Systematic Review and Meta-Analysis of the Y-Balance Test Lower Quarter: Reliability,Discriminant Validity,and Predictive Validity

BackgroundDeficits in dynamic neuromuscular control have been associated with post-injury sequelae and increased injury risk. The Y-Balance Test Lower Quarter (YBT-LQ) has emerged as a tool to identify these deficits.PurposeTo review the reliability of the YBT-LQ, determine if performance on the YBT-LQ varies among populations (i.e., sex, sport/activity, and competition level), and to determine the injury risk identification validity of the YBT-LQ based on asymmetry, individual reach direction performance, or composite score.Study DesignSystematic ReviewMethodsA comprehensive search was performed of 10 online databases from inception to October 30, 2019. Only studies that tested dynamic single leg balance using the YBT-LQ were included. Studies were excluded if the Y-Balance Test kit was not utilized during testing or if there was a major deviation from the Y-Balance test procedure. For methodological quality assessment, the modified Downs and Black scale and the Newcastle-Ottawa Scale were used.ResultsFifty-seven studies (four in multiple categories) were included with nine studies assessing reliability, 36 assessing population differences, and 16 assessing injury prediction were included. Intra-rater reliability ranged from 0.85-0.91. Sex differences were observed in the posteromedial direction (males: 109.6 [95%CI 107.4-111.8]; females: 102.3 [95%CI 97.2-107.4; p = 0.01]) and posterolateral direction (males: 107.0 [95%CI 105.0-109.1]; females: 102.0 [95%CI 97.8-106.2]). However, no difference was observed between sexes in the anterior reach direction (males: 71.9 [95%CI 69.5-74.5]; females: 70.8 [95%CI 65.7-75.9]; p=0.708). Differences in composite score were noted between soccer (97.6; 95%CI 95.9-99.3) and basketball (92.8; 95%CI 90.4-95.3; p <0.01), and baseball (97.4; 95%CI 94.6-100.2) and basketball (92.8; 95%CI 90.4-95.3; p=0.02). Given the heterogeneity of injury prediction studies, a meta-analysis of these data was not possible. Three of the 13 studies reported a relationship between anterior reach asymmetry reach and injury risk, three of 10 studies for posteromedial and posterolateral reach asymmetry, and one of 13 studies reported relationship with composite reach asymmetry.ConclusionsThere was moderate to high quality evidence demonstrating that the YBT-LQ is a reliable dynamic neuromuscular control test. Significant differences in sex and sport were observed. If general cut points (i.e., not population specific) are used, the YBT-LQ may not be predictive of injury. Clinical population specific requirements (e.g., age, sex, sport/activity) should be considered when interpreting YBT-LQ performance, particularly when used to identify risk factors for injury.Level of Evidence1b     

Lower Extremity Kinematics of the Y-Balance Test in Healthy and ACL Injured Adolescent Females

BackgroundAdolescent females are at significant risk for sustaining an ACL injury. The Y-Balance Test (YBT) is frequently used to evaluate neuromuscular control and lower extremity function. However, few studies have quantified 2D lower extremity kinematics during performance of the YBT, and there is an absence of kinematic data specific to at-risk adolescent females.PurposeTo examine lower extremity joint kinematics during execution of the YBT by healthy and ACL-injured adolescent females.Study DesignProspective cohort.MethodsTwenty-five healthy and ten ACL-injured (mean time from injury 143 days) adolescent females were assessed using the YBT. Sagittal and frontal plane knee and ankle motion was video recorded during execution of the YBT anterior reach movement. Ankle dorsi-flexion, knee flexion, and knee valgus angles were quantified via kinematic analysis. ANOVAs with a post hoc Bonferroni correction were used to compare YBT scoring (%LL) and kinematic data between groups. Pearson product-moment correlations determined the relationship between kinematic data and YBT scoring.ResultsHealthy and ACL-injured subjects demonstrated similar YBT scores and lower extremity kinematic data. Healthy subjects demonstrated a weak positive correlation between ankle dorsiflexion and YBT scoring, and a weak negative correlation between knee valgus and YBT scoring. These relationships did not exist for ACL-injured subjects. Kinematic data for both groups also demonstrated a large degree of variability, regardless of YBT score.ConclusionsAdolescent females frequently utilize a variety of lower extremity movement strategies when performing a functional movement task, and scoring on the YBT offers limited insight regarding lower extremity joint kinematics and ACL-injury risk in a physically active adolescent female population.Level of EvidenceLevel 3.     

