This study was performed to investigate the reproductibility of eccentric mandibular movements according to preferred chewing side, range of mouth opening, type of lateral guidance and involvement of temporomandibular disorders. 50 patients with temporomandibular disorders and 65 dental students without any signs and symptoms were randomly selected for this study as the patients group and the control group, respectively. For recording and observation of eccentric mandibular movement trajectory, BioEGN$^\textregistered$ of Biopak$^\textregistered$ system (Bioresearch Inc., USA) was used. Each eccentric movement to anterior, right and left side was performed three times similar to the movement pattern for Pantronic Reproducibility Index. mandibular path was analyzed by three dimensional positional change and the three paths from one direction were compared with one another. From this, reproducibility index of one-directional lateral movement could be calculated, and total reproducibility index, named BioEGN reproducibility index(BERI), was also computed from three-directional eccentric movement likewise. BioEGN reproducibility Index could have four value of score by small or large scale, and by outgoing or incoming movement. The data were analyzed by SAS/stat program and the results obtained were as follows: 1. Right side chewing subjects showed more consistent pattern In reproducibility index in comparison between patients group and control group than left chewing subjects have done, and reproducibility was low in patients group. However, there was no difference between the two stoups in bilateral chewing subjects. 2. There were no difference in reproducibility index between preferred chewing side and contralateral side in unilateral chewing subjects whereas reproducibility index in left side on outgoing movement were higher than in right side in bilateral chewing subjects. 3. Difference in total reproducibility index(BERI) between canine guidance group and non-canine guidance group were not observed though difference in reproducibility index on lateral movement were observed in part. 4. There were no difference in reproducibility index between affected side and contralateral side in unilaterally affected patients, and between unilaterally affected patients and bilaterally affected patients in patients group. 5. Highly significant positive correlationship were shown among the four 쇼pes of total reproducibility index(BERI) in total subjects, and range of clinical mouth opening was negatively correlated with BEBI on outgoing movements and with index on outgoing movement to preferred side.
Background: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group ($n_1=10$), a placebo group ($n_2=10$), and a control group ($n_3=10$). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton(R)PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone.
Journal of The Korean Society of Integrative Medicine
/
v.8
no.1
/
pp.57-66
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2020
Purpose : This study aimed to identify whether resistance exercise using elastic bands for six weeks can improve muscle strength, muscle tone, balance, and gait in patients with stroke. Methods : In total, 35 patients with stroke were randomly divided into three groups: resistance exercise using elastic band training combined with less affected side training group, more affected side training group, and both sides training group. Muscle strength, muscle tone, balance, and gait were assessed using a hand-held dynamometer, the modified Ashworth scale, the Berg Balance scale (BBS), and wireless 3-axis accelerometer, before and after training. Results : All three groups showed a significant increase in muscle strength of the lower extremity after training, and there was a significant difference among the groups. There was no change in muscle tone in all three groups. BBS scores increased significantly in all three groups after training, but these scores were not significantly different. The gait speed increased significantly in all three groups after the training, but the difference was not significant. The cadence increased significantly in Group 2 after training; however, there was no significant difference between Groups 1 and 3. There were no significant differences between the groups before and after the training. Step length increased significantly in Groups 2 and 3 after the training, but it was not significantly different in Group 1. After training, Groups 2 and 3 were significantly greater than Group 1 in the change in step length. Conclusion : The results show that resistance exercise using elastic bands can improve strength, balance, and gait in patients with chronic stroke. Especially, more affected side training was more effective in improving muscle strength than less affected side training. More affected side and both sides training are thought to be more effective than less affected side training to improve step length.
Objective: To investigate the association between one-leg standing ability and postural control for chronic hemiparetic stroke. Design: Cross-sectional study. Methods: Forty individuals who had a first diagnosis of stroke with hemiparesis before six months and over had participated in this study. To analyze the relationship between one-leg standing ability and postural control in the participants, six clinical measurement tools were used for assessment, including the Timed-Up-and-Go (TUG) test, Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Fugl-Meyer Assessment (FMA), 5 times sit-to-stand (5TSTS) and one-leg standing (OLS). Results: After analyzation, the OLS scores in the more-affected side showed significant positive correlations with BBS scores (r=0.469, p<0.01), DGI scores (r=0.459, p<0.01).and FMA scores (r=0.425, p<0.01). The OLS scores in the more-affected side showed significant negative correlations with TUG score (r=-0.351, p<0.05). The OLS score in the less-affected side showed significant positive correlations with BBS scores (r=0.485, p<0.01), DGI scores (r=0.488, p<0.01) and FMA score (r=0.352, p<0.05). The OLS scores in the less-affected side showed significant negative correlation with TUG scores (r=-0.392, p<0.05) and 5TSTS (r= -0.430, p<0.01). The OLS scores in the more-affected side showed significant positive correlations with the OLS scores in less-affected side (r=0.712, p<0.01). Conclusions: The results of the study suggest that the OLS time may be moderately correlated with static and dynamic postural stabilities and motor recovery following stroke. This study also suggests that the OLS test is as a simple clinical tool for predicting postural control performance for individuals with chronic hemiparetic stroke.
