Chiung-Ling Chen

Anterior ankle-foot orthosis effects on postural stability in hemiplegic patients

OBJECTIVES To evaluate the effects of an anterior ankle-foot orthosis (AFO) on static and dynamic postural stability in hemiplegic patients. DESIGN A cross-sectional assessment of hemiplegic subjects with and without an AFO. SETTING Outpatient department of a rehabilitation hospital. PATIENTS A convenience sample of 24 subjects who had been prescribed an anterior AFO. OUTCOME MEASURES Postural sway index and postural symmetry (body weight distribution through the affected leg) when standing were measured as static postural stability. Maximal balance range in anterior-posterior and lateral directions and the affected legs weight bearing after weight shift to affected side were measured as dynamic postural stability. RESULTS When wearing the anterior AFO, there was no significant difference and small effect size (r<0.3) in postural sway index (p = .35), postural symmetry (p = .21), and maximal balance range in anterior-posterior direction (p = .46). There was a significant improvement and large effect size (r>0.5) in lateral weight shifting (p<.01) and weight bearing through the affected leg after weight shifted to the affected side (p<.01). CONCLUSIONS The significant effects of the anterior AFO in long-term hemiplegic patients were on lateral weight shifting and weight bearing through affected leg after weight shifted to the affected side. Postural sway, postural symmetry, and anterior-posterior weight shifting were not significantly affected.

Cardiac rehabilitation vs. home exercise after coronary artery bypass graft surgery: a comparison of heart rate recovery.

Wu S-K, Lin Y-W, Chen C-L, Tsai S-W: Cardiac rehabilitation vs. home exercise after coronary artery bypass graft surgery: a comparison of heart rate recovery. Am J Phys Med Rehabil 2006;85:711–717. Objective:The autonomic dysfunction is known to adversely affect clinical outcome in patients with cardiovascular disease, and exercise training has been shown to modify the sympathovagal control of heart rate. The purposes of this study were to investigate the effect of cardiac rehabilitation on heart rate recovery in patients who received coronary artery bypass grafting (CABG) and compare the effect with that of a home-based exercise program. Design:Fifty-four male patients having undergone CABG were randomly assigned to a cardiac rehabilitation exercise program (n = 18), a home-based exercise program (n = 18), and a control group (n = 18) for 12 wks to evaluate the differences in heart rate recovery among groups. Results:Patients in the cardiac rehabilitation group had significant increases in heart rate recovery (19.1 ± 6.2 vs. 14.0 ± 5.4 beats/min, P = 0.022) compared with those in the control group. There were no significant differences in heart rate recovery between cardiac rehabilitation and home-based exercise groups (16.2 ± 4.8 beats/min) or between home-based exercise and control groups. All three groups had significantly improved heart rate recovery compared with their baseline data (P < 0.001, < 0.001, and 0.007). Conclusion:Our results point out that a cardiac rehabilitation exercise program has a positive effect on heart rate recovery in patients having undergone CABG and is consistent with the autonomic improvement. Although the home-based exercise group did not reveal statistical significances over those in the control group, it had comparable efficacy to that demonstrated in the cardiac rehabilitation group.

Postural responses to yaw rotation of support surface

The purposes of this study were to investigate EMG and kinematic responses to yaw rotation of a support surface. Twenty people participated in four conditions, i.e., two velocities (240°/s, 120°/s) and two amplitudes (30°, 15°). Longer latency and smaller muscle responses were induced for yaw rotation, and distal ankle and knee muscles were activated earlier than trunk and neck muscles. Joint kinematics demonstrated larger angular displacements in axial rotation. Velocity and amplitude did not affect onset latency or magnitude of muscle activation but had significant effects on joint movements and COM displacements. Preliminary information about normative data of healthy subjects was obtained, and questions were generated about optimal velocity and amplitude test protocols that require further investigation.

Amputees in Taiwan, 1995 to 2000

This study evaluates details concerning amputees in Taiwan, including cause for prosthetic treatment. Data is specific to the west central region, in particular the Rehabilitation .Hospital located in Taichung City. Patient case studies cover the period from 1995 to 2000. The target group totals 499 patients (321-male; 178-female); with a mean age of 48.7 + 23.0 years. In all, 379 amputees (76.0%) had been fitted with lower limb prosthesis and 120 amputees (24.0%) had been fitted with upper limb prosthesis. Trauma was the major cause of amputation (n=241, 48.3%), followed by disease (n=220, 44.1%), congenital defect (n=29, 5.8%) and tumor (n=9, 1.8%); the ratio of trauma/disease was 0.65 (142 to 219). Data further indicates that amputations resulting from occlusive peripheral vascular disease have increased when compared with earlier survey studies, and most were due to diabetes mellitus (n=208, 95%). These findings suggest the need for aggressive treatment and a focused education program to reduce or even prevent cases of lower limb amputation. The current study provides a critical guideline for evaluating future needs in terms of personnel, facilities, programs and funding.

Mechanical evaluation of topical silicone gel on skin wound healing

Dermatix is a Food and Drug Administration (FDA) registered treatment for hypertrophic scars and keloids. Some studies have evaluated its effects on scars and tried to find out its mechanism of effectiveness. However, there were few papers discussing about the mechanical properties of wounds after treated with Dermatix. Thus, our study aims to conduct tensile test to analyze the condition of skin wound treated with Dermatix and compare the results to the non-treated wounds. We evaluated the wound healing condition at 1, 2, 4 and 6 weeks healing time and introduced recovery index to normalize the different growing condition of each rats. The results showed that during healing time 4∼6 weeks, both wounds recovered rapidly. And in all the healing time, Dermatix treated group showed better tensile strength and better recovery index. However, no significant difference was found at all healing time. We guess it is occlusion, hydration and normalization of TEWL effects of Dermatix that help collagen synthesize.