Kinematic and Kinetic Predictors of Y-Balance Test Performance

BackgroundThe Y-Balance Test (YBT) assesses dynamic stability and neuromuscular control of the lower extremity. Several authors have analyzed kinematic predictors of YBT performance with conflicting results, but the influence of kinetic factors is not well understood.PurposeTo examine kinematic predictors of YBT performance and determine the joint kinetics which predict YBT performance.Study DesignCross-sectional study.MethodsThirty-one physically active individuals performed YBT trials on a force plate while whole body kinematics were recorded using a motion capture system. Sagittal, frontal, and transverse plane joint kinematics and joint moments were calculated at maximum reach in each YBT reach direction. Variables correlated with reach distances at the p < 0.2 level were entered into a stepwise linear regression.ResultsIn the anterior direction, knee flexion and torso rotation (R²=0.458, p<0.001) and knee extensor and hip abductor moments (R²=0.461, p<0.001) were the best kinematic and kinetic predictors of reach distance. In the posterior medial direction, hip flexion, ankle dorsiflexion, and ankle rotation accounted for 45.8% of the variance in reach direction (p<0.001) while hip and knee extensor, and hip abductor moments explained 72.6% of the variance in reach distance (p<0.001). In the posterior lateral direction, hip flexion and pelvic rotation (R²=0.696, p<.001) and hip extensor moments (R²=0.433, p=0.001) were the best kinematic and kinetic predictors of reach distance.ConclusionThe ability to generate large hip and knee joint moments in the sagittal and frontal plane are critical for YBT performance.Level of Evidence3.     

The Effect of Hand Position Changes on Electromyographic Activity of Shoulder Stabilizers during Push-up Plus Exercise on Stable and Unstable Surfaces

[Purpose] The purpose of this study was to determine the effect of hand position changes on electromyographic activity of shoulder stabilizers during push-up plus exercise (PUPE) performed on both stable and unstable surfaces. [Subjects] This study was performed on a cohort of 20 normal adults divided into an unstable surface group (USG) (n=10) and a stable surface group (SSG) (n=10). [Methods] A sling device was used to provide an unstable surface, and a push-up bar was used to provide a stable surface. PUPEs were performed with hands in various positions: the neutral position (NP), the internal rotation position (IRP), or the external rotation position (ERP). Electromyography was used to determine and analyze the electromyographic activity of the upper trapezius muscle (UT), the lower trapezius muscle (LT), the serratus anterior muscle (SA), and the pectoralis major muscle (PM). [Results] Comparison of the results within the USG and SSG showed significant differences depending on the hand position used during the exercise. Comparison between the USG and SSG showed that the ERP hand posture resulted in significant differences in electromyographic activity of the SA in the USG. [Conclusion] The electromyographic activity of the SA indicated that performing PUPEs using the ERP on an unstable surface provided more effective intervention for shoulder stabilization than ERP on a stable surface.Key words: Push-up plus, Hand position, Unstable surface     

The Influence of an Unstable Surface on Trunk and Lower Extremity Muscle Activities during Variable Bridging Exercises

