Effects of Respiratory Muscle Strengthening Exercise on Respiratory Function and Activities of Daily Living in Stroke Patients

PURPOSE: This study aimed to demonstrate reduction in stroke symptoms by analyzing the changes in respiratory function and activities of daily living (ADL) after respiratory muscle strengthening exercise in patients who had a stroke and thereby, propose an efficient exercise method. METHODS: Twenty patients with hemiplegic stroke were divided into two groups, with 10 patients in each. The control group (CG) received the traditional exercise therapy, and the experimental group (EG) received the traditional exercise therapy combined with expiratory muscle strengthening training. The training continued for 6 weeks, 5 days a week. Forced vital capacity (FVC) and forced expiratory volume at 1 second (FEV1) were measured with a spirometer, SpO₂ was measured with a pulse oximeter, and ADL were assessed by using the modified Barthel index (MBI). A paired t test was applied to compare the differences before and after the intervention, and an independent t test was used to compare the differences between the groups. The level of statistical significance was set as α=0.05. RESULTS: The changes in the FVC and FEV1 values within the group showed significant differences only in the EG (p<0.01). The between-group difference was statistically significant only for FVC and FEV1 in the EG (p<0.01). The changes in SpO₂ and MBI within the group showed significant differences only in the EG and CG (p<0.01). Between-group differences were statistically significant only for SpO₂ and MBI in the EG (p<0.05). CONCLUSION: The interventions with active patient involvement and combined breathing exercises had a positive impact on all the functions investigated in this study.

Muscle Mass, Strength, Mobility, Quality of Life, and Disease Severity in Ankylosing Spondylitis Patients: A Preliminary Study

OBJECTIVE: To determine if there is muscle mass reduction in patients with ankylosing spondylitis (AS) compared to the general population and to examine the relationship between skeletal muscle mass, quality of life (QOL), strength, and mobility in patients with AS. METHODS: A total of 30 AS patients were enrolled in this study. Skeletal muscle mass was measured by bioelectrical impedance analysis, and it was expressed as the skeletal muscle mass index (SMI). QOL was assessed using the EuroQOL (EQ-5D). To measure mobility, the modified Schöber test and chest expansion test were used. To measure grip strength as a measure of muscle strength, we used the hydraulic hand dynamometer. Additionally, we divided the patients into two groups according to the degree of X-ray finding and compared the differences between the two groups. RESULTS: There was no significant reduction in skeletal muscle mass in patients with AS compared to the general population. Also, there was no significant correlation between SMI and QOL. On the other hand, there was a significant positive correlation between SMI and mobility, and grip strength. A significant positive correlation was found between mobility and QOL. Additionally, there was a statistically significant difference in mobility between the two groups according to the degree of X-ray finding. CONCLUSION: Maintaining muscle mass in AS patients may not be helpful for improving QOL, but it may contribute to achieving adequate mobility and strength.

Group Education and exercise program for overweight knee osteoarthritic patients.

Objective: To study the benefits of patient education and an exercise program for the overweight knee osteoarthritis (OA) patients. Methods: Group education (GE) was arranged for overweight patients for 2 weeks including how to use their joints properly in their daily activities, how to calculate energy of various kinds of food as well as performing controlled group exercise. Each parameter was evaluated at three time points including before joining GE, after 2 weeks of attending GE and 3 months later. The outcomes were determined by the knowledge score about the disease, gait speed calculated from a 50-meter walk, knee pain score after walking, body weight and quadriceps strength. Results: Eighty-seven subjects were recruited, 11 males (12.6%) and 76 females (87.4%) with a mean age of 59.5 ± 7.6 years, and an average body mass index of 27.5 ± 3.5 kg/m2. The duration of disease was 4.6 ± 4.7 years. Most subjects (79.3%) have good compliance on performing exercise with an average 9.15 ± 1.46 days (range 3-10). The knowledge score before and after attending the group education were 35.1 ± 4.2 and 38.1 ± 4.9, respectively (p < 0.001). After two weeks, their body weight and pain score decreased whereas quadriceps strength and gait speed increased. Those outcomes were even better at the 3-month follow up period. Conclusion: GE, comprised of providing appropriate knowledge, sharing ideas among groups, learning about diet and daily exercise for 2 weeks which can significantly increase knowledge scores, decrease knee pain and body weight, as well as increase quadriceps strength and gait speed.

