The purpose of this study was to analyze the asymmetry of the reaction forces on lower limbs between dominant and nondominant sides during sit-to-stand movement in normal subjects. Fourteen normal subjects ($22.6{\pm}2.3yrs$, all men) participated in this study. To measure the reaction forces during sit-to-stand movement, two force plates were mounted on the ground and one dual top force plate was mounted on a chair. Five events(movement onset, max thigh reaction force, transition, max hip angle, seat off) were determined from the reaction force and joint angle trajectories. For each of thigh, foot, and total reaction forces, two-way ANOVA was performed with the events and sides as factors. Also investigated was the leg asymmetry expressed as the ratio of the reaction forces of dominant and nondominant sides. The significance of asymmetry was investigated and two-way ANOVA was performed with the events and body parts(foot, thigh and total) as factors. Thigh reaction force and total reaction force showed interaction of events and leg sides(p < 0.01). Post-hoc comparisons showed they were different between sides at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Asymmetry was also significant at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Interaction of events and body parts on asymmetry was significant(p < 0.01) and asymmetry was greater in thigh reaction forces than total and foot reaction forces at the events of the latter stage(p < 0.01). The results suggest that asymmetry exist in normal subject and should be fully considered when investigating sit-to-stand strategy of patients.
Objective: The rehabilitation protocols for functional recovery have been emphasized after total knee arthroplasty, and Pilates is in the spotlight as a safe and easily modified exercise method. The purpose of this study was to investigate the effects of mat Pilates exercise on lower extremity function, postural balance, and walking in the individuals with total knee arthroplasty. Design: One group pretest-posttest design. Methods: Eighteen older women with unilateral total knee arthroplasty was recruited in the study. The subjects were evaluated on lower extremity function, postural balance, and walking before and after mat Pilates exercise. All subject performed one hour mat Pilates exercise, 3 times a week for 8 weeks. Mat Pilates exercises were focused on core stability and lower extremity strengthening and, more dynamic movements were added to increase the difficulty of movements every two weeks. The lower extremity function was measured using the Western Ontario and McMaster Osteoarthritis Index (WOMAC), knee joint position sense, and five times sit-to-stand test. Postural balance was assessed by single leg stance test, functional reach test, and timed up and go test. Walking was measured by OptoGait system to temporospatial parameter. Results: The lower extremity function, postural balance, and walking were significantly improved after mat Pilates exercise, except for five times sit-to-stand test (p<0.05). Conclusions: This study demonstrated that the mat Pilates exercise was a useful method to improve lower extremity function, postural balance, and walking in the older women with unilateral total knee arthroplasty.
Purpose: The purpose of this study is to determine the effects of proprioceptive neuromuscular facilitation on the lower extremity function of chronic stroke patients. Methods: The participants consist of 26 chronic stroke patients. They were randomly assigned to either an experimental group (n=13) or a control group (n=13) and engaged in exercise three times per week for eight weeks. The experimental group engaged in proprioceptive neuromuscular facilitation exercises and the control group engaged in general mat exercises. To measure lower extremity strength, the sit to stand test and the static balance test (standing on one leg) were used. To measure the stability index (SI) and weight distribution index (WDI), a Tetrax Portable Multiple System (Tetrax Ltd, Israel) was used in addition to a static balance test (standing on one leg). Results: : Lower extremity strength and static balance showed a significant improvement in the experimental group (p<.05). The SI and WDI were significantly improved in the experimental group (p<.05) for tests of standing with their eyes open, standing with their eyes closed, and standing on a sponge with their eyes open. Conclusion: Proprioceptive neuromuscular facilitation exercises have confirmed that lower extremity function improves after exercise interventions in chronic stroke patients.