[Purpose] The aim of this study was to investigate the influence of an unstable surface on trunk and lower extremity muscle activities during various types of bridging exercises. [Subjects] Thirty healthy female adults voluntarily participated in this study. [Methods] All subjects were asked to perform 3 different bridging exercises (bridging exercise, single leg lift bridging exercise, single leg cross bridging exercise) with and without an unstable surface. The trunk and lower extremity muscle activities were measured by using surface electromyography during bridging exercise. [Results] During the bridging exercise (BE), single leg lift bridging exercise (LBE), and single leg cross bridging exercise (CBE), the muscle activities of the external oblique muscle (EO), erector spinae (ES), and biceps femoris (BF) were significantly higher on an unstable surface than on a stable surface. The muscle activities of the EO on both sides, contralateral BF, and ipsilateral ES were significantly higher during LBE than during BE and CBE. [Conclusion] Use of an unstable surface increases muscle activity of the trunk and lower extremities, and single leg lift bridging exercise increases the muscle activity of the EO on both sides, ipsilateral ES, and contralateral BF.Key words: Bridging exercise, Electromyography, Unstable surface     

The Effect of Respiratory Phase on Abdominal Muscle Activity During Stable and Unstable Sitting Positions in Individuals With and Without Chronic Low Back Pain

ObjectiveThe aim was to assess the abdominal muscle activities during inspiration and expiration at different sitting positions in individuals with and without chronic low back pain (CLBP).MethodsThis study was conducted on 36 participants (18 with CLBP and 18 healthy controls). Ultrasound imaging was used to assess thickness changes of the transverse abdominis, internal oblique, rectus abdominis, and external oblique muscles. Muscle thickness was measured during inspiration and expiration under 3 different stability levels: sitting on a chair, sitting on a gym ball, and sitting on a gym ball with lifting the left foot. The muscle thickness measured in these positions was normalized to the actual muscle thickness at rest in supine lying and presented as a percentage of thickness change.ResultsBoth groups displayed greater abdominal muscle activities as the stability of the surface decreased during both respiratory phases. However, compared with the healthy controls, the CLBP group showed smaller muscle thickness changes in all abdominal muscles, except the external oblique, in both respiration phases while sitting on a gym ball with lifting the left foot. The CLBP group displayed overactivity of the rectus abdominis muscle relative to the healthy controls while sitting on a chair in both respiratory phases.ConclusionThe findings of the study indicate that as the stability of the support surface decreases, individuals with CLBP had more difficulty activating all abdominal muscles in a similar manner compared to healthy controls in both respiratory phases, which might affect both respiration and postural stability.     

脑卒中患者坐位及站立位胫骨前肌和腓肠肌表面肌电图信号特征研究

目的分析脑卒中患者坐位及站立位胫骨前肌和腓肠肌表面肌电图(sEMG)信号特征。方法选取15例脑卒中患者和15例正常人作为实验组和对照组,令受试者连续做5次由坐到站,采用表面电极引导和记录两侧胫骨前肌和腓肠肌肌电信号并进行线性时、频分析。结果脑卒中患者坐位患侧与健侧、健侧与正常人对应健侧胫骨前肌的平均功率频率(MPF)和中位频率(MF)差异有显著性意义(P<0.05);脑卒中患者健侧与正常人对应健侧腓肠肌均方根差异有显著性意义(P<0.05);脑卒中患者站立位患侧与健侧、健侧与正常人对应健侧胫骨前肌均方根和积分肌电(iEMG)差异有非常显著性意义(P<0.01);脑卒中患者健侧与患侧、患侧与正常人对应患侧腓肠肌均方根和iEMG差异有显著性意义(P<0.05或P<0.01)。结论sEMG是一种简单、实用、可行的康复评定方法。     

Trunk Muscle Activity During Wheelchair Ramp Ascent and the Influence of a Geared Wheel on the Demands of Postural Control

Howarth SJ, Polgar JM, Dickerson CR, Callaghan JP. Trunk muscle activity during wheelchair ramp ascent and the influence of a geared wheel on the demands of postural control.

Objectives

To quantify levels of torso muscular demand during wheelchair ramp ascent and the ability of a geared wheel to influence trunk muscle activity.

