• Title/Summary/Keyword: Postural Control

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Effect on the Limit of Stability of the Lowered Center of Mass With a Weight Belt

  • Phan, Jimmy;Wakumoto, Kaylen;Chen, Jeffrey;Choi, Woochol Joseph
    • Physical Therapy Korea
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    • v.27 no.2
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    • pp.155-161
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    • 2020
  • Background: The consequences of falls are often debilitating, and prevention is important. In theory, the lower the center of mass (COM), the greater postural stability during standing, and a weight belt at the waist level may help to lower the COM and improve the standing balance. Objects: We examined how the limit of stability (LOS) was affected by the lowered center of mass with the weight belt. Methods: Twenty healthy individuals participated in the LOS test. After calculating each participant's COM, a weight belt was fastened ten centimeters below the COM. Trials were acquired with five weight belt conditions: 0%, 2%, 4%, 6%, and 8% of body weight. Outcome measures included reaction time, movement velocity, endpoint excursion, maximum excursion, and directional control in 4 cardinal moving directions. Results: None of our outcome variables were associated with a weight belt (p > 0.075), but all of them were associated with moving direction (p < 0.01). On average, movement velocity of the COM and maximum excursion were 31% and 18% greater, respectively, in mediolateral than anteroposterior direction (5.4°/s vs. 4.1°/s; 97.5% vs. 82.6%). Conclusion: Our results suggest that postural stability was not affected by the weight-induced lowered COM, informing the development and improvement of balance training strategies.

Clinical Criteria to Perform the Step through Step Gait with a Cane in Chronic Stroke Patients

  • Kim, Won-Bok;Lee, Jung-Ho
    • Journal of the Korean Society of Physical Medicine
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    • v.9 no.3
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    • pp.285-291
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    • 2014
  • PURPOSE: The purpose of this study was to propose clinical criteria to differentiate patients who are able to perform the step-through-step gait pattern in chronic stroke patients. METHODS: Sixty patients with chronic stroke patients participated this study. To differentiate patients who could perform the step-through-step gait pattern, age, gender, and causes of stroke were noted, a Chedoke-McMaster (CM) damage list, Fugl-Meyer (FM) assessment scales and the Berg Balance Scale (BBS) were determined. A 10 meter gait test and Timed Up and Go (TUG) test were conducted to determine the differences in gait speed and dynamic balance between patients walking with or without canes in the step-through-step gait pattern group. RESULTS: There was no significant statistical difference in age, gender, and stroke type between all subjects. There were significant differences in the CM scale for postural and lower extremities, and FM scale for lower extremities and BBS. The dynamic balance ability and gait speed showed significant differences between the subjects in the step-through-step gait pattern with or without a cane during gait. CONCLUSION: CM and FM scales for the lower extremities and postural control, as well as BBS scales, can be used as criteria to differentiate patients who are able to perform the step-through-step gait pattern. These results can also be used to provide beneficial information to patients that are walking with canes.

Review on Physical Therapy for Patients with Vestibular Disorder

  • Kwon, Yong Hyun;Ko, Yu Min
    • The Journal of Korean Physical Therapy
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    • v.29 no.6
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    • pp.316-323
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    • 2017
  • Effort to improve balance ability in the field of rehabilitation has been constantly issued and developed up to now. A variety of subcomponent of postural control including function and cognition should be needed in many body systems and be complicatedly linked to each system. In South Korea, although decreased postural dysfunction due to neurological or musculoskeletal disorders has been well documented, we do not have many experience and knowledge of vestibular rehabilitation for maintain and improve balance function. In the United States, vestibular physical therapy is already acknowledged as clinical subspecialty by American Physical Therapy Association. However, there is no curriculum subject related to vestibular rehabilitation in standard education of physical therapy and no specialist who has clinical experience and knowledge of this realm. Therefore, we reviewed general information and basic knowledge of vestibular rehabilitation such as current state of vestibular disorder in South Korea, pathology, major causes of vestibular dysfunction including peripheral vestibular disorders, vestibular neuritis, benign paroxysmal positional vertigo, and central disorder, evaluation of vestibular dysfunction, and treatment for vestibular dysfunction new approaches. We expect that physical therapist in South Korea recognize clinical significance of vestibular exercise and that clinical concern and research will be begun in near future.

