Earticle

This study aimed to examine the effects of sling exercise program involving coordination and functional training on cognitive function and physical performance in two patients with Parkinson’s disease dementia. The reversal design (A-B-A') of single-subject experimental design was used. In the intervention phase, sling exercise involving coordination and functional training were performed for 70 min/day daily for 24 days. Outcomes included the timed up and go test and sit-to-stand test that were measured immediately after the intervention, and the Mini-mental state examination, Berg balance scale, and 10-m walk test, 6-min walk test, modified Barthel index, and geriatric depression scale that were assessed before and after the intervention. The cognition, balance and walking abilities, activities of daily living and depression were remarkably increased after the intervention. These results demonstrate that the sling exercise program involving coordination and functional training may be helpful to improve cognition, physical performance, and depression of individuals with Parkinson’s disease dementia.

The purpose of this study was to determine the effects of trunk muscle strengthening training on siting balance and electromyography (EMG) activities oof selected trunk muscles in patients with traumatic thoracic spinal cord injuries. Eighteen subjects volunteered to participate in this study, and they were randomly allocated into either experimental group (EG) or control group (CG), 9 in each. Outcome measures comprised the modified functional reach test (mFRT) distance (mm), the modified motor assessment scale (mMAS), and modified sitting balance score (mSBS). And EMG activities also were measured for pectoralis major, upper trapezius, latissimus dorsi, thoracic and lumbar erector spinae, and external oblique. Trunk muscle strengthening training was peformed average 30-min per day, 5 times a week for 6 weeks (a total of 30 sessions). Measurements were performed before and after the intervention. In between-group comparison, changes between pre- and post-test revealed significant differences in mFRT score (p<.05), and EMG data on upper trapezius, latissimus dorsi, lumbar erector spinae, and external oblique of the right (p<.05). In within-group comparison, the EG appeared to be significantly different in mFRT와 mMAS scores (p<.05), while the CG showed a significant difference in mFRT score (p<.05). Futhermore, for EMG data of each muscle, there was significantly different in lumbar erector spinae of the right (p<.05). These findings suggest that trunk muscle strengthening training may be advantageous to enhance sitting balance and the activities of trunk muscles in patients with traumatic thoracic spinal cord injuries. Further studies need to warrant these findings.

This study aimed to determine the effects of trunk strengthening and stabilization exercise using proprioceptive neuromuscular facilitation (PNF) on the balance and walking ability in patients with basal ganglia stroke. Five patients with basal ganglia stroke volunteered for this study. PNF trunk strengthening and stabilization exercise was performed for average 30 minutes per day, five times a week for four weeks (a total of 20 sessions). Outcome measures included one-leg standing test (OLST), Berg balance scale (BBS), and tandem walking test (TWT) for balance function, and 10 meters walk test (10WMT) for walking function. Significant improvements were found for the OLST, BBS, TWT, and 10WMT scores after the intervention (p<.05). These results suggest that trunk strengthening and stabilization exercise using the PNF may be favorably used for patients with basal ganglia stroke.

This study aimed to identify alterations in the pennation angle of the gastrocnemius, active ankle dorsiflexion range-of-motion and pressure pain threshold in response to passive stretching(PS), instrument assisted soft tissue mobilization (IASTM) using Graston, and muscle energy technique (MET). Twenty-four people with no orthopedic or neurological diseases volunteered to participate in the study. Their both legs were allocated either the PS, IASTM, or MET groups, 16 in each. Outcome measure included the pennation angle of the gastrocnemius, active ankle dorsiflexion range-of-motion and pressure pain threshold. Intervention was a 4 repetitions of 30-sec stretch for the PS group, a 2-min sweeping the soft tissue for the IASTM, and a 8 repetitions of isometric contraction and 7-sec relaxation for the MET group. As a result of this study, pre- and post-treatment changes in the pennation angle and range-of-motion were significantly different for the three groups(p<.01). Pre- and post-treatment changes in the pressure pain threshold were significantly different for the IASTM and MET groups(p<.05). But not different for the PS groups(p>.05). There were found statistically significant differences in the active ankle dorsiflexion ROM between the PS group and the others.(p<.05). This study suggests that IASTM and MET are more recommended than PS to increase the active ankle dorsiflexion ROM effectively.

