Effects of Strengthening and Stretching Exercises on the Temporospatial Gait Parameters in Patients With Plantar Fasciitis: A Randomized Controlled Trial

Objective

To investigate the effects of physical therapy interventions using strengthening and stretching exercise programs on pain and temporospatial gait parameters in patients with plantar fasciitis (PF).

Methods

Eighty-four patients with PF participated in the study and were randomly assigned to the strengthening or stretching exercise groups. All patients received 8 physical therapy interventions two times per week in the first 4 weeks and performed daily strengthening or stretching exercises three times per day. After 4 weeks, they continued the assigned exercise programs every day for 8 weeks. Pain visual analogue scale (VAS) scores at the worst and in the morning and temporospatial gait parameters were evaluated at the baseline, intermediate of the intervention, end of the intervention, and the first and second month follow-up.

Results

There were significant effects of the time on the worst pain, morning pain, cadence, stride time, stride length, total double support, and gait speed, but there was no effect on step width. In addition, the main effect of the group and the interaction effects of the time and the group were not found in any parameters. For intra-group comparisons, there were significant differences in worst pain, morning pain, cadence, and stride time among the assessment times in both groups. For inter-group comparisons, there were no significant differences in all parameters.

Conclusion

Both strengthening and stretching exercise programs significantly reduced pain and improved gait in patients with PF.

Effect of speed on the upper and contralateral lower limb coordination during gait in individuals with stroke

The purposes of this study were to investigate the upper and contralateral lower limb coordination and to study the effect of speed on the upper and contralateral lower limb coordination in individuals with stroke and control groups. Thirty individuals with stroke who were able to walk independently without using any assistive devices and 30 control individuals were recruited for the study. Upper and contralateral lower limb coordination was analyzed using the shoulder and contralateral hip displacements in the sagittal plane. All data were analyzed by three-dimensional gait analysis. Results demonstrated high degrees of coordination in the upper and contralateral lower limbs of the controls and in the unaffected upper and affected lower limbs of individuals with stroke. Gait speed was found to be associated with the upper and contralateral lower limb coordination in individuals with stroke but not in the controls. The findings implied that the affected upper limb plays an important role for improving gait coordination and is necessary for gait performance in individuals with stroke. Thus, health professionals should exercise the affected arm to increase efficiency of walking in individuals with stroke.

Spatiotemporal gait parameters for patients with Parkinson's disease compared with normal individuals

BACKGROUND

Gait initiation is a major motor problem for patients with Parkinson's disease (PD). To understand the gait initiation in patients with PD, fluctuation on the first three steps of initiation was examined

METHODS

Force distribution measurement platform was used to record gait initiation in 10 patients with PD and healthy participants. Step length, step time and step width, as well as its coefficient of variation (CV) were investigated

RESULTS

The findings demonstrated significant main effect of group on step length (p < 0.001), step time (p = 0.034) and step width (p = 0.002), significant main effect of step on step time (p < 0.001) and step width (p < 0.001). No interaction between group and step (p > 0.05) was found on the variables. Compared with healthy participants, patients with PD showed significantly shorter step length in the first (p < 0.001), second (p = 0.001) and third (p = 0.001) steps and longer step time in the second step (p < 0.001). No difference in CV (p > 0.05) of the variables between groups comparison. Both groups had significant longer step time in the first step compared with the second step (PD, p < 0.001; healthy participants, p < 0.001) and the third steps (PD, p < 0.001; healthy participants, p < 0.001). They demonstrated significant wider step width in the first step when compared with the second step (PD, p = 0.043; healthy participants, p < 0.001) and the third steps (PD, p = 0.002; healthy participants, p < 0.001).

CONCLUSION

Patients with PD showed shorter step length of all steps, longer step time in the second step and similar step width when compared with healthy participants. Among the three steps, both groups demonstrated longer step time and wider step width in the first step when compared with other two step.

