Purpose: The purpose of this study was to assess the intra-rater and inter-rater reliability and validity of pelvic tilting angle measurements using a smart phone-based inclinometer (Clino) compared to a palpation meter (PALM) in the standing and sitting position. This study used an interchangeable method with Clino to measure the pelvic tilting angle in the standing and sitting positions. Methods: Twenty healthy subjects were recruited. Measurements of the pelvic tilting angle in the standing and sitting positions were obtained by two examiners using the Clino and PALM. A resting session was conducted 10 minutes later to assess the intra and inter rater reliability. To assess validity of the measurement using Clino, a PALM was used as the gold standard. The intra-class correlation coefficient (ICC) was used to determine the intra and inter rater reliability of Clino and a PALM. To assess the validity, the Pearson correlation coefficients were used for two measurement techniques to measure the pelvic tilting angle in the standing and sitting positions. The statistical significance was set to ${\alpha}=0.05$. Results: Measurements of the pelvic tilt had high inter-rater reliability in the standing (ICC=0.82) and sitting (ICC=0.88) positions using Clino and intra-rater reliability in the standing (ICC=0.87) and sitting (ICC=0.91) positions using Clino. Measurements of the pelvic tilt had high validity by a comparison of PALM and Clino in the standing (r=0.83) and sitting (r=0.89) positions (p<0.05). Conclusion: The use of Clino can be recommended as a tool to replace the PALM and measure the pelvic tilt angle in the standing and sitting positions while maintaining the clinical reliability and validity.
The purpose of this study was to investigate whether the standing balance could be influenced by the different foot positions. Seventeen patients with hemiplegia were tested for the static and dynamic balance under the different foot positions. In the balance test, subject stood by bearing weight on one foot, and the other foot was positioned in three different positions (symmetric, $45^{\circ}$ anterolateral, and anterior position). This study used the Kinesthetic ability trainer (KAT2000) to measure the standing balance. The results were as follows: 1) There were significant differences in the static standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 2) There were also significant differences in the dynamic standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 3) There was a significant difference when the paretic weight-bearing and the nonparetic weight-bearing were compared (p<.01). 4) when the paretic weight-bearing and the nonparetic weight-bearing were compared, anterior foot position showed a significant difference in the dynamic standing balance (p<.05), but $45^{\circ}$ anterolateral foot position did not show a significant difference (p>.05). In this study, the standing balance showed a significant difference according to different foot positions in hemiparetic patients, and standing balance was better when they stood by bearing weight on the nonparetic limb. These results indicate that it is a necessary to consider both weight-bearing limb and foot position not only in the rehabilitation program but also in achieving the stability in the independent life.
Purpose: The purpose of this study was to investigate muscle activation related to postural stability depending on different head positions with whole body vibration (WBV) in standing. Methods: Eighteen healthy subjects voluntarily participated in this single-group, repeated-measures study in which the surface electromyography (EMG) data from upper trapezius, rectus abdominis, external oblique abdominis, erector spinae, gluteus maximus, rectus femoris, semitendinosus, medial gastrocnemius were collected over 3 different frequencies (0-10-20Hz) and 4 different head positions (neutral, flexion, extension, chin tuck) for each subject on WBV while standing. Results: The results of this study demonstrated that the EMG activity of all recorded muscles shows significant difference between three different frequencies and four head positions of WBV while standing (p<0.05). In the multiple comparison, significant differences could be observed for most of different frequency conditions except 0-10Hz of RA, 10-20Hz of ST. In contrast, no significant difference showed the comparison of the EMG activity depending on different head positions (p<0.05). Conclusion: These findings suggest that different head positions on WBV do not activate muscles related to postural stability. However, higher frequency on WBV is highly effective to activate whole body muscles included postural muscles regardless of different head positions.