Multivalent Effect of Isokinetic Muscular Strengthening Exercise in Aged Persons

OBJECTIVE: To investigate the multivalent effects of isokinetic strengthening exercises in aged person. METHOD: Sixrteen physically active elderly men and women (age 64.40+/-3.66) were recruited. The subjects underwent a 12-week knee flexor/extensor isokinetic exercise program of concentric contractions at a velocity of 180 degrees/sec of the both knee twice a week for 12 weeks. Training was carried out on the isokinetic dynamometer. The subjects were evaluated with muscular strength at 90 degrees/sec, endurance at 180 degrees/sec, cardio-pulmonary function, balance, mood and life quality at baseline, 4-week, 8-week and 12-week. RESULTS: Six of 16 people gave up in the middle of the course, 10 people completed a muscle strengthening exercise program. Muscular strength, balance, mood and life quality improved. CONCLUSION: Isokinetic exercise of the knee joint muscle was carried out and showed the result of multivalent effect in old age. Therefore strengthening exercise in aged persons was thought to be provided for welfare policy of an aging society as well as personal health improvement.

Comparisons of Spinal Stabilization Exercise and Lumbar Extensor Strengthening Exercise in Chronic Low Back Pain

OBJECTIVE: To compare the effects of spinal stabilization exercise against with lumbar extensor strengthening exercise. METHOD: Sixty patients with chronic low back pain were enrolled into the study and randomly classified into three groups. Groups were treated with spinal stabilization exercise (Group 1), lumbar extensor strengthening exercise using a MedX machine (Group 2), or with a combination program (Group 3) for 8 weeks. Patients were not given any other treatment modalities. Isometric peak torque of the lumbar extensors, pain rating score (PRS), Medical Outcomes Study Short Form-36 (SF-36) score, and the Oswestry low back pain disability questionnaire (OLBPD-Q) were assessed at 0, 4, and 8 weeks of exercise. RESULTS: 1) After 8 weeks, all groups showed incremental improvements in maximal isometric torque of the lumbar extensors and exhibited improvement in SF-36, PRS, and OLBD-Q scores (p<0.05). 2) There were no significant differences in the degree of improvement among the three groups after 8 weeks of exercise. 3) The percentage of patients with scores of good or excellent in Group 3 was higher than in Groups 1 and 2 according to all evaluation tools. CONCLUSION: In the treatment of chronic low back pain, all exercise groups showed decreased pain, improved quality of life, and increased lumbar extensor strength regardless of the exercise type employed. We suggest that exercise programs in general are effective for the treatment of chronic low back pain and a combination exercise program seems to be most beneficial.

Effects of Muscle Strengthening Exercises Using a Thera Band on Lower Limb Function of Hemiplegic Stroke Patients / 간호학회지

PURPOSE: This study was to verify the effect of muscle strengthening exercises using a Thera-Band on the lower limbs. METHODS: The design utilized for this study was a nonequivalent control group pretest-posttest design. A control group (16) and experimental group (16) were selected from stroke patients of K Oriental Medicine Hospital who were hospitalized for 5 months from December 2005 through April 2006. While only acupuncture therapy and physical therapy were used on the control group, acupuncture, physical therapy and additional muscle strengthening exercises using a red thera band were used on the experimental group. Muscle strengthening was performed 20 minutes per session, more than one session a day for 4 weeks. Hypotheses for this study were verified using Two-way repeated ANOVA and ANCOVA using a pre test score as a covariate. RESULTS: The experimental group with thera band muscle strengthening exercises showed a decrease in asymmetry weight loading percentage(F=14.704, P= .010), range of knee (Z=-3.15, P= .001) & deep tendon reflex score(Z=-2.52, P= .012) and moving performance(F=12.328, P= .001)compared to the control group. CONCLUSION: It is confirmed that muscle strengthening exercises using a Thera-Band can be used as an effective nursing intervention to improve the function of the lower limb of hemiplegic stroke patients.