Sit-to-walk (STW) movement is a complex task characterized by starting one step before reaching a full standing posture and maintaining the body moment forward until the end of the movement. The purpose of this study was to provide an efficient interventional perspective in close proximity to daily life for improving the function of patients with chronic stroke by providing information on the positive effects of sit-to-walk training. Two patients with chronic stroke volunteered for this study. The STW training fior Subject 1 and the sit-to-stand training for Subject 2 were performed an average 30 minutes per day, 3 times a week for 4 weeks (a total of 12 sessions). Measurements included electromyographic analysis (muscle activity and onset time) on vastus medialis, bicepps femoris, tibialis anterior, and soleus, and timed up and go (TUG) test. With respect to anticipatory postural adjustments before and after training, the tibialis anterior muscle onset time of Subject 1 and 2 decreased from 1.09 to .63 seconds and from 2.46 to 1.25 seconds, respectively. In relation to multi-task performance, the TUG test with a motor task decreased by 5.90 seconds for Subject 1 and 12.03 seconds for Subject, respectively. These findings suggest that the STW training might be considered as a part of functional movement re-education close to everyday life in rehabilitation programs of stroke patients and as higher difficulty training.

The purpose of this study was to find correlations among the Queen’s college step test, modified Queen’s college step test, graded exercise test to predict 85% VO2max. Sixteen University students volunteered for this study. All participants were assessed by three tests. The data were analyzed using one way repeated analysis of variance, and Pearson product moment correlation. The results revealed that estimated VO2max values were significantly different among the three assessments (p<.05). In post-hoc test, the Queen’s college step test value was higher than other two tests. However, there was no significant difference between modified Queen’s college step test and graded exercise test (p>.05). In addition, graded exercise test had a significant correlation with the modified Queen’s college step test (p<.05). Therefore, modified Queen’s college step test may be considered as an appropriate assessment tool to predict submaximal oxygen consumption of normal adults.

The purpose of this study was to identify the effects of a problem-based balance exercise program on functional performance in ataxic cerebral palsy. A subject was 15 years old male with cerebellar ataxic cerebral palsy caused by brain tumor. To assess changes in function, gross Motor function measure (GMFM), timed up and go test (TUG), Korean version of the scale for the assessment and rating of ataxia (K-SARA), dynamic gait index (DGI). His own problems were identified from th use of Pediatric Balance Scale. A problem- based balance exercise program consisted of four tasks: (1) standing with feet together, (2) standing with one foot in front, (3) retrieving object from floor, and (4) placing alternate foot on stool. A subject performed this exercise program for average 30-min per day, three days weekly for four weeks (a total of 12 sessions). Values of the GMFM. TUG, K-SARA, and DGI appeared to be noticeably improved after the intervention. These findings indicate that problem-based balance exercise program might be helpful to improve balance function of children with cerebellar ataxia. The problem-based balance exercise 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.

The purpose of this study is to examine the types and methods of virtual reality (VR) rehabilitation and their clinical effects, and to introduce recently developed VR rehabilitation methods. VR rehabilitation is largely divided into desktop type VR, third person type VR, and immersive type VR, and various companies have already introduced several such products. In addition, a VR rehabilitation method that surrounds the anterior, left, and right sides of a patient on three or all four sides have recently been introduced that has the advantage of providing a variety of sensory stimuli in an environment similar to real life. These devices vary in price, size, and sense of immersion. To date, VR rehabilitation has mainly been applied to adults with brain damage, including stroke, as well as to individuals with cerebral palsy, dementia, or mild cognitive impairment. VR rehabilitation positively contributes to improvements in their physical function, cognitive function, mental function, and daily living activities for two reasons. First, virtual reality-based rehabilitation provides continuous multisensory stimulation to the brain’s cognitive and motor areas through dynamic interaction with an environment similar to real life. This can positively contribute to the improvement of cognitive, physical, and mental functions through a direct effect on brain restructuring or plasticity. In addition, VR rehabilitation can induce active participation in rehabilitation by evoking fun and interest in patients, using a variety of contents. Thus, active rehabilitation can not only increase the time spent participating in rehabilitation but also improve compliance, which can aid in successful rehabilitation.