Showing papers in "Journal of Physical Therapy Science in 1999"

Motricity Index Scores are Valid Indicators of Paretic Upper Extremity Strength Following Stroke

Abstract: This retrospective pilot study was conducted to examine the validity of upper extremity Motricity Index scores. The strength of the paretic upper extremity of 10 patients with stroke was measured using the Motricity Index and dynamometry. Specifically measured were hand-grasp, elbow flexion, and shoulder abduction. The criterion validity of the Motricity Index scores was supported by their significant and high correlations with dynamometer measures (r >.74). The construct validity of the Motricity Index scores was demonstrated by their high Cronbachis alpha (.968). The Motricity Index is a valid instrument for characterizing the strength of the paretic upper extremity following stroke.

Effect of Heel Height on the Foot in Unilateral Standing

Abstract: The purpose of this investigation was to study the effect of elevating the heel during unilateral weight-bearing on structure of the foot, especially a "flat" foot, and on function of the foot in maintaining balance. We examined 16 healthy women, 21 to 23 years of age, who stood unilaterally on the right foot with the heel elevated 0, 5, 10, 15, 20, 25, 30, and 40 mm. We measured height of the medial longitudinal arch, rearfoot pronation (calf-to-calcaneus angle), displacement of center of pressure under the foot during ten seconds, and mean position of the center of pressure during those ten seconds. Elevating the heel raised the medial longitudinal arch, reduced rearfoot pronation, increased length of displacement of the center of pressure, and brought the mean center of pressure forward and medially. In feet that initially had strong rearfoot pronation, presence of an initially high medial longitudinal arch was associated with a greater curtailment of rearfoot pronation when the heel was elevated than if the arch was not initially high. These results suggest that elevating the heel of a shoe can help reduce the signs of a flat foot, but the accompanying decrease in balance stability and shift of pressure toward the first metatarsal head makes the use of elevated heels questionable as a therapeutic measure.

Effects of Toe Grasp Training for the Aged on Spontaneous Postural Sway

Abstract: Falls are a common problem among elderly persons, but the training for the fall prevention is not well established. Therefore, the effectiveness of toe grasp training was examined in this study. Spontaneous postural sway was tested on elderly persons (N=19) with eyes open and eyes closed. Using a force plate, sway responses were quantified in terms of the total track length, the environmental areas, the maximum amplitude distance of X-axis, and the maximum amplitude distance of Y-axis. The data was compared between the toe grasp training group and the control group. Total track length (eyes open and eyes closed), environmental areas (eyes open) and maximum amplitude distance of X-axis (eyes open and eyes closed) were improved significantly in the toe grasp training group. The activation of foot mechanoreceptors and improvements of the eye-leg coordination were thought to be factors in this improvement and toe grasp training is expected to be effective for fall prevention of the aged.

Effect of Visual Feedback on Muscle Endurance in Normal Subjects

Abstract: The measurement of maximum voluntary isokinetic contraction is a common practice in research and clinical settings. The purpose of this study was to investigate the effect of visual feedback on muscle endurance. Subjects were 22 male, between the ages of 18 and 31. Each subject had no history of lower extremity joint injury, surgery, or disease. All subjects completed two isokinetic exercise test sessions. The tests consisted of 50 maximum voluntary isokinetic contractions, using dynamometer (KIN-COM500H) at 90 degrees per second. All left lower extremities were measured. On endurance and effects fatigue index of visual feedback and no visual feedback were compared about every tenth average peak torque. On comparisions between with and without visual feedback were analyzed using a paired t-test. On average between 11th and 20th repetitions, average peak torque with visual feedback was significantly greater than without visual feedback (p<0.05). Excepting average torque between 11th and 20th repetition the results indicated no significant difference between with and without visual feedback. The fatigue index with feedback was not significantly different from that without visual feedback. These results suggest that visual feedback does not influence the fatigue index in measurements of muscle endurance.

Application of an Electromyographic Index of Gait Instability to Developmental Process of Supported Walking in Normal Neonates and Infants.

Abstract: The purpose of this study was to see whether an electromyographic (EMG) index of gait instability is applicable to the developmental process of supported walking in normal neonates and infants. In six neonates ranging in age from 14 to 26 days after birth, EMGs of stepping were recorded at approximately from one to four week intervals until around four months. Additionally, longitudinal- EMGs of one subject were recorded at one or two week intervals until just before independent walking. EMG patterns of the lateral gastrocnemius (an ankle plantarflexor) and vastus medialis (a knee extensor) in the latter part of swing phase indicating unstable walking, not seen in the neonatal period up to first postnatal month, tended to increase in young infants at around three postnatal months. These results suggest the addition of voluntary infant stepping to reflex neonate stepping from around three months. From six to twelve months, these marked activities tended to decrease, gradually coming to resemble adult stable walking through development of strength, balance, and postural control. In conclusion, muscular activities of the lateral gastrocnemius and vastus medialis in the latter part of swing phase indicate unstable walking, findings which are applicable to developmental changes during newborn stepping and infant supported walking.

