Comparison of supraspinatus cross-sectional areas according to shoulder abduction angles

[Purpose] The purpose of this study was to determine the changes in the supraspinatus cross-sectional areas according to shoulder abduction angles, using ultrasonography. [Subjects and Methods] The subjects consisted of 40 individuals (20 males and 20 females). The cross-sectional areas of the supraspinatus of all subjects were measured with ultrasonography at abduction angle of 0°, 30°, 60°, 90°, and 120°. We set four abduction angle levels (I, II, III, and IV), 0° to 30°, 30° to 60°, 60° to 90°, and 90° to 120°, respectively, when determining the largest change in cross-sectional area. [Results] The results revealed that cross-sectional areas of the supraspinatus increased at all levels, but the abduction angle level with the largest increase in cross-sectional area of the supraspinatus was Level III. [Conclusion] The above results indicate that performing exercises at an abduction angle between 60° and 90° will be the most effective for supraspinatus strengthening in clinical practice.Key words: Rotator cuff, Supraspinatus cross-sectional area, Ultrasonography     

The effects of the length of rain boots on balance during treadmill walking

[Purpose] Effects of muscle fatigue on lower-extremity balance were evaluated in 12healthy young women in their 20s while they walked on a treadmill wearing rain boots ofdifferent lengths. [Methods] The rain boots were divided into three groups based on theshaft length (Long, Middle, Short). Romberg’s test was applied and limits of stabilitywere measured before and after treadmill walking. [Results] Romberg’s test showed asignificant main effect for time. There were significant differences between the center ofgravity area, length, and velocity when the eyes were open and the center of gravitylength, velocity, and length/cm² when the eyes were closed. Changes in thelimits of stability also showed a significant main effect of time. There were significantdifferences in pre-test and post-test values in the left, right, forward, and totaldirections. [Conclusion] It was found that muscle fatigue in the lower extremitiesgenerated by walking in rain boots affected the joints and the adjuster muscles, dependingon shaft lengths. Compensation due to visual feedback and the length of the boot shaftaffected movement of the distal joints, resulting in a reduced ability to balance.     

Comparison of quality of life according to community walking in stroke patients

[Purpose] The aim of this study was to examine the quality of life of stroke patients according to their degree of community walking. [Subjects] This study utilized raw data from the sixth Korea National Health and Nutrition Examination Survey conducted in 2013 by the Korea Centers for Disease Control and Prevention. The subjects were noninstitutionalized stroke patients (n = 71) diagnosed by a doctor. [Methods] Trained surveyors visited households selected for the sample and conducted face-to-face interviews in conjunction with a structured questionnaire. The content of the interview included demographic data and the EuroQoL; EQ-5D-3L. Inferential statistical analysis took into account the clustering and stratification of the sample survey data as usually done in a complex survey design. A χ² test was performed to identify the quality of life distribution according to walking days during a typical week. Finally, logistic regression analysis was performed to identify the correlation between quality of life and walking days. [Results] Mobility, usual activities, and anxiety/depression differed significantly according to number of walking days during a normal week. No significant difference was found in the relationship between quality of life and days of walking during a normal week. [Conclusion] This study indicates that community walking every day is better than walking 1–3 days a week or no walking in terms of the effect on quality of life. However, the extent to which community walking is good for improving quality of life is unclear. Further studies need to determine the optimal duration (days) of community walking.Key words: Community walking, Quality of life, Stroke     

Correlations among pelvic positions and differences in lower extremity joint angles during walking in female university students

[Purpose] This study aimed to identify correlations among pelvic positions and differences in lower extremity joint angles during walking in female university students. [Subjects] Thirty female university students were enrolled and their pelvic positions and differences in lower extremity joint angles were measured. [Methods] Pelvic position, pelvic torsion, and pelvic rotation were assessed using the BackMapper. In addition, motion analysis was performed to derive differences between left and right flexion, abduction, and external rotation ranges of hip joints; flexion, abduction, and external rotation ranges of knee joints; and dorsiflexion, inversion, and abduction ranges of ankle joints, according to X, Y, and Z-axes. [Results] Pelvic position was found to be positively correlated with differences between left and right hip flexion (r=0.51), hip abduction (r=0.62), knee flexion (r=0.45), knee abduction (r=0.42), and ankle inversion (r=0.38). In addition, the difference between left and right hip abduction showed a positive correlation with difference between left and right ankle dorsiflexion (r=0.64). Moreover, differences between left and right knee flexion exhibited positive correlations with differences between left and right knee abduction (r=0.41) and ankle inversion (r=0.45). [Conclusion] Bilateral pelvic tilt angles are important as they lead to bilateral differences in lower extremity joint angles during walking.Key words: Pelvic position, Lower extremity joint angle, Walking     

Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force

[Purpose] The purpose of this study was to investigate the effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The subjects of this study were 30 young adult males, who were divided into a Nordic walking group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the spatiotemporal parameters and ground reaction force during walking in the two groups, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for them between Nordic walking and walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. To determine the pole for Nordic walking, each subject’s height was multiplied by 0.68. We then measured the spatiotemporal gait parameters and ground reaction force. [Results] Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The results of this study indicate that Nordic walking increases the stride and can be considered as helping patients with diseases affecting their gait. This demonstrates that Nordic walking is more effective in improving functional capabilities by promoting effective energy use and reducing the lower limb load, because the weight of the upper and lower limbs is dispersed during Nordic walking.Key words: Nordic walking, Ground reaction force, Spatiotemporal gait parameters     

Detection of gait instability using the center of mass and center of pressure inclination angles

OBJECTIVE: To define a parameter that quantifies balance control during gait and better identifies elderly people who are at a higher risk of falling. DESIGN: Controlled study. SETTING: University research laboratory. PARTICIPANTS: Twelve elderly patients (mean age, 76.9+/-6y) with complaints of imbalance during walking, or with a history of falls, and 12 matched healthy elderly adults. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Temporal-distance gait parameters (gait velocity, stride length, step width); and sagittal and frontal center of mass (COM) and center of pressure (COP) inclination angles. RESULTS: Elderly patients demonstrated a significantly greater medial, but a significantly smaller anterior, inclination angle than their matched controls during both unobstructed and obstructed gait. The medial COM-COP inclination angle was not affected by the gait velocity in the healthy elderly. When the 2 groups were compared at a similar gait velocity ( approximately 1m/s), the elderly patients still had a significantly greater medial COM-COP inclination angle than did the controls. CONCLUSIONS: Instantaneous COM-COP inclination angles during walking provide information about the ability to control COM position in relation to the corresponding COP. The medial COM-COP inclination angle may be a sensitive measure of gait stability in the elderly.     

Test–retest reliability of the IDEEA system in the quantification of step parameters during walking and stair climbing

The aim of this investigation was to evaluate the inter‐ and intra‐session reliability of spatio‐temporal gait variables collected during walking and stair climbing with the Intelligent Device for Energy Expenditure and physical Activity (IDEEA) accelerometer‐based system. Eighteen healthy subjects (10 men, 8 women) completed a standardized indoor circuit comprised of walking and stair climbing. Intra‐and inter‐session reliability was investigated for several pertinent spatio‐temporal gait variables using intraclass correlations [ICC (3,1)]. Intra‐session reliability during walking showed a high reliability of the IDEEA with ICCs ranging between 0·84 (number of steps) and 0·97 (single limb support/double limb support). The ICCs for stair climbing were slightly lower than those during walking with values ranging between 0·74 (step duration) and 0·92 (number of steps). Inter‐session reliability during walking showed a high reliability of the IDEEA between all trials, with values ranging between 0·87 (speed) to 0·98 (step duration). The ICCs of stair climbing were again lower than those during walking with values ranging from 0·64 (swing duration) to 0·79 (number of steps). The IDEEA accelerometer‐based system provided a highly reliable measurement of spatio‐temporal variables, in healthy subjects, during walking with moderately reduced correlations during stair climbing.     

The influence of revised high-heeled shoes on foot pressure and center of pressure during standing in young women

[Purpose] Revised high-heeled shoes were developed to minimize foot deformities by reducing excessive load on the forefoot during walking or standing in adult females, who frequently wear standard high-heeled shoes. Specifically, this study aimed to investigate the effects of revised high-heeled shoes on foot pressure distribution and center of pressure distance during standing in adult females. [Subjects and Methods] Twelve healthy adult females were recruited to participate in this study. Foot pressures were obtained under 3 conditions: barefoot, in revised high-heeled shoes, and in standard 7-cm high-heeled shoes. Foot pressure was measured using the Tekscan HR mat scan system. One-way repeated analysis of variance was used to compare the foot pressure distribution and center of pressure distance under these 3 conditions. [Results] The center of pressure distance between the two lower limbs and the fore-rear distribution of foot pressure were significantly different for the 3 conditions. [Conclusion] Our findings support the premise that wearing revised high-heeled shoes seems to provide enhanced physiologic standing posture compared to wearing standard high-heeled shoes.Key words: Revised high-heeled shoes, Centre of pressure, Standing     