Twelve cases in eleven patients with segmental bone defects were treated with contralateral fibula free flap and ipsilateral island fibula flap in an antegrade, retrograde or bidirectional flow fashion. Five cases were managed with free flaps and seven were with ipsilateral fibula island transfer. Among seven cases, antegrade fashion was three, retrograde was three, and bidirectional was one. All patients were related with open tibial fractures and its sequelae except one who had open foot bone fracture. According to Gustilo's classification, ten patients were type IIIb and one was type IIIc. Basically, antegrade-flow flaps based on the peroneal vessels as in the conventional free flap were used for the proximal or middle one-third tibial defects. On the contrary, retrograde-flow flaps based on the communicating branch between the peroneal and posterior tibial vessels were used for the middle or distal one-third of the tibia. Bidirection-flow flap based on intact peroneal vessels were used for the middle portion of the tibia. The patients who have undergone ipsilateral fibula island flap had one of the following problems: a previously failed free flap, below-knee amputation of the opposite leg because of open tibial fracture, refusal to use the contralateral sound leg, or poor general condition to stand a lengthy operation. Six of the patients who have got ipsilateral fibula island flap also had an associated fibula fracture on the same leg, which was ultimately used as one of the osteotomy sites. The follow-up period was from 1 to 10 years. Two cases of free flap were failed: one patient had below-knee amputation and the other patient had ipsilateral fibula transfer. Other cases were successful and excellent hypertophy of the transferred fibula was achieved. Time to bone union ranged from 4 to 11 months. Time to full weight bearing was from 5 to 13 months after surgery. All of the transferred fibulas showed hypertrophy after weight bearing. In one case, stress fracture was developed during ambulation, which was healed conservatively. Nonunion occurred in two cases, which were treated with a long leg cast and cancellous bone graft, respectively. Length discrepancy of the legs was noted. The limb was shorter by an average 0.5 cm in three cases, longer by 1.1 cm in one case. In the case of island fibula transfer, limited arc of rotation was not a problem. Other disabling complications were not seen. We believe that these diverse modalities using a vascularized fibula will make us more comfortable to handle major bone defects.
Journal of the Korean Society of Physical Medicine
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v.19
no.2
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pp.1-16
/
2024
PURPOSE: This study examined the effects of four weeks of gaze stabilization exercises and balance training on the static and dynamic balance functions. METHODS: The study was an assessor-blinded randomized controlled trial conducted at Daegu University in South Korea. Thirty subjects who fulfilled the inclusion criteria were selected and divided randomly into three groups containing ten each. The first group received balance exercises with gaze stabilizing exercises (BGG). The second group received a balance exercise (BEG), and the third group received gaze-stabilizing exercise (GEG). Each group exercised for 40 minutes, three times a week for four weeks. The subjects were asked to complete the following static balance test: 1) one-leg standing test, 2) sharpened Romberg test, dynamic balance test, 3) Y-balance test, and 4) single-leg stand-squat-stand test. The static and dynamic balance were measured before and after four weeks to determine the effect of exercise on balance. RESULTS: The static (OLS and SRT) and dynamic (YBT and SST) balance tests showed significant differences in the surface and length of the three groups (p < .05), and the y-balance score effect size, 11.477 (p < .05), was improved significantly. On the other hand, the change in BGG value was larger than those of BEG and GEG, and the improvements in balance control were the most significant. CONCLUSION: After four weeks of exercise, BGG showed the best improvement in static and dynamic balance, suggesting that this specific type of gaze stabilization exercise with balance exercise may benefit healthy young adults.
This paper proposes a new string controller for puppet which is optimized in terms of the number of motors and its size. To optimize the number of motors needed for generating the essential motions of puppet, the motion of bending a leg is implemented by one string and the walking motion by two legs is implemented by one motor. To minimize the space needed for the controller when generating the essential motions of puppet, cylindrical and articulated joints are used in the controller. The proposed controller is actually implemented to perform various puppet shows and it has been proved that the size of the controller is small enough for two puppets to stand close to shake hands and it is fast enough to simulate fast dance motions.
Purpose: This study examined the effects of an exercise program involving the Proprioceptive Neuromuscular Facilitation (PNF) lower-extremity patterns on the Bone Mineral Density (BMD), balance and lower muscular strength in patients with osteoporosis. Methods: The participants were allocated randomly to 2 groups: experimental group and control group. To evaluate the effects of exercise, the subjects were evaluated using the BMD and Time Up & Go Test and One Leg Stance Test for balance, and the Sit To Stand for lower muscular strength. Results: After the 8 week study, the experimental group showed a significant difference in all items compared to the control groups. Conclusion: These results suggest that a PNF exercise program is effective in patients with osteoporosis. Furthermore, an exercise program involving these patterns can be used in a follow-up program for patients with osteoporosis. Overall, more study will be needed to develop and apply more efficient exercise programs for such patients.
