Kim, Si-Hyun;Park, Kyue-Nam;Kwon, Oh-Yun;Choi, Houng-Sik
한국전문물리치료학회지
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제21권4호
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pp.49-55
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2014
Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.
Objective: To evaluate the effects of sit-to-stand (STS) imagery group training (IGT) on STS movement and balance performance for chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: A total of 30 people with chronic hemiparetic stroke (15 for STS-IGT group and 15 for control) were recruited in this study. The STS-IGT group participated in a videotape-based STS-IGT for 30 minutes a day, five days a week for six weeks, while the control group watched a documentary on television for the same period. The STS-IGT focused on a five-stage protocol. Specifically, external imagery was used during the four phases of the STS movement from the seat of the chair to standing up. All of the participants also participated in a regular rehabilitation program. STS movement and balance performance were assessed using three clinical measures. Results: After training, time to perform the 5-repetition STS test significantly increased in the STS-IGT group (change value, $4.0{\pm}2.0$ sec) compared with the control group (change value, $0.9{\pm}0.7$ sec) (p<0.05). There was a greater improvement in Berg balance scale scores in the STS-IGT group (change value, $0.2{\pm}4.1$ points) compared with the control group (change value, $0.3{\pm}0.9$ points) (p<0.05). There was a greater improvement in Timed Up and Go scores in the STS-IGT group (change value, $2.6{\pm}1.5$ sec) compared with the control group (change value, $0.9{\pm}1.0$ sec) (p<0.05). Conclusions: STS-IGT can be considered as a useful option for restoration of STS movement and balance performance for individuals with chronic hemiparetic stroke who are unable to fully participate in physical activities.
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.
The purpose of this study was to analyze the 12-week horse riding exercise effect on the locomotion of a body and bilateral balance and flexion/extension of trunk during the sit-to-stand(STS) in elementary and middle school students. One-hundred eleven participants were divided into three groups. Each group was subject to a different horse riding exercise: control group(n = 36), 1 time/week group(n=37), and 3 times/week group(n=38). Two-way repeated ANOVA was used to compare weight transfer time(WTT), trunk flexion velocity(TFV), trunk extension velocity(TEV), mean rising index(MRI), mean weight asymmetry( MWA) among the groups, and STS changes in before and after 12 weeks. There was a group interaction in WTT, TFV, TEV, MRI, and MWA with different responses to horse riding exercise participation. There was a significant increase in 1 time/week group and 3 times/week group of WTT, TFV, TEV, and MRI. Additionally, MWA(an index of a capacity for bilateral balance) in lower extremity was decreased in 3 times/week group. It seems that horse riding exercise positively affected musculoskeletal function of the trunk and lower extremity by accelerating locomotion and bilateral balance.
Purpose: To investigate the effect of action observation training on the muscle onset time and symmetrical use of rectus femoris(RF) and gastrocnemius medialis(GCM) during sit-to-stand (STS). Methods: Sixteen patients with stroke entered a single-blind trial and were randomly assigned to the experimental(Action) or control(Landscape) groups. Those in the Action observation group watched video clips showing specific movement and strategies to STS, wheas those in the control group watched video clips of static pictures showing differnet landscapes. All patients was measured the EMG data in the STS on the affected side and unaffected side. The EMG data were collected from RF and GCM while performing the STS task. The EMG onset time and onset time ratio for the RF and GCM were calculated by dividing the EMG onset time of RF and GCM action on the affected side by these on the unaffected side. Results: Onset time of affected side RF, GCM was significantly faster action observation training group than control group(p<.05). But interventions before and after the symmetry did not show a significant increase. Conclusion: There findings suggest that action observation training has a positive effect on the muscle onset time shortened during STS tasks.
Lim, Ji Young;Yi, Yoonsil;Jung, Sang Woo;Park, Dae-Sung
Physical Therapy Rehabilitation Science
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제7권4호
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pp.179-185
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2018
Objective: The purpose of this study was to analyze and compare vertical ground reaction forces during sit to stand (STS) and gait between female elderly and young individuals using the Wii Balance Board (WBB). Design: Cross-sectional study. Methods: Fifty-one female elderly people (age: $75.18{\pm}4.60years$), and 13 young people (age: $29.85{\pm}3.69years$) performed the five times STS test and gait respectively on the WBB. We analyzed time (s), vertical peak (%), integral summation (Int_SUM, %), and counter variables (%) in STS and 1st peak (body weight, BW%), 2nd peak (BW%), peak minimum (BW%), time (second), center of pressure (COP) path length (mm), and Int_SUM (BW%) in gait. The independent t-test was used to assess for differences in STS, gait ability, and general characteristics between the female elderly group and young adults group. With the first and last trials excluded, the mean value was obtained from the middle three of the five trials. Results: During STS, Int_SUM and time of young adults were significantly less than of the female elderly subjects. There were no significant differences in peak and counter variables. In gait, all variables (1st peak, 2nd peak, min, time, COP_path, and Int_SUM) showed significant differences between groups (p<0.05). This study demonstrated that the validity of vertical ground reaction forces occurring during STS and gait was significant in female elderly and young adults. Conclusions: Based on the measurement of vertical ground reaction forces in STS and gait using the WBB, it is possible to clinically improve the quality of geriatric physical therapy. Further studies are necessary to examine concurrent validity of elderly patients who have undergone total hip or knee replacement.
