Jongeun Yim

Effects of Respiratory Muscle and Endurance Training Using an Individualized Training Device on the Pulmonary Function and Exercise Capacity in Stroke Patients

Background Because respiratory muscle function plays a strong role in exercise capacity and cardiopulmonary response to exercise, systematic training and measurement of respiratory muscle function should be considered in stroke patients. The purpose of this study was to determine whether an individualized respiratory muscle training device combined with conventional physical therapy exercise can improve the pulmonary function and exercise capacity of stroke patients. Material/Methods Twenty stroke patients were randomly assigned to an exercise group (n=10) or a control group (n=10). Over 4 weeks, each group participated in exercise training interventions 3 times per week. In each session, the control group received basic exercise treatments for 30 min, followed by an automated full-body workout for 20 min. The exercise group performed the same exercise regimen as the control group, as well as an additional respiratory muscle training regimen using a respiratory exercise device for 20 min. Results Pulmonary function of forced vital capacity (FVC), forced expiratory volume at 1 s (FEV1), FEV1/FVC, and peak expiratory flow (PEF) and exercise capacity of a 6-min walking test and Shortness of Breath Modified Borg Dyspnea Scale (SBMBDS) scores were assessed before and after the training. A significant intergroup difference was observed in the FVC, FEV1, PEF, 6MWT, and SBMBDS scores (p<0.05). Conclusions These findings suggest that exercise of the respiratory muscles using an individualized respiratory device had a positive effect on pulmonary function and exercise capacity and may be used for breathing rehabilitation in stroke patients.

Therapeutic Benefits of Laughter in Mental Health: A Theoretical Review

In modern society, fierce competition and socioeconomic interaction stress the quality of life, causing a negative influence on a persons mental health. Laughter is a positive sensation, and seems to be a useful and healthy way to overcome stress. Laughter therapy is a kind of cognitive-behavioral therapies that could make physical, psychological, and social relationships healthy, ultimately improving the quality of life. Laughter therapy, as a non-pharmacological, alternative treatment, has a positive effect on the mental health and the immune system. In addition, laughter therapy does not require specialized preparations, such as suitable facilities and equipment, and it is easily accessible and acceptable. For these reasons, the medical community has taken notice and attempted to include laughter therapy to more traditional therapies. Decreasing stress-making hormones found in the blood, laughter can mitigate the effects of stress. Laughter decreases serum levels of cortisol, epinephrine, growth hormone, and 3,4-dihydrophenylacetic acid (a major dopamine catabolite), indicating a reversal of the stress response. Depression is a disease, where neurotransmitters in the brain, such as norepinephrine, dopamine, and serotonin, are reduced, and there is something wrong in the mood control circuit of the brain. Laughter can alter dopamine and serotonin activity. Furthermore, endorphins secreted by laughter can help when people are uncomfortable or in a depressed mood. Laughter therapy is a noninvasive and non-pharmacological alternative treatment for stress and depression, representative cases that have a negative influence on mental health. In conclusion, laughter therapy is effective and scientifically supported as a single or adjuvant therapy.

Effect of Heat, Cold, and Pressure on the Transverse Carpal Ligament and Median Nerve: A Pilot Study

Background This study quantified the effects of heat, cold, and pressure on the median nerve and transverse carpal ligament in subjects without carpal tunnel syndrome. Material/Methods Subjects were individuals ages 20–50 who had no symptoms of carpal tunnel disease. Imaging ultrasound was used to measure the clearance around the median nerve, transverse ligament elasticity, nerve conduction velocity, thickness of the carpal ligament, and area of the median nerve. Pressure was applied to the carpal ligament to assess the effects of increasing pressure on these structures. On 3 separate days, 10 subjects had ThermaCare heat or cold packs applied, for either 60 or 120 minutes for heat or 20 minutes for cold, to the palmer surface of the hand. Results Tissue changes were recorded as a response to pressure applied at 0, 5, 10, and 20 N. The size of the nerve and ligaments were not significantly altered by pressure with the hand at room temperature and after cold exposure. After heat, the nerve, ligaments, and tendons showed significantly more elasticity. Conclusions Application of cold to the hand may reduce compression of the carpal ligament and nerve.

