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This study investigates the effects of home-based Kakao Healthcare breathing exercises and stretching on respiratory function and fatigue in COVID-19-cured patients. A total of 35 participants performed four movements of home-based breathing exercises and five respiratory muscle stretching exercises four times a week for four weeks. Respiratory function was measured using forced vital capacity(FVC), forced expiratory volume in one second(FEV1), FEV1/FVC ratio, and peak expiratory flow(PEF). Fatigue was assessed using the Fatigue Severity Scale (FSS). Data analysis was performed using independent-sample and paired-sample t-tests in SPSS 24, with the significance level set at p < 0.05. After four weeks of home-based Kakao Healthcare breathing exercises, there were significant increases in respiratory FVC, FEV1, FEV1/FVC, and PEF function values observed in the training group (T.G.) after the exercise intervention (p < 0.05). Such an increase was observed when comparing these values with their corresponding pre-exercise measurements. In contrast, there were no statistically significant differences in respiratory function outcomes before and after exercise in the control group (C.G.) (p > 0.05). The FSS scores were statistically significant within the training group (T.G.) (p > 0.05). The 4-week Kakao Healthcare breathing exercise scheme was found to be capable of improving some respiratory functions in COVID-19-recovered patients, but it showed no significant improvement in fatigue levels.
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The use of virtual reality (VR) content in neurological disorders with cognitive impairment is increasing. We have developed a device that incorporates virtual drum beating content, designed for digit memorization training. This study aimed to investigate the effects of realistic cognitive training on brain activity using functional near-infrared spectroscopy (fNIRS). Thirty healthy individuals were recruited and randomly assigned into two groups: conventional cognitive exercise (CCE) and a realistic cognitive exergame (RCE). Subjects in the CCE group underwent memory training by memorizing numbers displayed on a computer screen and then writing them on paper. The main outcome measure was the oxyhemoglobin level in the dorsolateral prefrontal cortex (DLPFC). As a result, the average number of digits was 7.86 ± 0.63 for the CCE and 7.6 ± 0.82 for the RCE. The mean difference in ΔHbO was 1.417 ± 0.616 µm (p = 0.029) in channel 2, located in the right DLPFC. Channel 7 and channel 10, which measured activations in the hypothesized medial orbitofrontal cortex (OFC), also showed a significant mean difference of ΔHbO. DLPFC and OFC presented higher activation in the RCE group (p < 0.05), attributable to the simultaneous memory training and virtual drum beating, which provided various sensory inputs (visual, auditory, and vibration). Although DLPFC involvement in cognitive processes remains controversial, our findings suggest that realistic memory training using drumming content can lead to safer activation of the DLPFC compared to conventional cognitive training.
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Functional ankle instability (FAI), which is characterized by recurrent ankle sprains and perceived joint instability, arises from various factors contributing to compromised biomechanical control during activities, particularly those involving landing tasks. While current research predominantly addresses lower-extremity and core stabilization interventions for FAI, the contribution of upper body control to landing biomechanics in this population remains insufficiently explored. In this study, 42 participants (19 males, 23 females) with FAI were randomly assigned to either the upper-body control training group (UBCTG) or the core muscle stabilization training group (CMSTG). The groups underwent six-week interventions, with the UBCTG receiving a dynamic core exercise program including upper body control and the CMSTG receiving static core muscle training. Pre- and post-intervention assessments encompassed electromyography of the gastrocnemius, tibialis anterior, and peroneus longus, motion analysis of the lower extremities, and ground reaction force (GRF) readings during a single-leg-jump task. Additionally, dynamic balance was assessed using the Y balance test and self-reported measurements of ankle instability were performed. The results showed similar increases in muscle activation, joint movement, and self-reported ankle instability scores within both groups. However, significant between-group differences were observed in terms of knee flexion angle, dynamic balance, and ankle instability scores, favoring the UBCTG. Although the peak vertical GRF significantly decreased and the time to peak vertical GRF increased in both groups, more changes were noted in the UBCTG. Our results demonstrated that dynamic core exercises with additional upper body control training enhance landing biomechanics, dynamic balance, and stability in individuals with FAI. Consequently, we recommend incorporating shoulder girdle exercises, proprioceptive drills, and balance exercises into dynamic core training.