Journal of International Academy of Physical Therapy Research
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v.4
no.2
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pp.557-561
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2013
The purpose of this study to identified the effect of muscle strengthening of ankle joints on postural sway. The subjects of this study were 29 healthy adults aged between 20 and 30 years(male 18, female 11). All subjects received ankle muscle strengthening exercise for 3 times, 3 sessions, 30 minutes per week over 4weeks period. The measured item of muscle strength, postural sway. Data collected from all subjects the result were as follows. The ankle strength showed significant increase(p<.05). One leg stand test with eye close increase in static balance(p<.05), left-right sway distance and anterior-posterior sway distance with eye open and close in static balance(p<.05). The result findings show that strength of the ankle joint muscles is a factor which affects postural sway and the ankle joints are important in static balance.
An, Seungheon;Jee, Youngju;Lee, Donggeon;Song, Sunhae;Lee, Gyuchang
Physical Therapy Rehabilitation Science
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v.5
no.1
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pp.1-8
/
2016
Objective: The present study was to investigate the discrimination capacity of the Performance Oriented Mobility Assessment-Gait Scale (POMA-GS), for predicting falls in stroke survivors. Design: Retrospective cohort study. Methods: Data including the characteristics and number of falls of 52 chronic stroke patients from a rehabilitation center were collected. The number of falls each subject had experienced in the previous year were investigated through interviews. The subjects were divided into two groups depending on the number of falls: if falls occurred twice or more on the basis of the time of study after stroke, they were defined as the falls group and if there was no fall experience or one fall, they were defined as the non-falls group. The subjects were examined with the POMA-GS, and physical functions were examined using by the One Leg Stand Test (OLST), Sit to Stand Test (SST), 10-m Walk Test, Lower Extremity in Fugl-Meyer assessment (FM-LE), and Trunk Impairment Scale (TIS). The validity of POMA-GS for falls prediction was analyzed. Results: In the POMA-GS, which predicts falls in stroke survivors, the cut-off value was 8.5 (sensitivity 72%; specificity 65%) and the area under the curve was 0.75 (95% confidence interval: 0.60-0.90, p<0.007). There was a significant difference in the OLST, SST, FM-LE, and TIS between the subjects with POMA-GS >8.5 and the subjects with POMA-GS ${\leq}8.5$. Conclusions: The POMA-GS could be a useful tool in predicting falls in stroke survivors, as its discrimination capacity and predictive validity is proven satisfactory.
Park, Da Won;Won, Cho Rong;Lee, Sung Ro;Park, Yang Sun
Korean Journal of Applied Biomechanics
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v.26
no.3
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pp.323-331
/
2016
Objective: The aims of this study were 1) to develop easy-to-use rhythmic balance training equipment for the elderly and 2) to investigate the effect of training with the equipment on balance and physical function. Method: Twenty-one elderly individuals (age: $75.4{\pm}3.34yrs$, height: $152.07{\pm}4.81cm$, weight: $58.35{\pm}8.34kg$) participated in this study. Each participant underwent balance and physical function testing before and after 12 weeks of training with the equipment. Y-balance (i.e. dynamic balance) and one leg static balance tests were used for balance testing, and timed up- and-down-stairs and five times sit-to-stand tests were used for physical function testing. A paired t test was used to determine whether there was a significant pre- and post-training difference. Results: The rhythmic balance training equipment provided a fun and motivating training program with age-friendly music, dance movements for lower extremity strength training, and touch screen controls with simple features. Post-training left foot dynamic balance was significantly greater (p<.05), and static balance with eyes open was significantly improved (p<.05) compared to pre-training. Completion of the timed up-and-down-stairs and the five times sit-to-stand tests was significantly shorter (p<.05) compared to pre-training. Conclusion: Training using the equipment developed in this study improved balance and physical function in elderly participants.
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