Benefits of Virtual Reality Program and Motor Imagery Training on Balance and Fall Efficacy in Isolated Older Adults: A Randomized Controlled Trial.

Background and Objectives: for isolated older adults, alternative training indoors to maintain balance is essential; however, related studies are lacking. To improve the balance of isolated older adults and reduce their fear of falling, we aimed to examine the balance−keeping effect of a virtual reality (VR) program and motor imagery training (MIT) and propose training that could improve physical activity among older adults. Methods: a total of 34 older adults admitted to a convalescent hospital were assessed. VR (n = 12) and MIT (n = 10) groups completed their assigned intervention in six weeks, whereas the control group (CG) (n = 12) did not. The follow−up was performed after two weeks. Results: in group × time interactions, body center movement area, open and closed eyes balance scores, and fall efficacy were significantly different (p < 0.05). In contrast with the VR group, the MIT group did not show a significant difference in the open or closed eyes balance scores depending on the period. However, there was a significant difference between the MIT group and CG in the open eyes balance score post-test (d = 1.13, 95% confidence interval, 0.40−12.33). Conclusions: we propose VR and MIT as training methods to prevent physical weakness in isolated older adults.

Effects of H-Reflex Onset Latency on Gait in Elderly and Hemiplegic Individuals.

Background and Objectives: The Hoffmann's reflex (H-reflex) is important in electrodiagnostic testing because it improves sensitivity and specificity in diagnosing radiculopathies. Although quantitative electromyography (EMG) measurements for H-reflex amplitudes during the gait cycle have been performed in both hemiplegic and healthy individuals, research on the H-wave latency in these individuals during the gait cycle is lacking. Materials and Methods: The H-reflex latency of the soleus muscle was investigated in hemiplegic stroke patients and healthy elderly persons in this observational analytical study. Two groups of individuals participated in this study: healthy adults (n = 25) and stroke patients with hemiplegia (n = 25) were compared. An MP150 with Ag-Ag/Cl electrodes was utilized to record and analyse electromyography measurements. All individuals could walk independently indoors. Stimuli were administered to elicit the H-reflex in the four gait phases as the participant walked. Results: Stroke patients had a significantly shorter latency than did healthy patients in the mid-swing, mid-stance, and toe-off phases of the gait cycle; heel-strike latency did not significantly differ. Conclusions: These results can be used as diagnostic data to help account for patient characteristics or measure the recovery extent for treatment planning and gait training in hemiplegic individuals.

Are Physical Therapeutics Important for Stroke Patients to Recover Their Cardiorespiratory Fitness?

Background and Objectives: Aspects of improving cardiorespiratory fitness should be factored into therapeutics for recovery of movement in stroke patients. This study aimed to recommend optimized cardiorespiratory fitness therapeutics that can be prescribed to stroke patients based on a literature review and an expert-modified Delphi technique. Materials and Methods: we searched PubMed, Embase, CINAHL, and Cochrane databases and yielded 13,498 articles published from 2010 to 2019 to support the development of drafts. After applying the exclusion criteria, 29 documents were analyzed (drafts, 17 articles; modified Delphi techniques, 12 articles). This literature was reviewed in combination with the results of a modified Delphi technique presented to experts in the physical medicine and rehabilitation field. Analysis of the literature and survey results was conducted at the participating university hospital. Results: the results of this analysis were as follows: first, 12 intervention items derived through a researcher's literature review and a Delphi technique questionnaire were constructed using the Likert scale; second, we asked the experts to create two modified Delphi techniques by reconstructing the items after statistical analysis for each order comprising five categories, and 15 items were finally confirmed. Conclusions: the recommendations in this study may lead to the development of a standard decision-making process for physiotherapists to improve their patients' cardiorespiratory fitness. Moreover, the study results can help prescribers document patient care to reduce prescription errors and improve safety. In the future, multidisciplinary studies could potentially provide better therapeutics alternatives for cardiorespiratory fitness.

Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model.

