Effects on Hamstring Muscle Extensibility,Muscle Activity,and Balance of Different Stretching Techniques

[Purpose] The purpose of this study was to investigate the effects of two different stretching techniques on range of motion (ROM), muscle activation, and balance. [Subjects] For the present study, 48 adults with hamstring muscle tightness were recruited and randomly divided into three groups: a static stretching group (n=16), a PNF stretching group (n=16), a control group (n=16). [Methods] Both of the stretching techniques were applied to the hamstring once. Active knee extension angle, muscle activation during maximum voluntary isometric contraction (MVC), and static balance were measured before and after the application of each stretching technique. [Results] Both the static stretching and the PNF stretching groups showed significant increases in knee extension angle compared to the control group. However, there were no significant differences in muscle activation or balance between the groups. [Conclusion] Static stretching and PNF stretching techniques improved ROM without decrease in muscle activation, but neither of them exerted statistically significant effects on balance.Key words: Balance, Muscle activation, Stretching     

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     

Validity and Reliability of Wii Fit Balance Board for the Assessment of Balance of Healthy Young Adults and the Elderly

[Purpose] Balance is an integral part of human ability. The smart balance master system (SBM) is a balance test instrument with good reliability and validity, but it is expensive. Therefore, we modified a Wii Fit balance board, which is a convenient balance assessment tool, and analyzed its reliability and validity. [Subjects and Methods] We recruited 20 healthy young adults and 20 elderly people, and administered 3 balance tests. The correlation coefficient and intraclass correlation of both instruments were analyzed. [Results] There were no statistically significant differences in the 3 tests between the Wii Fit balance board and the SBM. The Wii Fit balance board had a good intraclass correlation (0.86–0.99) for the elderly people and positive correlations (r = 0.58–0.86) with the SBM. [Conclusions] The Wii Fit balance board is a balance assessment tool with good reliability and high validity for elderly people, and we recommend it as an alternative tool for assessing balance ability.Key words: Wii Fit balance board, Smart balance master system, Balance     

An Ankle Proprioceptive Control Program Improves Balance,Gait Ability of Chronic Stroke Patients

[Purpose] Balance and gait ability determine to a large degree the level of independence of daily living which is an important goal of rehabilitation. This study was conducted in order to examine the effectiveness of an ankle proprioceptive control program on ankle muscle strength, balance, and gait of chronic stroke patients. [Methods] Thirteen chronic stroke patients more than six months post-stroke were recruited. All subjects received ankle proprioceptive control training for 30 minutes per session, two days per week, over a period of six weeks. Outcome measures were ankle strength (BTE-Primus), the Timed Up and Go test (TUG), and spatiotemporal parameters measured by a GAITRite instrument. [Results] Significant improvements in ankle dorsiflexor strength, TUG, gait speed and cadence, step length, and stride length were observed on the paretic side. [Conclusion] The results of this study provide evidence in support of incorporation of an ankle proprioceptive control program for effective improvement of both balance and gait ability of chronic stroke patients. The findings of this study suggest the feasibility and suitability of an ankle proprioceptive control program for chronic stroke patients.Key words: Stroke, Proprioception, Ankle     

The Effects of Horseback Riding Simulator Exercise on Postural Balance of Chronic Stroke Patients

[Purpose] The aim of this study was to examine the effects of horseback riding simulator exercise on postural balance of chronic stroke patients. [Subjects] A total of 67 stroke patients were assigned either to a horseback riding simulator exercise group (HEG, n=34) or a mat exercise group (MEG, n=33). [Methods] The subjects exercised three times per week for 8 weeks. Static balance ability was determined by eyes open balance (EOB) and eyes closed balance (ECB), which was measured using a Kinesthetic Ability Trainer Balance system. Dynamic balance was evaluated using the Berg balance scale (BBS). [Results] EOB and ECB significantly decreased and BBS had significantly increased after the intervention in the HEG and the MEG, and ECB decreased and BBS increased significantly more in the HEG than in the MEG. [Conclusion] Horseback riding simulator exercise is more effective than mat exercise for improving the ECB and BBS of stroke patients.Key words: Horseback riding simulator exercise, Postural balance, Stroke     

