The effects of ramp gait exercise with PNF on stroke patients’ dynamic balance

[Purpose] This study examined the effects of ramp gait training using lower extremity patterns of proprioceptive neuromuscular facilitation (PNF) on chronic stroke patients’ dynamic balance ability. [Subjects and Methods] In total, 30 stroke patients participated in this study, and they were assigned randomly and equally to an experimental group and a control group. The experimental group received exercise treatment for 30 min and ramp gait training with PNF for 30 min. The control group received exercise treatment for 30 min and ground gait training for 30 min. The interventions were conducted in 30 min sessions, three times per week for four week. The subjects were assessed with the Berg balance scale test, timed up and go test, and functional reach test before and after the experiment and the results were compared. [Results] After the intervention, the BBS and FRT values had significantly increased and the TUG value had significantly decreased in the experimental group; however, the BBS, FRT, and TUG values showed no significant differences in the control group. In addition, differences between the two groups before the intervention and after the intervention were not significant. [Conclusion] In conclusion, ramp gait training with PNF improved stroke patients’ dynamic balance ability, and a good outcome of ramp gait training with PNF is also expected for other neurological system disease patients.Key words: Stroke, Proprioception, Ramp gait     

Neck Proprioceptive Training for Balance Function in Patients with Chronic Poststroke Hemiparesis: A Case Series

[Purpose] This study investigated the effects of neck proprioceptive training on the balance of patients with chronic poststroke hemiparesis. [Subjects] Three patients with chronic stroke were recruited for this study. [Methods] The subjects underwent neck proprioceptive training using the red light of a laser pointer (30 min daily, five times per week for 4 weeks). Outcome measures included the stability and weight distribution indices measured with a Tetrax system and Timed Up and Go (TUG) and proprioception tests. [Results] For all subjects, the stability and weight distribution indices increased by 1.87–9.66% in the eyes-open and eyes-closed conditions, and the TUG and proprioception test scores improved by 2.49–15.27%. [Conclusion] Neck proprioceptive training may be a good option for improving the balance function of patients with chronic poststroke hemiparesis.Key words: Neck proprioceptive training, Balance, Stroke     

Pain,Work-related Characteristics,and Psychosocial Factors among Computer Workers at a University Center

[Purpose] Complaint of pain is common in computer workers, encouraging the investigation of pain-related workplace factors. This study investigated the relationship among work-related characteristics, psychosocial factors, and pain among computer workers from a university center. [Subjects and Methods] Fifteen subjects (median age, 32.0 years; interquartile range, 26.8–34.5 years) were subjected to measurement of bioelectrical impedance; photogrammetry; workplace measurements; and pain complaint, quality of life, and motivation questionnaires. [Results] The low back was the most prevalent region of complaint (76.9%). The number of body regions for which subjects complained of pain was greater in the no rest breaks group, which also presented higher prevalences of neck (62.5%) and low back (100%) pain. There were also observed associations between neck complaint and quality of life; neck complaint and head protrusion; wrist complaint and shoulder angle; and use of a chair back and thoracic pain. [Conclusion] Complaint of pain was associated with no short rest breaks, no use of a chair back, poor quality of life, high head protrusion, and shoulder angle while using the mouse of a computer.Key words: Ergonomics, Low back pain, Workplace     

Effects of Pilates on muscle strength,postural balance and quality of life of older adults: a randomized,controlled, clinical trial

[Purpose] The aim of the present study was to determine the effects of Pilates on lower leg strength, postural balance and the health-related quality of life (HRQoL) of older adults. [Subjects and Methods] Thirty-two older adults were randomly allocated either to the experimental group (EG, n = 16; mean age, 63.62 ± 1.02 years), which performed two sessions of Pilates per week for 12 weeks, or to the control group (CG, n = 16; mean age, 64.21 ± 0.80), which performed two sessions of static stretching per week for 12 weeks. The following evaluations were performed before and after the interventions: isokinetic torque of knee extensors and flexors at 300°/s, the Timed Up and Go (TUG) test, the Berg Balance Scale, and the Health Survey assessment (SF-36). [Results] In the intra-group analysis, the EG demonstrated significant improvement in all variables. In the inter-group analysis, the EG demonstrated significant improvement in most variables. [Conclusion] Pilates exercises led to significant improvement in isokinetic torque of the knee extensors and flexors, postural balance and aspects of the health-related quality of life of older adults.Key words: Exercise, Age, Muscle strength dynamometer     