Rehabilitative Exercise for Osteoarthritis Patients

Osteoarthritis is a common chronic, progressive degenerative disorder with a worldwide distribution. Approximately 70 percent of people over 70 years suffer from osteoarthritis. It is a major cause of disability and gradual loss of function. The symptoms of osteoarthritis such as pain, stiffness, fatigue, and negative idea about self-image make the patients avoid exercise, which leads to the development of muscle weakness, joint contracture and deformity. To avoid this vicious cycle, exercise is most important in the treatment of osteoarthritis. Exercise has proved to improve general health and mood, to reduce disability and fatigue, and to modify risk factors. Exercise for patients with osteoarthritis is composed of strengthening exercise, flexibility exercise, aerobic exercise, and proprioceptive training(including balance training). An appropriate exercise program tailored to the individual fitness(muscle strength, flexibility, and endurance) and goals should be stressed in the management of osteoarthritis.

The Effect of Back Extensor Strengthening Exercise on Chronic Low Back Pain and Bone Mineral Density

OBJECTIVE: To evaluate the effects of back extensor strengthening exercise on improving the pain, activities of daily living (ADL) and bone mineral density in the chronic low back pain patients. METHOD: 21 patients with chronic low back pain participated in back school program. Before program, measurement of lumbar extensor strength with MedX(R) (Ocala, USA), visual analogue scale (VAS) for pain, level of ADL and bone mineral density (BMD) with DEXA (Lunar(R), GE, USA) were done. For 12 weeks subjects had received the training for strengthening of back extensor and then, checked up with the above variables again. RESULTS: The results were as follows: 1) After 12 weeks of lumbar extensor strengthening program, isometric lumbar extensor strength was increased significantly (p<0.01), 2) VAS and ADL were significantly improved from 5.1 to 3.3, and 8.1 to 9.9, respectively (p<0.01), 3) BMD of lumbar spine were significantly improved from 1.1 to 0.8 (p<0.05) CONCLUSION: Twelve weeks lumbar extensor strengthening program with pelvic stabilization may be the effective therapeutic program for patients with chronic low back pain.

Effects of the Strengthening Exercise on Back Muscles after Lumbar Discectomy / 대한척추외과학회지

STUDY DESIGN: A retrospective study about lumbar strengthening exercise after lumbar discectomy. OBJECTIVES: To evaluate the effect of lumbar strengthening exercise on muscle power and pain, to analyze the problem of rehabilitation program after lumbar discectomy. SUMMARY OF LITERATURE REVIEW: The effectiveness of Lumbar strengthening exercise is still controversy and we can not found the similar article for this kind problem. MATERIALS AND METHODS: Three-hundred twenty eight patients of microscopic lumbar discectomy from 1998 to 1999, were divided into 2 groups; exercise group was 72 cases among 119 patients, and non-exercise group was 58 cases among 208 patients. degree of pain and functional activity were evaluated by visual analog scale and API test, respectively, at postoperative 3 months, 6 months, 1 year. the reason for not exercising was surveyed in non-exercise group. RESULTS: Exercise group 119 patients(36%). The most common cause of Non-Exercise was a deficiency of importance for lumbar strengthening exercise and exercise was done better in civil peoples than inrural peoples. There was a significant good result in exercise group by visual analog scale for pain at 3 months and 6 months postoperatively, but no difference between two groups after 1 year. exercise group had better results in flexion/extension test and fatigue endurance test. Lumbar strengthening exercise was a good method for relieving the pain in short term, but it was not effective in long term follow up. CONCLUSIONS: These results suggest that good results after lumbar discectomy in exercise group result from the secondary effects of increasing muscle power rather than relieving pain.

Hip position for knee strengthening exercise in Thais.

Sixty healthy Thai adults (30 men, 30 women) underwent the measurement of maximal isometric contraction of the dominant knee extensor muscles, while flexed their hips at 100o, 110o, 120o, and 130o, and their tested knee at 60o. There was no Significant difference in knee-extensor force between various hip angles tested both sexes.