Effects of a Randomized Controlled Recurrent Fall Prevention Program on Risk Factors for Falls in Frail Elderly Living at Home in Rural Communities

Background Falling can lead to severe health issues in the elderly and importantly contributes to morbidity, death, immobility, hospitalization, and early entry to long-term care facilities. The aim of this study was to devise a recurrent fall prevention program for elderly women in rural areas. Material/Methods This study adopted an assessor-blinded, randomized, controlled trial methodology. Subjects were enrolled in a 12-week recurrent fall prevention program, which comprised strength training, balance training, and patient education. Muscle strength and endurance of the ankles and the lower extremities, static balance, dynamic balance, depression, compliance with preventive behavior related to falls, fear of falling, and fall self-efficacy at baseline and immediately after the program were assessed. Sixty-two subjects (mean age 69.2±4.3 years old) completed the program – 31 subjects in the experimental group and 31 subjects in the control group. Results When the results of the program in the 2 groups were compared, significant differences were found in ankle heel rise test, lower extremity heel rise test, dynamic balance, depression, compliance with fall preventative behavior, fear of falling, and fall self-efficacy (p<0.05), but no significant difference was found in static balance. Conclusions This study shows that the fall prevention program described effectively improves muscle strength and endurance, balance, and psychological aspects in elderly women with a fall history.

Literature and Art Therapy in Post-Stroke Psychological Disorders

Stroke is one of the leading causes of morbidity and long-term disability worldwide, and post-stroke depression (PSD) is a common and serious psychiatric complication of stroke. PSD makes patients have more severe deficits in activities of daily living, a worse functional outcome, more severe cognitive deficits and increased mortality as compared to stroke patients without depression. Therefore, to reduce or prevent mental problems of stroke patients, psychological treatment should be recommended. Literature and art therapy are highly effective psychological treatment for stroke patients. Literature therapy divided into poetry and story therapy is an assistive tool that treats neurosis as well as emotional or behavioral disorders. Poetry can add impression to the lethargic life of a patient with PSD, thereby acting as a natural treatment. Story therapy can change the gloomy psychological state of patients into a bright and healthy story, and therefore can help stroke patients to overcome their emotional disabilities. Art therapy is one form of psychological therapy that can treat depression and anxiety in stroke patients. Stroke patients can express their internal conflicts, emotions, and psychological status through art works or processes and it would be a healing process of mental problems. Music therapy can relieve the suppressed emotions of patients and add vitality to the body, while giving them the energy to share their feelings with others. In conclusion, literature and art therapy can identify the emotional status of patients and serve as a useful auxiliary tool to help stroke patients in their rehabilitation process.

Do Oral Contraceptives Alter Knee Ligament Damage with Heavy Exercise

Hormones such as estradiol have an effect on human connective tissue, making women more susceptible to knee injuries. Indeed, women have a greater risk for non-contact injuries of anterior cruciate ligament (ACL) compared to men when participating in the same sports. The purpose of the present study was to examine the difference in ACL laxity after an eccentric exercise in the lower limbs in young healthy women between oral contraceptive pill (OCP) users and non-OCP users to see the effect of OCP on ACL laxity. Forty young healthy women participated in the experiments (25 with normal menstrual cycle and 15 with taking OCP). ACL laxity and a visual analog pain scale were measured before and after a bout of squat. OCP users had more pain than non-OCP users after heavy exercise (p < 0.001). Both groups showed a significant reduction in ACL laxity on the 2nd day after exercise (p < 0.05). While ACL laxity was always less in the OCP group, when expressed as a percent change from baseline, the ACL laxity change was similar in both groups (p > 0.05). We found that there was no statistically significant difference in ACL laxity recovery over time in response to the delayed onset muscle soreness after a bout of squat between two groups. However, health professionals working with young female adults should recognize that OCP users with less ACL laxity are at higher risk for having knee injuries because of ACL stiffness when doing exercise.

The acute effect of smoking a single cigarette on vascular status, SpO2, and stress level.

