The purpose of this study was to find which spatiotemporal gait parameters gained from stroke patients could be predictive factors for the gait part of Tinetti Performance-Oriented Mobility Assessment (POMA-G). Two hundred forty-six stroke patients were recruited for this study. They participated in two assessments, the POMA-G and computerized spatiotemporal gait analysis. To analyze the relationship between the POMA-G and spatiotemporal parameters, we used Pearson's correlation coefficients. In addition, multiple linear regression analyses (stepwise method) were used to predict the spatiotemporal gait parameters that correlated most with the POMA-G. The results show that the gait velocity (r=.67, p<.01), cadence (r=.66, p<.01), step length of the affected side (r=.49, p<.01), step length of the non-affected side (r=.53, p<.01), swing percentage of the non-affected side (r=.47, p<.01), and single support percentage of the affected side (r=.53, p<.01) as well as the double support percentage of the non-affected side (r=-.42, p<.01) and the step-length asymmetry (r=-.64, p<.01) correlated with POMA-G. The gait velocity, step-length asymmetry, cadence, and single support percentage of the affected side explained 67%, 2%, 2%, and 1% of the variance in the POMA-G, respectively. In conclusion, gait velocity would be the most predictive factor for the POMA-G.
Purpose : The study was to evaluate the weight distribution, balance and gait function of stroke patients wearing lateral wedged insole to the shoe of the affected side. Methods : 27 patients with stroke (15 men, 12 women) participated in this study. Participants performed weight distribution, dynamic balance and gait ability with or without wedged insole on affected side in a random order. The balancia was used to evaluate the weight distribution. Deviation from the center line was analyzed by Dartfish during sit to stand to evaluate dynamic balance. The functional walk ability evaluated by 10 m walking velocity. Results : The asymmetry index of weight bearing improved significantly with wedged insole of affected side(p<.05). During sit to stand, center of gravity significantly moved from non-affected side to more mid line of body(p<.05). Improvement were shown in walking speed after wearing the wedged insole(p<.05). Conclusion : Wedged insole applied on affected side have a beneficial effect on weight distribution, dynamic balance and walking speed with stroke.
The purpose of this study was to evaluate and compare the biceps muscles activity at the different angle and direction of the base of support on sitting position in hemiplegic patients. The biceps muscles activity was measured at the $0^{\circ},\;10^{\circ}$ of posterior tilt, $10^{\circ}$ of anterior tilt, $10^{\circ}$ of affected side tilt and $10^{\circ}$ of sound side tilt of the base of support by EMG biofeedback (MYOMED 432. ENLAF NONIUS CO.) In this study, 24 out-patients were evaluated who were treated at Yonsei University Medical College Rhabilitation Hospital. This study was carried out from December 5. 1993 to March 30. 1994. In order to determine the statistical significance of result, the ANOVA, and t-test were applied at the 0.05 level of significance. The results were as follows : 1. The biceps muscles activity of the sound side was no significantly difference at the different angle and direction of the base of support on sitting position(p>0.05). 2. The biceps muscles activity of the affected side was significantly increased at the 100 of sound side tilt and $10^{\circ}$ of posterior tilt of the base of support on sitting position(p<0.05). 3. There was no significantly difference in the change of the biceps muscles activity of the affected side between the affected group and the intact group of propriocetive sense(p>0.05). 4. The change of the biceps muscles activity of the affected side was significantly higer in the group of G 2 spasticity compared to that of G 1, G 1+ spasticity(p<0.05). These results showed that the biceps muscles activity of affected side was significantly increased when the base of support was tilted toward the sounde side and posterior direction on sitting position. In order to prevent the increment of biceps muscle activity, the patients must avoid to sit toward sound side and posterior tilt.
