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Lee JH, Kim EJ. Optimizing Rehabilitation Outcomes for Stroke Survivors: The Impact of Speed and Slope Adjustments in Anti-Gravity Treadmill Training. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:542. [PMID: 38674188 PMCID: PMC11052273 DOI: 10.3390/medicina60040542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Revised: 03/14/2024] [Accepted: 03/26/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: This study explored the efficacy of customized anti-gravity treadmill (AGT) training, with adjustments in speed and incline, on rehabilitation outcomes for stroke patients, focusing on knee extensor muscle strength, joint angle, balance ability, and activities of daily living (ADLs). Materials and Methods: In this study, 30 individuals diagnosed with a stroke were divided into three groups. Experimental group 1 (EG1) underwent training without changes to speed and incline, experimental group 2 (EG2) received training with an increased incline, and experimental group 3 (EG3) underwent training with increased speed. Initially, all participants received AGT training under uniform conditions for two weeks. Subsequently, from the third to the sixth week, each group underwent their specified training intervention. Evaluations were conducted before the intervention and six weeks post-intervention using a manual muscle strength tester for knee strength, TETRAX for balance ability, Dartfish software for analyzing knee angle, and the Korean version of the Modified Barthel Index (K-MBI) for assessing activities of daily living. Results: Within-group comparisons revealed that AGT training led to enhancements in muscle strength, balance ability, joint angle, and ADLs across all participant groups. Between-group analyses indicated that EG2, which underwent increased incline training, demonstrated significant improvements in muscle strength and balance ability over EG1. EG3 not only showed significant enhancements in muscle strength, joint angle, and ADLs when compared to EG1 but also surpassed EG2 in terms of knee strength improvement. Conclusions: In conclusion, the application of customized AGT training positively impacts the rehabilitation of stroke patients, underscoring the importance of selecting a treatment method tailored to the specific needs of each patient.
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Affiliation(s)
| | - Eun-Ja Kim
- Department of Physical Therapy, Kyungdong University, 815 Gyeonhwon-ro, Munmak-eup, Wonju-si 26495, Republic of Korea;
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Ha SY, Sung YH. Developmentally delayed children with different muscle tone have different muscle activity and acceleration during sit-to-stand. J Exerc Rehabil 2023; 19:327-331. [PMID: 38188129 PMCID: PMC10766446 DOI: 10.12965/jer.2346508.254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 11/09/2023] [Indexed: 01/09/2024] Open
Abstract
Developmental delays cover a wide range, with different movement characteristics occurring depending on differences in muscle tone. We aimed to investigate muscle activity and acceleration during sit-to-stand in developmentally delayed (DD) children with different muscle tones. Forty participants were divided into three groups: typically developing (TD) children (n=18), DD children with hypertonia (n=12), and DD children with hypotonia (n=10). Electromyography was used to measure muscle activity and BTS G-Walk was used to measure acceleration. As a result, the activities of the rectus abdominal muscle and quadriceps muscle were lower in DD children with hypertonia than in TD children (P<0.05). The activity of the tibialis anterior muscle was higher in DD children with hypotonia than in TD children (P<0.05). The trunk angle was greater in DD children with hypotonia than in TD children (P<0.05), and vertical acceleration was lower in DD children with hypertonia than in TD children (P<0.05). Based on these differences, we will be able to provide intervention programs appropriate for the characteristics of DD children with different muscle tone.
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Affiliation(s)
- Sun-Young Ha
- Institute for Basic Sciences Research, Kyungnam University, Changwon,
Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon,
Korea
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Shimizu N, Hashidate H, Ota T, Kawai Y. Physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty: a cross-sectional study. Physiother Theory Pract 2023; 39:2327-2335. [PMID: 35543544 DOI: 10.1080/09593985.2022.2074928] [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: 08/17/2021] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE This study investigated the characteristics of physical activity according to sit-to-stand, standing, and stand-to-sit abilities in subacute stroke with walking difficulty. METHODS In this study, 29 participants with subacute stroke and walking difficulty were enrolled and classified into two groups: participants who successfully completed three items (i.e., sit-to-stand, standing, and stand-to-sit) of the Functional Balance Scale (independent group, n = 13) and those who showed incomplete scores on any of the three items (dependent group, n = 16). Light-intensity physical activity (LIPA) and moderate-to-vigorous physical activity (MVPA) were measured using an accelerometer at three periods (i.e. daytime, therapy time, and non-therapy time) for a week. RESULTS Two-way analysis of variance (groups × physical activity intensity) demonstrated a significant interaction in each period. Post-hoc tests showed significantly more LIPAs and MVPAs in the independent group in all periods, except for MVPA in the non-therapy time. Particularly, LIPA showed significant between-group differences in each period. CONCLUSIONS Among individuals with subacute stroke and walking difficulty, those who could completely perform sit-to-stand, standing, and stand-to-sit could perform more LIPAs. Increasing sit-to-stand, standing, and stand-to-sit abilities could be an important factor in increasing the opportunity to perform LIPAs.