Action observation combined with gait training to improve gait and cognition in elderly with mild cognitive impairment A randomized controlled trial

Owing to advancement of medical technology and current knowledge, the population has a longer life expectancy, leading to an increase in the proportion of elderly.

A randomized controlled trial of motor imagery combined with structured progressive circuit class therapy on gait in stroke survivors

Structured Progressive Circuit Class Therapy (SPCCT) was developed based on task-oriented therapy, providing benefits to patients’ motivation and motor function. Training with Motor Imagery (MI) alone can improve gait performance in stroke survivors, but a greater effect may be observed when combined with SPCCT. Health education (HE) is a basic component of stroke rehabilitation and can reduce depression and emotional distress. Thus, this study aimed to investigate the effect of MI with SPCCT against HE with SPCCT on gait in stroke survivors. Two hundred and ninety stroke survivors from 3 hospitals in Yangon, Myanmar enrolled in the study. Of these, 40 stroke survivors who passed the selection criteria were randomized into an experimental (n = 20) or control (n = 20) group. The experimental group received MI training whereas the control group received HE for 25 minutes prior to having the same 65 minutes SPCCT program, with both groups receiving training 3 times a week over 4 weeks. Temporo-spatial gait variables and lower limb muscle strength of the affected side were assessed at baseline, 2 weeks, and 4 weeks after intervention. After 4 weeks of training, the experimental group showed greater improvement than the control group in all temporospatial gait variables, except for the unaffected step length and step time symmetry which showed no difference. In addition, greater improvements of the affected hip flexor and knee extensor muscle strength were found in the experimental group. In conclusion, a combination of MI with SPCCT provided a greater therapeutic effect on gait and lower limb muscle strengths in stroke survivors.

Concurrent validity and intratester reliability of the video-based system for measuring gait poststroke

BACKGROUND AND PURPOSE

Spatio-temporal parameters are commonly used in gait assessment. Advanced tools provide valid and reliable data, considered very effective for physiotherapy intervention. However, these tools may be limited in clinical usage caused by complicated applicability, inaccessibility, and high cost. Therefore, a video-based system is an alternative choice that is easy and affordable for the clinical setting. The purpose of the study was to evaluate the concurrent validity of the video-based system against the validated instrumented gait system (Force Distribution Measurement [FDM]) on the spatio-temporal gait parameters in individuals with stroke. In addition, the intratester reliability of a novice tester was determined.

METHODS

Twenty individuals with stroke participated in the study. Gait was captured by the video-based and FDM systems simultaneously to measure the degree of concurrent validity. Parameters composed of the affected and unaffected step lengths (cm) and step time (s), stride length (cm), gait velocity (m/s), and cadence (steps/min). Pearson correlation coefficient, paired t test, and intraclass correlation coefficient (ICC) were used to determine the concurrent validity, the difference of the data, and intratester reliability.

RESULTS

All spatio-temporal gait parameters showed excellent degrees of correlation (r_p = .94 to.99, p <.001) between the video-based and FDM systems. No significant difference in all parameters was found between the two systems. Excellent intratester reliability (ICC_3,1 = 0.91 to 0.99, p < .001) of all gait parameters were found in a novice tester.

CONCLUSION

The video-based system was valid and reliable for a novice tester to measure the spatio-temporal gait parameters in individuals with stroke.

Effect of spinal tap test on the performance of sit-to-stand, walking, and turning in patients with idiopathic normal pressure hydrocephalus

The aim of the study was to investigate the effect of the spinal tap test on sit-to-stand (STS), walking, and turning and to determine the relationship among the outcome measures of STS, walking, and turning in patients with iNPH. Twenty-seven patients with clinical symptoms of iNPH were objectively examined for STS, walking, and turning by the Force Distribution Measurement (FDM) platform connected with a video camera. Assessments were performed at before and 24 hours after spinal tap. Motor abilities were assessed by the STS time, time of walking over 3 meters, and time and number of steps when turning over 180 degrees. Significant improvements were found in the STS time (p = 0.046), walking time (p = 0.048), and turning step (p = 0.001). In addition, turning time was improved but not statistically significant (p = 0.064). Significant relationships were found among all outcome measures (p < 0.001). The relationship among these outcome measures indicated that the individuals had similar ability levels to perform different activities. This may serve as a new choice of outcome measures to evaluate the effect of intervention in different severity levels of patients with iNPH.

