Background: Individuals with pes planus tend to overuse the extrinsic foot muscles, such as the tibialis anterior (TA) and peroneus longus (PL), to compensate for the weakened intrinsic foot muscles, such as the abductor hallucis (AbdH). Furthermore, differences in weight-bearing can affect the activity of muscles in both the intrinsic and extrinsic foot muscles. To date, no study has compared the effects of the short foot exercise (SFE) and toe spread-out exercise (TSO) on intrinsic and extrinsic foot muscle activity and the corresponding ratios in different weight-bearing positions. Objects: To compare the effects of the SFE and TSO on AbdH, TA, and PL activity and the AbdH/TA and AbdH/PL activity ratios in the sitting and standing positions in individuals with pes planus. Methods: Twenty participants with pes planus were recruited. Surface electromyography was used to assess the amplitudes of AbdH, TA, and PL activity. Participants performed both exercises while adopting both the sitting and standing positions. Results: No significant interaction between exercise and position was found regarding the activity of any muscle or ratio of the activity, except for PL activity. We observed a significant increase in AbdH activity during the TSO compared to the SFE, and no significant difference in TA and PL activity between the two exercises. AbdH, TA, and PL activity were significantly higher in the standing position than in the sitting position. Furthermore, the AbdH/PL activity ratio significantly increased in the sitting position, although there was a significant increase in AbdH activity in the standing position. Conclusion: In individuals with pes planus, we recommend performing the TSO in the sitting position, which may increase the activity of the AbdH while concurrently decreasing the activity of the TA and PL, thus strengthening the AbdH.
Background: The weakness of the gluteus medius (GM) is associated with various musculoskeletal disorders. The increasing GM activity without synergistic dominance should be considered when prescribing pelvic drop exercise (PD). Isometric hip extension or flexion of the non-weight bearing leg using thera-band at the ankle during PD may influence hip abductor activities.
Objects: To determine how isometric hip extension or flexion of the non-weight bearing leg using thera-band at the ankle during PD influences the activities of three subdivisions of GM (anterior, GMa; middle, GMm; posterior, GMp), tensor fasciae latae (TFL), contralateral quadratus lumborum (QL), and GMp/TFL, GMm/QL activity ratios in patients with GM weakness.
Methods: Twenty-three patients with GM weakness were recruited. Three types of PD were performed: PD, PD with an isometric hip extension of the non-weight bearing leg (PDE), and PD with an isometric hip flexion of the non-weight bearing leg (PDF). Surface electromyography (SEMG) was used to measure hip abductor activities. One-way repeated-measures analysis of variance was used to assess the statistical significance of muscle activities and muscle activity ratios.
Results: GMa, GMm, and GMp activities were significantly greater during PDF than during PD and PDE (p < 0.001, p = 0.001; p = 0.001, p = 0.005; p = 0.004, p = 0.004; respectively). TFL activity was significantly greater during PDE than during PD and PDF (p < 0.001, p < 0.001, respectively). QL activity was significantly greater during PDF than during PD (p = 0.003). GMp/TFL activity ratio was significantly lower during PDE than during PD and PDF (p = 0.001, p = 0.001, respectively). There were no significant differences in the GMm/QL activity ratio.
Conclusion: PDF may be an effective exercise to increase the activities of all three GM subdivisions while minimizing the TFL activity in patients with GM weakness.
Background: A weight-bearing jacket during treadmill gait training is being used for rehabilitation in stroke patients. However, the effect on various gait parameters has not been confirmed.
Objectives: The purpose of this study was to investigate the comparison of exercise intensity through speed increase and weight-bearing jacket during treadmill gait training to restore gait ability in stroke patients.
Design: Randomized controlled trials.
Methods: This study recruited 24 stroke patients. The subjects were randomly assigned to the experimental group (wearing a weight-bearing jacket during treadmill gait training, n=12) and the control group (speed increase during treadmill gait training, n=12). Gait measurement device (G-walk) was used to measure the gait parameters of the subjects.
