Hye Seon Jeon

The application of client‐centred occupational therapy for Korean children with developmental disabilities

The aim of this paper was to investigate the effectiveness of client-centred occupational therapy using the Canadian Occupational Performance Measure (COPM) and the Assessment of Motor and Process Skills (AMPS). Eight girls and 23 boys from Korea, with developmental disabilities and from 3 to 10 years of age participated in this study. Each child participated in 20 to 24 sessions of client-centred occupational therapy. Both the COPM and the AMPS change scores demonstrated statistically significant improvement (p < 0.01) in occupational performance. Significant correlations were found between COPM - Performance and AMPS - Motor skills (r(s) = 0.64, p < 0.05), and COPM - Satisfaction and AMPS - Process skills (r(s) = 0.62, p < 0.05) in a group positive towards client-centred occupational therapy. The COPM was a valuable tool in guiding and measuring the client-centred occupational therapy for children with developmental disabilities. The small sample size of 31 children limits the generalizability of the studys results. Future research needs to use a larger and more diverse sample of children to further validate the effectiveness of client-centred occupational therapy.

Posture management program based on theory of planned behavior for adolescents with mild idiopathic scoliosis.

PURPOSE The purpose of this study was to evaluate the effects of a devised posture management program based on the Theory of Planned Behavior in adolescents with mild idiopathic scoliosis. METHODS A quasi-experimental study was conducted. It involved a nonequivalent comparison group design with pretest and posttest. Forty-four female adolescents with mild idiopathic scoliosis participated; data from 35 participants (20 for the test group, 15 for the control group) were used for the final analyses. The devised posture management program ran for 6 weeks. Posture management behavioral determinants (attitude, subjective norms, perceived behavioral control, and behavioral intention) as cognitive outcomes and muscular strength and flexibility as physical outcomes were measured three times: at baseline, week 6 and week 8. Cobbs angle as another physical outcome was measured twice: at baseline and week 8. Descriptive analysis, repeated measures analysis of variance and t test were used for data analyses. RESULTS Attitude, perceived control, and behavioral intention were consistently enhanced by the posture management program. The intervention increased flexibility and muscular strength and decreased Cobbs angle, which reduced spinal curvature. Frequency of posture management exercise showed a gradual increase in the test group. CONCLUSION The results indicate that the posture management program is effective in maintaining posture management behavior in adolescents with mild idiopathic scoliosis for both cognitive and physical outcomes. The posture management program should be helpful in expanding the role of school nurses in improving the health status of adolescents with mild idiopathic scoliosis.

Event-related Desynchronization of Mu Rhythms During Concentric and Eccentric Contractions

ABSTRACT The purpose of this study was to compare the electroencephalographic (EEG) patterns and reaction times (RTs) of muscle activation between concentric and eccentric biceps brachii contractions under the RT paradigm and to evaluate how the EEG patterns and RTs changed with practice. Sixteen subjects performed 3 sets of 30 repetitions of submaximal voluntary concentric and eccentric biceps contractions. RT, event-related desynchronization (ERD) patterns of mu rhythm onset, and ERD amplitudes were selectively analyzed. Mental demand decreased as familiarity with the motor action increased due to practice regardless of contraction type. However, the 2 types of muscle contractions still have differences in brain activity regardless of decreased mental demand: eccentric contractions require earlier preparation than concentric contractions.

Effects of novel tubing gait on neuromuscular imbalance in cerebral palsy.

