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To compare optical motion capture system (MoCap), attitude and heading reference system (AHRS) sensor, and Microsoft Kinect for the continuous measurement of cervical range of motion (ROM).
Fifteen healthy adult subjects were asked to sit in front of the Kinect camera with optical markers and AHRS sensors attached to the body in a room equipped with optical motion capture camera. Subjects were instructed to independently perform axial rotation followed by flexion/extension and lateral bending. Each movement was repeated 5 times while being measured simultaneously with 3 devices. Using the MoCap system as the gold standard, the validity of AHRS and Kinect for measurement of cervical ROM was assessed by calculating correlation coefficient and Bland–Altman plot with 95% limits of agreement (LoA).
MoCap and ARHS showed fair agreement (95% LoA<10°), while MoCap and Kinect showed less favorable agreement (95% LoA>10°) for measuring ROM in all directions. Intraclass correlation coefficient (ICC) values between MoCap and AHRS in –40° to 40° range were excellent for flexion/extension and lateral bending (ICC>0.9). ICC values were also fair for axial rotation (ICC>0.8). ICC values between MoCap and Kinect system in –40° to 40° range were fair for all motions.
Our study showed feasibility of using AHRS to measure cervical ROM during continuous motion with an acceptable range of error. AHRS and Kinect system can also be used for continuous monitoring of flexion/extension and lateral bending in ordinary range.
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To investigate the difference of range of motion (ROM) of ankle according to pushing force, gender and knee position.
One hundred and twenty-eight healthy adults (55 men, 73 women) between the ages of 20 and 51, were included in the study. One examiner measured the passive range of motion (PROM) of ankle by Dualer IQ Inclinometers and Commander Muscle Testing. ROM of ankle dorsiflexion (DF) and plantarflexion (PF) according to change of pushing force and knee position were measured at prone position.
There was significant correlation between ROM and pushing force, the more pushing force leads the more ROM at ankle DF and ankle PF. Knee flexion of 90° position showed low PF angle and high ankle DF angle, as compared to the at neutral position of knee joint. ROM of ankle DF for female was greater than for male, with no significant difference. ROM of ankle PF for female was greater than male regardless of the pushing force.
To our knowledge, this is the first study to assess the relationship between pushing force and ROM of ankle joint. There was significant correlation between ROM of ankle and pushing force. ROM of ankle PF for female estimated greater than male regardless of the pushing force and the number of measurement. The ROM of the ankle is measured differently according to the knee joint position. Pushing force, gender and knee joint position are required to be considered when measuring the ROM of ankle joint.
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To investigate whether an audible cracking sound during shoulder manipulation following distention arthrography is clinically significant in patients with adhesive capsulitis of the shoulder.
A total of 48 patients (31 women, 17 men) with primary adhesive capsulitis of the shoulder completed the study. All participants underwent C-arm-guided arthrographic distention of the glenohumeral joint with injections of a corticosteroid and normal saline. After distention, we performed flexion and abduction manipulation of the shoulder. The patients were grouped into sound and non-sound groups based on the presence or absence, respectively, of an audible cracking sound during manipulation. We assessed shoulder pain and disability based on a Numeric Rating Scale (NRS), the Shoulder Pain and Disability Index (SPADI), and passive range of motion (ROM) measurements (flexion, abduction, internal and external rotation) before the procedure and again at 3 weeks and at 6 weeks after the intervention.
The patients were divided into two groups: 21 were included in the sound group and 27 in the non-sound group. In both groups, the results of the NRS, SPADI, and ROM assessments showed statistically significant improvements at both 3 and 6 weeks after the procedure. However, there were no significant differences between the two groups except with respect to external rotation at 6 weeks, at which time the sound group showed a significant improvement in external rotation when compared with the non-sound group (p<0.05).
These findings showed that manipulation following distention arthrography was effective in decreasing pain and increasing shoulder range of motion. In addition, the presence of an audible cracking sound during manipulation, especially on external rotation, was associated with better shoulder range of motion.
