• Title/Summary/Keyword: Postural control

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A Study of Intervention for Adolescent Idiopathic Scoliosis (청소년기 특발성 척추측만증의 중재에 관한 연구)

  • Kim, Seung-Joon
    • The Journal of Korean Physical Therapy
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    • v.16 no.1
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    • pp.60-69
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    • 2004
  • Many methods have been described for the early intervention of adolescent idiopathic scoliosis. Adolescent idiopathic scoliosis is lateral and rotational spinal curvature in absence of associated congenital or neurologic abnormalities, the most common type of scoliosis observed in child and young adults, and refers to curves that develop after the age of $10{\sim}18$. The curves of adolescent idiopathic scoliosis have the potential to progress rapidly during growth. Curves are currently universally measured by the Cobb's method and Ferguson method. Some curves do not remain small, these may be mildly or severely progressive and the ribs on the convex side of the curve separate, and those on the concave side ribs approximate so rib undergoes deformation with rib humping. The latter may make angles that can affect vestibular system, balance, sensory, especially cardipulmonary function. Intervention for adolescent idiopathic scoliosis is based on the patient's age, the angular value of the curve, the maturity of their skeleton, and the topography. The purpose of intervention for adolescent idiopathic scoliosis consists of knowing how to go to the best approach the correction of the lateral curve and rotational deformity holding the achieved for the remainder of spinal growth, preventing significant cosmetic abnormality, pain and cardiopulmonary complication, control the muscle imbalance and proprioceptive postural disturbances, be less need for radical surgery to avoid early surgery.

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Effects of Lumbar Stabilization Exercise on Motor Neuron Excitability and Pain in Patients with Lumbar Disc Herniation

  • Kang, Jeongil;Jeong, Daekeun;Choi, Hyunho
    • Journal of International Academy of Physical Therapy Research
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    • v.10 no.2
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    • pp.1785-1790
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    • 2019
  • Background: Lumbar disc herniation (LDH) causes neurological symptoms by compression of the dura mater and nerve roots. Due to the changed in proprioception inputs that can result in abnormal postural pattern, delayed reaction time, and changed in deep tendon reflex. Objective: To investigate the effects of lumbar stabilization exercises on motor neuron excitability and neurological symptoms in patients with LDH. Design: Randomized Controlled Trial (single blind) Methods: Thirty patients with LDH were recruited; they were randomly divided into the balance center stabilization resistance exercise group (n=15) and the Nordic walking group (n=15). Each group underwent their corresponding 20-minute intervention once a day, four times a week, for four weeks. Participants' motor neuron excitability and low back pain were assessed before and after the four-week intervention. Results: There were significant differences in all variables within each group (p<.05). There were significant differences between the experimental and control groups in the changes of upper motor neuron excitability and pain (p<.05), but not in the changes of lower motor neuron excitability and Korean Oswestry Disability Index. Conclusion: Lumbar stabilization exercises utilizing concurrent contraction of deep and superficial muscles improved low back function in patients with LDH by lowering upper motor neuron excitability than compared to exercises actively moving the limbs. Lumbar stabilization exercises without pain have a positive impact on improving motor neuron excitability.

The Role of Vitamin D in the Pathogenesis of Adolescent Idiopathic Scoliosis

  • Ng, Shu-Yan;Bettany-Saltikov, Josette;Cheung, Irene Yuen Kwan;Chan, Karen Kar Yin
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1127-1145
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    • 2018
  • Several theories have been proposed to explain the etiology of adolescent idiopathic scoliosis (AIS) until present. However, limited data are available regarding the impact of vitamin D insufficiency or deficiency on scoliosis. Previous studies have shown that vitamin D deficiency and insufficiency are prevalent in adolescents, including AIS patients. A series of studies conducted in Hong Kong have shown that as many as 30% of these patients have osteopenia. The 25-hydroxyvitamin D3 level has been found to positively correlate with bone mineral density (BMD) in healthy adolescents and negatively with Cobb angle in AIS patients; therefore, vitamin D deficiency is believed to play a role in AIS pathogenesis. This study attempts to review the relevant literature on AIS etiology to examine the association of vitamin D and various current theories. Our review suggested that vitamin D deficiency is associated with several current etiological theories of AIS. We postulate that vitamin D deficiency and/or insufficiency affects AIS development by its effect on the regulation of fibrosis, postural control, and BMD. Subclinical deficiency of vitamin K2, a fat-soluble vitamin, is also prevalent in adolescents; therefore, it is possible that the high prevalence of vitamin D deficiency is related to decreased fat intake. Further studies are required to elucidate the possible role of vitamin D in the pathogenesis and clinical management of AIS.

