Purpose: This study aimed to investigate the effects of postural control exercise on the delayed heart rate increase in heart transplant patients. Methods: The subject was a female heart transplant recipient who had a delayed increase in heart rate during exercise. The intensity of exercise was performed at MBorg level 4. The A-B-A' and A-B-A'-B' designs were used to identify the changes in heart rate during active-assisted exercise, lower limb postural control exercise, and upper limb postural control exercise. Experiments were performed for four weeks. The heart rates at pre- and post-exercise were compared, and the time to reach MBorg 4 was measured. Results: In the active-assisted exercise, the average heart rates at pre- and post-exercise and after 10 min of exercise were 88, 89, and 87.7 bpm, respectively. In the repetitive comparison of pre- and post-exercise in the lower limb postural control exercise, the difference in the mean heart rate was 3.5 and 3 bpm in stable support and 14 and 14.5 bpm in unstable support, respectively. In the repetitive comparison of pre- and post-exercise in the upper limb postural control exercise, the difference in the mean heart rate was 6 and 4 bpm in stable support and 4 and 4.5 bpm in unstable support. The time required to reach MBorg 4 was short when both the upper and lower postural control exercises were performed in an unstable state. Conclusion: We suggest that combining proper postural control exercise with strength exercise and aerobic exercise, among others, may be effective in rehabilitating patients in the recovery stage after a heart transplant.
[Purpose] The combined effect of different types of post-exercise treatment has not been fully explored. We investigated the effect of combined cold water immersion (CWI) and compression garment (CG) use after maximal eccentric exercise on maximal muscle strength, indirect muscle damage markers in the blood, muscle thickness, and muscle soreness score 24 h after exercise. [Methods] Ten men performed two trials (CWI + CG and CON) in random order. In the CWI + CG trial, the subjects performed 15 min of CWI (15℃), followed by wearing of a lower-body CG for 24 h after exercise. In the CON trial, there was no post-exercise treatment. The exercise consisted of 6 × 10 maximal isokinetic (60°·s-1) eccentric knee extensions using one lower limb. The maximal voluntary contraction (MVC) and maximal isokinetic (60°·s-1) strength during knee extension, as well as the indirect muscle damage markers, were evaluated before exercise and 24 h after exercise. [Results] The maximal muscle strength decreased in both trials (p < 0.001), with no difference between them. The exercise-induced elevation in the myoglobin concentration tended to be lower in the CWI + CG trial than in the CON trial (p = 0.060). The difference in the MVC, maximal isokinetic strength, muscle thickness, and muscle soreness score between the trials was not significant. [Conclusion] CWI followed by wearing of a CG after maximal eccentric exercise tended to attenuate the exercise-induced elevation of indirect muscle damage markers in the blood.
Objective: This study investigated the different in isokinetic peak strength of the knee joint, and kinetics and kinematics in drop landing pattern of lower limb between the patellofemoral pain syndrome (PFPS) patients and normal. Method: 30 adult females were divided into the PFPS (age: 23.13±2.77 yrs; height: 160.97±3.79 cm, weight: 51.19±4.86 kg) and normal group (age: 22.80±2.54 yrs, height: 164.40±5.77 cm, weight: 56.14±8.16 kg), with 15 subjects in each group. To examine the knee isokinetic peak strength, kinematics and kinetics in peak vertical ground reaction force during drop landing. Results: The knee peak torque (Nm) and relative strength (%) were significantly weaker PFPS group than normal group. In addition, PFPS group had significantly greater hip flexion angle (°) than normal group. Moreover, normal group had significantly greater moment of hip abduction, hip internal rotation, and left ankle eversion than PFPS group, and PFPS group had significantly greater moment of knee internal rotation. Finally, there was significant differences between the groups at anteroposterior center of pressure. Conclusion: The PFPS patients had weakened knee strength, and which can result in an unstable landing pattern and cause of more stress in the knee joints despite to effort of reduce vertical ground reaction force.
