• Title/Summary/Keyword: Gait performance

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The effects of water-based exercise on postural control in children with spastic cerebral palsy

  • Kim, Kyung Ho;Shin, Hwa Kyung
    • Physical Therapy Rehabilitation Science
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    • v.6 no.2
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    • pp.77-82
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    • 2017
  • Objective: Swimming and water-based exercise (WE) programs can provide vigorous physical activity in a fun and a motivating environment. The properties of water, may make it easier for children with cerebral palsy (CP) to move and to participate in an WE program. The aims of this study was to evaluate the effect of WEs on postural control in children with spastic CP. Design: Quasi-experimental design (one group pretest-posttest design). Methods: Twenty preschoolers with spastic CP participated in this study. Prior to the application, sufficient warm-up training was performed to allow the subjects to adapt to the water. Afterwards, three different types of underwater leg exercises for the flexor, extensor, and adductor/abductor of muscles of the lower limb were performed. The WE program lasted during 8 weeks, with one-40 minute sessions per week (8 training session). The usual care was performed during the training session. The Korean-trunk control measurement scale (K-TCMS) and weight distribution variability (difference of both Fz) were measured before and after training session. Results: According to the results, the K-TCMS scores of the three sub-levels, including static sitting, dynamic sitting, and dynamic reaching, was significantly increased after the training session (p<0.05). Also, the weight distribution variability was significantly decreased after 8 weeks (p<0.05). Conclusions: We suggest that WEs may improve the postural control ability in children with spastic CP. Furthermore, we support the need for additional research on the effect of WE on gait or activity of daily living performance with a control group included.

Relationship between anticipatory postural adjustment of the trunk, dual tasks and physical performance with chronic stroke survivors: a pilot test

  • Hwang, Won Jeong;Cho, Min Kwon;Chung, Yijung
    • Physical Therapy Rehabilitation Science
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    • v.4 no.1
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    • pp.44-48
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    • 2015
  • Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.

Comparison of Heel-rocking Time Between Young Women and Elderly Women (젊은 여성과 고령자 여성의 힐락킹 시간 비교 분석)

  • Yun, Ju-seok;Kim, Ji-Won;Kwon, Yu-Ri;Heo, Jae-Hoon;Jeon, Hyeong-Min;Jeon, Hee-Jun;Eom, Gwang-Moon
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.65 no.7
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    • pp.1242-1246
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    • 2016
  • Heel rocking phase in gait cycle is from initial contact to forefoot contact. The purpose of this study was to investigate the effect of age on heel rocking time. Seven young women ($21.9{\pm}1.5yrs$) and seven elderly women ($74.1{\pm}6.7yrs$) participated in this study. Subjects wore the shoes equipped with pressure sensors and walked along 10 m walkway at comfortable speeds. Stride time, stance time, and heel rocking time were compared between groups. Stride time was not different between groups (p=0.087). Stance time was longer (p<0.001) but heel rocking time was shorter in the elderly than in the young (p<0.001). The shorter heel-rocking time in elderly women indicates less efficient shock-absorption in the heel-rocking phase, which might be related to the abnormal control and/or reduced performance of ankle dorsiflexors.

Prevalence of dynapenic obesity and sarcopenic obesity and their associations with cardiovascular disease risk factors in peritoneal dialysis patients

  • Tabibi, Hadi;As'habi, Atefeh;Najafi, Iraj;Hedayati, Mehdi
    • Kidney Research and Clinical Practice
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    • v.37 no.4
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    • pp.404-413
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    • 2018
  • Background: Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients. Methods: All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient. Results: The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors. Conclusion: This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.

Effects of Changes in the Indoor and Outdoor Environmental on the Walking Speed and Lower Extremity Muscle Activities in People Aged Forty and Older than Seventy Years (실내·외 보행환경의 변화가 40대와 노인의 보행속도와 다리 근활성도에 미치는 영향)

