Effects of Manual Lymphatic Drainage with Mobilization and Myofascial Release on Muscle Activities during Dynamic Balance in Adults with Calf Muscle Shortening.

Mobilization with movement (MWM) and myofascial release (MFR) are treatment techniques that increase ankle dorsiflexion range of motion (DFROM). Manual lymphatic drainage (MLD) facilitates waste drainage and improves soft tissue tension in peripheral tissues. To date, no studies have investigated how the combination of MLD, MWM, and MFR influences the human body. The purpose of this study is to determine how the combination of MLD, MWM, and MFR affects DFROM and balance ability. We randomly assigned 16 individuals (26 feet) to one of three groups: MWM-MFR (MR), MWM-MLD (MD), or MWM-MFR-MLD (MRD) intervention. To confirm the intervention effect of each group, DFROM was assessed using a modified lunge test, and dynamic balance was measured using a modified star excursion balance test. In the results, differences were found between the MR and MRD groups in PL and mGCM activities in the 1 section (p = 0.008, p = 0.036) and between the MD and MRD groups in mGCM activity in the 4 and 5 sections (p = 0.049, p = 0.004). We suggest that the application of MRD is the most effective intervention for increasing muscle activation of the PL and mGCM during the modified star excursion balance test.

Methodology for Mapping the Residual Stress Field in Serviced Rails Using LCR Waves.

Non-destructive stress measurement by ultrasonic testing is based on calculating the acoustoelastic modulus obtained from the relationship between material stress and sound wave velocity. A critically refracted longitudinal (LCR) wave, which is a bulk longitudinal wave penetrating below and parallel to the surface below an effective depth, is most suitable for ultrasonic stress measurement tests because it exhibits a relatively large change in travel time in response to a change in stress. In particular, the residual stress distribution through the thickness of the subject can be calculated if transducers of different frequencies are applied because of the characteristic of propagation to different depths of penetration depending on the frequency. The main purpose of this study was to visualize the internal or residual stress distribution through the thickness of rails using LCR waves. To this end, LCR probes with different center frequencies were designed and manufactured, and the residual stress values ​​of an unused railroad rail and two used railroad rails operated under different conditions were calculated. This was done using the ultrasonic signals received from each probe, of which the distributions were mapped. Through these mapping results, different residual stress values could be calculated according to the depth. The differences in residual stress generation and distribution according to the conditions surrounding the contact between train wheels and rails, and their characteristics, were visualized and analyzed. As a result, it could be concluded that the non-destructive evaluation technique using LCR waves could detect differences in the residual stress of a rail, and thus can be used to measure the residual stress of the rail accurately.

Experimental Consideration of Conditions for Measuring Residual Stresses of Rails Using Magnetic Barkhausen Noise Method.

Residual stress, a factor affecting the fatigue and fracture characteristics of rails, is formed during the processes of fabrication and heat treatment, and is also generated by vertical loads on wheels due to the weight of vehicles. Moreover, damage to rails tends to accelerate due to the continuous increase in the number of passes and to the high speed of passing vehicles. Because this can have a direct effect on safety accidents, having a technique to evaluate and analyze the residual stresses in rails accurately is very important. In this study, stresses due to tensile loads applied to new rails and residual stresses remaining in used rails were measured by using magnetic Barkhausen noise method. First, a magnetization frequency and noise band suitable for the rails were selected. Moreover, by applying tensile loads to specimens and comparing the difference in magnetization amplitudes for each load, the stresses applied to the rails by using the magnetic Barkhausen noise method were measured, and the analysis of the results was verified. Based on these results, the difference in the results for the loads asymmetrically applied according to the wheel shape was analyzed by measuring for the head parts of used rails.

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.

Ultrasonic device developed for non-invasive moxibustion therapy.