Following are brief statements about the delayed encephalopathy of a patient who recovered without disturbance of consciousness after acute carbon monoxide poisoning. A 72-year-old male was found without consciousness at home and then visited the ER center. Later we learned that the patient was using briquettes as a household heating source. Blood carbon monoxide hemoglobin level was 17.5%. As carbon monoxide poisoning was uncertain after the first interview with the patient, hyperbaric oxygen therapy was not administered at the early stage. After supplying 100% oxygen, the patient recovered consciousness, however, the strength of the lower limb muscle had decreased to class II. The patient showed continued weakening of the lower limb muscle and an increase of CPK; therefore, he was diagnosed as carbon monoxide intoxication and rhabdomyolysis and then admitted to the intensive care unit (ICU) for conservative treatment. During the hospitalization period, continued weakening of the lower limb muscle was observed and he was diagnosed as myopathy after EMG/MCV. However, he suddenly showed altered mentality on the 20th day of hospitalization, and underwent brain MRI. T2 weighted MRI showed typically high signal intensity of both globus pallidus and periventricular white matter; therefore, he was diagnosed as delayed carbon monoxide encephalopathy. This case showed delayed encephalopathy accompanied by rhabdomyolysis and myopathy of a patient who recovered without disturbance of consciousness.
Park, Hyung Jun;Shin, Ha Young;Kim, Seung Min;Park, Kee Duk;Choi, Young-Chul
Annals of Clinical Neurophysiology
/
제21권2호
/
pp.79-86
/
2019
Background: Magnetic resonance (MR) images are useful for diagnosing myopathy. The purpose of this study was to determine the usefulness of lower-limb MR images in Korean patients with distal myopathy. Methods: We reviewed medical records in the myopathy database from January 2002 to October 2016. We selected 21 patients from 91 unrelated families with distal myopathy: four with GNE myopathy, 11 with dysferlinopathy, and six with ADSSL1 myopathy. Results: Ten (48%) of the 21 patients were men. The ages of the participants at symptom onset and imaging were $19.2{\pm}9.5$ and $30.4{\pm}9.0$ years (mean${\pm}$standard deviation), respectively. Their grade on the modified Gardner-Medwin and Walton grade was $3.3{\pm}1.7$. The strength grade of the knee extensors was not correlated with the Mercuri scale for the quadriceps (r = -0.247, p = 0.115). However, the Medical Research Council grades of the knee flexors, ankle dorsiflexors, and ankle plantar flexors were significantly correlated with the Mercuri scale ratings of the knee flexors (r = -0.497, p = 0.001), tibialis anterior (r = -0.727, p < 0.001), and ankle plantar flexors (r = -0.620, p < 0.001), respectively. T1-weighted MR images showed characteristic fatty replacement patterns that were consistent with the causative genes. Unsupervised hierarchical clustering of the Mercuri scale showed that the main factors contributing to the dichotomy were the causative gene and the clinical severity. Conclusions: This study is the first to reveal the usefulness of lower-limb MR images in the differential diagnosis of distal myopathy in Korea.
Objective: To report a clinical case of Guillain-Barré syndrome-like neurological symptoms, including limb weakness, phantosmia, and nausea/vomiting after COVID-19 vaccination (AstraZeneca) that was improved by traditional Korean medicine (TKM) treatment. Methods: A 73-year-old male complained of extreme limb weakness, severe phantosmia, and nausea/vomiting after COVID-19 vaccination. No abnormalities had appeared in various radiological and laboratory tests, but the symptoms had continued to worsen for three months before visiting our clinic. Results: The patient was diagnosed with neurological complications suspicious of Guillain-Barré syndrome after COVID-19 vaccination. The patient was treated with acupuncture, moxibustion, herbal drugs (Banhabakchulchunma-tang), and nasal inhalation therapy with Aquilariae Lignum. Three weeks after Korean medicine treatment, his neurological symptoms had improved. Nausea/vomiting and phantosmia continued to show improvement, and muscle strength was gradually recovered in both lower limbs. Conclusion: Traditional Korean medicine could be a choice for the treatment of neurological complications after COVID-19 vaccination.
Purpose: This study investigated the effect of proprioceptive neuromuscular facilitation (PNF) on gait speed in a stroke patient with genu recurvatum. Methods: The subject was a 52-year-old female diagnosed with stroke. Information on health was collected through client Interview based on the International Classification of Functioning, Disability and Health (ICF). The ICF was used to identify connections between functional problems, and for diagnosis, and functional problems were described using ICF terms. For prognostic purposes, comprehensive goals for functional activity and participation level are presented as long- and short-term goals. Intervention was performed using an exercise program composed of techniques and principles based on PNF concepts for 50 minutes a day, 3 times a week, for 6 weeks. Gait speed and lower limb strength before to after intervention differences were used as study outcomes. Results: Clinical advantages were observed in body function (3.6kg increase in knee extension strength, 1.4kg increase in knee flexion strength, 0.9kg increase in hip abduction). Gait speed, which was the patient's primary limitation, was improved by 0.2m/sec. Conclusion: Based on the results of this study, application of the PNF concept would appear to improve gait speed and genu recurvatum in stroke patients.
