Effects of task velocity and center of mass acceleration during Y-Balance Test in elderly females with good and poor visual acuity.

[Purpose] To explore the effects of good binocular visual acuity (BVA) compared to poor BVA, reach distance, task velocity, and center of mass (COM) acceleration were evaluated in elderly females performing the Y-Balance Test (YBT) using a cross-sectional design. [Subjects and Methods] A total of 13 participants had BVA of ≥0.4 log of the minimum angle of resolution (logMAR) (poor BVA group), and the other 13 had BVA of ≤0.3 logMAR (good BVA group). An accelerometer was attached over participants' L3 spinous process, and they then performed the YBT. [Results] The normalized reach distances in the three directions among the good BVA group were longer than those among the poor BVA group. The task velocity in the good BVA group was significantly higher, whereas COM acceleration in the A direction was significantly lower compared with the poor BVA group. [Conclusion] Visual status must be considered when older adult individuals undergo physical therapy and functional training to ensure that healthcare professionals can better assist older adult women.

Effects of 4 weeks of dynamic neuromuscular stabilization training on balance and gait performance in an adolescent with spastic hemiparetic cerebral palsy.

[Purpose] The purpose of this study investigated the effects of 4 weeks of dynamic neuromuscular stabilization training on balance ability. [Subject and Methods] An adolescent with spastic hemiparetic cerebral palsy was recruited. The subject performed 4 weeks of dynamic neuromuscular stabilization training. We assessed the balance subtest of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition, the 10-meter walk test, and the 6-min walk test. [Results] The balance subtest scores were improved significantly after training. [Conclusion] This study suggests that 4 weeks of dynamic neuromuscular stabilization training is effective for improving balance and gait performance in spastic hemiparetic cerebral palsy.

Effects of mental practice combined with electromyogram-triggered electrical stimulation for upper extremity function in stroke patients.

[Purpose] To investigate the effect of mental practice combined with electromyogram-triggered electrical stimulation (MP-EMG ES) on the upper extremity of stroke patients. [Subjects and Methods] Participants were randomly assigned to experimental group or control group. The experimental group received MP-EMG ES plus conventional rehabilitation therapy for 5 days per week for 4 weeks. The control group received only conventional rehabilitation therapy. Outcome measure included the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL). [Results] Experimental group showed more improved in the FMA, MAL-AOU, MAL-QOM compared with the control group. [Conclusion] These results suggest that MP-EMG ES improves the upper extremity of subacute stroke patients better than conventional rehabilitation therapy alone.

Comparison of energy expenditure during the Y-balance test in older adults with different visual acuities.

[Purpose] This study compared the energy expenditure during the Y-balance test (YBT) between elderly women with good binocular visual acuity (BVA) and those with poor BVA. [Subjects] Twenty-one elderly women who could walk independently were recruited from a community dwelling. Eleven participants had a BVA equal to or less than 0.4 logarithm of the minimum angle of resolution (logMAR), and the other 10 participants had a BVA equal to or better than 0.3 logMAR. [Methods] The participants had an accelerometer attached over the L3 spinous process for measurement of energy expenditure and performed the YBT in the anterior, posteromedial, and posterolateral directions. [Results] The normalized reach distance in the good BVA group during the YBT in three directions and composite reach distance were significantly longer compared with the values in the poor BVA group. The energy expenditure in the good BVA group during the YBT in the three directions was significantly reduced compared with the values in the poor BVA group. [Conclusion] We suggest that visual acuity in the elderly influences dynamic balance and energy expenditure. Elderly subjects with poor BVA showed poor dynamic balance control and an inefficient biomechanical cost strategy compared to subjects with good BVA.

Differences in lumbar and pelvic angles and gluteal pressure in different sitting postures.

