Kim, Jung-Hyun;Kim, Hyun-Jin;Lee, Seung-Gu;Song, Chang-Ho
PNF and Movement
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제18권3호
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pp.305-313
/
2020
Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.
Purpose: This study was conducted in order to compare the ability to control postural sway during perturbation when stroke patients received postural sway induced by head rotation. Methods: This study included 15 stroke patients and 15 healthy adults. Each group was measured by 3D motion analysis for determination of the angle of the neck in static position and by balance performance monitor for estimation of swaying angle in both neutral posture and head rotation position. These results were then analyzed in order to compare the healthy control group and the stroke patients group. Results: In both static posture ($60.7{\pm}4.81$) and dynamic posture ($51.46{\pm}6.87$, $70.8{\pm}6.55$), significant decreases were observed in the angle of head rotation of the patient group, compared to the healthy group (p<0.05), and significant decreases were observed in the sway angle of the patient group when in the neutral position ($3.62{\pm}7$, $24{\pm}0.60$) and head rotation ($3.04{\pm}0.80$, $51.46{\pm}6.87$), compared to the healthy group (p<0.05). Conclusion: According to these findings, patients with stroke tend to restrict the ROM of head rotation and swaying angle in dynamic posture and maintain their posture instability using limitation of head movement relative to the trunk and sway angle of area which is larger than that of affected side in unaffected side.
Purpose: To analyze the clinical and radiologic results of the shoulder arthrodesis in brachial plexus injury patients with flail upper extremity. Material and Method: From Aug 1978 to April 2008, 29 shoulders in 29 patients with brachial plexus injury with shoulder fusion, we evaluated 20 shoulders in 20 patients, more than 1 year follow up. The average follow-up period was 6.45years (range: 1year~24years). There were 13 men and 7 women, and the mean age at the time of trauma was 32.0years(2~65 years). The type of injury was a motorcycle accident in 11 patients, in car accident in 5, pedestrian accident in 3, and fall from a height in 1. The lesion of injury was root and trunk in 1 patient, trunk and cord in 1, trunk in 18. Surgery was performed on the whole arm type paralysis in 12 patients, lower arm type paralysis in 8 patients. The preoperative visual analog scale score was 8.7(7~10). When the trapezius and serratus anterior muscle were in function, operation was performed. 18 patients were processed to the additional operation. Gracilis free flap in 6 patients, neurotization in 3, Steindler flexor plasty in 6, and tendon transfer in 3 were performed. Fixation was conducted with cancellous screws in 13 patients, Knoles pins in 5, and cancellous screws and Knoles pins in 2. The position of the arthrodesis at operation was $28.5^{\circ}$($20~45^{\circ}$) in abduction, $30.3^{\circ}$($20~45^{\circ}$) in flexion, and $30.8^{\circ}$($20~40^{\circ}$) in internal rotation. Result: The follow up visual analog scale score was 3.4(0~7). Postoperatively, shoulder spica cast was applied for 15.3weeks(8-20weeks). The median time to bony union was 17.7weeks(9~28weeks). Average range of motion was $32.0^{\circ}$($15~40^{\circ}$) of abduction, $24.0^{\circ}$($10~40^{\circ}$) of flexion, and $18.5^{\circ}$($10~30^{\circ}$)of internal rotation. Conclusion: The shoulder fusion in brachial plexus injury patients is one of the good methods to relieve pain, improve the function and stabilize the flail shoulder joint.
The purpose of this study was to compare the muscle activity during a push-up on a suspension sling and a fixed support at the same level. Tests were performed on 15 male subjects. Electromyography using a surface EMG recorded the activity of the triceps, pectoralis major, and internal and external oblique muscles during each push-up. EMG activity was recorded at 0, 45, and 90 degrees of elbow flexion in the push-up position on a suspension sling or a fixed support at the same height above the floor (30 cm). The testing order was selected randomly. The subjects were asked to maintain the push-up position with straight knees, hips, and trunk for 5 seconds at each elbow angle. The mean root mean square (RMS) of EMG activity was calculated. EMG activity was normalized using the maximum voluntary isometric contractιn elicited using a manual muscle testing technique. Two-factor repeated measures analysis of variance (ANOVA) was used to compare the average RMS value of EMG activity for each condition. The EMG activity for the pectoralis major, and internal and external oblique muscles during a push-up on a sling was significantly higher than on a fixed support at all angles of elbow flexion (p<.01). There were significant differences in the EMG activity of the pectoralis major and triceps brachii muscles at difference angles of elbow flexion (p<.05). The pectoralis major muscle had the highest EMG activity at 90 degrees of elbow flexion on both the sling and fixed support. The triceps brachii muscle had the highest EMG activity at 45 degrees of elbow flexion on both the sling and fixed support. The internal and external oblique muscles had the highest EMG activity at 0 degrees of elbow flexion, although the difference with angle of flexion was not significant. These results suggest that to improve proximal and trunk stability and muscle strength, push-ups are more useful when performed on a suspension sling than On a fixed support.
