Development and application of an in-house health care program to improve the physical and mental health of working mothers: A pilot study.

Working mothers are receiving a lot of physical and mental stress due to their various roles in the home and society. However, lack the time to manage their health because of their diverse roles in the workplace and at home; thus, it is necessary to implement a program that can help manage the health of working mothers in a company. The author's purposes in this study are to identify the health related quality of life and mental health problems of working mothers and to determine the effects of an in-house health care program to manage those problems. Fourteen female participants who are working, have children were recruited and measured health-related quality of life, degree of depression and anxiety and pain intensity were measured. After measurement, participants were enrolled in an in-house health care program for 8 weeks. The in-house health care program, consisting of physical therapy, psychiatrist consulting, and group education. After in-house health care program, all of the dependent values including health-related quality of life, degree of depression and anxiety, and pain intensity were improved. Therefore, this in-hose health care program is may an effective program to improve the mental health and quality of life of working mothers.

Pelvic floor muscle training for urinary incontinence in female stroke patients: a randomized, controlled and blinded trial.

OBJECTIVE: To examine the effects of pelvic floor muscle training (PFMT) on the contractility of pelvic floor muscle and lower urinary tract symptoms in female stroke patients. DESIGN: Randomized, single-blind controlled study. SETTING: Outpatient rehabilitation hospital. SUBJECTS: Thirty one female patients who were more than three months post-stroke and stress urinary incontinence. INTERVENTIONS: The subjects were randomized to either a PFMT group (n = 16), or a control group (n = 15). Both groups received general rehabilitation exercise for 6 weeks, but the PFMT group additionally received PFMT for 6 weeks. MAIN MEASURES: Vaginal function test using a perineometer (maximal vaginal squeeze pressure) and intra-vaginal electromyography (activity of pelvic floor muscle), and urinary symptoms and quality of life using a Bristol Female Lower Urinary Tract Symptom questionnaire. RESULTS: After intervention, the maximal vaginal squeeze pressures for the PFMT and control groups were 18.35 (5.24) and 8.46 (3.50) mmHg, respectively. And the activities of pelvic floor muscle of the PFMT and control groups was 12.09 (2.24) ㎶ and 9.33 (3.40) ㎶, respectively. After intervention, the changes of scores for inconvenience in the activity of daily living of the PFMT and control groups were -15.00 (6.25) and -0.17 (1.59), respectively. In addition, the changes of score for lower urinary tract symptom was improved more in the PFMT group (-4.17 (4.00)) than in the control group (-0.25 (1.29)) (P < 0.05). CONCLUSIONS: These findings suggest that PFMT is beneficial for the management of urinary incontinence in female stroke patients.

The immediate effects of spinal thoracic manipulation on respiratory functions.

[Purpose] The purpose of this study was to investigate the effects of thoracic spinal manipulation therapy on respiratory function including forced vital capacity and forced expiratory volume in one second in young healthy individuals. [Subjects and Methods] Thirty young healthy subjects recruited from a local university participated in this study. Subjects were randomly allocated into an experimental group (n=15) and a control group (n=15). The experimental group received thoracic spinal manipulation and the control group received placebo thoracic spinal manipulation. Respiratory function tests, including forced vital capacity and forced expiratory volume in one second, were measured before and after intervention. [Results] The values for both tests were significantly higher in the experimental group. The control group showed no changes after the intervention. Differences in pre- and post-intervention values for both tests were significantly different between the 2 groups. [Conclusion] Spinal manipulation therapy applied to the thoracic region improved respiratory function test results of participants in this study.

Canoe game-based virtual reality training to improve trunk postural stability, balance, and upper limb motor function in subacute stroke patients: a randomized controlled pilot study.

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

The effects of a balance exercise program for enhancement of gait function on temporal and spatial gait parameters in young people with intellectual disabilities.

[Purpose] The aim of the study was to assess the effect of an 8-week balance exercise program for enhancement of gait function on temporal and spatial parameters of school aged children with intellectual disabilities. [Subjects] Forty young people with intellectual disabilities were assigned either to the balance exercise program for enhancement of gait function group (BG group, n=19) or the control group (n=21). [Methods] The BG group attended an 8-week balance exercise program for enhancement of gait function consisting of two sessions a week. Gait was assessed using temporal and spatial parameters. [Results] The balance exercise program resulted in significant improvements in participant performance in temporal and spatial parameters. [Conclusion] A balance exercise program for enhancement of gait function can be an effective intervention for improving functional outcomes and can be recommended as an alternative mode of physical activity programming for improving balance and gait.

