Purpose: The purpose of this study was to develop a training program for swallowing and to test its effect on swallowing capacity and nutritional status among nursing home residents with stroke. Methods: A swallowing training program was developed by literature review, expert validation and a pilot test. A pretest and posttest quasi-experimental study design with nonequivalent control group was used to evaluate the effectiveness of the program. Swallowing training was conducted for thirty minutes, three times a week for 8 weeks. Swallowing capacity including dysphagia screening score, swallowing symptom questionnaire and tongue pressure, and nutritional status including body mass index and mid arm muscle circumference were measured at the baseline and at 8 weeks. Results: The exercised-based swallowing training program consisted of oromotor exercise, expiratory muscle strength exercise and effortful swallow. The participants were 77.2 years old on average. At the completion of 8-week program, the experimental group showed better scores in dysphagia screening (p=.039) and swallowing symptom questionnaire (p=.004) and a significant increase in tongue pressure (p=.003). Conclusion: The exercised-based swallowing training program was safely applied to nursing home residents with stroke and showed a significant improvement of swallowing capacity. Further studies are needed to identify its effect on the nutritional status.
Purpose: The purpose of this study was to investigate the effect of trunk-stabilization training using stabilizing reversal and rhythmic stabilization techniques of PNF on trunk muscle strength and respiratory function in elderly stroke patients. Methods: There were 26 stroke patients included in the study. Patients were divided into two groups, and all patients performed exercise 30 min five times per week for six weeks. The experimental group performed trunk stability exercise using stabilizing reversal and rhythmic stabilization techniques of PNF, and the control group performed flexibility and strength training. Trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure were measured to determine the changes after the intervention. For statistical processing, a paired t-test was performed within the group, and the value after intervention was performed as an independent t-test to find out the difference between the two groups. Results: In the experimental group, all of the trunk muscle strength, forced vital capacity, maximum inspiratory pressure, and maximum expiration pressure showed significant differences according to the intervention. In the control group, there were statistically significant differences in trunk muscle strength and forced vital capacity, but the maximum inspiratory pressure and the maximum expiration pressure did not show any statistical change. Conclusion: From these results, it can be seen that the trunk stability exercises that use the proprioceptive neuromuscular promotion method of stable reversal and rhythm stabilization can be a good intervention for the respiratory function of stroke patients.
Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.
The Journal of Korean Academy of Orthopedic Manual Physical Therapy
/
v.20
no.1
/
pp.21-26
/
2014
Background: This study was aimed to determine the effects of deep abdominal muscle exercises (DAME) and thoracic mobility exercises (TME) on pulmonary function. Methods: This study was conducted with 22 college students who are in their 20s and have no problem carrying out activities of daily living. All subjects were randomly assigned to either the DAME group (11) or the TME group (11) to undertake the exercises for 2 weeks. To measure pulmonary function of subjects, forced vital capacity (FVC), forced exploratory volume in 1 second (FEV1) and peak expiratory flow (PEF) were measured using chest graph. Chest expansion of subjects was also measured with tape ruler. These measurements were performed on the first day before the exercise program started and on the next day after the 2-week exercise program was completed. A paired-t test was performed to compare the differences in pulmonary function before and after the exercise program, and an independent t-test was performed to compare the two groups. Results: The results of this study were as follows: 1) In comparison of pre- and post-exercise changes in the DAME and TME groups, both groups showed significant increase in chest expansion and PEF after the exercise program, compared with the baseline data (p<.05). Both groups also demonstrated improvements in FVC and FEV1 after the exercise program, compared with the baseline data. However, the differences were not statistically significant (p>.05). 2) The comparison of the DAME and TME groups revealed no significant differences in chest expansion, FVC, FEV1 and PEF (p>.05). Conclusion: It is therefore concluded that both DAME and TME were effective in improving pulmonary function.
Alvarez A.I.;Oliveira A. C. Cabral de;Perez A.C.;Vila L.;Ferrando A.;Prieto J.G.
Proceedings of the Ginseng society Conference
/
2002.10a
/
pp.159-175
/
2002
The effect of Panax ginseng administration in muscle inflammatory process induced after eccentric exercise, that causes myofibrillar disruption, was studied. Changes in lipid peroxidation, inflammation, glycogen levels in muscle and release of myocellular proteins to blood were measured. The analyses were performed immediately after eccentric exercise and over week since this period are necessary for the muscle damage-repair cycle. The ginseng extract $(100\;mg\;kg^{-1})$ was orally administered to rats for three months, before the eccentric exercise performance. The results showed the protective role of ginseng against skeletal muscle damage. This effect could be associated with their membrane stabilising capacity since creatine kinase (CK) activity was significantly decreased 96 h post-exercise from $523{\pm}70\;to\;381{\pm}53$ and 120 h post-exercise from $443{\pm}85\;to\;327{\pm}75$ in treated animals. ${\beta}-glucuronidase$ activity, as indicator of inflammation, showed a significant reduction of about $15-25\%$ in soleus, vastus and triceps in these post-exercise times. The lipid peroxidation, measured by malondyaldehyde levels, was significantly decreased in the 24 h postexercise period in soleus and vastus intermedius muscles and on the recovery period. Finally ginseng administration reduced significantly the decrease of the glycogen levels immediately after exercise and when the regenerative process took place (72-168 h post exercise). Collectively, the results have showed that ginseng did not inhibit the vital inflammatory response process associated with the muscle damage-repair cycle but presumably ameliorate the injury.
