Objective: This review aims to analyze the effects of electromechanically assisted walking in patients with cerebral palsy(CP). Design: A systematic review and meta-analysis. Methods: We reviewed systematically using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) checklist guidelines. The inclusion criteria for this study were all CP patients. The intervention was electromechanically assisted walking. The outcome measures included gait parameters, function, spasticity. Studies excluded from this review were excluded from the review if they were non-English languages and if the study was not published as a full report, and if they were not randomized controlled trials (RCTs) designs. The RevMan 5.4 program was used to evaluate and explain the results. The risk of bias was evaluated independently by two reviewers. The quantitative meta-analysis, including mean differences (MD) and associated standard deviations (SD) from baseline and follow-up assessments, were recorded. Results: A total of 634 articles were searched. Two hundred eighty-nine duplicate articles were excluded, and 345 of 634 originals were left for selection. Of these 74 papers, 44 were out of topic, and 19 reported no mean or standard deviation values. And one was a non-experimental study. Finally, ten studies were included. All 10 RCTs of electromechanically assisted walking were analyzed. The meta-analysis showed a significant improvement in gait cycle (95% CI (confidence intervals), 0.09 to 0.19, I2=0%), Gross Motor Function Measure (GMFM) D (95% CI, 3.27 to 13.17, I2=0%) and GMFM E (95% CI, 0.22 to 6.41, I2=0%). Conclusions: Electromechanically assisted training helps in walking in patients with CP.
Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.
Objective: This study aimed to identify the effects of assuming different knee angles and hip abduction during bridge exercise and hip thrust exercise on lower body muscle activity. Design: Cross-sectional study Methods: Thirty-three healthy adults (18 men and 15 women) were instructed to perform the bridge and hip thrust exercises while randomly assuming 120°, 90° and 60° of knee flexion and 0° and 30° of hip abduction. EMG data (%maximum voluntary isometric contraction) were recorded three times from the erector spinae (ES), gluteus maximus (GM) and biceps femoris (BF) muscles of participant's dominant side and the mean values were analyzed. Results: The results showed that, during the hip thrust compared to the bridge exercise, there was significantly greater gluteus maximus muscle activity in all hip conditions while the biceps femoris activity was significantly less, and the erector spinae muscle activity was significantly greater with 30° of hip abduction (p<0.05). With all exercises, the erector spinae and the biceps femoris exhibited significantly greater muscle activity with 60° of knee flexion compared to 90° and 120° of knee flexion (p<0.05), and significantly greater muscle activity with 90° compared to 120° of knee flexion (p<0.05). In the case of the gluteus maximus, greater muscle activity was exhibited with 120° compared to 60° of knee flexion with all hip abduction conditions (p<0.05). Conclusions: It was effective for muscle activation of main agonists such as the gluteus maximus and erector spinae during thrust exercise, and the change in knee flexion angle was effective for muscle activation of the gluteus maximus. Therefore, it is considered that this study can be used as a selective indicator of the target movement angle during hip strengthening exercise for specific muscles.
Purpose: This study explored the prevalence of prenatal and postpartum depression in Korea and its influencing factors from 20 weeks of pregnancy to 12 weeks postpartum. Methods: Using a prospective cohort study design, data on women's depression and its influencing factors were collected at 20, 28, and 36 weeks of pregnancy and at 2, 6, and 12 weeks postpartum. The participants were 219 women and 181 spouses during pregnancy; and 183 mothers and 130 spouses after childbirth. Depressive symptoms were assessed by the Edinburgh Postnatal Depression Scale and influencing factors were measured by the Postpartum Depression Predictors Inventory-Revised, parity, and spousal depression. Results: The prevalence of maternal depression was 10.5% to 21.5% before birth, and it was 22.4% to 32.8% postpartum. The prevalence slightly decreased during the prenatal period but peaked at 2 weeks postpartum. Antenatal depression was influenced by low socioeconomic status, lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, a previous history of depression, lower social support, lower marital satisfaction, and higher life stress. The factors influencing postpartum depression were lower self-esteem, having experienced prenatal depression, having experienced prenatal anxiety, lower social support, lower marital satisfaction, and higher life stress, as well as infant temperament and maternal blues. Parity and spousal depression had no impacts. Conclusion: The prevalence and influencing factors of maternal depression changed over time. Nurses need to screen women accordingly during the perinatal period and should provide education or counseling to prevent depression and promote adjustment to parenthood.
Objective: This study attempted to find out if it changes the child's ability to perform daily life activities when visiting the familiar environment and daily living space of children with cerebral palsy and conducting a home activity support program for children and parents. Design: Randomized Controlled Trial Methods: Among 22 children aged 3 to 12 years old, they were assigned to the intervention group and control group. Of these, 12 boys and 10 girls participated in the study. Gross motor function measure and upper extremity function evaluation were used to measure the physical function of children with cerebral palsy, and self-care skills, mobility and social functions were evaluated in the pediatric evaluation of disability inventory. In addition, a parenting sense of competence was used to find out the efficacy of parents in raising children. After the pre-evaluation, basic rehabilitation treatment and intervention programs were applied to the intervention group, and only basic rehabilitation treatment was performed to the control group, and post-evaluation was performed 8 weeks later. Results: As a result of the study, among the items that measured the gross motor function, upper limb function, and daily life performance ability of the intervention group in the difference between the intervention group and the control group, statistically improved in personal processing and movement (p<0.05). In addition, the parenting sense of competence children in the intervention group was statistically significant (p<0.05). Conclusions: The home activity support program will help strengthen the ability of cerebral palsy children to perform daily life as a way to set mutually agreed goals with their families or children and achieve them in a familiar environment.