Concurrent Validity and Test-retest Reliability of the OPTOGait Photoelectric Cell System for the Assessment of Spatio-temporal Parameters of the Gait of Young Adults.

[Purpose] The purpose of this study was to investigate the concurrent validity and test-retest reliability of the recently introduced OPTOGait Photoelectric Cell System for the assessment of spatio-temporal parameters of gait. [Subjects] Twenty healthy young adults (mean age = 27.35, SD = 7.4) were asked to walk 3 times on walkway at a comfortable speed. [Methods] Concurrent validity was assessed by comparing data obtained using the OPTOGait and GAITRite systems, and reliability was assessed by comparing data from the first and third OPTOGait sessions. [Results] Concurrent validity, as identified by intra-class correlation coefficients (ICC (2, 1) = 0.929-0.998), coefficients of variation (CVME = 0.32-11.30%), and 95% limits of agreement, showed high levels of correlation. In addition, the test-retest reliability of the OPTOGait Photoelectric Cell System was demonstrated as showing a high level of correlation with all spatio-temporal parameters by intra-class correlation coefficients (ICC (3, 1) = 0.785-0.952), coefficients of variation (CVME = 1.66-4.06%), 95% limits of agreement, standard error of measurement (SEM = 2.17-5.96%), and minimum detectable change (MDC95% = 6.01-16.52%). [Conclusion] The OPTOGait Photoelectric Cell System has strong concurrent validity along with relative and absolute test-retest reliabilities. This portable system with easy-to-use features can be used for clinical assessments or research purposes as an objective means of assessing gait.

The effect of underwater gait training on balance ability of stroke patients.

[Purpose] The purpose of this study was to investigate the effects of underwater treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a control group (n =11). [Methods] Both groups received general rehabilitation for 30 min per session, 5 times per week, over a 4-week period. The underwater treadmill group received additional underwater gait training for 30 min per session, 5 times per week, over the same 4-week period. Static and dynamic balances were evaluated before and after the intervention. [Results] The means of static and dynamic balance ability increased significantly in both groups, but there was no significant difference between the two groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill gait training was not more effective at improving the balance ability of stroke patients than land-based training.

Electromyographic Activities of Trunk Muscles Due to Different Exercise Intensities during Pulley-based Shoulder Exercises on an Unstable Surface.

[Purpose] This study examined the relationship between core stability and exercise intensity during a pulley-based shoulder exercise (PBSE) on an unstable support surface. [Subjects] Twenty healthy college students enrolled in this study. [Methods] Surface EMG was carried out in twenty healthy adult men. The electromyographic activities of the rectus abdominis (RA), erector spinae (ES), exercises with 14 kg or 26 kg of resistance and external oblique (EO) muscles during pulley-based shoulder on an unstable support surface (USS) were compared. [Results] The EMG signals of the RA, ES, and EO did not increase with increasing exercise resistance. [Conclusion] Increasing the exercise intensity to increase the core stability during PBSE on a USS may be ineffective.

The effects of visual feedback training on sitting balance ability and visual perception of patients with chronic stroke.

[Purpose] The purpose of this study was to investigate the effects of visual feedback training (VFT) in the sitting position on sitting balance ability and visual perception of chronic stroke patients. [Subjects] Twenty-two hospitalized subjects who had experienced a stroke more than six months earlier were included in this study. [Methods] Subjects in both the experimental group (n=12) and the control group (n=10) participated in a conventional rehabilitation program involving a 60-minute session five days per week for a period of four weeks. Subjects in the experimental group additionally practiced VFT 30-minute sessions, five days per week, for a period of four weeks. [Results] After the intervention, the experimental group showed significantly improved static sitting balance ability (left∙right, anterior∙posterior moment, and velocity moment), and dynamic sitting balance ability (anterior∙lateral moment). In visual perception tests, motor free visual perception test (MVPT) scores showed a significant increase of approximately 17% in the experimental group after the intervention. [Conclusion] The results of this study demonstrate the effectiveness of VFT in enhancing body function, as evidenced by improved sitting balance and visual perception of chronic stroke patients.

Comparison of compensatory lumbar movement in participants with and without non-specific chronic low back pain: A cross-sectional study.

