Biomedical subjects

Mei-Hwa Jan

Publications and source records attributed to Mei-Hwa Jan.

8 recordsLinked to original sources

PubMed2006

Comparison of proprioceptive functions between computerized proprioception facilitation exercise and closed kinetic chain exercise in patients with knee osteoarthritis.

AIM: The aim of this study was to compare proprioceptive function between computerized proprioception facilitation exercise (CPFE) and closed kinetic chain exercise (CKCE) for knee osteoarthritis. DESIGN: Randomized-controlled. SETTING: Kinesiology laboratory. PATIENTS: Eighty-one patients with bilateral knee osteoarthritis were randomly assigned to CPFE, CKCE, and control groups. INTERVENTION: Both exercise groups underwent an 8-week program of three sessions per week. The control group received no training. The CPFE program included a 20-min computer game to be played by the trained foot of the subject. CKCE included 10 sets of 10 repetitions of repeated knee extension and flexion with resistance of 10-25% of body weight. MAIN OUTCOME MEASURES: Absolute reposition error, functional score, walking speed, and knee muscle strength were assessed with an electrogoniometer, the physical function subscale of Western Ontario and McMaster Osteoarthritis Index, a CASIO stopwatch, and a Cybex 6000 dynamometer before and after the 8-week period. RESULTS: The results of this study showed that both CPFE and CKCE were effective in improving joint position sense, functional score, walking speed, and muscle strength. Furthermore, CKCE showed greater effect in increasing knee extensor torque in patients with knee osteoarthritis. CONCLUSION: Clinical effects of CPFE were the same as those of CKCE except for knee extensor torque. The increase in knee extensor torque in CPFE patients was not as great as that seen in CKCE patients.

Aged↗

PubMed2006

Risk-factor analysis of high school basketball-player ankle injuries: a prospective controlled cohort study evaluating postural sway, ankle strength, and flexibility.

OBJECTIVE: To analyze risk factors, including postural sway, ankle strength, and flexibility, for the prediction of ankle injuries in men's high school basketball players. DESIGN: A cohort study with follow-up duration of 1 basketball season. SETTING: Biomechanics laboratory. PARTICIPANTS: Forty-two (age, 16.5+/-1.1y) players competing in first league of the High School Basketball Association without history of injury in the lower extremities within 6 months before recruitment and without significant malalignment in the lower extremities were included. None of these players met exclusion criteria such as using ankle braces or taping or failed in wearing low-top sports shoes during the follow-up season. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Biomechanic measurements including isokinetic ankle strength, 1-leg standing postural sway, and ankle joint dorsiflexion flexibility were performed before the basketball season by 1 physical therapist. The subsequent monthly follow-up questionnaires were sent and returned by mail to prospectively record the incidence of ankle injury occurring in the season. Results of these preseason measurements were analyzed to correlate if any of these measured variables could predict future ankle injuries. RESULTS: Eighteen ankle sport injuries were recorded for 42 players during the follow-up season. High variation of postural sway in both anteroposterior and mediolateral directions corresponded to occurrences of ankle injuries (P=.01, odds ratio [OR]=1.220; P< .001, OR=1.216, respectively). All other variables were not associated with injury. CONCLUSIONS: High variations of postural sway in 1-leg standing test could explain partly the increased prevalence of ankle injury in basketball players. It may be used as a screening tool to recommend balance training before basketball season.

Adolescent↗

PubMed2006

Assessment of stretching of the iliotibial tract with Ober and modified Ober tests: an ultrasonographic study.

OBJECTIVE: To assess stretching of the iliotibial tract with Ober and modified Ober tests, by assessing morphologic changes of the tract using ultrasonography during stretching. DESIGN: Cross-sectional study. SETTING: Orthopedic laboratory. PARTICIPANTS: Thirty-six healthy subjects (age, 24.3+/-4.0 y) were recruited. They had no history of previous low back, gluteus, hip, or knee pain and satisfied the inclusion criteria for this study. INTERVENTION: Each subject was randomly assigned to first undergo either the Ober test or the modified Ober test, and 30 minutes after the first to undergo the other test. Measurements were obtained with the subjects lying on the right side. The left knee was flexed 90 degrees for the Ober test and positioned at 0 degrees for the modified test. MAIN OUTCOME MEASURES: The iliotibial tract widths in subjects were measured in 3 gradually increased hip adduction positions (neutral, adducted, adducted with weight) when performing Ober and modified Ober tests. Ten of these 36 subjects were randomly chosen to undergo a repeat of the same protocol to test the reliability of ultrasonographic measurements in the iliotibial tract. RESULTS: Ultrasonography was reliable in measuring the width of iliotibial tract (intraclass correlation coefficient range, .81-.82). The width of the iliotibial tract was significantly reduced from the neutral to adducted position of the hip with both Ober (P=.001) and modified Ober (P<.001) tests. However, with further stretching using a greater hip adduction angle, the width of the iliotibial tract was only reduced with the modified Ober test. CONCLUSIONS: Both the Ober and modified Ober tests are effective in the initial stage of stretching of the iliotibial tract. However, the modified Ober test might be more effective in stretching the iliotibial tract if a further stretching effect is desired.

