[Purpose] This research was conducted to investigate the effects of modified trampoline
training on the balance, gait, and falls efficacy of stroke patients. [Subjects]
Twenty-four stroke patients participated in this study. The subjects were randomly
allocated to one of two groups: the trampoline group (n=12) or the control group (n=12).
[Methods] Both groups participated in conventional physical therapy for thirty minutes per
day, three times a week for six weeks. The trampoline group also took part in trampoline
training for thirty minutes per day, three times a week for six weeks. We evaluated
balance (Berg balance scale, timed up and go test), gait (dynamic gait index), and falls
efficacy (falls efficacy scale-K) to confirm the effects of the intervention. [Results]
Both the trampoline and the control group showed significant improvements in balance,
gait, and falls efficacy compared to before the intervention, and the improvements were
significantly greater in the trampoline group than in the control group. [Conclusion]
Modified trampoline training resulted in significantly improved balance, dynamic gait, and
falls efficacy of stroke patients compared to the control group. These results suggest
that modified trampoline training is feasible and effective at improving balance, dynamic
gait, and falls efficacy after stroke.
Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra-and between-group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.
The aim of this study was to measure the muscle architectural parameters of abdominal muscles in healthy individuals by rehabilitative ultrasound imaging (RUSI) and to investigate their changes after bridging exercise in various environments. Design: Cross-sectional study. Methods: The study included 40 healthy participants (19 men, 21 women). Subjects were randomly allocated to a stable surface group (SG, n=20) or an unstable surface group (UG, n=20). The participants assumed three positions in rest, bridging exercise with knee flexion 60 o , and bridging exercise with knee flexion 90 o for the measurement of abdominal muscle thickness by RUSI. For the resting position, the participants held the head neutral in a hook-lying position and the dominant side was measured. For contraction, the participants performed the bridging exercise with the knee joint in 60 o and 90 o of flexion for 10 seconds each. Results: For transversus abdominis, external oblique muscle thickness, within the stable surface group and the unstable surface group, no significant contraction difference was observed in both the 60 o and 90 o bridge exercise conditions. Contraction difference of internal oblique muscle was significantly larger at 90 o than at 60 o within the SG (p<0.05). But within the UG, no significant contraction difference was shown. There was no significant contraction difference between the surface group and the unstable SG at 60 o condition and at 90 o condition in all measured muscles. Conclusions: The contraction difference is different for each muscle during bridge exercise with knee flexion 60 o and bridging exercise with knee flexion 90 o. Muscle contraction difference is generally large when exercised on an unstable surface than a stable surface, but these are not statistically significant when bridging exercise is performed using dynamic air cushion for unstable surface.
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