What is a more effective method of cranio-cervical flexion exercises?

BACKGROUND: Cranio-cervical flexion exercise (CCFE) is a representative exercise that activates the deep muscles of neck pain patients. However, there is a lack of studies that propose specific exercise methods to examine the more effective activity level of the deep cervical flexor. OBJECTIVE: The objective of this study is to propose a more effective exercise method through effect comparison based on an optimal degree of mouth-opening, a mouth-open versus mouth-closed position, eye gaze, and body position change during CCFE. METHODS: As a result of examining the optimal degree of mouth-opening during CCFE using a pressure biofeedback unit with 50 subjects conforming to a selection standard, sternocleidomastoid muscle activity was examined. An optimal degree of mouth-opening during CCFE was examined as well. In addition, muscle thickness and muscle activity were measured based on eye gaze. Then, the effect of the exercise based on body position was examined. RESULTS: The lowest sternocleidomastoid activity was presented at a mouth-opening of 20 mm. A significant difference was presented in sternocleidomastoid and longus colli muscle activity at a mouth-opening of (p< 0.05). The eye gaze of 45∘ below presented the lowest sternocleidomastoid activity. CONCLUSIONS: The results suggest a new type of exercise method with the accompaniment of an optimal degree of mouth-opening of (20 mm), along with an eye gaze of 45∘ below, and an exercise method in the seated position without spatial restriction in order to increase the effect of CCFE, one of the conventional neck stabilization exercise methods.

Cardiorespiratory endurance in children with and without cerebral palsy as measured by an ergometer: a case series study.

[Purpose] This preliminary study aimed to determine the cardiorespiratory endurance of children with cerebral palsy (CP) using a case series study in order to provide the reference data required for interventions appropriate for South Korean CP sufferers, since aerobic ability evaluation and interventions for children with CP are not well recognized in South Korea. [Subjects and Methods] Four children and adolescents with CP GMFCS (Gross Motor Function Classification System) level I and II and two normally developing children (ND) (age: 7-15 years) were studied. Cycle ergometer testing was performed to determine their VO2 peak and RER peak concentrations as well as VE peak and 6MWT distance. [Results] The VO2 peak was lower in subject E (CP) at 44.5 than in subject B (ND), and it was lower in subject A (ND) at 22.9 than in subject C (CP). The 6MWT distance was longer in subjects A and B (ND) than in age-matched CP subjects. [Conclusion] This case report demonstrates that the cardiorespiratory parameters values of CP children were similar to those reported previously. Further research is required to evaluate the normative values of CP and the optimal cardiorespiratory parameters.

The effects of stretching and stabilization exercise on the improvement of spastic shoulder function in hemiplegic patients.

[Purpose] This study investigated the effects of stretching and joint stabilization exercises applied to spastic shoulder joints on improving shoulder dysfunction in hemiplegic patients. [Subjects and Methods] Hemiplegic patients were classified into three groups: one group received 30 min of traditional exercise therapy for the spastic shoulder joint; one group received 30 min stretching; and one group received 15 min of stretching and 15 min of joint stabilization exercises. The exercises were performed once a day, five times per week for eight weeks. Changes in the pathologic thickness of tendons and recovery of shoulder function were compared among the three groups. Differences among the three groups before the experiment, at four weeks, and at eight weeks were analyzed using repeated measures ANOVA. [Results] The stretching and joint stabilization exercise therapy group showed greater improvement in shoulder function than the traditional exercise therapy group and the stretching only group. This group also showed greater decreases in the pathologic thickness of tendons, than the other groups. [Conclusion] This study demonstrated that an exercise therapy program that combined stretching and joint stabilization exercise was more effective than other exercises for improvement of spastic shoulder joint dysfunction in hemiplegic patients.

The Impacts of ACE Activity according to ACE I/D Polymorphisms on Muscular Functions of People Aged 65.

OBJECTIVE: To investigate associations between angiotensin-converting enzyme (ACE) polymorphisms and muscle fatigability in 65-year-old Koreans. METHOD: The study participants were 49 Koreans aged 65 years. ACE insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction and serum ACE activity, by spectrophotometry. Body mass index (BMI), body fat mass (BFM), and lean body mass (LBM) were determined. To evaluate muscle fatigability, dynamic Electromyography was used to measure maximum voluntary isometric contractions (MVICs) of ankle plantar flexor muscles. Patients were seated with their hips flexed at 90°, knees fully extended, and ankles at 0°. Continuous submaximal VICs (40% MVIC) were then performed, and contraction duration and EMG frequency changes during the initial 2 min were measured. A self-reported physical activity questionnaire was used to evaluate effects of ACE activity levels on muscle fatigability. RESULTS: Among the 49 volunteers, 15 showed II genotype; 22, ID genotype; and 12, DD genotype. Serum ACE activity levels were significantly higher in DD genotype subjects than in II genotype subjects (p<0.05). Furthermore, the duration of submaximal isometric contractions was longer in II and ID genotype subjects than in DD genotype subjects (p<0.05). Dynamic EMG showed significantly lower mean frequency changes in II genotype subjects than in DD genotype subjects (p<0.05). However, LBM, BFM, and BMI were independent of ACE genotypes. CONCLUSION: ACE II genotype subjects showed significantly higher resistant to muscle fatigue than that by DD genotype subjects. However, body composition and BMI showed no correlations with ACE I/D polymorphisms.