Objective: This study aimed to investigate the impact of a 12-week combined cognitive and physical exercise program on cognitive and physical functions in older adults diagnosed with mild cognitive impairment (MCI). Design: A one-group pretest-posttest study. Methods: Twelve participants with MCI engaged in a weekly 60-minute session of combined cognitive and physical exercise program. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA), while physical function was evaluated through measures of muscle strength, postural balance, and walking capabilities. Muscle strength assessments included the arm curl test, handgrip strength, and the 5 sit-to-stand test. Postural balance was evaluated using the one-leg stance test, timed up-and-go test, functional reach test, and four square step test. Walking function was analyzed through a gait analysis device. Pre- and post-intervention measurements were compared to determine the effects of the exercise program. Results: The results demonstrated significant improvements in MoCA, arm curl test, timed up-and-go test, walking speed, and cadence following the 12-week intervention (p<0.05). MoCA scores revealed enhanced cognitive performance, while measures of muscle strength, including the arm curl test, exhibited significant changes. Improvements in timed up-and-go test scores indicated enhanced mobility, accompanied by increased walking speed and cadence, as evidenced by gait analysis. Conclusions: This study suggests that a structured 12-week program incorporating both cognitive and physical exercises can lead to meaningful improvements in cognitive and physical functions among older adults with MCI.
The purpose of this study was to determine the reliability and validity of the postural balance program which uses the movement accelerating field principles of posture balance training and evaluation equipment and smartphone movement accelerometer program (SMAP) in healthy young adults. A total of 34 people were appointed as the subject among the healthy young adults. By using Biodex stability system (BSS) and SMAP on the subject, the posture balance capability was evaluated. For the test-retest reliability, SMAP showed the intra-class correlation (ICC: .62~.91) and standard error measurement (SEM: .01~.08). BSS showed the moderate to high reliability of ICC (.88~.93) and SEM (.02~.20). In the reliability of inter-rater, ICC (.59~.73) as to SMAP, showed the reliability of moderate in eyes open stability all (EOSA), eyes open stability anterior posterior (EOSAP), eyes open stability medial lateral (EOSML) and eyes open dinamic all (EODA), eyes open danamic anterior posterior (EODAP), and eyes open danamic medial lateral (EODML). However, ICC showed reliability which was as low as .59 less than in other movements. In addition, BSS showed the reliability of high as ICC (.70~.75). It showed reliability which was as low as ICC (.59 less than) in other movements. In correlation to the balance by attitudes between SMAP and BSS, EOSML (r=.62), EODA (r=.75), EODML (r=.72), ECDAP (r=.64), and ECDML (r=.69) shown differ significantly (p<.05). However, the correlation noted in other movements did not differ significantly. Therefore, SMAP and BSS can be usefully used in the posture balance assessment of the static and dynamic condition with eyes opened and closed.
Objectives The purpose of this study was to examine the effects muscle fatigue at the knee muscles on balance during standing in healthy adults. Methods Thirty healthy adults were recruited along with their written informed consent. Subjects were randomly assigned to knee extensor group (fatigue on knee extensor, KE), and knee flexor group (fatigue on knee flexor, KF). And subjects performed exercise with each muscle group until muscle fatigue was induced. They were assessed balance ability by functional reaching test (FRT), limit of stability (LOS), and postural sway (one leg standing, normal eye open (NO), normal eye close (NC), pillow with eye open (FO), and pillow with eye close (FC)) before and after fatigue. Results There were significant group differences balance performances in FRT, anterior of limit of stability, one leg standing, and the muscle fatigue of knee muscles were decreased balance performances. The balance performance was affected by visual sense and proprioception. Conclusions These results show that the muscle fatigue of knee muscles decreased balance performance. Therefore, balance exercise program should be trained without muscle fatigue.
This paper investigated the effects of dynamic postural control for maintaining upright standing on a support surface during continuous sinusoidal horizontal translation in anterior-posterior direction. 15 healthy young subjects participated in this experiment. The analysis of body movement was analyzed using Ariel Performance Analysis System. Motion pattern was analyzed by seven markers on subject's body. Position of markers were head, chest, hip, right knee, left knee, right ankle and left ankle. Seven different frequencies of support surface were employed ; 0.1, 0.25, 0.5, 0.75, 1, 1.5 and 2Hz at 2cm of moving path of motionbase. The experiments were performed dynamic postural reponses at the condition of eye open. The results showed that median frequency of the knee, ankle were increased in all frequency bands. Following the frequency of perturbation increased, postural control strategy was changed from ankle strategy to combined strategy. The experiment results could be applied to the dynamic postural training for the elderly and the rehabilitation training for the patients to improving the ability of postural control.
