Tomoaki Shimada

Effects of dual task balance training on dual task performance in elderly people: a randomized controlled trial:

Objective: To investigate the effects of dual task balance training in the elderly on standing postural control while performing a cognitive task. Design: A randomized two-group parallel controlled trial. Participants: Forty-three subjects (all >65 years old) were enrolled in the study and were assigned randomly to either an experimental group (n = 21) or a control group (n = 22). Interventions: Subjects in the experimental group were given strength and balance training while performing cognitive tasks simultaneously. Subjects in the control group were given strength and balance training only. The training was administered twice a week for three months. Measurements: The Chair Stand Test, Functional Reach Test, Timed Up and Go Test and Trail Making Test were measured. The sway length of the centre of gravity was measured during standing while performing the Stroop task. The rate of Stroop task was also measured. All measurements were collected at baseline and after the training period. Results: There were no significant differences in Functional Reach Test, Timed Up and Go Test and sway length at baseline and after training between the two groups. However, the rate of Stroop task (P < 0.05) was significantly higher after training in the experimental group than in the control group. Conclusions: These results suggest that dual task balance training in elderly people improves their dual task performance during standing postural control.

Falls efficacy among stroke survivors living in the community

Purpose. The study focused on the falls efficacy of stroke survivors in the community and its association with the related factors. Method. The study was conducted through a cross-sectional design in the community setting. One hundred seven stroke survivors were recruited. Falls efficacy was measured by the 7-item Falls Efficacy Scale International version, where the higher mean score showed more concern about falling in daily life. Results. Activities of daily living (ADL) dependency levels, including mild, moderate and severe, contributed to 33.5%% of the explained variance. Women were over 7.5 times more likely to have high falls efficacy than men. Moderate and severe ADL dependency participants were 10.8 and 13.6 times more likely to have high falls efficacy than ADL independent participants. Single fall participants were also nearly 13 times more likely to have high falls efficacy than others who had either recurrent falls or no falls. Conclusions. Female gender, strong ADL dependency, and single falls were associated with high falls efficacy. The levels of ADL dependency were the most correlated with falls efficacy than with other related factors. Rehabilitation interventions should also be incorporated to minimise ADL dependency, and to improve falls efficacy for stroke survivors.

Effects of Ultrasound Therapy on Calcificated Tendinitis of the Shoulder

In general, surgery is recommended for calcificated tendinitis of the shoulder if the patients have symptoms after conservative treatments, including needle aspiration and physical therapy. Many researchers agree about the need for adequate physical therapy consisting of range of motion exercise, muscle strengthening exercises and electrophysical agents. Some researchers report that ultrasound (u/s) promotes angiogenesis and calcium uptake to fibroblasts, but there are few studies about u/s effects on calcificated tendinitis of the shoulder. The purpose of this study was to evaluate the u/s therapy effect on calcification, pain during active movement, and to identify factors related to improvement in a randomized controlled fashion. We used the stratified random allocation method to assign 40 consecutive patients to experimental and control groups, so each group consisted of 20 patients. The experimental group was treated by u/s therapy and therapeutic exercises, and the control group was treated with therapeutic exercises only. All patients in both groups came to our department 3 times per week and u/s therapy was performed 3 times per week until the end of the study. First, we classified the calcifications as type I (clearly circumscribed and with dense appearance on radiography), type II (dense or clearly circumscribed appearance) and type III (translucent or cloudy appearance without clear circumscription) according to the classification of Gartner and Heyer. Radiography was performed every one month, and the main outcome measure was the change from the base-line of the calcification on radiography at the end of the treatment. The three point scale of Gartner and Heyer was used, in which a score of 1 indicates no change or a worsening of the condition, a score of 2 a decrease of at least 50 percent in the area and density of the calcification, and a score of 3 a complete resolution of the calcification. We also examined the affected shoulders for presence or absence of pain in active movement at the start and at the end of the study. The calcifications improved significantly and fewer patients had pain during active movement in the experimental group. There was a statistical significant disease duration difference from the first clinical presentation between scores 2 and 3 in the experimental group. The results of this study suggest that u/s therapy helps to resolve calcifications of shorter disease duration. Calcifications of longer disease duration tended to persist in spite of u/s therapy, but we thought treatment of 27-38 times (95% CI), until score 2 was attained, was a desirable strategy.

Effects of methods of descending stairs forwards versus backwards on knee joint force in patients with osteoarthritis of the knee: A clinical controlled study

BackgroundThe aim of this study was to investigate the kinetic characteristics of compensatory backward descending movement performed by patients with osteoarthritis of the knee.MethodsUsing a three-dimensional motion analysis system, we investigated lower extremity joint angles, joint moments, joint force of the support leg in forward and backward descending movements on stairs, and joint force of the leading leg at landing in 7 female patients with osteoarthritis of the knee.ResultsCompared with the forward descending movement, knee joint angle, joint moment and joint force of the support leg all decreased in the backward descending movement. Joint force of the leading leg at landing was also reduced in the backward descending movement. In addition, we confirmed that the center of body mass was mainly controlled by the knee and ankle joints in the forward descending movement, and by the hip joint in the backward descending movement.ConclusionsSince it has been reported that knee flexion angle and extensor muscle strength are decreased in patients with osteoarthritis of the knee, we believe that backward descending movement is an effective method to use the hip joint to compensate forthese functional defects. In addition, due to the decreased knee joint force both in the leading and support legs in backward descending movement, the effectiveness of compensatory motion for pain control and knee joint protection was also suggested.

Excitability of Spinal Motor Neuron Function after the Transcutaneous Electrical Stimulation (TES) in Healthy Subjects —F-wave Study—

To clarify the excitability of spinal motor neuron function after transcutaneous electrical stimulation (TES), we investigated the F-wave before and after TES. Fourteen healthy volunteers with a mean age of 23.4 years were studied. TES was applied to the flexor hallucis brevis (FHB) for 15 minutes. F-wave and M-wave were recorded from the FHB after tibial nerve stimulation at the ankle before TES, just after TES, 10, 20 and 30 minutes after TES. TES evoked full flexion of the great toe. F-wave was analyzed for the amplitude ratio of F/M, latency and duration. The amplitude ratio of F/ M was 3.1% before TES, 1.4% just after TES, 1.6% 10 minutes after, 1.9% 20 minutes after and 1.7% 30 minutes after TES. Each amplitude ratio of F/M after TES was significantly lower than that before TES (p<0.05). There was no statistically significant difference in the latency and the duration. These results suggest that the excitability of spinal motor neuron function after TES to muscles under this condition was reduced in healthy subjects.