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To investigate the relationships between spinal mobility, pulmonary function, structural change of the spine, pain, fatigue, and quality of life (QOL) in patients with ankylosing spondylitis (AS).
Thirty-six patients with AS were recruited. Their spinal mobility was examined through seven physical tests: modified Schober test, lateral bending, chest expansion, occiput to wall, finger to ground, bimalleolar distance, and range of motion (ROM) of the spine. Pulmonary Function Test (PFT) was performed using a spirometer, and vertebral squaring was evaluated through the modified Stoke Ankylosing Spondylitis Spinal Score (mSASSS). QOL, disease activity, functional capacity, and fatigue were evaluated by SF-36 Health Survey (SF-36), the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), the Bath Ankylosing Spondylitis Functional Index (BASFI), and the Multidimensional Assessment of Fatigue (MAF) scale, respectively. Perceived physical condition and degree of pain were assessed using 10 cm visual analogue scale.
Participants showed reduced spinal mobility, which was negatively correlated with mSASSS. PFT results showed reduced forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) and increased FEV1/FVC. Reduced FEV1 and FVC showed positive correlations with reduced spinal mobility and a negative relationship with mSASSS. Perceived physical condition and degree of pain were both significantly related to the SF-36, BASDAI, BASFI, and MAF scores.
This study shows that both reduced spinal mobility and radiographic changes in the vertebral body may have a predictive value for pulmonary impairment in patients with AS. Likewise, pain and perceived physical condition may play an important role in the QOL, functional capacity, and fatigue level of these patients.
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To investigate the factors affecting rehabilitation outcomes in children with congenital muscular torticollis (CMT).
We retrospectively reviewed the medical records of 347 patients who were clinically suspected as having CMT and performed neck ultrasonography to measure sternocleidomastoid (SCM) muscle thickness. Fifty-four patients met the inclusion criteria. Included were demographic characteristics as well as measurements of cervical range of motion (ROM), SCM muscle thickness, and the abnormal/normal (A/N) ratio, defined as the ratio of SCM muscle thickness on the affected to the unaffected side.
Subjects were divided into three groups depending on degree of cervical ROM (group 1A: ROM>60, n=12; group 1B: 60≥ROM>30, n=31; group 1C: ROM≤30, n=11), the SCM muscle thickness (Th) (group 2A: Th<1.2 cm, n=23; group 2B: 1.2≤Th<1.4 cm, n=18; group 2C: Th≥1.4 cm, n=13), and the A/N ratio (R) (group 3A: R<2.2, n=19; group 3B: 2.2≤R<2.8, n=20; group 3C: R≥2.8, n=15). We found that more limited cervical ROM corresponded to longer treatment duration. The average treatment duration was 4.55 months in group 1A, 5.87 months in group 1B, and 6.50 months in group 1C. SCM muscle thickness and the A/N ratio were not correlated with treatment duration.
Infants with CMT who were diagnosed earlier and had an earlier intervention had a shorter duration of rehabilitation. Initial cervical ROM is an important prognostic factor for predicting the rehabilitation outcome of patients with CMT.
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To investigate the changes of ankle strength and range of motion with aging and which of the ankle strength and range of motion are contributed to balance.
Sixty healthy people (24 men and 36 women) have undergone tests for ankle strength and range of motion, using Biodex System 4 Pro; a one-leg balance, including postural sway and stability index using a Balance System; in which data were collected in a self-reported Desmond fall risk questionnaire.
Participants are classified into 3 groups by age (group 1, 20-40 years; group 2, 40-65 years; group 3, over 65 years). Stability index and postural sway is significantly increased with aging. Ankle plantarflexor strength and ankle eversion range of motion is significantly decreased with aging. Pearson's correlation revealed that ankle plantarflexor strength is significantly correlated with anterior/posterior sway, and ankle eversion range of motion is significantly correlated with medial/lateral sway in the aged group (over 65 years).