Effect of Different Positions on FVC and FEV1 Measurements of Asthmatic Patients

[Purpose] The purpose of our study was to investigate the effect of different positions on pulmonary function test (PFT) values such as forced vital capacity (FVC) and forced expiratory volume in one second (FEV₁) of asthmatic patients .[Subjects and Methods] Thirty subjects with severe asthma aged between 20–39 years were enrolled after they had signed a written consent. Subjects were selected using the inclusion criteria, and PFT were randomly administered. Spirometer measurements (FVC, FEV₁) were taken in the supine, side lying on right, side lying on left, sitting and standing positions. Each measurement was taken three times, and the average values were analyzed. [Results] One- way analysis of variance (ANOVA) and Tukey’s Test (post hoc) for pair- wise comparison indicated that there was a significant difference in the FEV₁ values of the asthmatic patients however a significant difference was obtained between standing and supine positions. There was also a significant difference in the FVC values between the standing and supine lying position in the pair -wise comparison. [Conclusion] This study showed standing is the best position for measuring FEV₁ and FVC of asthmatic subjects. The more upright the position, the higher the FEV₁ and FVC will be.Key words: Pulmonary function test, Standing position, Spirometry     

Relationships between Gross Motor Abilities and Problematic Behaviors of Handicapped Children in Different Age Groups

[Purpose] In this study, we examined problematic behaviors of independent-walking and non-independent-walking handicapped children in the infant, school child and adolescent development phases, using the Japanese version of the Aberrant Behavior Checklist (ABC-J) to determine if such behaviors relate to their gross motor abilities. [Subjects and Methods] The subjects were 86 handicapped children who were receiving physical therapy. The subjects were classified into three groups by age. Using the Gross Motor Function Classification System (GMFCS), each group was further divided into an independent-walking group and non-independent-walking group. Thirteen physical therapists and 8 occupational therapists, who were treating the subject children, rated the subjects using the ABC-J. [Results] Significant differences were observed between the independent-walking and the non-independent-walking groups in the stereotypy and lethargy scores of infants. [Conclusion] For schoolchildren and adolescents, no significant differences were observed between the independent-walking and the non-independent-walking groups in their problematic behavior scores.Key words: Problematic behaviors, Handicapped children, Gross motor abilities     

The Effects of Hippotherapy and a Horse Riding Simulator on the Balance of Children with Cerebral Palsy

[Purpose] We with respect to their effects on the compared hippotherapy with a horseback riding simulator (JOBA, Panasonic Inc. JP) static and dynamic balance of children with cerebral palsy (CP). [Subjects and Methods] Twenty-six children were randomly divided into two groups: a hippotherapy group that included 13 children, and a horseback riding simulator (JOBA, Panasonic Inc., Japan) group, which was also composed of 13 children. The two groups participated in 1 hour of exercise per day, 3 times a week, for 12 weeks. The subjects’ static balance ability was measured using BPM (software 5.3, SMS Healthcare Inc., UK) as the center of pressure sway length while standing for 30 seconds with their eyes open and looking to the front. Dynamic balance ability was measured using the PBS (Pediatric Balance Scale). [Results] Both groups showed significant improvements in static and dynamic balance but significant differences between the two groups were not found. [Conclusion] The horseback riding simulator could be a useful alternative to hippotherapy for the improvement of static and dynamic balance of children with CP.Key words: Cerebral palsy, Balance, Hippotherapy     

Change of Range of Motion of the Temporomandibular Joint after Correction of Mild Scoliosis

[Purpose] This study aimed to verify the change in range of motion of the temporomandibular joint on correction of scoliosis. [Subjects and Methods] This study examined 31 male and female participants in their 20s and 30s with a spinal curve degree of 10° or greater. The subjects performed therapeutic exercise based on the pilates exercise system, which is known to be effective in mitigating the spinal curve for patients with scoliosis. All participants completed an 8-week therapeutic exercise regimen to alleviate the scoliosis in which exercise was performed, the exercise was done three times a week for 8 weeks and each session lasted 60 minutes. Among them, 19 participants were selected as an experiment group, whose symptoms were mitigated significantly, and 12 participants who did not undergo the exercise were identified as a control group. All subject was assessed for spinal curve degree, apparent leg length discrepancy, and deviation and range of motion of the temporomandibular joint before and after the study. [Results] In the experimental group, the apparent leg length discrepancy and the deviation of the temporomandibular joint were significantly decreased after the exercise, and the ROM in the temporomandibular joint was significantly increased. In intergroup comparisons, all variables showed a significant difference. [Conclusion] The findings suggest that as the spinal curve degree decreases significantly, the range of motion and deviation in the temporomandibular joint showed a significant change, indicating that mild scoliosis may be a negative factor affecting the deviation and range of motion of the temporomandibular joint.Key words: Scoliosis, Temporomandibular joint, TMJ ROM     

