Measurement of excitation-contraction coupling time in lower extremities

Objective: The aim of this study was to apply a novel method to measure excitation-contraction coupling time (ECCT) in normal soleus muscles. Methods: We performed simultaneous recordings of soleus compound muscle action potential (CMAP) and foot movement-related potential (MRP), and measured ankle plantar flexion torque in 36 healthy subjects. We calculated ECCT and examined the relations between CMAP, MRP, ECCT and ankle plantar flexion torque. Results: Statistical analyses established reference ranges (mean ± SE) for CMAP (13.4 ± 0.9 mV), MRP (5.3 ± 0.4 m/s²), ECCT (5.2 ± 0.1 ms), torque (85.9 ± 6.4 Nm) and torque/body weight (1.4 ± 0.1 Nm/kg). The torque showed a positive linear correlation with CMAP (p = 0.041) and a negative linear correlation with ECCT (p = 0.045). Conclusion: Soleus ECCT can be recorded easily, and is useful to assess the impairment of E-C coupling in muscles of the lower extremities.     

Walking Attainment in Very Low Birth Weight Infants in Japan

Objective: To clarify the corrected age of walking attainment in very low birth weight infants by birth weight and gestational age, and determine perinatal factors affecting the delay in walking attainment. Method: This was a longitudinal study. We investigated walking attainment and perinatal factors in 145 very low birth weight infants without neurological abnormalities (mean birth weight 1019.3 ± 299.7 g, gestational age 29.0 ± 2.9 weeks). The study infants were stratified by birth weight (group A: <1,000 g, group B: 1,000 g≤, <1,500 g) and gestational age (group I: <28 weeks, group II: 28 weeks≤, <37 weeks) and were compared using unpaired t-tests. Furthermore, we examined the perinatal factors that affect the delay in walking attainment using multiple regression analysis. Results: Of the walking attainment, infants in Group A were older than those in Group B (50th percentile, 15.8 vs. 14.7 months). Infants in Group I were older than those in Group II (50th percentile, 16.0 vs. 14.8 months). Using multiple regression analysis with walking attainment age as the dependent variable, the duration of mechanical ventilation was found to be significantly related. Conclusion: Very low birth weight infants with light weight and short gestational age have delayed walking attainment, and longer duration of mechanical ventilation increases the risk of delay.     

The Feasibility of a Newly Developed Local Network System for Cardiac Rehabilitation (the CR-GNet) in Disease Management and Physical Fitness after Acute Coronary Syndrome

Objective: To examine the Cardiac Rehabilitation Gifu Network (CR-GNet) feasibility in managing diseases and assisting patients in attaining physical fitness, and its impact on long-term outcomes after acute coronary syndrome (ACS). Methods: In this prospective observational study, we enrolled 47 patients with ACS registered in the CR-GNet between February 2016 and September 2019. 37, 29, and 21 patients underwent follow-up assessments for exercise capacity (peak oxygen uptake) at 3 months, 6 months, and 1 year after discharge, respectively. Major adverse cardiac events (MACE) were compared with controls not registered in the CR-GNet. Results: The coronary risk factors, except blood pressure, improved at 3 and 6 months, and 1 year after discharge. These risk factors in each patient significantly reduced from 2.9 at admission to 1.6, 1.4, and 1.9 at 3 months, 6 months, and 1 year after discharge (p<0.05), respectively. Peak oxygen uptake was significantly higher at 3 months (17.5±4.9 ml/kg/min), 6 months (17.9±5.1 ml/kg/min), and 1 year (17.5±5.5 ml/kg/min) after discharge than that at discharge (14.7±3.6 ml/kg/min) (p<0.05). During follow-up, there was no significant difference; MACE did not occur in any patients in the CR-GNet but occurred in controls. Conclusion: CR-GNet is a feasible option for the long-term management of ACS patients.     

