Effects of Upper Limb Control on the Less-Affected Side on Upper Limb Function, Respiration, Balance, and Activities of Daily Living in Stroke.

Background and Objectives: This study aimed to investigate the effects of upper limb control exercises on upper limb function, respiration, balance, and activities of daily living in patients with stroke. Materials and Methods: The 28 patients who met the selection criteria were randomly assigned to two groups of 14 patients each. Subsequently, upper limb control exercises using real-time feedback were applied. The same interventional exercise was applied to both the less-affected and affected limbs of the study participants, who were classified into a less-affected side upper limb control group and an affected side upper limb control exercise group. Interventional exercises, 30 min each, were performed five times weekly for 4 weeks, and follow-up examinations were performed 2 weeks after the end of exercise. Electronic muscle strength measurements and an electronic goniometer were used to evaluate upper limb function. A spirometer was used to measure respiration. Balance ability was evaluated using a force plate pressure distribution measuring system with a sensor that detects the movement of the body center on the ground. Daily life movements were evaluated using the Korean version of the modified Barthel index. Results: When examining the results, the upper limb function on the paralyzed side showed an increase in the electromyographic strength of shoulder joint depression and flexion angle. Improvements were also observed in respiration (forced vital capacity [L] and forced expiratory volume in 1 s [L]), balance (95% confidence ellipse area [mm2] and center of pressure displacement [mm]), and daily life activities, all of which showed statistically significant differences in the time × group interaction effect (p < 0.05). Conclusions: Thus, it was found that the upper limb control exercise on the less-affected side had a significant effect when the exercise was performed together with treatment on the affected side in patients with stroke. It is anticipated that this study will provide basic data for evaluating both the trunk and upper limbs of the less-affected and affected sides.

Effects of Pain Neuroscience Education Combined with Lumbar Stabilization Exercise on Strength and Pain in Patients with Chronic Low Back Pain: Randomized Controlled Trial.

Chronic low back pain that lasts more than 12 weeks causes mental and physical distress. This study investigated the effects of pain neuroscience education combined with lumbar stabilization exercises on strength, pain, flexibility, and activity disorder index in female patients with chronic low back pain. Thirty-five female patients with chronic low back pain were randomly divided into two groups: the pain neuroscience education (PNE) combined with lumbar stabilization exercises (LSEs) group (n = 18, experimental group) and the lumbar stabilization exercises alone group (n = 17, control group). The experimental group underwent PNE combined with LSEs for 30 min per session, twice per week for 8 weeks, and the control group underwent LSEs only. The primary outcomes were strength (sit-up and back-up movements), Numerical Pain Rating Scale (NPRS), Korean Pain Catastrophizing Scale (K-PCS), and Tampa Scale of Kinesio-phobia-11 (TSK-11) for pain. The secondary outcomes were modified-modified Schober's test (MMST) and finger to floor test (FFT) for flexibility and activity disorder (Roland-Morris Disability Questionnaire index). A significant difference was observed in the primary outcomes after intervention in the abdominal muscle strength (group difference, mean, -7.50; 95% CI, -9.111 to -5.889, F = 9.598; ANCOVA p = 0.005), the back muscle strength (group difference, mean, -9.722; 95% CI, -10.877 to -8.568, F = 7.102; ANCOVA p = 0.014), the NPRS (group difference, mean, 1.89; 95% CI,1.65 to 2.12, F = 24.286; ANCOVA p < 0.001), K-PCS (group difference, mean, 7.89; 95% CI, 7.02 to 8.76, F = 11.558; ANCOVA p = 0.003), and TSK-11 (group difference, mean, 16.79; 95% CI, 13.99 to 19.59, F = 13.179; ANCOVA p = 0.014) for pain. In the secondary outcomes, there was a significant difference in the FFT (group difference, mean, -0.66; 95%CI, -0.99 to -0.33, F = 4.327; ANCOVA p = 0.049), whereas the difference in flexibility (MMST) and activity disorder index of the secondary outcomes did not reach significance. Therefore, this study confirmed that PNE combined with LSEs is an effective intervention compared to LSE alone in improving muscle strength and pain in female patients with chronic low back pain.

Detection of Abnormal Respiration from Multiple-Input Respiratory Signals.

In this paper, we propose a novel approach for the detection of abnormal signals from multiple respiration signals. An ultrawide-band (UWB) radar was used to acquire respiration signals that represent a distance from the chest to the radar sensor, i.e., shape variation of the chest due to breathing (inhaling or exhaling) activity provides quantitative information (distance values) about respiratory status. Distribution, shape, and variation of values across time provide information to determine respiratory status, one of the most important indicators of human health. In this paper, respiratory status was categorized into two classes, normal and abnormal. Abnormal respiration (apnea in this paper) was emulated by interrupting breathing activity because it is difficult to acquire real apnea from patients in hospital wards. This paper considered two cases, single and multiple respiration. In the first case, a single normal- or abnormal-respiration signal was used as input, and output was the classified status of respiration. In the second case, multiple respiration signals were simultaneously used as inputs, and we focused on determining the existence of abnormal signals in multiple respiration signals. In the case of multiple inputs, filters with varying cut-off frequency were applied to input signals followed by the analysis of output signals in response to the filters. To substantiate the proposed method, experiment results are provided. In this paper, classification results showed 93 % of the successful rate in the case of multiple inputs, and results are promising for applications to monitoring systems of human respiration.

The effects of posterior talar glide with dorsiflexion of the ankle on mobility, muscle strength and balance in stroke patients: a randomised controlled trial.

[Purpose] The purpose of this study was to examine the effectiveness of posterior talar glide (PTG) with dorsiflexion of the ankle on stroke patients ankle mobility, muscle strength, and balance ability. [Subjects and Methods] Thirty-four subjects were randomly assigned to either a PTG with dorsiflexion group (PTG; n=17), or a weight-bearing with placebo PTG group (control; n=17). Subjects in the PTG group performed PTG with dorsiflexion, designed to improve ankle mobility, muscle strength and balance ability with proprioceptive control of the ankle, for 10 glides of 5 sets/day, 5 days/week, for 4 weeks. [Results] The experimental group showed significant improvement on the Ankle Dorsiflexion Range of Motion assessment, Ankle Dorsiflexor Manual Muscle Test, Functional Reach Test, Time Up and Go test, and Functional Gait Assessment compared to the control group. However, regarding Ankle Plantarflexion Range of Motion assessment and the Ankle Plantarflexor Manual Muscle Test, no significant differences were found between the two groups. [Conclusion] The results of this study show that PTG with dorsiflexion can improve ankle mobility, muscle strength and balance ability in patients recovering from stroke. This exercise may prove useful in clinical rehabilitation. Further research on the long-term effectiveness of PTG on gait ability is suggested.