[Purpose] To investigate the effects of erect sitting, slouched posture with cross-legged sitting, and erect posture with cross-legged sitting on the lumbar and pelvic angles, and gluteal pressure. [Subjects] For the experiments, 17 healthy women were recruited. [Methods] All subjects were asked to perform three sitting postures: erect sitting, slouched posture with cross-legged sitting, and erect posture with cross-legged sitting. Lumbar and pelvic angles were measured using a three-dimensional motion-capture system, and gluteal pressure was measured using a pressure mat. [Results] Compared to erector sitting, slouched posture with cross-legged sitting showed significantly greater lumbar flexion, posterior pelvic tilt, and left pelvic tilt. Compared to erect sitting, erect posture with cross-legged sitting showed significantly greater lumbar flexion and posterior pelvic tilt. Compared to erect posture with cross-legged sitting, slouched posture with cross-legged sitting showed significantly greater lumbar flexion and posterior pelvic tilt. Compared to erect sitting and erect posture with cross-legged sitting, slouched posture with cross-legged sitting showed significantly greater left gluteal pressure; there was no significant difference in right gluteal pressure. [Conclusion] An erect posture can reduce changes in lumbar and pelvic angles, and gluteal pressure compared to a slouched posture during cross-legged sitting.

Immediate effects of an elastic arm sling on walking patterns of chronic stroke patients.

[Purpose] We developed a new arm sling with an elastic bandage which we hearafter refer to as "the elastic arm sling". This study investigated the immediate effects of the elastic arm sling on the gait patterns of stroke patients. [Subjects and Methods] Thirteen stroke patients were enrolled in this study after providing their informed consent. They walked on a GAITRite mat twice, with a 5-min rest between the trials. [Results] Significant improvements were seen in cadence and walking velocity during walking while wearing the elastic arm sling. Furthermore, patients who used the elastic arm sling showed significant increases in step lengths of the affected and unaffected limbs. The stride lengths of the affected and unaffected sides while wearing the elastic arm sling and those without the elastic arm sling also significantly differed. [Conclusion] These results demonstrate that the elastic arm sling is a useful tool for the gait training of stroke patients, especially cadence, walking velocity, and the step and stride lengths of both limbs. Therefore, therapists should use the elastic arm sling as a gait-training assistive device for stroke patients.

Effect of initial position on the muscle activity of the hip extensors and amount of pelvic tilt during prone hip extension.

[Purpose] The aim of this study was to identify the effects of initial position of the hip joint with changes in the hip joint angle on the respective muscle activities of the bilateral erector spinae (ES), unilateral gluteus maximus (GM), and biceps femoris (BF) and the amount of pelvic anterior tilt during prone hip extension (PHE). [Subjects] Fifteen healthy volunteers were enrolled in this study. [Methods] The subjects performed PHE in three positions: neutral, 20°, and 45° flexed hip joint. The activities of the ES, GM, and BF were measured using surface electromyography, and kinematic values for pelvic anterior tilt were calculated using a motion capture system. [Results] There was a significant decrease in muscle activity of the contralateral ES at 45°, and an increase in the GM muscle activity and decrease in the BF muscle activity at 20°. The amount of pelvic anterior tilt was lower at 20°. [Conclusion] These results suggest that a hip flexion position of 20° would have an advantage over the other measured positions.

The effects of mirror therapy with tasks on upper extremity function and self-care in stroke patients.

[Purpose] The purpose of this study was to determine the effects of mirror therapy with tasks on upper extremity unction and self-care in stroke patients. [Subjects] Thirty participants were randomly assigned to either an experimental group (n=15) or a control group (n=15). [Methods] Subjects in the experimental group received mirror therapy with tasks, and those in the control group received a sham therapy; both therapies were administered, five times per week for six weeks. The main outcome measures were the Manual Function Test for the paralyzed upper limb and the Functional Independence Measure for self-care performance. [Results] The experimental group had more significant gains in change scores compared with the control group after the intervention. [Conclusion] We consider mirror therapy with tasks to be an effective form of intervention for upper extremity function and self-care in stroke patients.

Comparison of gait velocity and center of mass during square and semicircular turning gaits between groups of elderly people with differing visual acuity.

