Effects of cranio-cervical flexion with transcranial direct current stimulation on muscle activity and neck functions in patients with cervicogenic headache.

[Purpose] To present an efficient treatment regimen for patients with cervicogenic headache by comparatively analyzing the neck disability index (NDI) and cervical muscle activity after an exercise intervention. [Participants and Methods] Thirty patients with cervicogenic headache were assigned to the cranio-cervical flexion group (n=15) and cranio-cervical flexion plus transcranial direct current stimulation (tDCS) group (n=15). Intervention was administered for four weeks, after which the participants' NDI and sternocleidomastoid muscle activity were measured. [Results] The treatment group demonstrated a significantly greater change in NDI after the intervention compared to the control group. The treatment group also showed a significantly greater change in sternocleidomastoid muscle activity than the control group. [Conclusion] Our results show that applying tDCS during cranio-cervical flexion exercise can strengthen the sternocleidomastoid muscle more effectively while improving pain and associated functions in patients with cervicogenic headache. These results would contribute towards developing a more efficient treatment for patients with cervicogenic headache.

The effect of disability awareness educational program of university students in the department of physical therapy on reducing prejudices against people with disabilities and increasing positive attitudes toward people with disabilities.

[Purpose] The purpose of this study is to investigate the effects of disability awareness educational program of university students in the department of physical therapy on reducing prejudice against people with disabilities and increasing positive attitudes toward people with disabilities. [Participants and Methods] Students who participated in the disability awareness educational program were selected as experiment group and 15 students who did not take program were selected as control group. [Results] First, in the comparisons between the control and experimental group, there was no difference in the overall prejudice on people with disabilities and positive attitudes toward people with disabilities before the disability awareness educational program. However, there was a significant difference in the overall prejudice and positive attitudes between two groups after the disability awareness educational program. Second, in the comparisons between pretest and posttest, there was no significant difference in the overall prejudice on people with disabilities in control group. However, in the comparisons between pretest and posttest, there was a significant difference in the overall prejudice in experimental group. [Conclusion] It is necessary to provide disability awareness educational program for the university students in the department of physical therapy to reduce the overall prejudices against people with disabilities and increase positive toward people with disabilities.

Effects of extracorporeal shock wave therapy on upper extremity muscle tone in chronic stroke patients.

[Purpose] The purpose of this study was to examine the effects of extracorporeal shock wave therapy (ESWT) on upper extremity muscle tone in chronic stroke patients. [Subjects and Methods] For this study, 30 stroke patients participated in this study and they were divided into ESWT group and sham-ESWT group, each group consisted of 15 patients. ESWT and sham-ESWT was performed by the patients for two times a week, for eight weeks. MyotonPRO was used to measure muscle tone. [Results] According to the results of the comparisons between the groups, after intervention, upper extremity muscle tone were significantly higher in the ESWT group than in the sham-ESWT group. [Conclusion] This study showed that ESWT is effective for improving decrease of muscle tone in chronic stroke patients.

Effects of cervical stretching and cranio-cervical flexion exercises on cervical muscle characteristics and posture of patients with cervicogenic headache.

[Purpose] The present study aimed to conduct a comparative analysis of changes in mechanical characteristics of cervical muscles and cervical posture in patients with cervicogenic headache following exercise program intervention in order to present effective treatment methods for such patients. [Subjects and Methods] A total of 30 patients with cervicogenic headache were recruited and 15 patients were allocated to cervical stretching exercise group and 15 to cervical stretching exercise and cranio-cervical flexion exercise group. After 3 weeks of exercise intervention, craniovertebral angle and tone (Hz) and stiffness (N/m) of the suboccipital and upper trapezius muscles were measured. [Results] After the exercise program intervention, a greater amount of change in tone of suboccipital and upper trapezius muscles was found in the experimental group, as compared to the control group, but the difference was not statistically significant. Greater amount of change in muscle stiffness and craniovertebral angle was found in the experimental group, as compared to the control group. [Conclusion] Findings of the present study showed that cranio-cervical exercise was an effective form of exercise for changing muscle characteristics and posture in patients with cervicogenic headache. Such findings will be helpful in providing effective treatments for patients with cervicogenic headache.

