The purpose of this study was to evaluate and compare the Limits of stability(LOS) in hemiplegic patients who can walking independently. The LOS was measured at stable surface, unstable surface with eye open and eye closed. In this study, 18 out-patients were evaluated who were treated at Yonsei University Medical Center Rehabilitation Hospital. In order to determine the statistical significance of results, T-test, paired t-test, and Kruskal-Wallis 1-way ANOVA were applied at 0.05 level of significance. The results were as follows: 1. The mean of lateral limits of stability was 9.89 degree. 2. The mean of anteroposterior limits of stability was 6.43 degree. 3. There was a significant difference of limits of stability between sound side and affected side(p<0.05). 4. The limits of stability was significantly decreased with eye closed(p<0.05) 5. The limits of stability was significantly decreased at unstable surface(p<0.05). 6. The limits of stability was a significant difference as spasticity degree of ankle plantar flexors(p<0.05). These results showed that the limits of stability in hemiplegic patients was more decreased than that of normal adult. In order to improve the balance in hemiplegic patients, we need to increase the limits of stability.
In the present study. the design of multi-axial lower extremity orthosis was presented with adduction and abduction force data which were measured from three children with cerebral palsy and a normal child. The measurements of adduction and abduction forces were conducted in standing and wolking condition. Adduction and abduction forces were measured by strain gages which were attached on the lateral uprights of lower extremity orthoses. In the standing condition. addcution force of childrens was distributed from 0.11 kgf to 0.26 kgf. During the walking condition. adduction force was reached to 1.56 kgf and abduction force was reached to 1.52 kgf.
Purpose: This study aimed to evaluate the relationships among quality of life, caregiver depression levels, and disease severity, especially motor function, in children with cerebral palsy. Methods: Data were collected through questionnaires using survey and interview from 80 caregivers of children with cerebral palsy. The caregivers' quality of life was measured using medical outcomes study 36-item short form health survey, and level of depression was scored using the beck depression inventory. In addition, children's motor function was evaluated using gross motor function measure-88 and functional independence measure scores. Results: Among 8 domains of medical outcomes study 36-item short form health survey, "physical functioning," "physical role functioning," "mental health," and "bodily pain" domains were significantly correlated to "total" percentage scores of gross motor function measure-88. In addition, "mental health" and "bodily pain" domains were correlated to each sub-dimension, including "lying and rolling," "sitting," "crawling and kneeling," "standing," and "walking, running, and jumping." Similarly, the "running" and "jumping" dimensions including motor function measures correlated with "transfer," "locomotion," and "motor subtotal" of functional independence measure scores. The beck depression inventory scores were negatively correlated to "lying and rolling," "sitting," "crawling and kneeling," and the "total" percentage scores of gross motor function measure-88. The beck depression inventory scores were negatively correlated to "sphincter control," "communication," "social cognition," "cognitive subtotal," and "total" functional independence measure scores. Conclusion: It is necessary to consider the quality of life and emotional problems of caregivers of CP children and support them both physically and psychologically with comprehensive rehabilitation.
Objectives : The purpose of this study was to describe and compare the temporo-spatial gait characteristics of healthy young people with those of healthy elderly people. Methods: The data were collected by 40 volunteers. 20 subjects were between 20 and 31 years of age, and 20 subjects were between 65 and 84 years of age. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : The system integrates specific components of locomotion to provide a single, numerical representation of gait, the Functional Ambulation Performance score. Differences in gait characteristics between the two groups were examined using a correlated t-test(p<.05). Significant differences were observed between the groups for step length, step/extremity ratio and velocity. Young people demonstrated a significantly larger velocity, step length and step/extremity ratio than the elderly people. Conclusions: These results indicate that the GAITRite system can be useful in detecting footfall patterns and selected time and distance measurements of young and older persons. Additionaly, differences in walking velocity, step length and step/extremity ratio between old and young people may have influenced the gait characteristics measured.