Quantitative gait analysis in mild cognitive impairment, dementia, and cognitively intact individuals: a cross-sectional case-control study

Background

Cognitive age-related decline is linked to dementia development and gait has been proposed to measure the change in brain function. This study aimed to investigate if spatiotemporal gait variables could be used to differentiate between the three cognitive status groups.

Methods

Ninety-three older adults were screened and classified into three groups; mild cognitive impairment (MCI) (n = 32), dementia (n = 31), and a cognitively intact (n = 30). Spatiotemporal gait variables were assessed under single- and dual-tasks using an objective platform system. Effects of cognitive status and walking task were analyzed using a two-way ANCOVA. Sub-comparisons for between- and within-group were performed by one-way ANCOVA and Paired t-tests. Area Under the Curve (AUC) of Receiver Operating Characteristics (ROC) was used to discriminate between three groups on gait variables.

Results

There were significant effects (P < 0.05) of cognitive status during both single and dual-task walking in several variables between the MCI and dementia and between dementia and cognitively intact groups, while no difference was seen between the MCI and cognitively intact groups. A large differentiation effect between the groups was found for step length, stride length, and gait speed during both conditions of walking.

Conclusions

Spatiotemporal gait variables showed discriminative ability between dementia and cognitively intact groups in both single and dual-tasks. This suggests that gait could potentially be used as a clinical differentiation marker for individuals with cognitive problems.

Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study

BACKGROUND

Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported.

OBJECTIVE

This study aimed to compare the immediate effects of MET and LSE in patients with chronic LBP with suspected facet joint origin.

METHODS

Twenty-one patients with low back pain were recruited and randomly assigned to receive treatment either MET or LSE. The outcomes were kinematic changes, pain intensity, and disability level. Lumbar active range of motion (ROM) of flexion, extension, left and right lateral flexion, and left and right rotation were evaluated using the three-dimension motion analysis system at baseline and immediately after treatment. Pain intensity was evaluated using visual analogue scale (VAS) at baseline, immediately after, and two days after treatment. Thai version of the modified Oswestry disability questionnaire (ODQ) was utilized at baseline and two days after treatment. The mixed model analysis of variance was used to analyze all outcomes.

RESULTS

The results showed that all outcomes were not different between groups after treatments. Although there were statistically significant improvements after the treatments when collapsing the groups, the minimal clinically important change was found only for pain but not for lumbar movements and disabilities scores.

CONCLUSION

The effect of MET and LSE alone in single session might not be intensive enough to improve movements and decrease disability in patients with chronic LBP with suspected facet joint origin.

Ground Reaction Forces of the Lead and Trail Limbs when Stepping Over an Obstacle

BACKGROUND

Precise force generation and absorption during stepping over different obstacles need to be quantified for task accomplishment. This study aimed to quantify how the lead limb (LL) and trail limb (TL) generate and absorb forces while stepping over obstacle of various heights.

MATERIAL AND METHODS

Thirteen healthy young women participated in the study. Force data were collected from 2 force plates when participants stepped over obstacles. Two limbs (right LL and left TL) and 4 conditions of stepping (no obstacle, stepping over 5 cm, 20 cm, and 30 cm obstacle heights) were tested for main effect and interaction effect by 2-way ANOVA. Paired t-test and 1-way repeated-measure ANOVA were used to compare differences of variables between limbs and among stepping conditions, respectively. The main effects on the limb were found in first peak vertical force, minimum vertical force, propulsive peak force, and propulsive impulse.