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Affiliation(s)
- Natsuki Shimizu
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Hiroyuki Hashidate
- Department of Physical Therapy, Kyorin University School of Health Sciences, Mitaka-city, Japan
| | - Tomohiro Ota
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
| | - Yumi Kawai
- Department of Kaifukuki-suppot, Hatsudai Rehabilitation Hospital, Shibuya, Japan
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Ha SY, Sung YH. Abdominal and lower extremity muscles activity and thickness in typically developing children and children with developmental delay. J Exerc Rehabil 2022; 18:369-375. [PMID: 36684535 PMCID: PMC9816619 DOI: 10.12965/jer.2244484.242] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/20/2022] [Indexed: 12/29/2022] Open
Abstract
We investigated abdominal and lower extremity muscle activity and thickness in typically developing children and children with developmental delays. A total of 35 children participated: typically developing peers (n=13), children with hypotonia (n=10), and children with spasticity (n=12). Muscle activity and thickness were measured at rest and during activity. Electromyography was used to measure abdominal and lower extremity muscle activities, and abdominal muscle thickness was measured using ultrasonography. There was a significant difference between the groups in the activity of the rectus abdominis and quadriceps muscles at rest and during activity (P<0.05). There was a significant difference between the groups in the thickness of the external oblique and transversus abdominis muscles during activity (P<0.05). There was a significant difference between the groups in the thickness of the external oblique and internal oblique muscles in the sitting position (P<0.05). Therefore, the characteristics of muscle tone should be considered when applying interventions to children with developmental delay.
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Affiliation(s)
- Sun-Young Ha
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon,
Korea
| | - Yun-Hee Sung
- Department of Physical Therapy, Graduate School, Kyungnam University, Changwon,
Korea,Department of Physical Therapy, College of Health Sciences, Kyungnam University, Changwon,
Korea,Corresponding author: Yun-Hee Sung, Department of Physical Therapy, College of Health Sciences, Kyungnam University, 7 Kyungnamdaehak-ro, Masanhappo-gu, Changwon 51767, Korea,
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Park S, Kim Y, Kim SA, Hwang I, Kim DE. Utility of ultrasound as a promising diagnostic tool for stroke-related sarcopenia: A retrospective pilot study. Medicine (Baltimore) 2022; 101:e30245. [PMID: 36086776 PMCID: PMC10550012 DOI: 10.1097/md.0000000000030244] [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: 02/16/2022] [Accepted: 07/13/2022] [Indexed: 11/27/2022] Open
Abstract
Stroke patients undergo extensive changes in muscle mass which lead to stroke-related sarcopenia. Stroke-related sarcopenia has a significant impact on the functional outcome of stroke survivors. So, it is important to measure muscle mass in stroke patients. This study aimed to examine the correlation between ultrasonographic quadriceps muscle thickness (QMT) and dual-energy X-ray absorptiometry (DXA) derived appendicular lean mass (ALM) in patients with acute hemiplegic stroke. Twenty five participants were included (13 men and 12 women) in this study, who were diagnosed with stroke within 1 month. For both paretic and non-paretic legs, QMT was measured by an ultrasound and ALM was obtained by performing DXA scan. We analyzed the difference and the correlation between ultrasonographic QMT and DXA-derived lean body mass of both paretic and non-paretic legs. Stroke patients were divided into 2 groups according to the paretic knee extensor power. Ultrasonographic QMT, DXA scan findings, and functional parameters were compared. There was a significant correlation between QMT and ALM index, and between QMT and site-specific lean mass (SSLM) of both the legs for both the sexes (P < .05). In multivariate linear regression model, we made adjustments for the confounding factors of age, sex, body mass index (BMI) and paretic knee extensor power. We observed a positive relationship between QMT and ALM index (P < .05), and between QMT and SSLM of both the legs (P < .05). The % QMT showed higher difference than % SSLM between paretic and non-paretic legs (10.25% vs 4.58%). The QMT measurements of ultrasound show a great relationship with DXA scan findings. Ultrasound better reflects the change of muscle mass between paretic and non-paretic legs than DXA scan at an acute phase of stroke. Ultrasound could be a useful tool to evaluate stroke-related sarcopenia.
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Affiliation(s)
- Siha Park
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Yuntae Kim
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Soo A Kim
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Insu Hwang
- Department of Physical Medicine and Rehabilitation, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
| | - Doh-Eui Kim
- Department of Emergency Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Republic of Korea
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Kim B, Youm C, Park H, Lee M, Choi H. Association of Muscle Mass, Muscle Strength, and Muscle Function with Gait Ability Assessed Using Inertial Measurement Unit Sensors in Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19169901. [PMID: 36011529 PMCID: PMC9407844 DOI: 10.3390/ijerph19169901] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 05/31/2023]
Abstract
Aging-related muscle atrophy is associated with decreased muscle mass (MM), muscle strength (MS), and muscle function (MF) and may cause motor control, balance, and gait pattern impairments. This study determined associations of three speed-based gait variables with loss of MM, MS, and MF in older women. Overall, 432 older women aged ≥65 performed appendicular skeletal muscle, handgrip strength, and five times sit-to-stand test to evaluate MM, MS, and MF. A gait test was performed at three speeds by modifying the preferred walking speed (PWS; slower walking speed (SWS); faster-walking speed (FWS)) on a straight 19 m walkway. Stride length (SL) at PWS was significantly associated with MM. FWS and coefficient of variance (CV) of double support phase (DSP) and DSP at PWS showed significant associations with MS. CV of step time and stride time at SWS, FWS, and single support phase (SSP) at PWS showed significant associations with MF. SL at PWS, DSP at FWS, CV of DSP at PWS, stride time at SWS, and CV of SSP at PWS showed significant associations with composite MM, MS, and MF variables. Our study indicated that gait tasks under continuous and various speed conditions are useful for evaluating MM, MS, and MF.
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Affiliation(s)
- Bohyun Kim
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
| | - Changhong Youm
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
- Department of Health Care and Science, Dong-A University, Busan 49315, Korea
| | - Hwayoung Park
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
| | - Myeounggon Lee
- Interdisciplinary Consortium on Advanced Motion Performance (iCAMP), Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hyejin Choi
- Department of Health Sciences, The Graduate School of Dong-A University, Busan 49315, Korea
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