Monophasic Pulsed Current Stimulation of Duty Cycle 10% Promotes Differentiation of Human Dermal Fibroblasts into Myofibroblasts

Objective: Many clinical trials have shown the therapeutic effects of electrical stimulation (ES) in various conditions. Our previous studies showed that ES (200 μA and 2 Hz) promotes migration and proliferation of human dermal fibroblasts (HDFs). However, the effective duty cycle and the effect of ES on myofibroblast differentiation are unclear. This study aimed to investigate the relationship between duty cycle and myofibroblast differentiation. Methods: HDFs were subjected to ES (200 μA and 2 Hz) for 24 h with the duty cycle adapted at 0% (control), 10%, 50%, or 90%. α-smooth muscle actin (SMA) and transforming growth factor (TGF)-β1 mRNA and α-SMA protein expressions were assessed. Collagen gel contraction was observed for 48 h after ES initiation and the gel area was measured. Cell viability and pH of culture medium were analyzed for cytotoxicity of the ES. Results: Cell viabilities were decreased in the 50% and the 90% groups but ES did not influence on pH of culture media. ES with a duty cycle of 10% significantly promoted the mRNA expression of α-SMA and TGF-β1. α-SMA protein expression in the 10% group was also significantly higher than that of the control group. Collagen gel subjected to ES with a duty cycle of 10% was contracted. Conclusion: Duty cycle can influence on myofibroblast differentiation and ES with a duty cycle 10% is the effective for wound healing.     

Efficacy of physical exercise using the balance board game on physical and psychological function in patients with hematological malignancies confined to a bioclean room

Objective: This study aimed to define the efficacy and features of physical therapy (PT) using the Nintendo Wii Fit U (Nintendo Inc., Kyoto, Japan) in patients with hematological malignancies confined to a bioclean room. Method: A total of 33 patients with hematological malignancies confined to a bioclean room were enrolled in this study. This study was designed as a randomized crossover test between two weeklong interventions: PT program (Therapist PT) and Wii Fit U program (Wii PT). We compared the efficacy of Wii PT and Therapist PT with regard to physical and psychological function test scores. Results: Of the 33 patients, 22 were analyzed. The validity of the crossover design was demonstrated, as there were no significant differences in period and carryover effects between the two groups. Therapist PT resulted in significantly better improvements in fatigue scores and total mood disturbance (TMD) scores in the Profile of Mood States short-form Japanese version compared to Wii PT (fatigue score, -5.2±8.3 vs 2.7±8.2; TMD score, -22.5±32.8 vs -2.6±20.5; p<0.05). Physical function improved post-Wii PT and post-Therapist PT interventions (p<0.05), and there was no difference in treatment effect. Conclusion: Improvements in physical function were clearly observed following the use of Wii PT in patients confined to a bioclean room. However, compared to Therapist PT, Wii PT was less effective in improving the psychological function of patients.     

Relationship between first mobilization following the onset of stroke and clinical outcomes in patients with ischemic stroke in the general ward of a hospital: A cohort study

Objective: The purpose of this study was to compare the effects of first mobilization following a stroke with independently performing the activities of daily living at discharge in acute phase ischemic stroke patients in a general ward of a hospital. Methods: A total of 158 patients with ischemic strokes were admitted to a general ward from June 1, 2014 to March 31, 2015. Of the 158 patients, 53 met the study''s eligibility criteria. First mobilization was defined as the transfer of a patient from the bed to a wheelchair by a rehabilitation therapist. A favorable primary outcome at discharge was defined as a modified Rankin Scale score of < 3. The outcome was analyzed using the proportional hazards analysis and receiver operating characteristic curves. Results: The age of the participants was 78.2 ± 11.7 years, stroke severity evaluated by the National Institutes of Health Stroke Scale scores on admission was 14.3 ± 10.6 points, and first mobilization of this population was 6.4 ± 5.2 days. Thirteen [25%] patients had a favorable outcome. Hazards analysis showed a favorable outcome due to first mobilization (adjusted hazards ratio 0.80, 95% confidence interval 0.65-0.98; p < 0.05). The cutoff point for first mobilization to produce a favorable outcome was 6.5 days after the stroke onset (area under the curve 0.729; p < 0.05). Conclusion: As seen in stroke units, early first mobilization is associated with improved clinical outcomes in ischemic stroke patients admitted to a general ward.     