Objective: The purpose of this research was to determine the immediate effects of wearing a foot-pressure-based insole (FPBI) on ankle dorsiflexion range of motion (DFROM), postural sway, and muscle activation in healthy individuals with genu varum. Design: Cross-sectional study. Methods: This study was conducted on thirteen adults, with six male and seven females subjects. The mean age was 24.08 years. Foot pressure was measured to apply the FPBI and the weight bearing lunge test was performed with the application of a flat insole (FI) and FPBI. Examination was randomly performed in four conditions to measure both postural sway and muscle activation. All participants applied both the FI and FPBI with four conditions. The four conditions were as follows: 1) Romberg test posture with eyes closed, 2) Romberg test posture with eyes opened, 3) dominant single leg standing with eyes opened, and 4) non-dominant single leg standing with eyes opened. Results: For ankle DFROM between the FI and FPBI, a significant increase was observed in both the dominant and non-dominant leg (p<0.05). For postural sway between the FI and FPBI in the Romberg test posture with eyes closed and dominant single leg standing with eyes opened conditions, a significant decrease was observed (p<0.05). However, the postural sway between FI and FPBI in the Romberg test posture with eyes opened and non-dominant single leg standing with eyes opened, no significant decrease was observed. Also, there were no significant effects on muscle activation between the application of the FI and FPBI. Conclusions: The result showed that FPBI immediately improved ankle DFROM and postural sway. It seems that FPBI may improve genu varum in healthy individuals with genu varum.
This paper presents the development of a robotic system for rehabilitation of the trunk's ability to maintain postural control under different balance conditions. The system, developed with extensive input from rehabilitation and biomedical engineering experts, consists of a seat mounted on a robotic mechanism capable of moving it with four degrees of freedom (3 rotational and 1 translational). The seat surface has built in instrumentation to gauge the movements of the user's center of pressure (COP) and it can be moved either to track the movements of the COP or according to operator given commands. The system allows two types of leg support. A ground mounted footrest allows participation of legs in postural control while a seat connected footrest constrains the leg movement and limits their involvement in postural control. The design evolution over several prototypes is presented and computer aided structural analysis is used to determine the feasibility of the designed components. The system is pilot tested by a stroke patient and is determined to have potential for use as a trunk rehabilitation tool. Future works involve more detailed studies to evaluate the effects of using this system and to determine its efficacy as a rehabilitation tool.
Objective: Stroke patients need the training to adjust their posture and maintain balance is necessary to restore movement function, and unstable support training is one of the appropriate training. In this study, a systematic review and meta-analysis were conducted to find out the effects of unstable surface training on balance and gait in stroke patients. Design: Systematic review and meta-analysis Methods: After creating a search expression referring to MeSH and EMTREE, the literature from 1976 to February 2022 was searched in the databases of PubMed, EMBASE, and Cochrane Library CENTRAL. A total of 331 studies were searched from three databases, and 11 studies were finally selected according to the inclusion criteria. Unstable surface training included studies using balance trainer, Whole-body vibration, and sand surfaces. Results: The results were found to be d=2.28 (p=0.02) and the effect size was 0.36 (95% CI: 0.05, 0.67) on the Berg Balance Scale. In the Kinesthetic Ability Trainer static balance, d=2.59 (p=0.01) and the effect size was 1.01 (95% CI: 0.24, 1.78). Timed Up and Go test showed that d=2.18 (p=0.03) and the effect size was 0.38 (95% CI: 0.04, 0.72). At the gait speed, d=0.99 (p=0.32) and the effect size was 0.15 (95% CI: -0.15, 0.45). In the 6-minute walk test, d=0.14 (p=0.89) and the effect size was 0.04 (95% CI: -0.47, 0.55). Conclusions: In this study was found that training was effective in balance if it became unstable in standing posture. Therefore, unstable surface training can be used to improve the balance of stroke patients in clinical practice.
Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.
Purpose : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke. Methods : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks. Results : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group. Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.
Objective To investigate the effect of treadmill training with eyes open (TEO) and closed (TEC) on the knee joint position sense (JPS), functional balance and mobility in children with spastic diplegia. Methods Forty-five children with spastic diplegia aged 11-13 years participated in this study. They were randomly assigned to three groups of equal number. The control group (CON) underwent designed physical therapy program whereas, the study groups (TEO and TEC) underwent the same program, in addition to treadmill gait training with eyes open and closed, respectively. Outcome measures were the degree of knee joint position error, functional balance and mobility. Measurements were taken before and after 12 weeks of intervention. Results After training, the three groups showed statistically significant improvement in all measured outcomes, compared to the baseline with non-significant change in the knee JPS in the CON group. When comparing posttreatment results, the TEC group showed greater significant improvement in all measured outcomes, than the TEO and CON groups. Conclusion Treadmill training with eyes open and closed is effective in rehabilitation of children with diplegia, but blocked vision treadmill training has more beneficial effect.
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