Many techniques have been developed for reconstruction of the hand; however, less attention has been paid to foot reconstruction techniques. In particular, reconstruction of the forefoot and big toe has been considered a minor procedure despite the importance of these body parts for standing and walking. Most of the weight load on the foot is concentrated on the forefoot and big toe, whereas the other toes have a minor role in weight bearing. Moreover, the forefoot and big toe are important for maintaining balance and supporting the body when changing directions. Recently, attention has been focused on the aesthetic appearance and functional aspects of the body, which are important considerations in the field of reconstructive surgery. In patients for whom flap reconstruction in the forefoot and big toe is planned, clinicians should pay close attention to flap survival as well as functional and cosmetic outcomes of surgery. In particular, it is important to assess the ability of the flap to withstand functional weight bearing and maintain sufficient durability under shearing force. Recovery of protective sensation in the forefoot area can reduce the risk of flap loss and promote rapid rehabilitation and functional recovery. Here, we report our experience with two cases of successful reconstruction of the forefoot and big toe with a sensate anterolateral thigh flap, with a review of the relevant literature.
Objectives: We report on a patient who showed mild bradykinesia due to injury of the corticofugal tract (CFT) from the secondary motor area following direct head trauma, which was demonstrated on diffusion tensor tractography (DTT). Case summary: A 58-year-old male patient underwent conservative management for subarachnoid hemorrhages caused by direct head trauma resulting from a fall from six-meter height at the department of neurosurgery of a local hospital. His Glasgow Coma Scale score was 3. He developed mildly slow movements following the head trauma and visited the rehabilitation department of a university hospital at ten weeks after the fall. The patient exhibited mild bradykinesia during walking and arm movements with mild weakness in all four extremities (G/G-). Results: On ten-week DTT, narrowing of the right CFT from the supplementary motor area (SMA-CFT), and partial tearing of the left SMA-CFT, left CFTs from the dorsal premotor cortex (dPMC-CFT) and both corticospinal tracts (CSTs) at the subcortical white matter were observed. Conclusion: This case demonstrated abnormalities in both CSTs (partial tearing at the subcortical white matter and narrowing), both SMA-CFTs (narrowing and partial tearing) and left dPMC-CFT. We believe our findings suggest the necessity of assessment of the CFTs from the secondary motor area for patients with unexplained bradykinesia following direct head trauma.
Journal of the Korea Academia-Industrial cooperation Society
/
v.18
no.10
/
pp.480-489
/
2017
Blood flow restriction(BFR) exercise is defined as low intensity and short term exercise using pneumatic pressure belts at the top of limbs, which affects the physiological functions of the body. The purpose of this study was to investigate the effects of walking exercise with BFR on inflammatory index, isokinetic muscle function, and thigh circumference in obese women. Eleven obese women(> BMI $25kg/m^2$ & > body fat 30%) wore pneumatic pressure belts on both femurs and performed walking exercise twice per day, 3 days/wk for 4 weeks (walking 2 min; resting 1 min). Data analysis was carried out using paired t-test. Body weight, BMI, and body fat significantly decreased after exercise(p<.05), and right thigh circumference significantly decreased(p<.05). The concentration of plasma IL-6 significantly increased(p<.05) after exercise. TNF-${\alpha}$ level was not statistically different but tended to slightly increase. CRP slightly decreased, although it did not reach statistical significance after exercise. Muscle strength significantly increased in the $60^{\circ}/sec$ of right/left side extension, left side flexion, and $180^{\circ}/sec$ of left side extension after training(p<.05). These results suggest that 4 weeks of blood flow restriction walking exercise has positive effects on inflammatory index and isokinetic muscle function. Therefore, we consider that blood flow restriction exercise can be used for treatment of obesity, related chronic diseases, and metabolic syndrome. Further, blood flow restriction exercise for a short time has similar effects as a high intensity resistance program.
