Action observation training of community ambulation for improving walking ability of patients with post-stroke hemiparesis: a randomized controlled pilot trial.

PURPOSE: To investigate the effects of action observation training involving community-based ambulation for improving walking ability after stroke. DESIGN: Randomized, controlled pilot study. SETTING: Inpatient rehabilitation hospital. SUBJECTS: A total of 25 inpatients with post-stroke hemiparesis were randomly assigned to either the experimental group ( n = 12) or control group ( n = 13). INTERVENTION: Subjects of the experimental group watched video clips demonstrating four-staged ambulation training with a more complex environment factor for 30 minutes, three times a week for four weeks. Meanwhile, subjects of the control group watched video clips, which showed different landscape pictures. MAIN MEASURES: Walking function was evaluated before and after the four-week intervention using a 10-m walk test, community walk test, activities-specific balance confidence scale, and spatiotemporal gait measures. RESULTS: Changes in the values for the 10-m walk test (0.17 ±0.19 m/s vs. 0.05 ±0.08 m/s), community walk test (-151.42 ±123.82 seconds vs. 67.08 ±176.77 seconds), and activities-specific balance confidence (6.25 ±5.61 scores vs. 0.72 ±2.24 scores) and the spatiotemporal parameters (i.e. stride length (19.00 ±11.34 cm vs. 3.16 ±11.20 cm), single support (5.87 ±5.13% vs. 0.25 ±5.95%), and velocity (15.66 ±12.34 cm/s vs. 2.96 ±10.54 cm/s)) indicated a significant improvement in the experimental group compared with the control group. In the experimental group, walking function and ambulation confidence was significantly different between the pre- and post-intervention, whereas the control group showed a significant difference only in the 10-m walk test. CONCLUSIONS: Action observation training of community ambulation may be favorably used for improving walking function of patients with post-stroke hemiparesis.

Correlation of knee proprioception with muscle strength and spasticity in stroke patients.

[Purpose] The purpose of this study was to investigate the relationship of knee proprioception with muscle strength and spasticity in stroke patients. [Subjects and Methods] The subjects were 31 stroke patients. The subjects received an explanation of the procedures and methods and provided informed consent before the experiment. A measurement board was used to determine the the proprioception deficit of the knee as a proprioception test. The proprioception test consisted of a passive and active angle reproduction test. A manual muscle test and modified Ashworth scale were used to evaluate knee muscle strength and spasticity level. The data were analyzed using an independent t-test and Spearman correlation. [Results] The results of this study revealed a significant difference between the affected side and non-affected side in the passive angle reproduction test and a significant difference in the correlation of the proprioception level with muscle strength and spasticity level. [Conclusion] This study indicates that the knee proprioception level is associated with spasticity and muscle strength in stroke patients.

Clinical feasibility of cervical exercise to improve neck pain, body function, and psychosocial factors in patients with post-traumatic stress disorder: a randomized controlled trial.

[Purpose] To investigate the effect of cervical exercise on neck pain, disability, and psychosocial factors in patients with post-traumatic stress disorder. [Subjects] Thirty patients with post-traumatic stress disorder, who also complained of neck pain. [Methods] The cervical exercise group (n = 15) participated in cervical exercises for 30 min, 3 times/week for 6 weeks, and the control group (n = 16) underwent conventional physical therapy alone, without exercise. The exercises were performed in the following order: cervical relaxation, local muscle stabilization, and global muscle stabilization using a sling system. [Results] Compared to the control group, the cervical exercise group demonstrated significant decreases as follows: Visual analogue scale score, 4.2 vs. 1.0; Neck disability index, 3.9 vs. 1.9; and depression on the Symptom checklist-90-revised, 9.4 vs. 4.3 and on the Hopkins symptom checklist-25, 6.3 vs. 2.8. However, anxiety on the Symptom checklist-90-revised (3.1 vs. 1.3) was not significantly different. Effect sizes were as follows: Visual analogue scale score, 1.8; Neck disability index, 0.9; depression, 1.0; and anxiety on Symptom checklist-90-revised and Hopkins symptom checklist-25, 0.6 and 0.8, respectively. [Conclusion] Cervical exercise is effective in improving neck pain, disability, and efficacy of psychological treatment for depression in patients with post-traumatic stress disorder.

Effects of hip exercises for chronic low-back pain patients with lumbar instability.

