Earticle

This study aimed to identify the effects of a progressive lower limb resistance training on the balance and gait function in patients with subacute stroke. Thirteen patients with post-stroke hemiparesis volunteered to participate in this study. All subjects underwent a progressive lower limb resistance training for averaging 20 minutes daily for 4 weeks (a total of 20 sessions). Assessment tools were made with the Berg balance scale (BBS) and 10 meter walking test (10MWT) before and after the 4-week training period. The BBS and 10MWT showed significant improvement after the progressive lower limb resistance training (p<.05). This study demonstrates that the progressive lower limb resistance training may be favorable to enhance balance and gait function of patients with subacute stroke. This study provides valuable information for future studies in this field. Further studies with larger sample size and longer experimental span are required to strengthen the results of this study.

The purpose of this study was to examine the effects of treadmill walking speed and elastic chest band (ECB) on respiratory function in healthy young women with limited chest mobility. Twenty women with limited chest mobility were volunteered for this study. The speed of treadmill walking was determined as 3.0 km/hr and 5.5 km/hr. The ECB was set at the level between 8 and 12 ribs. A 10-min treadmill walking at each walking speed was performed with the ECB. Respiratory function was evaluated by forced vital capacity(FVC), forced expiratory volume in one second (FEV1), forced expiratory volume in one second/forced vital capacity (FEV1/FVC), peak expiratory flow(PEF), expiratory reserve volume, vital capacity, inspiratory reserve volume(IRV), Maximum voluntary ventilation(MVV). Measurements were carried out the baseline and after a 3.0 km/hr and 5.5 km/hr of treadmill walking speed. With the ECB, there was statistically significantly different for the FEV1/FVC in the treadmill walking speed of 3.0 km/hr and the PEF in the 5.5 km/hr when comparing those of the baseline (p<.05). In addition, in the treadmill walking speed of 5.5 km/hr, significant differences were found for FVC and MVV between the baseline and no ECB (p<.05). All parameters were significantly different between the baseline and treadmill walking speed of 5.5 km/hr, except values of FEV1/FVC and IRV (p<.05). These findings suggest that treadmill walking speed of 5.5 km/hr is probably more favorable to improve pulmonary function of females with limited chest mobility than the 3.0 km/hr, with incorporating of the ECB. Further studies need to evidence the generality of our results.

This study aimed to identify alterations in the thickness of the hamstring and the muscle tone in response to soft tissue mobilization (STM), passive stretching (PS), and muscle energy technique (MET). Forty-five male subjects with no orthopedic or neurological diseases volunteered to participate in the study, which were allocated either the SEM, PS, or MET groups, 10 in each. Outcome measure included the thickness and muscle tone of the hamstring. Intervention was an isometric contraction and 10-sec stretching for the STM group, a 10 repetitions of 10-sec stretch for the PS group, and an isometric contraction and relaxation for the MET group. Pre- and post-treatment changes in the thickness and muscle tone of hamstring were significantly different for the three groups (p<.05). However, there were not found statistically significant differences in the thickness and muscle tone of hamstring between the groups (p>.05). This study suggests that all tree methods may be helpful to increase the condition of hamstring. Further studies with robust design will be needed for the generality of our results.

The purpose of this study was to investigate the effect of the occusal biteplane splint on the static balance ability of normal subjects. Sixteen adult males who had no orthopedic- surgical lesions in the jaw joints were enrolled. Subjects wore an occlusal bite-plane splint, and the static balance ability was measured with an occlusal bite-plane splint. The static balance, representing weight distribution of right-to-left ratio, appeared to be significantly decreased in eye open and closed status (p<.05) when wore the occlusal splint. This findings suggest that an occlusal bite-plane splint is probably favorably used to promote balance ability. We can recommend an occlusal bite-plane splint as a clinical method to improve the balance ability by adjusting the position of the lower jaw. Futher studies is needed.

