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To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification.
This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions.
Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. In particular, VO2max was significantly (p<0.005) improved in the HIIT group (7.58 mL/kg/min) compared to that in the MICT group (2.42 mL/kg/min). In addition, post-exercise psychological states (i.e., scores of Fatigue Severity Scale [FSS] and depression items of the Hospital Anxiety and Depression Scale [HADS_D]) were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions. HADS-D was improved by 1.89 in the HIIT group compared to decrement of 0.47 in the MICT group. FSS was improved by 6.38 in the HIIT group compared to decrement of 0.77 in the MICT group (p<0.005).
This study demonstrates that HIIT can improve cardiac function, psychological, and activity states in low and moderate risk MI patients. Compared to conventional MICT, HIIT can improve cardiovascular functions, activity states, depression, and fatigue more effectively.
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Intensity of Physical Activity and Depressive Symptoms in College Students: Fitness Improvement Tactics in Youth (FITYou) Project
To investigate the effect of dual-task training on the recovery of balance ability and cognitive function in patients with subacute stroke.
Twenty patients (12 males and eight females; average age, 59.70 years) with subacute stroke were enrolled in this study. All participants were randomly assigned to one of two groups, the dual-task group (n=10) or the control group (n=10). The dual task was simultaneous balance and cognitive training using the BioRescue. All patients were evaluated with posturographic parameters and the Berg Balance Scale for balance ability, a computerized neuropsychological test and the Korean version of the Mini-Mental State Examination for cognitive function, the Fugl-Meyer Assessment for motor function, and the Korean-Modified Barthel Index for activities of daily living (ADL) function before and after 4 weeks of rehabilitation.
The dual-task group showed significant improvements in the pressure of the weight distribution index (WDI), surface area, and length of the stability index during the eyes-open condition; surface area of the limit of stability (LOS) on the hemiparetic and intact sides, and the auditory continuous performance test and backward visual span test after rehabilitation. Although no significant difference was observed for the changes in balance ability or cognitive, motor, and ADL functions between the groups, changes in the WDI pressure during the eyes-open condition and in the area ratio of LOS (hemiparetic/intact) showed a tendency to improve in the dual-task group.
Our findings suggest that dual-task training could be as effective as conventional balance training for improving balance and cognition in subacute post-stroke patients.
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To compare the effect of two different hand exercises on hand strength and vascular maturation in patients who underwent arteriovenous fistula surgery.
We recruited 18 patients who had chronic kidney disease and had undergone arteriovenous fistula surgery for hemodialysis. After the surgery, 10 subjects performed hand-squeezing exercise with GD Grip, and other 8 subjects used Soft Ball. The subjects continued the exercises for 4 weeks. The hand grip strength, pinch strength (tip, palmar and lateral pinch), and forearm circumference of the subjects were assessed before and after the hand-squeezing exercise. The cephalic vein size, blood flow velocity and volume were also measured by ultrasonography in the operated limb.
All of the 3 types of pinch strengths, grip strength, and forearm circumference were significantly increased in the group using GD Grip. Cephalic vein size and blood flow volume were also significantly increased. However, blood flow velocity showed no difference after the exercise. The group using Soft Ball showed a significant increase in the tip and lateral pinch strength and forearm circumference. The cephalic vein size and blood flow volume were also significantly increased. On comparing the effect of the two different hand exercises, hand-squeezing exercise with GD Grip had a significantly better effect on the tip and palmar pinch strength than hand-squeezing exercise with Soft Ball. The effect on cephalic vein size was not significantly different between the two groups.
The results showed that hand squeezing exercise with GD Grip was more effective in increasing the tip and palmar pinch strength compared to hand squeezing exercise with soft ball.
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To investigate the effect of virtual reality on the recovery of cognitive impairment in stroke patients.
Twenty-eight patients (11 males and 17 females, mean age 64.2) with cognitive impairment following stroke were recruited for this study. All patients were randomly assigned to one of two groups, the virtual reality (VR) group (n=15) or the control group (n=13). The VR group received both virtual reality training and computer-based cognitive rehabilitation, whereas the control group received only computer-based cognitive rehabilitation. To measure, activity of daily living cognitive and motor functions, the following assessment tools were used: computerized neuropsychological test and the Tower of London (TOL) test for cognitive function assessment, Korean-Modified Barthel index (K-MBI) for functional status evaluation, and the motricity index (MI) for motor function assessment. All recruited patients underwent these evaluations before rehabilitation and four weeks after rehabilitation.
The VR group showed significant improvement in the K-MMSE, visual and auditory continuous performance tests (CPT), forward digit span test (DST), forward and backward visual span tests (VST), visual and verbal learning tests, TOL, K-MBI, and MI scores, while the control group showed significant improvement in the K-MMSE, forward DST, visual and verbal learning tests, trail-making test-type A, TOL, K-MBI, and MI scores after rehabilitation. The changes in the visual CPT and backward VST in the VR group after rehabilitation were significantly higher than those in the control group.