Objective: To investigate the effect of emphasized initial contact by using a wearable air-pressure insole to provide auditory-feedback with variations of maximum peak pressure (MPP) of the affected side on spatiotemporal gait parameters and gait symmetry of stroke patients Design: A cross-sectional study Methods: Eighteen stroke patients participated in this study. All subjects walked five trials using an air-pressure insole that provides auditory feedback with different thresholds set on the insole. First, subjects walked without any auditory feedback. Then, the MPP threshold on the affected side was set from 70% and increase threshold by 10% after each trial until 100%. They walked three times or more on the gait analyzer for each trial, and the average values were measured. Before starting the experiment, subjects measured body weight, initial gait abilities and affected side MPP without auditory feedback. Results: Temporal and spatial variables were significantly increased in trials with auditory feedback from air-pressure insole except for non-paralyzed single support time and spatial gait symmetry compared to trials without auditory feedback(p<0.05). Among the four different thresholds, the walking speed, unaffected side single support time, affected and unaffected side stride, and affected side step length were greatest at 80% threshold of maximum peak, while affected single support time, temporal gait symmetry, and unaffected step length were greatest at the maximum peak of 100% threshold. Conclusions: These results indicate that auditory feedback gait using air-pressure insoles can be an effective way to improve walking speed, single support time, step length, stride, and temporal gait symmetry in stroke patients.
Journal of the Korean Society of Physical Medicine
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v.10
no.4
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pp.81-90
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2015
PURPOSE: The purpose of this study was to compare the muscle architecture of serratus anterior and lower trapezius using rehabilitative ultrasound imaging (RUSI) in affected and unaffected side of chronic stroke patients. METHODS: The participants were thirty five patients with stroke hemiplegia in this study. RUSI was used to measure the muscle thickness of the serratus anterior and lower trapezius muscles. We compared the muscle thickness according to affected side and sex, determined the reliability of the measurement image. Independent t-test, intra-class correlation coefficient (ICC) and standard error of measurement (SEM) were used for statistical analysis. RESULTS: Significant difference in muscle thickness of serratus anterior was observed between affected and unaffected side (p<.001). Muscle thickness according to gender showed a significant difference in unaffected side of serratus anterior (p<.05). Compare asymmetry ratio of serratus anterior and lower trapezius muscle thickness showed a significant difference (p<.001). ICC for intra-reliability was .944~.962 in serratus anterior and .873~.925 in lower trapezius muscle thickness, respectively. SEM was .001~.004 in serratus anterior and .002~.008 in lower trapezius muscle. CONCLUSION: This study, using RUSI, showed significant difference in muscle thickness of serratus anterior in affected and unaffected side of stroke patients. RUSI is a practical tool for measuring soft-tissue thickness in the scapular region muscle of stroke.
Purpose: The purpose of this study was to identify the effects of heating on the non-affected hand on blood flow velocity, wound healing, and pain for hand microsurgery patients. Methods: This study was designed using the nonequivalent control group pretest-posttest design. Thirty-nine patients were assigned either to the experimental group (20 patients) or control group (19 patients). Data were analyzed with $x^2$-test, Fisher's exact test, t-test, and repeated measure ANOVA using SPSS/WIN 17.0 program. Results: After treatment in this program, blood flow velocity (F=5.13, p=.008) and wound healing (F=4.11, p=.020) improved significantly in the experimental group compared to the control group. But there was no significant improvement in pain in the experimental group compared to the control group (F=2.40, p=.097). Conclusion: Based upon these results, the non-affected side hand heating was recommended as an independent nursing intervention for the patients who need improvement in blood flow velocity and wound healing such as patients who have microsurgery. As the heating was effective even when applied on the non-affected side, it is the applicable to patients who cannot tolerate any therapy on affected side.