Importance of knee flexion range of motion during the acute phase after total knee arthroplasty

Background: We investigate the association with knee flexion range of motion (ROM) during the acute phases and that at 12 months after total knee arthroplasty (TKA). We also clarified the cut-off ROM during the acute phases in predicting the goal of knee flexion ROM at 12 months. Methods: In this retrospective study, 193 patients with knee osteoarthritis (female:144 patients, age:73.2 ± 7.7 years) who underwent unilateral TKA at an orthopedic clinic were recruited. They underwent assessments of knee flexion ROM at 5 days, 1 month, and 12 months after TKA. The goal of knee flexion ROM at 12 months after TKA was set at 120°. Single and logistic-regression analyses were performed with the dependent variables including the outcome of the goal of knee flexion ROM at 12 months, and the independent variables included knee flexion ROM at 5 days and 1 month, separately. We calculated the cut-off ROM at 5 days and 1 month for predicting the goal of knee flexion ROM at 12 months with receiver operating curve analysis. Results: Knee flexion ROM at 5 days and 1 month were significantly associated with the goal of that at 12 months (p < 0.01). The cut-off ROM were 85° at 5 days and 105° at 1 month separately. Conclusions: Our results suggest the importance of early improvement in knee flexion ROM after TKA, and that at 1 month postoperatively indicates the likelihood of achievement of the goal of knee flexion ROM at 12 months after TKA.     

Statistical Inference for Ergodic Algorithmic Model (EAM), Applied to Hydrophobic Hydration Processes

The thermodynamic properties of hydrophobic hydration processes can be represented in probability space by a Dual-Structure Partition Function {DS-PF} = {M-PF} · {T-PF}, which is the product of a Motive Partition Function {M-PF} multiplied by a Thermal Partition Function {T-PF}. By development of {DS-PF}, parabolic binding potential functions α) RlnK_dual = (−ΔG°_dual/T) ={f(1/T)*g(T)} and β) RTlnK_dual = (−ΔG°_dual) = {f(T)*g(lnT)} have been calculated. The resulting binding functions are “convoluted” functions dependent on the reciprocal interactions between the primary function f(1/T) or f(T) with the secondary function g(T) or g(lnT), respectively. The binding potential functions carry the essential thermodynamic information elements of each system. The analysis of the binding potential functions experimentally determined at different temperatures by means of the Thermal Equivalent Dilution (TED) principle has made possible the evaluation, for each compound, of the pseudo-stoichiometric coefficient ±ξ_w, from the curvature of the binding potential functions. The positive value indicates convex binding functions (Class A), whereas the negative value indicates concave binding function (Class B). All the information elements concern sets of compounds that are very different from one set to another, in molecular dimension, in chemical function, and in aggregation state. Notwithstanding the differences between, surprising equal unitary values of niche (cavity) formation in Class A <Δh_for>_A = −22.7 ± 0.7 kJ·mol⁻¹ ·ξ_w⁻¹ sets with standard deviation σ = ±3.1% and <Δs_for>_A = −445 ± 3J·K⁻¹·mol⁻¹·ξ_w⁻¹J·K⁻¹·mol⁻¹·ξ_w⁻¹ with standard deviation σ = ±0.7%. Other surprising similarities have been found, demonstrating that all the data analyzed belong to the same normal statistical population. The Ergodic Algorithmic Model (EAM) has been applied to the analysis of important classes of reactions, such as thermal and chemical denaturation, denaturation of proteins, iceberg formation or reduction, hydrophobic bonding, and null thermal free energy. The statistical analysis of errors has shown that EAM has a general validity, well beyond the limits of our experiments. Specifically, the properties of hydrophobic hydration processes as biphasic systems generating convoluted binding potential functions, with water as the implicit solvent, hold for all biochemical and biological solutions, on the ground that they also are necessarily diluted solutions, statistically validated.     