Our findings suggest that virtual reality training combined with computer-based cognitive rehabilitation may be of additional benefit for treating cognitive impairment in stroke patients.
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Method Fifty-nine subacute hemiparetic stroke in-patients participated in this study. All patients were randomly assigned to one of two groups: the control group and the experimental group. Both groups received the same conventional physical therapies for 4 weeks. The experimental group received an additional core strengthening program (CSP). Korean mini-mental state examination (K-MMSE) and Korean Modified Barthel Index (K-MBI) were performed on admission. CSP was performed for 30 minutes a day, 3 days per week for 4 weeks. We selected nine exercises available for stroke patients, and divided them as three steps according to the degree of difficulty. Because of the muscle weakness in stroke patients, a physical therapist often helped them during exercise. Outcome measurement included trunk control test (TCT), trunk impairment scale (TIS), and Berg balance scale (BBS) and we compared both groups before and after the period of training.
Results There were no significant differences in baseline general characteristics and initial values between the two groups. After rehabilitation therapy, both groups showed significant improvements in BBS, TIS, and TCT (p＜0.05). Following 4 weeks of therapy, changes of BBS, TIS score in the experimental group were significantly higher than those of the control group (p＜0.05). However, the change of TCT score was not significantly different.
Conclusion Analysis of different clinical parameters showed that better outcomes in BBS, TIS scores were achieved from CSP. This study suggests that CSP conducted for 4 weeks may be beneficial as a therapeutic technique for use in improvement of trunk balance in patients with subacute hemiparetic stroke.
Method: Fifty subjects with brain injury were enrolled and classified into two groups, experimental (n=25) and control group (n=25). Control group received conventional reha bilitation therapy including physical and occupational therapy. Experimental group received additional computer- assisted cognitive training using CogRehabKⰒ software consisted of 10 level-completing programs, 3 times per week, 30 minutes per session, for 4 to 6 weeks. All patients were assessed their cognitive functions using Seoul Computerized Neuropsychological Test (SCNTⰒ, Maxmedica, 2001), minimental status examination (MMSE), digit span, and Wechsler memory scale before and after treatment. Functional independence measure and geriatric depression scale were also applied for evaluation of functional and mood status.
Results: Before the treatment, two groups showed no difference in their cognitive functions. After 4 to 6 weeks of treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test, and visual continuous performance test in CNT and MMSE than control group (p＜0.05).
Conclusion: We conclude that the CogRehabKⰒ may be useful as an additional tool for the cognitive rehabilitation in patients with brain injury. (J Korean Acad Rehab Med 2003; 27: 830-839)
Method: Ten memory training programs, which included verbal/non-verbal, sequential/ non-sequential, and visual/auditory memory properties were designed and converted to the computer program using C-language. The training program included various aspects of memory such as spatial memory, sequential verbal and nonverbal recall, associated recall, categorical memory, and integrated semantic memory. Each program used familiar pictures and sounds in our living situation to give the patients comfortable feelings and interests. Seven patients with brain injury were trained using the computer-assisted memory program 3 times per week for 4 weeks. All patients were assessed their cognitive function using Seoul Computerized Neuropsychological Test (Maxmedica) before and 1 month after the treatment.
Results: Ten computer-associated memory training programs using C-language were successfully developed. The patients who were trained with computer-assisted memory programs showed higher performances in forward digit span, backward digit span, backward visual span, verbal learning, visual controlled continuous performance, auditory controlled continuous performance, and finger tapping tests after than before the treatment.
Conclusion: The computer-assisted memory training can be used as an additional tool for memory rehabilitation in patients with brain injury.
Objective: To evaluate the effect of computer-assisted cognitive rehabilitation program on cognitive function of the patients with brain injury.
Method: Twenty seven subjects with brain injury (23 males, 4 females) were enrolled and classified into two groups, experimental and control group. There was no significant difference between two groups in age and postonset duration. Control group received conventional rehabiliation therapy including physical and occupational therapy. Experimental group received additional computer- assisted cognitive training using PSS CogRehab software (USA, 1995), 3 times per a week, 30 minutes per session, for 4 weeks. The PSS CogRehab software consisted of foundation, memory, visual spatial and problem solving categories with 45 indivisualized training programs. These
45 programs are arranged according to the degree of difficulty. All patients were assessed their cognitive function using Computerized Neuropsychological Test (Mirae engineering, 1999) before treatment and at 1 month after treatment.
Results: Before the treatment, two groups showed no difference in their cognitive function. After 1 month treatment, the experimental group showed significantly higher performance in forward digit span, forward visual span, auditory continuous performance test and visual controlled continuous performance test than control group (p＜0.05).
Conclusion: Computer-assisted cognitive training would be useful as a additional tool of cognitive rehabilitation in patients with brain injury. (J Korean Acad Rehab Med 2002; 26: 1-8)
Objective: To evaluate the results of driver training program for the handicapped.