Increasing Gait Performance in Elderly Women Using a Step Exercise Training Program

Abstract: The purpose of this study was to examine the effects of training on sensorimotor functions including muscle strength, motor time for the ankle, balance reaction and performance in six minute walk using a step exercise training program for a period of 8 weeks in 10 elderly women (mean age=79.8, SD=5.8) among residents of a health institution for the aged. As a result of the training program the follow factors significantly improved: the best mean torque for the dorsi flexor and the plantar flexor (0.12 ± 0.07→0.21 ± 0.07 Nm/kg, 0.44 ± 0.13→0.62 ± 0.19 Nm/kg); motor time at the dorsi flexor and the plantar flexor (61.0 ± 6.4→45.0 ± 4.2 msec, 55.1 ± 5.4→42.7 ± 5.1 msec); anteroposterior movement distance of the body’s center of gravity (3.6 ± 2.0→5.6 ± 2.7 cm) and the six minute walk distance (256.4 ± 48.4→319.3 ± 65.4 m). Also, it was shown that there were significant correlations between Δ the best mean torque and both Δ the anteroposterior movement distance and Δ the six minute walk distance (r=0.78 p<0.01, r=0.66 p<0.05). These results suggest that the training program increased gait performance.

Human Gait Analysis as viewed from A/K and B/K Force Plate/Stick Figures.

Abstract: The motions involved in the ordinary act of walking which we all perform unthinkingly are in fact very complex and require great agility, and once impairment occurs, abnormal gait will result. The present study experimented with mechanical analysis of walking with a false leg, with a view to clinical application. Attention was focused on wave components common to the floor reaction patterns of A/K (-trans-femoral (Above Knee) amputation) and B/K (-trans-tibial (Below Knee) amputation) subjects, and waveform factors were analyzed. In this research, a VICON 3D motion analysis system was used to analyze the walking motions of A/K and B/K subjects by means of stick figure and force plate representations. Attention was focused on knee-joint movement in stick-figure analysis, and on Z-component waveforms in force plate analysis. Results showed significant differences between false leg and natural leg during mid stance in A/K subjects. Furthermore, the false leg Z-component waveforms were saw-tooth type with A/K subjects, and notch type with B/K subjects.

Sympathetic Skin Response and R-R Interval Variation in Chronic Administration of Salmon Calcitonin.

Abstract: The distribution of calcitonin and CGRP-producing cells and pathways in the brain and other tissues suggests functions for the peptide in nociception, ingestive behaviour and modulation of the autonomic and endocrine systems. Sympathetic skin response (SSR), is a reliable indicator of autonomic dysfunctions. The heart rate variability termed as R-R interval variation (RRIV) is another simple and reliable test which can be used to determine vagal autonomic dysfunction. Twenty female patients with active osteoporosis aged between 46-58 and for a control group 20 age-matched healthy female volunteers with no history or evidence of any other disease were included in this study. The study results show that long term therapy with salmon calcitonin does not effect any SSR and RRIV parameters. It can be speculated that though human calcitonin and CGRP have discrete functions in the human autonomic nervous system, replacement therapy with salmon calcitonin does not interfere normal autonomic functions.

Effects of the CREATOR Ankle Brace on Crural Muscle Activities in Some Kinds of Actions by EMG.

Abstract: This study investigated the effects of the ankle brace “CREATOR” on lower extremity muscles in performances by maximum amplitudes of the integrated electromyogram (IEMG). Twelve female handball players performed four exercises, repeated side step, vertical high jump, standing long jump and pivot. Maximum amplitudes of all muscles with the brace tended to be less than those without it. Those of tibialis anterior in the repeated side step and pivot, medial gastrocnemius in all performances except for repeated side step and peroneus longus and peroneus brevis in the repeated side step were significant. Thus with the brace, subjects performed the same with less muscle activity than without it, and this brace prevented an ankle sprain against the side direction.

Functional Recovery and Prediction of Prognosis in Incomplete Spinal Cord Injured Persons.

Abstract: Making a functional prognosis for patients with traumatic incomplete spinal cord injuries is extremely important not only for the patients themselves, in attempting to achieve independence in activities of daily living and social rehabilitation, but also for medical co-workers, the family and almost everyone in the society. However, only very few reports deal with this subject, and rehabilitation is often conducted aimlessly. In the present study we tried at our department to summarize the functional prognosis of patients with spinal injuries and set up a preliminary standard for rehabilitation. The present study included 75 patients with Frankel class C, D, E, incomplete spinal injury who underwent rehabilitation training in the past ten years at our department. The level of the injury was the cervical cord in 53 patients and the thoracic or lumbar cord in 22 patients. The average age of the patients was 36.2 years. Seventy of the patients were male and 5 female. The time of the final evaluation after the injury was on the average 11.8 months (SD=5.9 months). When muscle power of the lower extremities three months after injury reached [4], patients accomplished independent walking 6.8 months after the injury. When muscle power of the lower extremities 6.5 months after injury reached [3-], patients accomplished semi-independent walking with the help of a wheelchair 8.7 months after the injury. Patients with a muscle power of more than [3-] in the upper extremities could walk independently. Among patients with incomplete injury of the cervical cord 64% gained independence in ADL 8.6 months after the injury, but patients with central paralysis or strong spasticity required assistance.