Effects of kinetic chain exercise using EMG-biofeedback on balance and lower extremity muscle activation in stroke patients.

[Purpose] The purpose of this study was to examine the effect of kinetic chain exercise using EMG-biofeedback on balance and lower extremity muscle activation. [Subjects and Methods] For this study, 30 stroke patients participated in this study and they were divided into closed kinetic chain exercise using EMG-biofeedback group (CKCE+EB) and open kinetic chain exercise using EMG-biofeedback group (OKCE+EB), each group consisting of 15 patients. The kinetic chain exercise using EMG-biofeedback was performed by the patients for 20 minutes once a day, 5 days a week, for 6 weeks using an Myo-Ex. BioRescue was used to measure balance ability, while surface EMG was used to measure the lower extremity muscle activation. [Results] According to the results of the comparison within the groups, after the intervention, both groups showed significant increases in the balance ability and lower extremity muscle activation. In the comparisons between the groups, after the intervention, balance ability and lower extremity muscle activation were significantly higher in the CKCE+BE than in the OKCE+EB. [Conclusion] This study showed that closed kinetic chain exercise using EMG-biofeedback is effective for improving balance ability and lower extremity muscle activation in stroke patients.

Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache.

[Purpose] This study aimed to compare and analyze the mechanical properties of the upper cervical muscles in patients with cervicogenic headache to identify efficient methods of treatment and diagnosis. [Subjects and Methods] A total of 40 subjects including 20 healthy individuals and 20 patients with cervicogenic headache were selected. A MyotonPRO device was used to measure the tone (Hz), stiffness (N/m), and elasticity (log decrement) of the suboccipital muscles and upper trapezius of the subjects. [Results] There was no significant difference between the 2 groups in the elasticity of the suboccipital muscles and upper trapezius. However, there was a statistically significant difference in tone and stiffness. [Conclusion] This study showed that the tone and stiffness of the suboccipital muscles and upper trapezius in patients with cervicogenic headache had increased compared to healthy subjects.

Analysis of prejudices and attitudes of students in the department of physical therapy against people with disabilities.

[Purpose] The purpose of this study is to examine prejudices and attitudes of students in the department of physical therapy, in order to suggest basic data for constructing an effective program to develop a positive attitude toward people with disabilities and lower social distance from them. [Subjects and Methods] For this study, students in the department of physical therapy participate in the survey examining prejudices and attitude towards people with disabilities. [Results] First, there were statistically significant differences in the prejudice against people with disabilities among student groups divided by whether they had contact on a frequent basis currently with those who have disabilities. Second, there were statistically significant differences in the prejudice against people with disabilities among student groups divided by whether they had an experience of being harmed by people with disabilities. Third, there was a correlation among prejudices against people with disabilities with each other that is articulated in the eighth domain. Finally, as a result of regression analysis, the students' attitudes towards people with disabilities were explained appropriately by the prejudices about performance of daily tasks and NIMBY (Not In My Back Yard) syndrome. [Conclusion] It is crucial to create an environment where University students in the department of physical therapy can have positive interactions with people with disabilities, to reduce the overall prejudices, and specifically, the prejudices about performance of daily tasks and about NIMBY syndrome.

Study on the quality of life of children with cerebral palsy.

[Purpose] This study aims to analyze the factors that affect the quality of life of children with cerebral palsy. [Subjects and Methods] The study subjects were 138 children, aged 7-12, who suffer from cerebral palsy. Factors affecting subjects' quality of life were evaluated using the ICF-CY; quality of life was evaluated using the KIDSCREEN 52 - Health-Related Quality of Life questionnaire. Multiple regression analysis was conducted. [Results] The factors related to physical functions that affect subjects' quality of life were mental function, sensory function and pain, genitourinary and reproductive function, as well as neuromusculoskeletal and movement-related functions. Factors related to activities and participation were learning and applying knowledge, self-care, interpersonal interactions and relationships, major life areas, and community, social and civic life. Lastly, factors related to the environment were products and technology, natural environment and human made changes to environment, and attitude. [Conclusion] In order to improve the quality of life of children with cerebral palsy, the compound effects of several factors should be comprehensively considered without being limited to a specific variable from physical function. And children should be provided with ample opportunities to participate in diverse activities and their physical functions, as well as the environmental factors, should improve.

