Citations
To analyze the amount of weight-bearing during tilt table increments, with a review of neutral and unilateral knee flexion postures.
There were 17 healthy participants enrolled in this study. The subjects were tilted from 10° to 90°, and their body weight was measured at each 10° increment. In the first test, both plantar pressures, with the subjects in neutral posture, were recorded. During the second and third tests, the angle of inclination was thus recorded and increased, with the subjects in unilateral knee flexion posture; flexion was maintained at 25° by attaching a cylindrical support to the tilt table at the level of the popliteal fossa.
The study was divided into two types of postures: neutral and unilateral knee flexion. The percentage of body weight (%BW) between each leg during neutral posture was noted as not being statistically significant. The %BW of one side during tilt table inclination was significantly different between the two postures at 10° to 80° (p<0.05). The weight during unilateral knee flexion posture was lower as analyzed, regardless of tilt table inclination compared with that in neutral posture. We note that fifty percent of the ratio of %BW was noted at 33.12° and 38.76° in neutral and flexion postures, respectively.
The unilateral knee flexion could induce the effect of decreased body weight compared with non-flexion side. The results of this study will help in setting a safe and quantitative percentage of weight-bearing on the lower extremity during tilt training.
Citations
To evaluate characteristics of the postural instability in patients with stroke and to present a prediction model of post-stroke falls.
Patients with a first-ever stroke who had been evaluated by the Balance Master (BM) at post-stroke 3 months (±1 month) between August 2011 and December 2015 were enrolled. Parameters for the postural instability, such as the weight bearing asymmetry (WBA) and postural sway velocity (PSV), were obtained. The fall events in daily lives were assessed via structured telephone interview with a fall related questionnaire.
A total of 71 patients (45 men; 45 with ischemic stroke) were enrolled in this study. All subjects underwent BM evaluation at 3.03±0.40 months after stroke. The mean WBA was 17.18%±13.10% and mean PSV (measured as °/s) were noted as 0.66±0.37 (eyes-open on firm surface), 0.89±0.75 (eyes-closed on firm surface), 1.45±1.09 (eyes-open on soft surface), and 3.10±1.76 (eyes-closed on soft surface). A prediction model of post-stroke falls was drawn by multiple logistic regression analysis as follows: Risk of post-stroke falls = -2.848 + 1.878 x (PSVECSS) + 0.154 x (age=1 if age≥65; age=0 if age<65).
The weight bearing asymmetry and postural sway were significantly increased in patients with stroke. Older age and impaired postural control increased the risk of post-stroke falls.
Citations
Method A heterogeneous group of 18 prepubertal children with CP (age, 8.9±2.9 years; GMFCS level, IV and V) participated. Patients underwent a dual-energy X-ray absorptiometry scan of the lumbar spine (L1-L4) and proximal femur, and the Z scores were calculated by using data obtained from the control group who were normal children (age, 8.8±2.9 years). We divided the patients into 2 groups: group A standing for 2 hours a day, 5 days a week; group B standing for 30 minutes a day, 1 or 2 days a week. We measured BMD after 1 year and compared it to baseline measurements.
Results BMD was significantly higher on L2-L4 vertebrae, femoral neck and trochanter area after exercise in group A (p＜0.05). There was no significant difference in BMI after exercise in the group B (p＞0.05). BMD according to static weight-bearing exercise for 1 year were significantly different between groups A and B on the L1, L4 vertebrae, femoral neck and trochanter area (p＜0.05).
Conclusion This study suggests that weight-bearing exercise may be an important part of a rehabilitation protocol to maintain and improve BMD in children with spastic quadriplegic CP.
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