Applicability of pedometry and accelerometry in the calculation of energy expenditure during walking and Nordic walking among women in relation to their exercise heart rate

[Purpose] The objective of this study was to evaluate the usefulness of pedometry and accelerometry in the measurement of the energy expenditures in Nordic walking and conventional walking as diagnostic parameters. [Subjects and Methods] The study included 20 female students (age, 24 ± 2.3 years). The study used three types of measuring devices, namely a heart rate monitor (Polar S610i), a Caltrac accelerometer, and a pedometer (Yamax SW-800). The walking pace at the level of 110 steps/min was determined by using a metronome. [Results] The students who walked with poles covered a distance of 1,000 m at a speed 36.3 sec faster and with 65.5 fewer steps than in conventional walking. Correlation analysis revealed a moderate interrelationship between the results obtained with a pedometer and those obtained with an accelerometer during Nordic walking (r = 0.55) and a high correlation during conventional walking (r = 0.85). [Conclusion] A pedometer and Caltrac accelerometer should not be used as alternative measurement instruments in the comparison of energy expenditure in Nordic walking.Key words: Nordic walking, Accelerometer, Energy expenditure     

Comparison of foot pressure in stretching exercises according to the type of ankle ramp

[Purpose] This study compared and analyzed use of an existing ankle ramp and a newly developed ankle ramp for stretching exercises. [Subjects] Fourteen subjects were included; they were stroke patients more than 6 months after onset, with no orthopedic or biological problems in the legs, so independent gait was possible. [Methods] The subjects performed stretching exercises for 5 min with an existing ankle ramp and a newly developed ankle ramp; foot pressure was then measured. [Results] The averaged percentage and kilopascal data for weight bearing and foot pressure on the affected side with the newly developed ankle ramp for stretching exercises were significantly higher than those with the existing ankle ramp. [Conclusion] Our results suggest that stretching exercises using the newly developed ankle ramp more effectively increase foot pressure than the existing ankle ramp.Key words: Ankle ramp, Foot pressure, Stroke     

Changes in cervical muscle activity according to the traction force of an air-inflatable neck traction device

[Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation.Key words: Air-inflatable neck traction device, Electromyography, Muscle relaxation     

The effect of total knee replacement on dynamic support of the body during walking and stair ascent

BACKGROUND: Little is known about the effects of total knee replacement surgery on the contributions of individual joint moments to the total support moment. A better understanding of these effects may enhance rehabilitation protocols and determine factors related to long-term surgical outcome. METHOD: Twenty-one subjects with total knee replacement and 21 controls performed level walking and stair ascent at two testing periods, pre- and 6 months post-surgery. Variables studied included gait velocity, stride length, knee flexion angle, net joint moments of the hip, knee and ankle, and total support moment. Data were analyzed at the first peak vertical ground reaction force. FINDINGS: For level walking, the total support moment, knee extensor moment, and knee flexion angle of total knee replacement patients were less than controls at post-surgery. For stair ascent, the patient group total support moment, ankle plantarflexor moment, and knee flexion angle were less than controls at both testing periods, while knee extensor moment was less than controls at post-surgery. Extensor synergies of the total knee replacement patients revealed less knee and more hip contributions during level walking and larger hip contributions during stair ascent to the total support moment than controls at both testing periods. INTERPRETATION: A feature of total knee replacement gait, pre- and post-surgery, is a stiff knee attitude which may serve to protect the quadriceps. The larger hip extensor contribution to the total support moment observed in the patients may compensate for the diminished knee extensor contribution during level walking and stair ascent.     

The influence of Tai Chi training on the center of pressure trajectory during gait initiation in older adults

OBJECTIVE: To determine if a program of intense Tai Chi exercise that has been shown to reduce the risk of falling in older adults improves postural control by altering the center of pressure (COP) trajectory during gait initiation. DESIGN: Before-after trial. SETTING: Biomechanics research laboratory. PARTICIPANTS: Twenty-eight older adults transitioning to frailty who participated in either a 48-week intervention of intense Tai Chi training or a wellness education (WE) program. INTERVENTIONS: Eight Tai Chi forms emphasizing trunk rotation, weight shifting, coordination, and narrowing of lower-extremity stance were taught twice weekly. WE program participants met once a week and received lectures focused on health.Main outcome measures The COP was recorded during gait initiation both before and after the 48-week intervention by using a forceplate sampling at 300 Hz. The COP trajectory was divided into 3 periods (S1, S2, S3) by identifying 2 landmark events. Displacement and average velocity of the COP trace in the anteroposterior (x) and mediolateral (y) directions, as well as smoothness, were calculated. RESULTS: Tai Chi training increased the posterior displacement of the COP during S1 and improved the smoothness of the COP during S2. CONCLUSIONS: Tai Chi improved the mechanism by which forward momentum is generated and improved coordination during gait initiation, suggesting improvements in postural control.     

