Purpose: This study aimed to improve the asymmetrical weight-bearing ratio, by applying different repetitive sit-to-stand training methods to the paretic-side foot of hemiplegic patients, as well as to provide the necessary information for applying balance training with hemiplegic patients. Methods: The subjects were divided into two groups: a spontaneous foot group and an asymmetrical foot group. They all performed repetitive sit-to-stand training five times a week for a total of six weeks. The sit-to-standing movement was studied using standardized clinical tests. The Biodex Balance System, Time up and go test (TUG), 5 times sit-to-stand test (5XSST), and functional reach test (FRT) were used to measure the static and dynamic standing balance of the patients. Results: In the balance system measurement, the results for the overall index, ant-post index, med-lat index, fall risk index, 5XSST, and FRT after the training differed significantly between the comparison groups (p<0.05). In the evaluation of dynamic balance, the differences in TUG did not differ significantly between the comparison groups after the training (p>0.05). Conclusion: The study found that the asymmetrical group showed significant increases in static and dynamic balance in comparison to the spontaneous group after repetitive sit-to-stand training. Based on this result, it is clear that training in an asymmetrical position with the paretic foot back can increase the left-right stability limit and the anterior-posterior stability limit, thus improving balance control.
Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.
The purpose of this study was to determine the effectiveness of sit-to-stand training on unstable surfaces in individuals with stroke. Nineteen subjects with chronic stroke were divided into two groups: an experimental group (10 subjects) and a control group (9 subjects). They received 30 minutes of Neuro-developmental therapy (NDT) treatment, and sit-to-stand exercise for 15 minutes three times a week for four weeks. During the sit-to-stand training, the experimental group performed on an unstable AIREX balance pad, but the control group performed on a stable surface. Balance ability and weight-bearing distribution during quiet standing were measured before and after training period using the 7-item Berg balance scale-3P (BBS-3P) and the Five-times-sit-to-stand test (FTSST). In addition, the muscle strength of the knee extensor was evaluated before and after the training period. The results were as follows: 1) The weight-bearing distribution forward of the affected leg, increased significantly in the experimental group after the four-week intervention (p<.05), 2) The 7-item BBS-3P and FTSST increased significantly in the experimental group after the four-week intervention (p<.05), 3) The knee extensor muscle strength in both groups increased significantly after the four-week intervention (p<.05). In conclusion, the results of this study did not show that the sit-to-stand training on an unstable surface was more effective than on a stable surface. However, the results suggested that sit-to-stand training is effective in the balance training of stroke patients.
Although there have been various studies related to the body's movement from a sitting to a standing position (sit-to-stand task), there is limited information on the kinematic changes on the frontal and transverse planes. The purpose of this study was to ascertain how pelvic tilt affects kinematic changes in the frontal and transverse planes in the hip and knee joints during a sit-to-stand task. For this study, 33 healthy participants (13 female) were recruited. Each participant rose from a sitting to a standing posture at his or her preferred speed for each of three different pelvic tilt trials (anterior, posterior, and neutral), and the measured angles were analyzed using a 3-D motion analysis system. A one-way repeated measure analysis of variance was performed with Bonferroni's post hoc test. In addition, an independent t-test was carried out to determine the sex differences in hip and knee joint kinematic changes during the sit-to-stand tasks. The results were as follows: 1) The hip and knee joint angle in the frontal and transverse planes showed a significant difference between the different pelvic tilt postures during sitting in the pre-buttock lift-off phase (pre-LO) (p<.05). Compared to the posterior pelvic tilt posture, the anterior pelvic tilt posture involved significantly greater hip joint adduction and internal rotation, knee joint adduction, and reduced internal rotation of the knee joint. 2) Sex differences were found with significant differences for males in the initial and maximal angles in the frontal plane of the hip and knee joint (p<.05). Females had a significantly smaller initial abduction angle of the hip joint and a significantly greater maximal angle of the hip adduction joint. These results suggest that selecting a sit-to-stand exercise for pelvic tilt posture should be considered to control abnormal movement in the lower extremities.
Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.