If the hip joint continues to internal rotation, the knee joint may occur genu valgus deformity and the foot arches may collapse to flat, as resulting decrease functional activity like gait. The purpose of this study was investigated to the effect of a newly designed hip joint angle adjuster orthosis to correct the abnormal internal rotational of the hip joint and the abnormal alignment of the lower limb. Twenty five patients who had internal rotation angle of the hip joint greater than the normal angle of hip joint were applied to this research. Gait factors were used by the GaitRite device and the alignment of the lower limb were measured using a ABW-mapper device before and after intervetion, respectively. The statistical analysis was performed by a paired t-test. As a result, the gait velocity (28.70±19.90 m/sec)(p=.000) and cadence (7.45±12.71 m/sec)(p=.017) were significantly improved than before the intervention in the gait factors. The maximum rotation angle of the femur (20.08±5.54)(p=.000) has significantly improved than before the intervention in the lower limb alignment. This research suggest that newly designed hip joint angle adjuster orthosis may be effective gait velocity and the cadence in gait, and rotation angle of the femur on the lower limb symmetry.

The term “Automatic stability” refers to the unconscious and automatic postural responses that occur while a person consciously maintains a posture or moves. It has been reported that when a simple cognitive task is assigned, full attention is given and efficacy and automaticity of postural control, a primary task, are improved. This study aimed to examine the effects of cognitive balance task training using stroke patients. Cognitive balance task training was given to subjects, and was focused on their less affected side lower extremity in order to enhance automatic postural control of their affected side lower extremity. Two subjects were 52-year old male with stroke due to ICH and 43-year old male with stroke due to TBI, respectively. Outcome measures were a timed up and go (TUG) test; the Berg balance scale (BBS) to evaluate the subjects’ balance ability. Also, the GAITRite system was used to measure gait parameters. A cognitive balance training focused on unconscious control movement was performed for 30 minutes at a time, three times per week, for four weeks. The findings suggest that all variables improved after the intervention. Overall, a cognitive balance training is probably beneficially used to enhance stroke patients’ automatic postural control, and may be utilized to ameliorate their balance and gait ability in clinical settings.

The purpose of this study was to investigate the effects of GMFM-based walking task training on balance function in ataxic cerebral palsy. A subject was 5-year old male with cerebellar ataxic cerebral palsy due to brain tumor. Outcome measures included a limit of stability (LOS) and pediatric balance scale (PBS). Walking task training consists of four walking tasks (going ten steps and return, walking with carrying object, walking between parallel lines, and kicking a ball), which was performed averaging 30-min a day, four days weekly for two weeks (a total of 8 sessions). Values of the LOS (1263 mm2 to 2549 mm2) and PBS (33 points to 38 points) appeared to be improved after the intervention. These findings indicate that the GMFM-based walking task training is helpful to improve balance function of children with cerebellar ataxia. The walking task training based on performance was clinically feasible to facilitate a recovery of the balance and motor function of cerebellar ataxia children with cerebral palsy. Further studies need in this field.

Stroke leads to functional impairments related to proprioception deficits, which produce compensatory pattern to assure an independence in daily activities. Proprioception is one of essential elements to provide feedback and feedforward control, achieving appropriate motor control and learning. It’s fundamental for functional recovery after stroke. Proprioception is defined as a sense of position, motion, or force. It arises from sensory receptors (mechanoreceptors of muscle and joint) which locate in deep region of the body, or sensory receptors which locate in superficial region of the body. However, proprioception and tactile sense must be recognized to be different each other. Proprioceptors detect the change of proprioceptive information during posture and movement. Afferent information from proprioceptors plays an important role to build optimal motor control strategy for various activities in daily life, which needs integrative control in higher centers. This is completed by an integral mechanism interacting with a variety of environmental factors. Therefore, proprioception deficits after stroke result in serious functional problems. Although proprioceptive function has been essentially considered for functional recovery in clinical setting, there are many conflicts in evaluating the extent of its impairment. To test precisely proprioceptive function, it’s so important to understand that it requires working memory and interhemispheric connection to optimize proprioceptive integration in peripheral and central systems. Unfortunately, in stroke, neural control and its process frequently is difficult to be harmonized to achieve proper goal in motor control. In fact, such problems also contribute to the lack of beneficial treatment protocol in clinical setting. Therefore, clinicians should make an effort to develop objective, accurate, and reliable tools to measure proprioceptive function of patients with stroke. In addition, it needs to establish optimal treatment methods based on evaluation results. Accordingly, this study aimed to provide valuable information about peripheral and central mechanisms of proprioception, influences of proprioception deficits in stroke, and theeir evaluation and treatment using literature review.