Effect of Ankle Range of Motion (ROM) and Lower-Extremity Muscle Strength on Static Balance Control Ability in Young Adults: A Regression Analysis.

BACKGROUND The purpose of this study was to investigate the effect of ankle ROM and lower-extremity muscle strength on static balance control ability in young adults. MATERIAL AND METHODS This study was conducted with 65 young adults, but 10 young adults dropped out during the measurement, so 55 young adults (male: 19, female: 36) completed the study. Postural sway (length and velocity) was measured with eyes open and closed, and ankle ROM (AROM and PROM of dorsiflexion and plantarflexion) and lower-extremity muscle strength (flexor and extensor of hip, knee, and ankle joint) were measured. Pearson correlation coefficient was used to examine the correlation between variables and static balance ability. Simple linear regression analysis and multiple linear regression analysis were used to examine the effect of variables on static balance ability. RESULTS In correlation analysis, plantarflexion ROM (AROM and PROM) and lower-extremity muscle strength (except hip extensor) were significantly correlated with postural sway (p<0.05). In simple correlation analysis, all variables that passed the correlation analysis procedure had significant influence (p<0.05). In multiple linear regression analysis, plantar flexion PROM with eyes open significantly influenced sway length (B=0.681) and sway velocity (B=0.011). CONCLUSIONS Lower-extremity muscle strength and ankle plantarflexion ROM influenced static balance control ability, with ankle plantarflexion PROM showing the greatest influence. Therefore, both contractile structures and non-contractile structures should be of interest when considering static balance control ability improvement.

Study on the design development of a multi joint ankle foot orthosis.

[Purpose] The purpose of this study was to investigate the effects of a newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Participants and Methods] This study was investigated 10 participants who were diagnosed with stroke. Patients were evaluated based on a 10-meter walk test, timed up and go test and Berg balance scale after each participant wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis (AFO) that consisted of orthosis joints (having poster-stop joint and Klenzak joint functions). [Results] The 10-meter walk test, timed up and go test and Berg balance scale showed significant differences in the orthosis with the Klenzak joint function. [Conclusion] The appropriate use of Klenzak AFO of the newly designed multi joint AFO is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

The relationship between anterior pelvic tilt and gait, balance in patient with chronic stroke.

[Purpose] The aim of this study is to find out the association between anterior pelvic tilt and gait and balance in chronic stroke. [Subjects and Methods] Fourteen chronic stroke patients were included in this study. A palpation meter was employed to measure the anterior inclination of the pelvis. A GAITRite system automates measuring temporal and spatial gait parameters. A 10-Meter Walk test was used to measure gait speed. The Timed Up and Go test was used to measure the dynamic balance ability and gait ability of the participants. A BioRescue was used to assess balance by measuring the moving distance and area of the center of pressure. [Results] There were significant negative correlations between pelvic anterior tilt and velocity, step length, and stride. There were significant positive correlations between velocity and cadence, step length, and stride length. There were significant negative correlations between velocity and cycle time, H-H base, TUG, and 10MWT. There was significant negative correlation between cadence and cycle time and H-H base. [Conclusion] This study showed a negative correlation between pelvic anterior tilt and gait function including gait speed and step length.

Effects of skilled reach training with affected forelimb and treadmill exercise on the expression of neurotrophic factor following ischemia-induced brain injury in rats.

[Purpose] The aim of the present study was to investigate effects of skilled reach training with affected forelimb and treadmill exercise on the expression of neurotrophic factor following ischemia-induced brain injury in rats. [Subjects and Methods] Thirty male Sprague-Dawley rats were divided into 3 groups randomly: namely, the control sacrified 2 weeks after surgery, skilled reach training with forepaw contralateral to brain injury for 2 weeks, and treadmill exercise for 2 weeks. Transient focal cerebral ischemia was induced by intraluminal occlusion of the left middle cerebral artery. After that, skilled reach training and treadmill exercise were conducted. Western blot analysis was performed to investigate expressions of neurotrophic factors. [Results] There were significant differences in brain-derived neurotrophic factor and nerve growth factor expression between the control group and the experimental group. There were no significant differences in brain-derived neurotrophic factor and nerve growth factor expression between the skilled reach training group and the treadmill exercise group. [Conclusion] Skilled reach training and treadmill exercise can affect the expression of neurotrophic factors.

The effect of horse-riding simulator exercise on the gait, muscle strength and muscle activation in elderly people with knee osteoarthritis.

