Effects of Dual-Task Conditions on Turning Characteristics of Stroke Survivors in Healthcare Environment

Turning is an attentionally demanding task for stroke survivors especially when it involves challenging environments. The aim of this study was to investigate turning characteristics under dual-task conditions (dual motor and dual cognitive) in stroke survivors and healthy controls. We compared the turning characteristics based on the following: (1) staggering, (2) number of steps, (3) time was taken, and (4) strategy used to complete a 180º turn. We found that stroke survivors presented with turning difficulty, especially under dual cognitive task. Forthcoming research is needed to investigate further the social impact of stroke survival in their current environment.© 2016. The Authors. Published for AMER ABRA by e-International Publishing House, Ltd., UK. Peer–review under responsibility of AMER (Association of Malaysian Environment-Behaviour Researchers), ABRA (Association of Behavioural Researchers on Asians) and cE-Bs (Centre for Environment-Behaviour Studies, Faculty of Architecture, Planning & Surveying, Universiti Teknologi MARA, Malaysia.Keywords: Dual-task; stroke; turning; Timed Up & Go tes

PRACTICING OF PHYSICAL EXERCISE AMONG ACADEMIC STAFFS IN FACULTY OF MEDICINE: IS IT VARIES WITH SOCIO-DEMOGRAPHIC CHARACTERISTICS?

Healthy lifestyle and regular physical exercise are well documented preventive factors of several chronic diseases. As the frontline of health care services, medical practitioners should be among the healthiest members of the community. Unfortunately most of the physicians have routinely neglected their own health in favor of their profession and personal obligations. Hence, the stress due to increased workloads and long working shifts may adversely affect the habit of engagement in physical exercise. To evaluate the adequacy of physical exercise performance and to identify the barrier in performing physical exercise among medical staffs A cross sectional study was conducted among the academic staffs of Faculty of Medicine UiTM. Each participant was given structured questionnaire to be answered. The questionnaire consists of 1) socio-demographic and medical details and 2) practice of exercise. A total of 155 participants enrolled. More than half of them were performing exercise. Jogging was the most performed exercise followed by body stretching and cycling. Tiredness, time constraint and work commitment were identified as important barrier in performing exercise. Ethnicity was significantly associated with practice of exercise (x2=4.101, OR: 0.285, 95%CI 0.79-1.02). Clinicality of academic staffs was also associated with adequacy of exercise (x2=3.861, OR: 2.567, 95% CI: 0.99-6.68). Despite living in medical line, lecturers of Faculty of Medicine UiTM practice exercise.&nbsp

Electromyography (EMG) for assessment in low back pain; erector spinae muscle

The purpose of electromyography (EMG) study is to identify which position of surface EMG sensor attached to erector spinae muscle related with lower back pain by squat and stoop lifting technique. This is to avoid lower back pain (LBP) occur during Manual Materials Handling (MMH). There are only one types of upper extremity muscle were chosen to be monitored in this study which is erector spinae (ES) muscle with different electrodes placement on the surface electromyography (sEMG) sensor. However, each of the lifting styles come out with the different reading of root mean square (RMS) frequency for each muscle chosen. In this study, the two subjects consist of two females with normal body mass index (BMI) range from 18.5 to 24.9 with same physical measurement, was selected in order to perform both styles of lifting which are squatting and stooping. For every session the subject will undertake 15 repetitions with 15 minutes rest in between for each movement. In furtherance of to get the analysis muscle activity, proEMG software is used. The results of study for subject female 1 showed that the squat technique had higher levels of muscle activation compared to stoop technique on left erector spinae (LES) muscle. However, the LES muscle activation for subject 2 is greater at stoop activity. On the contrary, squat technique had lower fatigue analysis compared to stoop technique for both subjects on LES muscle. Conclusion, squat technique is better than stoop technique but stoop lift is more natural and spontaneously used for MMH

The Effect of Diabetic Peripheral Neuropathy on Ground Reaction Forces during Straight Walking in Stroke Survivors

Purpose. The aim of this present study was to investigate the ground reaction forces (GRFs) alterations in stroke survivors with diabetic peripheral neuropathy (DPN). Methods. Ten stroke survivors with DPN, 10 stroke survivors without DPN, and 10 healthy controls with matched body weight between groups participated in this case-control cross-sectional study. Three-dimensional GRFs (anterior-posterior, medial-lateral, and vertical) were collected at a comfortable walking speed using the Nexus Vicon motion analysis system and force plate. The Kruskal–Wallis test was used to analyze GRFs parameters. Results. We found significant alterations of medial-lateral forces of the nonparetic side and vertical forces of the paretic side in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. In addition, there were smaller braking and lower propulsion peak in anterior-posterior forces, smaller magnitude of medial-lateral forces, and lower first and second peak of vertical forces in stroke survivors with DPN compared to stroke survivors without DPN and healthy controls. Conclusion. The study findings identified that GRFs were affected in stroke survivors with DPN on both the paretic and the nonparetic sides. Further investigations are warranted to explore the impact of DPN on the kinematics and muscle activity related to the gait performance in stroke survivors with DPN

The impact of diabetic peripheral neuropathy on spatiotemporal gait parameters in stroke survivors: a case-control study