[Purpose] The purpose of this study was to compare hip range of motion between a lumbar stability group and a lumbar instability group, and to evaluate the effectiveness of hip exercises for low-back pain patients with lumbar instability. [Subjects] Seventy-eight patients with chronic low-back pain were the subjects. [Methods] The patients were divided into two groups: a lumbar stability group (n=45) and a lumbar instability group (n=33). They were assessed using the Korean version of the Oswestry Disability Index (KODI) to determine the level of disability of the patients with low-back pain. A 100 mm visual analog scale (VAS) was used to assess low-back pain. [Results] The limitation of hip range of motion of the lumbar instability group was significantly greater than that of the lumbar stability group. Comparisons among four groups at three weeks and six weeks after the start of hip exercises revealed that the VAS score of each group had significantly decreased. Comparisons among four groups at three weeks and at six weeks after the start of hip exercises revealed that the KODI score of each group had significantly decreased. [Conclusion] These findings suggest that the performance of hip exercises by chronic low-back pain patients with lumbar instability is more effective than conventional therapy at reducing low-back pain and levels of disability.

Comparison of chronic low-back pain patients hip range of motion with lumbar instability.

[Purpose] The purpose of this study was to compare differences in hip range of motion between a lumbar stability group and a lumbar instability group of patients with chronic low-back pain. [Subjects] Sixty-nine patients with chronic low-back pain were divided into two groups: a lumbar stability group (n=39) and a lumbar instability group (n=30). [Methods] The patients were assessed using a goniometer to evaluate the hip range of motion at pre-test. Data were analyzed using SPSS 18.0 software for Windows. The experimental data were analyzed using one-way ANOVA, repeated one-way ANOVA, and the t-test, and a significance level of 0.05. [Results] The limitation of hip range of motion of the lumbar instability group was significantly greater than that of the lumbar stability group. [Conclusion] The chronic low-back pain patients showed greater limitation of hip range of motion than healthy persons, and among them, those who had lumbar instability showed greater limitation than those with lumbar stability.

Effect of thorax correction exercises on flexed posture and chest function in older women with age-related hyperkyphosis.

[Purpose] The purpose of this study was to determine the effects of thorax correction exercises on flexed posture and chest function in older women with age-related hyperkyphosis. [Subjects and Methods] The study participants included 41 elderly women who were divided into a thorax correction exercise group (n = 20) and a control group (n = 21). Participants in the exercise group completed a specific exercise program that included breathing correction, thorax mobility, thorax stability, and thorax alignment training performed twice per week, 1 hour each session, for 8 weeks. Outcome measures included the flexed posture (thoracic kyphosis angle, forward head posture) and chest function (vital capacity, forced expiratory volume in a second, and chest expansion length). [Results] Participants in the thorax correction exercise group demonstrated significantly greater improvements in thoracic kyphosis angle, forward head, and chest expansion than those in the control group. [Conclusion] This study provides a promising exercise intervention that may improve flexed posture and chest function in older women with age-related hyperkyphosis.

The effect of a novel core stabilization technique on managing patients with chronic low back pain: a randomized, controlled, experimenter-blinded study.

OBJECTIVE: To identify the effect of a novel augmented core stabilization exercise technique on physical function, pain and core stability in patients with chronic low back pain. DESIGN: A block randomized controlled trial with two groups. SETTING: A sports rehabilitation clinic. PARTICIPANTS: Forty patients with low back pain (20 experimental, mean (SD) age 50.35 (9.26) years and 20 control, 51.30 (7.01)), 19 men and 21 women. INTERVENTIONS: In the experimental group ankle dorsiflexion was used in addition to drawing in the abdominal wall; the control group involved drawing in the abdominal wall alone. Both groups received the same conventional physical therapy training three days a week for eight weeks. MAIN OUTCOME MEASURES: Physical disability instruments; Oswestry Disability Index and Roland Morris Disability Questionnaire; pain intensity assessments; visual analogue scale, Pain Disability Index, and a pain rating scale; and core stability measures, such as the active straight leg raise, were determined at pretest, posttest and two-month follow-up. RESULTS: After the intervention, the experimental group showed significant greater improvement at two months compared with the control group. Physical disability results included Oswestry Disability Index (P = 0.001, from 24.25 (7.08) to 13.35 (4.17)) and Roland Morris Disability Questionnaire (P = 0.001, from 15.55 (1.99) to 8.15 (1.69)), pain intensity including visual analogue scale (P = 0.001, from 6.30 (1.03) to 3.35 (0.59)), Pain Disability Index (P = 0.001, 31.25 (5.44) to 19.00 (3.58)) and pain rating scale (P = 0.001, from 72.25 (18.73) to 50.10 (15.47)), and the core stability test such as active straight leg raise (P = 0.001, from 7.40 (0.75) to 2.15 (0.49)). CONCLUSIONS: This study provides the clinical evidence that adding ankle dorsiflexion to drawing in the abdominal wall gave increased benefit in terms of physical disability, pain and core stability in patients with chronic low back pain.