Purpose: This study demonstrated a postural alignment exercise as conservative management strategy for a woman with excessive thoracic kyphosis presenting decreased chest function, and reports its results. Methods: A 21-year-old woman with thoracic kyphosis presenting limited chest function. The exercise program underwent for 30 min in the intervention phase, which consisted of exercises to improve the strength of back extensor and to stretch anterior chest region. Outcome measures comprised the severity of thoracic kyphosis and chest function (vital capacity [VC], forced expiratory volume in a second [FEV1], and chest expansion length). Results: The thoracic kyphotic angle decreased by 23.6% ($9.38^{\circ}$) and 25.4% ($10.58^{\circ}$) in the intervention and follow-up phases respectively. Also, chest function was improved in the intervention (VC: 3.7% [$0.10{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 17.1% [0.96 cm]), and the improvement was maintained during the follow-up phase (VC: 4.8% [$0.13{\ell}$], FEV1: 17.1% [$0.39{\ell}$], and chest expansion length: 64.3% [1.81 cm]). Conclusion: These findings suggest that the postural alignment exercise was favorable for improving chest function of a woman with thoracic kyphosis.
The objective of this study was to make comparison of the physical work capacities(PWCs) for three different types of tasks. For this purpose, an ergometer exercise, a treadmill exercise, and lifting activities with four different frequencies (2, 5, 8, 11 lifts/min) for the lifting range from floor to 76cm were considered. Oxygen consumption rates and heart rates were measured during the exercises and lifting activities. The PWC values for ergometer exercise test was $2562.71ml-O_2/min$ and the one for treadmill exercise was $2874.89ml-O_2/min$. The value of lifting PWC increased from $1774.07ml-O_2/min$ to $2296.76ml-O_2/min$ as the lifting frequency increased from 2 to 11 lifts/min. The ratio of the lifting PWCs to the ergometer PWC increased from 69.36% to 89.77% as the lifting frequency increased. To the treadmill PWC, the ratio increased from 62.21% to 85.24% as the lifting frequency increased. From this result, it appears that the PWCs based on the lifting tasks rather than PWCs by ergometer or treadmill exercise should be considered to determine the physiological criterion for safe weights for lifting tasks. Therefore, the physiological criteria of the NIOSH Guideline should be reexamined.
This study aimed to evaluate the effect of a weekly circuit-group exercise program on functional performance, flexibility of the trunk and lower extremities, and balance in individuals with chronic stroke who are living in a community. Thirteen community-living individuals (eleven males and two females) with chronic stroke participated in this study. The group exercise program was set up as a weekly circuit application with four stations aiming to strengthen the muscles, increase endurance, improve flexibility, and enhance functional capacity. The average duration of a session was an hour, and the sessions were conducted once a week for six months for a total of 24 sessions. Assessments for functional performance, flexibility of the trunk and lower extremities and balance were conducted four times: before treatment, after one month of treatment, after four months of treatment, and after six months of treatment. There were significant improvements in functional performance and flexibility of the trunk and lower extremities in the given time frame. No significant improvement was observed in balance ability. The findings suggest that a weekly circuit-group exercise program has some benefits in terms of managing the physical symptoms of individuals with mobility problems after stroke. Therefore, this program can be adapted and employed as a community-based rehabilitation program for such patients. Further studies with various community-based treatments will be conducted to validate these findings.
The decrease of muscle power and muscle size between twenties and seventies was about 30% and 40% respectively. The loss of muscle mass by aging resulted in the decrease of muscle power. The loss of muscle mass was due to the decrease of number of Type I fiber and Type II fiber and size of each muscle fiber. The aging skeletal muscle didn't show the loss of glycolysis capacity but showed 20% decrease of the oxidative enzymes and muscle vascularization. The vigorous endurance exercise training with graded intensity played a role in the vascular proliferation, increase of activity of oxidative enzymes and improvement of $VO_2$ max. The graded resistance exercise also played a role in the muscle hypertrophy and increase of muscle power, if it performed with adequate intensity and period. The exercise adaptation of aging skeletal muscle prevented it from sarcopenia, provided the activity of daily living with great effect and provided the aging related disease, that is Type II diabetes mellitus, arteriosclerosis, hypertension, osteoporosis and obesity, with great effect.
The objective of this study was to make comparison of the physical work capacities(PWCs) for three different types of tasks. For this purpose, an ergometer exercise, a treadmill exercise, and lifting activities with four different frequencies (2, 5, 8, 11 lifts/min) for the lifting range from floor to 76cm were considered. Oxygen consumption rates and heart rates were measured during the exercises and lifting activities. The PWC values for ergometer exercise test was 2562.71 ml-O$_{2}$/min and the one for treadmill exercise was 2874.89 ml-0$_{2}$/min. The value of lifting PWC increased from 1774.07ml-0$_{2}$/min to 2296.76 ml-0$_{2}$/min as the lifting frequency increased from 2 to 11 lifts/min. The ratio of the lifting PWCs to the ergometer PWCs increased from 69.36% to 89.77% as the lifting frequency increased. To the treadmill PWCs, the ratio increased from 62.21% to 85.24% as the lifting frequency increased. From this result, it is appears that the PWCs based on the lifting tasks rather than PWCs by ergometer or treadmill exercise should be considered to determine the physiological criterion for safe weights for lifting tasks. Therefore, the physiological criteria of the NIOSH Guideline should be reexamined.
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