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Purpose This study aims to evaluate the falling incidence density and examine the potential risk factors associated with falling among women with breast cancer during taxane-based chemotherapy. Methods One hundred and twenty-three women with breast cancers were participated in this study. The fall incidence density, taxane-induced peripheral neuropathy (TIPN) symptoms, and physical performance tests were evaluated at five time points throughout chemotherapy treatment. A fall diary was used to record fall incidence density during treatment. The fall incidence density was calculated by the number of first fall occurrence divide by person-time at risk. The risk factors associated with falls incidence density were analyzed using the Cox proportional hazard model. The Kaplan-Meier curve illustrated the probability to survive from fall during chemotherapy treatment. RESULTS Over the course of taxane-based chemotherapy, 29 (23.58%) women with breast cancer reported falls. In addition, the fall incidence density was 3 per 1000 person-day. This study discovered a significant link between age (HR = 1.06; 95% CI: 1.01-1.11), BMI (HR = 1.10; 95% CI: 1.01-1.20), and a 30-s chair stand test (HR = 0.82; 95% CI: 0.79-0.97) and falling. CONCLUSIONS As evidenced by the findings, the initial fall occurred after the first cycle of chemotherapy treatment and was found throughout the course of treatment. Furthermore, falls were associated with age, BMI, and a 30-second chair stand test. Early detection of TIPN symptoms and lower limb muscular weakness, particularly among older persons and those with a high BMI, may be essential to prevent falls.

Women with breast cancer who underwent taxane-based chemotherapy demonstrate diminished postural stability. However, the data concerning dynamic postural stability among women with breast cancer during taxane-based chemotherapy remains insufficient.To investigate postural stability among women with breast cancer during taxane-based chemotherapy.Fifteen women with breast cancer participated in this study. Postural stabilities were assessed at five intervals during the course of chemotherapy treatment. Static postural stability was measured during single leg with eyes open (SEO) and eyes closed (SEC) conditions, while dynamic postural stability was measured during performance of the limit of stability test (LOS). Postural stability was described using 95% confidence ellipse area (EA), center of pressure (COP) path length (PL), and COP average velocity (AV).For static postural stability assessment, SEO condition was found to have significant increases in EA, PL, and AV (p = .001, p .001, and p = .02, respectively). For dynamic postural stability assessment, a significant difference in EA was observed in the forward, backward, right, and left directions (p = .02, p = .02, p .001, and p = .01, respectively). In addition, a significant difference in PL was found while performing in a backward direction (p = .02).The findings showed that women with breast cancer may have experienced decreased static and dynamic postural stability.

Background:There is a lack of evidence whether the combined visual and verbal cues could improve dynamic trunk control in the sitting position in children with spastic diplegic cerebral palsy (SDCP). Objective:To investigate the immediate effects of visual, verbal, and combined visual and verbal cues on dynamic trunk control in the sitting position in children with and without SDCP. Methods:Twenty children with SDCP and 20 typically developing (TD) children aged eight to 12 years in sitting positions maneuvered their trunks to lean forward, backward, to the left, and to the right under conditions of no sensory cues, visual cues, verbal cues, and combined visual and verbal cues. Dynamic trunk control in the sitting position was assessed using the center of force (CoF) trajectory and limit of stability (LOS). Results:Verbal cues and combined visual and verbal cues could improve CoF trajectories in the forward, backward, and leftward directions in TD children and children with SDCP. Combined visual and verbal cues could improve the LOS in both groups. Conclusion:This study provides evidence that combined visual and verbal cues are more effective at enhancing dynamic trunk control than either visual or verbal cues alone in TD children and children with SDCP.

Background Sit-to-stand (STS) movement is an important transition movement for daily life. STS movement is typically seen in children aged 1 year and older. According to the motor development process, the ability of children in different age groups to perform STS movement would be different before they meet the mutuality. However, it is still unclear whether there are changes in the STS movement of growing children and adults. Research question Are there any differences in the movement time, joint angles, and peak joint moments of STS in typically developing (TD) children? Methods Motion analysis and the force plate system were used to analyze the STS movement in 77 healthy participants. All participants were asked to perform the STS movement using an adjustable bench with a self-selected pattern. Statistical analysis was done with respect to age (4–6, 7–9, 10–12, 18–25 years) and body height (1.00–1.20, 1.20–1.40, 1.40–1.60, 1.60–1.80 meters). Results Children aged 4–6 years (or 1.0–1.20 m height) took less time to accomplish STS movement than adults (or 1.60–1.80 m height). Children aged 4–9 years performed STS movement by using more trunk and hip flexion and anterior pelvic tilt, but less knee flexion and ankle dorsiflexion than children aged 10–12 years and adults. At the final standing position, children aged 4–12 years exhibited more knee extension and more ankle plantar flexion than adults. In addition, children aged 4–12 years had more peak trunk-pelvic extension and less peak knee extension moments than adults. Significance Different strategies to achieve the STS task were found among children aged 4–12 years in terms of total movement time, joint angle, and joint moments. Adult-like kinematic and kinetic STS patterns were not seen in children up to 12 years old.

