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Jiroumaru T, Hyodo Y, Mori K, Hattori T, Wachi M, Shichiri N, Fujikawa T. Relationship between respiratory muscle strength and dynamic balance in older persons requiring care or support: Focusing on the maximal single step length test and maximal double step length test as dynamic balance indices. Gait Posture 2024; 109:64-69. [PMID: 38281431 DOI: 10.1016/j.gaitpost.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 12/10/2023] [Accepted: 12/28/2023] [Indexed: 01/30/2024]
Abstract
BACKGROUND Falls are a major health problem. The relationship between dynamic balance related to falls and respiratory muscle strength related to sarcopenia and frailty is poorly understood. RESEARCH QUESTION How do dynamic balance measures, such as maximal single step length test (MSL) and maximal double step length test (MDST), and respiratory muscle strength measures, such as maximal inspiratory (PImax) and maximal expiratory (PEmax), related to the requirement for long-term care or support in older people who live in the community? METHODS This was a cross-sectional study of 39 older people (17 men, 22 women) aged ≥ 65 years community-dwelling who were certified as requiring long-term care or support under the Japanese system. The participants' PImax, PEmax, MSL, and MDST results were recorded. The measurement data were evaluated using Pearson's correlation coefficients and multiple regression analysis. RESULTS MDST showed a positive correlation with PImax (r = 0.430, p = 0.006) but no correlation with PEmax. MSL showed no correlation with PImax or PEmax. A positive correlation was found between MDST and MSL (r = 0.851, p < 0.001), and multiple regression analysis with MDST as the dependent variable and PImax and MST as independent variables showed significant differences for MSL (p < 0.001) and PImax (p = 0.027). SIGNIFICANCE In older people requiring long-term care or support, MDST had a greater association with inspiratory muscle strength compared with MSL. These results suggest the importance of inspiratory muscle strength training and MDST assessment in the prevention of falls in older people requiring long-term care or support.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, School of Health Sciences, Bukkyo University, 7 Nishinokyohigashitoganocho, Kyoto Nakagyo-ku, Kyoto 604-8418, Japan.
| | - Yutaro Hyodo
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Kenji Mori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Tomoka Hattori
- Kanazawa Orthopaedic and Sports Medicine Clinic, Ritto, Shiga, Japan
| | - Michio Wachi
- Bukkyo University, Kyoto Nakagyo-ku, Kyoto, Japan
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Nakai Y, Kijimuta T, Takeshita Y, Kiyama R, Araki S, Miyazaki T, Kawada M. Effects of External Abdominal Pressure Support on Dynamic Balance: A Randomized Crossover Study. Sports (Basel) 2023; 11:217. [PMID: 37999434 PMCID: PMC10675581 DOI: 10.3390/sports11110217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 10/26/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
Abdominal pressure is vital in protecting the lumbar spine and controlling postural balance. Dynamic balance is associated with movement stability, adaptation to load, and reduced injury risk. Although trunk stability has been examined using belts and braces, the effects of external abdominal pressure support (APS) on balance control remain unknown. In this study, we aimed to determine the effects of external APS on dynamic balance. Overall, 31 young adults participated in this randomized crossover study. External APS was provided using a device that could be pressurized and decompressed by inflating a cuff belt wrapped around the trunk. The modified Star Excursion Balance Test was performed under external APS and non-APS conditions. The maximum anterior, posterolateral, and posteromedial values normalized to the spinal malleolar distance and their respective composite values were compared between the two conditions with and without APS. Posterolateral, posteromedial, and composite values were significantly higher in the APS condition than in the non-APS condition (p < 0.001). The external APS was effective in immediately improving dynamic balance. Furthermore, APS was effective in dynamic balance control as it improved stability during anterior trunk tilt, which displaces the center of gravity forward.