Background Tobacco use is a major cause of cardiovascular and respiratory disease and cancer. It is controversial whether smoking helps relieve stress. This study investigated the acute effect of smoking a single cigarette on vascular status, SpO2, and stress level. Material/Methods 38 non-smokers and 29 smokers were selected as subjects to measure BVOP (Blood Vessel Output Power), BVT (Blood Vessel Tension), RBV (Remained Blood Volume), BVAL (Blood Vessel Aging Level), SpO2, resistance to stress, and stress score. Pre- and post-experiment changes were recorded during a 20-min interval, with smokers being recorded 5 min after smoking for the post-experiment. Results The smoker group showed a significant decrease in vascular status (BVOP, RBV, BVAL) compared with the non-smoker group. SpO2 showed no difference between the smoker group and the non-smoker group. Smoking showed no effect on stress reduction compared to non-smoking. Conclusions The results of the study indicate that smoking causes a negative effect on vascular status and is not beneficial to stress reduction. Therefore, quitting smoking is encouraged for better physical and mental health.

Improving slow-transit constipation with transcutaneous electrical stimulation in women: A randomized, comparative study.

ABSTRACT The purpose of this study was to investigate the effect of transcutaneous electrical stimulation (TES) in women with slow-transit constipation. Twenty-eight women with slow-transit constipation were randomly assigned to a treatment group (14 women) or a control group (14 women). Data collection was conducted from March 7, 2014 to May 2, 2014. TES and sham TES were performed for 20 minutes, three times per week, for 4 weeks for the treatment and control groups, respectively. The results of the tests before and after treatment, including the Constipation Assessment Scale (CAS), abdominal pain, and number of defecations per week, were assessed. A significant decrease in CAS score and in abdominal pain (p < .05), and a significant increase in evacuation frequency per week (p < .05) were observed in the treatment group. In addition, a significant decrease in CAS score and in abdominal pain (p < .05) was observed in the control group. However, no noticeable change was observed in evacuation frequency per week in the control group. Based on these results, TES may have a beneficial effect in women with slow-transit constipation, and could be used to reduce the symptoms of constipation.

Correlation between Mechanical Properties of the Ankle Muscles and Postural Sway during the Menstrual Cycle

Ankle and foot injuries are common among athletes and physically active individuals. The most common residual disability, ankle sprain, is characterized by instability along with postural sway. If the supporting structures around a joint become lax, posture stability and balance are also affected. Previous studies have examined muscle stiffness and elasticity and postural sway separately; however, the relationship between these factors is yet unknown. It is well known that the levels of sex hormones, especially estrogen, change in women over the phase of the menstrual cycle. Therefore, this study examined the relationship between the mechanical properties of tissue and balance activity using a non-invasive digital palpation device to determine if they undergo any changes over the menstrual cycle in young women. Sixteen young women with regular menstrual cycles completed the study. Tone, stiffness, and elasticity of the ankle muscles (lateral gastrocnemius, peroneus longus, and tibialis anterior) were measured using a non-invasive digital palpation device. Postural sway was recorded while the participants performed balance tasks during ovulation and menstruation. Significantly greater posture sway characteristics and ankle muscle elasticity were found during ovulation than during menstruation; lower tone and stiffness of the ankle muscles were observed at ovulation (p < 0.05). Additionally, weak-to-strong relationships between ankle muscle mechanical properties and postural sway characteristics were found (p < 0.05). These results suggest the effect of estrogen on human connective tissues. We therefore postulate that estrogen increases joint and muscle laxity and affects posture stability according to the phase of the menstrual cycle.

Instrument-assisted Soft Tissue Mobilization Improves Physical Performance of Young Male Soccer Players

This study aimed to examine the effects of a rehabilitation exercise combined with instrument-assisted soft tissue mobilization on the isokinetic power, muscle fatigue, and fitness of soccer players. An interventional study design was used to assess 40 subjects aged 15-17 years. Twenty participants each in instrument-assisted soft tissue mobilization and control groups completed several tests to determine player development. The results showed significant differences between the two groups with respect to the isokinetic power of the ankle (i. e., dorsiflexion, peak torque body weight at the right- and left-foot angular velocities of 30°/s and 120°/s; plantar flexion, peak torque body weight at the right- and left-foot angular velocities of 30°/s and 120°/s) and knee (extension, right peak-torque body weight at 60°/s and 180°/s and left peak-torque body weight at 60°/s; flexion, right and left peak-torque body weight at 60°/s and 180°/s), muscle fatigue, and physical fitness (P<0.05). Instrument-assisted soft tissue mobilization in soccer players suggests that the characteristics of athletic performance may be improved by decrease in fatigue and increase in fitness and muscle power. Therefore, we suggest instrument-assisted soft tissue mobilization for soccer players to increase their performance.