[Purpose] The purpose of this study was to investigate gait velocity and center of mass (COM) during square and semicircular turning gaits between two groups of elderly people with differing visual acuity. [Subjects] Twenty elderly Korean women who could walk independently and who lived in the community were recruited. [Methods] We measured gait velocity and COM using an accelerometer during two different turning gaits. [Results] The velocity during square and semicircular turning gaits of participants with good binocular visual acuity (GBVA) was significantly higher than that of participants with poor binocular visual acuity (PBVA). The COM during square and semicircular turning gaits of the GBVA group was significantly decreased compared with that of the PBVA group. [Conclusion] These findings suggest that visual acuity affects velocity and COM during square and semicircular turning gaits of elderly people.

Changes in kinetic, kinematic, and temporal parameters of walking in people with limited ankle dorsiflexion: pre-post application of modified mobilization with movement using talus glide taping.

OBJECTIVE: The purpose of this study was to investigate the changes in passive ankle dorsiflexion range of motion (ROM), maximum plantar force, force-time integral, and time to heel off during walking between pre- and postapplication of modified mobilization with movement (MWM) using talus glide taping in people with limited ankle dorsiflexion. METHODS: Eighteen feet with limited ankle dorsiflexion in 13 people were examined. Participants performed 3 different walking tasks in the following order: walking before and immediately after applying the modified MWM using talus glide taping and walking after 5-minute walking with the modified MWM using talus glide taping. A floor-mat pressure measurement system (HR-mat) was used to measure maximum plantar force, force-time integral, and time to heel off; and passive ankle dorsiflexion ROM was measured using a standard goniometer. The significance of differences was assessed using repeated one-way analysis of variance. RESULTS: Passive ankle dorsiflexion ROM and time to heel off were significantly increased after 5-minute walking with the modified MWM using talus glide taping compared with walking before and immediately after applying the tape. Significantly increased maximum plantar force and force-time integral on the hindfoot and significantly decreased force-time integral on the forefoot during walking after 5-minute walking were observed with the modified MWM using talus glide taping compared with before applying the tape. No significant difference between before and immediately after applying the tape was observed in any variable. CONCLUSIONS: Our results suggest that walking an additional 5-minute with the modified MWM using talus glide taping increased passive ankle dorsiflexion ROM and time to heel off and improved dynamic plantar loading during walking.

Effects of a Fall Prevention Exercise Program on Muscle Strength and Balance of the Old-old Elderly.

[Purpose] The purpose of this study was to investigate the effects of an 8-week balance exercise and elastic-resistance exercise program on muscle strength and balance of the old-old elderly (over the age of 75). [Subjects and Methods] Fifty-five elderly persons were recruited from the community and assigned to three groups for convenience: balance exercise (intervention group 1; INT 1), resistance exercise (intervention group 2; INT 2), and control (CON) groups. The intervention was performed twice a week at a senior center and three times a week at home for 8 weeks. Muscle strength and balance were evaluated before and at the end of the trial, using a PowertrackIIand Tetrax. [Results] There were significant improvements in the strength of all seven muscle groups and balance in the INT 2 group. In the INT 1 group, there were significant improvements in the strength of all muscle groups except for the knee flexor and ankle plantar flexor muscle groups. [Conclusion] This study demonstrated that an intervention using balance exercises or elastic-resistance exercises is effective at improving the muscle strength and balance of the old-old elderly. These type of exercises should be appropriate for the physical characteristics of the subjects.

The Effect of an Inclined Ankle on the Activation of the Abductor Hallucis Muscle during Short Foot Exercise.

