Seung-Chul Chon

Effect of whole body vibration training on mobility in children with cerebral palsy: a randomized controlled experimenter-blinded study:

Objective: To evaluate ambulatory function and leg muscle thickness after whole body vibration training in children with cerebral palsy. Design: A block randomized controlled trial with two groups. Setting: Physical therapy department laboratory. Subjects: A total of 30 (15 experimental, mean (SD) age 10.0 (2.26) years and 15 control, 9.6 (2.58)) children with cerebral palsy, 15 males and 15 females. Interventions: The experimental group underwent whole body vibration training combined with conventional physical therapy training; the control group underwent conventional physical therapy training three days a week for eight weeks respectively. Main outcome measures: Three-dimensional gait analyses and ultrasonographic imaging of the leg muscles were measured at pre- and post-test of intervention for eight weeks. Results: Whole body vibration training resulted in significantly better gait speed (P = 0.001, from 0.37 (0.04) m/s to 0.48 (0.06)), stride length (P = 0.001, from 0.38 (0.18) m to 0.48 (0.18)) and cycle time (P = 0.001, from 0.85 (0.48) s to 0.58 (0.38)) in the experimental group compared with that in the control group. The ankle angle (P = 0.019, from 7.30 (4.02) degree to 13.58 (8.79)) also showed a remarkable increase in the experimental group, but not the hip (P = 0.321) and knee angle (P = 0.102). The thicknesses of the tibialis anterior (P = 0.001, 0.48 (0.08) mm to 0.63 (0.10)) and soleus (P = 0.001, 0.45 (0.04) mm to 0.63 (0.12)) muscles were significantly higher in the experimental group than in the control group. However, no significant effect was observed in the thickness of the gastrocnemius muscle (P = 0.645). Conclusions: These findings suggest that whole body vibration may improve mobility in children with cerebral palsy, probably through a positive effect on the leg muscles.

Use of the novel myokinetic stretching technique to ameliorate fibrotic mass in congenital muscular torticollis: an experimenter-blinded study with 1-year follow-up.

OBJECTIVEnTo investigate the effect of the myokinetic stretching technique (MST) on morphological changes and associated clinical outcomes.nnnMETHODnInfantile torticollis (N=32, 17 males) between 1 and 5 months of age (50.56 +/- 20.74 days) were treated with the MST for approximately 30 minutes per session, 5 times a week at university hospital. Diagnostic real-time ultrasound imaging was used on both unaffected and affected sides before and after the treatment to measure the sternocleidomastoid (SCM) muscle thickness of the involved area. Range of motion, head symmetry, and plagiocephaly with radiographs were determined. Data were analyzed using unpaired and paired t-test at p< 0.05.nnnRESULTSnA significant reduction in SCM muscle thickness was observed after the intervention (p< 0.05). This morphological change was associated with significant improvements in passive cervical range of motion and head symmetry (p< 0.05). The mean intervention duration was 53.59 +/- 25.12 days to completely resolve the mass. These effects continued to exist one year post-intervention.nnnCONCLUSIONSnThis was the first clinical evidence that demonstrated the efficacy of MST for improving cervical motion and muscle thickness in infants with congenital muscular torticollis as well as shortening the treatment duration.

The change in vastus medialis oblique and vastus lateralis electromyographic activity related to shoe heel height during treadmill walking

OBJECTIVEnThis study investigated the effect of different heel heights on the electromyographic (EMG) activity of the vastus medialis oblique (VMO) and vastus lateralis (VL) during treadmill walking.nnnMETHODSn17 young healthy women (age 22.06 +/- 1.2 years) were recruited. With and without a slope, the participants walked on a treadmill at a speed of 2 km/h for 90 seconds under three conditions: barefoot, 3-cm heels, and 7-cm heels. Data for surface EMG was collected from the standard sites of the VMO and VL during treadmill walking.nnnRESULTSnSignificant differences were observed in the VL EMG activity on the non-dominant side between barefoot and 7-cm heels while walking with and without a slope (p< 0.05). VMO:VL EMG ratios significantly decreased for the non-dominant side while walking with and without a slope (p < 0.05). The post hoc pair-wise comparisons revealed significant differences in barefoot vs. 7-cm heel and 3-cm vs. 7-cm heels.nnnCONCLUSIONnThe findings suggest that high-heeled shoes may contribute to a potential change of the knee joint muscles while walking, especially on the non-dominant side. This study provides information that will notify future research on how high-heeled shoe affects muscle activity around the knee joint.