Influence of Pilates Mat and Apparatus Exercises on Pain and Balance of Businesswomen with Chronic Low Back Pain

[Purpose] The purpose of this study was to examine the influence of mat Pilates and apparatus Pilates on pain and static balance of businesswomen with chronic back pain. [Subjects and Methods] Participants were randomly allocated to Pilates mat exercises (PME) or Pilates apparatus exercise (PAE), and performed the appropriate Pilates exercises 3 days per week for 8 weeks. In order to measure the improvement in the participants’ static balance ability as a result of the exercise, the sway length and sway velocity of the subjects were measured before and after the experiment while the subjects stood on a Balance Performance Monitor (BPM) facing the front wall for 30 seconds with their eyes open. The visual analogue scale (VAS) was used to measure the degree of pain. [Results] The VAS score, sway length, and sway velocity of both groups decreased significantly after the experiment, but the PME group showed a greater decrease than the PAE group. [Conclusion] PME showed greater improvement in pain level and balance compared with PAE in this research. Since the subjects of this study were patients with low back pain, PME is assumed to have been more suitable and effective because it uses body weight to strengthen core muscles rather than heavier apparatuses as in PAE.Key words: Pilates mat exercise, Pilates apparatus exercises, LBP     

The Effect of Trunk Stabilization Exercises Using a Sling on the Balance of Patients with Hemiplegia

[Purpose] The purpose of this study was to examine the effects of trunk stabilization exercise using a saing on the balance ability of patients with hemiplegia. [Subjects] Forty patients with hemiplegia resulting from stroke were divided into a sling exercise group (SEG, n=20) and a mat exercise group (MEG, n=20). [Methods] The SEG conducted the trunk stabilization exercise using a sling, and the MEG performed the trunk stabilization exercise on a mat. [Results] The balance ability of both groups significantly improved. Although there were no significant differences between the groups, the SEG showed a greater reduction in the sway area (SA) and the sway length (SL) of the center of the pressure compared to the MEG. [Conclusion] We recommend trunk stabilization exercise using a sling as a clinical intervention to improve the balance ability of patients with hemiplegia.Key words: Hemiplegia, Trunk stabilization exercise, Sling     

Different cutoff values for 10-m walking speed simply classification of walking independence in stroke patients with or without cognitive impairment

[Purpose] The aim of this study was to determine the threshold for classifying walking independence in stroke patients with and without cognitive disorders. [Subjects] The subjects were 130 patients with initial stroke hemiplegia. [Methods] The following factors were analyzed for associations with walking independence: Brunnstrom stage, one-leg standing time on the paralytic side, one-leg standing time on the non-paralytic side, and 10-m walking speed. We classified the patients with Mini-Mental State Examination (MMSE) scores ≥24 points into the high-score group and those with MMSE scores of ≤23 points into the low-score group and examined the main factors and cutoff values associated with walking independence in each group. [Results] The high-score group included 69 subjects (53.1%), and the low-score group included 61 subjects (46.9%). The primary factor associated with high MMSE scores among the stroke patients was the 10-m walking time. Using a cutoff level for the 10-m walking speed of 41.4 m/min resulted in a positive likelihood ratio of 6.3. The primary factor associated with low MMSE scores among the stroke patients was the 10-m walking time. Using a cutoff level for the 10-m walking speed of 48.0 m/min resulted in a positive likelihood ratio of 7.6. [Conclusion] The cutoff value for the 10-m walking speed can be used to evaluate walking independence in patients with stroke among patients with high or low MMSE scores.Key words: Walking, Cognition disorders, Stroke     

Epidemiological characteristics and prognostic factors of post-traumatic endophthalmitis