The correlation between muscle activity of the quadriceps and balance and gait in stroke patients.

[Purpose] The purpose of this study was to examine the correlation between quadriceps muscle activity and balance and gait in stroke patients. [Subjects and Methods] Fifty-five stroke patients (30 males 25 females; mean age 58.7 years; stroke duration 4.82 months; Korean mini-mental state examination score 26.4) participated in this study. MP100 surface electromyography, BioRescue, and LUKOtronic were used to measure the quadriceps muscle activity, balance, and gait, respectively. [Results] There was a significant correlation between quadriceps muscle activity (vastus lateralis % reference voluntary contraction, vastus medialis % reference voluntary contraction) and balance (limits of stability) and gait (gait velocity) but there was none between vastus lateralis % reference voluntary contraction, vastus medialis % reference voluntary contraction. [Conclusion] An increase in quadriceps muscle activity will improve balance and gait ability. To improve function in stroke patients, training is needed to strengthen the quadriceps muscles.

The effect of virtual reality-based eccentric training on lower extremity muscle activation and balance in stroke patients.

[Purpose] The purpose of this study was to examine the effect of virtual reality-based eccentric training on lower extremity muscle activity and balance in stroke patients. [Subjects and Methods] Thirty stroke patients participated, with 15 patients allotted to each of two eccentric training groups: one using a slow velocity (group I) and one using a fast velocity (group II). The virtual reality-based eccentric training was performed by the patients for 30 minutes once a day, 5 days a week, for 8 weeks using an Eccentron system. Surface electromyography was used to measure the lower extremity muscle activity, while a BioRescue was used to measure balancing ability. [Results] A significant difference in lower extremity muscle activation and balance ability was observed in group I compared with group II. [Conclusion] This study showed that virtual reality-based eccentric training using a slow velocity is effective for improving lower extremity muscle activity and balance in stroke patients.

Effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force.

[Purpose] The purpose of this study was to investigate the effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The subjects of this study were 30 young adult males, who were divided into a Nordic walking group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the spatiotemporal parameters and ground reaction force during walking in the two groups, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for them between Nordic walking and walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. To determine the pole for Nordic walking, each subject's height was multiplied by 0.68. We then measured the spatiotemporal gait parameters and ground reaction force. [Results] Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The results of this study indicate that Nordic walking increases the stride and can be considered as helping patients with diseases affecting their gait. This demonstrates that Nordic walking is more effective in improving functional capabilities by promoting effective energy use and reducing the lower limb load, because the weight of the upper and lower limbs is dispersed during Nordic walking.

Effect of changes in postural alignment on foot pressure and walking ability of stroke patients.

[Purpose] The aims of this study were to determine (1) the significance of walking and foot pressure in stroke patients, and (2) the association between changes in postural alignment of stroke patients. [Subjects and Methods] Foot pressure and walking ability based on postural alignment were measured in 50 stroke patients. Trunk imbalance, trunk rotation, pelvic tilt, kyphosis, lordosis were measured using DIERS formetric4D (DIERS International GmbH, Schlangenbad, Germany), which anlalyzes 3-dimensional spinal structure in order to measure postural alignment. To determine foot pressure, the support rate of weight and, average foot pressure were measured using DIERS pedoscan (DIERS International GmbH, Schlangenbad, Germany) apparatus as a pressure platform. [Results] DIERS formetric 4D, DIERS pedoscan, and a 10 m walking test were utilized to measure foot pressure and walking ability relative to changes in postural alignment in participating stroke patients. [Conclusion] This study confirmed the significance of foot pressure and walking ability as related postural alignment, indicating that postural alignment education and a recovery therapy program for functional improvement of stroke patients should be provided together.

