• Title/Summary/Keyword: Rehabilitative and Physical Therapy

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Biomechanical Properties of the Anterior Walker Dependent Gait of Patients with Knee Osteoarthritis (무릎관절 골관절염 환자의 보행기 보행에서 생역학적 특성)

  • Lee, In-Hee;Kwon, Gi-Hong;Park, Sang-Young
    • The Journal of Korean Physical Therapy
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    • v.25 no.5
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    • pp.239-245
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    • 2013
  • Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.

Effects of Aerobic Exercise Using a Flex-band on Physical Functions & Body Image in Women Undergoing Radiation Therapy after a Mastectomy (탄력 밴드를 이용한 유산소운동이 유방절제술여성의 신체적 기능과 신체상에 미치는 효과)

  • So, Hyang-Sook;Yoon, Jung-Han;Kim, In-Sook;Park, Oh-Jang
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1111-1122
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    • 2006
  • Purpose: This study examined the effects of aerobic exercise using a flex band on the improvement of physical functions & body image in breast cancer women undergoing radiation therapy after a mastectomy. Method: Women with breast cancer(n =26) were assigned to an experimental group(EG, n = 15) and control group(CG, n = 11). The E.G participated in an aerobic exercise program with a 60% to 80% intensity of maximal heart rate for 25 minutes during the main exercise, 3 times per week, for 6 weeks. The EG did not exercise regularly for 3 months before participating in this program. The CG received no exercise treatment during the research period. Data were analyzed using the $x^2-test$ and Mann-Whitney U test by the SPSS version 11.0 program at a 5% significant level. Results: Group analysis revealed that the EGwomen had significantly more improved cardio-pulmonary functions, ROM of the affected shoulder joint, and body image compared to the CG, Conclusion: Aerobic exercise using a flex band may be an effective rehabilitative measure for mastectomy women with respect to cardio-pulmonary functions, ROM, & body image. Further studies are recommended to study early rehabilitation programs within 10 days post-operatively.

A Comparison of Assessment Tools for Prediction of Falls in Patients With Stroke (뇌졸중 환자의 낙상 예측을 위한 평가도구 비교)

  • Won, Jong-Im
    • Physical Therapy Korea
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    • v.21 no.2
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    • pp.37-47
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    • 2014
  • Falls are common after stroke and most frequently related to loss of balance while walking. Consequently, preventing falls is one of the goals of acute, rehabilitative, and chronic stroke care. The purpose of this study was to investigate the incidence and risk factors of falls and to determine how well the Falls Efficacy Scale (FES), Timed Up and Go test (TUG), and Berg Balance Scale (BBS) could distinguish between fallers and non-fallers among stroke patients during inpatient rehabilitation. One hundred and fifteen participants with at least 3 months post-stroke and able to walk at least 3 m with or without a mono cane participated in this study. Fifty-four (47%) participants reported falling, and 15 (27.8%) had a recurrent fall. Logistic regression analysis for predicting falls showed that left hemiplegia [odds ratio (OR)=4.68] and fear of falling (OR=5.99) were strong risk factors for falls. Fallers performed worse than non-fallers on the FES, TUG, and BBS (p<.05, p<.01, respectively). In the receiver operator characteristic curve analysis, the TUG demonstrated the best discriminating ability among the three assessment tools. The cut-off score was 22 seconds on the TUG for discriminating fallers from non-fallers (sensitivity=88.9%, specificity=45.9%) and 27 seconds for discriminating recurrent fallers from single fallers and non-fallers (sensitivity=71.4%, specificity=40.2%). Results suggest that there is a need for providing fall prevention and injury minimization programs for stroke patients who record over 22 seconds on the TUG.

Dual task interference while walking in chronic stroke survivors

  • Shin, Joon-Ho;Choi, Hyun;Lee, Jung Ah;Eun, Seon-deok;Koo, Dohoon;Kim, JaeHo;Lee, Sol;Cho, KiHun
    • Physical Therapy Rehabilitation Science
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    • v.6 no.3
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    • pp.134-139
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    • 2017
  • Objective: Dual-task interference is defined as decrements in performance observed when people attempt to perform two tasks concurrently, such as a verbal task and walking. The purpose of this study was to investigate the changes of gait ability according to the dual task interference in chronic stroke survivors. Design: Cross-sectional study. Methods: Ten chronic stroke survivors (9 male, 1 female; mean age, 55.30 years; mini mental state examination, 19.60; onset duration, 56.90 months) recruited from the local community participated in this study. Gait ability (velocity, paretic side step, and stride time and length) under the single- and dual-task conditions at a self-selected comfortable walking speed was measured using the motion analysis system. In the dual task conditions, subjects performed three types of cognitive tasks (controlled oral word association test, auditory clock test, and counting backwards) while walking on the track. Results: For velocity, step and stride length, there was a significant decrease in the dual-task walking condition compared to the single walking condition (p<0.05). In particular, higher reduction of walking ability was observed when applying the counting backward task. Conclusions: Our results revealed that the addition of cognitive tasks while walking may lead to decrements of gait ability in stroke survivors. In particular, the difficulty level was the highest for the calculating task. We believe that these results provide basic information for improvements in gait ability and may be useful in gait training to prevent falls after a stroke incident.

Effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors: a preliminary study

  • Cho, Ki Hun;Song, Won-Kyung
    • Physical Therapy Rehabilitation Science
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    • v.8 no.2
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    • pp.93-98
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of robot arm reach training on upper extremity functional movement in chronic stroke survivors. Design: One group pretest-posttest design. Methods: Thirteen chronic stroke survivors participated in this study. Robot arm reach training was performed with a Whole Arm Manipulator (WAM) and a 120-inch projective display to provide visual and auditory feedback. During the robotic arm reach training, WAM provided gravity compensation and assist-as-needed (AAN) force according to the robot control mode. When a participant could not move the arm toward the target for more than 2 seconds, WAM provided AAN force to reach the desired targets. All patients participated in the training for 40 minutes per day, 3 times a week, for 4 weeks. Main outcome measures were the Fugl-Meyer Assessment (FMA), Action Research Arm Test (ARAT) and Box and Block Test (BBT) to assess upper extremity functional movement. Results: After 4 weeks, significant improvement was observed in upper extremity functional movement (FMA: 42.15 to 46.23, BBT: 12.23 to 14.00, p<0.05). In the subscore analysis of the FMA upper extremity motor function domains, significant improvement was observed in upper extremity and coordination/speed units (p<0.05). However, there were no significant differences in the ARAT. Conclusions: This study showed the positive effects of robot arm reach training on upper extremity functional movement in chronic stroke survivors. In particular, we confirmed that robot arm reach training could have a positive influence by leading to improvement of motor recovery of the proximal upper extremity.

Percutaneous Continuous Radiofrequency Application to Dorsal Root Ganglia in Spinal Cord Lesion Patients: Pilot Case Series

  • Lee, Dong-Gyu;Ahn, Sang-Ho
    • The Journal of Korean Physical Therapy
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    • v.23 no.6
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    • pp.31-36
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    • 2011
  • Purpose: This pilot case series study aimed to evaluate the efficacy of continuous radiofrequency (CRF) application on dorsal root ganglia (DRG) to reduce spasticity of spinal cord lesion (SCL) patients. Methods: We performed CRF procedures on DRG in 8 subjects (7 males; mean age 39 years, range 31-53 years) with intractable spasticity that impeded activities of daily living and caregiving, although they had maximal tolerable doses of anti-spastic medications and active rehabilitative treatment. All subjects underwent CRF (90 seconds at $90^{\circ}C$) at multiple lumbosacral and/or cervical DRG. Muscle tone of the extremities was measured by the modified Ashworth scale (MAS) before and one month after procedures. Functional goals were established at baseline, and subjects' satisfaction levels were categorized one month after procedures. Results: A total of 54 CRF treatments were performed in 8 patients. In all patients, we found some improvement in muscle tone measured by the MAS. Six patients reported themselves satisfied with their current status at one month's post-treatment, and 2 patients were fairly satisfied with their gait pattern. In 3 patients, neuropathic pain was present after CRF on DRG. In 1 lumbar case, the pain subsided after several days, and the other 2 cervical cases suffered from tolerable neuropathic pain treated with anti-convulsant medication. Conclusion: CRF on DRG might be a promising alternative treatment to reduce spasticity in SCL patients. Further well-designed clinical trials on the efficacy and safety of CRF application on DRG are needed.

Recovery of the ascending reticular activating system and consciousness following comprehensive management in a patient with traumatic brain injury: a case report

  • Jang, Sung Ho;Kwon, Young Hyeon
    • Journal of Yeungnam Medical Science
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    • v.39 no.4
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    • pp.332-335
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    • 2022
  • We report on changes in the ascending reticular activating system (ARAS) concurrent with the recovery of impaired consciousness following rehabilitation and cranioplasty in a patient with traumatic brain injury (TBI), which were demonstrated on diffusion tensor tractography (DTT). A 34-year-old male patient was diagnosed with a traumatic intracerebral hemorrhage after falling from a height of approximately 7 m and underwent a right frontoparietotemporal decompressive craniectomy and hematoma removal. At 5 months after onset, when starting rehabilitation, the patient showed impaired consciousness, with a Glasgow Coma Scale (GCS) score of 4. Comprehensive rehabilitative therapy was provided until 14 months after onset, and his GCS score improved to 8. Cranioplasty was performed using auto-bone at 14 months after onset. One month after cranioplasty, his GCS score improved to 12. On the 15-month DTT, the deviated lower dorsal ARAS was restored on both sides, and the right side had become thicker. The right lower ventral ARAS was reconstructed, and increased neural connectivity of the upper ARAS was detected in both the prefrontal cortices. Thus, changes in the ARAS were demonstrated in a patient with TBI during recovery of consciousness following rehabilitation and cranioplasty.