RESULTS

Significant main effects of condition were found in time to minimum force, time to the second peak force, time to propulsive peak force, first peak vertical force, braking peak force, propulsive peak force, vertical impulse, braking impulse, and propulsive impulse. Interaction effects of limb and condition were found in first peak vertical force, propulsive peak force, braking impulse, and propulsive impulse.

CONCLUSIONS

Adaptations of force generation in the LL and TL were found to involve adaptability to altered external environment during stepping in healthy young adults.

Thai version of the foot function index: a cross-cultural adaptation with reliability and validity evaluation

Background

The study aimed to translate the foot function index (FFI) questionnaire to Thai and to determine psychometric properties of the questionnaire among individuals with plantar foot complaints.

Methods

The Thai version of the FFI (FFI-Th) was adapted according to a forward and backward translation protocol by two independent translators and analyzed by a linguist and a committee. The FFI-Th was administered among 49 individuals with plantar foot complaints to determine internal consistency, reliability, and validity. Cronbach’s alpha and the Intraclass Correlation Coefficient (ICC_3,1) were used to test the internal consistency and test-retest reliability. The Principal Component Analysis with varimax rotation method was used to test the factor structure and construct validity. Furthermore, the criterion validity was tested using Pearson’s correlation coefficient (r_p) between the FFI-Th and the visual analogue pain scale (pain-VAS) as well as the EuroQol five-dimensional questionnaire (EQ-5D-5L).

Results

The FFI-Th showed good to excellent internal consistency and test-retest reliability in the total score, pain, disability, and activity limitation subscales. The Principal Component Analysis produced 4 principal factors from the FFI-Th items. Criterion validity of the FFI-Th total score showed moderate to strong correlations with pain-VAS and EQ-5D-5L, and EQ-VAS scores.

Conclusion

The FFI-Th was a reliable and valid questionnaire to assess the foot function in a Thai population.

Trial registration

NCT03161314 (08/05/2017).

Clinimetric properties of the one-leg sit-to-stand test in examining unilateral lower limb muscle strength among young adults

BACKGROUND

One-leg sit-to-stand (one-leg STS) test is a new clinical test developed to measure the unilateral lower limb (LE) muscle strength among young adults. This study examined the test-retest reliability and the criterion-concurrent validity of the one-leg STS.

METHODS

Forty young adults (mean age ± SD, 28.07 ± 5.39 years) participated in the study. The one-leg STS test was administered in two separate assessment sessions to examine test-retest reliability. Two-leg STS test was administered and the performance time was measured. The concentric peak strength of hip flexors/extensors, knee flexors/extensors and ankle dorsi-flexors/plantar-flexors were determined using an isokinetic dynamometer. An intraclass correlation coefficient (ICC) was used to examine the test-retest reliability of one-leg STS test. The criterion validity of the one-leg STS test was evaluated against the performance of the two-leg STS test using an independent sample t test. The concurrent validity of the one-leg STS test was evaluated by investigating the relationships between STS performance time and LE muscle strength using Pearson correlation coefficients.

RESULTS

 The reliability analysis showed that one-leg STS performance time had excellent test-retest reliability (ICC_3,1  = 0.960, P < .001). Also, the one-leg STS performance time was not different between the first and second sessions, t (39) = 0.672, P = .506. The performance time of the one-leg STS test was significantly greater than the two-leg STS test (t (39) = 20.63, P < .001). The performance time of the one-leg STS test significantly correlated with the concentric peak strength of all LE muscles (P < .05).

CONCLUSIONS

The one-leg STS test demonstrated excellent reliability and criterion-concurrent validity against the two-leg STS and the LE muscle strength. The one-leg STS test was simple to administer and could be beneficial for the assessment of unilateral LE muscle strength of young adults in clinical settings.

Five-Session Dual-Transcranial Direct Current Stimulation With Task-Specific Training Does Not Improve Gait and Lower Limb Performance Over Training Alone in Subacute Stroke: A Pilot Randomized Controlled Trial

OBJECTIVE

To determine the effect of five-session dual-transcranial direct current stimulation (dual-tDCS) combined with task-specific training on gait and lower limb motor performance in individuals with subacute stroke.