BACKGROUND Gait impairments from a neuromuscular imbalance are crucial issues in cerebral palsy. The purpose of our study was to compare the effects of the assistive tubing gait (ATG) and assistive-resistive tubing gait (ARTG) on improving the vasti and hamstring muscle imbalance during the initial contact to mid-stance phases in individuals with spastic diplegic cerebral palsy (CP). METHODS Fourteen age-matched individuals including seven normal individuals (11.7 years) and seven individuals with CP (12.9 years) were recruited. All participants underwent electromyography (EMG) measurement of the unilateral vasti and hamstring muscle activity during the three gait training conditions of no-tubing gait (NTG), ATG, and ARTG. A statistical one-way repeated-measure analysis of variance (ANOVA) was used to determine differences in the vasti and hamstring activity, the vasti/hamstring ratio, and the knee joint angle across the three gait training conditions for each group. RESULTS The initial vasti and hamstring muscle imbalance in CP was significantly improved by applying the ARTG compared with the ATG. The vasti/hamstring ratio during the ARTG was compatible with the ratio value obtained from the NTG of normal individuals. The knee joint angle in CP was not improved in this short-term intervention. CONCLUSIONS The ARTG proportionately increased the vasti activation and reciprocally inhibited the hamstring activity, subsequently improving the neuromuscular imbalance associated with the flexed-knee gait in individuals with spastic diplegic CP.

Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke

OBJECTIVES To compare the effects of conventional core stabilization and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke. DESIGN Two-group randomized controlled trial with pretest-posttest design. SETTING Hospital rehabilitation center. PARTICIPANTS Adults with chronic hemiparetic stroke (N=28). INTERVENTIONS Participants were randomly divided into either conventional core stabilization (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of conventional core stabilization or DNS training for 30 minutes per session 5 times a week during the 4-week period. MAIN OUTCOME MEASURES Electromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis (TrA)/internal oblique (IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling. RESULTS Baseline APA times were delayed and fear of falling was moderately high in both the conventional core stabilization and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the conventional core stabilization group (P<.008). The BBS and TIS scores (P<.008) and the FES score (P<.003) were improved compared with baseline in both groups, but FES remained stable through the 2-year follow-up period only in the DNS group (P<.003). CONCLUSIONS This is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke.

Effects of dynamic neuromuscular stabilization on diaphragm movement, postural control, balance and gait performance in cerebral palsy

PURPOSE To determine the effects of a novel dynamic neuromuscular stabilization (DNS) technique on gross motor function, diaphragm movement, and activation of the external oblique (EO) and internal oblique (IO)/transversus abdominal (TrA) muscles in participants with cerebral palsy (CP). METHOD Fifteen participants with CP (7 females) underwent DNS intervention for 30 minutes/day, 3 days a week for 4 weeks. Gross motor function, diaphragm movement, and muscle activation were determined using a gross motor function measure (GMFM-88), ultrasound, and electromyography measurements, respectively, before and after the DNS core stabilization intervention. Paired t-tests were used at p < 0.05. DESIGN A single-arm, pretest-posttest clinical trial. RESULTS GMFM scores for standing, walking, and jumping domains were significantly improved after the intervention (P < 0.05). Diaphragm descending movement (P = 0.0001) and activation of the internal oblique and transversus abdominals were initially undetectable, but remarkably increased after the intervention (P = 0.012). CONCLUSIONS DNS is a promising, effective intervention for facilitating deep core muscle activation of the underactive muscle chain comprising the diaphragm, internal oblique, and transversus abdominals, thereby improving age-appropriate standing, walking, and jumping in participants with spastic diplegic CP.

Diffusion Tensor Imaging in Patients with Thalamic Hemorrhage: Correlations between Diffusion Anisotropy and Motor Recovery

Diffusion tensor imaging (DTI) provides quantitative information in the magnetic resonance imaging on the diffusion anisotropy about the integrity of white matter tracts. The aim of this study was to measure diffusion anisotropy and to correlate with upper-limb motor recovery in four chronic hemiparetic patients with thalamic hemorrhage. Fractional anisotropy (FA) was measured in the posterior limb of internal capsules (IC) in the affected side and in the corresponding contralateral normal side before and after 6 week motor training. The correlation between motor recovery of the affected hand and the ratio of FAs of the affected side and the contralateral normal side were investigated. Both FA ratio and motor function significantly increased after the training. A significant correlation was found between motor recovery and FA in the posterior limb of IC. The degree of impairment in diffusion anisotropy of hemiparetic patients might be helpful in prognosis of the motor function.