The effect of a novel core stabilization technique on managing patients with chronic low back pain: a randomized, controlled, experimenter-blinded study

Objective: To identify the effect of a novel augmented core stabilization exercise technique on physical function, pain and core stability in patients with chronic low back pain. Design: A block randomized controlled trial with two groups. Setting: A sports rehabilitation clinic. Participants: Forty patients with low back pain (20 experimental, mean (SD) age 50.35 (9.26) years and 20 control, 51.30 (7.01)), 19 men and 21 women. Interventions: In the experimental group ankle dorsiflexion was used in addition to drawing in the abdominal wall; the control group involved drawing in the abdominal wall alone. Both groups received the same conventional physical therapy training three days a week for eight weeks. Main outcome measures: Physical disability instruments; Oswestry Disability Index and Roland Morris Disability Questionnaire; pain intensity assessments; visual analogue scale, Pain Disability Index, and a pain rating scale; and core stability measures, such as the active straight leg raise, were determined at pretest, posttest and two-month follow-up. Results: After the intervention, the experimental group showed significant greater improvement at two months compared with the control group. Physical disability results included Oswestry Disability Index (P = 0.001, from 24.25 (7.08) to 13.35 (4.17)) and Roland Morris Disability Questionnaire (P = 0.001, from 15.55 (1.99) to 8.15 (1.69)), pain intensity including visual analogue scale (P = 0.001, from 6.30 (1.03) to 3.35 (0.59)), Pain Disability Index (P = 0.001, 31.25 (5.44) to 19.00 (3.58)) and pain rating scale (P = 0.001, from 72.25 (18.73) to 50.10 (15.47)), and the core stability test such as active straight leg raise (P = 0.001, from 7.40 (0.75) to 2.15 (0.49)). Conclusions: This study provides the clinical evidence that adding ankle dorsiflexion to drawing in the abdominal wall gave increased benefit in terms of physical disability, pain and core stability in patients with chronic low back pain.

Immediate effects of somatosensory stimulation on hand function in patients with poststroke hemiparesis: a randomized cross-over trial.

This study aimed to determine the immediate effects of somatosensory stimulation on hand function in patients with poststroke hemiparesis. Eleven patients with poststroke hemiparesis participated in this study. Four types (no stimulation, vibration, and light and rough touches) of somatosensory stimulation were performed randomly for 4 days applying only one type of somatosensory stimulation each day. The box and block test (BBT), the Jebsen–Taylor hand function test (JTHFT), hand grip strength (HGS), and movement distance and peak velocity of the wrist joint during a forward-reaching task were measured. The BBT and JTHFT scores for no stimulation [BBT: median (interquartile range), 0.00 (−1.00 to 1.00) and JTHFT: 2.57 (−0.47 to 4.92)] were significantly different from those for vibration [BBT: 3.00 (2.00–5.00) and JTHFT: −16.02 (−23.06 to −4.31)], light touch [BBT: 3.00 (1.00–4.00) and JTHFT: −5.00 (−21.20 to −0.94)], and rough touch [BBT: 2.00 (1.00–4.00) and JTHFT: −6.19 (−18.22 to −3.70)]. The JTHFT score was significantly higher for vibration than that for rough touch (P<0.05). The increase in HGS was significantly greater for light touch than that for no stimulation (P<0.05) and for vibration than that for light touch (P<0.05). There were significant differences for the sagittal and coronal planes in movement distance and for the sagittal and horizontal planes in peak velocity during the forward-reaching task (P<0.05). The findings suggest that somatosensory stimulation may be advantageous to improve the hand function of patients with poststroke hemiparesis, with more favorable effects observed in vibration stimulation.