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Affiliation(s)
- Yuki Nakai
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Takara Kijimuta
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Yasufumi Takeshita
- Department of Mechanical Systems Engineering, Faculty of Engineering, Daiichi Institute of Technology, 1-10-2 Kokubuchuo, Kirishima 899-4395, Japan (Y.T.)
| | - Ryoji Kiyama
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; (R.K.); (M.K.)
| | - Sota Araki
- Course of Physical Therapist, Department of Rehabilitation, Faculty of Health Sciences, Tohoku Fukushi University, 1-8-1 Kunimi Aoba-ku, Sendai 981-8522, Japan;
| | - Takasuke Miyazaki
- Department of Orthopaedic Surgery, Graduate School of Medical and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan;
| | - Masayuki Kawada
- Department of Physical Therapy, School of Health Sciences, Faculty of Medicine, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima 890-8544, Japan; (R.K.); (M.K.)
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Bai J, Hua A, Weng D, Wang N, Wang J. Effects of non-extensible lumbar belts on static and dynamic postural stability. BMC Musculoskelet Disord 2023; 24:362. [PMID: 37158940 PMCID: PMC10165835 DOI: 10.1186/s12891-023-06476-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 04/28/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Previous studies have found that increased intra-abdominal pressure helps to reduce spinal loading and improve spine stability. Non-extensible lumbar belts (NEBs) could elevate intra-abdominal pressure and augment spinal stability. NEBs have been used in the healthcare field to help reduce pain and improve spine function for people with low back pain. However, the effect of NEBs on static and dynamic postural stability is not clear. METHODS This study aimed to investigate whether NEBs affect static and dynamic postural stability. Twenty-eight healthy male subjects were recruited to finish four static postural stability tasks and two dynamic postural stability tests. Center of pressure (COP) values during 30 s of quiet standing, dynamic postural stability index (DPSI) and Y balance test (YBT) score with and without NEBs were analyzed. RESULTS NEBs had no significant effect in all COP variables in the static postural tasks. The results of a repeated measure two-way ANOVA indicated the NEBs significantly improved the dynamic postural stability in YBT score and DPSI (F (1,27) = 5.506, p = .027, [Formula: see text] and F (1,27) = 83.94, p = .000, [Formula: see text] respectively). CONCLUSIONS The study results indicate that non-extensible belts improve dynamic stability in healthy male participants, with potential implications for rehabilitation and performance enhancement programs.
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Affiliation(s)
- Jingyuan Bai
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Anke Hua
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Dongkai Weng
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China
| | - Nan Wang
- Hangzhou Weizhen Health Technology Co., Ltd., 310058, Hangzhou, China
| | - Jian Wang
- Department of Sports Science, College of Education, Zhejiang University, Hangzhou, 310058, China.
- Center for Psychological Sciences, Zhejiang University, Hangzhou, 310058, China.
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Walters S, Hoffman B, MacAskill W, Johnson MA, Sharpe GR, Mills DE. The control of respiratory pressures and neuromuscular activation to increase force production in trained martial arts practitioners. Eur J Appl Physiol 2021; 121:3333-3347. [PMID: 34432148 DOI: 10.1007/s00421-021-04800-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 08/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The mechanisms that explain the ability of trained martial arts practitioners to produce and resist greater forces than untrained individuals to aid combat performance are not fully understood. We investigated whether the greater ability of trained martial arts practitioners to produce and resist forces was associated with an enhanced control of respiratory pressures and neuromuscular activation of the respiratory, abdominal, and pelvic floor musculature. METHODS Nine trained martial arts practitioners and nine untrained controls were instrumented with skin-surface electromyography (EMG) on the sternocleidomastoid, rectus abdominis, and the group formed by the transverse abdominal and internal oblique muscles (EMGtra/io). A multipair oesophageal EMG electrode catheter measured gastric (Pg), transdiaphragmatic (Pdi), and oesophageal (Pe) pressures and EMG of the crural diaphragm (EMGdi). Participants performed Standing Isometric Unilateral Chest Press (1) and Standing Posture Control (2) tasks. RESULTS The trained group produced higher forces normalised to body mass2/3 (0.033 ± 0.01 vs. 0.025 ± 0.007 N/kg2/3 mean force in Task 1), lower Pe, and higher Pdi in both tasks. Additionally, they produced higher Pg (73 ± 42 vs. 49 ± 19 cmH2O mean Pg) and EMGtra/io in Task 1 and higher EMGdi in Task 2. The onset of Pg with respect to the onset of force production was earlier, and the relative contributions of Pg/Pe and Pdi/Pe were higher in the trained group in both tasks. CONCLUSION Our findings demonstrate that trained martial arts practitioners utilised a greater contribution of abdominal and diaphragm musculature to chest wall recruitment and higher Pdi to produce and resist higher forces.