The effects of stair gait training using proprioceptive neuromuscular facilitation on stroke patients’ dynamic balance ability

[Purpose] This study aims to examine stroke patients’ changes in dynamic balance ability through stair gait training where in proprioceptive neuromuscular facilitation (PNF) was applied. [Subjects and Methods] In total 30 stroke patients participated in this experiment and were randomly and equally allocated to an experimental group and a control group. The experimental group received exercise treatment for 30 min and stair gait training where in PNF was applied for 30 min and the control group received exercise treatment for 30 min and ground gait training where in PNF was applied for 30 min. For the four weeks of the experiment, each group received training three times per week, for 30 min each time. Berg Balance Scale (BBS) values were measured and a time up and go (TUG) test and a functional reach test (FRT) were performed for a comparison before and after the experiment. [Results] According to the result of the stroke patients’ balance performance through stair gait training, the BBS and FRT results significantly increased and the TUG test result significantly decreased in the experimental group. On the contrary, BBS and FRT results did not significantly increase and the TUG test result did not significantly decrease in the control group. According to the result of comparing differences between before and after training in each group, there was a significant change in the BBS result of the experimental group only. [Conclusions] In conclusion, the gait training group to which PNF was applied saw improvements in their balance ability, and a good result is expected when neurological disease patients receive stair gait training applying PNF.Key words: Proprioceptive neuromuscular facilitation, Stroke, Balance ability     

Does whole-body vibration training in the horizontal direction have effects on motor function and balance of chronic stroke survivors? A preliminary study

[Purpose] The objective of this study was to investigate the effects of whole-body vibration (WBV) in the horizontal direction on the motor function and balance of chronic stroke survivors. [Subjects and Methods] This study was a randomized controlled trial. Twenty-one individuals with chronic stroke from an inpatient rehabilitation center participated in the study. The participants were allocated to either the WBV training group or the control group. The WBV training group (n = 12) received whole-body vibration delivered in the horizontal direction (15 min/day, 3 times/week, 6 wks) followed by conventional rehabilitation (30 min/day, 5 times/week, 6 wks); the control group (n = 9) received conventional rehabilitation only (30 min/day, 5 times/week, 6 wks). Motor function was measured by using the Fugl-Meyer assessment, and balance was measured by using the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test before and after the interventions. [Results] After the interventions, all variables improved significantly compared with the baseline values in the WBV training group. In the control group, no significant improvements in any variables were noted. In addition, the BBS score in the WBV training group increased significantly compared with that in the control group. [Conclusion] WBV training with whole-body vibration delivered in the horizontal direction may be a potential intervention for improvement of motor function and balance in patients who previously experienced a stroke.Key words: Stroke, Whole-body vibration, Motor function     

Effects of virtual reality-based training and task-oriented training on balance performance in stroke patients

[Purpose] This study aimed to investigate the clinical effects of virtual reality-based training and task-oriented training on balance performance in stroke patients. [Subjects and Methods] The subjects were randomly allocated to 2 groups: virtual reality-based training group (n = 12) and task-oriented training group (n = 12). The patients in the virtual reality-based training group used the Nintendo Wii Fit Plus, which provided visual and auditory feedback as well as the movements that enabled shifting of weight to the right and left sides, for 30 min/day, 3 times/week for 6 weeks. The patients in the task-oriented training group practiced additional task-oriented programs for 30 min/day, 3 times/week for 6 weeks. Patients in both groups also underwent conventional physical therapy for 60 min/day, 5 times/week for 6 weeks. [Results] Balance and functional reach test outcomes were examined in both groups. The results showed that the static balance and functional reach test outcomes were significantly higher in the virtual reality-based training group than in the task-oriented training group. [Conclusion] This study suggested that virtual reality-based training might be a more feasible and suitable therapeutic intervention for dynamic balance in stroke patients compared to task-oriented training.Key words: Stroke, Virtual reality, Task orientation     

The Effect of Underwater Gait Training on Balance Ability of Stroke Patients

[Purpose] The purpose of this study was to investigate the effects of underwater treadmill gait training on the balance ability of stroke patients. [Subjects] Twenty-two patients with stroke were randomly assigned to an underwater treadmill group (n =11) or a control group (n =11). [Methods] Both groups received general rehabilitation for 30 min per session, 5 times per week, over a 4-week period. The underwater treadmill group received additional underwater gait training for 30 min per session, 5 times per week, over the same 4-week period. Static and dynamic balances were evaluated before and after the intervention. [Results] The means of static and dynamic balance ability increased significantly in both groups, but there was no significant difference between the two groups. [Conclusion] Compared to the general rehabilitation program, underwater treadmill gait training was not more effective at improving the balance ability of stroke patients than land-based training.Key words: Stroke, Gait, Stability     