MATERIALS AND METHODS

Twenty-five participants who had a stroke in the subacute phase with mild motor impairment were recruited, randomized, and allocated into two groups. The active group (n = 13) received dual-tDCS with anodal over the lesioned hemisphere M1 and cathodal over the nonlesioned hemisphere, at 2 mA for 20 min before training for five consecutive days, while the sham group (n = 12) received sham mode before training. Gait speed as a primary outcome, temporospatial gait variables, lower-limb functional tasks (sit-to-stand and walking mobility), and muscle strength as secondary outcomes were collected at preintervention and postintervention (day 5), one-week follow-up, and one-month follow-up.

RESULTS

The primary outcome and most of the secondary outcomes were improved in both groups, with no significant difference between the two groups, and most of the results indicated small to moderate effect sizes of active tDCS compared to sham tDCS.

CONCLUSION

The combined intervention showed no benefit over training alone in improving gait variables and lower-limb performance. However, some performances were saturated at some point, as moderate to high function participants were recruited in the present study. Future studies should consider recruiting participants with more varied motor impairment levels and may need to determine the optimal stimulation protocols and parameters to improve gait and lower-limb performance.

Effect of progressive bridging exercise on weight-bearing during the extension phase of sit-to-stand, and on sit-to-stand ability in individuals with stroke: A randomised controlled trial

OBJECTIVE

To examine the effect of a progressive bridging exercise on force, time, and pressure during the extension phase of sit-to-stand, and on sit-to-stand ability in individuals with stroke.

DESIGN

A single-blinded randomised controlled trial.

SETTING

Hospital.

PARTICIPANTS

Forty-eight individuals with acute ischemic stroke, not at brainstem and cerebellum, randomly allocated to the intervention (n = 24) and control (n = 24) groups. Five participants dropped out during the 2-month follow-up, but they were in the intention-to-treat analysis.

INTERVENTIONS 

The intervention group undertook a 45-min conventional physiotherapy and a 30-min progressive bridging exercise. The control group received only the conventional exercise.

MAIN MEASURES

Peak vertical ground reaction force, time to peak force, peak foot pressure, and regional peak foot pressure during the extension phase of sit-to-stand, and sitting-to-standing item of the Motor Assessment Scale were assessed before training, after 4-week training, and 2-month follow-up.

RESULTS

The intervention group showed significantly (p < 0.001) less difference in peak vertical ground reaction force between feet during the extension phase of sit-to-stand than the control after 4-week training (mean ± standard deviation; intervention, 5.38 ± 3.99; control, 17.1 ± 10.3) and 2-month follow-up (intervention, 6.79 ± 3.84; control, 17.5 ± 9.89), and demonstrated significantly (p < 0.001) higher score in sit-to-stand than the control after training [mean (interquartile range); intervention, 5 (2-5); control, 2 (1-2)] and follow-up [intervention, 2 (2-5); control, 2 (1-2)]. Both groups demonstrated peak foot pressure on the medial and lateral heels, metatarsals, and hallux regions.

CONCLUSION 

Progressive bridging exercise improved symmetrical weight bearing during the extension phase of sit-to-stand, consequently enhanced sit-to-stand ability in individuals with stroke.

Feasibility of action observation effect on gait and mobility in idiopathic normal pressure hydrocephalus patients

Action observation (AO) has been proved to be of benefit in several neurological conditions, but no study has previously been conducted in idiopathic normal pressure hydrocephalus (iNPH).

Cross-Cultural Adaptation of the Compendium of Physical Activity: Thai Translation and Content Validity

OBJECTIVE

To translate the compendium physical activity (compendium) proposed by Ainsworth to Thai and to validate the Thai translated version.