[Purpose] The purpose of this study was to identify the effects of an inclined ankle on the activation of the abductor hallucis muscle during short foot exercises. [Subjects] We recruited 14 healthy volunteers who were free of pain, and did not suffer from arthritis or osteomuscular problems related to the foot or ankle. [Methods] The subjects performed short foot exercises and short inclined foot exercises with 30° passive ankle dorsiflexion. [Results] The exercise with an inclined foot showed a significantly larger activation of the abductor hallucis than that shown during the neutral short foot exercises. [Conclusion] These results suggest that passive ankle dorsiflexion during short foot exercise for strengthening the abductor hallucis is a more effective clinical treatment exercise.

The Effect of Motor Dual-task Balance Training on Balance and Gait of Elderly Women.

[Purpose] This study investigated the effect of a motor dual-task balance program on balance and gait of elderly women to suggest a more effective balance exercise method. [Subjects] Twenty elderly Korean women who could walk independently were recruited from the community dwelling. [Methods] The motor dual-task balance training (experimental) group stood on an Aero-step, and performed gym ball bouncing, catching, and throwing, while the simple task balance training (control) group merely stood on the Aero-step. Participants performed 45 minutes of training, 2 times a week for 6 weeks. Balance (fall index) was measured using a TETRAX. Gait variables were recorded on a GAITRite walkway at self-determined walking speed. [Results] The fall index of the experimental group was significantly lower than that of the control group. Step length, stride length, velocity, and cadence of the experimental group improved significantly more than those of control group. [Conclusions] We found that motor dual-task balance training improved balance and walking ability more than simple balance training. Further studies should investigate motor dual-task training with kinematic and kinetic data, and muscle activation based on motor strategies.

Effects of a Community-based Fall Prevention Exercise Program on Activity Participation.

This study was conducted to identify the effects of a fall-prevention exercise program on the participation and static balance of elderly persons in daily life roles. [Subjects] Ten participants over 65 years of age (75.29±2.93) who were healthy community-dwellers (two men and eight women) were recruited. [Methods] The participants exercised three times a week for eight weeks. The exercise program was based on the fitness and mobility exercise (FAME) protocol. The outcome measures were changes in activity participation level and the fall index. [Results] After the exercise, the activity participation level significantly increased, and the fall index significantly decreased. [Conclusion] A fall prevention exercise program can have a positive effect on participation and static balance in older adults.

Effects of Recreational Exercises on the Strength, Flexibility, and Balance of Old-old Elderly Individuals.

[Purpose] The purposes of this study were to investigate the effects of recreational exercises on the muscle strength, flexibility, and balance of old-old elderly individuals over the age of 75 years. [Subjects and Methods] Forty-three old-old elderly subjects (aged 78.7 ± 2.9 years) participated in 8 weeks of recreational exercises. The exercises were performed twice a week for 8 weeks. Muscle strength, flexibility, and balance were evaluated by the Senior Fitness Test before and at the end of the intervention. [Results] Significant improvements in muscle strength, flexibility, and balance were observed at the end of the intervention. [Conclusion] This study demonstrated that an intervention using recreational exercises effectively improves the muscle strength, flexibility, and balance of old-old elderly individuals.

EMG Activity of the Abductor Hallucis Muscle during Foot Arch Exercises Using Different Weight Bearing Postures.

[Purpose] This study examined the effects of different weight-bearing postures on the activation of the abductor hallucis muscle during foot-arch exercises. [Subjects] The study recruited 11 healthy volunteers who were pain-free, had no history of foot or ankle surgery, and were able to maintain a standing posture. [Methods] The subjects performed short-foot and toe-spreading exercises while sitting and standing. [Results] The abductor hallucis muscle activation in the toe-spreading exercise was significantly greater when standing than in sitting, while that in the short-foot exercise did not differ significantly between the two postures. [Conclusion] The results of this study suggests that a weight bearing posture such as standing is the most effective method of increasing the EMG activity of abductor hallucis muscle in the toe-spreading exercise.

Plantarflexor and Dorsiflexor Activation during Inclined Walking with and without Modified Mobilization with Movement Using Tape in Women with Limited Ankle Dorsiflexion.