Adult↗

PubMed2006

Effects of repetitive shortwave diathermy for reducing synovitis in patients with knee osteoarthritis: an ultrasonographic study.

BACKGROUND AND PURPOSE: Shortwave (SW) diathermy can be used to improve vascular circulation and reduce inflammation and pain for patients with osteoarthritis. However, reduction in synovial inflammation has never been explored. The purpose of this study was to investigate whether repetitive SW diathermy, using ultrasonographic examination, could reduce synovitis in patients with knee osteoarthritis. SUBJECTS AND METHODS: Thirty subjects with 44 osteoarthritic knees participated in this study. Eleven subjects received SW, and 10 subjects received SW and nonsteroidal anti-inflammatory drugs. Nine subjects received no treatment and served as a control group. Synovial sac thickness superior, medial, and lateral to the patella was measured using ultrasonography. The sum of these 3 measurements was taken as the total synovial sac thickness. Subjects in the treatment groups underwent ultrasonographic examination before and after 10, 20, and 30 treatments, whereas control subjects underwent ultrasonographic examination before the experiment and then once every 2 or 3 weeks for a total of 3 follow-up measurements. RESULTS: After 10 SW diathermy treatments, the total synovial sac thickness in both treatment groups was significantly less than the initial thickness, and the synovial sac continued to become significantly thinner with 20 sessions of treatment. These observations were not made in the control subjects. DISCUSSION AND CONCLUSION: The results indicate that SW diathermy in patients with knee osteoarthritis can significantly reduce both synovial thickness and knee pain. Such reductions of synovial sac thickness and pain index continue over treatment sessions.

Aged↗

PubMed2005

Effects of age and sex on the results of an ankle plantar-flexor manual muscle test.

BACKGROUND AND PURPOSE: The ability to perform 20 or more one-leg heel-rises is considered a "normal" grade for muscle strength (force-generating capacity of muscle) of the ankle plantar flexors, regardless of age and sex. Because muscle strength is closely related to age and sex, the "normal" test criterion was re-evaluated in different groups categorized by age and sex. SUBJECTS AND METHODS: One hundred eighty sedentary volunteers (21-80 years of age) without lower-limb lesions performed as many repetitions of one-leg heel-rise as possible. Lunsford and Perry criteria were used to determine completion of the test. RESULTS: The age and sex of the participants influenced the maximal repetitions of heel-rise, and the repetitions decreased with age and in female subjects. DISCUSSION AND CONCLUSION: The muscle strength of the ankle plantar flexors, as measured by manual muscle testing, varied with age and sex. Clinicians should consider the variances of age and sex when they perform manual muscle testing of the ankle plantar flexors.

Adult↗

PubMed2004

Effects of a home program on strength, walking speed, and function after total hip replacement.

OBJECTIVE: To assess the efficacy of a home exercise program in increasing hip muscle strength, walking speed, and function in patients more than 1.5 years after total hip replacement (THR). DESIGN: Randomized controlled trial. SETTING: Kinesiology laboratory. PARTICIPANTS: Fifty-three patients with unilateral THR were randomly assigned to the training (n=26) and control (n=27) groups. Patients in the training group were further divided into exercise-high (n=13) and exercise-low (n=13) compliance groups according to their practice ratio (high, > or =50%). INTERVENTION: The training group underwent a 12-week home program that included hip flexion range of motion exercises for both hip joints; strengthening exercises for bilateral hip flexors, extensors, and abductors; and a 30-minute walk every day. The control group did not receive any training. MAIN OUTCOME MEASURES: Strength of bilateral hip muscles, free and fast walking speeds while walking over 3 different terrains, and functional performance were assessed by using a dynamometer, videotape analysis, and the functional activity part of the Harris Hip Score, respectively, before and after the 12-week period. RESULTS: Subjects in the exercise-high compliance group showed significantly (P <.05) greater improvement in muscle strength for the operated hip, fast walking speed, and functional score than those in the exercise-low compliance and control groups. CONCLUSIONS: The designed home program was effective in improving hip muscle strength, walking speed, and function in patients after THR who practiced the program at least 3 times a week, but adherence to this home program may be a problem.