Ko, Young Jun;Ha, Hyun Geun;Jeong, Juri;Lee, Wan Hee
Physical Therapy Rehabilitation Science
/
제3권2호
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pp.101-106
/
2014
Objective: To investigate the appropriate position for abdominal drawing-in maneuver (ADIM) exercise by rehabilitative ultrasound image. Design: Cross-sectional study. Methods: Twenty-eight young adults with no history of low back pain participated in the study. Three positions compared were crook lying position with hip $60^{\circ}$ flexion, standing position with the feet hip width apart and knees straight, and saddle standing positionunsupported with the knees $20^{\circ}$ flexed. Once in the appropriate position, the subjects were verbally cued to draw in their abdominal wall, with the intention of pulling their navel inward toward their lower back. The thickness of each transversus abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles were measured via ultrasound and recorded at the end of inspiration. Results: When compared to the TrA thickness of rest, the TrA thickness was significantly increased in all three positions (crook lying, standing, and saddle standing) during the ADIM (p<0.05). IO thickness was significantly greater in standing and saddle standing than in crook lying (p<0.05). EO thickness was constant in all the three positions. Conclusions: The present study suggests that standing and saddle standing positions could be recommended for the ADIM to maximize recruitment of the TrA and IO activation. Specifically, the saddle standing position with knees flexed to $20^{\circ}$ was observed to increase the TrA activation more than the standing position. These findings should be considered when core stability exercises such as the ADIM are conducted.
Purpose: This study aimed to compare the contraction ratios of the abdominal muscles and the preferential activation ratios of the transversus abdominis muscle (TrA) during the abdominal drawing-in maneuver (ADIM) in the hook-lying, sitting, and standing positions. Methods: This study included 30 healthy participants. The thicknesses of the TrA, internal oblique muscle (IO), and external oblique muscle (EO) were measured at rest and during the ADIM in the hook-lying, sitting, and standing positions using B-mode ultrasound imaging. The contraction ratios of these muscles and the preferential activation ratios of the TrA were calculated for each position. Results: The contraction ratio of the TrA and preferential activation ratio of the TrA during the ADIM in the hook-lying position were significantly higher than those in the sitting and standing positions (p < 0.05). The contraction ratio of the TrA during the ADIM in the sitting position was significantly higher than that in the standing position (p < 0.05). Conclusion: The hook-lying position tended to facilitate TrA activity better than the sitting position. Furthermore, the sitting position tended to facilitate TrA activity better than the standing position. These findings suggest that the ADIM in the hook-lying position should be implemented before that in the sitting position and that the ADIM in the sitting position should be implemented before that in the standing position.
Purpose: This study was designed to investigate inter-rater and intra-rater reliability of navicular drop measurements by clinicians in sitting and standing positions. Methods: Fourteen subjects with pronated foot were recruited. Two physical therapists randomly assessed the same patients on different occasions but on the same day. Almost all patients were assessed on more than one day. The intra-rater and inter-rater reliability of navicular dropwas estimated by calculation of the intraclass correlation coefficient (ICC). Results: The intra-rater reliability of navicular drop measurements ranged from 0.93 to 0.87, the inter-rater reliability from 0.98 to 0.70 with the patient in standing and sitting positions. These results showed good reliability for calculated variables. Intra-rater and inter-rater reliability of navicular drop in standing position was higher than those of sitting position. Conclusion: Although inter-rater and intra-rater reliability of navicular drop in the sitting position was lower than in the standing position, measurement of navicular drop in the sitting position showed good reliability and was acceptable for patients who could not stand alone without assistance. We recommend that having the patient in the standing position is appropriate in navicular drop measurement.
Purpose: This study aimed to develop new digital navicular drop test (ND-NDT) equipment and to determine its validity and reliability. Methods: A total of 24 healthy male and female adults, who fully understood the purpose of the study and gave consent to participate in the study, were selected as participants. The NDT and ND-NDT were conducted in the dominant foot of the participants in a random order. For the NDT, the position of the navicular bone was marked with a pen first; then, the height of the navicular bone from the ground was measured in both sitting and standing positions. For the ND-NDT, after the sticker-type reflection markers were attached to the position of the navicular bone, the height of the navicular bone from the ground was measured in both sitting and standing positions. To assess the validity of the diagnostic tests, the same examiner measured the height of the medial longitudinal arch (MLA) three times in both the sitting and standing positions. To assess the inter-rater reliability of the ND-NDT, three examiners, in a random order, attached the sticker-type reflection markers to the position of the navicular bone and then measured the height of the MLA in both positions. Results: In the sitting position, the Pearson correlation coefficient (r) between the two diagnostic tests was very high (r = 0.97) and statistically significant. In the standing position, the Pearson correlation coefficient (r) between the two tests was 0.95, which was also statistically significant. The ICC2,1 values in the sitting and standing positions were 0.93 and 0.95, respectively, indicating significantly high inter-rater reliability. Conclusion: The ND-NDT equipment showed very high diagnostic validity, as well as excellent inter-rater reliability, indicating the clinical usefulness of the equipment as a diagnostic system for confirming pes planus.