MATERIAL AND METHOD

Five steps of cross-cultural adaption were conducted as follows: (1) forward translation, (2) group review, (3) backward translation, (4) group review and final decision and (5) a pilot study. Eight hundred and twenty-one activities ofthe compendium were translated to Thai by two independents translators. Thai translated version was considered by 23 persons who have studied physical activity for at leastfive years. Backward translation was carried out by two bilingual translators. The research team completed the final Thai translation by comparing original and translated versions. For pilot study the Thai translated version was validated by 22 allied health persons. Data was analyzed by multi-rater agreement (Fleiss's kappa) and qualitative analysis.

RESULTS

For translations and group review, recommendations included; (a) changing to lay language with the same meaning, (b) converting the U.S. customary unit to the metric unit, and (c) using consistent language. More than 80% of 22 persons accepted the Thai translation and the Kappa agreement rangedfrom 0.187 to 0.694. Some activities demonstratedpoor multi-rater agreement and required additional definitions.

CONCLUSION

Thai translated compendium physical activity was constructed to reduce the language barrier and promote physical activity in Thailand. The poor to moderate agreement of each major heading of translation may partly be due to Western culture. Many activities in the compendium were assembled but they were not recognized by Thais. Hence, Thai compendium physical activity should to be developed in afuture study.

Plantar Pressure Distribution Pattern during Mid-Stance Phase of the Gait in Patients with Chronic Non-Specific Low Back Pain

OBJECTIVE

To examine the characteristics of the plantar pressure distribution patterns during mid-stance phase of the gait cycle in subjects with chronic non-specific low back pain and asymptomatic subjects.

MATERIAL AND METHOD

Twenty-three males and 17 females with chronic non-specific low back pain and age- and gender-matched asymptomatic subjects walked barefoot along a gait mat at comfortable speedfor three trials. The left and right plantar pressure distributions were recorded during mid-stance phase and divided into 12 areas. Descriptive statistics including mean and standard deviation of demographic data and plantar pressure were calculated, and plantar pressure distribution patterns were described.

RESULTS

Mean and standard deviation of numeric pain rating scale of chronic non-specific low back pain group were 4.04±1.58. The average mean peak pressure of both chronic non-specific low back pain and asymptomatic subjects located at the fifth area (lateral aspect offorefoot) in both feet. However the modes of the peak pressure of subjects with chronic non-specific low back pain were in the different areas in the left and right feet. The distribution patterns of the average mean peak pressure were not the same in chronic non-specific low back pain and asymptomatic subjects. This altered foot contact in the subjects with chronic non-specific low back pain may be used to avoid pain or to compensate for limited mobility of the lower limbs at pre-swing phase.

CONCLUSION

At mid-stance phase of walking, the pressures on the plantar surface were unequally distributed in subjects with chronic non-specific low back pain.

Reach-to-grasp training in individuals with chronic stroke augmented by low-frequency repetitive transcranial magnetic stimulation

OBJECTIVE

The present study investigated the immediate effects of low frequency repetitive transcranial magnetic stimulation (LF-rTMS) combined with reach-to-grasp (RTG) training of the paretic hand in individuals with chronic stroke.

MATERIAL AND METHOD

Fourteen participants were randomly assigned to receive LF-rTMS or sham stimulation conditions. All participants underwent RTG training after the stimulation. Corticospinal excitability (CE) of the non-lesioned hemisphere, the total time of the wolf motor function test (WMFT) for dexterity tasks, maximum aperture, and movement time of RTG actions were evaluated at baseline, after the stimulation, and after RTG training.

RESULTS

Significant differences between interaction (group x time) were found in the total time of WMFT The CE of non-lesioned hemisphere diminished after LF-rTMS and showed moderate correlation with the reduction in time of RTG actions after the stimulation. The total time of WMFT and RTG actions reduced after motor training only in the LF-rTMS group. No change was observed in maximum aperture in either group.

CONCLUSION

The application of LF-rTMS combined with RTG training enhanced the training effect as evidenced by faster movement for the dexterity tasks of the paretic hand than RTG training alone. The findings suggested the benefit of LF-rTMS for enhancing the training effects in stroke rehabilitation.