Purpose: The aim of this study was to ascertain the effects of the lower extremity muscle strengthening exercise on balance and ambulation of children with cerebral palsy. Methods: 10 subjects who participated in this research undertook the 12-week the lower extremity muscle strengthening exercise program, which consisted of a series of mat exercises and sling exercises. The statistical significances were examined by using Wilcoxon signed-rank test, a non-parametric test, for evaluating the improvement of balance and ambulation of the subjects. In order to evaluate the correlation among the variables, Pearson's correlation coefficients were also calculated. In all statistical analyses the significance level was selected as ${\alpha}$=0.05. Results: Berg balance scale(BBS) was significantly increased after the intervention(p<.05). Percentage weight bearing(PWB) was decreased after the intervention, but there was no significant difference. Time up and go test(TUG) value was significantly decreased(p<.05). Gait velocities was increased after the intervention, but there was no significance. Stride length, step lengths of the affected side and the sound side were significantly increased after the intervention(p<.05). In the correlation analyses of the measures before the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). In the correlation analyses of the measures after the intervention, TUG had significant negative correlation to BBS and gait velocity(p<.05). BBS revealed significant positive correlations to stride length, step lengths of the sound side and the affected side(p<.05). Stride length, step lengths of the sound side and the affected side had significant positive correlation between themselves(p<.01). Conclusion: Based upon the outcomes as above, it is likely that the muscle strength exercises have substantial effects on balance and ambulation of children with cerebral palsy. Thus various lower extremity muscle strengthening exercise programs are required to be studied and developed in order to contribute to functional improvements of children with cerebral palsy.
Journal of Korean Academy of Oral and Maxillofacial Radiology
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v.17
no.1
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pp.151-162
/
1987
The author obtained the computed tomograms around the condylar head from 10 normal subjects and 5 patients having clicking condylar head from 10 normal subjects and 5 patients having clicking sound or limitation of mouth opening by using a Hitachi-W 500. And then. the author had the axial analysis of condyle position and sagittal analysis of that after sagittal reformation on centric occlusion and 18㎜ interincisal opening. Transcranial view and submentovertex view were taken and compared with computed tomographic view. The obtained results were as follows: 1. Median angle of long axis of condylar head was 17 degrees on centric occlusion and the angles of long axis of both condylar heads were reduced symmetrically on 18㎜ interincisal opening in normal group. however. in the patient group, the affected side of condyle heads showed greater change in the angle on 18㎜ interincisal opening. 2. In the patient group, the condyle head of affected side was located superiorly to that of normal side on centric occlusion and the discrepancy of condular positional height was increased after 18㎜ interincisal opening. 3. The distances from medial pole of condylar head to triangular fossa of temporal bone were same on both right and left side in normal group, however, in the patient group, the distance of affected side was wider than that of opposite side on centric occusion and became narrower than the opposite side on 18㎜ interincisal opening. 4. The distances of posterior joint space were same on both right and left side. The distance t lateral pole 1/3 of condyle head was similar to that on transcranial view on centric occlusion in normal group. 5. The distances of posterior joint space were narrower in patient group than in normal group. 6. Conclusively, the affected condylar head of patient showed postero-latero-superior displacement on centric occlusion and larger range of rotational movement on 18㎜ interincisal opening.
Purpose: The purpose of this study was to determine the effects of bilateral visual feedback training with visual targets on the postural balance and fall efficacy of stroke patients with hemiparesis. Methods: A total of 24 stroke patients with hemiparesis were randomly assigned to either a bilateral visual feedback training (BVFT, n=8) group, unilateral visual feedback training (UVFT, n=8) group, or a control group (n=8). The BVFT and UVFT groups performed weight-bearing training on the bilateral (less-affected and affected side) or unilateral side (affected side) with visual feedback using visual targets. The control group performed squat training without visual feedback using visual targets. The training program was conducted in the form of 3 sets a day, 3 times a week, for 4 weeks. The participants were evaluated using the Berg balance scale (BBS), lateral reaching test (LRT), timed up and go test (TUG), and the activities-specific balance confidence scale (ABC). Results: In the intra-group comparison after the intervention, the BVFT group showed a significant difference in the BBS, TUG, affected and less-affected side LRT, and ABC (p<0.05). The UVFT group showed a significant difference in the BBS and ABC (p<0.05). In the inter-group comparison after the intervention, the BVFT group showed significant improvements in their BBS, affected side LRT, and TUG, when compared to the control group (p<0.05). Conclusion: These findings show that bilateral visual feedback training with visual targets during bilateral weight-bearing exercises can improve the postural balance function in stroke patients.
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