Results: Both the experimental group and control group showed a significant increase in cadence, gait speed, stride length, and gait symmetry index post intervention (P<.05). In comparison between the two groups, the experimental group showed a significant increase in the gait symmetry index post the intervention than the control group (P<.05).
Conclusion: Through this study, it was found that wearing a weight-bearing jacket was a more effective method for improving the gait symmetry index than increasing speed during treadmill gait training in stroke patients.
This study aimed to identify the effects of kinesio taping (KT) applied in a proprioceptive neuromuscular facilitation (PNF) pattern on the pain, weight-bearing distribution (WBD), and walking ability of knee osteoarthritis (KOA) patients. Thirty women with KOA were randomly allocated to a control group (n=15) with KT at the quadriceps only, and a PNF pattern group (n=15) with KT at the quadriceps and gastrocnemius muscle. Pain intensity was measured using a visual analogue scale during walking. In addition, WBD, and walking ability were measured before and 30 minutes after KT application. The VAS significantly reduced in both groups after the intervention (p<.05). WBD (p<.05, ES=.32) and walking ability (p<.05, ES=.38) showed a significant change in the PNF pattern group, and in the inter-group comparison, the PNF pattern group showed a significant difference compared to the control groups. These results demonstrate that KT application with PNF pattern effectively attenuate the pain and improves WBD and walking ability in KOA patients.
The purpose of this study was to examine the relationships between the ankle dorsiflexion passive range of motion (DF PROM) under a non-weight bearing condition and the normalized reach distance in three directions of the Y-Balance Test (YBT). Sixty-one healthy adults (32 males and 29 females, age: 23.0±3.0 years, height: 169.3±8.9 ㎝, weight: 61.9±5.4 ㎏) participated in this study. The ankle DF PROM was measured using a goniometer. To assess dynamic balance, all subjects performed three trials to determine the maximum lower extremity reach in the anterior, posteromedial, and posterolateral directions of the YBT. The relationship between the ankle DF PROM and both the normalized reach distance in each direction and the composite score of the YBT were analyzed using the Pearson correlation. Only the normalized reach distance in the anterior direction of the YBT was significantly related to the ankle DF PROM measured under a non-weight bearing condition (r=.50, p<.001). Neither the normalized reach distances in the posterior directions nor the composite score of the YBT were significantly correlated with the ankle DF PROM measured under a non-weight bearing condition. These findings suggest that ankle DF PROM does not affect the overall dynamic balance of the lower extremity, with only the anterior dynamic balance affected among the three directions.
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 investigate the influence of the static pelvic inclination and declination in the static standing position on weight bearing rate and gait elements. Fourteen healthy adults in their twenties were participated. Two groups of healthy adults were allocated in this study: above and below the average of pelvic tilt. The correlation between the pelvic inclination, weight bearing rate and gait elements were measured. There was a statistical correlation between the pelvic tilt and step. Also, there was a statistical difference when we compared anterior declination with swing period and posterior declination with step. There was an asymmetric correlation between pelvic tilt and step. However, there was no statistical difference between the groups above and below the average of pelvic tilt. This result indicates that dipper pelvic inclination doesn't affect the asymmetry of step.
The purpose of this study was to investigate the effects of a task-oriented approach on weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement in 18 chronic stroke patients. Both groups were received neurodevelopmental treatment for 30 min/day and then the experimental group (=9) followed additional a task-oriented approach (sit-to stand training with controlled environment) and the control group (=9) followed a passive range of motion exercise for 15 min/day, five days/week, for four weeks. Weight-bearing distribution and muscular activities of the paretic leg during sit-to-stand movement were measured before and after four weeks of training. There was significantly improved weight-bearing distribution of the paretic leg during sit-to-stand movement in the experimental group compared with that of the control group after four weeks of training (p<.05). But electromyographic activities of the quadriceps and the tibialis anterior of the paretic leg were not significantly different (p>.05). Thus, it is necessary to apply a task-oriented approach to improve the weight-bearing distribution of the paretic leg during sit-to-stand movement in chronic stroke patients.