Background and Objectives: This study aimed to assess the effect of neck stabilization exercise on respiratory function in stroke patients through longitudinal observation and determine whether there is a difference in its effect based on the side of paralysis in the patients. It is difficult to observe the amount of change observed in individuals and groups as most intergroup comparison studies only use mean values. To address these shortcomings, this study adopted a hierarchical linear model (HLM) in our trajectory analysis. Materials and Methods: We conducted neck stabilization training three times a week for four weeks in a single group of 21 stroke patients. To evaluate respiratory function, their forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiration ratio (FEV1/FVC), and peak cough flow (PCF) were measured. Data analysis was performed using HLM 8.0. Results: A significant increase was found in the respiratory function after neck stabilization training (p < 0.05). While neck stabilization training overall was longitudinally effective, the growth rate of respiratory function in left-sided paralytic patients was less than the whole group value. Conversely, the growth rate of respiratory function in right-sided paralytic patients was greater than the whole group value. Conclusions: This study demonstrated that neck stabilization training is longitudinally effective in improving respiratory function in stroke patients. Additionally, the growth rate of respiratory function was greater in patients with right side paralysis than in patients with left side paralysis.

Effect of Resistance Exercise on Serum Osteoprotegerin Levels and Insulin Resistance in Middle-Aged Women with Metabolic Syndrome.

BACKGROUND Osteoprotegerin (OPG) is a soluble glycoprotein that belongs to the tumor necrosis factor (TNF) receptor superfamily. OPG is mainly secreted by bone. The relationship between acute resistance training, serum OPG levels and metabolic syndrome, including insulin resistance, remains unclear. The purpose of this study was to determine the effect of resistance exercise on serum OPG levels and insulin resistance in middle-aged women with metabolic syndrome. MATERIAL AND METHODS Twenty-four middle-aged women were divided into those with metabolic syndrome (n=12) and a normal control group without metabolic syndrome or insulin resistance (n=12). Metabolic syndrome was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. The quantitative insulin-sensitivity check index (QUICKI) and the homeostatic model assessment (HOMA) index for assessing beta-cell function and insulin resistance were used. The intensity of the resistance exercise was 60-70% of the repetition maximum, for 40 minutes with 10-12 repetitions, performed three times per week. Venous blood samples were tested using standard laboratory procedures. RESULTS Before exercise, the metabolic syndrome group showed a significant increase in waist circumference (P=0.030) and serum triglyceride (TG) (P=0.014), and lower high-density lipoprotein-cholesterol (HDL-C) (P=0.010) compared with the control group. After the eight-week resistance exercise program, waist circumference, and the QUICKI decreased and OPG levels were significantly increased in the metabolic syndrome group compared with the normal control group. CONCLUSIONS A resistance exercise program was effective in reducing factors associated with metabolic syndrome including insulin resistance and increases serum levels of OPG in middle-aged women.

The effects of standing balance in anteroposterior and mediolateral directions on knee strengthening in post-total knee replacement.

[Purpose] The purpose of this study was to examine the association between muscle-strengthening exercises applied to the knee extensor muscles and the maintenance of standing balance in both, the anteroposterior and mediolateral directions in patients who had undergone total knee replacement. [Subjects and Methods] Thirty patients who underwent total knee replacement with bilateral artificial joints participated in this study. During the eight-week study period, the load on the knee extensors was gradually increased, and the standing balance ability was measured by differentiating the anteroposterior and mediolateral directions both, before and after the experimental period. [Results] In both, the anteroposterior and the mediolateral directions, there were statistically significant increases after the eight-week experiment, with a 29% increase in standing balance maintenance in the anteroposterior direction and a 22% increase in the mediolateral direction. [Conclusion] In patients who underwent bilateral total knee replacement, strengthening exercises applied to the knee extensor muscles with gradually increasing load positively affected standing balance in both anteroposterior and mediolateral directions.

Multicenter survey analysis of satisfaction according to actual utilization of rehabilitation services.

[Purpose] Most such studies have been limited to evaluating the muscle activity patterns of lower extremity muscles using surface electromyograms, but studies of muscle activity patterns according to chair types are lacking. [Subjects and Methods] In the present study, 52 university students in their 20s (26 males, 26 females) were selected in order to analyze the activity of five lower extremity muscles (vastus lateralis, rectus femoris, vastus medialis, tibialis anterior, and gastrocnemius). The selected subjects had sufficient muscle strength for the experiment and normal joint range of motion. [Results] To examine the sociodemographic variables of the study subjects, the frequencies and percentages of individual items were presented as follows Table 3. [Conclusion] Differences in lower extremity muscle activity levels during standing and sitting were identified, and differences between genders were also seen. There was no significant difference in lower extremity muscle activity levels between use of fixed and wheeled chairs.

