Lower Quarter Y-Balance Test in healthy women 50-79 years old.

The Lower Quarter Y-Balance Test (LQ-YBT), a measure of dynamic balance used in young adults, has not been adequately studied in older women. We determined the reliability, normative values, and relationships to other balance measures for LQ-YBT in women aged 50-79 years. Interrater reliability was strong, and test-retest reliability was moderate to strong. Results by decade showed women 50-59 years had significantly better scores than both older groups. There were moderate positive correlations between single leg stance, gait speed, and LQ-YBT composite score. LQ-YBT may be used as a dynamic balance assessment in healthy older women.

Relationships between trunk performance, gait and postural control in persons with multiple sclerosis.

BACKGROUND: Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system. Compared to healthy individuals, persons with multiple sclerosis (PwMS) have increased postural sway in quiet stance, decreased gait speed and increased fall incidence. Trunk performance has been implicated in postural control, gait dysfunction, and fall prevention in older adults. However, the relationship of trunk performance to postural control and gait has not been adequately studied in PwMS. OBJECTIVE: To compare trunk muscle structure and performance in PwMS to healthy age and gendered-matched controls (HC); to determine the effects of isometric trunk endurance testing on postural control in both populations; and to determine the relationship of trunk performance with postural control, gait and step activity in PwMS. METHODS: Fifteen PwMS and HC completed ultrasound imaging of trunk muscles, 10 m walk test, isometric trunk endurance tests, and postural sway test. Participants wore a step activity monitor for 7 days. RESULTS: PwMS had worse isometric trunk endurance compared to HC. PwMS trunk flexion endurance negatively correlated to several postural control measures and positively correlated to gait speed and step activity. CONCLUSIONS: Clinicians should consider evaluation and interventions directed at impaired trunk endurance in PwMS.

Continued recovery in an adult with cerebellar ataxia.

BACKGROUND AND PURPOSE: The authors previously reported on the functional recovery of an adult with chronic, severe ataxia secondary to traumatic brain injury (TBI) after 28 sessions of trunk stabilization and locomotor training (LT). The purpose of this case report is to describe this individual's functional abilities 3.5 years after the intervention. CASE DESCRIPTION: Thirteen months post-TBI and not expected to be a functional ambulator, an adult male participated in a trunk stabilization and LT intervention. After the intervention, he continued to exercise in a hospital-based fitness program and received additional physical therapy. Evaluation of balance, gait, trunk performance, self-reported function, and quality of life was performed at 6 weeks (baseline), 1 year, and 3.5 years after completing the intervention. OUTCOMES: Balance, gait, and function improved. Resting left transverse abdominis thickness, measured using ultrasound imaging, increased as did left-side bridge and trunk flexion endurance. He increased community participation and expressed general satisfaction with his overall quality of life. DISCUSSION AND CONCLUSION: In the 3.5 years after participation in an intervention of trunk stabilization and LT this adult became an independent limited community ambulator. Persons with severe ataxia secondary to TBI may continue to improve many years after injury.

Use of trunk stabilization and locomotor training in an adult with cerebellar ataxia: a single system design.

The purpose of this study is to describe the effects of trunk stabilization training and locomotor training (LT) using body-weight support on a treadmill (BWST) and overground walking on balance, gait, self-reported function, and trunk muscle performance in an adult with severe ataxia secondary to brain injury. There are no studies on the effectiveness of these combined interventions in persons with ataxia. The subject was a 23-year-old male who had a traumatic brain injury 13 months prior. An A-B-A withdrawal single-system design was used. Outcome measures were Berg Balance Test (BBT), timed unsupported stance, Functional Ambulation Category (FAC), 10-meter walk test (10-MWT), Outpatient Physical Therapy Improvement in Movement Assessment Log (OPTIMAL), transverse abdominis (TrA) thickness, and isometric trunk endurance tests. Performance on the BBT, timed unsupported stance, FAC, 10-MWT, and OPTIMAL each improved after 10 weeks of intervention. In additions, TrA symmetry at rest improved as did right side-bridge endurance time. LT, using BWST and overground walking, and trunk stabilization training may be effective in improving balance, gait, function, and trunk performance in individuals with severe ataxia. Further research with additional subjects is indicated.