[Purpose] This study compared the EMG activities of the plantarflexor and dorsiflexor muscles during inclined walking with and without modified mobilization with movement (modified MWM) using tape in women with limited ankle dorsiflexion. [Subjects] Fifteen women with limited dorsiflexion in their feet (22 feet in total) were recruited for this study. [Methods] The subjects walked with and without modified MWM using tape on a treadmill at 6 degrees with a speed of 1.25 m/s for 5 minutes. The EMG activities of the medial gastrocnemius (GCM) and tibialis anterior (TA) muscles were measured using a surface EMG system. [Results] During incline walking with modified MWM using tape, the mean EMG activity of the GCM significantly increased, and that of the TA decreased between heel strike and heel off. There was no difference between heel off and toe off in the two muscles. [Conclusions] Modified MWM using tape on the talus during incline walking could alter the muscle activities of the GCM and TA between heel strike and heel off in women with limited ankle dorsiflexion.

Effects of a Pelvic Belt on the EMG Activity of the Abdominal Muscles during a Single-leg Hold in the Hook-lying Position on a Round Foam Roll.

[Purpose] This study investigated the effects of a pelvic belt on the electromyography (EMG) activity of the abdominal muscles during a single-leg hold in the hook-lying position on a round foam roll. [Subjects] Seventeen healthy female volunteers were recruited for this study. [Methods] The participants performed single-leg-hold exercises on a round foam roll with and without a pelvic belt. Surface EMG was recorded from the rectus abdominis (RA), internal oblique (IO), and external oblique (EO) bilaterally. [Results] The EMG activity of the bilateral RA, EO, and IO was significantly lower when the pelvic belt applied. [Conclusions] Our finding that the bilateral EO, IO, and RA muscles were less active with a pelvic belt during trunk-stabilizing exercises on an unstable surface suggests that the pelvic belt provided "form closure".

The effects of different gait speeds and lower arm weight on the activities of the latissimus dorsi, gluteus medius, and gluteus maximus muscles.

[Purpose] This study researched the effects of different gait speeds and lower arm weight on the activities of the latissimus dorsi, gluteus medius, and gluteus maximus muscles. [Subjects] Fourteen healthy adult men participated in this study. [Methods] All the participants carried out walking on a treadmill at speeds of 3.5 km/h and 5.5 km/h for half a minute. During treadmill gait, electromyographic activity muscle was measured of the latissimus dorsi, gluteus medius and gluteus maximus. [Result] There were significant differences in the muscle activities due to changes in gait speed and lower arm load in the latissimus dorsi and gluteus maximus, but there were no significant differences in the muscle activities of the gluteus medius. [Conclusion] According to our results, arm swing is related to increasing gait speed, and lower arm load is influences the muscle activity of the lower extremities through the posterior oblique sling system.

Assessing the effects of sway-back posture on global and regional spinal sagittal angles using inertial measurement units.

BACKGROUND: Sway-back posture in the sagittal profile is a commonly adopted poor standing posture. Although the terms, definitions, and adverse health problems of sway-back posture are widely used clinically, few studies have quantified sway-back posture. OBJECTIVE: To investigate spinal sagittal alignment in sway-back posture while standing based on global and regional angles using inertial measurement units (IMUs). METHODS: This cross-sectional study recruited 30 asymptomatic young adults. After measuring the sway angle while standing, the participants were divided into sway-back and non-sway-back groups (normal thoracic group). Each participant stood in a comfortable posture for 5 seconds with IMUs at the T1, T7, T12, L3, and S2 levels. Then, we measured the global and regional lumbar and thoracic angles and sacral inclination in the standing position. RESULTS: Although there was no difference in the global lumbar angle, there was a difference in regional lumbar angles between the two groups. The normal thoracic group had balanced lumbar lordosis between the upper and lower lordotic arcs, whereas the sway back group tended to have a flat upper lumbar angle and increased lower lumbar angle. CONCLUSION: It is useful to assess the global and regional angles in the spinal sagittal assessment of individuals with sway-back posture.