Efficacy of pulmonary rehabilitation using cervical range of motion exercise in stroke patients with tracheostomy tubes.

[Purpose] In this study, stroke patients who were intubated with tracheostomy tubes performed cervical range of motion exercises, and changes in their pulmonary and coughing functions were examined. [Subjects and Methods] Twelve stroke patients who were intubated with tracheostomy tubes participated in the study. The subjects were randomly assigned to either the control group (n=6), which did not perform cervical range of motion exercises, or the experimental group (n=6), which did perform exercises. [Results] With regards to forced vital capacity, forced expiratory volume at one second, and peak cough flow rate before and after the exercises, the control group did not show any significant differences while the experimental group showed statistically significant increases in all three parameters. [Conclusion] The results indicate that cervical range of motion exercises can effectively improve the pulmonary function and coughing ability of stroke patients intubated with tracheostomy tubes, and that cervical range of motion exercises can help in the removal of tracheostomy tubes.

The effect of non-elastic taping on balance and gait function in patients with stroke.

[Purpose] This study investigated the influence of exercise on balance ability and gait function in stroke patients after applying non-elastic tape, which can stabilize muscles and joints, to the lower extremities of the affected side. [Subjects and Methods] The subjects were 30 patients diagnosed with stroke. They were divided into an experimental group (n = 15) and a control group (n = 15). The experimental group performed mat and treadmill exercises three times a week for six weeks with non-elastic tape applied to the lower extremities of the affected side. The control group performed the same exercises but without taping. [Results] The intervention significantly improved Berg balance scale scores and timed up and go (TUG) test scores as well as reduced stance duration and stride duration in the experimental group. In the control group, statistically significant improvements were observed in TUG test scores. [Conclusion] Although some differences did not reach the level of statistical significance, the application of non-elastic tape stabilized the joints of the lower extremities, thereby increasing balance and reducing stance duration and one step duration, which resulted in a reduction of overall gait duration.

Effects of horseback riding exercise therapy on hormone levels in elderly persons.

[Purpose] The purpose of this study was to investigate the effect of riding exercise on hormone levels in normal elderly people who were taught horseback riding for 8 weeks. [Subjects] Subjects were classified into an exercise group (n=10) and control group (n=10). [Methods] The two groups, horseback riding exercise group of 10 and control group of 10, were each tested for 15 minutes, 3 times, over 8 weeks. Post-exercise tests were implemented in both groups in the same way as pre-study tests. [Results] The horseback riding group showed a significant difference in the pre- and post-exercise serotonin and cortisol levels. Additionally, serotonin and cortisol levels showed significant differences between the two groups. [Conclusion] Serotonin and cortisol levels significantly increased in the experimental group, suggesting that horseback riding exercise is effective for improving the levels of these hormones.

Effects of horseback riding exercise therapy on background electroencephalograms of elderly people.

[Purpose] This study investigated the effect of horseback riding exercise on the background electroencephalograms of elderly people who performed horseback riding for 8 weeks. [Subjects] Twenty elderly people were divided into the horseback riding exercise and control group (n = 10 each). [Methods] The exercise was performed for 15 minutes, 3 times per week for 8 weeks. Electroencephalograms were analyzed. Post-exercise evaluation was performed after 8 weeks. [Results] After the horseback riding exercise, the relative slower alpha power index was active in the T3 and P4 domains but suppressed in the Fp1, Fp2, F3, F4, T4, and P3 domains. Moreover, the relative faster alpha power index was active in all domains of the horseback riding exercise group but was suppressed in all domains of the control group. There was a significant difference between groups in the F3 domain. [Conclusion] The alpha power index increased significantly after horseback riding exercise, suggesting the exercise improved background electroencephalogram.

Comparison of the Effects of Hollowing and Bracing Exercises on Cross-sectional Areas of Abdominal Muscles in Middle-aged Women.