ObjectiveTo examine the prognostic factors and features of post-traumatic endophthalmitis.MethodsThis retrospective study enrolled adult patients (>18 years old) diagnosed with post-traumatic endophthalmitis. Their medical records were reviewed and the patient demographic characteristics, features of injury, management, outcomes and microbiology data were analysed.ResultsA total of 131 eyes from 131 patients were enrolled. Post-traumatic endophthalmitis was more common in male patients (122 of 131 patients: 93.1%), in those aged 30–44 years (51 of 131 patients: 38.9%), in those injured with a metallic object (86 of 131 patients; 65.6%), in those with a penetrating injury (90 of 131 patients; 68.7%) and those that were injured at work (106 of 131 patients; 80.9%). The mean ± SD time of presentation to the hospital and developing endophthalmitis was 40.60 ± 19.32 h and 5.19 ± 2.55 days, respectively. Of the cultures, 84 of 131 (64.1%) were negative and 22 of 131 (16.8%) were positive for Staphylococcus species. Patients with delayed presentation, an intraocular foreign body, traumatic cataract, retinal detachment, larger wounds, positive smears and cultures and work-related injuries had worse outcomes.ConclusionImmediate presentation to an ophthalmic centre and timely diagnosis and intervention may lead to better outcomes.     

Comparison of isokinetic muscle strength and muscle power by types of warm-up

[Purpose] The purpose of this study was to clarify the influence of static stretching at warm-up on the isokinetic muscle torque (at 60°/sec) and muscle power (at 180°/sec) of the flexor muscle and extensor muscle of the knee joint. [Subjects and Methods] The subjects of this study were 10 healthy students with no medically specific findings. The warm-up group and warm-up with stretching group performed their respective warm-up prior to the isokinetic muscle torque evaluation of the knee joint. One-way ANOVA was performed by randomized block design for each variable. [Results] The results were as follows: First, the flexor peak torque and extensor peak torque of the knee joint tended to decrease at 60°/sec in the warm-up with stretching group compared with the control group and warm-up group, but without statistical significance. Second, extensor power at 180°/sec was also not statistically significant. However, it was found that flexor power increased significantly in the warm-up with stretching group at 180°/sec compared with the control group and warm-up group in which stretching was not performed. [Conclusion] Therefore, it is considered that in healthy adults, warm-up including two sets of stretching for 20 seconds per muscle group does not decrease muscle strength and muscle power.Key words: Stretching, Warm-up, Muscle power     

Comparison of the Plantar Pressure Distributions at Different Degrees of Tilting: A Preliminary Report

[Purpose] The purpose of this study was to investigate the amount of plantar pressures on the lower limb during tilt table standing and to indicate the ideal degree of tilting for partial weight bearing. [Subjects and Methods] Fifteen healthy subjects between the ages of 20 and 30 were recruited as volunteers for this study. All the measurements were taken while standing on a tilt table according to different inclination angles. [Results] The plantar pressures for 60° tilt table standing were lower by 7–9% of total body weight than the pressures during tilt table standing at 90°, and the pressures for 30° tilt table standing were lower by 18–20% of total body weight than the pressures for tilt table standing at 90°. [Conclusion] Standing training on a 60° tilt table might be equivalent to 80% of full weight bearing training, and tilt table standing training at 30° might be equivalent to 60% of full weight bearing training.Key words: Tilt table standing, Partial weight bearing, Standing training     

Effect of Different Insoles on Postural Balance: A Systematic Review

[Purpose] The aim of the present study was to perform a systematic review of the literature on the effect of different insoles on postural balance. [Subjects and Methods] A systematic review was conducted of four databases. The papers retrieved were evaluated based on the following inclusion criteria: 1) design: controlled clinical trial; 2) intervention: insole; 3) outcome: change in static postural balance; and 4) year of publication: 2005 to 2012. [Results] Twelve controlled trials were found comparing the effects of different insoles on postural balance. The papers had methodological quality scores of 3 or 4 on the PEDro scale. [Conclusion] Insoles have benefits that favor better postural balance and control.Key words: Postural balance, Proprioception, Foot     

Clinicopathological features and differential diagnosis of gastrofibromatosis-like undifferentiated carcinoma