BACKGROUND: Recently, some adverse effects of moxibustion has been reported such as burns, smoke, allergies, and so on. To overcome the adverse effects of traditional moxibustion, an ultrasonic moxibustion device (UMD) was designed, simulated, fabricated, and tested. The objective of this study is to provide detailed information about the main design parameters, simulation outcome, and performance-test results. METHODS: The main components of the UMD are a 1-MHz ultrasonic transducer (UT) with concave lens, and its applicator. The acoustic pressure and temperature distribution of the UT was simulated and described graphically using COMSOL software, which is based on the finite element method (FEM). Experimental verification of the temperature distribution was performed on the skin of pork. The temperature-change profiles of pork in relation to increase of therapy time were obtained at an unfocused point (2 mm) and at a focal distance of 13 mm. For the performance test, moxibustion therapy was conducted on the abdominal skin of mice for 120 min using the new UMD and its histological images were acquired to analyze the skin-tissue damage. RESULTS: The FEM simulation of temperature distribution and acoustic pressure agreed with the experimental outcome. Histological images showed that there was no skin-tissue damage to the mouse abdomens after therapy. The results clearly show that the newly developed UMD can overcome the disadvantages of traditional moxibustion therapy and achieve the proposed design parameters. CONCLUSION: The FEM simulation and performance tests provided valuable information about developing future UMDs. In addition, its performance can be compared with traditional moxibustion therapy for future study.

Propagation and Attenuation Characteristics of an Ultrasonic Beam in Dissimilar-Metal Welds.

Ultrasonic inspection of welds joining dissimilar metals in nuclear power plants has proven to be a challenge, because the ultrasonic waves are subject to diffraction, distortion, scattering, and noise. These perturbations are due to their interactions with coarse-grained microstructures having anisotropic and heterogeneous metallurgical properties that can promote ultrasonic attenuation. In this paper, to improve the reliability of ultrasonic testing for dissimilar-metal welds (DMWs), ultrasonic beam characteristics for DMWs with a buttering layer were investigated in order to analyze the beam distortion phenomenon caused by inhomogeneous anisotropic properties and coarse grains. Ultrasonic testing was performed on DMW specimens using single ultrasonic transducers to investigate the behavior of the ultrasonic beam in the welds. According to the anisotropic and heterogeneous properties, when passing through the weld and the buttering layer of the DMW, ultrasonic waves were distorted and attenuation was high. In particular, in the case of using angular incidence that passed through the weld and the buttering layer in turn, the received ultrasonic data did not contain accurate internal information. From this, it was verified that internal defects may be detected by transmitting ultrasonic waves in different directions. Finally, the existing limitations on the application of non-destructive ultrasonic testing to dissimilar-metal welds were verified, and a solution to the measurement method was proposed.

Comparison of the Intrinsic Foot Muscle Activities between Therapeutic and Three-Dimensional Foot-Ankle Exercises in Healthy Adults: An Explanatory Study.

BACKGROUND: In recent years, a three-dimensional ankle exercise has been proposed as a practice for strengthening the intrinsic foot muscles, however this topic still requires further research. This study aimed to compare the activities of the intrinsic muscles in healthy participants during 3D foot-ankle exercises, namely, short foot (SF), and toe spread out (TSO). METHODS: Prior to the experiment, 16 healthy adults were trained on how to perform SF, TSO, and 3D foot-ankle exercises for an hour. Once all participants passed the foot-ankle exercise performance test, we randomly measured the activity of the intrinsic foot muscles using electromyography while the patients were performing foot-ankle exercises. RESULTS: The abductor hallucis (AbH), extensor hallucis longus (EHL), and flexor hallucis brevis (FHB) activities showed significant differences among the exercises for intrinsic foot muscle strengthening (p < 0.01). Additionally, the AbH/AdH (adductor hallucis) ratio showed significant differences among the exercises for strengthening the intrinsic foot muscles (p < 0.01). CONCLUSIONS: Our results showed that the 3D extension exercise is as effective as the therapeutic exercise in terms of the AbH and FHB activities, and the AbH/AdH ratio. On the contrary, the 3D flexion exercise showed superiority in terms of the EHL activity.

Comparison of lumbar multifidus thickness and perceived exertion during graded superman exercises with or without an abdominal drawing-in maneuver in young adults.

