The purpose of this study was to investigate the kinematic and kinetic changes that may occur in the pelvic and spine regions during cross-legged sitting postures. Experiments were performed on sixteen healthy subjects. Data were collected while the subject sat in 4 different sitting postures for 5 seconds: uncrossed sitting with both feet on the floor (Posture A), sitting while placing his right knee on the left knee (Posture B), sitting by placing right ankle on left knee (Posture C), and sitting by placing right ankle over the left ankle (Posture D). The order of the sitting posture was random. The sagittal plane angles (pelvic tilt, lumbar A-P curve, thoracic A-P curve) and the frontal plane angles (pelvic obliquity, lumber lateral curves, thoracic lateral curves) were obtained using VICON system with 6 cameras and analyzed with Nexus software. The pressure on each buttock was measured using Tekscan. Repeated one-way analysis of variance (ANOVA) was used to compare the angle and pressure across the four postures. The Bonferroni's post hoc test was used to determine the differences between upright trunk sitting and cross-legged postures. In sagittal plane, cross-legged sitting postures showed significantly greater kyphotic curves in lumbar and thoracic spine when compared uncrossed sitting posture. Also, pelvic posterior tilting was greater in cross-legged postures. In frontal plane, only height of the right pelvic was significantly higher in Posture B than in Posture A. Finally, in Posture B, the pressure on the right buttock area was greater than Posture A and, in Posture C, the pressure on the left buttock area was greater than Posture A. However, all dependent variables in both planes did not demonstrate any significant difference among the three cross-legged postures (p>.05). The findings suggest that asymmetric changes in the pelvic and spine region secondary to the prolonged cross-legged sitting postures may cause lower back pain and deformities in the spine structures.
The purpose of this study was to determine the effects of weight shift training with joint mobilization on the ankle joint passive range of motion (PROM), balance capacity and gait velocity in hemiplegic patients. Fourteen subjects were randomly assigned to either the experimental group (EG) or the control group (CG), with seven subjects in each group. The EG received weight shift training with joint mobilization in the paretic leg's subtalar joint in order to increase ankle dorsiflexion. The CG received general physical therapy training. Both groups received training five times a week over a period of two consecutive weeks. The figures for PROM of ankle dorsiflexion on the paretic leg, the functional reach test (FRT), the timed up and go (TUG) test, and gait velocity were recorded both before and after the training sessions for both groups. The EG's results in gait velocity, the FRT and the TUG test improved after training (p<.05). The PROM of ankle dorsiflexion improved both in the EG and the CG (p<.05), the EG demonstrated a significantly higher increase (p<.05) than that of the CG. The results of this study suggest that increased joint mobilization positively affects balance and gait velocity of hemiplegic patients. Further studies with a greater sample size are necessary in order further prove the accuracy of the results of this study.
The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on thickness of lumbar stabilizers during hip abduction in side-lying. Twenty healthy subjects without back pain were recruited for this study. The thickness of transverse abdominis (TrA), internal oblique (IO) and quadratus lumborum (QL) were measured by ultrasonography. Pelvic lateral tilting motion was measured using a three-dimensional motion analysis system. Measurements were performed at rest position (RP), preferred hip abduction (PHA) and abduction with contralateral hip adduction (CHA) in side-lying at the end of expiration. During the measurements, subjects were asked to maintain steady trunk alignment without hand support. Thickness of TrA and IO was significantly greater in CHA than in PHA and RP conditions. There was no significant difference in thickness of TrA and IO between PHA and RP conditions. Medio-lateral (M-L) thickness of QL was not significant between PHA and CHA conditions. Anterio-posterior (A-P) thickness of QL in PHA and CHA significantly decreased compared to RP condition. Angle of pelvic lateral tilting was significantly decreased in CHA compared to PHA condition. In conclusion, CHA can be recommended for increasing trunk stability without compensatory pelvic motion during hip abduction exercise in side-lying.
This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support surface conditions applied to the lower limbs were divided into four categories: condition 1 had a stable platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.
The purpose of this study was to assess the influence of patellar height on quadriceps muscles' electromyography (EMG) activity during a squat exercise in adults with patella baja. For the study, we recruited 15 volunteers who had patella baja on the right side. We measured the EMG activity of the right rectus femoris, vastus medialis oblique, and vastus lateralis muscles during squat exercises under two conditions, specifically with and without an infra-patellar strap. The infra-patellar strap was applied below the tested patella to elevate the patella to a normal height. A paired t-test was used to compare the effects of patella height on EMG activity of the quadriceps muscles. The EMG activity of the rectus femoris (RF), vastus medialis oblique (VMO), and vastus lateralis (VL) muscles were significantly decreased during the squat exercise with the infra-patellar strap compared to the same exercise without the infra-patellar strap (p<.05), while the VMO/VL ratio was not different significantly between two conditions (p>.05). The findings of this study suggest that an infra-patellar strap may benefit people with patellar baja, as changes in patellar height could improve the efficiency of the quadriceps muscles.
