Effects of the Computer Desk Level on the Musculoskeletal Discomfort of Neck and Upper Extremities and EMG Activities in Patients with Spinal Cord Injuries.

BACKGROUND: Computers are used as a means of social communication, for work and other purposes. However, patients with spinal cord injuries may have a higher risk than normal individuals with musculoskeletal problems when using computers owing to their inability to control respective postures due to problems in motor and sensory functioning. OBJECTIVES: This study is aimed at identifying the effect of computer desk heights on musculoskeletal discomforts of the neck and upper extremities and EMG activities in patients with spinal cord (C6) and upper thoracic spinal cord injuries. METHODS: Participants of the present study were the patients diagnosed with ASIA A or B. The patients were divided into two groups according to their spinal cord injuries: C6 group and T2-T6 group. The level of the desk was set at 5 cm below the elbow, at the elbow level, and 5 cm above the elbow level. Electromyography was used to measure the duration of typing task EMG(%RVC) of the cervical erector spinae, upper trapezius, anterior deltoid, and wrist extensor. Subjective musculoskeletal discomfort (Borg-RPE) was measured at the end of the experiment. RESULTS: The two groups showed differences in terms of RPE corresponding to each level of the computer desk (p < .05). Postanalysis revealed the C6 group had decreased RPE as the level of computer desk increased, whereas the subjects in the T2-T6 group had decreased RPE values in accordance with the decreasing level of computer desk (p < .05). In EMG, both groups had no significant differences (p > .05). However, in terms of the interaction between the muscles and the level of computer desk in both groups, the differences in the interactions of the upper trapezius and wrist extensor with each level of the desk were found (p < .05). CONCLUSION: This study is meaningful in that it confirms computer work posture and preference of spinal cord-injured individuals.

Effects of stabilization exercise using flexi-bar on functional disability and transverse abdominis thickness in patients with chronic low back pain.

[Purpose] The purpose of this study is to examine the effects of lumbar stabilization exercises using flexi-bar (FB) on pain, functional disability, transverse abdominis muscle (TrA) activation capacity and thickness in patients with chronic low back pain (CLBP). [Subjects and Methods] Twenty-seven patients were randomly assigned to an experimental (14 patients performing stabilization exercises with flexi-bar (FB)) or control (13 patients performing stabilization exercises) group. The patients in both groups then underwent stabilization exercises with or without FB 30 min/day, 3 times a week, for 6 weeks. The main outcome measures were perceived disability based on the pain, Oswestry disability index (ODI), TrA activation capacity and thickness. [Results] Both groups showed improved ODI, VAS, and TrA activation capacity performed for 6 weeks in patients with CLBP, but all outcomes, except for TrA thickness, showed greater improvements in patients following stabilization exercises with FB than following stabilization exercises. [Conclusion] Based on the above results, lumbar stabilization exercises with FB could restoring pain, functional disability and improving TrA activation capacity in CLBP patients.

Impact of the difference in the plantar flexor strength of the ankle joint in the affected side among hemiplegic patients on the plantar pressure and walking asymmetry.

[Purpose] This study was to examine the changes in the gait lines and plantar pressures in static and dynamic circumstances, according to the differences in the strengths of the plantar flexors in the ankle joints on the affected sides of hemiplegic patients, and to determine their impacts on walking symmetry. [Subjects and Methods] A total of thirty hospitalized stroke patients suffering from hemiplegia were selected in this study. The subjects had ankylosing patterns in the ankle joints of the affected sides. Fifteen of the patients had plantar flexor manual muscle testing scores between poor and fair, while fifteen of the patients had zero and trace. [Results] The contact pattern of the plantar surface with the ground is a reliable method for walking analysis, which is an important index for understanding the ankle mechanism and the relationship between the plantar surface and the ground. [Conclusion] The functional improvement of patients with stroke could be supported through a verification of the analysis methods of the therapy strategy and walking pattern.

Effects of ankle strengthening exercises combined with motor imagery training on the timed up and go test score and weight bearing ratio in stroke patients.

[Purpose] The purpose of the present study was to compare the effects of ankle strengthening exercises combined with motor imagery training and those of ankle strengthening exercises alone in stroke patients. [Subjects and Methods] Thirty stroke patients were randomly assigned to one of the following two groups: experimental group (15 patients) and control group (15 patients). The experimental group underwent motor imagery training for 15 minutes and ankle joint strengthening exercises for 15 minutes, while the control group underwent only ankle joint strengthening exercises for 30 minutes. Each session and training program was implemented four times a week for 4 weeks. The timed up and go (TUG) test score, affected-side weight bearing ratio, and affected-side front/rear weight bearing ratio were assessed. [Results] Both groups demonstrated improvement on the TUG test, and in the affected-side weight bearing ratios, affected-side front/rear weight bearing ratios, and balance errors. The experimental group demonstrated greater improvement than the control group in all variables. [Conclusion] Motor imagery training is an effective treatment method for improving static balance ability in stroke patients.

Reliability of ultrasound imaging of the transversus abdominis muscle in asymptomatic subjects.

[Purpose] The purpose of this study was to assess intra-rater and inter-rater procedural reliability of ultrasound imaging measurements of transversus abdominis thickness. [Subjects] Thirty therapists who attended the B Hospital in Hwaseong participated in the study. [Methods] Two examiners assessed transverse abdominis thickness at rest and during contraction. Intra-class correlation coefficient with 95% confidence interval and, standard error of measurement were calculated. [Results] The intra-rater procedural reliability of ultrasound imaging measurements of transverse abdominis thickness, assessed using the intra-class correlation coefficient, was 0.65-0.86 (within-day, 0.65-0.86; between-day, 0.77-0.85). The inter-rater procedural reliability of ultrasound imaging measurements of transverse abdominis thickness, assessed using the intra-class correlation coefficient, was 0.72-0.86 (within-day, 0.72-0.86; between-day, 0.82-0.83). [Conclusion] Ultrasound imaging can be used as a reliable method for measurements of transverse abdominis thickness.

The effects of gait velocity on the gait characteristics of hemiplegic patients.

[Purpose] The present study investigated the effects of gait speed on temporal and spatial gait characteristics of hemiplegic stroke patients. [Subjects and Methods] Twenty post-stroke hemiplegic patients participated in the present study. To enhance the reliability of the analysis of the gait characteristics, the assessments were conducted three days per week at the same time every day. Each subject walked maintaining a comfortable speed for the first minute, and measurement was conducted for 30 seconds at a treadmill speed of 1 km/hour thereafter. Then, the subjects walked at a treadmill speed of 2 km/hour for 30 seconds after a 30-minute rest. The differences in the measurements were tested for significance using the paired t-test. [Results] The measures of foot rotation, step width, load response, mid stance, pre-swing, swing phase, and double stance phase showed significant difference between the gait velocities. [Conclusion] The present study provides basic data for gait velocity changes for hemiplegic patients.

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.