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Comparison Between Stroke Patients and Normal Persons for Trunk Position Sense and It's Relation to Balance and Gait (정상인과 뇌졸중 환자의 체간 위치감각 비교 및 보행과 균형에 미치는 영향)

  • Yang, Hea-Duck;Kim, Chang-beom;Choi, Jong-Duk;Moon, Young
    • Physical Therapy Korea
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    • v.27 no.3
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    • pp.178-184
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    • 2020
  • Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.

Effects of Trunk Position Sense through Visual Cue Deprivation Balance Training in Subacute Stroke (앉은 자세에서의 시각을 차단한 균형훈련이 아급성기 뇌졸중 환자의 체간 위치감각에 미치는 영향)

  • Han, Kyu-Bum;Shin, Won-Seob
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.3
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    • pp.327-335
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    • 2013
  • PURPOSE: The purpose of this study is to investigate effects of trunk position sense through visual cue deprivation balance training in subacute stroke patients. METHODS: The subjects were randomly allocated to two groups: experimental(n=10) and control(n=10). Both groups performed balance training on sitting for 30minute after measurements. Trunk position sense test was assessed using the David back concept to determine trunk repositioning error for four movement(flexion, extension, affected side lateral flexion, non-affected side lateral flexion). Measurements on each test were assessed prior to the balance training and then immediately following the balance training. RESULTS: In comparison of the difference of the trunk position sense between groups, the experimental group decreased significantly in trunk repositioning error of flexion, extension and affected side lateral flexion than control group(p<.05). CONCLUSION: The trunk position sense of the experimental group showed more improvement after the balance training program compared to the control group, Therefore, these results suggest that visual cue deprivation training is considered an effective exercise method for individuals with subacute stroke.

Activation of the Triceps Surae During Heel Raising Depend on the Knee Joint Flexion Angles (무릎관절 굽힘 각도에 따른 뒤꿈치 들기 동안 종아리 세갈래근의 활성도)

  • Kwon, Yu-Jeong;Song, Min-Young
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.4
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    • pp.497-503
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    • 2013
  • PURPOSE: The purpose of this study was to investigate the change of triceps surae activation during heel raise test in standing among knee flexion angles($0^{\circ}C$, $30^{\circ}C$, $45^{\circ}C$, $60^{\circ}C$). METHODS: Twenty healthy individuals performed unilateral plantarflexion in standing with $0^{\circ}C$, $30^{\circ}C$, $45^{\circ}C$, $60^{\circ}C$ knee flexion. Activity of medial gastrocnemius(MG), lateral gastrocnemius(LG), soleus(Sol) was recorded with surface electromyography(EMG). RESULT: The muscle activations induced the four different positions were compared and results showed that was significant difference MG and LG while the angle increase from $0^{\circ}C$ to $30^{\circ}C$, $45^{\circ}C$, $60^{\circ}C$ but Sol did not show significant differences in every angle. CONCLUSION: This study suggest that $30^{\circ}C$ knee flexion is required to induce a significant mechanical disadvantage of gastrocnemius.

The Effects of Manipulation and Mobilization on NDI and CROM in Young Adults with Mild Neck Disability (경도의 경부장애를 가진 젊은 성인에서 도수교정과 관절가동술이 NDI 및 CROM에 미치는 영향)

  • Kim, Dong-Dae
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.16 no.2
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    • pp.53-60
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    • 2010
  • Purpose : Neck pain is commonly experienced by both adolescents and adults. The purpose of this study was to measure neck disability index(NDI) and the cervical range of motion(CROM) following spinal manipulation and mobilization techniques. Methods : Thirty participants(manipulation=15, mobilization=15) with mild neck disability volunteered for this study. It was used to measure NDI with NDI questionnaire and six motions(neck flexion and extension, left and right lateral flexion, left and right rotation) with the CROM instrument. Independent t-test and paired t-test were used to estimate NDI and CROM, and compared left with right motions. Results : A significant decrease in NDI were found after spinal manipulation and mobilization treatment(p<.05). A trend toward increase in all cervical motions(flexion, extension, left and right lateral flexion, left and right rotation), after interventions, were revealed(p<.05). The significant differences were not found on NDI and CROM between the group(p<.05). It was presented asymmetric motions in cervical lateral flexion(p<.05) before and after treatment. Conclusions : Our results suggest that manipulation and mobilization probably provide at least short-term benefits for patients with mild neck pain. It is needed to be studied the factors and preventive methods influencing the asymmetric cervical motion.