Design

Repeated-measures design. Each participant completed manual wheelchair ramp ascents for each combination of 4 ramp grades (1:12, 1:10, 1:8, and 1:6) and 3 wheel conditions (in gear, out of gear, and a standard spoked wheel) in a block randomized order by wheel condition.

Setting

Biomechanics laboratory.

Participants

Healthy novice wheelchair users (N=13; 6 men) from a university student population.

Interventions

Not applicable.

Main Outcome Measures

Peak electromyographic activity, expressed as a percentage of maximal voluntary isometric contraction (MVIC) of the abdominals, latissimus dorsi, and erector spinae during ramp ascent. Temporal location of peak electromyographic activity (EMG) within a propulsive cycle and integrated electromyographic activity for a single propulsive cycle.

Results

Abdominal peak activity increased 13.9% MVIC while peak posterior trunk muscle activity increased 4.9% MVIC between the shallowest and steepest ramp grades (P<.05). The geared wheel prevented increased peak activity of the rectus abdominis and external oblique (P>.05). Only peak electromyographic timing of the erector spinae was influenced during the push phase by increasing ramp slope.

Conclusions

Increased trunk muscular demand as a result of increasing ramp slope is required to enhance stiffness of the spinal column and provide a stable base during manual propulsion. Manual wheelchair users with compromised activity capacity, compromised abdominal muscle strength, or both, may be able to navigate more difficult terrains while using a geared wheelchair wheel because of reduced demands from the abdominal musculature in the geared wheel condition.     

The Effect of Ground Tilt on the Lower Extremity Muscle Activity of Stroke Patients Performing Squat Exercises

[Purpose] The purpose of this study was to determine the effect of ground tilt on the lower extremity muscle activity of stroke patients performing squat exercises. [Subjects] Fifteen hemiparetic patients volunteered to participate in this study. [Methods] The subjects performed squat exercises at three different ground tilt angles: 15° plantar flexion, a neutral position, and 15° dorsiflexion. A surface electromyogram (sEMG) was used to record the electromyographic activities of the leg extensor muscle in the vastus lateralis (VL), vastus medialis (VM), gastrocnemius lateralis (GL), and gastrocnemius medialis (GM). The sEMG activity was analyzed using a one-way repeated measures ANOVA and a post hoc Bonferroni correction. [Results] The results of this study are summarized as follows. Significant differences were noted for the VL and the GL when the angle of the ankle joint was between the 15° plantar flexion and neutral positions during squat exercises involving the VL and when the angle of the ankle joint was between the neutral position and 15° dorsiflexion during squat exercises involving the VM. [Conclusion] In this study, sEMG showed that the VL and GL changed significantly during squat exercises according to the ground tilt angle of hemiparetic patients. Therefore, squat exercises with different ground tilt angles can be used to improve VL and GL strength.Key words: Electromyogram, Hemiplegic patient, Squat exercises     

Comparison of the Effects of Walking with and without Nordic Pole on Upper Extremity and Lower Extremity Muscle Activation

[Purpose] The aim of this study was to assess the effect of Nordic pole walking on the electromyographic activities of upper extremity and lower extremity muscles. [Subjects and Methods] The subjects were randomly divided into two groups as follows: without Nordic pole walking group (n=13) and with Nordic pole walking group (n=13). The EMG data were collected by measurement while the subjects walking on a treadmill for 30 minutes by measuring from one heel strike to the next. [Results] Both the average values and maximum values of the muscle activity of the upper extremity increased in both the group that used Nordic poles and the group that did not use Nordic poles, and the values showed statistically significant differences. There was an increase in the average value for muscle activity of the latissimus dorsi, but the difference was not statistically significant, although there was a statistically significant increase in its maximum value. The average and maximum values for muscle activity of the lower extremity did not show large differences in either group, and the values did not show any statistically significant differences. [Conclusion] The use of Nordic poles by increased muscle activity of the upper extremity compared with regular walking but did not affect the lower extremity.Key words: Nordic pole walking, Upper extremity muscle, Lower extremity muscle     