Effectiveness of manual therapy and cervical spine stretching exercises on pain and disability in myofascial temporomandibular disorders accompanied by headaches: a single-center cohort study.

BACKGROUND: Previous studies have demonstrated a relationship between headaches and temporomandibular disorders (TMDs). Moreover, recent studies have shown functional, anatomical, and neurological associations between the temporomandibular joint (TMJ) and upper cervical spine. This study aimed to investigate the effectiveness of manual therapy and cervical spine stretching exercises for pain and disability in patients with myofascial TMDs accompanied by headaches. METHODS: Thirty-four patients recruited from Gyeryong Hospital with headaches and diagnosed with TMDs were randomly assigned to the experimental (n = 17) and control (n = 17) groups. Headache impact was assessed using the Korean Headache Impact Test-6. Masseter myofascial pain was measured using the visual analog scale, and TMJ pressure pain threshold levels were evaluated using an algometer. Neck pain intensity was assessed using the numerical rating scale. Once per week for 10 weeks, the experimental group received cervical spine-focused manual therapy and stretching exercises alongside conservative physical therapy, and the control group received conservative physical therapy alone. Patients were evaluated at baseline and 5 and 10 weeks post-intervention. RESULTS: After the intervention, the experimental group exhibited significant reductions in the cervical kyphotic angle, Korean Headache Impact Assessment score, neck pain intensity, TMJ pain pressure threshold, Neck Disability Index score, and Jaw Functional Limitation Scale level compared with the control group (p < 0.01). CONCLUSION: Manual therapy and stretching exercises could help resolve TMDs accompanied by headaches through biomechanical changes in the cervical spine. These findings may guide protocols and clinical trials involving manual therapy that align morphological structures.

Pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence: randomized controlled pilot trial of supervised versus unsupervised training.

OBJECTIVE: To investigate the effect of supervised and unsupervised pelvic floor muscle exercises utilizing trunk stabilization for treating postpartum urinary incontinence and to compare the outcomes. DESIGN: Randomized, single-blind controlled study. SETTING: Outpatient rehabilitation hospital. SUBJECTS: Eighteen subjects with postpartum urinary incontinence. INTERVENTIONS: Subjects were randomized to either a supervised training group with verbal instruction from a physiotherapist, or an unsupervised training group after undergoing a supervised demonstration session. MAIN MEASURES: Bristol Female Lower Urinary Tract Symptom questionnaire (urinary symptoms and quality of life) and vaginal function test (maximal vaginal squeeze pressure and holding time) using a perineometer. RESULTS: The change values for urinary symptoms (-27.22 ± 6.20 versus -18.22 ± 5.49), quality of life (-5.33 ± 2.96 versus -1.78 ± 3.93), total score (-32.56 ± 8.17 versus -20.00 ± 6.67), maximal vaginal squeeze pressure (18.96 ± 9.08 versus 2.67 ± 3.64 mmHg), and holding time (11.32 ± 3.17 versus 5.72 ± 2.29 seconds) were more improved in the supervised group than in the unsupervised group (P < 0.05). In the supervised group, significant differences were found for all variables between pre- and post-test values (P < 0.01), whereas the unsupervised group showed significant differences for urinary symptom score, total score and holding time between the pre- and post-test results (P < 0.05). CONCLUSIONS: These findings suggest that exercising the pelvic floor muscles by utilizing trunk stabilization under physiotherapist supervision may be beneficial for the management of postpartum urinary incontinence.

Immediate effect of trunk flexion and extension isometric exercise using an external compression device on electromyography of the hip extensor and trunk range of motion of healthy subjects.