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BACKGROUND: This study was conducted to assess the effect of electromechanical-assisted gait training intensity on walking ability in patients over 3-month post-stroke. METHODS: Data from two randomized controlled trials (RCTs) were collected under the same study design of assessment and intervention, excluding intervention time per session. After matching the inclusion criteria of two RCTs, the experimental groups of each RCT were defined as low-intensive (LI) and high-intensive (HI) group according to the intervention time per session. Primary outcome was the difference of the change in Functional Ambulatory Categories (FAC) between LI and HI gait training. Secondary outcomes were the difference of changes in mobility, walking speed, walking capacity, leg-muscle strength, balance and daily activity evaluated with Rivermead Mobility Index (RMI), 10 m walk test (10MWT), 6-min walk test (6MWT), Motricity Index (MI), Berg Balance Scale (BBS) and Modified Barthel Index (MBI) respectively. RESULTS: The FAC improved after gait training in both groups. The secondary outcomes also improved in both groups except RMI and MI in HI group. The change of all outcomes were not different between groups except RMI. The change of RMI in the LI group was greater than that in the HI group statistically, but it did not meet minimal clinically important difference. CONCLUSIONS: The improvement of walking ability after LI or HI gait training was not different if providing the same total gait training time. By providing the electromechanical gait training intensively, we could shorten the gait training period to improve walking ability and customize the training program according to the patient training abilities. TRIAL REGISTRATION: Name of the registry: Clinical Research Information Service. TRIAL REGISTRATION NUMBER: No. KCT0002195(RCT1), No. KCT0002552(RCT2). Date of registration: 10/04/2016(RCT1), 10/05/2017(RCT2). URL of the trial registry record: https://cris.nih.go.kr/cris/search.
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OBJECTIVE: To investigate the efficacy of electromechanically-assisted rehabilitation of upper limb function in post-stroke patients. DESIGN: Randomized controlled trial. SUBJECTS: Forty-eight stroke patients. METHODS: Patients were randomly assigned to control and experimental groups. The control group underwent occupational therapy training with conventional methods. The experimental group underwent electromechanically-assisted training using an end effector robot (Camillo®). Interventions were provided for 30 min per day, 5 days a week, for 4 weeks. Primary outcome was change in Fugl-Meyer Assessment (FMA) before and after training. Secondary outcomes were changes in hand function, upper limb strength, spasticity, mental status and quality of life. RESULTS: Mean improvement in FMA was 1.17 (standard deviation (SD) 4.18) in the control group and 2.52 (SD 5.48) in the experimental group. Although FMA in the experimental group improved significantly after training, the improvement in FMA did not differ significantly between groups. Among the secondary outcomes, the Motricity Index (MI) improved significantly after training in the experimental group, and the change in MI between groups was statistically significant. CONCLUSION: Electromechanically-assisted rehabilitation using Camillo® was not more effective than conventional occupation therapy for upper arm function.
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OBJECTIVE: To assess the effect on walking ability of electromechanically assisted gait training with a gait trainer (Exowalk®) for patients with chronic stroke. DESIGN: Randomized controlled trial. SUBJECTS: Forty patients with hemiplegia after stroke. METHODS: Patients were randomly assigned to control and experimental groups. The control group underwent physical therapist-assisted gait training and the experimental group underwent electromechanically assisted gait training. Interventions were provided for 60 min, 5 days a week, for a period of 2 weeks. Primary outcome was change in Functional Ambulatory Category. Secondary outcomes were walking speed, walking capacity, leg muscle strength and balance. All outcomes were measured before and after the intervention. RESULTS: Although the Functional Ambulatory Category improved significantly after gait training in both groups, the change in Functional Ambulatory Category did not differ between groups. In both groups most secondary outcomes also improved after gait training, but the changes in secondary outcomes did not differ between groups. CONCLUSION: In patients with chronic stroke, walking improved after gait training with or without electromechanical assistance. Electromechanically assisted gait training was not superior to conventional physiotherapy.