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Characteristics of Muscle Contraction During the Wrist Movement in Chronic Hemiplegic Stroke Patients (만성 편마비 환자의 손목 운동 시 근수축 특성)

  • 태기식;김사엽;송성재;이지용;이영희;김영호
    • Proceedings of the Korean Society of Precision Engineering Conference
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    • 2004.10a
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    • pp.246-249
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    • 2004
  • The purpose of this study was to investigate the characteristics between EMG timing of muscle contraction and motor impairment in chronic hemiplegic stroke patients. Delay time and co-contraction of 4 patients who had stroke less than 3 years were measured during isometric wrist flexion and extension along the 3 seconds beep signal. Onset and offset of muscle contraction were significantly delayed on the more affected sides than control sides. Offset was significantly delayed than the onset on the affected sides in wrist flexion. Also, recruitment of antagonist was larger than agonist on the affected sides. Co-contraction ratio on the affected side was significantly smaller than control sides in wrist flexion. In affected sides, Fugl-Meyer motor assessment(FMA) shows the correlation of onset delay in wrist flexion and extension. However, co-contraction ratio correlated with FMA in wrist flexion. EMG assessment is likely to be useful outcome measure and provide insights into mechanism for motor recovery in stroke patients.

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The suggestion of Proper Pressure level in Cranio-Cervical Flexion Exercise for Deep Cervical Flexor by Ultrasonographic Measurement (초음파 영상을 통한 머리-목 굽힘 운동의 적정 수준 제시에 관한 연구)

  • Jun, Deok-Hoon;Fell, Dennis W.;Kim, Kyoung
    • Journal of the Korean Society of Physical Medicine
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    • v.6 no.4
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    • pp.497-504
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    • 2011
  • Purpose : Chronic cervical pain is a common source of disability in society. There has been no research regarding the amount of pressure for the deep cervical flexors during cranio-cervical flexion exercise (CCFE). The purpose of this study is to determine optimal pressure levels to facilitate deep cervical muscles (longus colli & longus capitis) during cranio-cervical flexion exercise, using ultrasound measurement of the muscles. Methods : Using a cross-sectional design, the study was performed in an experimental group of 19 subjects (7 men, 12 women) with no cervical pain. Participants were instructed to perform the CCFE, and during the five incremental stages of the test, changes in thickness, as compared to resting baseline values, were measured using ultrasonography for sternocleidomastoid muscle (SCM) and deep cervical muscles (DCF). Results : Both DCF and SCM muscles demonstrated an increase in recruitment with each progressive phase of the test. In comparing the different pressure increments, the most significant changes found in DCF thickness were between phase 2 and phase 3 (p<.05). However no differences were found between pressure increments for SCM thickness (p>.05). Conclusion : The results suggest 26 mm Hg as the optimal pressure level during cranio-cervical flexion exercise for facilitation of deep cervical flexor.

Effects of Isometric Upper Limb Contraction on Trunk and Leg Muscles During Sit-to-stand Activity in Healthy Elderly Females

  • Jang, Eun-Mi;Oh, Jae-Seop;Kim, Mi-Hyun
    • Journal of the Korean Society of Physical Medicine
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    • v.12 no.1
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    • pp.61-66
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    • 2017
  • PURPOSE: The purpose of this study was to investigate the effects of isometric upper limb contraction on the trunk and lower extremity muscles during the sit-to-stand activity in elderly females. METHODS: Eighteen healthy elderly females performed three directional isometric upper extremity contractions (flexion, extension, and horizontal abduction movements) using an elastic band during sit-to-stand activity. Electromyography signals were collected from the internal oblique, erector spinae, rectus femoris, and biceps femoris muscles. RESULTS: Internal oblique activity was greater in bilateral shoulder flexion and bilateral shoulder horizontal abduction than in neutral position (p<.05). Erector spinae and rectus femoris muscle activities in bilateral shoulder flexion was greater than in neutral position and bilateral shoulder extension (p<.05). Biceps femoris activity was significantly greater in bilateral shoulder flexion than in bilateral shoulder extension and horizontal abduction, and in neutral position compared to bilateral shoulder extension (p<.05). CONCLUSION: These results suggest that incorporating isometric upper limb contraction may be beneficial for enhancing the contribution of trunk and lower extremity muscle activities to trunk stabilization during sit-to-stand activity. Therefore, isometric upper limb contraction during sit-to-stand tasks, especially in flexion, may be used to elicit contraction of the lumbopelvic region muscles within a tolerable range, for developing endurance and strength in the elderly.