BACKGROUND: Sacroiliac joints (SIJs) transmitted trunk load to lower extremities through the lumbopelvis. External compression devices across the SIJs could provide stability to the SIJs. A previous study established that using a device known as Active Therapeutic Movement version 2 (ATM®2) has been developed to improve pain and joint range of motion (ROM) in patients with LBP. However, no study has examined the physiological change in the muscle through ATM®2-based exercise thus far. This study aimed to determine the immediate effects of ATM®2 exercise on the contraction timing, back extension endurance, muscle fatigue, and trunk ROM of lumbar and lower limb muscles in healthy subjects. METHODS: Thirty-six healthy subjects (mean age = 23.16 ± 2.3) volunteered to participate in this study. Subjects were instructed to perform ROM test using sit and reach test, back extensor endurance test using Biering-Sorensen test, erector spinae (ES), lumbar multifidus (LM) fatigue and onset time of Gluteus maximus (GM) in prone hip extension using electromyography before and after trunk flexion and extension isometric exercises. RESULTS: The ROM in trunk flexion showed a significant increase of 7.9% after exercise compared to that before exercise (p < 0.05). Relative GM contraction onset timing significantly decreased after exercise (p < 0.05). The result of the Sorensen test after exercise showed a trend of increase in duration time. Muscle fatigue in the LM, however, showed a significant increase (p < 0.05), whereas muscle fatigue in the ES was reduced without statistical significance. CONCLUSIONS: The results base on this study showed that exercise-based on ATM®2 is an effective exercise protocol with an effect on the biomechanics of healthy subjects. Clinical trial registration numbers KCT0006728. Clinical trial registration date: 09/11/2021.

Visual and kinesthetic locomotor imagery training integrated with auditory step rhythm for walking performance of patients with chronic stroke.

OBJECTIVE: To compare the effect of visual and kinesthetic locomotor imagery training on walking performance and to determine the clinical feasibility of incorporating auditory step rhythm into the training. DESIGN: Randomized crossover trial. SETTING: Laboratory of a Department of Physical Therapy. SUBJECTS: Fifteen subjects with post-stroke hemiparesis. INTERVENTION: Four locomotor imagery trainings on walking performance: visual locomotor imagery training, kinesthetic locomotor imagery training, visual locomotor imagery training with auditory step rhythm and kinesthetic locomotor imagery training with auditory step rhythm. MAIN OUTCOME MEASURES: The timed up-and-go test and electromyographic and kinematic analyses of the affected lower limb during one gait cycle. RESULTS: After the interventions, significant differences were found in the timed up-and-go test results between the visual locomotor imagery training (25.69 ± 16.16 to 23.97 ± 14.30) and the kinesthetic locomotor imagery training with auditory step rhythm (22.68 ± 12.35 to 15.77 ± 8.58) (P < 0.05). During the swing and stance phases, the kinesthetic locomotor imagery training exhibited significantly increased activation in a greater number of muscles and increased angular displacement of the knee and ankle joints compared with the visual locomotor imagery training, and these effects were more prominent when auditory step rhythm was integrated into each form of locomotor imagery training. The activation of the hamstring during the swing phase and the gastrocnemius during the stance phase, as well as kinematic data of the knee joint, were significantly different for posttest values between the visual locomotor imagery training and the kinesthetic locomotor imagery training with auditory step rhythm (P < 0.05). CONCLUSIONS: The therapeutic effect may be further enhanced in the kinesthetic locomotor imagery training than in the visual locomotor imagery training. The auditory step rhythm together with the locomotor imagery training produces a greater positive effect in improving the walking performance of patients with post-stroke hemiparesis.

Effectiveness of community-based ambulation training for walking function of post-stroke hemiparesis: a randomized controlled pilot trial.

OBJECTIVE: To investigate the effect of community-based ambulation training on walking function of patients with post-stroke hemiparesis. DESIGN: Randomized, single-blind, controlled pilot study. SETTING: Inpatient rehabilitation hospital. SUBJECTS: Twenty-five subjects were randomly assigned to either the experimental group or the control group, with 13 and 12 subjects, respectively. INTERVENTIONS: All subjects received a routine physical therapy. The subjects in the experimental group also received community-based ambulation training, which was performed for an hour, once a day, three times a week for a four-week period. MAIN MEASURES: Ten-metre walk test, 6-minute walk test, community walk test, walking ability questionnaire and activities-specific balance confidence scale before and after the intervention. RESULTS: The change values of the 10-m walk test (0.21 ± 0.12 m/s versus 0.07 ± 0.10 m/s), community walk test (-13.61 ± 10.31 minutes versus -3.27 ± 11.99 minutes), walking ability questionnaire (6.15 ± 3.60 score versus 2.75 ± 2.38 score) and activities-specific balance confidence scale (17.45 ± 11.55 score versus 2.55 ± 10.14 score) were significantly higher in the experimental group than in the control group (P < 0.05). At post-test, the 10-m walk test was significantly higher in the experimental group than in the control group (0.72 ± 0.24 m/s versus 0.50 ± 0.23 m/s) (P < 0.05). In the experimental group, there were significant differences for all variables between pre-test and post-test (P < 0.01), whereas the subjects of the control group showed a significant difference in only the walking ability questionnaire (P < 0.01). CONCLUSIONS: The findings demonstrate that community-based ambulation training can be helpful in improving walking ability of patients with post-stroke hemiparesis and may be used as a practical adjunct to routine rehabilitation therapy.