A Study for Hip Joint in Children with Cerebral Palsy (뇌성마비 아동의 엉덩관절에 관한 연구)

  • Oh, Tae-young
    • The Journal of Korean Society for Neurotherapy
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    • v.22 no.3
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    • pp.43-48
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    • 2018
  • Purpose The purpose of this study is to identify the prevalence, risk factors, characteristics, and interventions of hip joint problems in children with cerebral palsy, and to be able to serve as leverage for early detection, prevention, and function recovery. Method The electronic journal site was searched by the search terms "cerebral palsy", "hip joint", "hip joint dislocation", we analyzed and descript the cited articles from domestic and foreign papers in Pubmed 9, Science Direct 7, and K RISS analysis and analysis. Results Children with cerebral palsy showed the different prevalence according to their disability type, severity, and functional level, and we knew that abnormal neuromuscular control, stiffness, and biomechanical changes could be risk factors. Migration Index, Acetabolum Index, Neck shaft angle using by radiography and passive ROM test, special tests were available for the diagnosis and evaluation of the hip joint. Combination of physical therapy and orthopedic surgery was very important intervention, and complementary alternative therapy, orthosis, and postural assistant are effective. Conclusion We suggested that early detection and prevention is the most important periodic examination and that a multidisciplinary approach is a major factor in intervention.

Factors Influencing Activities-specific Balance Confidence in Community-dwelling Old Adults (지역사회 거주 노인의 활동 특이적 균형자신감에 영향을 미치는 요인)

  • Kim, Hee Ryang;Ko, Young
    • Research in Community and Public Health Nursing
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    • v.29 no.4
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    • pp.520-529
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    • 2018
  • Purpose: The purpose of this study is to identify factors influencing activities-specific balance confidence in community-dwelling older adults. Methods: This is secondary analysis of data from an intervention study for improving cognitive function. The data were collected from March 2 to September 30, 2017 at a senior center. Data of 131 older adults were included for this secondary analysis, and were analyzed by using t-test, ANOVA, and multiple regression. Results: The mean score of activities-specific balance confidence is 65.08 out of a possible range of 0-100. The significant factors affecting activities-specific balance confidence among old adults include 'more than 85 years old', 'waist circumference', 'depressive symptoms', 'activity restriction due to fear of falling', and 'self-rated health' which explained 52.8% of the variance. Conclusion: The study results indicate that psychologic factors as well as physical condition should be considered for interventions to increase activities-specific balance confidence.

The Effects of Walking and Turning and Treadmill Training on Postural Balance and Walking in People with Parkinson's Disease

  • Bang, Dae-Hyouk;Jeong, Wang-Mo
    • PNF and Movement
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    • v.17 no.2
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    • pp.189-197
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    • 2019
  • Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson's disease (PD). Methods: Twenty-four participants with Stage 1 to 3 ($2.13{\pm}0.64$) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson's disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081-6.519), BBS (p = 0.042; 95% CI, 1.375-4.541), TUG (p = 0.034; 95% CI, -3.315--0.143), 10MWT (p = 0.011; 95% CI, -2.032--0.289), and 6MWT (p = 0.002; 95% CI, 24.39-91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

Functional Connections of the Vestibulo-spino-adrenal Axis in the Control of Blood Pressure Via the Vestibulosympathetic Reflex in Conscious Rats

