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This study investigated the effects of comprehensive core body resistance exercise on lower extremity motor function in stroke survivors. This resistance exercise was developed to aid stroke patients with various severity to perform this exercise, aimed to improve their core strength, stability, and control. Thirty-four stroke patients aged 47.7±13.16 years old were selected from the Rehabilitation Department, Queen Elizabeth I Hospital in Sabah, Malaysia. All patients underwent supervised training either assistive, active or active resistance exercise, biweekly for 12 weeks. Motor function was evaluated using Fugl-Meyer Assessment Lower Extremity (FMA-LE). The data were collected at baseline and at four weeks training interval. Repeated measures ANOVA and paired t test were employed to analyse the effects of the resistance exercise on lower extremity motor function. The twelve-week resistance exercise showed statistically significant effects on lower extremity motor function, lower extremity, coordination/speed, passive joint motion, and joint pain. However, sensation was found insignificant. Paired t test showed statistically significant improvement in lower extremity motor function, lower extremity, coordination/speed, passive joint motion, joint pain, and sensation. This study suggested that the obtained results indicate that the core body resistance exercise was applicable without any induced negative effect such as spasticity or joint pain.

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Paresis of the upper and lower limbs is a typical issue in stroke survivors. This study aims to determine whether core exercises help stroke survivors with very severe motor impairment recover their motor function. This study employed a within-subjects design. Eleven hemiparetic stroke patients with very severe motor impairment (FMA score < 35) and ages ranging from 24 to 52 years old were enrolled in this study. All participants engaged in supervised core exercise training twice a week for 12 weeks. The main outcome measures were Fugl-Meyer Assessment Lower Extremity (FMA-LE) and Fugl-Meyer Assessment Upper Extremity (FMA-UE), which were measured before training and at intervals of four weeks during training. Repeated measures ANOVA was used to analyze the effect of core exercises on motor function performance and lower extremity motor function and upper extremity motor function recovery. There were significant differences in the mean scores for motor function performance, lower extremity motor function, and upper extremity motor function throughout the four time points. A post-hoc pairwise comparison using the Bonferroni correction revealed that mean scores significantly increased and were statistically different between the initial assessment and follow-up assessments four, eight, and twelve weeks later. This study suggests that 12 weeks of core exercise training is effective for improving motor function recovery in patients with very severe motor impairment.

Cardiopulmonary capacity should be evaluated accurately to determine exercise intolerance and training intensity of stroke survivors before an exercise rehabilitation programme is prescribed. However, no cardiopulmonary exercise test (CPET) is suitable because of the stroke victims' physical impairment. The aim of this study was to develop and validate a new rowing-ramp protocol as a CPET for stroke survivors. Eleven stroke patients (6 male; 5 female; age, 45 + 16.01 years, performed two incremental exercise tests on a Concept II rowing ergometer to determine the peak oxygen consumption (VO 2 peak). Test-retest reliability for VO 2 peak, measured 1-week apart, resulted in an intra-class correlation of 0.97 and 0.95, respectively. A linear regression equation was developed to predict the VO 2 peak from final stage stroke power. Validity and reliability of the prediction equation were established. The regression equation for predicted VO 2 peak was VO 2 peak=11.429±+ 0.232 (Final Stage Stroke Power) + 12.63 (F=25.326, p<0.01; R=0.859, R 2 =0.738). Limits of agreement between predicted and measured VO 2 peak were acceptable, with a mean bias of 0.37 ml/kg/min. The validity coefficient (R) was 0.83 (p<0.01) and 0.81 (p<0.01) in both trials. Test-Retest reliability coefficient for predicted VO 2 peak 0.95 (p<0.01). The positive relationship between Final Stage Stroke Power and VO 2 peak suggests that the Rowing-Ramp protocol could be used to measure VO 2 peak of stroke survivors. Additional studies are needed to cross-validate the regression equation using larger sample size, different type and severity of stroke.