Effects of Salmon Calcitonin on Somatosensory Evoked Potentials.

Abstract: Besides its Ca++ regulative effects, calcitonin is known to diminish sensitivity to painful stimuli. The present study aims to clarify whether calcitonin has similar effects on stimulus processing in other modalities. The study was performed according to a double-blind and placebo controlled protocol. Sixteen patients with osteoporosis were given intramuscularly 100 IU salmon calcitonin (sCT) or 1 ml saline solution as placebo, randomly on first and fifteenth days. One hour after injection, SEP’s were recorded at the scalp, following right posterior tibial nerve stimulations at the ankle. Latencies of wave-form modalities and amplitude did not differ between sCT and placebo groups (p>0.05). However, latency differences of N42-N65 (ΔLAT) and area were significantly prolonged in sCT group (p<0.05). As a result we can speculate that sCT can change some SEP modalities which can be interpreted as the central effects of sCT.

Relationship of the Lung Volume to Height, Arm Span, Upper Arm Length and the Second Digital Proximal Phalangeal Length.

Abstract: The purpose of this study was to clarify whether the estimation formula for height (Ht) is suitable for correcting data from lung function tests. We collected fundamental data in healthy young adults to investigate whether the data was correlated to the actual pulmonary functions or not. The subjects were 157 healthy young persons (59 males and 98 females). We measured arm span (AS), length of upper arm (UA), and the right second digit proximal phalangeal length (RII). The values of AS, UA, RII for males and females correlated positively and significantly with each other. Next, the vital capacity (VC) and forced expiratory volume per second (FEV1.0) were determined in 70 females and 35 males in all subjects, by the electrospirometer. In both sexes, correlation coefficients between VC, FEV1.0 and Ht was more than 0.6, but correlation coefficients between VC and the sizes of body parts was 0.6 or less. These results suggest that height estimation derived from RII, obtained from the upper extremities, was useful. However, the accuracy of estimation for VC and FEV1.0 based on the lengths of body parts was low because their correlation coefficients were as low as 0.6 or less.

Factor of Determination of the Center of Gravity Point on Sitting of the Right and Left Axis in Patients with Hemiplegia

Abstract: The purpose of this study was to investigate the factor of determination of the center of gravity of the right and left axis in sitting of hemiplegic patients. Subjects were 30 hemiplegic patients. The subjects center of gravity point was measured during 1) natural sitting, 2) sitting on the non-paretic weight-bearing, and 3) sitting on the paretic weight-bearing under eyes open and eyes closed conditions for ten seconds. We calculated the middle point value for 2) and 3), and observed a correlation between the center of gravity point during natural sitting and the middle point. This result indicate that the center of gravity point is decided by relative position of the maximal voluntary weight-bearing of the non-paretic and paretic sides.

Effects of Active Thumb Movements upon Early Component of Somatosensory Evoked Potential.

Abstract: This study aimed to investigate the effects of thumb movement at three frequencies on early components of SEP. Subjects consisted of eighteen healthy persons whose age ranged from 19 to 30 years old (average age; 22 ± 3). The subjects pressed a counter set on a desk with the right thumb and electric stimulation was simultaneously applied to the median nerve of part of the right wrist joint. SEP was recorded at C3 on the contralateral scalp. The following results were obtained: 1) The latencies of P1, N1 and P2 were significantly prolonged during the counter pushing at a frequency of 1 Hz.citation=2. The peak to peak amplitudes of the P1-N1 and N1-P2 were significantly reduced by about 14% and 38%, respectively, during thumb movement at a frequency of 3 Hz.citation=3. These peak to peak amplitudes were not significantly decreased during counter pushing at a frequency of 0.25 Hz. The amplitude reduction of early components of SEP was observed during the thumb movements at a high frequency. The reduction was thought due to a repression of the sensory area by the ipsilateral motor one. These repressive effects varied with the frequency of movement.

Correlations between Magnetic Resonance Imaging and Clinical Findings of Traumatic Incomplete Spinal Cord Injuries in the Chronic Stage

Abstract: Because of recent rapid progress in magnetic resonance imaging (MRI), intraspinal lesions have been clarified. On the correlation between the paralysis grade and MRI signal pattern, it was known that cases of complete paralysis were many in spinally-ruptured and large type while those of incomplete paralysis were many in medium and small type; however, many cases of incomplete paralysis with various symptoms did not necessarily coincide with MRI signal patterns. In this study the correlation between MRI signal patterns in the coronal plane and incomplete paralysis was studied in 27 cases of spinal cord injury in the chronic stage. The results found were 1) the spinal cord lesion of many cases were C3-4 and C4-5; 2) the types of many MRI signal patterns were small oval 44% and girdle 26%; 3) three-dimensional types of the patterns were cylindroid 56%, polygon 22%, cone 18.5%, and gourd 3.5%; 4) the coincidence ratios in size between expected injured areas and the patterns were small 86%, medium 55%, and large 67%.