Applicability of bilateral transfer paradigm to the rehabilitation programs for children with hemiplegic cerebral palsy (편마비 아동의 재활프로그램에 대한 양측성 전이 패러다임의 적용가능성)

  • Kim Mi-Hyun;Park Sang-Bum
    • The Journal of Korean Physical Therapy
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    • v.12 no.1
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    • pp.163-172
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    • 2000
  • The purpose of this study was to provide experimental evidence and theoretical background for the applicability of bilateral transfer paradigm to the rehabilitation programs for children with hemiplegic cerebral palsy. Children with hemiplegia, which means unilateral motor disabilities, display abnormal motor and postural patterns of the affected side due to hemiparesis, spasticity, and sensory disorders, resulting in a decreased motor abilities of the affected side compared to unaffected side. Accordingly, they tend to rely on the unaffected limb for everyday activities, which further deteriorates the functions of the affected side by causing associated reaction, abnormal postural patterns, and hypertonus. Rehabilitation programs developed for children with hemiplegic cerebral palsy include neurodevelopmental treatment, application of cast or splint to unaffected limb, neuromuscular electrical stimulation, and task oriented model. These programs, however, have several drawbacks, such as discontinuity in treatment effect and psychological hatred to the force use of the affected side. In order to solve these problems and enhance the efficiency of the rehabilitation programs, it is required to maximize the use of the affected side without hatred. Characteristics of the control system, such as temporal coupling and spatial assimilation between limbs and neural crosstalk at different levels of central motor pathway, suggest that the bilateral transfer paradigm may enhance the efficiency of the rehabilitation programs for children with hemiplegic cerebral palsy.

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A Quantitative Analysis of Electromyography Obtained from Subjects Performing Seated Tasks (앉은 자세로 행하는 작업에서 측정된 근전도의 정량적 해석)

  • Son, Kwon
    • Journal of Biomedical Engineering Research
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    • v.13 no.1
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    • pp.9-18
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    • 1992
  • This paper describes a quantitative analysis of electromyography (EMG) measured from seven subjects performing four seated dynamic tasks. EMG signals were mom- bored using 15 surface electrodes which were placed on selected trunk and lower extrmity muscles of the right side of the body. Each EMG signal was then processed through rectification, integration, and filtering. Based on the maximum level of the processed EMG, it was found that the trunk and ankle muscles play an important role on the postural control during the seated tasks.

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The inter-rater absolute reliability and validity of the Figure-of-8 Walk test in patients with chronic stroke (만성 뇌졸중 환자 8자 모양 경로 보행 검사의 측정자간·절대적 신뢰도와 타당도)

  • Park, Chang-Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.5
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    • pp.467-474
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    • 2017
  • To investigate the intra-rater absolute reliabilities and validity of the Figure of-Eight Walk test (F8WT) in patients with chronic stroke. A total of 36 subjects with chronic stroke participated in this study. The inter-rater reliability of F8WT was calculated using intra-class correlation coefficients($ICC_{2,1}$). Moreover, we used the standard error measurement (SEM) and the small real difference (SRD) to examine the absolute reliability indices. The validity was demonstrated by a spearman correlation of F8WT with Postural Assessment Scale for Storke(PASS) and Trunk Impairment Scale(TIS). The inter-rater reliability of F8WT was excellent; ICC2,1=0.95(0.91~0.97), acceptable SEM=1.02, and SRD=2.82. F8WT were also found to be significantly associated with PASS(r=-0.82) and TIS(r=-0.85). Therefore, F8WT is a reliable measurement tool and is correlated well with stroke-impairments, such as postural and trunk control. F8WT will be a useful tool in evaluating the walking performance of subjects with chronic stroke.

Effects of Force and Position Aspects of the Ankle Proprioception on the Balance Ability (발목관절에서 힘과 위치 측면의 고유수용성감각 수준이 균형능력에 미치는 영향)

  • Ree, Jae Sun;Hwang, Seonhong
    • Journal of Biomedical Engineering Research
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    • v.41 no.2
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    • pp.84-93
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    • 2020
  • Despite of a lot of studies about proprioception tests, there are little study results to investigate the relationship between the functional movement and proprioception level. In this study, we tried to perform quantitative analysis for the effect of ankle joint proprioception level on the one leg standing postural control ability. Nine healthy people volunteered for this study. Force and position aspects of proprioception were evaluated using the electromyography system (EMG) and mobile clinometer application, respectively. The center of pressure (COP) trajectories, measured by a pressure mat sensor, were used for quantitative analysis of balance for each subject. We computed indices and errors of force and position aspects of proprioception from the EMG and ankle angle. Mean velocity of total and anterior-posterior direction (Vm and Vm_ap), root mean squared distance in anterior-posterior direction (RDap), travel length (L), and area (A) of COP trajectories were also calculated as indices of postural control ability of subjects. Two aspects of proprioception showed the low correlation from each other as previous studies. However, the EMG error of gastrocnemius lateral activation showed a high correlation coefficient with COP variables such as Vm (ρ=0.817, p=0.007), Vm_ap (ρ=0.883, p=0.002), RDap (ρ=0.854, p=0.003), L (ρ=0.817, 0.007) and A (ρ=0.700, p=0.036). Within our knowledge, this is almost the first study that investigated the relationship between proprioception level and functional movement. These study results could support that the ankle joint proprioception facilitation exercise would have positive effects on functional balance rehabilitation interventions.