Determine the effect of neck muscle fatigue on dynamic visual acuity in healthy young adults

[Purpose] The aim of this study was to determine whether neck muscle fatigue affects dynamic visual acuity in healthy young participants. [Subjects and Methods] This study was a double-blinded, prospective, randomized, controlled trial. Thirty healthy young subjects (ages 21 to 30 years) participated in the study. Participants were randomly divided into an experimental group (n=15) and a control group (n=15). The experimental group performed an exercise designed to induce neck muscle fatigue and the control group preformed non-fatiguing sham exercises. [Results] There were significant differences in mean dynamic visual acuity between the two groups (0.26±0.11 LogMar versus 0.003±0.02 LogMar). Subjects in the experimental group showed a significant decline in their dynamic visual acuity compared with the control group. Dynamic visual acuity strongly correlated with neck muscle fatigue (r = 0.79). No significant differences in joint position error were observed between the two groups and no significant correlations between joint position error and neck muscle fatigue were observed (r = 0.23). [Conclusion] The results of this study suggest that neck muscle fatigue negatively impacts dynamic visual acuity. Although not statistically significant, cervical spine proprioception as measured by the joint position error in the experimental group was diminished after fatigue.Key words: Dizziness, Cervical vertigo     

Effects of isometric exercise using biofeedback on maximum voluntary isometric contraction,pain, and muscle thickness in patients with knee osteoarthritis

[Purpose] The purpose of our study was to investigate the effects of isometric exercises using electromyographic biofeedback (EMGBF) and ultrasound biofeedback (USBF) on maximum voluntary isometric contraction (MVIC), pain assessed by the Visual Analogue Scale (VAS), and vastus medialis oblique (VMO) thickness in patients with knee osteoarthritis (OA). [Subjects and Methods] Thirty females over 65 years of age who had been diagnosed with knee osteoarthritis were recruited and randomly assigned to three groups, each comprising of 10 subjects. The Subjects in the EMGBF training and USBF training groups were trained with the corresponding physical training exercise program targeting the vastus medialis oblique, whereas the subjects in the control group were treated with conventional physical therapies, such as a hot pack, ultrasound, and transcutaneous electrical nerve stimulation. Subjects in each group were trained or treated for 20 min, 3 times a week for 8 weeks. [Results] The MVIC in the EMGBF and USBF training groups was significantly increased compared with that in the control group, and the VAS score (for measurement of pain) in the EMGBF and USBF training groups was significantly decreased compared with that in the control group. Only the EMGBF training group showed a significantly increased VMO thickness compared with before training. [Conclusion] These results suggest that USBF training is similar to EMGBF training in terms of its effectiveness and is helpful for treating patients with knee OA.Key words: Conventional physical therapy, Electromyographic biofeedback, Ultrasound biofeedback     

Effects of community-based virtual reality treadmill training on balance ability in patients with chronic stroke

[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit^™ balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.Key words: Stroke rehabilitation, Community-based virtual reality, Balance     

Effects of shoulder stabilization exercise on pain and function in patients with neck pain

[Purpose] The objective of this study was to investigate the effects of shoulder stability exercise on pain and function in neck pain patients. [Subjects] The study design consisted of a shoulder stability exercise group and a control group. [Methods] The effects of the therapies were evaluated using a visual analog scale of pain, a pressure pain threshold, neck disability index, cervical range of motion, and a closed kinetic chain test. Each group received treatment five times per week for 4 weeks. [Results] Pain levels showed no significant differences between groups, while pain threshold in all muscles, showed significant increases for both control groups. Neck disability significantly decreased for both groups and the differences between the groups were statistically significant. Ranges of motion and limb stability were measured before and after the exercise period. Flexion, extension, and right rotation were not significantly different between groups. The results showed no significant differences in shoulder stability between the groups. [Conclusion] The use of this exercise should have pronounced effects on pain reduction and functional improvement and should also improve the quality of life in patients with neck pain.Key words: Neck pain, Shoulder stabilization training, Neck stabilization training     

Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review

[Purpose] Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to improve pain and disability in short-term and midterm follow-ups. This study performed a literature review of the long-term effects of therapeutic exercise on subjects with nonspecific chronic neck pain. [Subjects and Methods] The databases of the CINAHL, MEDLINE, PEDro and PubMed were used. Randomized controlled trials (RCT) published from January 2000 to January 2014 and explicitly including a one-year follow-up were identified. [Results] Only six articles were included in this review. They had scores of 5 to 8 points on the PEDro scale, and the level of evidence was grade I. The study results show that the main exercises used were cervical strengthening and endurance training exercise. Short-term exercises (10 to 12 weeks) helped to improve the body function, structure, activity and participation immediately after the intervention, but not at the long-term follow-up. On the other hand, long-term interventions (1 year) resulted in improvements in body function and structure at the 3 year follow-up. [Conclusion] The results of the six high-quality studies suggest that long-term exercise have long-term benefits for patients with nonspecific neck pain in terms of body function and structure.Key words: Nonspecific neck pain, Therapeutic exercise, Long-term effect     

The Effects of Visual Feedback Training on Sitting Balance Ability and Visual Perception of Patients with Chronic Stroke

[Purpose] The purpose of this study was to investigate the effects of visual feedback training (VFT) in the sitting position on sitting balance ability and visual perception of chronic stroke patients. [Subjects] Twenty-two hospitalized subjects who had experienced a stroke more than six months earlier were included in this study. [Methods] Subjects in both the experimental group (n=12) and the control group (n=10) participated in a conventional rehabilitation program involving a 60-minute session five days per week for a period of four weeks. Subjects in the experimental group additionally practiced VFT 30-minute sessions, five days per week, for a period of four weeks. [Results] After the intervention, the experimental group showed significantly improved static sitting balance ability (left∙right, anterior∙posterior moment, and velocity moment), and dynamic sitting balance ability (anterior∙lateral moment). In visual perception tests, motor free visual perception test (MVPT) scores showed a significant increase of approximately 17% in the experimental group after the intervention. [Conclusion] The results of this study demonstrate the effectiveness of VFT in enhancing body function, as evidenced by improved sitting balance and visual perception of chronic stroke patients.Key words: Visual feedback, Sitting balance, Stroke     

The effects of a neck musculoskeletal intervention on neck pain levels and depression in post-traumatic stress disorder patients

[Purpose] To identify the effects of a neck intervention on neck pain and depression in patients with post-traumatic stress disorder (PTSD). [Subjects] Thirty-one patients with neck pain and a diagnosis of PTSD were enrolled. [Methods] Neck exercise training was performed with the experimental group and neck self-exercise (using a modification of the McKenzie exercise) was used with the control group. Both groups performed their exercises for 30 minutes at a time, three times per week. To compare the effects of the interventions, the threshold of neck tenderness and depression levels were measured at each period. [Results] The pain threshold of both sides of the trapezius showed a significant difference between the two groups at the three measurement periods. In the experimental group, the threshold increased by 19.7% on the left and 18.3% on the right after the intervention compared to before. Depression levels significantly differed in the experimental group between the three measurements. [Conclusion] This study has important implications for therapeutic strategies, as it provides strong evidence for a method of improving symptoms of neck pain; furthermore, it is effective for subjects with psychological problems such as PTSD.Key words: Post-traumatic stress disorder, Neck pain, Depression     

Comparison of the effectiveness of balance training using a reaching task between a sitting position and a standing position in the elderly

[Purpose] The purpose of this study was to compare the effectiveness of balance training using a reaching task between a sitting position and a standing position in the elderly. [Subjects and Methods] The study included 30 elderly women from D city. The subjects were divided into the following two groups, according to the training position: the sitting group (n = 15) and standing group (n = 15). Both groups performed training for 20 min, thrice a week for 8 weeks. The short form of the berg balance scale (SFBBS), timed 10-m walk test (10MWT), timed up & go test (TUG), and falls efficacy scale (FES) were used before and after training. [Results] SFBBS, 10MWT, and TUG values were significantly different between before and after training in both groups. However, FES values were significantly different in only the standing group. [Conclusion] Balance training in a standing position is helpful for improving activities that mainly use the lower extremities, such as gait, and training in a sitting position is somewhat helpful for improving balance ability. In addition, balance training in both positions can help overcome the fear of falling.Key words: Postural balance, Falls efficacy, Elderly     

Effect of exercise on the expression of nerve growth factor in the spinal cord of rats with induced osteoarthritis