[Purpose] The purpose of this study was to examine the effects of hollowing and bracing exercises on cross-sectional areas of abdominal muscles. [Subjects] Thirty healthy female adults participated in this study. The exclusion criteria were orthopedic or neurologic diseases. [Methods] The subjects of this study were assigned randomly to one of two groups, each with 15 people. Each group performed a 60-minute exercise program, one performed a bracing exercise, and the other performed a hollowing exercise, with both groups performing the exercise three times a week for six weeks. [Results] The changes in cross-sectional areas after the bracing exercise showed statistically significant differences in the left rectus abdominis and both internal and external obliques. The changes in cross-sectional areas after the hollowing exercise showed statistically significant differences in the left and right transversus abdominis and left rectus abdominis. [Conclusion] Performing bracing exercises rather than hollowing exercises is more effective for activating the abdominal muscles.

Comparison of the Amplitudes of the H-reflex of Post-stroke Hemiplegia Patients and Normal Adults during Walking.

[Purpose] The purpose of this study was to compare H-reflex characteristics during gait of hemiplegic stroke patients. [Subjects] Twenty-five patients and age-matched twenty-five volunteers in good health were studied. All the subjects could walk independently. [Methods] An MP150 (BIOPAC Systems, Inc., Goleta, CA, USA) was used to record the electromyography (EMG) data collected with Ag-Ag/Cl measurement electrodes (BIOPAC, diameter of 2 cm). [Results] The comparison showed significant differences of Hmax/Mmax ratio (%) in all gait cycles between the stroke group and the control group. [Conclusion] In conclusion, this study furnished basic reference data for gait strategies and functional training programs for hemiplegic stroke patients.

Effect of extracorporeal shock wave therapy on denervation atrophy and function caused by sciatic nerve injury.

[Purpose] The present study examined the effects of treatment using extracorporeal shock wave therapy (ESWT) on the muscle weight and function of the hind limb in sciatic nerve injury. [Subjects] Forty rats with sciatic nerve crushing injury were randomly divided into two groups: an ESWT group (n=20), and a control group (n=20). [Methods] The ESWT group received extracorporeal shock wave treatment, and the control group did not receive any treatment after injury. Experimental animals were measured for muscle weight on an electronic scale and were tested for function on a sciatic functional index (SFI). [Results] All groups showed significant increases in the weights of the left soleus and gastrocnemius muscles, and decreases in the weights of the right soleus and gastrocnemius muscles (p<0.05). Comparison of SFI scores and muscle weights between the groups showed significant differences in SFI scores, and the right soleus and gastrocnemius muscles (p<0.05) [Conclusion] Exercise programs that use ESWT can be said to be effective at improving the function of the sciatic nerve and preventing the denervation atrophy.

Effects of closed kinetic chain exercises on proprioception and functional scores of the knee after anterior cruciate ligament reconstruction.

[Purpose] The purpose of this study was to examine the effect of closed kinetic chain exercises performed by an unstable exercise group (UEG) and a stable exercise group (SEG) on the knee joint, proprioception, and functional scores of patients who underwent anterior cruciate ligament (ACL) reconstruction. [Subjects] Twenty-eight patients participated in this study. The exclusion criteria were fracture or neurological disease. [Methods] The subjects were randomly assigned to one of two groups, each with 14 people. Each group took part in a 60-minute exercise program, three times a week for six weeks. [Results] The results of the clinical evaluation at 45°proprioception showed statistically significant differences between the two groups. The results of the clinical evaluation at 15°proprioception showed no statistically significant differences between the two groups. [Conclusion] The proprioception and functional scores of the patients in the UEG who underwent ACL reconstruction were superior to those in the SEG group.

Analysis according to gender and body mass index of the number of steps taken by sedentary workers as measured by a pedometer.

[Purpose] The purpose of this study was to determine according to gender and body mass index the number of steps taken by the sedentary workers as measured by a pedometer. [Subjects] Thirty-six sedentary workers in their twenties in Ulsan city were enrolled in for this study and their step counts were investigated. [Methods] Step counts at the workplace between 9 am and 6 pm everyday for 2 weeks were measured by a pedometer. Data were analyzed using SPSS 20.0 to compare step count according to gender and BMI on different days of the week. [Results] Females showed a higher step count than males on every day of the week except Fridays and Sundays. The step count was higher among the low weight group than overweight group on every day of the week. [Conclusion] Future studies should examine ways of helping sedentary workers to increase their step count. Also, more effort should be made to find practical ways of improving the number of steps taken in the workplace to keep workers in good health, as additional benefit would accrue, such as improved work efficiency.

The Changes of Electromyography in the Upper Trapezius and Supraspinatus of Women College Students According to the Method of Bag-carrying and Weight.