Objective: This study aimed to identify how various applications of weight bearing on the affected side of hemiplegia patients affect the ability of balance keeping of the affected leg and the gait parameters. Design: Cross-sectional study. Methods: Eighteen patients with hemiplegia participated in this study. There were twelve males and six females. This study investigated the effects of the single-leg stance exercise on dynamic balance, weight bearing, and gait ability compared with four conditions. Dynamic balance and weight bearing were measured using the step test (ST) of the affected side in stroke patients. In addition, gait parameters were measured using the optogait system for analysis of the spatial and temporal parameters of walking in stroke patients. Results: This study investigated the effect of the single leg stance exercise on the paralysis side. The ST showed significant findings for all conditions (p<0.05). Therefore, knee extension and flexion exercise on the affected side single-leg stance (condition 4) significantly improved dynamic balance and weight bearing on the affected side (p<0.05). In the condition of moving the knee joint in a single-leg stance was discovered that the stance phase time significantly increased more than in the condition of supporting the maximal voluntary weight on the affected side (p<0.05). Conclusions: Single-leg stance on the paralysis side with knee flexion and extension increased symmetry in weight bearing during stance phase time. This study suggests that single-leg stance exercises augments improved gait function through sufficient weight bearing in the stance phase of the affected side.
Purpose: This study was conducted to determine the effects of Mulligan's mobilization with movement (MWM) on changes in the talofibular interval in the sagittal plane in subjects with chronic ankle instability (CAI). Methods: Sixteen subjects with chronic ankle instability participated in this study. The talofibular intervals were measured from US images, and the weight-bearing lunge test was used to assess dorsiflexion of the ankle joint. Each dependent variable were measured on the both affected side and sound side in three trials in pre- and post-MWM. Dependent variables were examined with a two-way mixed-design analysis of variance (ANOVA). The two factors were side (sound side versus affected side) and intervention (pre- versus post-intervention). For post hoc analysis, paired t-tests were performed to compare the dependent variables. A p<0.05 was considered to indicate significance. Results: Dorsiflexion and talofibular interval differed significantly pre- and post-intervention (p<0.05). Post-hoc analysis revealed that the talofibular interval post-MWM was significantly less than that pre-MWM on the both the affected and sound side (p<0.05). The ankle dorsiflexion in the post-MWM group was significantly greater than that in the pre-MWM group on the affected side and the sound side (p<0.05). Conclusion: The Mulligan's MWM decreased the talofibular interval in subjects with CAI. These findings suggest that the MWM technique can change the position of the talus relative to the fibular in the weight bearing position.
The purpose of this study was to provide experimental evidence and theoretical background for the applicability of bilateral transfer paradigm to the rehabilitation programs for children with hemiplegic cerebral palsy. Children with hemiplegia, which means unilateral motor disabilities, display abnormal motor and postural patterns of the affected side due to hemiparesis, spasticity, and sensory disorders, resulting in a decreased motor abilities of the affected side compared to unaffected side. Accordingly, they tend to rely on the unaffected limb for everyday activities, which further deteriorates the functions of the affected side by causing associated reaction, abnormal postural patterns, and hypertonus. Rehabilitation programs developed for children with hemiplegic cerebral palsy include neurodevelopmental treatment, application of cast or splint to unaffected limb, neuromuscular electrical stimulation, and task oriented model. These programs, however, have several drawbacks, such as discontinuity in treatment effect and psychological hatred to the force use of the affected side. In order to solve these problems and enhance the efficiency of the rehabilitation programs, it is required to maximize the use of the affected side without hatred. Characteristics of the control system, such as temporal coupling and spatial assimilation between limbs and neural crosstalk at different levels of central motor pathway, suggest that the bilateral transfer paradigm may enhance the efficiency of the rehabilitation programs for children with hemiplegic cerebral palsy.
This study was performed for Investigation of the magnitude of mandibular positional change in maximum mouth opening. protrusion, lateral excursion, gum and peanut chewing with BioPAK system(Bioresearch Inc. USA) which can analyze mandibular rotational torque movements. For this study 17 female patients with Temporomandibular joint(TMJ) closed lock and 18 female control without any Temporomandibular disorders(TMDs) signs and premature occlusal contact were included. The obtained results were as follows : 1. In maximum mouth opening, the mandibular rotational angle and distance of patients were significantly greater than those of control group in horizontal plane(P<0.05). 2. In protrusion, the mandibular rotational angle and distance of patients were significantly greater than those of control group in frontal and horizontal plane(P<0.01, P<0.05). 3. The mandibular rotational angle and 야stance in lateral excursion to affected side of patients were significantly greater than those in lateral excursion to non-affected side in frontal plane(P<0.05). 4. The mandibular rotational angle in gum chewing to affected side of patients was significantly greater than that in gum chewing to non-affected side in frontal plane. 5. The mandibular rotational angle and distance in peanut chewing to affected side of patients were significantly greater than those in peanut chewing to non-affected side in frontal and horizontal plane. 6. The mandibular rotational angle and distance in peanut chewing to affected side of patients were greater than those in gum chewing, and was the same result in control group in frontal and horizontal plane.
