Kyoung Kim

The relation between motor function of stroke patients and diffusion tensor imaging findings for the corticospinal tract

Although the corticospinal tract (CST) is a major neural tract for motor function, the detailed role of the CST has not been clearly elucidated. We investigated relations between motor function of patients with chronic hemiparetic stroke and diffusion tensor imaging (DTI) findings for the CST. We recruited 82 consecutive chronic stroke patients. Medical Research Council, Modified Brunnstrom Classification, and Functional Ambulatory Category were used in measurement of the affected side. All motor functions showed positive correlations with fractional anisotropy (FA) and fiber number (FN) ratios (p<0.05). With regard to Medical Research Council, shoulder abductor (r=0.70, 0.68), elbow flexor (r=0.75, 0.72), finger flexor (r=0.73, 0.74), and finger extensor (r=0.69, 0.77) showed strong correlations with FA and FN ratios. Modified Brunnstrom Classification (r=0.70, 0.73) also showed strong correlation. According to our findings, it appears that the CST is related to motor function of upper and lower extremities, with particular relation to motor function of upper extremities, including the hand, compared with other motor functions.

The effect of contralateral training: Influence of unilateral isokinetic exercise on one-legged standing balance of the contralateral lower extremity in adults

PURPOSE To investigate the effects of unilateral isokinetic exercises on the one-legged standing balance of the contralateral lower extremity. SUBJECTS A volunteer sample of 32 healthy adults (12 men and 20 women) was randomized to training and control groups. METHODS The training group received unilateral hip isokinetic exercises of the dominant leg for two weeks. Contralateral single-limb balance was measured before and after intervention, including three stability index scores of balance using Biodex Stability System: Anterior-Posterior Stability Index (APSI), Medio-lateral Stability Index (MLSI), and Overall Stability Index (OSI) scores. RESULTS Comparison of pre-test and post-test data revealed significant improvements in APSI, MLSI, and OSI scores in the training group (p<0.05), but not in the control group. The gains of stability scores from pre- to post-test, were also significantly greater (p<0.05) in the training group than the control group. CONCLUSION These results suggest that contralateral training with unilateral isokinetic exercises increases the one-legged standing balance of the contralateral limb following a short duration of training.

The Effect of Open and Closed Kinetic Chain Exercises on Dynamic Balance Ability of Normal Healthy Adults

[Purpose] This study investigated the effect of open and closed kinetic chain exercise on the dynamic balance ability of healthy young adults. [Subjects] Thirty-three healthy adults participated in this study. [Methods] Subjects were randomly assigned to either an open kinetic chain exercise group (n=17) or a closed kinetic chain exercise group (n=16). Both the open kinetic chain and closed kinetic chain exercise groups performed 3 sets of exercises 3 times per week for 6 weeks. Dynamic balance was measured at the beginning and end of the 6-week training period, including anterior-posterior, medial-lateral, and total displacement of the center of pressure. [Results] Both exercise groups showed improvement in balance parameters but the improvement was only statistically significant in the closed kinetic chain group. [Conclusion] Closed kinetic chain exercise appears to be more effective at improving of dynamic balance ability than open kinetic chain exercise within a 6-week training period.

A Comparison of the Deep Cervical Flexor Muscle Thicknesses in Subjects with and without Neck Pain during Craniocervical Flexion Exercises

[Purpose] The purpose of the present study was to examine the amount of change in the thicknesses of the deep cervical flexor (DCF) and sternocleidomastoid (SCM) muscles in subjects with neck pain and subjects without neck pain during craniocervical flexion exercise (CCFE). [Subjects] The total number of subjects was 40, comprising 20 in the no-pain group (males 11, females 9) and 20 in the pain group (males 8, females 12). [Methods] Muscle images were obtained using ultrasound, and the thicknesses of the individual muscles were measured using the NIH ImageJ software. [Results] During CCFE, as pressure increased, the no-pain group recruited the DCF more than the pain group, while the pain group recruited the SCM more. [Conclusion] Selective DCF contraction exercises are considered very useful in the treatment of patients with neck pain.

The Effect of Obstacle Training in Water on Static Balance of Chronic Stroke Patients

[Purpose] This study evaluated the effects of water and land-based obstacle training on static balance of chronic stroke patients. [Subjects] The subjects were randomly allocated to an aqua group (n=15) and a land group (n=15). [Methods] Both groups trained for 40 minutes, 3 times a week for 12 weeks. Static balance was assessed by measuring the mean velocities of mediolateral (ML) and anteroposterior (AP), and sway area with the eyes closed. [Results] Following the intervention, both groups showed significant changes in ML velocity, AP velocity, and sway area. The static balance of the aqua group was significantly better than the land group. [Conclusion] The results of this study suggest the feasibility and suitability of obstacle training in water for stroke patients.

Influence of Isokinetic Strength Training of Unilateral Ankle on Ipsilateral One-legged Standing Balance of Adults.