Reliability of the Physical Performance Test in People with Dementia

ABSTRACT

Purpose. Approximately 30% of older adults have dementia. Disease progression has been found to be the largest predictor of function, and dementia has been found to influence fall risk. In order to identify individuals with dementia who may benefit from interventions to increase function and decrease fall risk, assessment tools for these domains that are validated in this population are necessary. The 7-item Physical Performance Test (PPT) is a valid measure of balance and function in older adults; however, its reliability has not been established in those with dementia. The purpose of this study was to establish intra-tester, inter-tester, and test–retest reliability of the 7-item PPT in people with dementia. Methods. Thirty-three subjects with a diagnosis of dementia and a Mini-Mental State Examination (MMSE) score between 10 and 24 were tested with the PPT on two separate days with performance on the second day videotaped. One tester scored the videotaped performance on two separate occasions and intra-tester reliability was determined using an intraclass correlating coefficient (ICC) (3,1). Two testers independently scored the videotaped performances and inter-tester reliability was determined using an ICC (2,1). Scores from the first and second testing days were compared and test–retest reliability was determined using an ICC (3,1). Results. All subjects completed both testing sessions and reliability was established for intra-tester, inter-tester, and test–retest with ICCs of 0.99, 0.96, and 0.90, respectively. Conclusion. The 7-item PPT is reliable for use in people with mild to moderate dementia as defined by MMSE scores between 10 and 24.     

Reference Values and Psychometric Properties of the Lower Extremity Motor Coordination Test

Objectives

(1) To create predictive nomograms for the dominant and nondominant limbs on the Lower Extremity Motor Coordination Test (LEMOCOT) using reference values, and (2) to determine the inter- and intrarater reliability for the LEMOCOT; the best scoring method (first vs mean of the first 2 vs mean of the last 2 vs mean of 3 vs the highest of 3 trials); the best testing method (direct vs video observation); and the ability to detect real change (smallest real difference [SRD] and standard error of the measurement [SEM]).

Design

Normative and methodological study.

Setting

Metropolitan area.

Participants

Healthy individuals (N=320, 50% women) in 7 age groups: 20 to 29, 30 to 39, 40 to 49, 50 to 59, 60 to 69, 70 to 79, and ≥80 years. Each group had 50 participants, except for ≥80 years (n=20).

Interventions

Not applicable.

Main Outcome Measure

LEMOCOT.

Results

Age and sex explained 48% of the variance in the LEMOCOT scores for the dominant limb and 44% for the nondominant limb (125<F<148; P<.001). No significant differences were found regarding the different scoring methods (.12<F<1.02; .10<P<.92), and all of them demonstrated good reliability (intraclass correlation coefficients between .90 and .99; P<.001). There was agreement between scores from direct and video observation (limits of agreement −1.99 to 1.85; −1.55 to 1.62). Appropriate SEM (2.27–1.85) and SRD (6.27–5.11) values were found.

Conclusions

Reference values were determined for the LEMOCOT, and predictive nomograms were created based on age and sex. The LEMOCOT is reliable, needing only 1 trial (after familiarization) to generate reliable scores; can be scored from either direct or video observation; and has the ability to detect real change over time.     

Effect of Concussion on Reaction Time and Neurocognitive Factors: Implications for Subsequent Lower Extremity Injury