This study investigated therapeutic effects of pelvic tilt exercise (PTE) on weight bearing and body sway during sit-to-stand (STS) on 18 hemiplegic patients who had visited the Hanyang University Seoul Hospital and Injae University Sanggyebek Hospital physiotherapy rooms. The study compared the patients with 18 normal adults. The subjects were sampled out from those who could get up independently, maintain a standing posture more than 10 seconds, understand the movements of this study and have no difficulty in performing the tasks. By executing STS in a natural way with habitual movements before and after PTE, the weight bearing was measured by using Mediance II. In order to compare the difference of weight distribution, weight bearing and body sway on affected and nonaffected sides during STS before and after PTE, the Wilcoxon Signed Ranks Test was used. The statistical significance level was based on p<.05. The results revealed that the difference of weight distribution in the hemiplegic group was significantly decreased (p<.05), whereas there was no significant difference in the healthy group (p>.05). Weight bearing loaded on the affected side was $42.53{\pm}7.65%$ and $44.20{\pm}6.32%$, respectively, in the hemiplegic group during STS before and after PTE. Weight bearing during STS after PTE is increased significantly, as compared with weight bearing before PTE (p<.05). Body sway in the hemiplegic group was significantly decreased (p<.05). As mentioned, PTE proved to be effective for improvement in weight bearing on the affected side during STS of hemiplegic patients.
PURPOSE: The purpose of this study was to investigate the comparison of muscle activity and mechanical loading according to the angle of ankle joint during a sit-to-stand (STS) task. METHODS: Thirty-four young participants performed the STS in a randomized trial with the ankle joint at a neutral, 15 degrees dorsiflexion and 15 degrees plantarflexion angle in a fixed sitting posture with the knee in 105 degrees flexion. Muscle activity of the tibialis anterior (TA), rectus femoris (RF), biceps femoris (BF), and gastrocnemius medialis (GCM) was measured, and the parameters calculated in relation to mechanical loading were the STS-time, maximum peak, minimum peak, and total sum of mechanical loading. RESULTS: In the dorsiflexion position, the muscle activity of the TA and GCM showed a significant increase (p<.05), and the STS time, maximum peak and total sum of mechanical loading showed a significant difference compared to that in the neutral position (p<.05). In the plantarflexion position, the muscle activity of the RF and GCM showed a significant increase (p<.05), while that of the TA showed a significant decrease (p<.05) compared to that in the neutral position. And the minimum peak was significantly increased than the neutral position (p<.05), and the maximum peak and total sum of mechanical loading were showed significant difference compared with dorsiflexion position (p<.05). CONCLUSION: These results show that there is a difference in muscle activity and mechanical loading when performing the STS movement according to the change in the ankle joint angle.
We propose some applications of image processing techniques to extract quantitative measurements by using a camera system developed in Korea university and Catholic Medical School. From now on the system will be called as KCMOTION. The purpose of this study is to provide basic kinematic and kinetic data for the analysis of human movements and to find the clinical usefulness and reliability of the proposed motion analysis system. Two tests, sit-to-stand (STS) movements and pendulum test, are conducted by the system. The aims of the tests are to identify variability and reliability of KCMOTION to give some quantitative comparisons to the other systems. The result of STS movement are compared to the LOCUS IIID motion analyzer by the ratio of maximum flexion movement per body weight to the actual maximum flexion extension torque per body weight. That result in 29 % and 33 % for hip and knee joint, respectively in KCMOTION and 27 % and 30 % in LOCUS IIID System. The results of the pendulum movements are compared to that of using Cybex and Electrogoniometer with relaxation index, amplitude ratio, swing number and swing time. The results of relaxation index and amplitude ratio of the KCMOTION are between those of the Cybex and Electrogoniometer. We also observed that the KCMOTION detect more natural movement, from the results of swing number and time.
Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.
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