BACKGROUND: Many studies have compared muscle length and muscle activity for low back pain. However, compensatory movement for non-specific low back pain has not yet been studied sufficiently. OBJECTIVE: The purpose of this study was to compare the length of the hip flexor, lumbar extensor endurance and the muscle activity of the erector spinae and gluteus maximus during hip extension, and the compensatory movement of the lumbar in people with or without nonspecific chronic low back pain. METHODS: In this case-control study, 16 participants with non-specific chronic LBP and 17 without LBP were included. Hip flexor length was assessed by the modified Thomas test. Lumbar extensor endurance was assessed by the modified Biering-Sorensen test. Muscle activity of the erector spinae and gluteus maximus during hip extension was measured using a Delsys-Trigno wireless EMG system. Compensatory lumbar movements during hip extension were measured using a digital inclinometer. RESULTS: Muscle activity of the erector spinae and compensatory lumbar movements were significantly higher in the LBP group. (p< 0.05). Hip flexor length, muscle activity of the gluteus maximus and endurance of the lumbar extensor were significantly differences in the LBP group (p< 0.05). CONCLUSIONS: Shortened hip flexors, low gluteus maximus activity, and high erector spinae activity during hip extension, lumbar extensor weak endurance, lumbar compensatory movement are potential factors for non-specific LBP.

Smartphone-based visual feedback trunk control training for gait ability in stroke patients: A single-blind randomized controlled trial.

BACKGROUND: The gait ability of stroke patients is highly related with trunk control. Studies that addressed the effects of trunk control training using visual feedback on gait parameters of stroke patients are lacking. OBJECTIVE: The purpose of this study was to investigate the role of smartphone-based visual feedback trunk control training for improvement of trunk control and spatio-temporal gait parameter in stroke patients. METHODS: Twenty-four stroke patients participated in this study. Participants were randomly allocated to the experimental and control groups. Both groups completed conventional rehabilitation over 4 weeks. The experimental group additionally received smartphone-based visual feedback trunk control training for 4 weeks. The primary outcome of this study was evaluated by trunk impairment scale and spatio-temporal gait parameters. RESULTS: The trunk impairment scale in the experimental group was significantly improved compared to the control group (P< 0.05). The spatio-temporal gait parameters are significantly more different in the experimental group than in the control group (P< 0.05). CONCLUSIONS: Additional smartphone-based visual feedback trunk control training may improve trunk control and spatio-temporal gait parameter in chronic stroke patients.

Smartphone-Based Visual Feedback Trunk Control Training Using a Gyroscope and Mirroring Technology for Stroke Patients: Single-blinded, Randomized Clinical Trial of Efficacy and Feasibility.

OBJECTIVE: The purpose of this study was to assess the preliminary efficacy and feasibility of smartphone-based visual feedback trunk control training (SPVFTCT) for improving balance and trunk performance in stroke patients. DESIGN: Twenty-four patients who had experienced a stroke more than 6 months previously and could sit and walk independently participated in the study. The participants were allocated to a SPVFTCT (n = 12) or to a control group (n = 12). Both groups completed five 80-minute sessions per week of conventional rehabilitation for 4 weeks. The SPVFTCT group additionally received three 20-minute sessions per week of SPVFTCT for 4 weeks. The outcome was assessed using static balance assessment, the modified functional reach test, the timed up and go test, and the trunk impairment scale. Feasibility of SPVFTCT was evaluated by retention, adherence, acceptability, and safety. RESULTS: The static balance assessment, modified functional reach test, timed up and go test, and trunk impairment scale scores in the SPVFTCT group improved significantly compared to those in the control group (P < 0.05). In the SPVFTCT group, retention and adherence rates were 100% and 97%, respectively. All participants reported that SPVFTCT was enjoyable, easy to use, and helpful for their recovery. CONCLUSIONS: The SPVFTCT approach is a feasible method to improve balance and trunk performance in stroke patients. TO CLAIM CME CREDITS: Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES:: Upon completion of this article, the reader should be able to: (1) Understand the role of trunk control in postural stability and functional improvement; (2) Describe the benefits of smartphone-based visual feedback trunk control training (SPVFTCT); and (3)Discuss the feasibility of incorporating smartphone-based visual feedback trunk control training in stroke rehabilitation. LEVEL: Advanced ACCREDITATION: : The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s). Physicians should only claim credit commensurate with the extent of their participation in the activity.