Feasibility of action observation effect on gait and mobility in idiopathic normal pressure hydrocephalus patients / Viabilidade do efeito de observação da ação na marcha e mobilidade de pacientes com hidrocefalia de pressão normal idiopática

ABSTRACT. 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). Objective: This study aimed to investigate the feasibility of AO in iNPH patients. Methods: A single-group pretest-posttest design was conducted in twenty-seven iNPH patients. Gait and mobility parameters were assessed using the 2D gait measurement in the timed up and go (TUG) test for two trials before and after immediate AO training. The outcomes included step length and time, stride length and time, cadence, gait speed, sit-to-stand time, 3-m walking time, turning time and step, and TUG. In addition, early step length and time were measured. AO consisted of 7.5 min of watching gait videos demonstrated by a healthy older person. Parameters were measured twice for the baseline to determine reproducibility using the intraclass correlation coefficient (ICC3,1). Data between before and after immediately applying AO were compared using the paired t-test. Results: All outcomes showed moderate to excellent test-retest reliability (ICC3,1=0.51 0.99, p<0.05), except for the step time (ICC3,1=0.19, p=0.302), which showed poor reliability. There were significant improvements (p<0.05) in step time, early step time, gait speed, sit-to-stand time, and turning time after applying AO. Yet, the rest of the outcomes showed no significant change. Conclusions: A single session of AO is feasible to provide benefits for gait and mobility parameters. Therapists may modify this method in the training program to improve gait and mobility performances for iNPH patients.

RESUMO. A observação de ação (OA) teve benefícios comprovados em diversas condições neurológicas, mas nenhum estudo foi conduzido anteriormente em Hidrocefalia de Pressão Normal idiopática (HPNi). Objetivo: O presente estudo teve como objetivo investigar a viabilidade da OA em pacientes com HPNi. Métodos: Um projeto de pré-teste e pós-teste de grupo único foi realizado em 27 pacientes com HPNi. Parâmetros de marcha e mobilidade foram avaliados por meio de parâmetros 2D para a medida da marcha com o teste timed up and go (TUG) com duas tentativas antes e imediatamente depois do OA. Os resultados incluíram comprimento e tempo do passo, comprimento e tempo da passada, cadência, velocidade da marcha, tempo para sentar-e-levantar, tempo de caminhada de 3 metros, tempo de virada e passo, e tempo do teste (TUG). Além disso, o comprimento do passo inicial e o tempo da etapa inicial foram medidos. A OA consistia em assistir 7,5 minutos de vídeos de marcha demonstrados por um idoso saudável. Os parâmetros foram medidos duas vezes para a linha de base para determinar a reprodutibilidade usando o coeficiente de correlação intraclasse (CCI3,1). Os dados entre antes e depois da aplicação imediata de OA foram comparados com o teste t pareado. Resultados: Todos os resultados mostraram confiabilidade teste-reteste moderada a excelente (CCI3,1=0,51 0,99, p<0,05), exceto para o tempo do passo (CCI3,1=0,19, p=0,302), que apresentou confiabilidade pobre. Houve melhorias significativas (p<0,05) no tempo do passo, tempo do passo inicial, velocidade da marcha, tempo sentar-e-levantar e tempo de virar após a aplicação de OA. Os demais resultados não mostraram nenhuma mudança significativa. Conclusões: Uma única sessão de aplicação de OA é viável para proporcionar benefícios aos parâmetros de marcha e mobilidade. Os terapeutas podem modificar esse método no programa de treinamento para obter desempenho de marcha e mobilidade para pacientes com HPNi.

Obstacle crossing characteristics in the healthy young female and elderly female subjects.

Objective: To investigate obstacle crossing characteristics in the young and the elderly subjects. Methods: Twenty young and 20 elderly subjects were investigated for their obstacle crossing characteristics by using a 3D motion analysis system. Markers were placed on the bony prominences of the feet and obstacles. Obstacle crossing characteristics were determined with the obstacle crossing time, the vertical distance between toe and obstacle, and the maximum vertical toe clearance. The main effects and interaction effect of age (young and elderly) and limb [leading limb (LL) and trailing limb (TL)] were examined by two way analysis of variance. The obstacle crossing characteristics were also compared in each condition by using Independent sample t-test and Paired t-test. Results: There were main effects of the age and the limb on the obstacle crossing time. No interaction effect of the age and limb was found in any variables. In each condition of age and limb, there was a significant difference (p<0.05) in the obstacle crossing time between the limbs in both the young and the elderly. Furthermore, the vertical distance between toe and obstacle between the LL and TL was found to be significantly different (p<0.05) in the young, but not in the elderly (p>0.05). Conclusion: Age and limb were found to be the factors which related to the obstacle crossing time characteristic. The present findings suggested that the TL’s clearance is critical and should pay more consideration for the elderly.