Journal of the Korean Association of Oral and Maxillofacial Surgeons
/
제27권5호
/
pp.428-434
/
2001
After miniplate fixation of mandibular angle fractures, fracture line stability during functional loading was evaluated. Using panoramic radiographs, 15 mandibular angle fracture patients who were treated by open reduction and one miniplate fixation along the external oblique ridge, were evaluated at postoperative 1, 4 and 8 weeks. At each time, 2 radiographs were taken: one taken during maximum biting of hardened silicone sheet on the affected side molar area and the other on the non-affected side. The distraction gap of inferior border of mandible at each time and each side was measured and these data were analysed statistically with clinical findings. The differences of inferior border distraction gap during hardened silicone sheet biting on the affected side molar area and on the non-affected side molar area at 4 week radiographs were smaller than those of 1 week's except one case. At 8 week's radiographs, the fracture lines were so stabilized that it was almost impossible to find the gap differences except one case and there were increased radiopacity along the entire fracture lines. Clinically, bony union was confirmed in all cases during plate removal performed at postoperative 6 month. By statistical analysis(paired t-test), the inferior border distraction gap during biting of hardened silicone sheet on the affected side was significantly reduced during 1 and 4 week interval(p<0.01). The differences of inferior border distraction gap during biting on the affected side molar area and on the non-affected side molar area were also significantly reduced at 1 and 4 week interval(p<0.01). But the inferior border distraction(compression) gap during non-affected side biting was not significantly changed. From these findings, it could be concluded that fracture line stability during functional loading after one miniplate fixation of mandibular angle fractures stems mainly from reduction of inferior border distraction gap during affected side biting on time interval. According to these radiographic and clinical findings, the clinical superiority of one miniplate fixation technique in mandibular angle fracture treatment could be confirmed.
Purpose: This study was to find a correlation between the bilateral reciprocal leg press test and a the balance in chronic stroke patients. Methods: Eighteen patients performed an isokinetic leg press test consisting of a bilateral reciprocal and unilateral mode. Following the isokinetic leg press testing, subjects performed the balance test: Berg Balance Scale (BBS), Timed Up & Go (TUG) test, and stability limit. Pearson product moment correlation coefficients were used to determine the correlation between the mean score of the isokinetic leg press test, balance test in both affected and non-affected side. Results: This study indicated a significant correlation between the bilateral reciprocal leg press test and stability limit. There were significant correlation between non-affected side bilateral leg press(NBL) and BBS (r=0.501), affected side bilateral leg press (ABL) and non-affected side stability limit(NS) (r=0.614), ABL and total stability limit (TS) (r=0.493), NBL and affected side stability limit(AS) (r=0.480), NBL and NS (r=0.560), NBL and TS (r=0.563), among the patients. Conclusion: Measurement of the lower extremity strength using the bilateral reciprocal leg press test can be used as an evaluating tool of the balance test.
PURPOSE: The purpose of this study was to investigate the effect of balance training on different support surface (affected and non-affected sides) on the balance and gait function of chronic stroke patients. METHODS: The patients were randomly assigned to 1 of 4 groups. Group 1 received balance training on the stable surface, group 2 received balance training on the unstable surface, group 3 received balance training on different support surface (affected side: stable surface, non-affected side: unstable surface), and group 4 received balance training on different support surface (affected side: unstable, non-affected side: stable). Twelve sessions (30 min/d, 3 times/wk for 4 wk) were applied. There were assessed before and after the intervention with Balancia, functional reach test (FRT), lateral reach test (LRT), timed up-and-go (TUG), and 10-meter walking test (10MWT). RESULTS: After the training, all of the groups improved significantly than before training in Balancia, FRT, LRT, TUG, and 10MWT. There were significantly variable in sway distance, FRT, LRT, TUG, and 10MWT among the 4 groups. Post hoc analysis revealed that the group 3 had significantly higher results than other 3 groups in sway distance, and FRT, LRT, TUG, and 10MWT. CONCLUSION: Balance training on different support surface (affected side: stable surface, non-affected side: unstable surface) could facilitate a stronger beneficial effect on balance and walking ability than other balance trainings on different support surface in patients with stroke.
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