Background: The purpose of this study was to determine the effect of massage and muscle reeducation training with conventional treatment in patients with facial paralysis. Methods: Twenty-five patients with facial nerve paralysis were randomly allocated to 3 groups: massage, muscle reeducation training, and control groups. Therapeutic intervention for the massage (n=8) and muscle reeducation training (n=8) groups consisted of conventional therapy such as application of hot pack and electrical stimulation plus massage therapy and muscle reeducation training, respectively. The control group (n=9) received only conventional therapy. Therapeutic intervention for each group was performed 6 times per week for 4 weeks. The patients were assessed by using the House-Brackmann Grading System (H-B grade) and Yanagihara Unweighted Grading System (Y grade) once every week. Results: The H-B and Y grades improved significantly in all 3 groups after a 4-week intervention (p<.01). At 3 and 4 weeks, the H-B and Y grades of the massage group improved significantly when compared with those of the control group (p<.01). Muscle reeducation training group showed significant improvements in the scores of the two grades with time when compared with the massage and control groups (p<.01). The rate of change in the H-B grade was significantly different between the control and muscle reeducation training groups (p<.01), and that of change in the Y grade was significantly different between the control and muscle reeducation training groups (p<.01) and between the control and massage groups (p<.01). Conclusion: These findings suggest that massage and muscle reeducation training are more effective in improving the condition of patients with facial nerve paralysis than conventional therapy. In particular, the results of this study indicate that muscle reeducation training can be recommended by clinicians since it provides more benefits.
The purpose of this study was to investigate the treatment effect of three interventions on the disuse atrophy of rat hindlimb after two weeks suspension. Forty-eight 11~12 weeks old female Sprague-Dawley white rats were divided into four intervention groups: 1) suspension only (S; n=10), 2) intensive weight bearing treadmill (IWBT; n=10), 3) electrical stimulation (ES; n=9), 4) 2)+3) (ES/IWBT; n=9). Another 10 rats received no intervention or hindlimb suspension and served as controls (C). After the interventions, 1) the cross-sectional area (CSA), 2) the ratio of white muscle fiber composition (WMFC), 3) isometric tetanic tension (ITT), and 4) muscle weights (MWs) were measured from the four calf muscle specimens. The results were as follows: 1. In all intervention groups, the CSAs of medial and lateral gastrocnemius (MG LG), soleus (SOL), and flexor digitorum superficialis (FDS) decreased when compared to the control (C) group (p<.05). The CSA increased in FDS and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group (p<.05). 2. The ratios of WMFC in MG, LG, SOL, and FDS increased compared to the C group for all interventions (p<.05). The ratios of WMFC decreased in SOL and LG for the IWBT group, in SOL for the ES/IWBT group compared to the S only group, and decreased in SOL for the ES/IWBT group compared to the IWBT group (p<.05). 3. The ITT in the MG, LG, SOL, and FDS decreased compared to the C group for all interventions (p<.05). The ITT increased in MG LG/FDS, SOL, and the whole calf muscles (WCMs) in the IWBT, ES and ES/IWBT groups compared to the S only group (p<.05). 4. The MWs in MG LG/FDS, SOL, WCMs decreased compared to the C group for all interventions (p<.05). The MWs increased in MG LG/FDS and WCMs for the IWBT group, in SOL for the ES group, and in SOL for the ES/IWBT group compared to the S only group (p<.05). 5. In atrophied muscles, the IWBT group showed the best recovery and the ES/IWBT and ES groups followed in decreasing order. The most susceptible muscle to disuse atrophy was the SOL. But conversely, it showed the best recovery in the ES/IWBT group. After two weeks of hindlimb suspension, the calf muscles of rats atrophied and their isometric tension decreased. These changes were best reversed by hindlimb-focused treadmill activity. The next best results were achieved by electrical stimulation combined with the treadmill followed by only electrical stimulation. These findings indicate that full weight bearing treadmill activity alone or in combination with electrical stimulation are effective treatments for non-weight bearing induced muscle atrophy. Further study of the effect of different intensities of electrical stimulation and variations in the duration period of full weight bearing treadmill activity on disuse atrophy is recommended.