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Terapia por Exercício/métodos , Marcha/fisiologia , Modalidades de Fisioterapia/normas , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/complicações , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: To assess the efficacy of electromechanical exoskeleton-assisted gait training on walking ability of stroke patients based on ambulatory function, muscle strength, balance, gait speed, and capacity. DESIGN: Randomized controlled trial. SETTING: University rehabilitation hospital. PARTICIPANTS: Individuals (N=40) with stroke who could stand alone. INTERVENTIONS: Patients were randomly assigned to control and experimental groups. The control group underwent physical therapist-assisted gait training by conventional method. The experimental group underwent electromechanical gait training assisted by an exoskeleton device. Both types of gait training were performed for 30 minutes each day. The therapeutic interventions were provided for 5 days a week for a period of 4 weeks in both groups. MAIN OUTCOME MEASURES: Functional ambulatory category (FAC) before and after gait training. Changes in FAC were the primary outcomes to evaluate the efficacy of electromechanical exoskeleton-assisted gait training. Changes in mobility, walking speed, walking capacity, leg muscle strength, daily activity, and balance were secondary outcomes. RESULTS: FAC in the control group was 2.44±1.55 in the pretraining and 2.75±1.53 in the post-training. FAC in the experimental group was 3.22±1.31 in the pretraining and 3.78±1.44 in the post-training. Although FAC between pre- and post-training sessions improved in both groups, the changes in FAC were statistically significant in the experimental group alone. Most secondary outcomes in both groups also showed improvement after gait training. However, the differential outcomes were not varied between the 2 groups after adjusting the data for age and stroke duration. We did not exclude patients based on time since stroke onset. The average stroke duration was 530.11±389.21 days in the experimental group. The changes in FAC of the experimental group were negatively correlated with stroke duration. No adverse events were noticed during gait training in either group. CONCLUSIONS: Electromechanical exoskeleton-assisted gait training is as effective as conventional gait training by a physical therapist when administered by a gait trainer. As an overground walking system without harness, electromechanical exoskeleton replaced a physical therapist in assisted gait training for patients who stand alone. Because the ambulatory function of stroke patients was affected negatively by stroke duration, the effect of electromechanical-assisted gait training might decline with increased stroke duration.
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Terapia por Estimulação Elétrica/métodos , Exoesqueleto Energizado , Transtornos Neurológicos da Marcha/terapia , Reabilitação do Acidente Vascular Cerebral/métodos , Acidente Vascular Cerebral/fisiopatologia , Adulto , Idoso , Avaliação da Deficiência , Terapia por Estimulação Elétrica/instrumentação , Feminino , Transtornos Neurológicos da Marcha/etiologia , Transtornos Neurológicos da Marcha/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade , Acidente Vascular Cerebral/complicações , Reabilitação do Acidente Vascular Cerebral/instrumentação , Resultado do Tratamento , Teste de Caminhada , Caminhada/fisiologiaRESUMO
[Purpose] The purpose of this study was to investigate the effect of co-stabilizer muscle activation on knee joint position sense. [Subjects and Methods] This study was a pre-post, single-blinded randomly controlled trial (angle sequence randomly selected) design. Seven healthy adults with no orthopaedic or neurological problems participated in this study. Knee joint position sense was measured by a target matching test at target angles of 30°, 45° and 80° of knee flexion a using digital inclinometer under two conditions: erect sitting, which is known to highly activate co-stabilizer muscle and slump sitting, which is known to little activate the co-stabilizer muscle. [Results] A significant difference in joint position matching error at the knee flexion angle of 45° was founded between two conditions erect sitting: (3.83 ± 1.47) and slump sitting: (1.00 ± 0.63). There were no significant differences in joint position matching error at the other target angles. [Conclusion] Knee joint position sense at 45° is likely to be affected by activation of co-stabilizer muscle, and this value is suitable for facilitation of joint position sense with skilled movement.