Incidence of floating toe and its association with the physique and foot morphology of Japanese children

[Purpose] Physical development, foot morphology, and toe contact of children aged 3 to 5 years were assessed in order to investigate the relationships between body and foot morphology and the incidence of the condition known as “floating toe”. [Subjects] A total of 198 children, aged 3 to 5 years old, participated in this study. [Methods] Height and weight were measured for body morphology, and foot length and width were measured for foot morphology. Footprint images were taken to calculate the number of floating toes. Information about the children’s height and weight at birth, and the time of starting to walk was obtained from their guardians. [Results] At least one floating toe was observed in 87.7–98.7% of the children depending on their ages. The fifth toe was most commonly affected, occurring in 74.2% of the study population. Among the body and foot morphology parameters, only weight at birth showed a significant but very weak correlation with the number of floating toes. [Conclusion] There was a high incidence of floating toe among the children, with the fifth toe most commonly affected. Floating toe weakly but significantly correlated with weight at birth, but did not correlated with other measures of physique at birth, physical development, or the time of starting to walk.Key words: Foot morphology, Physical development, Floating toe     

Predictors of energy cost during stair ascent and descent in individuals with chronic stroke

[Purpose] This study aimed to determine which clinical measures of walking performance and lower limb muscle strength would predict energy cost during stair ascent and descent in community-dwelling individuals with stroke. [Subjects and Methods] Regression analysis of cross-sectional data from 55 individuals between one and five years post-stroke was used to investigate the measures of walking (speed and distance covered during the 6-minute walk test [6MWT]), and strength of the paretic knee extensor and ankle plantar flexor muscles would predict energy cost during stair ascent and descent. [Results] Three predictors (habitual walking speed, distance covered during the 6MWT, and strength of the paretic knee extensor muscles) were kept in the model. Habitual walking speed alone explained 47% of the variance in energy cost during stair ascent and descent. When the strength of the paretic knee extensor muscles was included in the model, the explained variance increased to 53%. By adding the distance covered during the 6MWT, the variance increased to 58%. [Conclusion] Habitual walking speed, distance covered during the 6MWT, and strength of the paretic knee extensor muscles were significant predictors of energy cost during stair ascent and descent in individuals with mild walking limitations.Key words: Stroke, Energy metabolism, Stairs     

Differences in lumbar and pelvic angles and gluteal pressure in different sitting postures

[Purpose] To investigate the effects of erect sitting, slouched posture with cross-legged sitting, and erect posture with cross-legged sitting on the lumbar and pelvic angles, and gluteal pressure. [Subjects] For the experiments, 17 healthy women were recruited. [Methods] All subjects were asked to perform three sitting postures: erect sitting, slouched posture with cross-legged sitting, and erect posture with cross-legged sitting. Lumbar and pelvic angles were measured using a three-dimensional motion-capture system, and gluteal pressure was measured using a pressure mat. [Results] Compared to erector sitting, slouched posture with cross-legged sitting showed significantly greater lumbar flexion, posterior pelvic tilt, and left pelvic tilt. Compared to erect sitting, erect posture with cross-legged sitting showed significantly greater lumbar flexion and posterior pelvic tilt. Compared to erect posture with cross-legged sitting, slouched posture with cross-legged sitting showed significantly greater lumbar flexion and posterior pelvic tilt. Compared to erect sitting and erect posture with cross-legged sitting, slouched posture with cross-legged sitting showed significantly greater left gluteal pressure; there was no significant difference in right gluteal pressure. [Conclusion] An erect posture can reduce changes in lumbar and pelvic angles, and gluteal pressure compared to a slouched posture during cross-legged sitting.Key words: Cross-legged sitting, Lumbar and pelvic angles, Gluteal pressure     

The effect of total knee replacement on the knee varus angle and moment during walking and stair ascent

