Effects of elastic neutral ankle-foot orthoses on 3 dimensional parameters during gait training in patients with stroke: A pilot study.

BACKGROUND: General ankle-foot orthosis (AFO) cannot be flexibly adjusted to volumetric change in the lower leg because the molding is custom-fit. Thus, we developed a flexible assistive device called elastic neutral AFO (EN-AFO) to help stroke patients hold a neutral ankle position. The purpose of this study was to investigate the effects of EN-AFO and improve gait patterns in stroke patients with rearfoot varus deformity. METHODS: Fifteen stroke patients with a varus deformity of the foot performed a walking test with and without the use of EN-AFO. Kinematic data were measured with a 3D motion analysis system with inertial measurement unit (IMU) sensors. RESULTS: In the stance phase, maximal pelvic tilt and maximal ankle dorsiflexion in the affected side changed, and maximal and minimal pelvic tilts and maximal hip abduction in the less-affected limb effectively changed, as well. During the swing phase, minimal pelvic tilt and minimal ankle abduction in the affective limb greatly changed; particularly, the reduction of maximal ankle inversion was significantly cleared. CONCLUSIONS: The EN-AFO was effective in controlling the tendency of foot inversion in patients with varus deformities. This is suitable for gait training, as it can adjust the orthosis stiffness according to the foot condition.

Comparison of muscular activities between subjects with and without scapular downward rotation impairment during diagonal pattern of exercises.

BACKGROUNDS: One form of abnormal scapular alignment is scapular downward rotation (SDR). Changes in muscle function in SDR have not been clearly identified, and SDR exercises also require investigation. Although a diagonal pattern of exercise is commonly used as part of the exercise protocol, a direct comparison of shoulder and scapular diagonal exercises has not yet been conducted. The objectives of this study were to determine the altered activation of the scapular musculature in the SDR group and to investigate which diagonal pattern of exercise effectively activates the scapular musculature. METHODS: Thirty-two participants (18 in the control group and 14 in the SDR group) volunteered to participate in this study. Electromyographic signals were collected from four muscles, the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD), during standing performance of diagonal shoulder and scapular exercises. RESULTS: The control group showed significantly lower UT activity, UT/LT ratio, and UT/SA values than the SDR group (p < .05). Activation of the AD was significantly higher in the SDR than in the control group (p < .05). SA and AD activation were significantly higher in shoulder diagonal pattern exercises than in scapular diagonal pattern exercises (p < .05). The scapular posterior elevation pattern exercise showed significantly higher UT and LT activities than anterior elevation and shoulder diagonal pattern exercises (p < .05). CONCLUSION: Our findings suggest that reduced activation of the UT could lead to greater activation in the AD in SDR. Scapular posterior elevation exercise is advantageous as selectively activates the trapezius musculature, and shoulder diagonal pattern exercise is advantageous in activating the SA and AD.

A pilot study of balance performance benefit of myofascial release, with a tennis ball, in chronic stroke patients.

BACKGROUND: We hypothesised that the balance of spastic chronic stroke patients is related to myofascial problems. We performed myofascial release (MFR) with a tennis ball on the affected limb, as suggested by Myers. PURPOSE: This study investigated the benefits of 8 weeks of MFR using a tennis ball on the balance of spastic patients. METHODS: Eight stroke patients were enrolled voluntarily after providing informed consent. All subjects received 8-week interventions with MFR using a tennis ball three times per week. The patients were evaluated using the Berg Balance Scale (BBS) and Timed 'Up & Go' (TUG) test before and after 4 and 8 weeks of the intervention. RESULTS: There were significant differences in the BBS scores (p = 0.001). The TUG time decreased significantly at 4 and 8 weeks (p = 0.034). CONCLUSION: Myofascial release appears to improve the balance of spastic chronic stroke patients; however, further studies should evaluate the effective of MFR on walking in stroke patients and determine the mechanism of the effect of MFR.

The comparison of the immediate effects of application of the suboccipital muscle inhibition and self-myofascial release techniques in the suboccipital region on short hamstring.

[Purpose] The purpose of this study was to research the effect of performing the suboccipital muscle inhibition (SMI) and self-myofascial release (SMFR) techniques in the suboccipital area on the flexibility of the hamstring. [Subjects] Fifty persons with short hamstrings participated in this research. According to the results of the finger-floor distance (FFD) test, the subjects were allocated to SMI and SMFR groups of 25 subjects each. [Methods] The SMI and SMFR techniques were applied to the groups. For the analysis, we used the FFD test and the straight leg raise (SLR) test for the flexibility of hamstring. The evaluator was blindfolded. [Results] In the SMI group, FFD, SLR, and PA were significantly changed after the intervention, and in the SMFR group, there was a significant change in SLR after the intervention. In a comparison between the groups, FED was found to be significantly increased in the SMI group. [Conclusion] Application of the SMI and SMFR to persons with short hamstrings resulted in immediate increases in flexibility of the hamstring. However, we could see that the SMI technique was more effective.