• The Journal of Korean Physical Therapy
• /
• v.25 no.3
• /
• pp.136-142
• /
• 2013

Purpose: The application of transcutaneous electrical nerve stimulation (TENS) is beneficial for joint movements, inhibition of spasticity, and the improvement of walking ability in patients with chronic hemiplegia. This study aimed to identify the effect of the application of TENS to the knee extensor on the affected side with respect to postural-sway distance and velocity during the sit-to stand movement. Methods: We included 19 patients with post-stroke hemiplegia in this study. They underwent measurements during the sit-to stand movement on a force plate with 5 different stimulation dosages applied over 7 s:No TENS, high-frequency and high intensity TENS, high-frequency and low intensity TENS, low-frequency and high intensity TENS, and low-frequency and low intensity TENS The 5 different condition were administered in random order. Results: The group that received TENS application exhibited a significant decrease in path length and average velocity of center of pressure (COP) displacement compared with the group that did not receive TENS application. TENS dosage at low frequency (3Hz) and high intensity yielded a significant decrease in path length, average velocity, mediolateral distance and anteroposterior distance of COP displacement (p<0.05). Conclusion: Our results demonstrated the effectiveness of the application of low-frequency TENS on STS performance. These findings provide useful information on the application of TENS for the reduction of postural sway during the sit-to-stand movement after stroke.

• Science of Emotion and Sensibility
• /
• v.5 no.4
• /
• pp.45-49
• /
• 2002

Recently, virtual environment systems are used in various application fields such as industry, medicine, and training and education. However, the negative effect, cybersickness including nausea, visual fatigue, and disorientation, could be happened while using VR systems. It prevents VR system from spreading much more. To control the cybersickness, first of all, the objective measurement method should be established. As one of alternative methods, the postural instability could be a measure of cybersickness. In this study, 45 participants' postural sway before and after experiencing a H driving simulator was measured by using a force platform. Especially, we examined if two factors, motion and feedback, could affect on the postural instability The results showed the postural instability slightly increased after experiencing the VR driving simulator. For the factors, the providing of motion synchronized to visual display showed statistical significant decrease in postural sway along lateral side. To check the effectiveness of postural instability as a cybersickness measure, further studies are needed.

• Journal of Institute of Control, Robotics and Systems
• /
• v.13 no.9
• /
• pp.843-850
• /
• 2007

This paper proposes a somatosensory stimulation system for the improvement of postural stability using vibration as somatosensory stimulation. This system consists of vibratory stimulation and postural response measurement. To evaluate this system, the center of pressure(COP) was closely observed in turn with simultaneous or separate mechanical vibratory stimulations to flexor ankle muscles (tibialis anterior, triceps surae) and two plantar zones on both feet while standing on a stable and an unstable support. The simultaneous vibratory stimulations cleared influenced postural stability and the effects of vibrations were higher with the unstable support. In separate vibratory stimulations, the extent of the COP sway reduced when the direction of the vibratory stimulations and that of the inclination of body coincided for flexor ankle muscle stimulations. In the contrary, the extent of the COP sway increased when the direction of the stimulations and that of body inclination coincided for plantar zone stimulations. These results can be useful for the development of rehabilitation systems that utilizes somatosensory inputs for postural balance.

• Physical Therapy Korea
• /
• v.7 no.2
• /
• pp.35-54
• /
• 2000

The purposes of this study were to assess variation of body sway prior to and after submaximal treadmill exercise; to determine the time course of the effects of a fatiguing performed on a treadmill on body sway; and to compare position sense prior to and after exercise in order to assess any variance in proprioception caused by submaximal treadmill exercise. The subjects were twenty-four healthy men in their twenties. They stood barefoot on the Kinesthetic Ability Training Balance Platform to measure body sway. Control trials were performed with eyes alternately open and closed. In the eyes open condition, they were asked to look at a target placed at eye level 1 m in front them. A total of 10 trials, each lasting 20 seconds, were performed. After this series of trials, position sense was measured. Subjects then exercised on the treadmill until 85% of each person's maximal heart rate was reached. The first series of postural sway measurements began immediately after this exercise. The second identical series of postural sway trials was performed at approximately 10 minutes after exercise. The third series was performed approximately 20 minutes after exercise. This allowed approximately 5 minutes of rest between each experimental series. Position sense was measured at approximately 15 and 25 minutes after exercise. The results were as follows: 1) There was a significant increase in body sway after submaximal treadmill exercise compared to pre-exercise values under both visual conditions (p<.05). 2) After submaximal treadmill exercise, under the eyes open condition, the mean value of body sway was significantly increased after both the first and second series (p<.05). Under the eyes closed condition, the mean value of body sway increased significantly after the first series but decreased significantly after the third series (p<.05). 3) Position sense, measured repeatedly after submaximal treadmill exercise, did not change significantly with respect to pre-exercise values (p>.05). These results suggest that fatigue induced by submaximal treadmill exercise produced an increase in body sway in young healthy subjects with or without visual input, but the increase appeared to be lasting less than 15 minutes. No significant change in position sense suggested that proprioception was unaffected by submaximal treadmill exercise-induced fatigue.

