ABSTRACT
OBJECTIVE: To examine the changes in postural alignment and kyphosis-correlated factors after 6 months of back extensor strengthening exercise in a group of community-dwelling older adults aged ≥65 years. METHODS: We quasi-randomized 29 subjects into an intervention group treated with a back extensor strengthening program and a control group treated with a full-body exercise program. These groups completed 20-30 minutes of exercise directed by a physical therapist one or more times per week and were instructed to exercise at home as well. The participants were assessed prior to and after the intervention using the following criteria: postural alignment of "usual" and "best" posture, physical function, physical performance, self-efficacy, and quality of life. The differences between two factors (group and period) were compared for each of the measurement variables. RESULTS: Subjects who adequately completed the exercises were analyzed. A reduced knee flexion angle was noted in the "best" posture of both groups, as were improved physical function and performance with the exception of one-leg standing time. Verifying the effect size in the post-hoc analysis, the body parts that showed changes to postural alignment after the intervention differed between groups. CONCLUSIONS: Back extensor strengthening exercises improved physical function and performance, but did not improve spinal alignment. The changes due to these interventions were not significantly different from changes observed in the full-body exercise group. However, post-hoc analysis revealed that the effect size of posture change was different, possible indicating that the two groups experienced different changes in the postural alignment.
ABSTRACT
[Purpose] Dysfunction of lower extremity muscles is one risk factor of falls for amputee patients. However, the change in muscle activity pattern and balance ability of amputees who have no experience in standing with prosthesis during the period from prosthesis fitting to regaining the ability to walk has never been studied. Therefore, the objectives of the present study were to elucidate changes over time in the muscle activity pattern and walking speed from first prosthesis fitting to hospital discharge. We also investigated the differences of muscle activity during standing between younger and elderly amputee patients. [Methods] Electromyography measurements were performed on the gastrocnemius of the intact leg during standing. The test subjects were asked to shift their center of gravity forward. [Results] Two unique patterns of gastrocnemius activities were observed over time. In a younger patient, the amount of muscular activity of the gastrocnemius gradually increased over time. In an elderly patient, however, the amount of muscular activity of gastrocnemius gradually decreased over time. [Conclusion] The time-dependent changes in gastrocnemius muscle activities are indicative postural control ability. Therefore, understanding the time-dependent changes in muscle activities during rehabilitation and the differences of postural control between younger and elderly patients would contribute to the development of effective rehabilitation programs for each patient.