The deterioration of gait performance following stroke is related to the impairment of sensorimotor function on the paretic side. Improper gait performance in post-stroke with additional diabetic peripheral neuropathy (DPN) on paretic and non-paretic legs may create destabilizing effects, including serious injuries and falls. Therefore, this study aimed to investigate the effect of DPN on spatiotemporal gait parameters in stroke survivors and determine the correlation of movement functioning and functional balance post-stroke with gait parameters. Ten stroke survivors with DPN, 10 stroke survivors without DPN and 10 healthy controls participated in this case-control study. Movement functioning and functional balance were assessed before the actual testing. Spatiotemporal gait parameters were recorded using the Nexus Vicon motion analysis system. Kruskal-Wallis test was used to analyze the gait parameters and Spearman’s rank-order correlation coefficient was used to identify the correlation between variables. Results showed that stroke survivors with DPN had longer stride time (temporal gait parameter, p = 0.001), lower cadence (p = 0.001) and greater gait variability than those without DPN and the healthy controls. The gait parameters were significantly correlated with movement functioning and functional balance in stroke survivors with DPN (p < 0.05). These findings suggested that DPN possibly affected the gait parameters in stroke survivors. DPN could also play a role in movement functioning and functional balance in stroke survivors

The impact of diabetic peripheral neuropathy on spatiotemporal gait parameters in stroke survivors: A case-control study

The deterioration of gait performance following stroke is related to the impairment of sensorimotor function on the paretic side. Improper gait performance in post-stroke with additional diabetic peripheral neuropathy (DPN) on paretic and non-paretic legs may create destabilizing effects, including serious injuries and falls. Therefore, this study aimed to investigate the effect of DPN on spatiotemporal gait parameters in stroke survivors and determine the correlation of movement functioning and functional balance post-stroke with gait parameters. Ten stroke survivors with DPN, 10 stroke survivors without DPN and 10 healthy controls participated in this case-control study. Movement functioning and functional balance were assessed before the actual testing. Spatiotemporal gait parameters were recorded using the Nexus Vicon motion analysis system. Kruskal-Wallis test was used to analyze the gait parameters and Spearman’s rank-order correlation coefficient was used to identify the correlation between variables. Results showed that stroke survivors with DPN had longer stride time (temporal gait parameter, p = 0.001), lower cadence (p = 0.001) and greater gait variability than those without DPN and the healthy controls. The gait parameters were significantly correlated with movement functioning and functional balance in stroke survivors with DPN (p < 0.05). These findings suggested that DPN possibly affected the gait parameters in stroke survivors. DPN could also play a role in movement functioning and functional balance in stroke survivors

Postural Control and Gait Performance in the Diabetic Peripheral Neuropathy: A Systematic Review

Purpose. The aim of this paper is to review the published studies on the characteristics of impairments in the postural control and gait performance in diabetic peripheral neuropathy (DPN). Methods. A review was performed by obtaining publication of all papers reporting on the postural control and gait performance in DPN from Google Scholar, Ovid, SAGE, Springerlink, Science Direct (SD), EBSCO Discovery Service, and Web of Science databases. The keywords used for searching were “postural control,” “balance,” “gait performance,” “diabetes mellitus,” and “diabetic peripheral neuropathy.” Results. Total of 4,337 studies were hit in the search. 1,524 studies were screened on their titles and citations. Then, 79 studies were screened on their abstract. Only 38 studies were eligible to be selected: 17 studies on postural control and 21 studies on the gait performance. Most previous researches were found to have strong evidence of postural control impairments and noticeable gait deficits in DPN. Deterioration of somatosensory, visual, and vestibular systems with the pathologic condition of diabetes on cognitive impairment causes further instability of postural and gait performance in DPN. Conclusions. Postural instability and gait imbalance in DPN may contribute to high risk of fall incidence, especially in the geriatric population. Thus, further works are crucial to highlight this fact in the hospital based and community adults

Electromyography analysis of lower extremity muscles during squat and stoop movement

There are different styles of lifting objects of the ground, and each style gives out different percentage of contribution of each muscle. The purpose of this study is to investigate the muscle activity between stooping and squatting to avoid low back pain and how the muscle activities differ from a correct technique of squatting, and an incorrect one. The Rectus Abdominis, Erector Spinae, Quadriceps and Hamstrings muscle were chosen to be monitored for differences in this study. Selected subjects were two healthy males, with the same height and age, one subject has no experience in doing squats - define as amateur, and the other subject know the basic method of squat-ting - define as non-amateur. In order to capture and analyze the activity of the muscles, Myon EMG and ProEMG software were used. Participants performed, stooping and squatting movement for 12 repetitions with 5 minutes' rest in between. The muscle activation strength was obtained by calculating the Root Mean Square of the EMG data. Results shows that the non-amateur gave out greater RMS difference in muscle activation for the Erector Spinae and Rectus Abdominis among other muscles compared to amateur for both stooping and squatting. Another finding was that, the results of a non-amateur were more balanced between both left and right muscles activation compared to the amateur subject. These observations raised the need of mind muscle connection and muscle coordination in order to lift efficiently in order to avoid low back injury

Finite Element Analysis of Cushioned Diabetic Footwear Using Ethylene Vinyl Acetate Polymer

With the development of societies, diabetic foot ulcers have become one of the most common diseases requiring lower extremity amputation. The early treatment and prevention of diabetic foot ulcers can considerably reduce the possibility of amputation. Using footwear to redistribute and relieve plantar pressure is one of the important measures for the treatment and prevention of diabetic foot ulcers. Thus, the evaluation and prediction of the distribution of plantar pressure play an important role in designing footwears. Herein, the finite element method was used to study plantar pressure under two kinds of foot models, namely, the skeletal structure foot model and the whole foot model, to explore the influence of human bones on the pressure of the soles of the feet and obtain accurate foot pressure. Simulation results showed that under the two models, the plantar pressure and the pressure from the footwear with ethylene vinyl acetate were all reduced. The total deformation demonstrated a slight increase. These stresses are very useful as they enable the design of suitable orthotic footwear that reduces the amount of stress in individuals with diabetic foot ulcers