Knee Muscles Strength Can be Improved by Using an Elastic Band as an Assistive Device for Knee-Ankle Complex.

BACKGROUND There are various tools and methods used for strength exercise. Elastic bands, one of the resistance exercise tools, have been used for various purposes, including muscle strengthening; however, there is very little evidence supporting their efficacy. The study was performed to investigate the effect of knee-ankle elastic bands on knee muscle strength-related parameters according to sex in healthy adults. MATERIAL AND METHODS This was a cross-sectional study. Twenty-one participants (11 female and 10 male) were studied using a cross-over design. Isokinetic concentric knee extension and flexion strength was measured at 60°/s and 180°/s with and without application of a therapeutic elastic band in the shape of an "8", with knee flexion and ankle dorsiflexion. The variables related to muscle power automatically calculated in the protocol of the isokinetic system were compared according to sex and angular velocity. RESULTS Peak moment (PM), PM/body weight, average power, total work, and the agonist/antagonist ratio, demonstrated significant improvement (P<0.05) at both 60°/s and 180°/s "with" compared to "without" the elastic band according to sex. CONCLUSIONS The use of therapeutic elastic bands in the shape of a figure 8 with knee flexion and ankle dorsiflexion may be used as assistive devices for improving strength in muscles supporting the knee. Further high-quality studies are needed to assess the potential of elastic bands as assistive devices and not merely as exercise tools. Therapeutic elastic bands in the shape of an "8" with knee flexion and ankle dorsiflexion may be useful in sports activities.

A novel one arm motorized walker for hemiplegic stroke survivors: a feasibility study.

BACKGROUND: A hemiplegic stroke survivor with a moderate to severe gait disturbance may have difficulty walking using a one-arm walker. This study aimed to test the safety and feasibility of a prototype one-arm motorized walker that uses a power-driven device to provide gait assistance to hemiplegic stroke survivors with moderate to severe gait disturbances. METHODS: A one-arm motorized walker with a power-driven device was developed and tested with respect to 10 distinct variables, including weight, degrees of freedom, handle, handle substitution function, two-sided use function, variable handle height, redirecting function, electric moving parts through the handle control, brake function using the handle control, folding chairs, and design stability. Its safety and feasibility were tested in 19 hemiplegic stroke individuals using the Likert scale and a simple interview. RESULTS: The walker consists of a frame platform including a handle, electric motor for driving, one wheel for driving, two wheels for turning, unlocking sensor, driving button, and turning buttons. The walker is programmed so that a touch sensor in the handle can unlock the locking system. Furthermore, it is programmed so that a user can propel it by pushing the handle downward or pressing a button and can control directions for turning right or left by pressing buttons. Safety and performance testing was achieved for 10 separate variables, and a Likert scale score of 3.5 of 5 was recorded. CONCLUSION: This walker's novel design was developed for hemiplegic stroke survivors with moderate to severe gait disturbances. Our findings indicate that the walker is both safe and feasible for providing walking assistance to hemiplegic stroke survivors and establish the potential advantages of the one-arm motorized walker.

Effects of Kinect Video Game Training on Lower Extremity Motor Function, Balance, and Gait in Adolescents with Spastic Diplegia Cerebral Palsy: A Pilot Randomized Controlled Trial.

The Kinect video game (KVG) has received attention as an intervention method for cerebral palsy (CP). However, evidence remains limited. PURPOSE: To investigate the effects of training using Xbox Kinect on lower extremity motor function, balance, and gait in adolescents with spastic diplegia CP. METHODS: This study was a pilot randomized controlled trial. Ten participants were randomly allocated to either the KVG training group (n = 5) or the conventional training (CT) group (n = 5). The Selective Control Assessment of the Lower Extremity (SCALE) tool, Pediatric Balance Scale (PBS), and GAITRite were used for the outcome measurements. RESULTS: In the comparison between the groups, the KVG group showed significant improvements in all the items in the SCALE (except for right hip abduction) and PBS score as compared with the CT group. CONCLUSIONS: KVG training might be an effective intervention for the rehabilitation of adolescents with spastic diplegia CP.

Gait analysis in hemiplegic stroke survivors who used the one-arm motorized walker.