The present study aimed to investigate lumbar multifidus (LM) thickness and perceived exertion during graded superman exercises (GSE) or GSE with an abdominal drawing-in maneuver (GSE-AD) in young adults. Twelve young adult males and females, who were informed of the purpose and procedures of this study and then gave their voluntary consent to participate, were included in this study. All subjects randomly performed three GSE and GSE-AD over 3 days. Ultrasonography was used to measure the LM thickness to the left and right of the L5 region. Additionally, the issue of whole-body fatigue felt by the subject while performing the GSE or GSE-AD was measured using the Borg scale. The intrarater reliability of the LM measurement was found to be intraclass correlation coefficient (ICC[3,1])=0.97 (0.87-0.99) at resting and ICC(3,1)=0.94 (0.78-0.99) at contraction. Both the left and right LM showed significantly higher contraction during the grade 3 GSE (P< 0.05). The whole-body fatigue was significantly greater following GSE 2 and 3 than following GSE-AD 2 and 3 (P<0.05). In particular, GSE-AD had a significantly lower Borg score compared to GSE (P<0.05) and did not show any significant difference in muscle thickness (P>0.05). It is recommended that the abdominal drawing-in maneuver be applied with grade 3 GSE to enhance stability and reduce spinal fatigue.

Effects of pelvic tilt angles and forced vital capacity in healthy individuals.

[Purpose] The purpose of this study was to investigate the effect of pelvic tilt angles and lung function in participants performing pelvic tilts on a ball. [Subjects and Methods] Eighteen subjects participated in this study. While they performed pelvic tilt on sitting at a ball, the peak expiratory flow (PEF) and forced expiratory volume in one second (FEV1) were measured at 10 degrees of anterior and posterior pelvic tilt, respectively, and neutral position. The repeated measure ANOVA was performed, and the Bonferroni correction was used for post-hoc analysis. [Results] The PEF of the participants was significantly higher at neutral position, compared with an anterior pelvic tilt at 10 degrees. The FEV1 was also higher in neutral position, compared with anterior and posterior pelvic tilt. [Conclusion] This study underlines the need for the standardization of the FVC testing protocol for positioning the pelvic angle in a neutral position in patients with respiratory disorders to promote reliable interpretation of intervention outcomes.

Comparison of abdominal muscle activity during abdominal drawing-in maneuver combined with irradiation variations.

Many experts have used an indirect method for enhancing strength and performance of muscles in clinical practice. The indirect method, which called an irradiation is a basic procedure of proprioceptive neuromuscular facilitation, there is little research related the effects of irradiation. This study investigated abdominal muscle activity during abdominal drawing-in maneuver (ADIM) combined with irradiation variations. The study recruited 42 healthy, young adults who were divided randomly into three groups according to which intervention they received. The first group performed the ADIM combined with coactivation of the pelvic floor muscle. The second group performed the ADIM combined with the irradiation resulting from dorsiflexion of the ankle. The third group performed the ADIM combined with the irradiation resulting from bilateral arm extension. Electromyography data were collected from the rectus abdominis, external oblique abdominis, and transversus abdominis/internal oblique abdominis (TrA/IO) muscles during ADIM combined with irradiation variations. There were significant differences in the abdominal muscle activity and the preferential contraction ratio of the TrA/IO among the three groups (P<0.05). ADIM combined with irradiation resulting from bilateral arm extension may be effective for enhancing the deep and superficial abdominal muscles of healthy people and athletes. The ADIM without the irradiation is advantageous for recovering motor control of the TrA/IO.

Changes in gait kinematics and muscle activity in stroke patients wearing various arm slings.

Stroke patients often use various arm slings, but the effects of different slings on the joint kinematics and muscle activity of the arm in the gait have not been investigated. The effects of joint kinematics and muscle activity in the gait were investigated to provide suggestions for gait training for stroke patients. In all, 10 chronic stroke patients were voluntarily recruited. An eight-camera three-dimensional motion analysis system was used to measure joint kinematics while walking; simultaneously, electromyography data were collected for the anterior and posterior deltoids and latissimus dorsi. The amplitude of pelvic rotation on the less-affected side differed significantly among the different arm slings (P<0.05). Changes in the knee kinematics of the less-affected side also differed significantly (P<0.05), while there were no significant differences in the muscle activity of the affected arm. In stroke patients, an extended arm sling is more useful than no sling or a flexed arm sling in terms of the amplitude of the rotation of the less-affected pelvic side in the stance phase while walking. The less-affected knee joint is flexed more without a sling than with any sling. All arm slings support the extension of the contralateral knee.