The STarT Back Screening Tool: The Nepali Translation, Cross-Cultural Adaptation and Measurement Properties in Adults With Non-Specific Low Back Pain

INTRODUCTION/OBJECTIVE

The STarT Back Screening Tool (SBST) stratifies low back pain (LBP) patients based on their risk of chronicity to guide treatment accordingly. The absence of its validated Nepali version limits stratified LBP care in Nepal. The study aimed to translate and cross-culturally adapt the SBST into Nepali and evaluate its measurement properties in adults with LBP.

METHODS

The measurement properties of the Nepali SBST were evaluated in 102 Nepali adults with non-specific LBP. We assessed content validity, internal consistency, test-retest reliability, construct and discriminant validity. Item redundancy was evaluated using Cronbach's alpha (α > 0.90), test-retest reliability using Intraclass Correlation Coefficient (ICC2,1) and Cohen's kappa using established cutoffs score for categorising patients into risk groups, construct validity using hypothesis testing (if a minimum of 75% of the hypotheses were supported), and discriminant validity using Area Under the Curve (AUC) with the reference scales administered at baseline.

RESULTS

Cronbach's alpha scores were 0.72 for the overall scale and 0.66 for the psychosocial subscale. Test-retest reliability values were good to excellent with ICC2,1 of 0.94 (95% CI: 0.87-0.97) for the overall scale and 0.87 (95% CI: 0.73-0.94) for the psychosocial subscale and Kappa values of 0.68 (95% CI: 0.43-0.93) for the overall scale and 0.79 (95% CI: 0.52-1.00) for psychosocial subscale. Construct validity was confirmed as 100% of a priori hypotheses were met. Acceptable discriminative validity was observed with reference scales with AUCs (0.75-0.80).

CONCLUSIONS

Nepali SBST demonstrates the reliability and validity of screening for chronicity risk in Nepali adults with LBP. Future studies should evaluate its responsiveness, predictive abilities, and effectiveness in stratifying LBP patients in the Nepalese context.

Gait symmetrical indexes and their relationships to muscle tone, lower extremity function, and postural balance in mild to moderate stroke

OBJECTIVE

To investigate asymmetrical gait characteristics and degree of associations between gait symmetrical indexes and clinical measures in a stroke population.

MATERIAL AND METHOD

Thirty patients with stroke participated in the present study. Clinical measures included muscle tone of affected hip adductors (HA), hip extensors (HE), knee extensors (KE), ankle plantar flexors (AP) and ankle invertors (AI), lower extremity function and postural balance. Symmetrical indexes of gait biomechanics included braking peak force (Y1), propulsive peak force (Y2), first peak vertical force (Z1) and second peak vertical force (Z2), step length, single support time (SST), step time, stance time and swing time were determined.

RESULTS

The symmetrical index of force was significantly related with muscle tone and lower extremity function. Temporospatial variables significantly related to muscle tone and lower extremity function, but not to postural balance.

CONCLUSION

Muscle tone and lower extremity function were important for walking efficiency as the presented relationships with symmetrical gait characteristic in patients with a stroke.

The Comparison of Ground Reaction Force Between Dominant and Non-Dominant Legs During Ten-sao in Khon Masked Dancers