[Purpose] The aim of this study was to examine the effects of horse-riding simulator exercise on gait ability and muscle strength, muscle activation in elderly with knee osteoarthritis. [Subjects and Methods] Thirty elderly patients with knee osteoarthritis were recruited, a horse-riding simulator group consisted of fifteen subjects and they performed exercise three times a week for eight weeks. And each exercise was performed, horse riding simulator exercise for 15 minutes and knee strengthening exercise for 15 minutes. Knee strengthening exercise group consisted of fifteen subjects and performed knee strengthening exercise for 30 minutes. [Results] The horse-riding simulator group showed significant differences after the intervention in timed 10-meter walk test (10MWT), muscle strength, muscle activation. [Conclusion] The results of this study indicate that horse-riding simulator exercise is effective on knee osteoarthritis. Therefore, horse-riding simulator exercise can be used for gait training for knee osteoarthritis.

Test-retest reliability of an active range of motion test for the shoulder and hip joints by unskilled examiners using a manual goniometer.

[Purpose] The purpose of this study was to analyze test-retest reliability of an active range of motion test using a manual goniometer by unskilled examiners. [Subjects and Methods] Active range of motion was measured in 30 students attending U university (4 males, 26 females). Range of motion during flexion and extension of the shoulder and hip joints were measured using a manual goniometer. [Results] Flexion and extension of the shoulder joint (ICC=0.906 and ICC=0.808) and (ICC=0.946 and ICC=0. 955) of the hip joint showed excellent reliabilities. [Conclusion] The active range of motion test using a manual goniometer showed very high test-retest reliability in unskilled examiners. When examiners are aware of the method of the test, an objective assessment can be conducted.

The effect of an active vibration stimulus according to different shoulder joint angles on functional reach and stability of the shoulder joint.

[Purpose] The purpose of this study was to analyze the effect of an active vibration stimulus exercise according to shoulder joint angles on functional reach and stability of the shoulder joint. [Subjects and Methods] Thirty healthy male students participated in this study. Upper limb length of each subject was measured to obtain normalized measurement values. The exercise groups were as follows: group I (n=10, shoulder joint angle of 90°), group II (n=10, shoulder joint angle of 130°), and group III (n=10, shoulder joint angle of 180°). After warm-up, an active vibration stimulus was applied to the subjects with a Flexi-Bar. The Functional Reach Test and Y-balance test were conducted for measurement of shoulder stability. [Results] Analysis of covariance was conducted with values before the intervention as covariates to analyze the differences among the groups in the two tests. There were significant differences among the groups. According to Bonferroni post hoc comparison, group I showed greater improvement than group III in the Functional Reach Test, and group II showed greater improvement than group I and group III in the Y-balance test. [Conclusion] The effect of the exercise with different shoulder joint angles revealed that the shoulder joint has a certain effective joint angle for its functionality and stability. In addition, application of an active vibration stimulus with a Flexi-Bar can be a very effective tool for improvement of functionality and stability of the shoulder joint.

Partial correlation between lower muscle thickness, 10-meter walk test, and the timed up & go test in children with spastic cerebral palsy.

[Purpose] The purpose of this study was to examine the correlation between lower extremity muscle thickness and gait ability through the 10-meter walk and timed up and go tests. [Subjects and Methods] A total of 28 children (20 males and 8 females) with spastic cerebral palsy undergoing physical therapy at D hospital in D city, South Korea participated in this study. Partial correlation analysis was performed to analyze the correlation between lower extremity muscle thickness and gait ability (10-meter walk test and timed up and go test). [Results] There was a positive correlation between muscle thickness and the 10-meter walk test (RF=0.41 and VL=0.52). Correlation between the muscle thickness and the timed up and go had a negative correlation (VL=-0.45, MG=-0.51, and LG=-0.39). [Conclusion] In children with cerebral palsy, knee extensor muscles that are more developed increased gait ability and calf muscles that are more developed increased sit to stand ability.

Analysis of the reliability of the make test in young adults by using a hand-held dynamometer.

[Purpose] The purpose of this study was to analyze intra-rater and inter-rater reliabilities of the make test, a manual muscle testing measurement method, using a hand-held dynamometer in Korean young adults. [Subjects and Methods] A total of 42 university students participated in this study. The make test, a manual muscle testing method, was conducted. A hand-held dynamometer was used to measure elbow joint flexion during the make test. [Results] Both intra-rater (the intraclass correlation coefficient=0.992) and inter-rater reliabilities (the intraclass correlation coefficient=0.949) were excellent, with values over 0.9. [Conclusion] The make test is a useful manual muscle testing method with high intra-rater and inter-rater reliability.

Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain.

[Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula.

Analysis of the correlation between the differences in muscle strengths between the bilateral lower extremities and postural stability in healthy adults.

