Age-related degenerative changes lead to a gradual decrease in bone mineral density (BMD) and muscle mass. We aimed to assess the effects of decreased BMD and lumbar denervation on lumbar spinal muscle morphometry and the relationship between BMD and lumbar spinal muscular morphometry, respectively. Eighty-one patients, aged 50–85 years, diagnosed with unilateral lumbosacral radiculopathy based on electrodiagnostic studies between January 2016 and April 2021 were enrolled. BMD T scores in the lumbar spine and hip were measured using dual-energy X-ray absorptiometry. The cross-sectional area (CSA) of the psoas, multifidus, and erector spinae located in the middle of the lumbar spine, between the L3 and L4 and between the L4 and L5 levels, respectively, was measured using axial MRI. Functional CSA (FCSA) was defined as the CSA of lean muscle mass. Pearson correlation analyses were performed to evaluate the association between BMD T scores and the CSA, FCSA, and the ratio of the FCSA to the CSA (functional ratio) for each side. The CSA of lumbar spinal muscles showed no significant correlation with lumbar BMD. The FCSA and functional ratio of lumbar spinal muscles were significantly correlated with lumbar BMD. There was no correlation between femur BMD and lumbar spinal muscle morphometry.
Objective: Stroke patients may have balance and gait disturbances due to decreased muscle strength and loss of proprioception. Although previous studies have evaluated balance, walking ability, and functional status of stroke patients, studies that quantitatively evaluate these problems and clarify the correlation between each parameter are insufficient. The purpose of this study was to measure the biomechanical gait parameters of subacute stroke patients and investigate their association with balance and function.Method: A cross-sectional study was conducted on patients admitted with stroke as the main diagnosis between November 2020 and November 2021. Functional evaluation was performed using the Korean version of the Modified Barthel Index (K-MBI) and the Short Physical Performance Battery (SPPB); balance was evaluated using Berg balance scale (BBS), Trunk Control Test (TCT), and Trunk Impairment Scale (TIS). Quantitative gait parameters were measured using the Zebris gait analysis system. Bilateral hand grip strength, and bilateral knee extension and flexion strength were measured using a dynamometer. The correlation between each evaluation item was analyzed using Spearman’s correlation analysis.Results: Analysis confirmed a strong positive correlation between K-MBI and SPPB, indicators of functional status, and BBS, TIS, and TCT, indicators of balance. Grip, knee extension, and knee flexion strength of the hemiplegic side were positively correlated with overall balance and functional status. The hemiplegic side showed a shorter stance phase and a longer swing phase, and these values showed a significant correlation with functional status. Step length, step time, and gait line length were significantly correlated with balance.Conclusion: It may be helpful to focus on measuring and correcting the center of pressure and stance phase of the hemiplegic side during gait for balance and functional status improvements. Quantitative biomechanical gait analysis may be helpful in assessing balance and functional status in patients with subacute stroke.
Background: Shoulder subluxation occurs in 17–64% of hemiplegic patients after stroke and develops mostly during the first three weeks of hemiplegia. A range of shoulder orthoses has been used in rehabilitation to prevent subluxation. However, there is little evidence of their efficacy. AIM: This study aimed to investigate whether there is a difference in the subluxation distance, pain, and functional level of the hemiplegic upper extremity among patients with two different shoulder orthoses. Design: This is a prospective, randomized controlled trial with intention-to-treat analysis. SETTING: Multicenter, rehabilitation medicine department of two university hospitals in South Korea. Population: Forty-one patients with subacute stroke with shoulder subluxation with greater than 0.5 finger width within 4 weeks of stroke were recruited between January 2016 and October 2021. Methods: The experimental group used an elastic dynamic sling while sitting and standing to support the affected arm for eight weeks. The control group used a Bobath sling while sitting and standing. The primary outcome was to assess the distance of the shoulder subluxation on radiography. The secondary outcomes were upper-extremity function, muscle power, activities of daily living, pain and spasticity. Result: The horizontal distance showed significant improvement in the elastic dynamic sling group, but there were no significant differences in the vertical distance between the elastic dynamic and Bobath sling groups. Both groups showed improvements in upper-extremity movements and independence in daily living after 4 and 8 weeks of using shoulder orthoses, and the differences within the groups were significant (p < 0.05). However, there were no significant differences in upper-extremity movements and independence in daily living between the two groups. Conclusions: The subluxation distance showed better results in the elastic dynamic sling, which has both proximal and distal parts, than in the Bobath sling, which holds only the proximal part. Both shoulder orthoses showed improvements in the modified Barthel index, upper-extremity function, and manual muscle testing.
Objective: People with stroke may have balance and gait disturbances due to decreased muscle strength and loss of proprioception. Although previous studies have evaluated balance, walking ability, and functional status of people with stroke, studies that quantitatively evaluate these problems and clarify the correlation between each parameter are insufficient. The purpose of this study was to measure the biomechanical gait parameters of subacute stroke patients and investigate their association with balance and function.Method: A cross-sectional study was conducted on patients admitted with stroke as the main diagnosis between November 2020 and November 2021. Functional evaluation was performed using the Korean version of the Modified Barthel Index and the Short Physical Performance Battery; balance was evaluated using Berg balance scale, Trunk Control Test, and Trunk Impairment Scale. Quantitative gait parameters were measured using the Zebris gait analysis system. Bilateral hand grip strength, and bilateral knee extension and flexion strength were measured using a dynamometer. The correlation between each evaluation item was analyzed using Spearman’s correlation analysis.Results: Analysis confirmed a strong positive correlation between the Korean version of the Modified Barthel Index and the Short Physical Performance Battery, indicators of functional status, and Berg balance scale, Trunk Control Test, and Trunk Impairment Scale, indicators of balance. Grip, knee extension, and knee flexion strength of the hemiplegic side were positively correlated with overall balance and functional status. The hemiplegic side showed a shorter stance phase and a longer swing phase, and these values showed a significant correlation with functional status. Step length, step time, and gait line length were significantly correlated with balance.Conclusion: It may be helpful to focus on measuring and correcting the center of pressure and stance phase of the hemiplegic side during gait for balance and functional status improvements. Quantitative biomechanical gait analysis may be helpful in assessing balance and functional status in patients with subacute stroke.
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