[Purpose] We examined the impact of exercise on the expression pattern of nerve growth factor in the spinal cord of rats with induced osteoarthritis of the knee joint. [Subjects and Methods] To produce monosodium iodoacetate-induced arthritis, rats were administered 3 mg/50 µL monosodium iodoacetate through the interarticular space of the right knee. The animals were randomly divided into four groups: rats sacrificed 3 weeks after 0.9% saline solution injection (shame group, n = 10), rats sacrificed 3 weeks after monosodium iodoacetate injection (control group, n = 10), rats with 4 weeks rest from 3 weeks after monosodium iodoacetate injection (no exercise group, n = 10), and rats with 4 weeks treadmill training from 3 weeks after monosodium iodoacetate injection (exercise group, n = 10). Serial coronal sections of the lumbar spine were cut and processed for immunohistochemistry. [Results] The expression of nerve growth factor was significantly increased in the EG compared with the SG, CG, and NEG. [Conclusion] Increased nerve growth factor expression in the spinal cord due to exercise-induced stimulation can be effective in treating chronic pain. Such treatment will contribute not only to improving the joint function of patients with chronic pain but also their quality of life.Key words: Osteoarthritis, Treadmill exercise, Nerve growth factor     

Effects of mechanical horseback riding on the balance ability of the elderly

[Purpose] This study was conducted to evaluate the effect of mechanical horseback riding exercise on the balance ability of the elderly. [Subjects and Methods] Ten elderly patients were assigned to an experimental group, and they performed 15 min of horseback riding. Another 10 elderly patients were assigned to a control group, and they performed 15 min of one-leg standing exercise. Both exercises were repeated five times a week for a total of six weeks. The participants’ balance ability was evaluated. [Results] The horseback-riding group showed significant differences between the pre-and post-test balance abilities as assessed by the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. [Conclusion] Horseback riding effectively improves the balance ability of the elderly. Horseback riding should be considered as a therapeutic method for the physical therapy of the elderly.Key words: Balance ability, Elderly, Mechanical horseback riding     

Effect of dual tasks on balance ability in stroke patients

[Purpose] The purpose of this study was to determine the effects of training using dual tasks on balance ability in stroke patients. [Subjects] Forty stroke patients were divided into a dual-task training group (N = 20) and a single task training group (N = 20) randomly. [Methods] The subjects in the single-task traing group stood in a comfortable position, faced a therapist, then threw a Swiss ball back and forth. They then performed balance training in which they raised and lowered their ankles while facing forward or moved objects from one table to another. The DTG performed dual tasks, which involved performing a task on an unstable surface using a balance pad. Both groups received training 30 min per day, five times per week, for eight weeks. [Results] The DTG showed significant increases in weight distribution rate, anterior limit of stability, posterior limit of stability, and BBS scores compared with the STG. [Conclusion] According to the results of this study, dual-task training and single-task training were effective in improving balance in stroke patients, dual task training is more effective for increasing balance ability.Key words: Stroke, Dual-task training, Balance     

Analgesic Effects of Transcutaneous Electrical Nerve Stimulation and Interferential Current on Experimental Ischemic Pain Models: Frequencies of 50?Hz and 100?Hz

[Purpose] This study compared the analgesic effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) on induced ischemic pain in healthy volunteers. [Subjects] The subjects were 36 volunteers (18 male, 18 female) without known pathology that could cause pain. Their mean age was 24.5±2.2 years. [Methods] A single-blind and parallel-group method was used. Subjects were randomly allocated to receive each 50 Hz TENS, 50 Hz IFC, 100 Hz TENS, and 100 Hz IFC. This study experimentally induced ischemic pain in otherwise pain-free subjects using a modified version of the submaximal effort tourniquet technique. Subjects completed twelve cycles of the ischemic-induced pain test. The primary outcome measure was the change in self-reported of pain intensity during one of four possible treatments. [Results] There were significant effects for Time, which were attributed to a significant reduction in pain intensity for all groups. There were no significant effects for groups or group-time interaction. The 50 Hz IFC treatment was more comfortable than the other treatments in the present study, and it is likely to be better accepted and tolerated by patients. [Conclusion] We conclude that there were no differences in the analgesic effects of the four treatments under the present experimental conditions. The 50 Hz IFC treatment is more comfortable than the other treatments.Key words: Transcutaneous electrical nerve stimulation, Interferential current, Ischemic pain model