[Purpose] The purpose of this study was to investigate differences in upper extremity muscle activities of women college students' due to method of bag-carrying and weight. [Subjects] Thirty healthy adult females participated in this study. The exclusion criteria were orthopedic or neurologic disease, or a dominant left side. [Methods] Electromyographic activities of the supraspinatus and upper trapezius were recorded bilaterally under two conditions: crossbody bag, ipsilateral bag. [Results] There were no significant differences in the supraspinatus and upper trapezius muscles according to the weight carried; however, there was significant difference in the right supraspinatus and both upper trapezius muscles according to the method of carrying. [Conclusion] An effective backpack safety program for female college students is necessary to educate them how to prevent possible musculoskeletal pain related to the weight carried and the method of carrying from the perspective of an ergonomical approach.

A study of effect of the compound physical activity therapy on muscular strength in obese women.

[Purpose] The aim of this study was to determine how compound physical activity affects muscular strength of middle-aged obese women. [Subjects] The research subjects were 40-50 year-old middle-aged women with excess body fat (30%). [Methods] The subjects were randomly assigned to two group, the experimental group and the control group. The experimental group performed two types of exercise programs for 16 weeks. Aerobic physical activity was performed 5 times per week, and anaerobic physical activity was performed every two days, and the exercise program each day was composed of a warm-up, the main exercise, and cooldown. The type of exercise focused on walking at a quick pace, and the intensity of the exercise focused on long periods of exercise at low intensity with the level of HRmax being 40-60%. The weight training, which was useful for beginners, as a type of kinetic load exercise, was applied with a composition recommended by the ACSM for muscle fitness (intensity of 40-60% of 1 RM and 10-15 repetitions). SPSS version 16.0 was used to analyze the data by ANCOVA and the t-test. [Results] The chest, leg, and abdominal strengths were significantly increased in the experimental group, and this indicates that compound physical activity is effective for improvement of muscular strength. [Conclusion] In conclusion, there were significant differences between groups in terms of muscular strength.

Effects of vibratory stimulations on maximal voluntary isometric contraction from delayed onset muscle soreness.

[Purpose] The aim of this study was to investigate the effect of vibratory stimulation on maximal voluntary isometric contraction (MVIC) from delayed onset muscle soreness (DOMS). [Subjects] Sixty healthy adults participated in this study. The exclusion criteria were orthopedic or neurologic disease. [Methods] The researchers induced DOMS in the musculus extensor carpi radialis longus of each participant. Subjects in the control group received no treatment. The ultrasound group received ultrasound treatment (intensity, 1.0 W/cm(2;) frequency 1 MHz; time, 10 minutes). The vibration group received vibration stimulation (frequency, 20 MHz; time, 10 minutes). Maximal voluntary isometric contraction (MVIC) was recorded at baseline, immediately after exercise, and 24, 48, and 72 hours after exercise. [Results] MVIC measurements showed statistically significant differences in the vibration group compared with the control group. [Conclusion] Vibratory stimulation had a positive effect on recovery of muscle function from DOMS.

Evaluation of the Reporting Standard Guidelines of Network Meta-Analyses in Physical Therapy: A Systematic Review.

The concept of network meta-analyses (NMA) has been introduced to the field of physical therapy. However, the reporting standard guidelines of these studies have not been evaluated. In this systematic review, we included all published NMA physical therapy studies that compared the clinical efficacy of three or more interventions to evaluate whether NMAs in physical therapy exhibit adequate reporting recommendations. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched up to 30 June 2022. Among the 252 identified articles, 19 NMAs including 805 randomized controlled trials were included. We applied both preferred reporting items for systematic reviews and meta-analysis (PRISMA) and PRISMA-NMA checklists, which are 27- and 32-item reporting standard guidelines assessment tools, respectively. Protocol registrations (68.4%), risk of bias across studies (63.2%), additional analysis (57.9%), and funding (31.6%) were problematic items considering the PRISMA guidelines. Four studies reported all five new NMA-reporting items, and 15 (78.9%) did not address items S1-5 from the PRISMA-NMA guidelines. The median score (interquartile range) of the reporting standard guidelines was 27.0 (25.8-28.0). The identified shortcomings of published NMAs should be addressed while training researchers, and they should be encouraged to apply PRISMA-NMA, as a recognized tool for assessing NMA reporting guidelines is required.