Hemiplegia-induced immobilizatoin and reduction of mechanical loading in chronic stroke limbs are common cause of disuse osteoporosis. The purpose of this study was to investigate the effects of asymmetrical weight bearing on the loss of bone mineral in the individual with chronic stroke. Sixteen hemiplegic patients with strokes were evaluated. The measurements of bone mineral density (BMD) were evaluated with the quantitative ultrasound system on the calcaneus region of the paretic and non-paretic side. Plantar pressure was measured using the Mat-Scan system. The paretic side showed significantly smaller values in the T-score of BMD, and peak value of plantar pressure, which included forefoot, midfoot, and hindfoot, than the non-paretic side (p<.05). Results from the pearson correlation analysis showed statistically significant correlation between the BMD difference and the peak-pressure difference of midfoot pressure (p<.05). This finding indicated that BMD loss depended on decrease of body weight born on the paretic leg.
목적 : 편마비 환자의 비대칭적 체중부하와 일상생활동작과의 상관관계를 알아보고자 한다.연구방법 : 2007년 12월부터 2008년 2월까지 뇌졸중으로 인한 편마비 환자로 삼육재활병원에서 재활치료를 받고 있는 63명의 편마비 환자를 대상으로 비대칭적 체중부하의 정도를 알아보기 위해 Tetrax를 이용하여 환측 하지의 체중부하율을 측정하였고, MBI를 이용하여 일상생활동작 수행정도를 측정하여 상관관계를 알아보았다.결과 : 환측 하지의 체중부하율과 일상생활동작과의 상관관계를 분석한 결과 상관관계(r=.539)가 있음을 알 수 있었으며, MBI는 이동하기, 개인위생, 보행 항목이 상관관계가 높게 나타났다.
The purpose of this study was to investigate the treatment effect of three interventions on the disuse atrophy of rat hindlimb after two weeks suspension. Forty-eight 11~12 weeks old female Sprague-Dawley white rats were divided into four intervention groups: 1) suspension only (S; n=10), 2) intensive weight bearing treadmill (IWBT; n=10), 3) electrical stimulation (ES; n=9), 4) 2)+3) (ES/IWBT; n=9). Another 10 rats received no intervention or hindlimb suspension and served as controls (C). After the interventions, 1) the cross-sectional area (CSA), 2) the ratio of white muscle fiber composition (WMFC), 3) isometric tetanic tension (ITT), and 4) muscle weights (MWs) were measured from the four calf muscle specimens. The results were as follows: 1. In all intervention groups, the CSAs of medial and lateral gastrocnemius (MG LG), soleus (SOL), and flexor digitorum superficialis (FDS) decreased when compared to the control (C) group (p<.05). The CSA increased in FDS and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group (p<.05). 2. The ratios of WMFC in MG, LG, SOL, and FDS increased compared to the C group for all interventions (p<.05). The ratios of WMFC decreased in SOL and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group, and decreased in SOL for the ES/IWBT group compared to the IWBT group (p<.05). 3. The ITT in the MG, LG, SOL, and FDS decreased compared to the C group for all interventions (p<.05). The ITT increased in MG LG/FDS, SOL, and the whole calf muscles (WCMs) in the IWBT, ES and ES/IWBT groups compared to the S only group (p<.05). 4. The MWs in MG LG/FDS, SOL, WCMs decreased compared to the C group for all interventions (p<.05). The MWs increased in MG LG/FDS and WCMs for the IWBT group, in SOL for the ES group, and in SOL for the ES/IWBT group compared to the S only group (p<.05). 5. In atrophied muscles, the IWBT group showed the best recovery and the ES/IWBT and ES groups followed in decreasing order. The most susceptible muscle to disuse atrophy was the SOL. But conversely, it showed the best recovery in the ES/IWBT group. After two weeks of hindlimb suspension, the calf muscles of rats atrophied and their isometric tension decreased. These changes were best reversed by hindlimb-focused treadmill activity. The next best results were achieved by electrical stimulation combined with the treadmill followed by only electrical stimulation. These findings indicate that full weight bearing treadmill activity alone or in combination with electrical stimulation are effective treatments for non-weight bearing induced muscle atrophy. Further study of the effect of different intensities of electrical stimulation and variations in the duration period of full weight bearing treadmill activity on disuse atrophy is recommended.