Journal of rehabilitation welfare engineering & assistive technology
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v.9
no.1
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pp.45-51
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2015
This study was to verify effect on muscle strength of trunk and body composition for elderly according to spinal stability exercise with three dimension. We recruited forty elderly participants(twenties as training group, the other twenties as control group) over sixty five aged. The participant performed muscle strength estimation to exercise of eight direction using spinal stability training system. Also, we estimated body composition in participants using inbody 720. Trining group performed direction exercise(F, FOR, R, BOR, B, BOL, L, FOL) and multiple exercise with band exercise, strengthening gym and walking during thirty minute. But control group only performed multiple exercise without direction exercise. All training progressed three days a week for eight weeks. The results showed that muscle strength of trunk in training group increased significantly from 79.9 point to 85.6 point with reducement of body weight, body fat and BMI. However, control group showed a few exercise effect with increasement of amount of muscles and reducement of body fat without muscle strength of trunk. These results means that spinal stability exercise could be helped to prevent obey and fall of elderly caused by muscle strengthening and improving body composition. This could be applied to develop rehabilitation program efficiently based these data.
Functional recovery of cerebrovascular accident (CVA) patients were studied by examining functional independence measure (FIM) to evaluate the functional state of the patients at admission to and at discharge from the hospital and its relationship with the family support. Study subjects consisted of 129 CVA patients, who were admitted and received rehabilitation treatment at K Medical Center of Oriental Medicine from August 3 to December 18, 1997. The results were as follows: 1) Total FIM score was $72.37{\pm}25.16$ at admission and $101.67{\pm}22.13$ at discharge. The difference of average score was 29.30, which was statistically significant by paired t-test. 2) The largest difference between FIM scores at admission and at clischarge was observed in items of walking and wheel-chair riding, and the smallest clifference in items of social interaction. 3) The recovery was faster with motor function than with cognitive function, because the difference of FIM scores at admission and at discharge was much larger with motor function. 4) Recovery was better in groups under age 49 than in groups above age 70. Functional recorvery was prominent especially in groups with normal sensory state and speech functions, and groups without urinary incontinence. Recovery was less significantly in patients with paraplegic patients hospitalized longer than 2 months, patients with family all the time, and patients with CVA over 11 days. 5) We could not find any relationship between functional recovery and family support. FIM scores were lower in groups of old age(r=-0.325), long stayed in hospital (r=-0.426), and long period of time after the onset of disease(r= -0.339) with a reciprocal correlation between FIM scores and these parameters. 6) Stepwise multiple regression analysis was done to evaluate factors to affect the recovery from CVA. FIM score at admission could explain 51.2 % of the functional recovery. Important factors were periods of hospitalization, state of sensory function, age, and education (listed in decreasing order of importance). In total, they could explain 64.89% of the functional recovery. These results indicate that functional recovery of CVA patients, who were admitted to oriental medicine hospital for rehabilitation treatment, could be estimated by measuring FIM scores. Recovery was significantly better at discharge from the hospital than at admission and motor function recovery rate was much faster than that of cognitive function. 2. Recommendation Based on these results, we recommend following further studies. 1) Comparative study of recovery of motor function and of sensory function would be necessary by measuring FIM scores once a week to evaluate the recovery of CVA patients. 2) It would be interesting to see whether there is any difference of functional recovery between patients treated with either western medicine or oriental medicine. 3) Psychological factors affecting the recovery of CVA patients need to be studied.
Gait is an evaluation index used in various clinical area including brain nervous system diseases. Signal source localizing and time-frequency analysis are mainly used after extracting independent components for Electroencephalogram data as a method of measuring and analyzing brain activation related to gait. Existing treadmill-based walking EEG analysis performs signal preprocessing, independent component analysis(ICA), and source localizing by merging data after the multiple EEG measurements, and extracts representative component clusters through inter-subject clustering. In this study we propose an analysis method, without merging to single dataset, that performs signal preprocessing, ICA, and source localization on each measurements, and inter-subject clustering is conducted for ICs extracted from all subjects. The effect of data merging on the IC clustering and time-frequency analysis was investigated for the proposed method and two conventional methods. As a result, it was confirmed that a more subdivided gait-related brain signal component was derived from the proposed "non-merging" method (4 clusters) despite the small number of subjects, than conventional method (2 clusters).
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