Cross-cultural adaptation of modified Oswestry Low Back Pain Disability Questionnaire to Thai and its reliability.

OBJECTIVE: The present study aimed to cross-culturally adapt the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) into Thai. MATERIAL AND METHOD: The process comprised of an initial forward translations from English to Thai, synthesis of the translations, back translation, and back translation approval. The approved version of Thai ODQ was then calculated for test-retest reliability. Forty patients with LBP, aged 40.1+/-10.7 years, were recruited into a test-retest reliability study. RESULTS: The test-retest reliability, calculated by intraclass correlation coefficient, was assessed on two occasions separated by a time interval of 20-30 minutes. The values of test-retest reliability of items ranged from 0.80-1.00. The value of total score was 0.98. CONCLUSION: This finding indicated good reliability of the Thai version modified ODQ.

Three-dimensional kinematic and kinetic gait analysis in young Thai adults, using the motion analysisTM System.

The purposes of this study were to investigate three-dimensional gait characteristics of hip, knee and ankle joints, and ground reaction forces in young Thai male and female subjects. Twenty healthy volunteer subjects (10 male and 10 females) in the age range 17-25 years were tested. Gait analysis was acquired using a Motion AnalysisTM six-camera system and two force platforms with Ortho TrakTM II software. Seventeen spherical reflective body markers were attached to the left and right sides of the body. Subjects were asked to walk across the camera fields of view. Three trials of preferred speed walking were collected for each subject. The temporospatial characteristics, the sagittal angular displacements of hip, knee and ankle joints, and ground reaction forces (GRF) were calculated and analysed. Comparisons of gait characteristics between left and right lower extremities, and between male and female subjects were also reported. The results revealed no significant differences in temporospatial characteristics between the male and female groups. There were consistent patterns of motion for the hip joint in female subjects were greater than those in the male subjects, while the sagittal angular angular displacements of the knee joint in the male subjects were greater than those in the female subjects. A typical pattern of vertical GRF was demonstrated in all subjects. The results of this study have shown symmetrical gait characteristics between left and right lower extremities in both the male and female groups.

The rotatory manipulation during cervical traction for painful neck movement.

Thirty-nine female patients with chronic (1-24 months) painful and limited neck movements were divided into two groups: a controlled group (n = 17) and a manipulated group (n = 22). In the controlled group, a non-steroidal anti-inflammatory drug (NSAID) named Voltaren® was prescribed for the patients to take three times a day for three weeks. In the manipulated group, patients were treated with Voltaren® plus ratatory manipulation during cervical traction. All patients were screened to exclude pathologic neurological signs by physical examination and cervical roentgenograms. Patients in the manipulated group were put on an intermittent traction machine with 20 degrees flexion of the neck and ratatory manipulation of the cervical spine was carried out while a pull of 25 kilograms (kg) was exerted. Patients were manipulated twice weekly for six sessions (3 weeks). In the manipulated group, results showed a marked reduction of pain (5levels on a visual analygue scale). Degrees of active range of motion (ROM) of neck in all directions improved significantly (p < 0.001) before and/after the first treatment and/after the last treatment (mean + SD): flexion and extension = 108.13+14.48/114.81+12.62/125.40+10.04; lateral flexion to the left and right = 67.86+13.72/73.77+10.18/80.50+10.37; rotation to the left lateral flexors of the cervical spine were also significantly increased from the beginning (P<0.01): 3.92+1.79/4.74+1.80 kg in flexors, 6.97+2.67/8.28+2.05 kg in extensors, 4.28+1.52/5.38+1.35 kg in the left lateral flexors and 4.31+1.51/5.27+1.25 kg in the right lateral flexors. About five sessions (twice a week) should improve the condition. No significant change occurred in the controlled group.