Effects of sling-based manual therapy on cervicothoracic junction in patients with neck pain and forward head posture: A randomized clinical trial.

OBJECTIVE: The purpose of this study was to investigate the effect of 4 weeks of sling-based manual therapy on the cervicothoracic junction (CTJ) area in patients with neck pain and forward head posture. DESIGN: Single-blind randomized controlled trial. SETTING: Outpatient, Chonbuk National University hospital, Republic of Korea. SUBJECTS: A total of 22 participants with neck pain (Numeric Pain Rating Scale >3) and forward head posture (craniovertebral angle <51) were randomly assigned to a CTJ group or a control group (n = 11 each). INTERVENTION: In the control group, joint mobilization and motor control training was applied for the upper cervical spine (C0-C1). The CTJ group applied the same intervention to the upper cervical spine and cervicothoracic junction (C7-T3). MAIN MEASURES: Numeric pain rating scale and neck disability index, craniovertebral angle, active range of motion, and muscle activity were evaluated before and after 4 weeks of intervention. RESULT: The CTJ group participants showed significant improvement in the craniovertebral angle and cervical extension range after the intervention than the control group (P = 0.025, P = 0.001). While both groups presented significant differences after the intervention regarding Numeric pain rating scale, neck disability index, and muscle activity (sternocleidomastoid and anterior scalene muscle), there were no statistically significant differences between the groups (P > 0.05). CONCLUSION: Our results suggest that the CTJ and the upper cervical region in patients with neck pain and forward head posture represent an area which if approached by manual therapy, improves cervical mobility and posture.

Comparison of immediate effects of sling-based manual therapy on specific spine levels in subjects with neck pain and forward head posture: a randomized clinical trial.

Purpose: Forward head posture is identified as the flexion of the lower cervical spine along with the extension of the upper cervical spine, with an overall increase in the cervical curve. This study aimed to compare the immediate effect of upper-cervical level and cervicothoracic junction level manual therapy on head posture, cervical range of motion and muscle activity of the subjects with forward head posture.Methods: A total 22 subjects with chronic neck pain (numeric pain rating scale >3, forward head posture: cranio-vertebral angle <51°) participated in the study and were randomly allocated into the upper-cervical (n = 11) and cervicothoracic junction (n = 11) groups. Cranio-vertebral angle, cervical range of motion, and electromyography amplitude during performance of the craniocervical flexion test were measured before and immediately after the intervention.Results/findings: There were no significant main effects for the group by time outcome score of craniovertebral angle and electromyography amplitude. However, in the range of motion of the cervical area, the cervicothoracic junction group showed a significant increase in extension and right rotation than the upper-cervical group (p < 0.05). Moreover, in both groups, the electromyography amplitude of the sternocleidomastoid muscle was significantly reduced after intervention. The electromyography amplitude of the anterior scalene muscle in only the cervicothoracic junction group was significantly reduced after intervention (p < 0.05).Conclusion: Cervicothoracic junction manual therapy improved cervical alignment, cervical mobility (extension, rotation), and muscle recruitment ability in subjects with forward head posture. These observations may partially explain the efficacy of this manual therapy in rehabilitation of individuals with mechanical neck disorder (with forward head posture).Implications for rehabilitationForward head posture is identified as the flexion of the lower cervical spine along with the extension of the upper cervical spine, with an overall increase in the cervical curve.Cervicothoracic area manual therapy in subjects with neck pain and forward head posture better improved the muscle recruitment ability than upper cervical area manual therapy during motor tasks.

Effects of integrating Neurac vibration into a side-lying bridge exercise on a sling in patients with chronic low back pain: a randomized controlled study.