Initiation gait variability is higher in the morning in elderly inpatients

Objective: Although elderly inpatients are known to experience decreased physical activity in the morning, falls occur frequently during this time. Gait variability is an evaluation of gait instability and a risk factor for falls. Gait initiation requires complex processes, and it is important to evaluate gait variability not only during steady-state gait but also during gait initiation. However, the effect of the diurnal pattern on variability in gait characteristics is still unknown. The aim of this study was to investigate the effect of the diurnal pattern on initiation and steady-state gait variability in elderly inpatients. Method: Thirty-seven elderly inpatients (28 women; mean age, 79.7 ± 9.5 years) who could walk without support were sampled in this study. The quantitative measure of gait variability was evaluated using the coefficient of variation (CV) based on four consecutive stride durations determined using triaxial accelerometers. Gait characteristics were evaluated during initiation and steady-state gait and defined as initiation CV and steady-state CV, respectively. This measurement was performed at two time points, morning and daytime. Results: There was no significant difference between initiation and steady-state gait characteristics in the daytime condition. However, in the morning condition, the initiation CV was higher than the steady-state CV. Furthermore, the initiation CV was higher in the morning than during daytime (p < 0.01). Conclusion: Our study revealed that the variability of initiation gait is higher in the morning. It may be important to assess the risk of falls, including initiation gait, in the morning.     

Information Dark Energy Can Resolve the Hubble Tension and Is Falsifiable by Experiment

We consider the role information energy can play as a source of dark energy. Firstly, we note that if stars and structure had not formed in the universe, elemental bits of information describing the attributes of particles would have exhibited properties similar to the cosmological constant. The Landauer equivalent energy of such elemental bits would be defined in form and value identical to the characteristic energy of the cosmological constant. However, with the formation of stars and structure, stellar heated gas and dust now provide the dominant contribution to information energy with the characteristics of a dynamic, transitional, dark energy. At low redshift, z < ~1.35, this dark energy emulates the cosmological constant with a near-constant energy density, w = −1.03 ± 0.05, and an energy total similar to the mc² of the universe’s ∼10⁵³ kg of baryons. At earlier times, z > ~1.35, information energy was phantom, differing from the cosmological constant, Λ, with a CPL parameter difference of ∆w_o = −0.03 ± 0.05 and ∆w_a = −0.79 ± 0.08, values sufficient to account for the H₀ tension. Information dark energy agrees with most phenomena as well as Λ, while exhibiting characteristics that resolve many tensions and problems of ΛCDM: the cosmological constant problem; the cosmological coincidence problem; the H₀ tension, and the σ₈ tension. As this proposed dark energy source is not usually considered, we identify the expected signature in H(a) that will enable the role of information dark energy to be falsified by experimental observation.     

Isokinetic trunk and knee muscle strengths and gait performance in walking patients with T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP)

The aim of this study was to investigate the isokinetic trunk and knee muscle strengths, and examine the clinical relevance of dynamic muscle strengths and gait performance in walking patients with human T-cell lymphotropic virus type 1-associated myelopathy/ tropical spastic paraparesis (HAM/TSP). Thirteen patients with HAM/TSP (8 females and 5 males, aged 38–76) and 13 sex- and age-matched healthy control subjects participated in the study. We assessed gait speed, stride length, cadence; and maximal isokinetic torque of trunk and knee extensors and flexors at 30°/s, 60°/s and 90°/s using a Biodex System 3 dynamometer. Furthermore, we calculated the isokinetic trunk extensor/flexor (E/F) and hamstrings/quadriceps (H/Q) strength ratios (parameter of the muscle strength balance about the trunk and knee joint). Compared with the age-matched controls, the patients with HAM/TSP had significantly reduced gait speed, stride length and cadence (P < 0.05). Peak torque values related to body weight (PTBW) were significantly reduced, especially for the knee flexors (P < 0.05). For the knee extensors, the PTBW values were significantly reduced at an increased angular velocity (P < 0.05). The PTBW of knee flexors was positively correlated with gait speed and cadence in the patients with HAM/TSP. The H/Q ratio but not E/F ratio was significantly decreased compared with the control. Our results indicated that the isokinetic trunk and knee muscle performance had reduced from the ambulatory stage, and suggested the deterioration in knee muscle performance to be associated with gait disturbance in walking HAM/TSP patients.     