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.

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.

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.

The preferential contraction ratios of transversus abdominis on the variations of knee angles during abdominal drawing-in maneuver in wall support standing.

The objective of this study was to determine appropriate knee angles for the abdominal drawing-in maneuver (ADIM) through evaluation of changes in contraction ratios of the abdominal muscles and activity of quadriceps muscle in relation to changes in knee angles occurring while the ADIM is performed in the wall support standing (WSS). 20 subjects performed the ADIM at different knee angles (0°, 20°, 40°, 60°) in random order, standing at a point 6 inches away from the wall with the spine maintained in the neutral position. The WSS with knee flexion at 20° showed significantly higher preferential contraction ratio (PCR) of transversus abdominis (TrA) compared to other positions (0°, 40°, 60°). Therefore, performing the ADIM in the WSS with knee flexion at 20° appears to be the most appropriate position for TrA PCR.

Effects of the Elastic Walking Band on gait in stroke patients.

This study investigated how stroke patients improve the walking patterns by using the Elastic Walking Band, which was included with a long elastic band and four pierced plastics as fixed points. Fifteen patients with stroke were recruited. Participants were nine males and six females. Gait parameters were measured with the GAITRite system to analyze the spatial and temporal parameters of walking by stroke patients. The Elastic Walking Band had no significance in cadence, swing time and stance on both limbs. However, the Elastic Walking Band significantly improved velocity in stroke patients. Furthermore, there was a significant difference in step length of the less-affected limb between the two conditions, but no significant difference in the affected side. When the patients walked with the Elastic Walking Band, affected and less-affected stride length were also significantly increased as compared with barefoot walking. There were significant differences of velocity, less-affected step length, both stride length between walking with and without the Elastic Walking Band. Consequently, the Elastic Walking Band can be used as an assistive walking device that is lighter and less expensive for stroke patient gait training in the clinic.

The effect of an AFO-shaped elastic band on drop-foot gait in patients with central neurological lesions.

We investigated the effectiveness of an AFO-shaped band as an assistive walking device in patients with neurological lesions. The participants included 11 patients with a recent history of a CVA and one multiple sclerosis patient. In each patient, the order of conditions (AFO, AFO-shaped band, barefoot) was randomized. Participants were required to walk on the GAITRite mat twice during each condition. The average gait velocity among patients using the AFO-shaped elastic band was significantly higher than those under barefoot conditions (p = 0.015). Participants using the AFO-shaped elastic band also showed a significantly higher average number of steps per minute (cadence) as compared with the barefoot and AFO conditions (p = 0.007). Significant differences in stride length on the unaffected side were found between the AFO-shaped band and barefoot conditions (p = 0.029). Our results indicated that the AFO-shaped elastic band could be useful for patients with central neurological lesions with respect to gait, especially walking velocity, cadence, and stride length on the affected side. Thus, the AFO-shaped elastic band could be a practical tool for clinicians to train patients with central neurological lesions to walk.

Effects of the Dual AFO on gait parameters in stroke patients.

This study investigated how to improve the walking patterns in stroke patients by using the Dual AFO, which was devised as an alternative AFO consisting of two thin pierced plastic pieces for the lower leg and foot. Fifteen individuals with hemiplegia were recruited. Participants were seven males and eight females. Gait parameters were measured with the GAITRite system to analyze the spatial and temporal parameters of walking by stroke patients.The Dual AFO significantly improved the step time of the non-affected foot compared with barefoot walking. There was no significance difference in the affected swing time between the two conditions, and participants with the Dual AFO had a significantly shorter non-affected swing time. There was a significant difference in the affected single support time between walking with and without the Dual AFO. Additionally, the velocity was increased significantly in subjects with the Dual AFO compared with barefoot. Consequently, the Dual AFO might enhance stability during the stance phase on the affected side and mobility during the swing phase on the non-affected side to promote better walking in stroke patients.