Sujitra Boonyong

Development of Postural Control during Gait in Typically Developing Children: The Effects of Dual-task Conditions

The purpose of this study was to investigate the typical development of postural control in younger (5-6 yrs) and older (7-16 yrs) children (YTD and OTD) during two gait tasks, including level walking and obstacle-crossing, using a dual-task paradigm, and to compare the results of the childrens performance with that of healthy young adults (HYA). Our findings revealed that gait control in typical children requires attentional resources to maintain stability. Moreover, dual-task interference was less in HYA compared to YTD and OTD. Gait performance decrements in the dual-task context were greater in YTD compared to OTD, whereas cognitive performance decrements in YTD and OTD were similar. In addition, dual-tasking affected cognitive performance more in YTD when gait task difficulty was increased. Results suggest a developmental trend in attentional resources used to control gait in typical children. Postural control during gait under dual-task conditions was improved when children were more mature, as attentional resources increased with age.

Effect of flexibility exercise on lumbar angle: A study among non-specific low back pain patients

The study investigated the influence of lumbar flexibility exercise on the lumbar angle among patients with non-specific low back pain (LBP). Pre-experimental one-group pretest-posttest design trial was conducted at Health Service Center, Chulalongkorn University, Thailand. Thirty-five non-specific LBP patients with limitation in lower back range of motion and without neurological deficits were recruited (based on the LBP guidelines by RCGP 1999). Lumbar flexibility exercise program developed based on McKenzie therapy was performed individually each day for 2 weeks. Patients attended an exercise program daily in the first week under the supervision of a physiotherapist. The exercise program consisted of 7 sets a day (3-2-2 in the morning-afternoon-evening) in series of 10 repetitions for each set for 2 weeks. Lumbar angle was measured at the beginning and at the end of 2 weeks in order to determine the range of motion improved. The results indicated that the low back pain symptom improved as well as the angle.

Multi-directional Reach Test: An Investigation of the Limits of Stability of People Aged between 20-79 Years.

[Purpose] The multi-directional reach test (MDRT) is a simple, inexpensive, reliable and valid screening tool for assessing the limits of stability in the anterorposterior and mediolateral directions. The aim of this study was to quantify the limits of stability of people aged between 20 and 79 years using the MDRT. [Subjects] One hundred and eighty subjects were divided into the following 6 age groups: 20–29, 30–39, 40–49, 50–59, 60–69 and 70–79 years (n=30 per group). [Methods] The MDRT was used to measure the limits of stability in four directions: forward, backward, leftward and rightward. Subjects performed maximal outstretched arm reach in each direction with their feet flat on the floor. [Results] All age groups performed the greatest values of the limit of stability in the forward direction. The 60–79 year group demonstrated significantly lower limits of stability in the forward, leftward and rightward directions compared to the 20–39 year group. [Conclusion] The limits of stability declined with age mainly in the forward, leftward and rightward directions. The MDRT appears to be a useful assessment tool for postural control and balance of those aged 60 years and over.

The effects of vision on sit-to-stand movement

[Purpose] It is well known that vision is an important factor contributing to postural control. However, there has been little discussion about the effect of vision on sit-to-stand movement. The purpose of this study was to evaluate the effect of constrained vision on sit-to-stand movement. [Subjects and Methods] Twenty-three healthy subjects (11 males, 12 females) aged 18–23 years with normal body mass indices were recruited for this study. Each participant was asked to stand as quickly as possible from a height-adjustable chair 3 times under 2 conditions: with eyes closed (EC) and eyes open (EO). The weight transfer time, rising index, and center of gravity sway velocity were measured using a NeuroCom Balance Master. [Results] The results show there were significant differences between the EC and EO conditions in the weight transfer time and the centre of gravity sway velocity. No significant difference was found between the EC and EO conditions in the rising index. These findings suggest that visual perception may play a role in balance control while performing sit-to-stand movement.

The effect of an acupressure backrest on pain and disability in office workers with chronic low back pain: A randomized, controlled study and patients’ preferences

OBJECTIVE This study investigated the effects of an acupoint-stimulating lumbar backrest on pain and disability in office workers who suffering from low back pain (LBP) as well as the preference influence on pain and disability. METHODS Sixty-four participants were randomly assigned to two groups: one with no intervention (n=32) and another with 1 month of backrest use (n=32). An additional group (n=37) who wished to try 1 month of acupressure backrest were recruited to indicate the preference effect. Pain and disability were two key outcomes. RESULTS Significant differences between control and randomized acupressure backrest groups were found at 2 week period for disability and at 4 weeks for pain after the backrest use. Also, significant differences were found in both groups for 3 month period with an increase of the treatment effect on pain and disability. Both control and randomized acupressure backrest groups showed greater improvement in pain and disability scores which were more than the minimal clinically important change (30% improvement for both outcomes). No significant difference was found for pain and disability between the randomized and preferred backrest groups. CONCLUSION These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect.