Effects of the Thermal Environment on Articular Chondrocyte Metabolism: A Fundamental Study to Facilitate Establishment of an Effective Thermotherapy for Osteoarthritis

Aim: To facilitate establishment of an effective thermotherapy for osteoarthritis (OA), we investigated the effects of the thermal environment on articular chondrocyte metabolism in vitro. Methods: Chondrocytes were isolated from porcine knee joints, and cultured at 32°C, 37°C and 41°C. Cell proliferation and viability were assessed at Days 2, 4 and 8. In addition, TdT-mediated dUTP nick end labeling (TUNEL) assay was performed at Day 3 to determine the proportion of apoptotic chondrocytes. Analysis of genes specific for factors related to the cartilage extracellular matrix (ECM), cartilage destruction, and cartilage protection was performed at Day 2. Furthermore, evaluation of heat stress tolerance, and heat shock protein 70 (HSP70) mRNA expression and protein synthesis was performed at Day 2 and 3, respectively. Results: Cell proliferation was more at 37°C than at 32°C and 41°C. Cell viability and the number of TUNEL-positive cells were not affected until Day 8 and 3, respectively. The expression of the ECM-related genes was up-regulated at higher temperature. The expression of MMP13, a type II collagen destructive enzyme, and that of TIMP1 and TIMP2, which are MMP inhibitors, were up-regulated at higher temperatures. Finally, the chondrocytes cultured at 41°C may acquire heat stress tolerance, in part, due to the up-regulation of HSP70, and may inhibit apoptosis induced by various stresses, which is observed in OA. Conclusions: The thermal environment affects articular chondrocyte metabolism, and a heat stimulus of approximately 41°C could enhance chondrocyte anabolism and induce heat stress tolerance.     

Impact of Spray Cone Angle on the Performances of Methane/Diesel RCCI Engine Combustion under Low Load Operating Conditions

The behaviors of spray, in Reactivity Controlled Combustion Ignition (RCCI) dual fuel engine and subsequent emissions formation, are numerically addressed. Five spray cone angles ranging between 5° and 25° with an advanced injection timing of 22° Before Top Dead Center (BTDC) are considered. The objective of this paper is twofold: (a) to enhance engine behaviors in terms of performances and consequent emissions by adjusting spray cone angle and (b) to outcome the exergy efficiency for each case. The simulations are conducted using the Ansys-forte tool. The turbulence model is the Renormalization Group (RNG) K-epsilon, which is selected for its effectiveness in strongly sheared flows. The spray breakup is governed by the hybrid model Kelvin–Helmholtz and Rayleigh–Taylor spray models. A surrogate of n-heptane, which contains 425 species and 3128 reactions, is used for diesel combustion modeling. The obtained results for methane/diesel engine combustion, under low load operating conditions, include the distribution of heat transfer flux, pressure, temperature, Heat Release Rate (HRR), and Sauter Mean Diameter (SMD). An exergy balance analysis is conducted to quantify the engine performances. Output emissions at the outlet of the combustion chamber are also monitored in this work. Investigations show a pressure decrease for a cone angle θ = 5° of roughly 8%, compared to experimental measurement (θ = 10°). A broader cone angle produces a higher mass of NO_x. The optimum spray cone angle, in terms of exergy efficiency, performance, and consequent emissions is found to lie at 15° ≤ θ ≤ 20°.     