Objective: The purpose of the present study was to determine whether sit to stand training combined with ultrasound improves the spasticity, muscle strength and gait speed in stroke patients Design: Randomized controlled study Methods: The current study included 40 stroke patients, who were randomly divided into two groups: the sit to stand training with ultrasound (USTS) group (n=20) and the sit to stand training (STS) group (n=20). All the participants underwent 30 sessions of STS training (thirty minutes, five days per week for six weeks). Additionally, the USTS group received ultrasound therapy. The present study evaluated the spasticity of ankle plantar-flexors by the composite spasticity score. The muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively. Results: The USTS group and the STS group showed significant improvements in spasticity, muscle strength and gait speed after the intervention (p<0.05). Significant improvement in the spasticity, muscle strength, and gait speed were observed in the USTS group compared to the control group (p < 0.05). Conclusions: The results of the current study imply that sit to stand training combined with ultrasound is a beneficial and effective therapeutic modality that can be employed to improve the spasticity, muscle strength and gait speed in stroke patients.
PURPOSE: This study is designed as a retrospective study, and identified the clinical usability of Sit to Stand (STS) test for predicting of fall incidence in stroke patients who experienced a fall within 1 year. METHODS: Between July 2011 and November 2012, 69 inpatients with stroke in K rehabilitation hospital were participated under voluntarily signing the informed consent form. STS test and 10m walk test (10MWT) were used to assess the muscle strength of lower-extremity and walking velocity, respectively. Also, we tested dynamic balance and motor function of lower-extremity in affected-side using with the Berg balance scale (BBS) and the Fugl-Meyer assessment of lower extremity (FM-L/E). METHODS: There were significant differences between subjects with fall-experienced group and without subjects without fall-experienced group in STS test, 10MWT, BBS scores and FM-L/E. STS test significantly showed a negative correlation between 10MWT (r=-.657), BBS (r=-.512), and FM-L/E (r=-.563). And, 10MWT have a influence on the performance of STS test (the capacity of explanation = 20%). The cut-off value of STS performance predicting falls experience is ${\geq}14.36$ seconds (sensitivity=76%; specificity=79%, area under curve=.785). According to logistic regression analysis of falls experience, subjects ${\geq}14.36$ s showed that 4.164 times (odd ratio) increased in falls than subjects < 14.36 s in STS test. CONCLUSION: This study demonstrated that STS test may be a useful tool predicting and measuring falls in patients with stroke. Further study will be needed to elucidate the kinematic analysis of STS test and the relationship between physical activity level and falls in stroke patients.
Purpose: The purpose of this study was to investigate examine how the kinematics and kinetics of lower limb joints were changed depending on the unstable shoes (US) during sit-to-stand task (SitTS). Methods: Nineteen healthy females were participated in this study. The subjects performed sit-to-stand task with US and barefoot. The experiment was repeated three times for each tasks with conditions. The kinematics and kinetics of lower limb joint were measured and analyzed using a 3-D motion analysis system. A paired t-test was utilised performed for to identificationy of changes in mean of angle, force, and moment between both the two conditions. Results: The results of this study showed kinematic differences in lower limb joints during SitTS based on the US. The hip, knee, and ankle angle showed statistically significant differences during SitTS. At the initial of SitTS, Tthe force and moment of the hip flexor, hip extensor, knee flexor, knee extensor, ankle flexor, and ankle extensor showed statistically significant differences. At the terminal of SitTS, Tthe force and moment of the hip flexor, hip extensor, knee flexor, knee extensor, ankle flexor, and ankle extensor showed statistically significant differences. At the maximum of SitTS, Tthe moment of the hip extensor showed statistically significant differences. The force and moment of the ankle flexor, extensor moment showed statistically significant differences. Conclusion: Therefore, Wwearing US is considered to influence on the lower limb joints kinematics and kinetics during SitTS movements, and thus suggests the possibility that of reducing the risks of pain, and osteoarthritis caused by changes in the loading of lower limb joints.
Purpose : Sit-to-stand (STS) is one of the important activities of daily living (ADL) and each of its parameters is used frequently. This study aimed to examine the influence of different seat height on performance time and floor reaction force strength during an STS movement. Methods : Fifteen young-adult male subjects participated in this study. The subjects were divided into three groups based on lower leg length. Subjects performed an STS movement twice from chairs at height adjusted by the lower leg length of each subject. To examine the influence of the chair seat height, ground reaction forces during a STS performed with 3 chair heights adjusted to each subjects lower leg length were compared. Results : Vertical ground reaction force and time during an STS movement were measured to evaluate. Parameters regarding ground reaction force were selected for analyses. Significant differences were found in ground reaction force at G1 was greater than G2 and G3. Conclusion : The STS movement achievement strategy differed since chair seat height changes relatively by the difference in lower leg length. When conducting the ability to achieve STS movement rating test, chair seat height considering each subject's lower leg length may be needed.
Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.
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