Stability, ankle plantarflexor strength, and eversion range of motion is declined with aging. In addition, strength of ankle plantarflexor and eversion range of motion is significantly correlated with balance stability. Further studies are needed for programs to improve the strength of plantarflexor, and range of motion of eversion of the ankle are beneficial in improving balance, stability, and prevention of falling in the elderly.
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Method: Ten healthy adult volunteers were included. We attached surface markers at the corresponding skin surface of each lumbar vertebral bodies and measured lumbar segmental ROM in flexion-extension, right bending, left bending, axial rotation with 3-D motion analysis. We compared some of the results with radiologic segmental ROM measurements.
Results: In 3-D motion analysis, segmental ROM of flexion and extension, right bending, left bending, right rotation, left rotation were, respectively: 10.1o, 45o, 3.5o, 1.7o and 1.9o (L1-L2); 17.9o, 6.2o, 5.1o, 1.4o and 1.1o (L2-L3); 15.0o, 7.2o, 4.9o, 2.1o and 1.1o (L3-L4); 14.9o, 5.8o, 4.6o, 1.7° and 1.6° (L4-L5); 10.6o, 4.9o, 3.8°, 2.6° and 0.8° (L5-S1). There was no statistically significant difference in segmental ROM between 3-D motion analysis measurements and radiologic measurements except L5-S1 right bending, L2-L3 and L5-S1 left bending. No statistical significant difference in lumbar flexion and bending ROM was found between two methods.
Conclusion: 3-D motion analysis is a useful method when measuring the lumbar segmental range of motion and it has an advantage to analyze segmental lumbar motion with three directions simultaneously. (J Korean Acad Rehab Med 2003; 27: 424-432)
Objective: This study is designed for comparison of the clinical usefulness between computerized and manual inclinometer and to find out more reliable and acceptable method in measuring spinal ROM (range of motion).
Method: Twenty healthy volunteers (mean age 23⁑4) were selected. Spinal ROM was measured by computerized and manual inclinometer twice a week. Data was analyzed with paired t-test and Pearson's correlation test.
Results: There was no significant difference between the measured value of two methods. In the repeated measurement by computerized inclinometer, there was significant reliability of spinal ROM except right rotation of the lumbar spine, and by manual inclinometer, there was significant reliability of spinal ROM except cervical left lateral bending, thoracic lateral bending, and lumbar right rotation (p＜0.05). In cases of computerized inclinometer, estimated times to measuring ROM were 8 min 46 sec in cervical spine, 10 min 22 sec in thoracic spine, 9 min 50 sec in lumbar spine, and of manual inclinometer, those were 3 min 27 sec in cervical spine, 5 min 8 sec in thoracic spine, 4 min 35 sec in lumbar spine.
Conclusion: In the measurement of spinal ROM, computerized inclinometer is more reliable than manual inclinometer for its higher reliability, but has a limitation of long measurement time. This study suggest that computerized inclinometer can be acceptable tool for accurate measuring spinal ROM. (J Korean Acad Rehab Med 2002; 26: 456- 460)
Objective: Shoulder pain in hemiplegia is common and serious problem, but is not completely understood and somewhat controversial. This preliminary study attempt to evaluate the effect and usefulness of subacromial massage in the management of hemiplegic shoulder.
Method: In this ramdomized controlled trial, twenty nine hemiplegic patients with shoulder pain and limitation of motion were treated with either subacromial massage (treatment group) or massage on the supra-acromial area (control group). Outcome measurement of pain intensity, and range of motion were obtained by blinded assessment.
Results: After massage, in treatment group, mean active range of shoulder motion was increased by 14.3o in abduction, 9.0o in flexion, 10.3o in external rotation and 13o in internal rotation versus 3.9o in abduction, 7.5o in flexion, 4.3o in external rotation and 6.4o in internal rotation in control group. The mean pain intensity decreased from VAS 5.47 to 3.8 in treatment group and from VAS 4.57 to 3.71 in control group. This result was statistically significant, except in increment of active range of motion of flexion and external rotation of shoulder joint.