OBJECTIVE: A high number of stroke survivors experience limitations in balance and gait abilities. Thus, an improvement in gait ability is an important goal in the rehabilitation of hemiplegic stroke survivors. This study aimed to investigate the effect of using the one-arm motorized walker, a hemi-walker developed to assist hemiplegic stroke survivors in gait training and activities of daily living, on the improvement in gait ability in hemiplegic stroke survivors. METHODS: Eleven hemiplegic stroke survivors who met the inclusion criteria were included. The participants were instructed to walk thrice using traditional walking aids on a gait mat and then to walk thrice using the one-arm motorized walker. During each walk, spatiotemporal gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were evaluated using a gait analysis system. RESULTS: Velocity and cadence significantly increased when the participants walked using the one-arm motorized walker compared to those who used traditional walking aids (p< 0.05), whereas double support time significantly decreased for both the more affected and less affected sides (p< 0.05). However, no significant difference was observed in terms of step length and single support time. CONCLUSION: The one-arm motorized walker may have a positive effect on the improvement of gait ability in hemiplegic stroke survivors. It can be an effective walking aid for hemiplegic stroke survivors who experience difficulties in independent walking.

Effect of Horizontal Whole-Body Vibration Training on Trunk and Lower-Extremity Muscle Tone and Activation, Balance, and Gait in a Child with Cerebral Palsy.

BACKGROUND The aim of the present study was to investigate the effect of horizontal whole-body vibration (WBV) training on trunk and lower-extremity muscle tone and activation, balance, and gait in a child with spastic diplegia cerebral palsy. CASE REPORT A 10-year-old male with spastic diplegia cerebral palsy received horizontal WBV training followed by conventional physiotherapy (50 min per day, 12 days per month), but only conventional physiotherapy during followup. Muscle tone was assessed using the Modified Ashworth Scale (MAS) and muscle activation with surface electromyography. Balance was assessed using the Timed Up and Go test (TUG) and Pediatric Balance Scale (PBS), and gait parameters were assessed using the GAITRite system. Assessment was performed at 3 points: pre-intervention, post-intervention, and follow-up. Following the intervention, MAS decreased in both the hip extensor and right ankle plantar flexor. Muscle activation increased post-intervention in the bilateral erector spinae (ES), rectus abdominis (RA), rectus femoris (RF), and right tibialis anterior (TA) during standing, and in the left RA, bilateral RF, gastrocnemius (GCM), and left TA during squatting. At follow-up, activation increased in the right ES, left RA, and RF during standing. At post-intervention and follow-up, improvement was observed in PBS score, gait velocity, right step length, and right stride length, with decreased single-leg support time, and double support and toe deviation angle. CONCLUSIONS Horizontal WBV training can safely and effectively maintain and improve physical performance and can be considered for inclusion in rehabilitation programs.

Does virtual reality training using the Xbox Kinect have a positive effect on physical functioning in children with spastic cerebral palsy? A case series.

PURPOSE: The present study investigated the effects of virtual reality (VR) training using the Xbox Kinect on motor function, balance, gait, and functional mobility in children with cerebral palsy (CP). METHOD: This was a case series. Four children with spastic diplegic cerebral palsy were provided VR training using the Xbox Kinect for 12 sessions (three sessions per week for 4 weeks). At baseline and follow-up, physical function was measured using the following: Selective Motor Control (SMC) for motor function, Pediatric Balance Scale (PBS) for balance, Timed Up and Go (TUG) test and Functional Mobility Scale (FMS) for functional mobility, and 6-meter walk test (6WT) for gait. RESULTS: As compared with the baseline scores, SMC, PBS, TUG, FMS, and 6MWT scores after training showed improvements. In participant 1, PBS and TUG scores improved after VR training. In participant 2, SMC (left ankle dorsiflexor, left knee extensor), PBS, TUG, and FMS scores improved after training. In participant 3, SMC (left hip flexor), TUG, FMS, and 6MWT scores improved after training. In participant 4, SMC (right ankle dorsiflexor), PBS, TUG, FMS, and 6MWT scores improved after training. CONCLUSION: The results show that VR training using the Xbox Kinect may improve physical functioning in children with spastic diplegic cerebral palsy. However, its utility in the rehabilitation of children with CP requires further investigation.

A novel hinged ankle foot orthosis for gait performance in chronic hemiplegic stroke survivors: a feasibility study.