A rehabilitative ultrasound imaging investigation of lateral abdominal muscle thickness in healthy aging adults.

PURPOSE: Rehabilitative ultrasound imaging (RUSI) is used to evaluate lateral abdominal muscle size and function during the abdominal drawing-in maneuver (ADIM), an exercise used to improve lumbar spine stability. Little is known about the size and performance of these muscles in healthy aging adults. The purpose of this study was to investigate, using RUSI, the size and symmetry of the lateral abdominal muscles bilaterally at rest and during the ADIM in healthy older adults and the reliability of these measurements. METHODS: Three ultrasound images of the right and left lateral abdominal muscles were taken at rest and during the ADIM in 12 healthy older adults. Thickness of the transversus abdominis muscles (TrA), internal oblique (IO), and external oblique (EO) were measured for all images. Intraclass correlation coefficients were computed using model 3, form 1 (ICC3,1). Two ratios of the abdominal muscles were calculated in the relaxed and contracted states. Paired t-tests were used to compare relaxed muscle thickness to contracted muscle thickness for all 3 muscles for each side. To test further for interactions of side and contractile state, 2 x 2 repeated measures ANOVAs were performed. Side-to-side differences in absolute and relative thickness were assessed with paired t-tests for the TrA and IO muscles. Absolute and relative side-to-side muscle symmetry indices were computed for each muscle at rest. RESULTS: There was a significant difference in muscle thickness between the contracted and relaxed states for both the TrA and IO. There was no significant difference between left/right muscle thickness for the TrA or IO at rest or during the ADIM. The TrA nearly doubled in size while thickness of the IO + EO stayed relatively constant during the ADIM. Reliability for absolute muscle thickness was generally excellent: ICCs3,1 ranged from 0.95 to 1.00 for intra-image reliability; 0.77 to 0.97 for inter-image reliability. CONCLUSIONS: These findings support symmetrical and preferential activation of the TrA during the ADIM in healthy older adults. Continued research on the use of RUSI as a tool for both assessment and intervention in older adults is needed.

Electromyographical analysis of selected lower extremity muscles during 5 unilateral weight-bearing exercises.

STUDY DESIGN: Prospective single-group repeated-measures design. OBJECTIVES: To quantify electromyographic (EMG) signal amplitude of the gluteus maximus, gluteus medius, vastus medialis oblique, and biceps femoris during 5 unilateral weight-bearing exercises. BACKGROUND: Using normalized EMG (NEMG) signal amplitude as a measure of muscle activation and, therefore, an estimate of exercise intensity, the relative contributions and interaction of the hip and thigh muscles during unilateral weight-bearing exercise can be examined. With regard to potential efficiency for strengthening, data on the amount of EMG signal amplitude for these 4 muscles during commonly used exercises are limited. METHODS AND MEASURES: Twenty-three healthy, asymptomatic subjects (16 men, 7 women; mean +/- SD age, 31.2 +/- 5.8 years) participated. A repeated-measures analysis was conducted using general linear models. The percent maximum voluntary isometric contraction was measured within each subject across 4 muscles during 5 exercises for 2 separate trials. Effect sizes of pairwise comparisons were computed. RESULTS: Statistically significant differences were noted in the amount of mean NEMG signal amplitude for the 4 muscles across the 5 exercises. A similar recruitment pattern between muscles was observed across all exercises. CONCLUSION: Even though all muscles except the biceps femoris demonstrated mean NEMG signal amplitudes sufficient for strengthening, the wall squat produced the highest levels of activation and should be considered the most efficient for targeting any of the 4 muscles or for training a cooperative effort among the muscles.