Effect of Dynamic Trunk Equilibrium Exercise on Neglect, Balance, Activities of Daily Living in Stroke Patients With Hemi-Spatial Neglect (편측무시를 가진 뇌졸중 환자를 위한 동적 체간 평형 훈련이 편측무시, 균형, 일상생활수행능력에 미치는 효과)

  • Kang, Tae-woo;Oh, Duck-won
    • Physical Therapy Korea
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    • v.25 no.2
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    • pp.30-43
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    • 2018
  • Background: Hemispatial neglect is defined as the failure to attend, report, respond, or orient toward meaningful stimuli provided in the contralateral side of a brain lesion. Objects: This study was conducted to find out the effect of dynamic trunk equilibirum exercise for stroke patients with hemi-spatial neglect. Methods: This study included 21 stroke subjects, randomly assigned to either the experimental group or the control group. The exercise program consisted of 5 sessions of 20 minutes per week during 4 weeks. The line-bisection test, the Albert test, the balance function score, the Berg balance scale, the postural assessment scale for stroke and the modified Barthel index were measured before and after training. All data were analyzed using SPSS 12.0 for Windows. Between-group and within-group comparison was analyzed by using Independent t-test and Paired t-test respectively. Results: The results of study were as follows: There were significant differences between before and after intervention in both group (p<.05). There were significant differences in the line-bisection test, Albert test, balance function score, Berg balance scale, postural assessment scale for stroke and modified Barthel index between the experimental group and the control group (p<.05). Conclusion: Dynamic trunk equilibrium exercise had a positive effect on patients' neglect, balance ability and activities of daily living. Further studies are required to generalize the results of this study.

Studies on Renin Stimulation in Normal Controls and in Patients with Essential Hypertension (정상인(正常人) 및 고혈압환자(高血壓患者)에서의 Renin 분비자극시험(分泌刺戟試驗)에 관(關)한 연구(硏究))

  • Koh, Chang-Soon;Choe, Kang-Won;Lee, Hong-Kyu;Lee, Jung-Sang
    • The Korean Journal of Nuclear Medicine
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    • v.12 no.1
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    • pp.1-8
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    • 1978
  • To find out a convenient and reliable method of. detecting low renin status, we employed intravenous furosemide injection as a stimulatory maneuver. The results thus obtained were compared with those from the postural stimuli and basal plasma renin activity (PRA) in relation to sodium excretion. Intravenous furosemide test was performed in 66 control subjects and 44 patients with essential hypertension. The results were as follow; 1) Mean PRA in control subjects rose from $2.5{\pm}1.95$ ng/ml/hr (basal) to $4.5{\pm}2.51,\;5.2{\pm}2.49\;and\;4.2{\pm}2.44$ ng/ml/hr at 1, 2 and 3hrs after IV injection. One-hour response is more convenient in clinical practice. 2) Postural stimuli by assuming an upright posture for 3 hrs gave rise to considerable increase in PRA ($4.0{\pm}2.92\;from\;2.4{\pm}1.85$), but we found it less convenient than stimulation with furosemide. 3) The increase in PRA was much less marked in patients with essential hypertension as a whole ($2.9{\pm}2.75$). Hyporesponsiveness to furosemide stimuli was found in 34.1%. Of these hypo responders, a third had a normal basal PRA, indicating the need for this kind stimulatory procedure. 4) Younger age group showed greater renin responsiveness than older age group after furosemide stimuli. Likewise mean age of low renin patients ($52.9{\pm}5.38$ years old) was significantly higher than that of high and normal renin patients ($44.1{\pm}13.78$ years old).

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The Effect of Medio-lateral Balance to Head Rotation in Stroke Patient (뇌졸중 환자의 머리회전 각도가 내.외측 균형에 미치는 영향)

  • Lee, Kwan-Sub;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • v.24 no.5
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    • pp.334-339
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    • 2012
  • Purpose: This study was conducted in order to compare the ability to control postural sway during perturbation when stroke patients received postural sway induced by head rotation. Methods: This study included 15 stroke patients and 15 healthy adults. Each group was measured by 3D motion analysis for determination of the angle of the neck in static position and by balance performance monitor for estimation of swaying angle in both neutral posture and head rotation position. These results were then analyzed in order to compare the healthy control group and the stroke patients group. Results: In both static posture ($60.7{\pm}4.81$) and dynamic posture ($51.46{\pm}6.87$, $70.8{\pm}6.55$), significant decreases were observed in the angle of head rotation of the patient group, compared to the healthy group (p<0.05), and significant decreases were observed in the sway angle of the patient group when in the neutral position ($3.62{\pm}7$, $24{\pm}0.60$) and head rotation ($3.04{\pm}0.80$, $51.46{\pm}6.87$), compared to the healthy group (p<0.05). Conclusion: According to these findings, patients with stroke tend to restrict the ROM of head rotation and swaying angle in dynamic posture and maintain their posture instability using limitation of head movement relative to the trunk and sway angle of area which is larger than that of affected side in unaffected side.