Effect of Interferential Current Stimulation in Management of Hemiplegic Shoulder Pain

OBJECTIVE To study the immediate effects of interferential current stimulation (IFC) on shoulder pain and pain-free passive range of motion (PROM) of the shoulder in people with hemiplegic shoulder pain (HSP). DESIGN Double-blind, placebo-controlled clinical trial. SETTING Institutional physical therapy clinic, neurologic rehabilitation center. PARTICIPANTS A population-based sample of people with HSP (N=30) was recruited. INTERVENTION Participants were divided into 2 groups--an IFC group and a placebo group--by using a match-paired method (age, sex, and Brunnstrom motor recovery stage). In the IFC group, participants received IFC for 20 minutes with an amplitude-modulated frequency at 100 Hz in vector mode. The current intensity was increased until the participants felt a strong tingling sensation. MAIN OUTCOME MEASURES Pain intensity and pain-free PROM of the shoulder until the onset of pain were measured at baseline and immediately after treatment. RESULTS Participants reported a greater reduction in pain during the most painful movement after treatment with IFC than with placebo (P<.05). The IFC group showed a greater improvement in posttreatment pain-free PROM than the placebo group in shoulder flexion (P<.01), abduction (P<.01), internal rotation (P<.01), and external rotation (P<.01). CONCLUSIONS This study provides evidence that IFC is effective for the relief of pain during movement and also increases the pain-free PROM of the shoulder in people with HSP.

Mechanical work, kinematics, and kinetics during sit-to-stand in children with and without spastic diplegic cerebral palsy

BACKGROUND Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7-12 years old. RESEARCH QUESTION What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children? METHODS Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7-12 years were enrolled. Motion analysis and force plate systems were used to collect data. All participants performed the STS task from an adjustable chair. Independent sample t-test and two-way analysis of variance were used in this study. RESULTS The children with SDCP took a longer time and used more mechanical work during STS than TD children. At the beginning of the STS task, children with SDCP showed more trunk flexion and posterior pelvic tilting; in addition, during the STS task they also presented more trunk, hip, and knee flexion than TD children. However, the children with SDCP showed less ankle dorsiflexion compared with TD children. For the kinetic variables, asymmetry was found in children with SDCP. The maximum hip and knee extension moment, plantar flexion moment, and peak vertical ground reaction force (GRF) of the non-dominant leg were higher than the values of the dominant leg in these children. SIGNIFICANCE Even though, children with SDCP who are able to independently STS. They were also a mechanically less efficient performance during STS task. Therefore, this task still needs to be trained during rehabilitation sessions.

Predictors of plantar fasciitis in Thai novice conscripts after 10-week military training: A prospective study

OBJECTIVE To identify the individual, anatomical, and biomechanical predictors of plantar fasciitis among novice conscripts. DESIGN A prospective cohort study. SETTING Military training camp in Bangkok, Thailand. PARTICIPANTS One hundred thirteen novice conscripts without lower extremity pain prior to the commencement of military training. MAIN OUTCOME MEASURE(S) Individual, anatomical, and biomechanical variables were assessed in all participants at baseline. The primary criterion variable was the presence or absence of plantar fasciitis. RESULTS After 10 weeks of training, 113 participants were classified as having (n = 71) and not having (n = 42) plantar fasciitis. The results indicated that the conscripts with poorer quality of movement and lesser femoral anteversion angle tended to exhibit plantar fasciitis (odds ratio = 1.996 and 0.720, respectively). Regarding individual components, the conscripts with higher body mass index and higher stress level had increased risk of plantar fasciitis (odds ratio = 1.238 and 1.110, respectively). Moreover, the conscripts with a higher level of physical exercise before military training had a reduced risk of presenting with plantar fasciitis (odds ratio = 0.242). CONCLUSIONS Multiple predictors-especially individual characteristics and the abnormalities from the proximal region (other than foot and ankle)-contributed to the development of plantar fasciitis among Thai novice conscripts.

Exercise using mung bean bag improves balance in healthy young adults

ABSTRACT The purpose of this study was to investigate the effects of exercise using a mung bean bag (MB) for balance ability. Thirty-nine healthy female young adults (aged 18–25 years with normal body mass index) were randomly assigned into three groups (n for each group = 13): control group, firm surface (FS) exercise group, and MB exercise group. The FS and MB groups were trained with static and dynamic balance exercises (20 minutes × 3 times/week × 6 weeks). Participants’ balance abilities were measured using a Balance Master 4 times: at pre-training (baseline) and at the second, fourth, and sixth weeks post-training. Three tests were assessed: unilateral stance test, modified clinical test for sensory integrations on balance (mCTSIB), and limits of stability (LOS) test. The MB group significantly improved unilateral stance balance in both eyes-open and eyes-closed conditions, whereas the FS group improved only in the eyes-closed condition. No significant difference was found across groups in the mCTSIB parameters. Only the FS group significantly improved LOS parameters. These results suggest the MB exercise could be used to improve unilateral stance balance, but not the LOS or mCTSIB, in healthy young adults.

Comparisons of the effects of a foam pad, mung bean bag, and plastic bead bag on postural stability disturbance in healthy young adults.

[Purpose] The aim of the present study was to compare the effects of unstable support surfaces, i.e. foam pad, mung bean bag, and plastic bead bag, on postural stability disturbance. [Subjects and Methods] Twenty-two healthy young adults (11 male and 11 female; aged 21.09 ± 1.44 years; BMI 20.40 ± 1.40 kg/m2) participated in the study. The Balance Master™ was used to evaluate the limit of stability and the unilateral stance performance. Each participant was assessed while standing on the following surfaces: 1) a firm surface, 2) a foam pad, 3) a mung bean bag, and 4) a plastic bead bag. The order of surfaces was randomly assigned. [Results] The mung bean bag and plastic bead bag showed greater disturbances in limit of stability and unilateral stance than the foam pad. There was no significant difference in postural stability disturbance between the mung bean bag and plastic bead bag. [Conclusion] These results suggested that both the mung bean bag and plastic bead bag could be used as a low-cost tool for balance assessment instead of a foam pad in healthy young adults.