PURPOSE: This study examined the effects of integrated Neurac vibration during side-lying bridge exercise using a sling system on pain, strength, and balance in patients with chronic low back pain (LBP). Subjects and Methods: A total of 30 patients were randomly assigned to experimental (EG; n = 15) or control groups (CG; n = 15). Both groups performed side-lying bridge exercise; however, the EG group also received Neurac vibration during exercise. Outcome measures included perceived pain level, asymmetry of weight distribution, asymmetry of hip abductor strength (AHAS), and static balance in one-leg standing. A 2 × 2 repeated-measures analysis of variance was used to determine main effects and interaction for each parameter. Results: Significant interaction effects were found between group and time factors for all parameters. Between-group comparisons revealed significant differences in observed changes for all parameters (P < 0.05). In within-group comparisons, EG showed significant changes in all parameters after intervention (P < 0.05); however, significant changes were only found for pain and AHAS in the CG (P < 0.05). Pain score showed greatest effect size (d = 0.77) among all parameters, indicating a moderate effect of intervention. Conclusion: The side-lying bridge exercise on a sling system may alleviate pain and improve strength and balance in patients with chronic LBP, with more favorable effects when Neurac vibration is integrated into the exercise plan.

An 8-week scapular stabilization exercise program in an elite archer with scapular dyskinesis presenting joint noise: A case report with one-year follow-up.

This case report demonstrates the effects of a scapular stabilization exercise program for managing the clinical symptoms of scapular dyskinesis in an archer presenting joint noise during shoulder movement. A 31-year-old man with a 20-year career in archery who complained of scapular dyskinesis and joint noise during shoulder movement was referred for proper management. The player performed the scapular stabilization exercise program, with an emphasis on strengthening scapular stabilizers and neutralization of scapular position, for 40 min, three times per week for 8 weeks (a total of 24 sessions). Measurements included the extent of scapular deviation, strength of scapular stabilizers, emotional burden related to joint noise, and upper limb disability. These measurements were taken before and after the intervention and during 1-year follow-up. After the 8-week intervention, scapular position improved by a range of 3.75-12.88% and muscle strength improved by a range of 8.69-28.60%. Further, emotional burden and upper limb disability improved by 56.86% and 91.67%, respectively. A 1-year follow-up showed that these improvements had been favorably maintained. These findings indicate that shoulder stabilization exercise may be helpful for alleviating scapular and shoulder problems related to archery performance.

Effects of Corrective Exercise for Thoracic Hyperkyphosis on Posture, Balance, and Well-Being in Older Women: A Double-Blind, Group-Matched Design.

BACKGROUND AND PURPOSE: The purpose of this study was to identify the effects of a corrective exercise for thoracic hyperkyphosis on posture, balance, and well-being in Korean community-dwelling older women. METHODS: Fifty women 65 years of age and older, recruited from 2 senior centers, participated in this study. Participants were assigned to either the experimental group (EG) or the control group (CG) on the basis of convenience of location, and 22 in each were analyzed. Participants in the EG underwent a thoracic corrective exercise program 1 hour each session, twice per week for 8 weeks (a total of 16 sessions), which consisted of specific exercises to enhance breathing, thoracic mobility and stability, and awareness of thoracic alignment. The CG received education on the same thoracic corrective exercise program and a booklet of the exercises. Outcome measures included the extent of postural abnormality (angle of thoracic kyphosis, kyphosis index calculated both in relaxed- and best posture using flexicurve, the ratio of the kyphosis index calculated best posture/relaxed posture, craniovertebral angle, and tragus-to-wall distance), balance (Short Physical Performance Battery and limit of stability), and well-being (Geriatric Depression Scale Short Form and the 36-Item Short Form Health Survey [SF-36]). All data were collected by 6 blinded assessors at baseline, at 8 weeks after the completion of intervention, and at 16 weeks for follow-up. RESULTS AND DISCUSSION: For participants of the EG, means of all parameters showed significant improvements over time (P < .05), with improved values both in comparison of baseline to postintervention and baseline to follow-up. Means of CG parameters were significantly improved in only the angle of thoracic kyphosis and the tragus-to-wall distance (P < .05). Furthermore, in all parameters, percent change between baseline and postintervention data was significantly (P < .05) higher for the EG than that for the CG, except for the limit of stability and SF-36 which improved but not significantly. All parameters between baseline and follow-up data were significantly (P < .05) higher for the EG than those for the CG, except for the limit of stability. CONCLUSIONS: The findings of this study suggest that a well-designed exercise program may be beneficial to improve spinal posture, balance, and well-being in older women with thoracic hyperkyphosis. We recommend the use of the therapeutic strategies utilized in this study to enhance thoracic posture, balance, and well-being of older women with thoracic hyperkyphosis. Future research is needed to apply this exercise protocol on a larger and more diverse population.