The purpose of this study was to compare the differences of weight-bearing distribution between subjects with low back pain and healthy subjects. Fifty-one subjects (22 men, 29 women; mean age = 42.9 years) with low back pain and 31 healthy subjects (11 men, 20 women; mean age = 35.4 years) were evaluated. The weight-bearing distribution was measured by two commercial scales during comfortable standing. The difference of weight-bearing distribution between right and left side was calculated for each subject. The differences of weight-bearing distribution in subjects with low back pain and healthy subjects were 6.0 kg and 4.5 kg, respectively. However, there were no significant differences in the weight-bearing distribution between subjects with low back pain and healthy subjects.
Decreased equilibrium in standing and walking is a common problem associated with hemiparesis secondary to cerebral vascular accident. In patients with hemiplegia, postural sway is increased and often displaced laterally over the non-affected leg, reflecting asymmetry in lower extremity weight bearing during standing balance. Human balance is a complex motor control task, requiring integration of sensory information, neural processing, and biomechanical factors. Limits of stability (LOS) is a one of the biomechanical factors. The purposes of this study were to establish the influence of asymmetrical weight-bearing on the LOS of independent ambulatory hemiparetic patients. The subjects of this study were 29 hemiparetic patients (18 males, 11 females) being treated as admitted or out patients at Young-Nam University Hospital and Taegu Catholic University Hospital, all of whom agreed to participate in the study. Participants were asked to lean and displace their center of gravity (COG) as far as possible in directions to the sides and front of the body. The LOS and weight-bearing ratio were measured with a Balance Performance Monitor (BPM) Dataprint Software Version 5.3. In order to assure the statistical significance of the results, the independent t-test and a Pearson's correlation were applied at the .05 and .01 level of significance. The results of this study were as follows: 1) There were statistically significant differences in anteroposterior LOS according to the cause of brain demage (p<.01). 2) There were statistically significant differences in mediolateral LOS according to the hemiparetic side (p<.05). 3) There were statistically significant differences in anteroposterior and mediolateral LOS according to the brain operation (p<.01). 4) The mediolateral LOS significantly correlated with weight-bearing ratio (p<.01).
형상 최적설계에서 절점의 재배치 및 형상 민감도 계산은 많은 노력이 필요하다. 본 연구에서는 구조물의 형상을 Bezier 곡선을 이용하여 표현하고, 민감도 계산을 위하여 개선된 직접미분법을 이용한다. 그리고, 절점의 재배치에는 변위장을 수정한 속도장을 이용한다. 또한, 본 연구에서는 자중을 고려한 외팔보와 3차원 저널베어링을 수치예제로 선택하여 본 연구의 기법들을 적용한 형상 최적설계를 해석한다.