Introduction: Leg asymmetry is common in many sports, including dance. Ten-sao, a fundamental practice movement in Khon masked dance, involves symmetrical continuous movements where dancers perform strong stomping actions. Objectives: to compare ground reaction forces (GRFs) and calculate the absolute symmetry index (ASI) between dominant and non-dominant legs during Ten-sao in Khon masked dancers. Methods: Fifteen healthy male Khon masked dancers with at least 5 years of experience participated in the study. Each dancer performed Ten-sao continuously for 10 cycles. The GRFs of each leg were assessed using two force plates, capturing in the vertical, antero-posterior, and medio-lateral directions during different phases of the Ten-sao dance. The ASI was calculated to assess symmetry in GRF distribution. Results: A significant difference in vertical GRF was found during the single-leg stance phase, with the dominant leg exhibiting greater force than the non-dominant leg (P = .023). The median and interquartile range (IQR) for the dominant leg was 90.005 N/kg (IQR 9.73), while the non-dominant leg exhibited a median of 57.494 N/kg (IQR 8.401). These findings highlight the asymmetry in force production between the dominant and non-dominant legs. The ASI showed asymmetries in the antero-posterior direction during double-leg support (DLS), and in the antero-posterior and medio-lateral directions during peak GRF (pGRF). Further asymmetries were observed in the antero-posterior, medio-lateral, and vertical directions during single-leg standing (SLS). Conclusion: The study reveals significant leg asymmetry in vertical GRF between the two legs among Khon dancers performing Ten-sao. The dominant leg demonstrates higher vertical force during SLS, and various asymmetries are presented in both DLS and SLS phases. Addressing these asymmetries in training programs is crucial for enhancing performance and reducing injury risk for Khon masked dancers.

Improvement of Gait Symmetry in Patients with Stroke by Motor Imagery

OBJECTIVE

To investigate effect of gait training with motor imagery (MI) on gait symmetry and self-efficacy offalling in stroke patients.

MATERIAL AND METHOD

Fourteen stroke patients were categorized in the MI (n = 7) and control (n = 7) groups. They were matched by age range, stroke type, paretic side, time since stroke, and severity. All participants received physical therapy and only the MI group received additional MI training. Both groups were trained for 12 sessions over 1 month. Outcome measurements comprised gait symmetry detecting by theforce distribution measurement platform and self-efficacy offalling testing by the Fall Efficacy Scale-International (FES-I). Both groups were assessed three times:.pre-, intermediate- and post-trainings. Comparisons of all variables between and within groups were tested by Mann-Whitney U test and Friedman ANOVA test, respectively.

RESULTS

No significant difference was observed of gait symmetry between MI and control groups. Within group comparison, tendencies of improvement were found in step length and step time symmetry for the MI group. Significant improvements in step length symmetry and FES-I score were found among assessments for the MI group (p<0.05).

CONCLUSION

Gait training with MI enhanced ability of step length symmetry and decreased fear offalling in patients with stroke.

Alteration of the multi-segment foot motion during gait in individuals with plantar fasciitis: a matched case-control study

PURPOSE

The objective of this study was to compare the ground reaction forces (GRFs) and the multi-segment foot motion between individuals with plantar fasciitis (PF) and healthy controls.

METHODS

Twenty-one individuals with PF and 21 matched-case healthy controls who passed the criteria participated in the study. Gait data were assessed during their self-selected comfortable speeds by the 3D motion analysis system. The multi-segment foot motions were determined by the Oxford Foot Model. Outcome measures included the vertical and antero-posterior ground reaction forces (GRFs) and the multi-segment foot motions [the dorsiflexion (DF), plantarflexion (PF), inversion (Inv), eversion (Eve), adduction (Add), and abduction (Abd) peak angles for the forefoot with respect to hindfoot (FFHF) and the DF, PF, Inv, Eve, internal rotation (IR), and external rotation (ER) peak angles for the hindfoot with respect to tibia (HFTB) as well as their ranges (R)].

RESULTS

Comparisons between individuals with PF and healthy controls showed no significant differences in any of the GRFs. Significant reductions were found in the FFHF-DF, FFHF-DF-R, FFHF-Inv, and HFTB-Inv/Eve-R in individuals with PF. In addition, there were tendencies of the increased angles of the FFHF-PF, HFTB-DF, HFTB-Inv, and HFTB-ER, but not significantly for individuals with PF, compared to healthy controls.

CONCLUSIONS

Adaptations of the intra-foot motion showed the reduction of some angles but no change for the GRFs in individuals with PF compared to the healthy controls when both groups walked at a similar gait speed.