Background: Mobilization with movement (MWM) is an effective intervention for increasing range of motion (ROM) and function without pain. Objectives: The purpose of this study is to comprehensively characterize the functional effects of MWM applied to the ankle joint in patients with stroke. Design: Systematic Review and Meta-analysis. Methods: International electronic databases, CINAHL, Embase, MEDLINE, PubMed, and Google scholar were included and identified after review by two investigators in July 2023 according to PRISMA guidelines. Data were synthesized using software provided by Cochran and analyzed using a random effects model with reweighting to account for heterogeneity between participants. Results: After excluding duplicate studies, 14 of the 19 articles screened through the abstracts were excluded, resulting in a total of five studies involving 109 participants with stroke. MWM showed significant differences in ankle ROM [overall effect (Z=3.27, P=0.00)], gait speed [overall effect (Z=3.33, P=0.00)], and cadence [overall effect (Z=2.49, P=0.01)]. Conclusion: The results of the meta-analysis confirmed that MWM is effective in improving ankle ROM and gait parameters in patients with stroke.
Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method.
Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL.
Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle.
Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001).
Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.
본 연구의 목적은 딥 스쿼트 동작 시 발목 관절 유연성이 무릎 관절의 운동역학적 요인들간의 관련성을 분석하는데 있었다. 본 연구는 최근 1년간 하지 근골격계 병력이 없는 성인 남성 19명과 여성 8명이 연구대상자로 참여하였다. 딥 스쿼드 시 발목 관절 유연성과 하지 관절의 운동역학적 요인들과 상관관계를 검증하기 위해 pearson의 적률상관계수(pearson’s correlation coefficient)를 이용하였고(SPSS 24.0, Armonk, NY, USA), 통계적으로 유의미한 상관성을 나타낸 변인들은 단순회기분석(simple regression analysis)을 실시하였으며, 유의 수준은 .05로 설정하였다. 본 연구를 통해 발목 관절 유연성과 무릎 관절의 압력을 결정하는 최대 관절모멘트와 관절반발력 요인들 간의 관련성을 확인할 수 있었다. 그러므로 근력 트레이닝 시 딥 스쿼트와 같은 무릎 관절에 많은 부하를 발생시킬 수 있는 운동을 적용할 때 개인에 신체적 특성 중 발목 관절의 유연성의 정도를 확인하는 것은 신체의 안정성과 무릎 관절의 상해 위험성을 감소시킬 수 있는 운동 강도를 설정하는데 도움이 될 수 있을 것으로 기대한다.
This study was conducted to examine the effect of joint mobilization on forward head posture and to propose an effective method to improve correct body posture and balance. A total of eight patients from a Maitland-applied group (n=8) received mobilization therapy to increase the mobility of the cervical joint, with Maitland's movement grade III intensity for 30 seconds of treatment and 30 seconds of rest, for ten intervals, three times a week for four weeks. The craniovertebral angle (CVA) changes before and after the intervention with the Maitland technique were measured as 56.85 ± 2.31° before, 63.23 ± 2.23° two weeks after, and 64.98 ± 1.27° four weeks after joint intervention. There were significant CVA changes before and after the Maitland technique (P <.05). The results of this study suggest that the Maitland technique is useful for improving the head vertebral angle in patients with forward head posture
This study was conducted to investigate the effect of FES and ankle mobilization on the ankle motion and the quality of gait of chronic hemiplegic patients with limited ankle joint motions. As research subjects, 24 chronic hemiplegic patients who could walk independently, regardless of assistive aids, were selected. Then, 8 subjects received mobilization randomly and 8 subjects received FES and 8 subjects received mobilization and FES, at the same time. The dorsiflexion PROM significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.01). There were statistically significant differences among the three groups(p<.01). The 10m walking test significantly decreased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The gait velocity significantly increased in the group of mobilization therapy, FES therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.01). The stride length significantly increased in the group of mobilization therapy, mobilization and FES all together(p<.05). There were statistically significant differences among the three groups(p<.05). In conclusion, these findings demonstrate that rather than only using one treatment technique, applying mobilization and FES together brings a more satisfactory result to hemiplegic patients with limited ankle joint motions.
The purpose of this study is to identify the level of masseter muscle tension according to the levels of restricted movement and pain in the temporomandibular joint(TMJ), thereby verifying the fact that excessive masseter muscle tension can be a cause for restricted movement and pain in the TMJ. The subjects of this study were 81 men and women in their 20s and 30s, who feel uncomfortable with their masticatory function on the preferred chewing side. The subjects were measured in terms of the range of motion (ROM) and deviation of the TMJ and the degree of pain in the affected region. The ROM and deviation of the TMJ were measured using the Global Posture System(GPS) after instructing each subject to open his/her mouth to the fullest and taking photos of the subject with a digital camera. The tension of the masseter muscle was measured with a Pressure Threshold Meter(PTM). After the measurements, in order to compare the ROM of the TMJ, the subjects were divided into two groups based on the ROM of above 35mm and below 35mm. For the deviation and pain, based on the average of total subjects, the subjects were divided into two groups of above and below average. Thereafter, the levels of masseter muscle tension were compared between each pair of groups. According to the results, when each variable was compared between the respective two groups, in terms of the deviation, the pressure pain threshold(PPT) of the masseter muscle revealed a statistically significant difference(p<.05). However, the ROM and pain showed no statistically significant difference. Consequently, masseter muscle tension may cause restricted movement in the TMJ. In particular, the deviation and tension in the masseter muscle is considered to be a factor that causes deviation in the TMJ.