  • Lee, Jun-Young;Kim, Tack-Hoon
    • Journal of the Korean Society of Physical Medicine
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    • v.13 no.4
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    • pp.139-148
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    • 2018
  • PURPOSE: This study compared the effects of indoor and outdoor environmental changes on the activity of the major lower limb muscles and walking factors in people 40-50 years and those aged older than 70 years. METHODS: Ten middle-aged people in their forties (age:$44.2{\pm}2.7$, BMI:$21.8{\pm}1.8$) and 10 elderly aged more than 70 years (age:$76.4{\pm}5.9$, BMI:$22.2{\pm}1.9$) with a normal walking ability were included. The participants walked 100 m both indoors and outdoors at their own speed. Using a 3D motion analyzer and EMG, the walking speed, angle of the ankle and activity changes of the lower limb muscles were compared. RESULTS: Significant differences in walking speed and peak-plantar flexion angle were observed between the two groups (p<.05). The muscular activity of the gastrocnemius muscle (GCM) was significantly different outdoors in the swing phase between the two groups (p<.05). In the people aged in their forties, the muscular activity of the rectus femoris (RF) was significantly higher outdoors than indoors (p<.05). In the elderly, however, the muscular activity of the RF was lower outdoors than indoors (p<.05). When compared to those in there forties, the muscular activity of the outdoor RF significantly decreased in the elderly group (P<.05). The muscular activity of the biceps femoris (BF) in the elderly decreased significantly outdoors compared to indoors (p<.05). CONCLUSION: For the elderly, increasing the exposure to the new environments or focusing on the performance of repeated movements for gradual speed control and precise movements is required to maintain normal gaits and movements that are less affected by environmental changes.

Screening Sarcopenia in Rural Community-Dwelling Older Adults in Korea

  • KIM, Mi-Kyoung;LEE, Ji-Yeon;GIL, Cho-Rong;KIM, Bo-Ram;CHANG, Hee-Kyung
    • International Journal of Advanced Culture Technology
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    • v.8 no.4
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    • pp.64-76
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    • 2020
  • Purpose: Several screening tools have been developed to identify sarcopenia in rural community-dwelling older adults. We aimed to compare the diagnostic accuracy of two such tools, namely the SARC-F and SARC-CalF assessments. Methods: This cross-sectional study on 388 community-dwelling older adults comprised 254 women and 134 men with a mean age of 77.8 ± 6.26 year in Korea. We assessed muscle mass, muscle strength, and physical performance using a bioimpedance analysis device, hydraulic hand dynamometer, and 4 m gait speed test, respectively. Three widely-used diagnostic criteria [the Asian Working Group for Sarcopenia (AWGS), European Working Group on Sarcopenia in Older People, and the International Working Group on Sarcopenia] were applied. Sensitivity and specificity analyses were performed on the SARC-CalF and SARC-F tests. We used receiver-operating characteristic curves and the area under the curves (AUCs) to compare the diagnostic accuracy of the assessments with regard to sarcopenia. Results: An analysis using four sets of diagnostic criteria showed that the prevalence of sarcopenia was 27.6% to 41.0%. Using the AWGS 2019 criteria as a reference standard, the SARC-CalF had a sensitivity of 83.02% and a specificity of 53.71% in the entire study population, whereas the SARC-F had a sensitivity of 79.87% and a specificity of 41.92%. The AUCs for the SARC-CalF and SARC-F tests were 0.725 (95% confidence interval 0.678-0.769) and 0.645 (95% confidence interval 0.595-0.693), respectively (p<001). In the analyses using the other three diagnostic criteria, similarity was also confirmed. Conclusion: SARC-CalF showed better sensitivity than did SARC-F when diagnosing sarcopenia in rural community-dwelling older adults. Further studies are needed to verify this finding in different populations.

Dual-Task Training Effect on Cognitive and Body Function, β-amyloid Levels in Alzheimer's Dementia Patients: A Randomized Controlled Trial

  • Nam, Seung-Min;Kim, Seong-gil
    • The Journal of Korean Physical Therapy
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    • v.33 no.3
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    • pp.136-141
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    • 2021
  • Purpose: Dementia is a disease in which cognitive function declines, leading to deterioration of body functions and activities of daily living. The purpose of this study is to explore the effects of dual-task training, including cognitive tasks, on cognitive and body function and β-amyloid levels in Alzheimer's dementia patients. Methods: 34 inpatients diagnosed with Alzheimer's dementia at a nursing hospital located in South Korea. The patients were randomly divided into a dual-task group (n=16) and a single-task group (n=18). Each group was trained for 30 minutes three times a week for eight weeks. The MMSE-K was used to measure the patients' cognitive function. To assess the patients' static balance ability, their LOS was measured using BioRescue. while dynamic balance was measured using the BBS. The 10MWT were conducted to evaluate the patients' walking ability. Blood analysis was performed to measure levels of β-amyloid. Results: Both groups exhibited statistically significant improvements in gait function after the training (p<0.05). The dual-task group exhibited statistically significant differences in cognitive function, static and dynamic balance function, and β-amyloid levels after training (p<0.05). A significant difference was observed between the two groups (p<0.05). Conclusion: Dual-task training were found to be effective in improving cognitive and bodily functioning and reducing β-amyloid levels in Alzheimer's dementia patients. Thus, this may be suggested as an effective exercise method for the treatment and early prevention of Alzheimer's dementia.