[Purpose] The purpose of the current study was to investigate the changes in one-legged standing balance of the ipsilateral lower limb following unilateral isokinetic strength training. [Subjects and Methods] Thirty healthy adult volunteers were randomly assigned to either a training group or a control group, so that each group included 15 subjects. Subjects in the training group performed unilateral ankle isokinetic exercises of the dominant leg using the Biodex 3 PRO System for a period of four weeks. Ipsilateral one-legged standing balance was evaluated before and after the intervention with three stability indexes of balance using the Biodex System: Anterior-Posterior Stability Index (APSI), Medial-Lateral Stability Index (MLSI), and Overall Stability Index (OSI). [Results] Comparison of pre- and post-test data revealed significant improvements in strength values (dorsiflexion, plantarflexion, eversion, and inversion) and stability indexes (APSI, MLSI, OSI). [Conclusion] These results suggest that ankle strengthening exercise can be considered as a form of exercise that may assist individuals with improvement of balance.

The Effects of Aquatic Exercise on Pulmonary Function in Patients with Spinal Cord Injury

[Purpose] The purpose of this study was to determine the effects of aquatic exercise on pulmonary function of patients with spinal cord injury. [Subjects] The subjects were randomly allocated to an aqua group (n=10) and a land group (n=10). [Methods] Both groups trained for 60 minutes, 3 times a week for 8 weeks. Pulmonary function was assessed by measuring the forced vital capacity (FVC), forced expiratory flow rate (FER), force expiratory volume at one second (FEV1) and force expiratory volume at one second/forced vital capacity (FEV1/FVC). [Results] Following the intervention, the aqua group showed significant changes in FVC, FER, FEV1, and FEV1/FVC. The land group showed only significant differences FER. [Conclusion] The results of this study suggest the effects on the aqua group were significantly higher than those on the land group in patients with spinal cord injury.

Comparison of Muscle Activities Using a Pressure Biofeedback Unit during Abdominal Muscle Training Performed by Normal Adults in the Standing and Supine Positions

[Purpose] The purpose of this study was to assess the effects of draw-in exercise on abdominal muscle activity in the standing and supine positions. [Methods] Twenty healthy women participated in this study. The subjects were required to complete two draw-in exercises (standing and supine positions) using a biofeedback pressure unit. The root mean square (RMS) values of the EMG data were expressed as a percentage of the resting contraction. The data were analyzed using the independent t-test. [Results] According to the changes in the activities of the abdominal muscles, the draw-in exercise in the standing position produced the most significant increase in the activities of the rectus abdominis, the transverse abdominis, the internal oblique, and the external oblique muscles. [Conclusion] The activities of the trunk stability muscles (rectus abdominis, transverse abdominis, internal oblique, and external oblique) increased more in the standing than in the supine position, enabling the subjects to overcome gravity. Therefore, to strengthen the activation of the abdominal muscles, a standing position seems to be more effective than a supine position for draw-in exercises.

Immediate Effect of Short-foot Exercise on Dynamic Balance of Subjects with Excessively Pronated Feet.

[Purpose] The aim of this study was to determine the immediate effect of short-foot exercise (SFE) on the dynamic balance of subjects with excessively pronated feet. [Subjects] This study included 18 subjects with excessively pronated feet (navicular drop ≥ 10 mm) selected using the navicular drop test. [Methods] The limit of stability (LOS) was measured to determine the changes in the dynamic balance from before and after SFE in the standing and sitting positions. [Result] After the SFE, LOS increased significantly in all areas, namely, the left, right, front, back, and overall. [Conclusion] SFE immediately improved the dynamic balance of subjects with excessively pronated feet. Subsequent studies will be conducted to examine the effects of SFE performed over the long term on postural stability.

The effects of closed and open kinetic chain exercises on lower limb muscle activity and balance in stroke survivors.

OBJECTIVE The major contributors to physical disability after stroke are the negative impairments related to loss of functional ability and muscle strength. The aim of this study was to examine the effects of close kinetic chain (CKC) exercise and open kinetic chain (OKC) exercise on muscle activation of the paretic lower limb and balance in chronic stroke subjects. METHODS Thirty-three patients with chronic stroke of over 6 months were enrolled. They were randomly allocated to three groups: CKC exercise group (n = 11), OKC exercise group (n = 11), and control group (n = 11). CKC and OKC exercise groups were trained 5 times per week for 6 weeks. The control group maintained routine activities and did not participate in any regular exercise program. All subjects were measured on muscle activation of the paretic lower limb and balance. RESULTS Muscle activation of rectus femoris (RF) and biceps femoris (BF) was significantly increased in both CKC exercise and OKC exercise groups, compared to the control group. However, muscle activation of gastrocnemius (GC) and tibialis anterior (TA) was significantly increased in only the CKC exercise group. Antero-posterior (A-P) andmedio-lateral (M-L) sway velocities (both with EO and EC) were decreased with the application of CKC exercise. CONCLUSION These findings indicate that the CKC exercise can improve lower limb muscle strength, and balance in chronic stroke, and it may carry over into an improvement in functional performance.