The aim of this study was to examine the effects of repeated passive movement (RPM) of different velocities on the improvement of knee joint position sense (JPS) in post-stroke patients with hemiplegia, thereby investigate the possibility of clinical application in the initial stage of rehabilitation for patients with post-stroke hemiplegia. Thirteen hemiplegic patients participated in this study. For the subjects' knee JPS tests, a passive angle reproduction test and an active angle reproduction test were performed prior to and after the intervention, which involved 30 repetitions of passive full-range-of-motion flexion and extension exercise of the knee joints at randomized degrees of , , and . Paired t-test analysis was done in order to compare changes in the pre- and post-intervention knee JPS. One-way repeated analysis of variance was used in order to compare changes in JPS after intervention at three different movement velocities. The level of significance was set at .05. The result was that the subjects' post-intervention knee JPS significantly improved after the RPM exercise at a and a relative to the RPM exercise (p<.05). JPS changes with RPM intervention at the rapid velocity of were most increased, suggesting the most effective enhancement in knee JPS is with intervention at the velocity (p<.05). Therefore, RPM intervention at a half or higher velocity improved stroke patients' knee JPS. During the initial stage of rehabilitation for patients with post-stroke hemiplegia, the efficient application of the RPM exercise at a half or higher velocity will be possible.
The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.
인체의 동작 센싱 방법에 대한 연구가 다양하게 진행되어 왔으나, 기존의 동작 센싱 방식에는 많은 한계점들이 있다. 기존의 동작 센싱 방식의 한계점을 보완하기 위한 일환의 노력으로, 이 논문에서는 비구속적인 동작 센싱이 가능한 광섬유 기반 의류 소매형 동작센서를 탐색적으로 연구하는데 목표를 두었다. 이 논문에서는 광섬유 기반의 의류 소매형 동작 센서를 고안하고, 이를 통하여 일상생활 중에 다양한 동작을 센싱하는 것이 가능한가에 대하여 탐색적 연구를 수행하였다. 또한 본 연구의 범위는 광섬유 기반 동작센서의 가능성 여부와 주요 요건을 탐색하는 것이며, 소매 패턴과 봉제 방식의 특성, 착용자의 체형 특성이 미친 영향은 연구 범위에서 제외되었다. 이러한 방식으로 의복에 적용 가능하도록 고안된 광섬유 기반 의류 소매형 동작센서는, 기존의 동작 센싱 시스템에 비하여 더욱 미세한 인체 동작 측정이 가능하며 시간 공간의 제약 없이 저 비용으로 인체 동작 측정이 가능하다는 장점을 갖는다.
본 연구의 목적은 관절계 댐핑특성을 상용 에르고미터(BIODEX)의 등속운동을 이용하여 파악할 수 있는지를 평가하는 것이다. 제안된 방법은 등속운동을 유지하기 위해 인가한 외부토크와 하퇴의 관성토크의 차로부터 슬관절의 댐핑토크를 계산하는 것이다. 댐핑토크는 여러 가지 관절각속도에서 산출되었고, 이로부터 댐핑특성을 유도하였다. 실험장치는 BIODEX 시스템과 별도의 힘센서 및 Labview 시스템으로 구성되었다. 댐핑특성의 해석에는 Matlab을 사용하였다. 실험결과로부터 등속운동의 기동 및 종료를 위한 크랭크 암의 가속 및 감속으로 인한 미세한 각속도의 변화가 댐핑토크의 영향보다 큰 관성토크를 유발하는 것을 알 수 있었다. 따라서, 현재의 등속운동장비로는 댐핑특성을 추정하기가 어렵다고 보여진다.
The purpose of this study was to analyse the subtalar joint movement characteristics in human stance phase. The data of subtalar joint movement patterns are collected by CTA(calcaneus to tibia angle) measurements. CTA is defined as a angle formed between the bisect of the posterior shank and bisect of the posterior heel, as determined by placement of the retroreflective markers. The angle measured in degrees. The participants are 74 healthy individuals (37 men and 37 women) who have no orthopedic and neurological impairment, aged from 19 to 29 years(mean 22.95). Prior to participation, each subjecct informed the procedures of experiment from researcher and assistant researcher. The equipments of this study are walking grid, marking tapes, goniometer, video camera, monitor and ink for foot print are used in the study. In order to determine the statistical significance of result, the paired t-test and Pearson correlation were applied at the 0.05 level of significance. The results were as follows : 1. The reliability of measured CTA value are showed a high correlation, ranged from .86 - .94. 2. The mean value of step width are 7.67cm in men and 6cm in women. So, significant difference between men and women in 0.05 level of significance. 3. There was significant difference between man and women's TOA(toe out angle)(p<0.05). 4. The CTA of female's is more higher than male's one, however not statistical difference between man and women(p>0.05). 5. The CTA is reduced according to increasing TOA(p<0.05).