Journal of the Korean Society of Physical Medicine
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v.6
no.2
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pp.189-197
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2011
Purpose: Trunk muscle weakness in the children with cerebral palsy can lead to postural and alignment problems, breathing difficulties, and so on. Therefore, children with cerebral palsy can benefit from exercises that strengthen the muscles in their trunks. The purpose of this study was to investigate the effects of trunk muscle strengthening exercise on functional gross movement and balance ability in children with spastic diplegic cerebral palsy. Methods: We used single group repeated measure design in 8 children(four males, four females; aged 6~12 years; mean 8.3 years) with diplegia. The functional gross motor outcome measured by using the GMFM and balance ability of all children was measured by pediatric balance scale. All participants were alternately received trunk strengthening exercise and neurodevelopment treatment for 40 minutes twice per week during 8 weeks. Results: Significant and clinical meaningful improvement in functional gross motor and balance ability were shown. Conclusion: The results indicate that trunk strengthening exercise has a positive effect on both functional gross motor and balance ability in children with spastic diaplegic cerebral palsy.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.6
no.1
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pp.89-96
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2011
Objective : The purpose of this study is to evaluate the korean medical treatment for compressive neuropathy of radial nerve, especially chuna treatment of cervical vertebrae. Methods : Two patients were treated with acupuncture and moxibustion, herbal medication, chuna treatment on cervical vertebrae. To evaluate the wrist drop and numbness of hand, Coding Result of arbitrary values and manual muscle test(MMT), visual analogue scale(VAS) were used. Results : After 2 weeks-treatment(in case 1) & 5 weeks-treatment(in case 2), the movement and power of wrist were restored to nearly normal range, also the numbness of hands was removed. All cases show the improvement in the movement of wrist and the numbness of hands. Conclusions : Korean medical treatment including cervical manual therapy as chuna treatment is remarkably effective for radial nerve palsy. But further studies are required to concretely prove the effectiveness of chuna treatment on central vertebrae for peripheral neuropathy.
Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.
Purpose: The purpose of this study was to review articles in order to establish optimal contraction intensity and duration in the performance of relaxation techniques for maximal increase in range of motion. Methods: The Cochrane, EBSCO, Embase, Medline, ProQuest, PubMed, ScienceDirect, and Scopus databases were used to search articles from 1990 to January 2016. The search terms were "contract relax," "hold relax," "muscle energy technique (MET)," and "proprioceptive neuromuscular facilitation (PNF) stretching." Only experimental human studies (randomized controlled trials) that compared the effects of varying intensity and duration of isometric contraction were included. Non-English language and unpublished studies were excluded. Results: A total of 2,156 articles were initially identified, with only five eventually meeting the inclusion and exclusion criteria. Three studies compared the effects of varying intensity in isometric contraction and two studies compared the effects of varying duration in isometric contraction with regard to range of motion (ROM). Two articles suggested that submaximal voluntary isometric contraction was more effective than maximum voluntary isometric contraction (MVIC) in the improvement of ROM. One article showed that a longer contraction time led to greater increases in ROM. Conclusion: Submaximal voluntary isometric contraction was recommended during contract-relax exercises in healthy people. Lack of evidence makes it difficult to suggest the optimal duration of isometric contraction during relaxation techniques. For future research, high-quality evidence will be needed to establish the optimal contraction intensity for maximum improvement of ROM.
Purpose: The purpose of this study was to investigate the effect of Proprioceptive Neuromuscular Facilitation (PNF) applied to the unilateral upper extremity on the muscle activation of contralateral lower extremity. Twenty-two healthy subjects (mean age of 23.7 years) participated in this study. Method : PNF patterns applied on the unilateral upper extremity in all subjects were the flexion/abduction/external rotation and lifting pattern. The hold and appoximation techniques for the irradiation were applied to end range of both patterns. Muscle activations in four patterns were measured in vastus medialis, tibialis anterior, rectus femoris, and gastrocnemius medial muscles of contralateral lower extremity using surface EMG system. Each EMG value in individual muscle was normalized for maximal voluntary contraction. The data were analyzed by one factor analysis of variance with repeated measure test. Result : There were significant differences in the between-subject effect (muscles) and within-subject effect (patterns) in comparison of muscle activation by application of PNF patterns (p<.05). The irradiation led to higher activation in the flexion/abduction/external rotation pattern than that of lifting pattern in all muscles (p<.05). The approximation techniques revealed more activations than these of hold technique in all muscles (p<.05). Conclusion : These results suggest that the application of PNF patterns to the unilateral upper extremity affect on the muscle activation of contralateral lower extremity and increase according to the intensity of resistance. This mechanism of contralateral effect might provide a help to the development of treatment method for the affected side and functional improvement for the patients who have damages of central nervous system or musculoskeletal problems by orthopedic injury.