Conclusion: Subacromial massage was used in an effort to increase shoulder motion and to reduce shoulder pain in hemiplegic patients. There were increase in shoulder motion especially abduction, and decrease shoulder pain in study group compared with control group. Further investigation in the form of long term follow up studies is needed. (J Korean Acad Rehab Med 2002; 26: 385-390)
Objective: The purpose of this study was to examine the change of heart rate, mean arterial pressure, respiration rate, and spasticity at passive leg range of motion exercise for one month in hemiplegic patients.
Method: Subjects were composed of twenty hemiplegic patients who had spasticity above two grade in modified Ashworth scale. Passive leg range of motion exercise was performed with passive cycle leg exerciser (Autocybex) at the speed of 40 rpm. Training program consisted of two sessions a day, and each session was done for twenty minutes. The heart rate, mean arterial pressure, and respiration rate were checked for each subject before and after passive leg range of motion exercise at initial state and after one month. Spasticity was measured at knee joint of the affected side at initial state and after one month.
Results: The resting heart rate, mean arterial pressure and respiration rate were significantly decreased after one month (p＜0.05). The changes of heart rate, mean arterial pressure, and respiration rate after passive leg range of motion exercise were significantly decreased after one month (p＜0.05). The grade of spasticity was decreased after one month (p＜0.05).
Conclusion: We concluded that passive leg range of motion exercise during one month stabilized heart rate, mean arterial pressure, and respiration rate, and reduced spasticity.
Objective: The purpose of this study was to determine the usefulness of manual medicine therapy in adhesive capsulitis of shoulder.
Method: Twelve patients with adhesive capsulitis of shoulder were treated with the muscle energy technique of Greenman in manual medicine therapy. The muscle energy technique of Greenman was repeated 6 times for each subject. The therapeutic effect of manual medicine therapy was assessed by the shoulder range of motion (ROM) and visual analogue scale (VAS) before and after the treatment. Two patients took the fluoroscopic examination before and after the treatment.
Results: After the manual medicine therapy, active range of shoulder motion were increased by 30.0o in forward flexion, by 21.2o in abduction, by 11.2o in external rotation, and by 18.7o in internal rotation, respectively. The visual analogue scale was decreased after treatment. None of the subjects complained pain during treatment. The mobility of shoulder joint was improved and the rhythm of scapulohumeral joint was restored.
Conclusion: The manual medicine therapy is an effective, tolerable and noninvasive treatment method for the painful adhesive capsulitis of shoulder.
Measurement of spinal range of motion(ROM) can be effectively used in guiding the direction of therapy, determining the patient's response to rehabilitation treatment and functional assessment. However for a method of measurement to be commonly used in clinical and research settings, it must be easy to perform, rapid and highly reliable. The purpose of this study was to determine the possibility of clinical application of 2-dimensional motion analysis system to measure spinal ROM in patients with low back pain(LBP).
Subjects included 10 healthy males and 10 patients with LBP. Using Electronic Digital Inclinometer (EDI 320) and 2-dimensional motion analysis system, thoracic, lumbar and pelvic ROMs were measured for trunkal flexion, extension, lateral flexion and rotation. Also proportions of decreased ROMs in LBP patients relative to healthy subjects and movement patterns of each spinal segment according to time sequence were investigated.
LBP patients compared to normal subjects showed significantly low spinal ROM(P＜0.05) except thoracic and pelvic ROM for extension. When looking at the change of each spinal ROM in respect to time with motion analysis system, normal subjects showed synchronized and sigmoid motion curve time from the initiation to the end of motion in all areas of spine during 4 motions. LBP patients took longer time from the initiation to the end of each motion, and showed smaller initial change and fluctuation in spinal ROM during each motion compared to normal subjects.
The results of this preliminary study suggest that 2-dimensional motion analysis system can be effectively used for measuring spinal ROM in patients with LBP.
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