Purpose: This study investigated changes in the thickness of the transversus abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) muscles between crook lying and wall support standing positions during abdominal hollowing (AH), using ultrasound imaging. Methods: Experiments were conducted on 20 healthy male adults (mean age=$22.45{\pm}4.08$ years) who voluntarily agreed to participate in the experiments. The changes in the thickness of the subjects' abdominal muscles were measured during AH in crook lying and wall support standing positions. Results: The difference in the thickness of TrA between the two positions during AH was statistically significant, but the differences in the thicknesses of IO and EO were not significant. Conclusion: Activity of the TrA, which is a deep muscle, was stimulated in the standing position, which is, therefore, more functional than the crook position, but the activities of IO and EO muscles did not decrease. Therefore, various methods to induce the activity of TrA while decreasing the activities of IO and EO, in the functional standing position that can stimulate deep muscles, need to be designed.
International Journal of Internet, Broadcasting and Communication
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제10권2호
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pp.84-94
/
2018
The purpose of this study was to compare the balance ability at different foot positions using K A T 2000 (Berg, Inc, vista, CA.1994). Thirty (male 15, female 15) normal subjects participated in this study. All subjects were tested at a one leg position or a two leg position that were toe-in $25^{\circ}$, toe-out $25^{\circ}$, and $45^{\circ}$. The starting position was where the subject crossed their arms across the chest and flexed knees slightily. The results of each test were displayed on a screen in a score format, which indicated balance index. These collected data were analyzed by using one way ANOVA, and t-test. The results of this study were as follows: When changing the angle of the foot in the one-foot and two-foot standing positions, there was no statistically significant difference, but the balance performance with the foot rotated by $25^{\circ}$ was better than that with the foot rotated by $45^{\circ}$. When changing the direction of the foot in the one-foot and two-foot standing positions, there was no statistically significant difference, but the balance performance with the foot rotated laterally was better - except for the case when the foot was medially rotated by $25^{\circ}$ in the right-foot static standing position. When the feet were medially rotated by $25^{\circ}$ in the two-foot static standing position, and were medially rotated by $25^{\circ}$ and $45^{\circ}$ in the one-foot static standing position, the balance performance of females was better than that of males. In this study, it was found that the balance performance of the subjects changed when the position of the foot was shifted on an unstable base of support. However, there was little correlation between balance performance and the height, weight and foot length of the subjects. It is necessary to conduct a follow-up study targeting various age groups and those with various diseases using an unstable platform or applying different physical or visual conditions, such as the length of the legs. Physical therapists need to consider the position of the foot in clinical settings for a better balance training or assessment.
Objective : Thoracic pedicles have special and specific properties. In particular, upper thoracic pedicles are positioned in craniocaudal plane. Therefore, manipulation of thoracic pedicle screws on the left side is difficult for right-handed surgeons. We recommend a new position to insert thoracic pedicle screw that will be much comfortable for spine surgeons. Methods : We retrospectively reviewed 33 patients who underwent upper thoracic pedicle screw instrumentation. In 15 patients, a total of 110 thoracic pedicle screws were inserted to the upper thoracic spine (T1-6) with classical position (anesthesiologist and monitor were placed near to patient's head. Surgeons were standing classically near to patient's body while patients were lying in prone position). In 18 patients, a total of 88 thoracic pedicle screws were inserted to the upper thoracic spine with the new standing position-surgeons stand by the head of the patient and the anesthesia monitor laterally and under patient's belt level. All the operations performed by the same senior spine surgeons with the help of C-arm. Postoperative computed tomography scans were obtained to assess the screw placement. The screw malposition and pedicle wall violations were divided and evaluated separately. Cortical penetration were measured and graded at either : 1-2 mm penetration, 2-4 mm penetration and >4 mm penetration. Results : Total 198 screws were inserted with two different standing positions. Of 198 screws 110 were in the classical positioning group and 88 were in the new positioning group. Incorrect screw placement was found in 33 screws (16.6%). The difference between total screw malposition by both standing positions were found to be statistically significant (p=0.011). The difference between total pedicle wall violations by both standing positions were found to be statistically significant (p=0.003). Conclusion : Right-handedness is a problem during the upper thoracic pedicle screw placement on the left side. Changing the surgeon's position standing near to patient's head could provide a much comfortable position to orient the craniocaudal plane of the thoracic pedicles.
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