Effects of a novel forced intensive strengthening technique on muscle size and upper extremity function in a patient with chronic stroke.

[Purpose] This research demonstrated a forced intensive strength technique as a novel treatment for muscle power and function in the affected upper extremity muscle to determine the clinical feasibility with respect to upper extremity performance in a stroke hemiparesis. [Subject and Methods] The subject was a patient with chronic stroke who was dependent on others for performing the functional activities of his affected upper extremity. The technique incorporates a comprehensive approach of forced, intensive, and strength-inducing activities to enhance morphological changes associated with motor learning of the upper extremity. The forced intensive strength technique consisted of a 6-week course of sessions lasting 60 minutes per day, five times a week. [Results] After the 6-week intervention, the difference between relaxation and contraction of the affected extensor carpi radialis muscle increased from 0.28 to 0.63u2005cm2, and that of the affected triceps brachii muscle increased from 0.30 to 0.90u2005cm2. The results of clinical tests including the modified Ashworth scale (MAS; from 1+ to 1), muscle strength (from 15 to 32u2005kg), the manual function test (MFT; scores of 16/32 to 27/32 score), the Fugl-Meyer assessment (FMA; scores of 29/66 to 49/66 score), and the Jebsen-Taylor hand function test (JTHFT; from 38/60 to 19/60 sec) were improved. [Conclusion] Our results suggest that the forced intensive strength technique may have a beneficial effect on the muscle size of the upper extremity and motor function in patients with chronic stroke.

Responses of Korean physical therapy students after practice with a virtual anatomical system in Japan

[Purpose] To investigate responses of Korean physical therapy students, receiving medical terminology education in physical therapy both in Korean and English, after practice with a virtual anatomical system. [Subjects and Methods] The participants were 25 physical therapy students from Konyang University in South Korea visiting the International University of Health and Welfare for training purposes. The virtual anatomy practice was conducted in English using 3 dimensional virtual anatomy software constructed using real cadaver photographs. A questionnaire about this practice and anatomy was completed after the practice. [Results] The results of the questionnaire showed a trend toward high scores for virtual anatomy practice. [Conclusion] The present virtual anatomy system was created using multi-directional photographs from a real cadaver; therefore, it can be used as an auxiliary means of education using cadavers.

Effect of glenohumeral stabilization exercises combined with scapular stabilization on shoulder function in patients with shoulder pain: A randomized controlled experimenter-blinded study

BACKGROUNDnShoulder stabilization exercises consisted of a glenohumeral stabilization and scapular stabilization. No studies have been assessed the superiority of shoulder stabilization until now.nnnOBJECTIVEnTo compare the effect of a glenohumeral stabilization exercise (GSE) combined with a scapular stabilization exercise (SSE) on changes in shoulder function in patients with shoulder painMETHODS: Shoulder stability, scapular alignment, pain, muscle power, and range of motion (ROM) were measured before and after the intervention in both groups.nnnRESULTSnForty subjects with shoulder pain were randomly assigned to an experimental or control group. GSE in the experimental group (n= 20) resulted in significantly better shoulder stability (P= 0.020, from 9.00 ± 6.90 score to 14.25 ± 8.58) and pain intensity (P= 0.042, 7.40 ± 2.44 score to 4.60 ± 2.06) compared to SSE in the controls (n= 20). However, no significant effects were observed for scapular symmetric alignment including the angles of inferior scapular distance (P= 0.555) and inferior scapular height difference (P= 0.770), muscle power including shoulder flexion (P= 0.942) and shoulder abduction (P= 0.551), or ROM including shoulder flexion (P= 0.852) and shoulder abduction (P= 0.622).nnnCONCLUSIONnThis study suggests that GSE positively affects shoulder stability and pain control in patients with shoulder pain, probably through a centralization effect on the shoulder mechanism.