BackgroundRecent evidence has demonstrated that athletes are at greater risk for a lower extremity injury following a return-to-sport (RTS) after sport-related concussion (SRC). The reason for this is not completely clear, but it has been hypothesized that persistent deficits in neurocognitive factors may be a contributing factor.Hypothesis/PurposeThis study assessed simple reaction time, processing speed, attention, and concentration in a group of athletes, post-concussion upon clearance for RTS for potential deficits that may result in slower reaction time, processing speed, attention, and concentration. The researchers hypothesized that the concussion group would demonstrate worse scores on both assessments compared to a sex-, age-, and sport-matched cohort.Study DesignCase-controlled studyMethodsTwelve participants who had suffered a SRC and eight healthy individuals who were matched to the concussed group by age, sex, and sport were evaluated. Those with a concussion had been cleared for RTS by a licensed healthcare provider. Each participant underwent neurocognitive tests that included a simple reaction time test (SRT) and the King-Devick Test (K-D). Independent t-tests were performed to compare the groups with significance set a priori at p<0.05.ResultsThere was a significant difference (p =0.024) between groups for SRT with the concussed group demonstrating a better SRT than the control group. There were no significant differences (p =0.939) between the groups for the K-D.ConclusionWith no significant differences between groups in the K-D assessment and, surprisingly, the concussed group having a better SRT compared to the healthy group, our hypothesis was not supported.Clinical RelevanceThese specific measures, compounded with extensive post-concussion time lapse until RTS clearance, may have limited capacity in revealing potential persistent deficits in relevant neurocognitive characteristics.Level of EvidenceLevel of Evidence 3     

Comparison of Shoulder Muscle Electromyographic Activity During Standard Manual Wheelchair and Push-Rim Activated Power Assisted Wheelchair Propulsion in Persons With Complete Tetraplegia

Lighthall-Haubert L, Requejo PS, Mulroy SJ, Newsam CJ, Bontrager E, Gronley JK, Perry J. Comparison of shoulder muscle electromyographic activity during standard manual wheelchair and push-rim activated power assisted wheelchair propulsion in persons with complete tetraplegia.

Objectives

To compare spatio-temporal propulsion characteristics and shoulder muscle electromyographic activity in persons with cervical spinal cord injury propelling a standard pushrim wheelchair (WC) and a commercially available pushrim-activated power assisted wheelchair (PAPAW) design on a stationary ergometer.

Design

Repeated measures.

Setting

Motion analysis laboratory within a rehabilitation hospital.

Participants

Men (N=14) with complete (American Spinal Injury Association grade A or B) tetraplegia (C6=5; C7=9).

Intervention

Participants propelled a standard pushrim WC and PAPAW during 3 propulsion conditions: self-selected free and fast and simulated 4% or 8% graded resistance propulsion.

Main Outcome Measures

Median speed, cycle length, cadence, median and peak electromyographic activity intensity, and duration of electromyographic activity in pectoralis major, anterior deltoid, supraspinatus, and infraspinatus muscles were compared between standard pushrim WC and PAPAW propulsion.

Results

A significant (P<.05) decrease in electromyographic activity intensity and duration of pectoralis major, anterior deltoid, and infraspinatus muscles and significantly reduced intensity and push phase duration of supraspinatus electromyographic activity at faster speeds and with increased resistance were seen during PAPAW propulsion.

Conclusions

For participants with complete tetraplegia, push phase shoulder muscle activity was decreased in the PAPAW compared with standard pushrim WC, indicating a reduction in demands when propelling a PAPAW.     

基于四肢联动训练的下肢血流限制对健康青年人心肺耐力、下肢肌耐力和平衡功能的影响

目的 观察短期下肢血流限制(BFR)联合四肢联动训练对健康人心肺耐力、下肢肌耐力和平衡功能的影响。方法 2019年12月至2020年3月,选取本院健康青年人20例,随机分成对照组和试验组各10例。两组根据心肺运动试验(CPET)结果选择无氧阈水平强度进行四肢联动训练,每次20 min,每周3次,共2周;试验组于双侧大腿根部以血流加压训练带250 mmHg加压,对照组于相同位置佩戴无压力的血流加压训练带。训练前后采用CPET、6分钟步行测试、靠墙静蹲、座椅试验、功能性前伸试验进行评定。结果 训练后,除功能性前伸试验外,两组各项测试成绩均提高(|t| > 2.321, P < 0.05),试验组靠墙静蹲和座椅试验成绩高于对照组(t > 2.660, P < 0.05)。结论 下肢BFR基础上行四肢联动训练有助于进一步提高下肢肌耐力。     

偏瘫患者下肢肌力与站立功能的相关性研究

对30例偏瘫患者的站立功能及双下肢的7组肌群的肌力,进行了评定和分析,结果表明:最终评定的站立功能与最初评定的瘫痪侧下肢肌力及非瘫痪侧下肢肌力之间有显著的相关性;年龄、性别、瘫痪侧别及病程时间与站立功能之间无显著相关性.提示对偏瘫患者进行增强下肢肌力训练或进行下肢肌力不足的代偿处理,均有助于改善站立功能.     