Objective: Tension-type headache is caused by hormones, foods, irritants, stress, obesity, fatigue, and neck and head trigger points-prolonged abnormal posture. The purpose of this study was to evaluate the effects of relaxation approach on head posture, static postural stability, and headache in persons with tension-type headache. Design: Randomized controlled trial. Methods: Thirty-five persons with tension-type headache participated in this study. This study was a pretest-posttest with a control group design for a duration of 4 weeks (60 min/3 times/1 wk). The participants were randomly allocated to the relaxation approach group (n=18) and the control group with conventional rehabilitation including thermotherapy and transcutaneous electrical stimulation for the same period (n=17). Outcome measures involved forward head posture (FHP), foot pressure, neck disability index (NDI), and six-item headache impact test (HIT-6). Results: Relaxation approach and control groups improved significantly in the amount of forward head posture, neck disability index, and six-item headache impact test scores after training (p<0.05). The control group was found to be significantly different in the amount of FHP, backward foot pressure, NDI, and HIT-6 after training compared to before training (p<0.05). The relaxation approach group significantly improved in forward head posture, neck disability index, and six-item headache impact test compared with control group after training (p<0.05). Neck disability index and six-item headache impact test significantly improved after training compared with before training in the control group (p<0.05). However, the foot pressure was not significantly different between relaxation approach and control groups. Conclusions: This study suggests that treatment with relaxation approach combined with self-exercise would be effective in reducing the amount of forward head posture, neck disability and headache impacts.
Purpose : The purpose of the present study is to examine the effects of VR training with FES on improving the muscle strength, AROM, and function of the upper limb joints in patients with chronic stroke. Methods : The present study makes use of a pre-post control group design. Thirty patients with chronic stroke were randomly assigned to two groups according to treatment method - the VRFES group and the control group. The VRFES group received 15 minutes of VR training and 15 minutes of FES treatment. The control group received 15 minutes of conservative physical therapy and 15 minutes of VR training. All subjects received 30 minutes of treatment, three times a week, for eight weeks, which amounted to 24 sessions of training. The muscle strength, AROM, and function of the upper extremities were measured before the training and eight weeks after. Upper limb muscle strength was tested using the Digital Manual Muscle Tester while AROM was measured using the Digital Dual Inclinometer. The clinical assessment tools for upper extremity function included the use of the Manual Function Test and the Jebsen-Taylor Hand Function Test. Results : Both groups exhibited great improvements in muscle strength and upper extremity function during the intervention period. The VRFES group exhibited a significant difference in muscle strength, AROM, and function of the upper extremities in comparison with the control group(p<.05). Our results reveal that VRFES is more effective for the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke. Conclusion : VRFES treatment will be used as an important intervention for improving the muscle strength, AROM, and function of the upper extremities in patients with chronic stroke and achieving the functional recovery of the upper extremities.
PURPOSE: This study aimed to determine the effects of task-oriented treadmill training on the gait and balance ability and functional activity in 20 patients with subacute stroke. METHODS: The study subjects were twenty stroke patients, ten randomly placed in the experimental group and ten in the control group. Both the experimental and control groups received 30 minutes of traditional physical therapy and an additional 15 minutes of functional electrical stimulation therapy. The experimental group was given task-oriented treadmill training, while the control group received general treadmill training. Each session lasted for 25 minutes, three times a week, over four weeks, totaling 12 sessions. RESULTS: Both groups showed statistically significant differences in the 10-metre walk test (10MWT), timed up and go test (TUG), Fugl-Meyer Assessment (FMA), and Modified Barthel index (MBI). However, statistically significant differences in the Functional Ambulation Categories (FAC) and Berg Balance Scale (BBS) were seen only in the experimental group. There were statistically significant differences in the between-group differences value comparisons in the 10MWT, BBS, TUG, FMA, and MBI. CONCLUSION: Task-oriented treadmill training positively impacts gait, balance, and daily function in subacute stroke patients. This study highlights the benefits of training on unstable surfaces and offers valuable insights for stroke rehabilitation and gait training.