Objectives : In Oriental Medicine, the improvement of constipation is very important for patients at the acute stage of cerebrovascular accident. For constipation, oral medicine has usually been used but is not available to stroke patients with dysphagia and mental disorder, and may bring about side effects on the gastrointestinal tract. In such cases, general enema has been used for assistant therapy, We needed to develop a more effective enema technique on constipation of stroke patients. Methods : Sixty-three patients were researched. We treated 29 patients with Bo-Ryu enema and 34 patients with general enema. To compare the effect of the Bo-Ryu enema group with that of the general enema group, we analyzed general characteristics, bowel movement, abdominal examination and related symptoms. Results : Sixty-three patients comprised the Bo-Ryu (n=29) and general (n=34) enema groups. Between the Bo-Ryu and general enema groups, the Bo-Ryu enema was more effective than the general enema in the number of bowel movements, total and corrected amount of stool, tonus of rectus abdominis muscle and abdominal discomfort. However, there were not significant differences in the power of abdominal muscle, digestion and physical power. Among the subgroups, Bo-Ryu enema group was most effective in the number of bowel movements, total amount of stool and tonus of rectus abdominis muscle, and Bo-Ryu enema group was best in the corrected amount of stool and abdominal discomfort. Conclusions : Bo-Ryu enema should be considered as an effective and safe treatment for patients with constipation during the acute stage of cerebrovascular accident.
Purpose: The aim of this study was to investigate the effects of sit-to-stand training with various foot positions combined with visual feedback on muscle onset time and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned into three standing groups: one with a symmetrical foot position (SSF; n = 10), one with an asymmetrical foot position with the affected foot at the rear (SAF; n = 10), and one with visual feedback and an asymmetrical foot position (SVAF; n = 10). Sit-to-stand training with different foot positions was performed for 30 minutes a day, 5 times a week, for a total of 4 weeks. The effects on muscle onset time and balance were assessed. Results: In a comparison of the onset time of muscle contraction, the onset time of the affected side tibialis anterior and less-affected side gastrocnemius muscle and tibialis anterior was significantly shortened in the SAVF group. And onset time of the less-affected side tibialis anterior was shortened in the SAF group. There was a significant difference in the result of functional reach testing in the SVAF group. Conclusion: VRG was effective in improving muscle activity and balance in elderly women aged 65 and older. In this study, sit-to-stand training with visual feedback and asymmetrical foot position showed significant functional improvement.
Purpose: This study was conducted to determine the effects of motion taping on muscle activity and the WOMAC in a rehabilitation exercise program for elderly women with knee joint osteoarthritis. Methods: The subjects were 28 elderly women aged over 65 years with knee joint osteoarthritis. The subjects were divided into two groups: one experimental and one control group. During the study period, a total of 26 patients completed the experiment, with one drop each from the experimental group and control group. The experimental group applied motion taping and conducted a rehabilitation exercise program. The control group experienced a rehabilitation exercise program without motion taping. The rehabilitation exercise program consisted of warm-up exercises, maximum isometric exercises, the range of motion of the joints, and leg stretching exercises. The intervention was conducted three times a week for six weeks. To investigate the effects of the intervention, muscle activity and the WOMAC were measured. The WOMAC is a tool that can be used to evaluate the pain, stiffness, and physical function of osteoarthritis patients; it has 29 items in three areas. Results: The change in muscle activity according to the intervention showed a statistically significant increase in both the experimental group and control group. The WOMAC also showed statistically significant changes in terms of pain, stiffness, and physical function in both the experimental and control groups. The experimental group showed a greater functional improvement than the control group. Conclusion: For older women with osteoarthritis of the knee, a rehabilitation exercise program is a good intervention. When motion-taping is applied, it is considered to be an intervention program that can be expected to have a better effect on knee joint osteoarthritis.
Journal of the Korean Society of Physical Medicine
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v.17
no.3
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pp.59-67
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2022
PURPOSE: This study examined the effectiveness of task gait exercise combined with self-observation training to provide basic clinical data by analyzing the factors that task gait exercise combined with self-observation training has on the leg muscle activity and gait improvement in stroke patients. METHODS: The subjects were assigned randomly to experimental Group I, which mediated task gait exercise combined with self-observation training, and experimental Group II, which mediated task-walking movement. They received 30-minute interventions three times a week for four weeks. The leg muscle activity and 10 m walking test (10MWT) were conducted as pre-intervention tests, and they underwent a post-test four weeks later in the same manner as the pre-test. RESULTS: A statistically significant difference was observed in all muscles and 10MWT (p < .01) in experimental group I (p < .05), while there were significant differences only in the rectus femoris, biceps femoris, and 10MWT (p < .05). In a comparison of the changes between groups, there were statistically significant differences only in the tibialis anterior, soleus muscle, and 10MWT (p < .05). CONCLUSION: Self-observation training in experimental group I was effective in increasing the leg muscle activity and improving walking speed by discovering and correcting incorrect movements and following a normal gait pattern using the ankle joint. Therefore, the task gait exercise combined with self-observation training should be introduced and actively utilized for the rapid social recovery of stroke patients.
Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.
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