The purpose of this study was to investigate the effect of the two different types of chairs on trapezius muscle activation during dictation tasks. Seventeen university students, each of whom were within standard deviation of the mean Korean standard body size, voluntarily participated in this study. Surface electromyography was used to collect electrical signals from both the upper and lower trapezius muscles. Amplitude Probability Distribution Function (APDF) was performed to analyze the muscle activity. The findings of this study were 1) The backrest-point height of the auditorium chair and the height, length and width of the connected desk were shorter than what was suggested by the KS. Another difference was that the auditorium chair had a bigger angle of the backrest compared to the classroom chair. 2) Regarding within-subject effect the sole statistically significant difference was found between activation of the upper trapezius muscle. The upper trapezius muscle's %RVC in the APDF 10th-50th-90th percentile was statistically higher for participants sitting in the auditorium chair than for participants sitting in the classroom chair (p<.05). 3) There was an interaction effect between the 'two chair-types' and the 'two muscle-sides' in the APDF 10th-50th percentile (p<.05). 4) There was an interaction effect between the 'two chair-types' and the 'three gaze-direction' in the APDF 90th percentile (p<.05). The findings of this study indicated that maintaining a writing posture for a prolonged period of time in an auditorium chair significantly increased the left upper trapezius muscle activation compared to a classroom chair.
This study examines the effects of a rehabilitation program on quality of life (QOL), cardiopulmonary function and fatigue during radiotherapy for breast cancer patients. The program includes aerobic exercise, stretching and strengthening exercises. Sixty-five women participated in this study and they were asked to perform supervised exercises that last for 60 minutes five times a week for six weeks. The European organization for research and treatment of cancer-cancer (EORTC QLQ-C30) and the breast (EORTC QLQ-BR23), predicted maximal volume of oxygen consumption () and fatigue severity scale (FSS) were assessed before and after the rehabilitation program. The 60-minute program consisted of a 10-minute warm-up, 30-minute of aerobic exercises, and 15-minute of strengthening exercises, followed by a five-minute cool-down. Heart rates were monitored throughout the exercise class to ensure that patients were exercising at the target heart rate of 40~75% of the age-adjusted heart rate maximum. There were statistically significant differences in the changes of physical function and cancer related symptoms in the EORTC QLQ-C30 and EORTC QLQ-BR23 (p<.05). There was a statistically significant improvement in the predicted (p<.05), although there were no significant differences in the FSS (p>.05). The results of our study suggest that a supervised rehabilitation program may benefit the physical aspects and QOL of patients receiving radiotherapy for breast cancer.
The purpose of this study was to identify the effects of two types of stretching extensor carpi radialis on the visual analog scale (VAS), pressure-pain thresholds (PPTs), grip strength (GS), and strength of wrist extensor (SWE) in patients with lateral epicondylalgia. Sixteen patients with lateral epicondylalgia were recruited for this study and randomly assigned to two groups; the conventional stretching group (CS) and the stretching of proximal functional massage group (PFM); the VAS, PPTs, GS, and SWE were measured before and after the intervention. Over a period of stretching exercises were performed for five minutes per day, five days per week. The paired t-test and Wilcoxon signed-rank test were used to determine the statistical differences in the VAS, PPTs, GS, and SWE (pre- and post-test). The Independent t-test and Mann-Whitney U test were used to compare the effects of stretching exercises between the CS and PFM groups. The results of this study demonstrated that in the PFM group, the PPTs, GS, and SWE significantly increased, and the VAS decreased (p<.05). In the CS group, the VAS and GS increased significantly after the three-week intervention (p<.05). Pain was decreased and strength (GS and SWE) was increased in the PFM group, compared to the CS group (p<.05). The findings of this study indicate that PFM technique can be applied for decreasing pain and increasing the GS and SWE in patients with lateral epicondylalgia.
The purpose of this study was to identify the factors determining the participation restriction of chronic stroke patients based on international classification of functioning, disability, and health (ICF) model. Sixty-eight stroke patients participated. The participants were assessed participation restriction using the Korean version of London handicap scale (K-LHS), modified Barthel index (K-MBI) to measure activities of daily living, Berg balance scale (K-BBS) to assess balance, and the center for epidemiologic studies depression (K-CES-D) to gauge depression. Also, 3 minutes walking test (3MWT), gait velocity, asymmetric posture, and family support were assessed. A stepwise multiple regression analysis was used to explore the factors determining participation restriction. There were no significant different in the K-LHS and K-MBI results by gender (p>.05). Correlations between the K-LHS and K-MBI (r=-.656), K-BBS (r=-.543), K-CES-D (r=.266), 3MWT (r=-.363), gait velocity (r=.348), and family support (r=-.389) were significant (p<.05). Also, the K-MBI and family support were the factors that determined participation restriction (p<.05) and that 40.2% of the variation in the K-LHS can be explained. Therefore, it is suggested that evaluation and intervention of patient's activity level and extent of family support is necessary to reduce participation restriction of chronic stroke patients.
The purpose of this study was to assess the feasibility of task-oriented arm training for chronic hemiparetic stroke patients. The experimental design in this study was the pre-test and post-test with control group for 4-week intervention. Thirty patients with chronic hemiparetic stroke were recruited from 2 rehabilitation units. The subjects were divided randomly into experimental and control groups. The experimental group conducted task-oriented approach, involving 3 subparts of upper extremity activities, and the control group involved in the general upper extremity exercises. Functional movements of the upper extremities were assessed using clinical measures, including the Fugl-Meyer Assessment-Upper Extremity Section, Box and Block Test, and Action Research Arm Test. The score of Fugl-Meyer Assessment showed greater increases in the experimental group than in the control group after training. The improvement in Box and Block Test between pre-test and post-test measurements was significantly greater after task-oriented arm training compared to general upper extremity exercises. Action Research Arm Test scores also improved after task-oriented arm training compared to exercises in the control group. The task-oriented arm training improves the gross and fine motor activities and encouraging the use of the paretic arm through activity dependent intervention expedites the recovery of functional activities in the upper extremities for chronic hemiparetic stroke.