[Purpose] The purpose of this study was to examine the correlation between the differences in muscle strengths between the bilateral lower extremities and the level of postural sway that indicates postural stability. [Subjects and Methods] A total of 49 students (18 males and 31 females) at Y University in Gyeongsangnam-do, South Korea, participated in this study. Partial correlation analysis was performed to determine the effects of sway length and velocity on the differences in muscle strengths between the lower extremities. [Results] Both sway length and sway velocity showed a negative correlation with the difference in bilateral ankle dorsiflexion strength. Both sway length and sway velocity showed a positive correlation with the difference in bilateral hip flexion strength. [Conclusion] Difference in left-right muscle strengths of hip flexion and ankle dorsiflexion can affect postural stability when the levels of lower extremity muscle strengths are excluded.

The intra- and inter-rater reliabilities of the Short Form Berg Balance Scale in institutionalized elderly people.

[Purpose] The purpose of this study was to examine the intra- and inter-rater reliabilities of the Short Form Berg Balance Scale in institutionalized elderly people. [Subjects and Methods] A total of 30 elderly people in a nursing facility in Y city, South Korea, participated in this study. Two examiners administered the Short Form Berg Balance Scale to one subject to investigate inter-rater reliability. After a week, the same examiners administered the Short Form Berg Balance Scale once more to investigate intra-rater reliability. [Results] The intra-rater reliability was 0.83. The inter-rater reliability was 0.79. Both reliabilities were high (more than 0.7). [Conclusion] The Short Form Berg Balance Scale is a version of the Berg Balance Scale shortened by reducing the number of items, but its reliabilities were not lower than those of the Berg Balance Scale. The Short Form Berg Balance Scale can be useful clinically due to its short measurement time.

The intra- and inter-rater reliabilities of lower extremity muscle strength assessment of healthy adults using a hand held dynamometer.

[Purpose] The purpose of this study was to examine the intra- and inter-rater reliabilities of lower extremity muscle strength assessment of healthy adults using hand held dynamometer. [Subjects and Methods] A total of 55 students (19 males and 36 females) in Y University in Gyeongsangnam-do, South Korea participated in this study. Lower extremity muscle strength was measured using a hand-held dynamometer (Commander Muscle Tester, JTech, USA). Flexion and extension strengths of the hip joint, the knee joint, and the ankle joint were measured. [Results] The intra-rater reliabilities were excellent (above 0.9) for the flexion and extension strengths of the ankle, knee, and hip joints. The inter-rater reliabilities were also excellent (above 0.8) for the flexion and extension strengths of the ankle, knee, and hip joint. [Conclusion] Lower extremity muscle strength assessment using a hand-held dynamometer provided consistent results when conducted by different examiners and when measured several times. Therefore, this method is a useful way of deriving objective and quantitative measurement values.

The effects of dual-task gait training on foot pressure in elderly women.

[Purpose] The purpose of this study was to evaluate the effect of dual-task gait training on foot pressure in elderly women. [Subjects and Methods] Twenty elderly people in local communities performed dual-task gait training for 20 minutes three times per week for 8 weeks. Foot pressure was measured using an F-scan System (Tekscan, South Boston, MA, USA) before the intervention and in the 4th and 8th weeks of the intervention. [Results] Foot pressure increased significantly between the 4th and 8th weeks of the intervention in the CFF (central forefoot); between before the intervention and the 4th week, between the 4th and 8th weeks, and between before the intervention and the 8th week in the MF (midfoot); and between before the intervention and the 4th and 8th weeks in the HL (heel). [Conclusion] The results of this study indicate that dual-task gait training may improve the gait ability of elderly persons residing in the community.

Correlation between the Mini Mental State Examination-Korean version and the Measurement of Quality of the Environment in the institutionalized elderly.

[Purpose] This study aimed to investigate the correlation between the cognitive level of the elderly and their attitude towards the living environment. [Subjects and Methods] A total of 80 elderly people hospitalized in a nursing home in K city, South Korea, participated in this study. Pearson correlation analysis was used to test the relationships between scores on the Mini Mental State Examination-Korean Version and Measurement of Quality of the Environment (facilitators and obstacles). [Results] A positive and moderately strong correlation (r = 0.462) was found between scores on the Mini Mental State Examination and the Measurement of Quality of the Environment (obstacle). [Conclusion] In a nursing home, patients with relatively higher cognitive levels can perceive more obstacles in the surrounding environment.

The ratio of change in muscle thickness between superficial and deep cervical flexor muscles during the craniocervical flexion test and a suggestion regarding clinical treatment of patients with musculoskeletal neck pain.