  • Lu, Huan-Jun;Li, Mei-Han;Li, Mei-Zhi;Park, Sang Eon;Kim, Min Sun;Jin, Yuan-Zhe;Park, Byung Rim
    • The Korean Journal of Physiology and Pharmacology
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    • v.19 no.5
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    • pp.427-434
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    • 2015
  • Significant evidence supports the role of the vestibular system in the regulation of blood pressure during postural movements. In the present study, the role of the vestibulo-spino-adrenal (VSA) axis in the modulation of blood pressure via the vestibulosympathetic reflex was clarified by immunohistochemical and enzyme immunoassay methods in conscious rats with sinoaortic denervation. Expression of c-Fos protein in the intermediolateral cell column of the middle thoracic spinal regions and blood epinephrine levels were investigated, following microinjection of glutamate receptor agonists or antagonists into the medial vestibular nucleus (MVN) and/or sodium nitroprusside (SNP)-induced hypotension. Both microinjection of glutamate receptor agonists (NMDA and AMPA) into the MVN or rostral ventrolateral medullary nucleus (RVLM) and SNP-induced hypotension led to increased number of c-Fos positive neurons in the intermediolateral cell column of the middle thoracic spinal regions and increased blood epinephrine levels. Pretreatment with microinjection of glutamate receptor antagonists (MK-801 and CNQX) into the MVN or RVLM prevented the increased number of c-Fos positive neurons resulting from SNP-induced hypotension, and reversed the increased blood epinephrine levels. These results indicate that the VSA axis may be a key component of the pathway used by the vestibulosympathetic reflex to maintain blood pressure during postural movements.

Comparison of Abdominal Muscle Thickness Between the Nonparetic and Paretic Side During Quiet Breathing in Patients With Chronic Stroke (만성 뇌졸중 환자에서 편안한 호흡 시 건측과 마비측으로 복근 두께 비교)

  • Lee, Young-Jung;Lee, Gyu-Wan;Yi, Chung-Hwi;Cynn, Heon-Seock
    • Physical Therapy Korea
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    • v.18 no.3
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    • pp.8-15
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    • 2011
  • Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

The Effects of Repetitive Transcranial Magnetic Stimulation on Balance Ability in Acute Stroke Patients

  • Ji, Sang-Goo;Shin, Young-Jun;Kim, Myoung-Kwon
    • Journal of the Korean Society of Physical Medicine
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    • v.11 no.3
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    • pp.11-17
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    • 2016
  • PURPOSE: The aim of the present study was to determine whether high frequency repetitive transcranial magnetic stimulation (rTMS) can improve balance ability in acute stage stroke patients. METHODS: The study was conducted on 30 subjects diagnosed with hemiparesis caused by stroke. The experimental group consisted of 15 patients that underwent rTMS for 15 mins and the control group consisted of 15 patients that underwent sham rTMS (for 15 minutes). A 70-mm figure 8 coil and a Magstim Rapid stimulator was used in both groups. Patients in the experimental group received 10 Hz rTMS applied to the hotspot in the lesioned hemisphere in 10-second trains with 50-second intervals between trains, for 15 minutes (total 2,000 pulses). Both groups received conventional physical therapy for 30 minutes a day, 5 days a week, for 4 weeks. Static balance ability analysis was performed using the Gaitview system to measure pressure rate, postural sway, and total pressure, and dynamic balance ability analysis was performed to measure pressure variables using a balance system. RESULTS: A significant difference was observed in post-training gains for pressure rate, total pressure in static balance, and overall stability index in dynamic balance between the experimental group and the control group (p<.05). CONCLUSION: The results of this study indicate that high frequency rTMS may be beneficial for improving static and dynamic balance recovery in acute stroke patients.

Evaluation of the Usefulness of Ancillary Devices for Patients with Acute Lumbar Pain During Magnetic Resonance Imaging (자기공명영상검사 시 급성 요추 통증 환자를 위한 보조기구의 유용성 평가)

  • Park, Hee-Wang;Lee, Moo-Sik;Kim, Yong-Kwon;Bae, Seok-Hwan
    • Journal of radiological science and technology
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    • v.41 no.3
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    • pp.193-199
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    • 2018
  • The purpose of this study was to evaluate the convenience and image quality of patients with acute lumbar pain patients at a general hospital in Daejeon using ancillary devices for postural changes and correction. The results of the study are summarized as follows. First, the Turbo S pin Echo technique(TS E) using ancillary equipment has the highest image evaluation rating with an average score of 4.440, which is highly valuable on a diagnosis. Second, the average score for patient the questionnaire 'When using ancillary equipment, I feel that my body is calibrated to side without bias.' was shown as 4.440, which is very useful for the correction of the patient's body when using ancillary equipment. Finally, Breath Hold technique(BH) is very effective in shortening test time of acute lumbar pain patients, because it can reduce test time 86.4% faster than Turbo Spin Echo technique(TSE). The results of the study showed that the use of ancillary equipment to perform the test through the side lying postures helped to reduce the pain and control the patient's breathing, and the diagnostic value of the image was high.