BACKGROUND: This study examined the effect of total knee replacement surgery on the frontal plane knee varus angle and moment. Secondarily, the relationships between knee varus angle and moment to a clinical outcome measure were assessed. METHODS: Twenty-one patients with total knee replacement and 21 controls performed level walking and stair ascent at two testing periods, pre- and 6-months post-surgery. The dependent variables included frontal plane knee angle and moment, and Western Ontario and McMaster Universities Osteoarthritis Index scores. FINDINGS: During level walking the mean knee varus moment of the patient group was significantly greater than controls at pre-surgery but was restored to control level post-operatively. During stair ascent the patient group produced a significantly smaller knee varus moment post-surgically. The mean frontal knee valgus angle of total knee replacement patients increased significantly from pre- to post-surgery during level walking. The Western Ontario and McMaster Universities Osteoarthritis Index score was not significantly correlated to the knee variables. However, the knee angle and moment were significantly correlated during level walking pre- and post-operatively and stair ascent post-operatively. INTERPRETATION: The decreased frontal plane knee moment in total knee replacement patients during level walking appeared to be affected by surgical realignment of the tibio-femoral joint, as the frontal knee angle and varus moment were strongly correlated. The subjective Western Ontario and McMaster Universities Osteoarthritis Index and the objective gait measures appeared to capture different dimensions of knee osteoarthritis.     

An effective strategy to reduce blood pressure after forest walking in middle-aged and aged people

[Purpose] Forest walking may be effective for human health, but little information is available about effects of energy expenditure on blood pressure responses after forest walking. The aim of this study was to investigate the relationship between the activity energy expenditure and changes in blood pressure in individuals after forest walking. [Subjects] The subjects were 54 middle-aged and elderly people. [Methods] All subjects walked in the forest for approximately 90 min. Blood pressure, salivary amylase, and the Profile of Mood States were evaluated before and after forest walking, and activity energy expenditure was monitored throughout forest walking. Subjects were divided into two groups according to mean arterial pressure changes: a responder group (>5% decreases) and a nonresponder group (<5%). [Results] Forest walking significantly reduced the mean arterial pressure and improved the Profile of Mood States in both groups. Activity energy expenditure was related to changes in mean arterial pressure in the responder group, while this relation was not observed in the nonresponder group. Differential activity energy expenditure did not strongly affect improvement of the Profile of Mood States. [Conclusion] Greater walking-related greater activity energy expenditure might be required to accentuate physiological beneficial effects on in middle-aged and aged people. Furthermore, the forest environment per se can attenuate psychological stress.Key words: Hypertension, Profile of Mood States, Responder and nonresponder     

Immediate effects of kinesio taping on fixed postural alignment and foot balance in stroke patients

[Purpose] The main aim of this study was to identify the short-term effects of Kinesio taping (KT) on the static body alignment and overall balance function presented by the coordinate and foot balance in stroke patients. [Subjects and Methods] Thirty-eight stroke subjects were randomly allocated into the study groups. The kinematic analysis measured deviation or changes from standard body alignment and foot pressure by the human anatomy-based coordinates were examined using the Shisei Innovation System PA200 ver.9.0. [Results] The glabellas on the front view, larynx on the front view, rt. greater tubercle of the humerus (vertical changes), lt. greater tubercle of the humerus (vertical changes), posterior superior iliac spine, and greater trochanter (horizontal changes) showed statistically significant decreases, indicating dislocation from the axis center, after taping. [Conclusion] The clinical use of KT for stroke patients who have asymmetrical and imbalanced body posture could be an optimal therapeutic approach. Since more evidence based practices are needed, future studies should include large numbers of subjects and examine diverse KT application patterns.Key words: Kinesio taping, Stroke, Postural balance     

The effects of stepper exercise with visual feedback on strength,walking, and stair climbing in individuals following stroke

[Purpose] This study investigated the effect of stepper exercise with visual feedback on strength, walking, and stair climbing in stroke patients. [Subjects] Twenty-six stroke patients were divided randomly into the stepper exercise with visual feedback group (n = 13) or the stepper exercise group (n = 13). [Methods] Subjects in the experimental group received feedback through the mirror during exercise, while those in the control group performed the exercise without visual feedback; both groups exercised for the 30 min thrice per week for 6 weeks. The hip extensor and knee extensor strength, 10-m walking test results, and 11-step stair climbing test results were evaluated before and after the intervention. [Results] The stepper exercise with visual feedback group showed significantly greater improvement for hip extensor strength and the 10-m walking test. The knee extensor strength and 11-step stair climbing in both groups showed significantly greater improvement after the intervention, but without any significant difference between groups. [Conclusion] The findings of this study indicate that the stepper exercise with visual feedback can help improve the strength of the hip extensor and the 10-m walking test; the stepper exercise alone may also improve the knee extensor strength and stair climbing ability.Key words: Stroke, Stairs, Visual feedback