[Purpose] The purpose of this study was to identify the imbalance of muscle recruitment in cervical flexor muscles during the craniocervical flexion test by using ultrasonography and to propose the optimal level of pressure in clinical craniocervical flexion exercise for people with neck pain. [Subjects and Methods] A total of 18 students (9 males and 9 females) with neck pain at D University in Gyeongsangbuk-do, South Korea, participated in this study. The change in muscle thickness in superficial and deep cervical flexor muscles during the craniocervical flexion test was measured using ultrasonography. The ratio of muscle thickness changes between superficial and deep muscles during the test were obtained to interpret the imbalance of muscle recruitment in cervical flexor muscles. [Results] The muscle thickness ratio of the sternocleidomastoid muscle/deep cervical flexor muscles according to the incremental pressure showed significant differences between 22 mmHg and 24 mmHg, between 24 mmHg and 28 mmHg, between 24 mmHg and 30 mmHg, and between 26 mmHg and 28 mmHg. [Conclusion] Ultrasonography can be applied for examination of cervical flexor muscles in clinical environment, and practical suggestion for intervention exercise of craniocervical flexors can be expected on the pressure level between 24 mmHg and 26 mmHg enabling the smallest activation of the sternocleidomastoid muscle.

Comparison of the effectiveness of balance training using a reaching task between a sitting position and a standing position in the elderly.

[Purpose] The purpose of this study was to compare the effectiveness of balance training using a reaching task between a sitting position and a standing position in the elderly. [Subjects and Methods] The study included 30 elderly women from D city. The subjects were divided into the following two groups, according to the training position: the sitting group (n = 15) and standing group (n = 15). Both groups performed training for 20 min, thrice a week for 8 weeks. The short form of the berg balance scale (SFBBS), timed 10-m walk test (10MWT), timed up & go test (TUG), and falls efficacy scale (FES) were used before and after training. [Results] SFBBS, 10MWT, and TUG values were significantly different between before and after training in both groups. However, FES values were significantly different in only the standing group. [Conclusion] Balance training in a standing position is helpful for improving activities that mainly use the lower extremities, such as gait, and training in a sitting position is somewhat helpful for improving balance ability. In addition, balance training in both positions can help overcome the fear of falling.

The effects of horse-riding simulator exercise and Kendall exercise on the forward head posture.

[Purpose] The aim of this study was to examine the effects of horse-riding simulator exercise and Kendall exercise on forward head posture. [Subjects and Methods] Thirty elderly college students with a forward head posture were randomly divided into two groups for 15 persons each, a horse-riding simulator group and Kendall exercise group, and performed exercise for eight weeks. [Results] The horse-riding simulator group and Kendall exercise group showed significant differences after the intervention in New York state posture rating, craniovertebral angle, and cranial rotation angle. The horse-riding simulator group showed a significantly smaller value than the Kendall exercise group for New York state posture rating evaluation after the intervention. [Conclusion] The results of this study indicate that horse-riding simulator exercise is more effective on forward head posture than Kendall exercise. Therefore, horse-riding simulator exercise can be used as a new simple treatment method for the ever-growing forward head posture.

The effects of virtual reality game exercise on balance and gait of the elderly.

[Purpose] The aim of this study was to examine the effects of ball exercise as a general exercise on the balance abilities of elderly individuals by comparing ball exercise with virtual reality exercise. [Subjects and Methods] Thirty elderly individuals residing in communities were randomly divided into a virtual reality game group and a ball exercise group and conducted exercise for 30 min 3 times a week for 8 weeks. [Results] Step length increased significantly, and the average sway speed and Timed Up and Go time significantly decreased in both groups. A comparison of sway length after the intervention between the two groups revealed that the virtual reality game exercise resulted in a reduction than the ball exercise. [Conclusion] The results of this study indicated that the virtual reality game exercise may improve balance and gait of elderly individuals in communities.

The effects of horseback riding on body mass index and gait in obese women.

[Purpose] The aim of this study was to examine the effect of horseback riding on body mass index (BMI) and gait in obese women. [Subjects and Methods] Twenty-four obese women residing in Seoul and Gyeonggi-do were randomly divided into a horseback riding group and a walking group and conducted their respective exercises 3 times a week for 8 weeks. [Results] Step length increased significantly and BMI and width of the base of support significantly decreased in both groups. A comparison of BMI and width of the base of support after the intervention between the two groups revealed that the horseback riding group showed larger decreases than the walking group. [Conclusion] The result of this study indicated that the horseback riding may improve gait ability and obesity.