect of the EG for correcting sagittal spine angle in adolescents with thoracic hyperkyphosis is still debatable. However, since we showed that DS decreases in the EG, this method could be applied in correcting the scapular protraction.
The purpose of this study was to investigate the effect of attentional focus and distance of external focus on the performance of balance task of upper extremity. Subjects (N=30) held a stick (2 m) and maintained it horizontally. All of the subjects performed balance task of upper extremity under four different attentional focus conditions: focus on hand (internal focus), marker at 10 cm inside of hand (external focus 1), marker at 10 cm outside of hand (external focus 2), marker at 20 cm outside of hand (external focus 3). The mean velocity of the bar (mm/s) and the muscle activity of biceps brachii (%RVC) were measured. They were decreased when the subjects focused on external focuses compared to internal focus and decreased as distance of attentional focus from body increased (p<.05). There were significant differences between groups (p<.05); internal focus-external focus 1, internal focus-external focus 2, internal focus-external focus 3, external focus 2-external focus 3. These results showed that external focus is more effective than internal focus in enhancing motor performance and focusing on more distant attentional focus results in enhanced motor performance promoting the utilization of more automatic control mechanisms.
Ultrasonography (US) is a recent technique that has proven to be useful for assessing muscle thickness and guiding the rehabilitation decision-making of clinicians and researchers. The purpose of this study was to determine the inter-rater reliability of the US measurement of transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) thicknesses for different probe locations and measurement techniques. Twenty healthy volunteers were recruited in this study. Muscle thicknesses of the transversus TrA, IO, and EO were measured three times in the hook-lying position. The three different probe locations were as follows: 1) Probe location 1 (PL1) was below the rib cage in direct vertical alignment with the anterior superior iliac spine (ASIS). 2) Probe location 2 (PL2) was halfway between the ASIS and the ribcage along the mid-axillary line. 3) Probe location 3 (PL3) was halfway between the iliac crest and the inferior angle of the rib cage, with adjustment to ensure the medial edge of the TrA. The two different techniques of thickness measurement from the captured images were as follows: 1) Muscle thickness was measured in the middle of the muscle belly, which was centered within the captured image (technique A; TA). 2) Muscle thickness was measured along a horizontal reference line located 2 cm apart from the medial edge of the TrA in the captured image (technique B; TB). The intraclass correlation coefficient (ICC [3,k]) was used to calculate the inter-rater reliability of the thickness measurement of TrA, IO and EO using the values from both the first and second examiner. In all three muscles, moderate to excellent reliability was found for all conditions (probe locations and measurement techniques) (ICC=.70~.97). In the PL1-TA condition, inter-rater reliability in the three muscle thicknesses was good to excellent (ICC=.85~.96). The reliability of all measurement conditions was excellent in IO (ICC=.95~.97). Therefore, the findings of this study suggest that TA can be applied to PL1 by clinicians and researchers in order to measure the thickness of abdominal muscles.