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Affiliation(s)
- Sherrilyn Walters
- Respiratory and Exercise Physiology Research Group, School of Health and Wellbeing, University of Southern Queensland, 11 Salisbury Road, Ipswich, QLD, 4305, Australia.
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia.
| | - Ben Hoffman
- Respiratory and Exercise Physiology Research Group, School of Health and Wellbeing, University of Southern Queensland, 11 Salisbury Road, Ipswich, QLD, 4305, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - William MacAskill
- Respiratory and Exercise Physiology Research Group, School of Health and Wellbeing, University of Southern Queensland, 11 Salisbury Road, Ipswich, QLD, 4305, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
| | - Michael A Johnson
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Graham R Sharpe
- Exercise and Health Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, Nottinghamshire, UK
| | - Dean E Mills
- Respiratory and Exercise Physiology Research Group, School of Health and Wellbeing, University of Southern Queensland, 11 Salisbury Road, Ipswich, QLD, 4305, Australia
- Centre for Health Research, Institute for Resilient Regions, University of Southern Queensland, Ipswich, QLD, Australia
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Jiroumaru T, Wachi M, Noguchi S, Ikeya M, Hattori T, Fujitani R, Suzuki M, Tanida S, Shichiri N, Fujikawa T. Is the diaphragm thickness related to gait speed in patients with hemiplegia caused by cerebrovascular accident? J Phys Ther Sci 2021; 33:450-454. [PMID: 34177107 PMCID: PMC8219597 DOI: 10.1589/jpts.33.450] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 03/10/2021] [Indexed: 11/24/2022] Open
Abstract
[Purpose] We aimed to determine the relationship between gait speed and diaphragm thickness in community-residing patients with hemiplegia caused by cerebrovascular accidents. [Participants and Methods] We recruited 11 elderly participants (six male and five female, mean age 71.1 ± 13.6 years) from an outpatient rehabilitation unit. The inclusion criteria were as follows: patients with hemiplegia caused by cerebrovascular accidents, those able to walk without assistance, and those able to understand our instructions. We measured the diaphragm thickness on both the paretic and non-paretic sides in each participant during maximum exhalation and inhalation during three laboured breaths by ultrasonography with a 7.5-MHz linear scanner. The liner scanner was placed on the eighth or ninth rib between the anterior and middle axillary lines. And their gait speed was measured during a 10 m walk. [Results] There was a strong positive correlation between gait speed and the ratio of diaphragm thickness between the paretic and the non-paretic sides during maximal inspiration. The other measured parameters did not show significant correlation with gait speed. [Conclusion] The symmetrical thickness of the diaphragm is a key factor in increasing gait speed in patients with hemiplegia. These findings may contribute to the development of trunk muscle strength-training programs that improve trunk function and gait speed in patients with hemiplegia.
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Affiliation(s)
- Takumi Jiroumaru
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Michio Wachi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Shinichi Noguchi
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Masae Ikeya
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | | | - Ryo Fujitani
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
| | - Mika Suzuki
- Department of Physical Therapy, Biwako Professional University of Rehabilitation: 967 Kitasaka-cho, Higashiomi, Shiga 527-0145, Japan
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