减重平板步行训练对完全性脊髓损伤患者下肢骨骼肌萎缩与步行能力的影响

目的研究减重平板步行训练对完全性脊髓损伤患者下肢骨骼肌萎缩与步行能力的影响。方法20例胸段完全性脊髓损伤患者分为对照组与减重组各10例。所有患者均采用综合康复治疗方法,减重组在身体条件许可的情况下及早接受减重平板步行训练3个月。在训练前后对患者进行大腿周经测量、功能独立性评定(FIM)步行能力评定、10m步行速度、日常生活活动能力(ADL)评定。减重组患者还在减重平板步行训练前后进行下肢大腿中部肌肉MRI检查。结果减重组患者训练后,MRI示下肢肌肉均较训练前相对肥大。减重组步行能力、10m步行速度的恢复优于对照组(P<0.05)。治疗前后减重组与对照组大腿周经、ADL评分无显著性差异(P>0.05)。结论减重平板步行训练不仅能够改善脊髓损伤引起的下肢骨骼肌萎缩,而且能够提高脊髓损伤患者的步行能力。     

Reliability and Validity of the Lower Extremity Motor Activity Log for Measuring Real-World Leg Use in Adults With Multiple Sclerosis

ObjectivesTo determine the test-retest reliability and validity of the Lower Extremity Motor Activity Log (LE-MAL) for assessing LE use in the community in adults with multiple sclerosis (MS).DesignProspective analysis of measures conducted by trained examiners.SettingParticipants were evaluated by telephone on several measures of LE use.ParticipantsAdults with MS (N=43).InterventionsNot applicable.Main Outcome MeasuresThe LE-MAL has 3 subscales (Assistance, Functional Performance, and Confidence). It was administered twice, at least 2 weeks apart. The Multiple Sclerosis Walking Scale (MSWS-12), Patient Determined Disease Steps (PDDS), and Mobility Scale were only administered during the first call.ResultsThe test-retest reliability of the composite and the 3 subscale LE-MAL scores were high (intraclass correlation, >0.94). The composite and subscale LE-MAL scores were strongly correlated with the MSWS-12, PDDS, and Mobility Scale scores (r=–0.56 to –0.77; P<.001).ConclusionThis initial study suggests that the LE-MAL reliably and validly measures LE use in the community in adults with MS.     

水中运动疗法联合电针对恢复期脑卒中患者下肢肌力和平衡功能的影响

目的:观察水中运动疗法对恢复期脑卒中下肢肌肉力量、痉挛程度及平衡功能的影响。方法:选取62例恢复期脑卒中患者,分为治疗组(水中运动疗法+常规康复治疗+电针治疗)、对照组(常规康复治疗+电针治疗),每组31例。治疗前及治疗6周后,分别采用等速肌力评定、改良Ashworth痉挛量表(MAS)、临床痉挛指数(CSI)、10m最大步行速度测定(MWS)、Berg平衡量表(BBS)对2组患者进行评定。结果:治疗后,2组患者下肢肌肉力量、MWS、BBS评分均较治疗前显著增加(均P0.05),MAS分级评分、临床痉挛指数CSI均较治疗前显著降低(P0.05);治疗后组间比较,观察组下肢肌肉力量、MWS、BBS评分均明显高于对照组(均P0.05),观察组MAS分级评分、CSI指数均低于对照组(均P0.05)。结论:水中运动疗法联合电针疗法可有效提高恢复期脑卒中患者下肢肌力,改善患者平衡功能。