Method: Retrospective study on the 699 disabled who participated in the two-months driver training program at the NRC (National Rehabilitation Center) from January 1995 to May 1998.
Results: 1) Of these subjects, 70.4% were men and 29.6% were women. 2) According to the disability grading system by the Ministry of Health and Social Welfare of Korea, 19.2% of the subjects had the first grade disability, 28.2% the second grade, 26.3% the third grade, 18.3% the fourth grade, 6.3% the fifth grade, and 1.4% the sixth grade. 3) The licensing rate was 74.6% for the first grade, 64.7% for the second grade, 70.9% for the third grade, 73.6% for the fourth grade, 55.8% for the fifth grade, and 70% for the sixth grade. 4) The licensing rate was the highest in the subjects with spinal cord injury (79.2%) and the lowest in the subjects with stroke (45.0%). 5) Overall, 78.2% of subjects licensed with automatic transmission and 21.8% with hand- control. On the other hand, in the subjects with spinal cord injury, 42.5% licensed with automatic transmission and 57.5% with hand-control.
Conclusion: The mean licensing rate of this program was 69.2%. Further study is required for the effect of cognitive function on driving test and various driving aids to promote the licensing rate for the handicapped.
Objective: To examine the effects of unilateral leg exercise on the contralateral leg and the cross training effect according to the training intensity.
Method: Nineteen healthy males volunteered to be subjects for this investigation and were divided into a training group (N=13) and a control group (N=6). One leg of each subject in the training group was randomly assigned to a six week, three day/week isokinetic strengthening training program for concentric knee extension-flexion performed at 60 degrees/second (group A, N=6) and 180 degrees/second (group B, N=7). The control group did not train for six weeks. The strength of the knee extensor and flexor was tested before and after the six week period training by Cybex 770 dynamometer.
Results: In both groups A and B, the training resulted in significant increase of knee extensor strength in trained limb compared to control group. However, the strength increment of untrained limb was not significant compared to control group.
Conclusion: There was no significant cross training effect following unilateral leg strength exercise.
Objective: The purpose of this study is to compare muscle strength, endurance and the change of myosin heavy chain isoform after sprint training(ST) and heavy resistance training(HRT).
Method: Fourteen young athletes were enrolled and were randomly assigned into each training group. Before and after training for 8 weeks, the strength and the endurance were evaluated using isokinetic exercise system(Cybex 6000). The specimens of muscle biopsy were obtained from vastus lateralis muscle and were analysed for muscle fiber type using one dimensional electrophoresis.
Results: Peak torque, total work and mean power were increased significantly in both groups, but endurance ratio increased only in the sprint training group(P＜0.05).
The proportions of myosin heavy chain(MHC) IIa fibers were increased in both groups and those of MHC IIb fibers were decreased in both groups(P＜0.05). MHC I fibers were significantly increased in ST group, but decresed in HRT group(P＞0.05).
Conclusion: This study shows that it is possible to increase muscle strength and to achieve fiber type transformation with the sprint training and the high resistance training.
Respiratory insufficiency is a common cause of morbidity and mortality in patients with Duchenne muscular dystrophy(DMD). In these patients, progressive muscle weakness is a major factor in the development of respiratory insufficiency. Therefore, the physical training program to improve the strength and endurance of respiratory muscle could conceivably improve respiratory function and prevent respiratory complication in patients with DMD.
The purpose of this study is to examine the effects of inspiratory muscle training on respiratory function of DMD patients according to functional state.
Eighteen DMD patients who were registered at the Muscle clinic of Yong Dong Severance Hospital were assessed for the pulmonary function using the routine pulmonary function test and measurements of maximal static pressures at 6 weeks before the training, at the beginning of training, and after the end of 6 week-training. The first 6 weeks were used as a control period. Inspiratory muscle training consisted of breathing through Threshold inspiratory muscle trainer (IMT) at 30% of patients' maximal inspiratory pressures(MIP) for 15 minutes twice a day and the 'endurance time' was recorded weekly for an assessment of inspiratory muscle endurance.
This study showed significant improvement of MIP and endurance time after the training in both ambulatory and wheelchair-bound patients. The amounts of improvement were greater in the patients with a better functional state and greater baseline forced vital capacity.
We conclude that, in the early stages of DMD, inspiratory muscle training with pressure threshold device is more useful when the forced vital capacity is well preserved.
The purpose of this study is to clarify the clinical usefulness of Computerized Balance Evaluation and Training System(COBETS) in treating the patients with balance disturbance. Twenty- three patients who received rehabilitative management due to their balance disturbance after brain damage were treated either by conventional physical therapy(PT) or by visual biofeedback balance training(VBBT) using COBETS for 4 weeks. The static and dynamic postural balance were evaluated at pre- and post-treatment conditions using COBETS balance assessment software. The neurologic and functional assessment and somatosensory evoked potential study were performed as well.
Comparing with the control group, the patients treated by VBBT showed significantly improved static and dynamic postural control.
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