Analysis of Variance↗

PubMed2003

Analysis of impairments influencing gait velocity and asymmetry of hemiplegic patients after mild to moderate stroke.

OBJECTIVE: To identify the most important impairments determining gait velocity and asymmetry in patients with mild to moderate stroke. DESIGN: Descriptive analysis of convenience sample. SETTING: Outpatient rehabilitation clinic of a hospital in Taiwan. PARTICIPANTS: Twenty-six subjects with mild to moderate spastic hemiparesis after a single onset of stroke, all able to walk independently without any assistance or device. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Subjects' maximal muscle strength (isokinetic peak torque, total work), motor and sensation function, and ankle plantarflexor spasticity of the affected lower extremity were examined using the Cybex 6000 dynamometry, Fugl-Meyer Assessment, and Modified Ashworth Scale, respectively. Gait velocity, as well as temporal and spatial asymmetry, were evaluated when subjects walked at their comfortable and fast speeds by using the GaitMatII. RESULTS: Regression analyses revealed that the total work isokinetic measures of the affected hip flexors and knee extensors were the most important independent determinants of the comfortable and fast gait velocities, respectively (R(2)=.57, R(2)=.72). Spasticity of the affected plantarflexors was the most important independent determinant of temporal and spatial gait asymmetry during comfortable-speed (R(2)=.76 for temporal asymmetry; R(2)=.46 for spatial asymmetry) and fast-speed (R(2)=.75 for temporal asymmetry; R(2)=.45 for spatial asymmetry) walking. CONCLUSIONS: Gait velocity and asymmetry of patients with mild to moderate stroke were affected by different physical impairments. Whereas gait velocity was mainly affected by weakness of the affected hip flexors and knee extensors, gait asymmetry was influenced primarily by the degree of the spasticity of the affected ankle plantarflexors. Therapeutic interventions aiming to improve different aspects of gait performance of these patients may emphasize treatment of different impairments.

Adult↗

PubMed2002

Test-retest reliability of isokinetic muscle strength of the lower extremities in patients with stroke.

OBJECTIVE: To i the test-retest reliability of isokinetic strength measurements of 3 muscle groups of the lower extremities in stroke patients. DESIGN: Isokineth tests of bilateral hip flexors, knee extensors, and ankle plantarflexors at 2 angular velocities, performed during 2 sessions scheduled 1 week apart for each subject. SETTING: Outpatilitation clinic of a local hospital in Taiwan. PARTICIPANTS: Nts with mild spastic hemiparesis secondary to stroke and with poststroke onset time of at least 6 months. All subjects could communicate and voluntarily move the affected lower extremity. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: The maximal peak torque, total work, and average power of the 3 muscle groups on the affected side examined during each test were quantified by using the normalization and the deficit methods. The normalization method divides the measured strength value by the patient's body weight, whereas the deficit method divides the difference between the strengths of the unaffected and affected extremities by the strength of the unaffected extremity. RESULTS: The normalized strength measures for muscles on the affected side showed good to excellent test-retest reliability (intraclass correlation coefficient [ICC] range,.62-.94; P<.05), whereas the deficit strength measures did not always show good reliability (ICC range,.13-.91). The knee extensors and ankle plantarflexors, but not the hip flexors, on the affected side showed better test-retest reliability of isokinetic strength generated at faster velocity (ICC range,.73-.94) than that generated at slower velocity (ICC range,.62-.88). The normalized peak torque (ICC range,.76-.94) and total work (ICC range,.83-.91) were more reliable than the normalized average power (ICC range,.62-.90) for all 3 muscle groups on the affected side. CONCLUSIONS: Quantitative assessment of muscle strength of the affected lower extremity in patients with mild spastic hemiparesis secondary to stroke is feasible using isokinetic testing. However, the test-retest reliability of isokinetic strength measures is affected by the quantifying method, testing velocity, and strength measures.

Adult↗