Effects of augmented trunk stabilization with external compression support on shoulder and scapular muscle activity and maximum strength during isometric shoulder abduction.

The aim of the present study was to investigate the effects of augmented trunk stabilization with external compression support (ECS) on the electromyography (EMG) activity of shoulder and scapular muscles and shoulder abductor strength during isometric shoulder abduction. Twenty-six women volunteered for the study. Surface EMG was used to monitor the activity of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and middle deltoid (MD), and shoulder abductor strength was measured using a dynamometer during three experimental conditions: (1) no external support (condition-1), (2) pelvic support (condition-2), and (3) pelvic and thoracic supports (condition-3) in an active therapeutic movement device. EMG activities were significantly lower for UT and higher for MD during condition 3 than during condition 1 (p < 0.05). The MD/UT ratio was significantly higher during condition 3 than during conditions 1 and 2, and higher during condition 2 than during condition 1 (p < 0.05). Shoulder abductor strength was significantly higher during condition 3 than during condition 1 (p < 0.05). These findings suggest that augmented trunk stabilization with the ECS may be advantageous with regard to reducing the compensatory muscle effort of the UT during isometric shoulder abduction and increasing shoulder abductor strength.

Effects of integrating hip movements into bridge exercises on electromyographic activities of selected trunk muscles in healthy individuals.

This study aimed to identify the electromyographic (EMG) effects in selected trunk muscles after incorporating hip movement into bridging exercise. Twenty-six healthy adults (13 men and 13 women) volunteered for this experiment. EMG data (% maximum voluntary isometric contraction) were recorded from the rectus abdominis (RA), obliquus internus (OI), erector spinae (ES), and multifidus (MF) muscles of the dominant side while the subjects performed 3 types of bridging exercise, including bridging alone (Bridging 1), bridging with unilateral hip movements (Bridging 2), and bridging with bilateral hip movements (Bridging 3) in a sling suspension system. The RA and OI showed greater EMG activity during Bridging 2 and 3 compared to Bridging 1, with the greatest OI activity during Bridging 3 (p < 0.05), and the activity of the MF appeared to be greater during Bridging 3 than during Bridging 1 and 2 (p < 0.05). Furthermore, the OI/RA and MF/ES ratios were significantly higher for Bridging 2 (OI/RA = 1.89 ± 1.41; MF/ES = 1.03 ± 0.19) and Bridging 3 (OI/RA = 2.34 ± 1.86; MF/ES = 1.03 ± 0.15) than Bridging 1 (IO/RA = 1.35 ± 0.92; MF/ES = 0.98 ± 0.16). The OI/RA ratio was significantly higher for Bridging 3 than for Bridging 2. Based on these results, adding hip abduction and adduction, particularly bilateral movements, could be a useful method to enhance OI and MF EMG activity and their activities relative to global muscles during bridging exercise.

Comparison between muscle activation measured by electromyography and muscle thickness measured using ultrasonography for effective muscle assessment.

In this study, we aimed to compare the intrarater reliability and validity of muscle thickness measured using ultrasonography (US) and muscle activity via electromyography (EMG) during manual muscle testing (MMT) of the external oblique (EO) and lumbar multifidus (MF) muscles. The study subjects were 30 healthy individuals who underwent MMT at different grades. EMG was used to measure the muscle activity in terms of ratio to maximum voluntary contraction (MVC) and root mean square (RMS) metrics. US was used to measure the raw muscle thickness, the ratio of muscle thickness at MVC, and the ratio of muscle thickness at rest. One examiner performed measurements on each subject in 3 trials. The intrarater reliabilities of the % MVC RMS and raw RMS metrics for EMG and the % MVC thickness metrics for US were excellent (ICC=0.81-0.98). There was a significant difference between all the grades measured using the % MVC thickness metric (p<0.01). Further, this % MVC thickness metric of US showed a significantly higher correlation with the EMG measurement methods than with the others (r=0.51-0.61). Our findings suggest that the % MVC thickness determined by US was the most sensitive of all methods for assessing the MMT grade.