Stroke survivors with gait disturbances may use ankle foot orthoses (AFOs). However, most AFOs come in one-piece styles, which make it difficult for spasticity-affected stroke survivors to don. AFOs are also limited since they do not properly prevent ankle joint for foot drop by itself. Therefore, the present study developed a novel hinged AFO by adding a locking device to a hinged joint. We then tested its feasibility in 9 hemiplegic stroke survivors by investigating temporal-spatial gait parameters using the GAITRite in the following 3 conditions: no AFO, traditional AFO, and novel hinged AFO. There was no significant difference in spatiotemporal gait parameters among the different conditions. There were greater decreases in gait velocity, cadence, step length, and stride length in the novel hinged AFO group than in the no AFO and traditional AFO groups. This novel hinged AFO was developed to prevent foot drop. However, the AFO did not show significant differences in gait parameters because it consists of metal with extra weight and volume. Functionally, it prevented foot drop. It also improved convenience by its releasable design. Thus, further studies are needed to develop an AFO that improves gait and is convenient to use for hemiplegic stroke survivors.

Usability of the Thera-Band® to improve foot drop in stroke survivors.

BACKGROUND: Stroke survivors show "foot drop", dragging their toes on the ground in the swing phase of gait. Ineffective ankle dorsiflexion may result in an abnormal gait pattern. OBJECTIVE: The purpose of this study was to investigate the effect of ankle Thera-Band® use on gait patterns in stroke survivors. METHODS: Gait data were collected in eight subjects who had had strokes using gait analysis system, both with and without the Thera-Band®. The following dependent variables of gait parameters were analyzed: velocity, cadence, step length, stride length, single support time, and double support time. RESULTS: There were significant improvements in gait velocity, cadence, stride length, and double support time in those who used the Thera-Band® compared to those who did not (p <  0.05). However, there were no significant differences in step length or single support time (p >  0.05). CONCLUSIONS: The results show that ankle Thera-Band® use may have a positive effect in improving gait parameters by increasing the ankle stability in stroke survivors with foot drop. Its usefulness in the rehabilitation of foot drop in stroke survivors needs to be further investigated.

Comparison of trunk electromyographic muscle activity depends on sitting postures.

BACKGROUND: Different postural positions can be characterized by the activation and relative contributions of different postural muscles, and may variously contribute to the recovery from or worsening of chronic lower back pain. OBJECTIVE: The present study aimed to investigates trunk muscle activities in four types of seated postures: cross-legged, long, side, and W-shaped. METHODS: Eight healthy adults participated in the study. Trunk muscle activities of the external oblique (EO), rectus abdominis (RA), latissimus dorsi (LD), and erector spinae (ES) muscles in each of the sitting postures including cross-legged, long, side, and W-shaped were collected utilizing surface electromyography (sEMG). The mean sEMG signals in each of the sitting postures were used for statistical comparisons. RESULTS: There were no significant differences in electromyographic muscle activity of EO, RA, LD, and ES in the four postures (p > 0.05). However, in the W-shape sitting posture, the left LD showed the greatest electromyographic muscle activity, followed by the right LD and left EO, respectively. The right and left LD in the long sitting posture and left ES in the side sitting posture showed greater electromyographic muscle activity than that of other muscles. CONCLUSION: Based on the results, trunk muscle activity did not significantly differ between the four types of sitting postures. However, our study is limited by its experimental method and sample size. Thus, in the Future, further study will be needed.

Changes in gait pattern during multitask using smartphones.

BACKGROUND: With the development of science and technology, smartphones have been deeply involved in people's everyday lives, and many perform various tasks simultaneously on smartphones. OBJECTIVE: To investigate gait pattern changes on performing multitask simultaneously when using smartphones. METHODS: Three tasks were performed by 26 healthy adults. In the first, participants were directed to walk without using smartphones (single-task). In the second, they were required to walk while finding applications (dual-task). Lastly, in addition to performing the second task, they were asked to listen to questions and answer them on their smartphone (triple-task). Spatiotemporal variables of gait and degree of lateral deviation during walking were measured. RESULTS: The results showed that there was a significant difference between the single-task and dual tasks, as well as between the single task and triple task in all variables (p < 0.05). In particular, gait velocity decreased by 33.49% in the dual task and 41.69% in the triple task compared to the single-task, the degree of deviation increased by 119.18% in the dual task and 122.67% in the triple task in comparison to the single-task. CONCLUSIONS: It was determined that changes in gait, appear when walk while using smartphones in comparison to walking without using smartphones.