A case report of spinal cord injury patient from a high velocity gunshot wound to the lumbar spine.

We report on operational and rehabilitation management, as well as the outcome, of a patient who with sustained spinal cord injury from a high velocity gunshot wound to the lumbar spine. More specifically, a patient with a gunshot wound to the spine is more likely to sustain a complete injury and have a poor prognosis. As such, there should be concerns regarding associated and extended injuries related to bullet fragmentation as well as the possibility of long-term sequelae.

The correlation analysis of functional factors and age with duchenne muscular dystrophy.

OBJECTIVE: To correlate existing evaluation tools with clinical information on Duchenne muscular dystrophy (DMD) patients following age and to investigate genetic mutation and its relationship with clinical function. METHOD: The medical records of 121 children with DMD who had visited the pediatric rehabilitation clinic from 2006 to 2009 were reviewed. The mean patient age was 9.9±3.4 years and all subjects were male. Collected data included Brooke scale, Vignos scale, bilateral shoulder abductor and knee extensor muscles power, passive range of motion (PROM) of ankle dorsi-flexion, angle of scoliosis, peak cough flow (PCF), fractional shortening (FS), genetic abnormalities, and use of steroid. RESULTS: The Brooke and Vignos scales were linearly increased with age (Brooke (y(1)), Vignos (y(2)), age (x), y(1)=0.345x-1.221, R(Brooke) (2)=0.435, y(2)=0.813x-3.079, R(Vignos) (2)=0.558, p<0.001). In relation to the PROM of ankle dorsi-flexion, there was a linear decrease in both ankles (right and left R(2)=0.364, 0.372, p<0.001). Muscle power, Cobb angle, PCF, and FS showed diversity in their degrees, irrespective of age. The genetic test for dystrophin identified exon deletions in 58.0% (69/119), duplications in 9.2% (11/119), and no deletions or duplications in 32.8% (39/119). Statistically, the genetic abnormalities and use of steroid were not definitely associated with functional scale. CONCLUSION: The Brooke scale, Vignos scale and PROM of ankle dorsi-flexion were partially available to assess DMD patients. However, this study demonstrates the limitations of preexisting scales and clinical parameters incomprehensively reflecting functional changes of DMD patients.

Tai Chi Qigong for the quality of life of patients with knee osteoarthritis: a pilot, randomized, waiting list controlled trial.

OBJECTIVE: To evaluate the effects of Tai Chi Qigong training on the quality of life and physical function of patients with osteoarthritis of the knee. DESIGN: A preliminary, single-blind, randomized controlled trial. SETTING: General community, performed at Hwaseong City Health Center. PARTICIPANTS: Forty-four elderly subjects (mean age, 69.1 +/- 5.4 years) with knee osteoarthritis. INTERVENTION: The patients were randomized (2:1) to: (1) an eight-week Tai Chi Qigong training programme or (2) a waiting list control group. The programme involved eight weeks of group Tai Chi Qigong sessions, with 60 minutes per session twice a week. MAIN OUTCOME MEASURES: The primary outcome was quality of life measured with the Short Form 36 (SF-36) at baseline and week 8. Secondary outcomes included the Western Ontario and McMaster University Osteoarthritis Index (WOMAC) and 6-m walking time. RESULTS: The training group had statistically significant improvements in the quality of life (changes of SF-36, Qigong versus control: 21.6 +/- 16.8 versus 9.8 +/- 13.6, P < 0.05) and 6-m walking test (change in walking time, Qigong versus control: -1.6 +/- 1.7 versus -0.2 +/- 0.8 s, P < 0.01). The WOMAC scores in the training group were markedly improved, although the differences were not statistically significant. CONCLUSIONS: Tai Chi Qigong training appears to have beneficial effects in terms of the quality of life and physical functioning of elderly subjects with knee osteoarthritis. However, more rigorous trials are needed to confirm the efficacy of this training for patients with osteoarthritis of the knee.