ObjectiveTo study the clinicopathological features and differential diagnosis of gastrofibromatosis-like undifferentiated carcinoma (GFLUC).MethodsThree patients with GFLUC underwent histological and immunophenotypic analyses and fluorescence in situ hybridization to detect human epidermal growth factor receptor (HER2) gene amplification.ResultsAmong the three patients (2 male [36 and 44 years old], 1 female [58 years old]), two had lesions in the gastric body and one had lesions in the gastric antrum. Histological analysis revealed mixtures of aggressive fibromatosis and undifferentiated carcinoma in all three cases. Highly invasive fibromatous tissue, consisting of fibroblasts, proliferating myofibroblasts, and collagenous fibrous tissues, accounted for >90% of the tumor, with undifferentiated cancerous tissue accounting for <10% scattered in the gaps within the invasive fibromatous tissue, with no glandular ducts or nests. Immunophenotypic analysis showed that the undifferentiated cancerous cells were positive for pan-cytokeratin, CDX2, villin, and p53, while the cytoplasm of invasive fibromatous cells was positive for vimentin, β-catenin, and smooth muscle actin. No HER2 gene amplification was detected.ConclusionsUnlike other gastric carcinomas, GFLUC shows specific histological, biological, and immunophenotypic characteristics.     

Development and Comparative Evaluation of New Shapes of Pillows

The purpose of this study was to determine pillow designs suitable for supine and side-lying positions. [Subjects] Twenty female and twenty male subjects with a mean age of 22.7 years (SD = 1.3) participated in the study. [Methods] First, a three-dimensional motion analysis system was used to analyze the movements of the head and the shoulder joints during changes from supine positions to side-lying positions. Second, the height from the face to the shoulder and the height from the floor to the middle of the neck in a side-lying position were measured. Third, the weight distribution ratios of the head and the trunk were compared using general pillows (polyester sponge), memory foam, and prototype pillows. [Results] During position changes from supine positions to side-lying positions, the head moved in a fan shape, and the shoulder joint moved an average of 4.4 cm upward. The height from the face to the shoulder was 9 cm on average. The height from the floor to the middle of the neck was 11 cm on average. The weight distribution ratios between the head and the trunk were compared among general pillows (polyester sponge), memory foam, and prototype pillows. The results showed significant differences in the side-lying position. [Conclusion] Pillows with uniform heights are not suitable for a supine or side-lying position. In the case of both positions, users should be allowed to select pillows in shapes that can support the neck.Key words: Pillow, Sleep position, Motion analysis     

The Relationship of Abdominal Muscles Balance and Body Balance

This study aimed to identify what impact the thickness differences between the leftside and rightside transversus abdominis (TrA), internal obliquus (IO) and external obliquus (EO) have on balance ability in the abdominal drawing-in maneuver (ADIM) and resting postures. [Subjects and Methods] In this study, 41 young adults were asked to adopt a resting posture and to perform ADIM. The thicknesses of the abdominal muscles (TrA, IO, EO) were measured using ultrasound imaging, Then balance ability was measured, so that a comparative analysis could be carried out. [Results] According to the results, the thicknesses of TrA and IO very significantly increased when ADIM was performed. The changes in thickness of the muscles on the left and right sides showed no significant correlations with balance ability. [Conclusion] According to the study results, the difference in thickness between the left and right side muscles in a normal person is small (symmetric), and the differences in the thickness of TrA and IO on the left and right side reduced when the ADIM, which is a re-education method for abdominal muscles was performed. Therefore, we consider that the ADIM should be used in future clinical trials to induce symmetric contraction of the abdominal muscles. Also, the correlation results of muscle balance and body balance can be used as empirical data.Key words: Ultrasound, Abdominal muscle, Imbalance     

不同致病菌致老年肺炎血清降钙素原的改变

目的 :评价血清降钙素原 (PCT)在鉴别老年细菌性肺炎与病毒性肺炎方面的预测价值。方法 :对全部 82例老年肺炎患者进行血清降钙素原、C-反应蛋白 (CRP)及外周血白细胞计数 (WBC)检查 ,并比较各指标在细菌及病毒感染中的差异。结果 :若以 PCT≥ 0 .5 ng/ ml为阳性阈值 ,则血清 PCT检测对细菌感染的敏感性为 91.4 % ,特异性为83.3% ,阳性预测值为 93.0 % ,阴性预测值为 80 .0 %。病毒感染组和细菌感染组 PCT有显著性差异 (P<0 .0 1)。结论 :PCT可作为细菌感染诊断的有效指标之一 ,可用于鉴别病毒感染和细菌感染。