The purpose of this study is to find out its effect on changes in the joint angle and the success rate of cardiopulmonary resuscitation by conducting cardiopulmonary resuscitation (CPR) when wearing and not wearing PPE (personal protective equipment) targeting 20 paramedics with more than 5 years of experience. The subjects carried out CPR in 30:2 for 4 minutes and collected images were digitized by Kwon3D XP Software Package(Version 4.0) and then data were obtained. Data, which were collected by analyzing the motion when starting in one cycle, when pressing to the maximum, in the final position (relaxed), were analyzed by using SPSS 18.0. In conclusion, during CPR, the angle of the both shoulder joints was not significant (p>.05) and the angle of the right elbow joint was reduced in all positions and was statistically significant (p<.05) and the angle of the left was significantly reduced in the maximum pressure posture and the final position (p>.05). In the case of the trunk, the angle increased statistically significantly at all stages (p<.01, p<.001). Also, during CPR, the average compression rate was significantly reduced after wearing PPE (p<.05) and average hand escape time by cycle increased statistically significantly (p<.05) but chest compression execution rate at the correct depth did not show any significant difference between the two groups (p>05).
Hwang, Donggi;Lee, Ju Hyeong;Moon, Seongyeon;Park, Soon Woo;Woo, Juha;Kim, Cheong
Physical Therapy Rehabilitation Science
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제6권2호
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pp.65-70
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2017
Objective: The purpose of this study was to examine the intertester reliability and validity of four nonradiologic measurements of thoracic spine rotation in healthy adults. Design: Descriptive laboratory study. Methods: This study was conducted on 20 male and 20 female university students aged between 19 and 26. To measure thoracic rotation, a goniometer, a bubble inclinometer, a dual inclinometer, and a smartphone application-clinometer were used. The measurement was performed twice for each device and the same measurement was performed by two examiners. The measurements were performed in the lumbar locked position. The arm in the direction of rotation was taken back and placed onto the back of the lumbar region. With right and left trunk rotation, the head was rotated together but remained in the center line so that the axial rotation was maintained. Both examiners performed the measuring procedures and directly handled the measuring instrument. All measurement results were recorded by the recorder. Results: The range of motion (ROM) of thoracic rotation in lumbar locked position for all four devices was 47 degrees. The intra-rater reliability estimates ranged from 0.738 to 0.906 (p<0.05). The inter-rater reliability estimates ranged from 0.736 to 0.853 (p<0.05). The goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer showed high validity (p<0.05). This result indicates that all four devices may be used by the same examiner and by other examiners obtaining follow-up measurement. Conclusions: The use of the goniometer, bubble inclinometer, dual inclinometer, and smartphone clinometer for measurements in the lumbar locked posture are reliable and valid nonradiologic measures of thoracic rotational ROM in healthy adults.
This study was investigated the kinematic factors of the last approach strides and. take off motion for the skill improving of BKH elite male athlete. 'The subjects chosen for the study were BKH and. KASZCZYK Emillian male athletes who were participated in 2003 Dae-Gu Universiad Games. Three high speed video cameras set in 60frames/s setting were used. for recording from the last approach strides to the apex position. After digitizing motion, the Direct Linear Transformation(DLT) technique was employed to obtain 3-D position coordinates, The kinematic factors of the distance, velocity and angle variable were calculated for Kwon3D 3.1. The following conclusions were drawn; 1. It showed longer stride length, as well as faster horizontal and lateral velocity than the success trial during the approach phase. For consistent of the approach rhythm, it appeared that the subject should a short length for obtain the breaking force by the lower COG during the approach phase. 2. The body lean angle showed a small angle by a high COG during the take-off phase. For obtain the vertical displacement of the COG and a enough space form the bar after take-off, it appeared that the subject should increase the body lean angle. 3. For obtain the vertical force during the takeoff phase, it appeared that the subject should keep straight as possible the knee joint. Therefor, the subject can be obtain a enough breaking force at the approach landing.
Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.
Purpose: The purpose of this study was to investigate the effect of regularly strength exercise of spine in teenagers with tutor. Method: Study subjects were 24 middle school students. They were arranged to 2 groups(n=12, respectively). Then experimental group did regularly strength exercise of spine as the handout maneuver during 50min/day and 1day/week in 8 weeks with tutor, but control group did regularly exercise of spine as same maneuver without tutor. For muscle strength of both extensor and flexor of lumbar, the balancing ability and weight distribution index were measured before and after the intervention. Results: For muscle strength of both extensor and flexor of lumbar, there was not significant differences after the intervention, but both flexor and extensor increase mean value of muscle strength than control group. For balancing ability and weight distribution index, there were not significant difference after intervention(p>.05), but experimental group show a tendency to decrease in a few position than control group. Conclusion: When teenagers regularly exercise for spine strengthening for a long time with tutor, it may be increased muscle strength of lumbar and trunk balance.
Purpose: The aimed of this study was to investigate muscle activation related to postural stability according to different frequency of whole body vibration during quiet standing, to identify the most effective training conditions that cause the highest neuromuscular responses, and to evaluate the difference of EMG activation according to the anatomical position of the muscle - proximal or distal from the vibration platform. Methods: Eighteen healthy subjects voluntarily participated in this single-group, repeated-measures study in which EMG data from upper trapezius, rectus abdominalis, external oblique abdominalis, elector spinae, gluteus maximus, rectus femoris, semitendinosus, and gastrocnemius were collected over different frequencies (0-5-10-15-20-25Hz) for each subject during quiet standing. Results: We observed a statistically significant difference in the mean values of %RVC of muscular activation according to different frequencies of whole body vibration during quiet standing in all muscles (p<0.05). Conclusion: Our results indicate that lower frequencies of vibration result in low muscular activation, and higher frequencies elicit high muscular activation. However, the most effective training condition that caused the highest activation was 20 Hz. In addition, the proximally located lower extremity muscles (GCM, RF, ST, GM) showed higher activation than the distally located trunk and neck muscles (ES, EO, RA, UT) together with increasing frequency.
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