Musculoskeletal disorder (MSD) is a major health problem, which can lead to an enormous burden to the institution as well as chronic disability to the individual. Teachers are at risk of developing MSD due to the exposure to various ergonomic risk factors. Teachers of special education, for example, are expected to perform extra duty such as lifting and moving students, feeding food, changing diapers, and helping them in ambulation. Although there is an adequate amount of scientific research on MSD’s prevalence and its risk factors among regular teachers, only few studies have focused on special education teachers. This review aimed to address these gaps by describing the evidence from various papers on the prevalence of MSD among regular and special education teachers and the related risk factors. The papers have been gathered using electronic databases, including PubMed, Science Direct, Google Scholar, and Springer. The prevalence of MSD among regular teachers ranges from 48.7% to 73.7%, while the prevalence ranges from 38.7% to 94% in special education teachers. Risk factors, such as individual (age, duration of teaching, working hours, and work burden), physical (teaching activities, affected body areas), and psychological factors (stress, anxiety, fear), were identified. From the review, it is recommended to implement ergonomically designed workplaces, comprehensive ergonomic training, psychological approaches, and functional training among teachers at risk.

Background Aerobic exercise can increase oxidative stress, but it can produce the necessary stimulus for physiological adaptation of exercise. However, the effects of intensity and duration of exercise on oxidative stress status are unclear. This study aimed to compare the effects of exercise intensity (I) and duration (D) on the oxidative stress [malondialdehyde (MDA)], and the responses of the antioxidant enzymes [catalase (CAT), glutathione peroxidase (GPx), superoxide dismutase (SOD), antioxidant enzymes ratio (AE)] among sedentary adults. Methods In a randomized crossover design, 25 sedentary adults, performed nine cycling exercise sessions with a constant load of 50%, 60% and 70% VO2peak for 10-, 20- and 30- minutes duration. Plasma MDA, CAT, GPx and SOD activity were measured before exercise (baseline) and immediately after each session (post). Results The interaction effect of intensity and duration was significant for percentage changes of MDA (FIxD=3.59, df=4, p<0.05) and CAT activity (FIxD =3.38, df=2.146, p<0.05). Repeated Measures ANOVA analysis revealed that intensity is the major controlling factor for MDA (FI =54.24, df=2, p<0.05 vs FD=8.62, df=2, p<0.05), and CAT responses (FI =14.24, df=1.619, p<0.05 vs FD = 5.96, df=1.347, p<0.05). However, the main determinant factor for SOD (FD =11.82, df=1.166, p<0.05 vs FI =5.58, df=1.289, p<0.05) and AE (FD =11.63, df=1.201, p<0.05 vs. FI =3.035, df=1.32, p>0.05) is exercise duration. Conclusions These findings suggest that exercise intensity was an essential factor of acute oxidative stress and antioxidant enzyme responses compared with the duration of exercise.

Background: Home-based exercise (HBE) and patient education (EDU) have been reported as beneficial additions to usual knee osteoarthritis (KOA) rehabilitation. However, previous trials mostly examined the effects of HBE and EDU separately. Thus, this study aimed to evaluate the effects of a structured combined HBE and EDU program in addition to usual KOA rehabilitation on pain score, functional mobility, and disability level. Study Design: A parallel-group, single-blinded randomized controlled trial. Methods: Eighty adults with KOA were randomly allocated to experimental (n=40) and control (n=40) groups. All participants underwent their usual physiotherapy care weekly for eight weeks. The experimental group received a structured HBE+EDU program to their usual care, while the control group performed home stretching exercises to equate treatment time. The Knee Injury and Osteoarthritis Outcome Score (KOOS) for the disability level, visual analogue scale (VAS) for pain, and timed up-and-go test (TUG) for mobility were measured pre-post intervention. Results: After eight weeks, the experimental group demonstrated significant improvements in the KOOS (all subscales), pain VAS, and TUG scores compared to baseline (P<0.001); meanwhile, only KOOS (activities of daily living and sports subscales) was significant in the control group. Relative to the control, the experimental group presented higher improvements (P<0.001) by 22.2%, 44.1%, and 15.7% for KOOS, pain VAS, and TUG, respectively. Conclusion: Integrating the HBE+EDU program into usual KOA rehabilitation could reduce pain and disability, while it improved functional mobility. The finding of this study suggests a combination of a structured HBE and EDU program to be considered as part of mainstream KOA management.