본 연구의 목적은 여러 가지 하지입식검사에 적용할 수 있는 Multi-Function Device(MFD)를 제작하여 기 존에 사용하던 Weight Bearing Platforms(WBPs)들과 X 선 영상의 비교를 통해 임상 활용을 제안하고자 한 다. MFD는 단상(보조기구)를 이용한 Weight Bearing Foot/Ankle, Hindfoot Alignment View 검사시 X선 장치 의 X선 관구의 최하 조절 높이를 고려하여 제작하였다. 그리고 Foot/Ankle Phantom으로 MFD와 WBPs에서 Weight Bearing Lateral Foot과 Hindfoot Alignment View를 검사하여 X선 영상의 해상력을 Quick MTF(modula tion transfer function)프로그램으로 비교하였다. 연구결과 MFD와 WBPs에서 검사한 두 가지 영상 모두 MTF 50(50% Contrast Spatial Frequency)과 10-90%(10-90% of Maximum Energy Rise Distance) Rise의 C/P(Cycles Pe r Pixel)평균과 LPH(Lines Per Image Height)평균 모두 유의한 차이는 없었다(p>0.05). 연구에서 제작한 MFD 는 환자의 안전과 여러 가지 검사를 복합적으로 수행 할 수 있는 유용한 보조기구로 임상 활용을 제안한 다. 또한 정책적으로 보조기구의 활용을 권장한다면 전문 업체의 활성화를 돕는 길이며 의료의 질도 더욱 향상할 수 있을 것이다.
체중부하 상태에서의 족관절 검사 시 양측 족관절을 동시 촬영 했을 때와 편측 족관절을 나누어 각각 촬영 했을 때, 족관절염의 평가에 해당되는 측정값들의 변화에 대해 알아보고자 한다. 양측을 동시촬영 할 때, 다리를 모아 촬영하게 됨으로 Tibia axis축이 기울게 되고, 족관절의 external rotation으로 인해 족관절의 각도와 joint space의 왜곡이 발생하게 된다. 양측 족관절 동시촬영과 편측 족관절을 나누어 촬영한 영상을 PACS system 이용하여 족관절 평가에 이용되는 TAS, TT, TMM, JSW, Tibiotalar joint, Fibulotalar joint의 측정값을 구한 후 통계 분석 하였다. 각도 측정에 있어, 체중부하 양측 족관절 동시 촬영한 검사의 오른쪽 족관절의 TAS, TT, TMM 측정값은 87.24°, 6.44°, 26.67° 이였으며 편측을 나누어 촬영한 오른쪽 족관절의 TAS, TT, TMM은 88.93°, 2.41°, 19.77° 였다. 양측 족관절 동시촬영의 왼쪽 족관절 TAS, TT, TMM의 측정값은 87.25°, 5.71°, 23.92° 였으며 편측을 나누어 촬영한 왼쪽 족관절의 TAS, TT, TMM은 88.75°, 3.19°, 21.45° 였다. 양측 족관절을 동시촬영한 검사와 편측을 나누어 촬영한 족관절과의 비교 시, 양측을 동시 촬영한 검사에서 족관절 평가의 중증도 비율이 높게 나타났으며, 자세로 인한 측정값의 왜곡을 확인할 수 있었다. 반면 너비 측정에서 JSW, Tibiotalar joint는 검사 자세로 인한 측정값들 간의 유의성은 없었지만, Fibulotalar joint 의 양측 족관절 동시 검사에서 오른쪽 0.98mm 왼쪽 1.22mm 로 나타났고, 한쪽씩 촬영한 오른쪽 족관절에서는 1.6mm 왼쪽 1.22mm로 측정 자세로 인한 측정값의 유의한 차이를 보였다. 따라서 족관절염 평가를 위한 체중부하 족관절 검사시 양측을 동시에 검사하기 보다는 각각의 족관절을 나누어 촬영하는 것이 족관절염 평가값에 왜곡을 최소화 하며, 측정값의 정확성을 높일 수 있다.
본 논문의 목적은 경량기포모르터를 충전한 스틸스터드와 복합스터드 내력벽체의 내화성능을 KS규준에 따라 평가하는데 있다. 주거용과 상업용 건물의 최소 내화 요구시간은 2시간이다. 시험 결과로부터 스틸 스터드와 복합스터드에 경량기포 모르터를 충전한 두 시험체 모두 2시간 내화 성능을 만족하는 것으로 나타났다. 또한 복합스터드 패널 시험체의 경우 내화 성능면에서 스틸 스터드 패널 시험체 보다 우수하다는 것을 정량적 평가하였다.