Park, Jong Hang;Park, Hyun Sik;Shin, Young Il;Lee, Ho Jong
Journal of Korean Physical Therapy Science
/
v.29
no.1
/
pp.1-14
/
2022
Background: The legal and academic definitions of manual therapy in domestic and foreign countries are reviewed, and problems and improvement plan of manual therapy are established through comparative analysis of the current status and system of manual therapy in Korea and abroad. Design: Review. Methods: In this study, the development direction of manual therapy in Korea was derived by analyzing the definition, application status, and service system of domestic and foreign manual therapy. Results: Firstly, it lays the foundation for a more comprehensive national health promotion by solving problems arising from the current unclear definition of manual therapy. Secondly, the subject of manual therapy is a physiotherapist but the subject of claiming non-benefit costs is a doctor, moreover illegal manual therapy by an unqualified or non-professional who is not a physiotherapist is being carried out in the medical field. Thirdly, in order to provide quality physiotherapy services (manual therapy) under a cooperative relationship between medical staff and physiotherapists, it is appropriate that physiotherapist have a clear "prescription" or "request" by a doctor. Fourth, there is no provision for the preparation of medical records in the current Medical Technicians Act, and this causes safety accidents of patients during manual treatment. Conclusion: As described above, the current manual therapy in Korea is being performed indiscriminately without a clear interpretation, resulting in various problems. I think it is necessary to lay the foundation for institutional and legal re-establishment of manual therapy through additional research on manual therapy in the future.
Objective: The purpose of this study was to investigate the effects of squat exercises using elastic bands of ballet dancers on muscle activity, arabesque angle, and static balance of ballet dancers during arabesque posture. Design: A randomized controlled trial Methods: A total of 25young female ballet dancer svoluntarily participated in the study. The participants were randomized to the elastic resistance squat group(n1=13) and body squat group(n2=12). The squats exercise was applied to a total of 12 exercises per four weeks and consisted of 15 times per one set in one to two weeks, 4 sets in three to four weeks. All subjects were evaluated muscle activity, arabesque angle, and static balance during arabesque posture at before-after intervention. All participants were measured muscle activity, arabesque angle, and static balance during arabesque posture at before-after intervention. Results: Elastic resistance squat group and body groups showed a significant increase in the muscle activity, angle, and static balance ability during arabesque posture(p<0.05). In the comparison between the groups, the elastic resistance squat group showed a significant increase in muscle strength, angle, and static balance during arabesque posture (p<0.05). The results showed that the elastic resistance squat exercise was more increased than the body squat exercise in all variables (p<0.05). Conclusions: Therefore, when planning a training program for a ballet dancer, the elastic resistance squat movement can be applied as an exercise method to improve the muscular performance and balance ability of the ballet dancer.
Purpose: The purpose of this study was to construct a hypothetical model based on Meleis and colleagues' Transition Theory and a literature review to explain women's menopausal transition, constructing a modified model considering previous studies and model fit and testing the effects between variables. Methods: With a correlational survey design, middle-aged Korean women aged 40 to 64 years who had experienced menopausal symptoms were recruited and filled out a self-administered study questionnaire. Measures included menopausal symptoms, resilience, social support, menopause management, menopause adaptation, and quality of life. The data were analyzed using SPSS 24.0 and AMOS 24.0. Results: The model fit indices were considered acceptable: 𝛘2/degree of freedom=2.93, standardized root mean residual=.07, comparative fit index=.90, and parsimonious normed fit index=.73. All eight direct-effect paths-from menopausal symptoms to support and adaptation, from support to adaptation and resilience, from resilience to adaptation and management, from management to quality of life, and from adaptation to quality of life-were significant. The explanatory power of the menopause transition model was 63.6%. Conclusion: Women who experience menopausal symptoms may be able to maintain and improve their quality of life if menopause management and menopause adaptation are successful through resilience and social support. Future research is needed to confirm whether strengthening facilitation as a nursing intervention strategy may promote healthy response patterns.
Purpose - This paper examines the international R&D contest in which the extent of intellectual property right (IPR) affects both the size of prize for the winning firm and the extent of positive spillover through cost of firms. Recognizing the possibility of incomplete protection of IPR, the present paper analyzes the effect of changes in the extent of IPR on payoffs to firms and social welfare. Design/methodology - This paper examines coordination of IPRs by countries in economic integration. The paper then develops a general model of international R&D contest with incomplete protection of IPR. An increase in the extent of IPR augments the share of the prize the winning firm can appropriate, while decreasing the positive cost externality. To derive sharper results, the paper considers the cases of linear and fixed spillovers. Findings - Under plausible assumptions, an increase in the IPR augments the payoff to each firm and the aggregate payoffs as well. The paper also shows that the number of firms participating in the R&D contest can be endogenously determined in the two-stage R&D contest. The higher the extent of cost spillover, and the larger the effective prize, the more firms participate in the international R&D contest. Originality/value - Existing studies assume that firms winning the R&D contest enjoy perfect IPR to the output of their R&D activities. This is a very restrictive assumption in that other firms can copy the new products or processes. By allowing for the incompleteness of the IPR, the present paper develops a more realistic model of R&D contest. The novelty of the present paper is to allow for the possibility that the higher extent of IPR increases the prize and decreases positive cost externality at the same time. The findings of the present paper can serve as a basis for government policy toward R&D activities of firms and protection of IPRs.
Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ2=21.18, df=7, I2=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ2=47.42, df=7, I2=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.
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