A Comparison of Gluteus Maximus Muscle and Biceps Femoris Muscle Thickness According to Weight Load during Prone Hip Extension with Knee Flexion Exercises (엎드려 무릎관절 굽힘 자세에서 엉덩관절 폄 동작 시 무게 부하 변화에 따른 큰볼기근과 넙다리두갈래근의 두께 비교)

  • Eun-Mi Jang;Da-Eun Jung
    • PNF and Movement
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    • v.21 no.3
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    • pp.309-317
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    • 2023
  • Purpose: This study set out to investigate the effects of prone hip extension with knee flexion (PHEKF) exercises according to external load on the thickness of the gluteus maximus (Gmax) and biceps femoris (BF). Methods: Twenty-three healthy men participated in this study. All subjects randomly practiced PHEKF under the burden of external loads created by sandbags (0 kg, 1 kg, and 2 kg). Rehabilitative ultrasound imaging (RUSI) was used to measure the thickness of the Gmax and BF during the PHEKF with different external loads. Results: The thickness of the Gmax was highest during the 2 kg resistance exercise and lowest at 0 kg. The thickness of the Gmax was significantly increased at 1 kg and 2 kg compared to 0 kg and significantly increased at from 1 kg to 2 kg (p < 0.05). The thickness of the biceps femoris was highest at 0 kg and lowest at 2 kg. The thickness of the biceps femoris muscle was significantly reduced at 1 kg and 2 kg compared to 0 kg (p < 0.05), but there was no significant difference between 1 kg and 2 kg (p > 0.05). Conclusion: The thickness of the Gmax was increased by applying PHEKF with a higher external load, whereas the muscle thickness of the biceps femoris decreased. These results suggest that the application of external loads during PHEKF exercises may be an effective method for selective strengthening of the Gmax.

Biomechanical Effect on Knee Adduction Moment by Lateral Wedge Insole in Transfemoral Amputee (외측웨지인솔이 대퇴절단자의 무릎내전모멘트에 미치는 영향)

  • Chang, Yun-Hee;Lee, Wan-Hee
    • Journal of the Korean Society for Precision Engineering
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    • v.29 no.2
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    • pp.239-244
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    • 2012
  • The prevalence of knee osteoarthritis was higher people with lower limb amputation. This was identified that transfemoral amputees have a greater external knee adduction moment than ablebodied subjects by biomechanical studies. Therefore, they need rehabilitative intervention for prevention and reduction of knee osteoarthritis. The purpose of this study was to determine the effect of lateral wedge insole used in the treatment of knee osteoarthritis. This study was participated in fourteen unilateral transfemoral amputees and we were analyzed the difference gait variables between without lateral wedge insole and with $5^{\circ}$ and $10^{\circ}$ lateral wedge insole during gait. Our results showed that step length ratio was more symmetrical and, hip adduction and ankle inversion angle were more close to normal value, and knee adduction moment was decreased as the wedge angle increases. We proposed that these data would be utilized conservative treatment of knee osteoarthritis in lower limb amputees.

Muscle Function Path Analysis through Muscle Activity Analysis of Human Myofascial Meridians

  • Park, Young Hyun;Hong, Aa Reum;So, Jea Moo
    • Korean Journal of Applied Biomechanics
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    • v.27 no.4
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    • pp.279-285
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    • 2017
  • Objective: The purpose of this study was to perform a muscle function path analysis of muscle function on myofascial meridians. Method: Seven male students (mean age: $22{\pm}3.46years$; mean mass: $72.71{\pm}8.19kg$; mean height: $174{\pm}4.39cm$) without a history of musculoskeletal system symptoms or injuries were recruited for this study. The measurement muscle of the myofascial line was selected along with the muscle presented in "anatomy trains (Thomas W. Myers. 2014)", and the attachment of the surface EMG (Telemyo 2400T G2, USA) pad was determined according to "EMG analysis (Kim Tae Wan et al., 2013)". The subjects underwent maximum volumetric contraction of their fascia line end muscles three times in lying and standing postures and were subjected to the maximum number of contractions of the myofascial line muscle three times in the lying and standing postures. The sampling rate of the EMG signal was set to 1,000 Hz, and the bandwidth was 20 to 350 Hz. The activity of each muscle was quantitated using the Pearson correlation coefficient, and SPSS 22.0 was used for data analysis. Results: In myofascial meridians, a positive correlation in the myofascial connection and a negative correlation in the mechanical connection were observed. Conclusion: Muscles that show significant contract correlations with one another may be expected to be used as an effective clinical marker in muscle strengthening or relaxation therapy, and rehabilitative training. In this study, the correlation of total myofascial meridians may differ without consideration of functional posture. Future studies need to consider these points.