Relationships among bedding materials, bedding bacterial composition and lameness in dairy cows

  • Li, Han;Wang, Xiangming;Wu, Yan;Zhang, Dingran;Xu, Hongyang;Xu, Hongrun;Xing, Xiaoguang;Qi, Zhili
    • Animal Bioscience
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    • v.34 no.9
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    • pp.1559-1568
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    • 2021
  • Objective: Bedding materials directly contact hooves of dairy cows and they may serve as environmental sources of lameness-associated pathogen. However, the specific composition of bacteria hidden in bedding materials is still not clear. The aim of this study was to determine the effect bedding material and its bacterial composition has on lameness of Holstein heifers. Methods: Forty-eight Holstein heifers with similar body weights were randomly assigned into three groups including sand bedding (SB), concrete floor (CF), and compost bedding (CB). Hock injuries severity and gait performance of dairy cows were scored individually once a week. Blood samples were collected at the end of the experiment and bedding material samples were collected once a week for Illumina sequencing. Results: The CF increased visible hock injuries severity and serum biomarkers of joint damage in comparison to SB and CB groups. Besides, Illumina sequencing and analysis showed that the bacterial community of CB samples had higher similarity to that of SB samples than CF samples. Bacteria in three bedding materials were dominated by gastrointestinal bacteria and organic matter-degrading bacteria, such as Actinobacteria, Firmicutes, and norank JG30-KF-cM45. Lameness-associated Spirochaetaceae and Treponeme were only detected in SB and CB samples with a very low relative abundance (0% to 0.08%). Conclusion: The bacterial communities differed among bedding materials. However, the treponemes pathogens involved in the pathogenesis of lameness may not be a part of microbiota in bedding materials of dairy cows.

Factors Influencing Caregiver Burden During Rehabilitation of Stroke Patients (뇌졸중 환자 재활 시 간병인 부담에 영향을 미치는 요인)

  • Yu-Mi, Kim;Seung-Min, Baek;Yong-Il, Na;Yong-Soon, Yoon
    • Journal of Industrial Convergence
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    • v.20 no.11
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    • pp.27-34
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    • 2022
  • In this study, we aimed to determine which medical conditions of the stroke patients admitted for rehabilitation more than four weeks after onset affect caregiver burden. Participants diagnosed with stroke and their respective primary caregivers were enrolled and assessed after an 8-week follow-up period. The areas of evaluation for stroke patients included neurologic state, cognition, performance in daily life movements, gait, and balance, and caregivers were evaluated in the area of burden. The evaluation was conducted at the start of the rehabilitation course and eight weeks later. Patient caregivers were found to be under mild to moderate burden while providing care throughout the hospitalization period. The patient's neurologic state and cognition were correlated with caregiver burden. In the all patient and the subacute stroke patient group, multiple regression analysis confirmed that the neurologic state and balance stability were factors that influenced caregiver burden. Hence, we suggest that improvement in the patient's balance stability be emphasized during the course of rehabilitation to mitigate caregiver burden.

Motor and cognitive function according to level of physical activity in stroke patients (뇌졸중환자의 신체활동수준에 따른 운동기능과 인지기능)

  • Jeong Ja Kim;Jong Won Lee
    • Journal of Korean Physical Therapy Science
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    • v.30 no.4
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    • pp.29-43
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    • 2023
  • Background: In the rehabilitation of stroke patients, regular physical activity is very important not only as a treatment for maximal functional recovery but also as a strategy to prevent the recurrence of stroke. The purpose of this study was to objectively measure the amount of physical activity in people with stroke, and to examine the differences in motor and cognitive function according to a level of physical activity. Design: A cross-sectional study. Methods: Physical activity (GENEActiv), motor function (Fugl-Meyer Assessment), cognitive function (Montreal Cognitive Assessment-Korean version), and the Korean version of Modified Barthel Index were evaluated in adult stroke patients with hemiplegia. Results: There was no statistically significant difference in the level of physical activity according to the motor and cognitive function. There was no statistically significant difference in motor and cognitive function according to the level of physical activity, but there was a statistically significant difference in the MBI (p<.01). Conclusion: As a result of the difference in the MBI according to the level of physical activity, it was found that the more moderate to vigorous physical activities are performed, the higher the independence in daily living. These results can be interpreted as that the more often you participate in physical activities such as physical therapy (gait training), the better your independence in ADL. Since regular physical activity participation of adult stroke patients can improve daily living performance, it is considered necessary to participate in physical activities such as continuous physical therapy.