High Entropy Alloys as Filler Metals for Joining

In the search for applications for alloys developed under the philosophy of the High Entropy Alloy (HEA)-type materials, the focus may be placed on applications where current alloys also use multiple components, albeit at lower levels than those found in HEAs. One such area, where alloys with complex compositions are already found, is in filler metals used for joining. In soldering (<450 °C) and brazing (>450 °C), filler metal alloys are taken above their liquidus temperature and used to form a metallic bond between two components, which remain both unmelted and largely unchanged throughout the process. These joining methods are widely used in applications from electronics to aerospace and energy, and filler metals are highly diverse, to allow compatibility with a broad range of base materials (including the capability to join ceramics to metals) and a large range of processing temperatures. Here, we review recent developments in filler metals relevant to High Entropy materials, and argue that such alloys merit further exploration to help overcome a number of current challenges that need to be solved for filler metal-based joining methods.     

Reduced System Complexity of Heart Rate Dynamics in Patients with Hyperthyroidism: A Multiscale Entropy Analysis

Studying heart rate dynamics would help understand the effects caused by a hyperkinetic heart in patients with hyperthyroidism. By using a multiscale entropy (MSE) analysis of heart rate dynamics derived from one-channel electrocardiogram recording, we aimed to compare the system complexity of heart rate dynamics between hyperthyroid patients and control subjects. A decreased MSE complexity index (CI) computed from MSE analysis reflects reduced system complexity. Compared with the control subjects (n = 37), the hyperthyroid patients (n = 37) revealed a significant decrease (p < 0.001) in MSE CI (hyperthyroid patients 10.21 ± 0.37 versus control subjects 14.08 ± 0.21), sample entropy for each scale factor (from 1 to 9), and high frequency power (HF) as well as a significant increase (p < 0.001) in low frequency power (LF) in normalized units (LF%) and ratio of LF to HF (LF/HF). In conclusion, besides cardiac autonomic dysfunction, the system complexity of heart rate dynamics is reduced in hyperthyroidism. This finding implies that the adaptability of the heart rate regulating system is impaired in hyperthyroid patients. Additionally, it might explain the exercise intolerance experienced by hyperthyroid patients. In addition, hyperthyroid patients and control subjects could be distinguished by the MSE CI computed from MSE analysis of heart rate dynamics.     

Effect of Body Weight-supported Walking on Exercise Capacity and Walking Speed in Patients with Knee Osteoarthritis: A Randomized Controlled Trial

Objective: To compare the effect of body-weight-supported treadmill training (BWSTT) and full-body-weight treadmill training (FBWTT) on patients with knee osteoarthritis (OA). Methods: Design was Randomized controlled trial. Patients with knee osteoarthritis (n = 30; mean age, 76.0±7.5 y) were randomly assigned to BWSTT or FBWTT group. All patients performed 20 min walking exercise twice a week for 6 weeks under the supervision of the therapist. Main measures were 10-meter walking test (10MWT), functional reach test (FRT), timed get up and go test (TUG), one-leg standing test, 6-minute walking test (6MWT), the parameters set on the treadmill, MOS Short-Form 36-Item Health Survey (SF36), Japanese Knee Osteoarthritis Measure (JKOM). Results: Twenty-five patients (10 men, 15 women; mean age, 76.5 ± 8.0 y) completed the experiment. Exercise capacity, indicated by the heart rate, was similar in both groups. After 3 weeks of BWSTT, the patients performed significantly better in the 10-m and 6-min walking tests. This was not the case with FBWTT even after 6 weeks training. Pain levels assessed were significantly improved after 3 weeks of BWSTT and 6 weeks of FBWTT. There were no significant improvements in either group assessed by the FRT, one-leg standing time test, TUG, or SF -36 questionnaire. Conclusions: BWSTT enhanced exercise capacity in terms of walking speed and pain reduction after 3 weeks; however, there was no significant improvement in patients'' functional abilities or quality of life.     

