Earticle

This study aimed to identify the effect of a balance training using mirror on the balance and activities of daily living (ADL) in patients with acute stroke. twelve subjects with post-stroke hemiparesis volunteered to participate in this study. All subjects underwent the balance training for averaging 20 minutes daily for 4 weeks (total of 20 sesions). Assessment tools were made with Berg balance scale (BBS) and modified Barthel index (MBI) before and after the 4-week training period. BBS and MBI showed significant improvement after balance training using mirror (p<0.05). This study demonstrates that a balance training using mirror may be favorable for enhancing balance and ADL of patients with acute stroke. This study provides valuable information for future studies in this field. Further studies with wider range of subjects and longer experiment span are required to strengthen the results of this study.

The purpose of this study was to investigate the electromyographic (EMG) activity of vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) during open kinetic chain exercise (OKC) and close kinetic chain (CKC) exercise at various angle of the knee joint. 11 normal subjects (6 men, 5 women) participated. Root mean square (RMS) of the vastus medialis (VM), vastus lateralis (VL), and rectus femoris (RF) was measured by the surface EMG during CKC and OKC exercise at 0°, 45°, and 90° of knee joint. In isotonic contraction of knee extension, RMS of the VL was more increased than the VM and RF during CKC and OKC exercise. In isometric contraction during OKC, RMS of RF was more increase than the VL and VL at 0°and 45°. RMS of the VL was more increased than the RF and VM at 90°. In isometric contraction during CKC, RMS of the VM was more increase than the VL and RF at 0°, 45°, and 90° of knee joint. These findings suggest that isometric contraction of knee using CKC may be more favorable to increase activity of the VM.

This study evaluated the effects of upper trapezius pain (UTP) and head positions on scapuar upwrad rotators’ activities during shoulder abduction on the scapular plane. The study participants included 10 subjects with and without UTP respectively. In forward and neutral head positions, the muscle activity of the upper trapezius (UT), low trapezius (LT), and serratus anterior (SA) was measured during shoulder elevation on the scapular plane. The EMG signals was normalized through maximal voluntary isometric contraction. The muscles’ activities between the two positions was compared using a paired t-test. The UT and SA activities were significantly greater in the group with UTP than the group without UTP (p<0.05). In addition, the UT and SA activities were significantly different between forward and neutral head positions (p<0.05). However, no significant difference in LT activity between with and without UTP, and between the postures was found (p>0.05). These results indicate that the UTP and head position may have may influence on the activities of the UT and SA during should elevation on scapular plane.

In stroke rehabilitation, the coordinative control of various joints is imperative to maintain functional activities in everyday activities, particularly walking and balance. However, it is probably to find appropriate protocol for its recovery. Purpose of this study was to describe a specific lower limb control training program for enhancing walking and balance, with an emphasis on the facilitation of proprioceptive inputs in affected lower limb and control of lower limb movements in walking. The training consisted of trunk, elongation, stimulation of lower limb's proprioception, bridging exercise, standing, weight shifting, toe-off practice using a roller, and control of affected knee. The intervention was performed for 1-hr, twice per week for 4 weeks (total of 8 sessions). Assessment tools were made with a 10-m walk test (10MWT), timed-up-and-go test (TUG), and Berg balance test (BBS). Assessments were completed at pre- and post-test. Results appeared to be improved for the 10MWT, TUG, and BBS after the intervention. These findings indicate that a structured lower limb control program may be favorable to recover walking and balance function of patients with post-stroke hemiparesis.

The purpose of the study was to identify the effects of closed chain exercise on strength of the vastus medialis obliquus (VMO) muscle and functional activities in patients with total knee replacement. 19 patients was divided by the experimental group (n=9) and control group (n=10). Experimental group was received closed chain exercise including terminal knee extension and lateral set up. Control group was received electrotherpy and continuous passive motion (CPM) for 30 min/day, 4-weeks. strength of VMO was measured by isometic contraction at knee flexion of 30° using isokinetic dynomometer. Korean-Western Ontario and McMaster University Osteoarthritis Index (K-WOMAC) was measured, There was significant difference in strength of VMO and K-WOMAC (p<.05). Comparing with control group, experimental group was more improved. Therefore, after surgery, Closed chain based strength training as early rehabilitation intervention seems to be needed for early return to the patients with total knee replacement.

Aging, in general, leads to changes in skeletal, collagenous, and cardiovascular tissues, body composition, nervous and immune systems, as well as the hormonal axis. As a result, most elderly people have remarkably impaired aerobic capacity/endurance, joint mobility, muscle performance, balance as well as abnormal position and gait patterns, cognitive disorders and depression. Based on age-related changes in the elderly, clinicians use measurements of the following: aerobic capacity/endurance (the 6-min walk test), position (range of motion and thoracic kyphosis index), strength (the grip strength test), gait (the 10-m walk test and dynamic gait index), balance (the Berg balance scale, timed ‘up and go’ test, and functional reach test), cognition and depression (the mini-mental state exam, activities-specific balance confidence scale, geriatric depression scale), and functional activity (the functional independence measure, Katz index of independence in activities of daily living, and modified Barthel index), as standard clinical assessment tools to establish appropriate therapeutic exercise programs for successful rehabilitation. This review describes several clinical assessment tools and elucidates implementation guidelines for the assessment of functional mobility among the elderly in clinical settings. Moreover, this review provides valuable information for clinicians and researchers for exploring the systematic evaluation strategies and optimal therapeutic programs to enhance functional mobility in the elderly.

Following stroke, long-lasting symptoms require specific procedures to improve functional level in everyday life, with aiming of assuring independent daily activities. Based on this principle, the recovery of ambulatory capacity is one of the most important objectives in stroke rehabilitation. Recently, a progress in scientific knowledge highlights neuromechanical approaches and applied technologies (robot-assisted walking system and functional electrical stimulation) to support functional recovery of patients with post-stroke hemiparesis. Although various therapeutic techniques for stroke rehabilitation have successfully used in clinical setting, such techniques are kinds of different and contradict each other in many way. Given that their effects have been reported to be similar, major principles in stroke rehabilitation approaches often cannot be obviously illustrated for clinical use. Recent knowledge has introduced two ways to improve functional disability of stroke patients: Bottom-up and top-down. In general, conventional approaches, including Bobath and proprioceptive neuromuscular facilitation, may be characterized by the bottom-up approach, while top-down approach can be described by the use of task-oriented training focusing on functional training based on principles of motor learning. In stroke rehabilitation, recent consensus highlights functional aspects of the patients and reintegration to premorbid life, and then top-down approach focusing on the effects of functional training supports current prospective to manage their own symptoms and functional disability. However, the effects of musculoskeletal disparity after stroke have not been in full consideration, even though joint malalignment and muscle imbalance is one of major contributing factors to impede normal movement patterns. Such fact indicates that a combination of top-down approaches and musculoskeletal techniques to facilitate normal movement is better alternative to support functional improvement in stroke rehabilitation. Therefore, introduction of novel concepts needs to establish appropriate clinical reasoning and decision-making strategies for stroke rehabilitation in future. This study aimed to demonstrate comprehensive knowledge related to neurophysiological mechanism and therapeutic approaches to improve walking function of patients with post-stroke hemiparesis.