Foot drop is a common symptom in stroke patients due to central nervous system (CNS) damage, which causes walking disturbances. Functional electrical stimulation (FES) is an effective rehabilitation method for stroke patients with CNS damage. Aim of this study was to determine the effectiveness of 6 weeks FES walking training based lower limb muscle synergy of stroke patients. Lower limb muscle synergies were extracted from electromyography (EMG) using a non-negative matrix factorization algorithm (NMF) method. Cosine similarity and cross correlation were calculated for similarity comparison with healthy subjects. In both stroke patients, the similarity of leg muscle synergy during walking changed to similar to that of healthy subjects due to a decrease in foot drop during. FES walking intervention influenced the similarity of muscle synergies during walking of stroke patients. This intervention has an effective method on foot drop and improving the gait performance of stroke patients.
Purpose: The purpose of this study was to evaluate the effects of early body-weight-supported treadmill training on quadriceps strength, knee pain, and arthrogenic muscle inhibition (AMI) after knee surgery. Methods: Sixteen adults were selected. Seven patients in the experimental group performed body-weight-supported treadmill training, and nine patients in the control group performed general therapeutic exercise programs. Both groups received 20 minutes of neuromuscular electrical stimulation and 20 minutes of exercise therapy for two weeks. We measured quadriceps strength, visual analogue scale, and modified AMI classification grade before and after the intervention. Data were analyzed using the Mann-Whitney U test and Wilcoxon signed-rank test. Results: Within the experimental group, significant differences were observed in quadriceps strength, visual analogue scale, and modified AMI classification grade. Significant differences were observed between the before- and after-intervention groups in quadriceps strength and visual analogue scale. However, no significant differences were found in the modified AMI classification. Conclusion: The results of this study indicate that early body-weight-supported treadmill training may be an effective intervention for improving strength, reducing pain, and addressing arthrogenic muscle inhibition following knee surgery.
Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.
Objectives : The aim of this study is to review clinical studies of facial palsy sequelae treatment Methods : We used search engines such as PUBMED, OASIS, RISS. We limited sequelae as the cases after three months from the onset. We excluded the studies including operational treatments. We considered papers pubulished only after year 2000. Results : The kinds of treatments were acupunture treatment, physical therapy, Botulinum toxin, and steroids and antiviral agent. Four studies about acupuncture treatment were searched. Two were case studies and the other two were case series studies. Six studies about physical therapy were searched and they were devided into three according to their specific methods - neuromuscular training and biofeedback, electrical stimulation, and facial exercises. We reviewed three studies about Botulinum toxin and 3 studies about combined therapy. Conclusions : Evidence level of the acupuncture studies was not high. Neuromuscular retraining and biofeedback therapies were shown to be effective especially to synkinesis. Mime therapy, one of the facial exercise has significant effect. Electrical stimulation is thought to activate the plasticity of central nerve system. Botulimum Toxin has effective temporary treatment. Steroid therapy increases recovery rate and reduces sequelae.
This study was carried out to investigate the muscle strength of quadriceps muscles by means of isokinetic test. The experimental objects were devided into electrically stimulated, isotonic and isometric groups and trained for 4weeks. The results were as follows : 1. the values of total work, peak torque, average power and the ratio of peak torque between flexors and extensors revealed singnificant statistically in three experimental groups(p<0.05). 2. The endurance was increased slightly in electrically stimulated group, but decreased in isotonic and isometric group, 3. The value of post training on all items did not reveal significant statistically in three experimental groups(P>0.05). 4. The electrically stimulated groups effected on increasing of muscle strength as isotonic and isometric exercises.
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