Stability of centrosome numbers in poly(ADP-ribose) polymerase-1- and poly(ADP-ribose) glycohydrolase-deficient mouse ES cells

Poly(ADP-ribose) polymerase-1 (Parp-1) localizes mainly in the nucleus and functions in DNA repair, genome stability and cell death regulation. Meanwhile, it also localizes in centrosomes and is involved in the regulation of centrosome duplication. An abnormal increase in centrosome numbers is frequently observed in Parp-1-deficient (Parp-1^−/−) mouse embryonic fibroblasts (MEFs) (Kanai et al. (2003) Mol. Cell. Biol. 23, 2451–2462). However, there are no studies on whether the centrosome abnormality occurs also in other cell types under Parp-1 deficiency. In this study, we report that Parp-1^−/− mouse embryonic stem (ES) cell lines did not show an abnormally increased number of centrosomes compared to wild-type ES cells. Recently, poly(ADP-ribose) glycohydrolase (Parg) has also been shown to localize in centrosomes (Ohashi et al. (2003) Biochem. Biophys. Res. Commun. 307, 915–921). The number of centrosomes of Parg-deficient (Parg^−/−) ES cells was also analyzed in this study and was found to be stable under Parg deficiency. We also examined centrosome numbers in wild-type, Parp-1^−/− and Parg^−/− ES cell lines after treatment with methylmethanesulfonate (MMS) or γ-irradiation. Although a slight increase in the number of centrosomes is observed in each genotype twenty-four hours after treatment with MMS at 50 μM or with γ-irradiation at 1.4 Gy, there was no difference among the genotypes. These results suggest that loss of Parp-1 and Parg is insufficient to induce abnormality in centrosome numbers in ES cells and that ES cells possibly possess a strict mechanism for the maintenance of a normal number of centrosomes.     

Effect of Interventions for Improving Lumbar Motor Control on Low Back Pain in Sedentary Office Workers: A Randomized Controlled Trials

Objective: To clarify the effect of intervention with dynamic motor control exercise (DMCE) for the lumbar region on low back pain in sedentary office workers (SOWs). Methods: The participants comprised 32 SOWs with low back pain who were randomly categorized into two groups: the DMCE group and the normal trunk exercise (NTE) group. Both groups performed each exercise for three days per week for 8 weeks. The primary endpoints were evaluated for the lumbar and hip flexion angles during trunk forward bending, effect of low back pain on activities of daily living (using the Oswestry Disability Index), and intensity of low back pain (using the Visual Analog Scale) pre- and post-intervention. The extent of changes was calculated by subtracting the pre-intervention value from the post-intervention value and was compared between the two groups using an unpaired t-test. Results: The extent of changes in the lumbar flexion and hip flexion angles at 10° of trunk forward bending were significantly greater in the DMCE group than in the NTE group, and no significant differences were noted between the two groups at other angles of trunk forward bending. The extent of changes in the Oswestry Disability Index and the Visual Analog Scale scores were significantly greater in the DMCE group than in the NTE group. Conclusion: DMCE is effective in improving motor control in the lumbar region and hip joints, thereby ameliorating low back pain in SOWs.     

The Effects of Comprehensive Exercise Program on the Adjustments of Standing Balance in Community-Dwelling Elderly Persons

The objective of this study was to assess the effect of comprehensive exercise program widely accepted as a community-based physical intervention for the prevention of falling in the elderly persons on their controlling standing balance. Twenty-six community-dwelling elderly persons (13 males and females; 69.8 ± 2.8 years old) participated in this study. Daily exercise was comprised of walking for more than 30 min, stretching, muscle strengthening and balance exercise without exercise equipments. The intervention was continued for three months. Indicators of standing balance related to static balance, dynamic balance and postural response were measured before and after the intervention. As an effect of the intervention on static balance, the sway of center of pressure (COP) in the static stance significantly increased. In the dynamic balance, significant improvements were observed in one leg standing time, the 10-m gait time, functional reach. Additionally, the maximal movable length of COP which subjects can move voluntarily to right and left significantly increased. In the postural response, the integrated electromyography (IEMG) induced by postural response for sudden postural perturbation significantly decreased in the lower leg muscles. Since less muscular activities were sufficient to maintain posture, it was suggested that postural response was elicited more efficiently following the intervention. This study suggested that the comprehensive exercise program, which has been widely introduced as community-based interventions for the prevention of falling, have extensive effects on the control of standing balance covering static balance, dynamic balance and postural response in the elderly persons.