The Effects of High-frequency, Non-noxious TENS on RIII Nociceptive Flexion Reflex and Temporal Summation in Human Subjects (정상인에서 고빈도의 무통증성 경피적 신경자극이 RIII Nociceptive Flexion Reflex와 Temporal Summation에 미치는 영향)

  • Kim, Yong-Ik;Lee, Jang-Weon;Kim, Jung-Soon;Chung, Jin-Hun;Park, Wook
    • The Korean Journal of Pain
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    • v.14 no.1
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    • pp.19-25
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    • 2001
  • Background: Transcutaneous electrical nerve stimulation (TENS) has been used widely, but its effects are controversial. This is probably due to the varying intensity and type of pain. We designed a study to assess the effects of the TENS on the RIII nociceptive flexion reflex as the resting pain level and the temporal summation as a repeated, movement related pain in 7 normal volunteer subjects. Methods: High frequency (80 Hz), non-noxious TENS was applied over the left popliteal fossa for 20 minutes. Ipsilateral RIII reflexes induced by single electrical stimulus and temporal summation of pain responses to repeated stimuli (five stimuli at 2 Hz) were recorded before, during (just before stopping), and subsequently at 20 minutes after TENS. Results: R (III) nociceptive flexion reflex activity during and after TENS was more significantly decreased than before treatment. However, the temporal summation threshold was not changed. Conclusions: We conclude that high frequency, non-noxious TENS could be effective on resting pain relief in the same segment but not on the movement related pain.

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The Effect of the Laptop Computer Stand to Maintain the Good Posture of Neck (랩톱 컴퓨터 스탠드의 목 자세 개선효과 분석)

  • Oh, Imsuk;Lee, Jaehyun;Chee, Youngjoon
    • Journal of Biomedical Engineering Research
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    • v.38 no.6
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    • pp.291-294
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    • 2017
  • It is known that laptop computer stand is helpful to maintain the good posture while using laptop computer on the desk. But the quantitative validation of its effect has not been reported. Using the wearable neck posture tracker, the forward flexion angle of the neck can be measured in daily life. In this study, the forward flexion angles of the neck while using the laptop computer with and without laptop computer stand were compared. From the posture data of 10 subjects for 6 hours, the average of the forward flexion angle was 0.9 degree with laptop computer stand and 16.3 degree without laptop computer stand. As the conclusion, laptop computer stand can decrease the forward flexion angle which is known as forward head posture while using the laptop computer on the desk.

The Effect of Self-controlled Feedback on Proprioception in Elbow Flexion of Healthy Subjects (정상성인의 팔굽 굽힘 시 자기통제 피드백이 고유수용성감각에 미치는 영향)

  • Yoon, Jung-Gyu
    • Journal of the Korean Society of Physical Medicine
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    • v.7 no.4
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    • pp.493-500
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    • 2012
  • PURPOSE: The purpose of this study was to investigate effect of self-controlled feedback on proprioception in elbow flexion. METHODS: Thirty young adult volunteered to participate and were randomly assigned to one of three groups (self-controlled, yoked, control). Power and velocity in elbow flexion was measured by PRIMUS RS (BTE Tech., Hanover, U.S.A). Statistical analysis was used multivariate ANOVA to know effect of self-controlled feedback on proprioception in elbow flexion. Post hoc was used Scheffe. RESULTS: In acquisition phase to practice effect, variable errors in self-controlled group was significantly low scored more than yoked and control group. In retention phase to learning effect, variable errors in self-controlled group was significantly low scored more than yoked and control group. CONCLUSION: Self-controlled feedback was more effective on movement control when the learner could make a decision about receiving feedback after the trial. This seems to support the view that self-controlled feedback benefits learning, because learners can make a decision about feedback based on their performance on a given trial.