Background: This study investigated the effects of face-to-face and non-face-to-face McKenzie exercises and elastic band strengthening exercises on falls and fitness in older adults. Methods: A total of 44 subjects were divided into a face-to-face group (FG; n=22) and a non-face-to-face group (NFG; n=22) who met older adults. Both groups used McKenzie exercises and strength training with elastic bands The fall efficacy scale (K-FES) and glycosylated hemoglobin (HbA1c) Pro were used to compare the senior fitness test (SFT). Results: No significant differences were detected between the two groups before the intervention; however, a significant difference was noted in the K-FES scores after the intervention. The change in HbA1c after the intervention was not statistically significant in the FG or the NFG, and no significant difference was detected between the two groups. The change in lower limb muscle strength in the elderly physical fitness test showed no significant difference between the two groups before or after the intervention. The change in upper limb flexibility after the intervention was not significantly different in the FG or NFG, indicating no significant difference between the two groups. The change in the 3-meter round-trip test after the intervention was significantly different in both the FG and NFG groups, but the difference between the groups was not statistically significant. The change in the grip strength test of the dominant hand showed no significant difference after the intervention in the FG or the NFG, and the difference between the FG and NFG groups was not statistically significant. The dominant foot external standing after the intervention was significantly improved in the FG, but no significant difference was detected in the NFG, and the difference between the two groups was not statistically significant. Conclusion: The study findings revealed that FG and NFG McKenzie exercises and elastic band strengthen exercises were equally effective at preventing falls and improving fitness in older adults.
PURPOSE: Application of an oscillating program for the lower extremities is an effective training method for increasing muscle strength. However, no oscillatory program has yet been identified to confirm the effectiveness of oscillation for balance ability and maximum muscle strength. We investigated the effects of an 8-week vibration exercise program on the maximum muscle strength and balance of the lower extremities. METHODS: Research subjects participating in the study were 22 male and female college students with no past history of diseases of the nervous or musculoskeletal systems. All subjects were randomly divided into two groups and performed their assigned experimental treatment 3 times a week over a period of 20 min for 8 weeks. Maximum strength of the quadriceps extension, flexion, and balance ability were measured using Biodex System 4 and Biodex balance systems. RESULTS: The 8-week oscillation program resulted in a significant increase in quadriceps extension and flexion strength in both male and female participants (p<.05). The balance ability also showed a significant improvement after the oscillation program (p<.05). The balance value was higher for male 17% than for female 21% (p<.05) participants. CONCLUSION: An 8-week oscillation program led to an increase in the strength of knee flexion and extension. The balance ability also improved significantly. This positive effect on balance ability was higher in female than in male subjects.
The purpose of this study was to compare gait patterns during pregnancy. Because of the changes in hormone levels and anatomical changes such as body mass, body-mass distribution, joint laxity, and musculotendinous strength that result from pregnancy, it was possible that there would be certain gait deviations associated with these changes. Three-dimensional gait analyses were performed from a self-selected pace, and six subjects(height : $163{\pm}5.3cm$, mass : $61.3{\pm}3.80kg$, $65.3{\pm}5.14kg$, $70.2{\pm}4.98kg$) participated in the three times(the early, middle and last years). 7 cameras(Proreflex MCU-240, Qualisys) and 2 force plates (Type 9286AA, Kistler) were used to acquire raw data. The parameters were calculated and analyzed with Visual-3D and Joint moments computed using inverse dynamics. In conclusion, pregnant women's gait patterns were changed during pregnancy period because pregnancy makes them physical changes. The main changes were joint moments and kinematic factors during pregnancy period. The pregnancy transformed normal gait pattern Into toe out position. Therefore, exercise programs to improve muscle activity were necessary where joint moments were small. The development of simulator should be studied for pregnant women's tailored shoes and accessories in future.
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