• The Journal of Korean Physical Therapy
• /
• v.22 no.5
• /
• pp.63-70
• /
• 2010

Purpose: In this study, children with cerebral palsy were treated for 8 weeks using horse riding trunk proprioception, stability and posture to investigate the effect of hippotherapy in the field of physical therapy. Methods: A total of 18 subjects were divided into an experimental group treated by horseback riding and a control group. Both groups were evaluated pre- and post-treatment. Trunk proprioception was measured three times in the sitting position with their eyes and ears closed to reach the target position the angle error of the mean was calculated. Trunk stability was measured using a forceplate and the data were used to calculate the postural sway path & postural sway velocity. Posture was evaluated using the Posture Assessment Scale (PAS). Results: After hippotherapy, the experimental group showed a significant improvement in trunk proprioception, stability and posture (p<0.05), but the control group improved in posture only (p<0.05). Trunk proprioception, stability and posture was significantly different between the two groups (p<0.05). Conclusion: Eight weeks of hippotherapy is effective in improving trunk proprioception, stability, and posture. Research using this therapy should be studied further as a possible new therapeutic approach in the field of physical therapy.

• Journal of Biomedical Engineering Research
• /
• v.30 no.6
• /
• pp.521-528
• /
• 2009

This study is about to evaluation of postural stability according to characteristics of electrical stimulation on the ankle muscles. We measured body sway(center of pressure, COP) when various parameters of electrical stimulation was applied to ankle muscles in stable and unstable posture. Subjects consisted of 10 young adults, and electrical stimulation was delivered on right and left of tibialis anterior and Achilles tendon. The body sway was measured during electrical stimulation of three duty cycle and frequencies in stable posture and three amplitudes of sensory threshold in unstable posture. Consequently, the COP Shift is higher during electrical stimulation of 1/30(duty ratio) and 100Hz(frequency) in stable posture. In unstable posture, 100% amplitude of sensory threshold induced postural stability. These findings are important for the rehabilitation system of postural stability and the use of electrical stimulation as somatosensory information.

• Journal of the Korean Society of Physical Medicine
• /
• v.3 no.3
• /
• pp.169-176
• /
• 2008

Purpose : Tandem stance is a clinical measure of standing balance considered to assess postural steadiness in a heel-to-toe position by a temporal measurement. The aim of this study is to investigate postural steadiness and to explore the weight distribution between legs during 25s of quiet stance and tandem stance(right foot was leading) in healthy young adults. Methods : 107 healthy young adults(mean age 21.1 years) are participated. Weight distribution beneath both feet and sway distance were recorded while the subjects performed 25s of quiet stance and tandem stance. Results : Subjects placed more weight on the rear leg in tandem stance and on the left foot in quiet stance. So, quiet stance and tandem stance is not a task for equal weight bearing. Subjects show larger sway distance in anteroposterior direction of tandem stance than quiet stance. Conclusion : The results of this study will be useful to researchers and clinicians using tandem stance measures to evaluate postural steadiness and to predict fall. The results suggest that tandem stance is useful to treat of weight distribution and to improve of balace in elderly adults and stroke patients.

• 재활복지
• /
• v.14 no.3
• /
• pp.225-256
• /
• 2010

This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

• Physical Therapy Rehabilitation Science
• /
• v.5 no.3
• /
• pp.113-119
• /
• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 대한임상약리학회:학술대회논문집
• /
• 1992.11a
• /
• pp.32-32
• /
• 1992