Chulalongkorn Medical Journal, 66, 4, 411-417

Anterior seat inclination has been applied in children with spastic diplegic cerebral palsy (SDCP) to adjust alignment during sitting. However, there has been a lack of evidence reporting the effects of anterior seat inclination on sit-to-stand (STS) performance in children with SDCP. Therefore, the aim of the study was to investigate the effects of anterior seat inclination on STS performance in children with SDCP.Fourteen children with SDCP (aged 8.74 (1.79) years, GMFCS levels I and II) participated in this study. All participants performed STS in four conditions of the seat including the horizontal seat (HS), anterior seat inclination of 5° (A5), 10° (A10) and 15° (A15). Three-dimensional motion analysis system was used to capture STS movements.The total movement time and total mechanical work during the STS with A5, A10 and A15 were significantly lower than STS with HS. At the beginning of the task, STS with A5, A10 and A15 showed less trunk and hip flexion than HS.Anterior seat inclination with 5°, 10° and 15° could improve STS performance in children with SDCP. Therefore, applying these seats would be another option for children with SDCP to enhance STS performance.IMPLICATIONS FOR REHABILITATIONAnterior seat inclination could improve sitting posture in children with diplegia.Children with diplegia spent less time when STS from the anterior seat inclination.Children with diplegia used less energy when STS from the anterior seat inclination.

Background Sit-to-stand (STS) is one of the most common fundamental activity in daily life. The pathology of the neuromuscular control system in children with spastic diplegic cerebral palsy (SDCP) could contribute to atypical movement patterns leading to the inefficiency performance including the STS task. However, there was also a lack of evidence about kinematics, kinetics, and especially mechanical work during the STS task in children with SDCP aged 7–12 years old. Research question What were the differences in mechanical work, kinematics and kinetics during STS task between children with SDCP and typically developing (TD) children? Methods Eleven children with SDCP (GMFCS I-II) and eleven age and gender-matched control TD children with an age range of 7–12 years were enrolled. Motion analysis and force plate systems were used to collect data. All participants performed the STS task from an adjustable chair. Independent sample t-test and two-way analysis of variance were used in this study. Results The children with SDCP took a longer time and used more mechanical work during STS than TD children. At the beginning of the STS task, children with SDCP showed more trunk flexion and posterior pelvic tilting; in addition, during the STS task they also presented more trunk, hip, and knee flexion than TD children. However, the children with SDCP showed less ankle dorsiflexion compared with TD children. For the kinetic variables, asymmetry was found in children with SDCP. The maximum hip and knee extension moment, plantar flexion moment, and peak vertical ground reaction force (GRF) of the non-dominant leg were higher than the values of the dominant leg in these children. Significance Even though, children with SDCP who are able to independently STS. They were also a mechanically less efficient performance during STS task. Therefore, this task still needs to be trained during rehabilitation sessions.

Objective To identify the individual, anatomical, and biomechanical predictors of plantar fasciitis among novice conscripts. Design A prospective cohort study. Setting Military training camp in Bangkok, Thailand. Participants One hundred thirteen novice conscripts without lower extremity pain prior to the commencement of military training. Main outcome measure(s) Individual, anatomical, and biomechanical variables were assessed in all participants at baseline. The primary criterion variable was the presence or absence of plantar fasciitis. Results After 10 weeks of training, 113 participants were classified as having (n = 71) and not having (n = 42) plantar fasciitis. The results indicated that the conscripts with poorer quality of movement and lesser femoral anteversion angle tended to exhibit plantar fasciitis (odds ratio = 1.996 and 0.720, respectively). Regarding individual components, the conscripts with higher body mass index and higher stress level had increased risk of plantar fasciitis (odds ratio = 1.238 and 1.110, respectively). Moreover, the conscripts with a higher level of physical exercise before military training had a reduced risk of presenting with plantar fasciitis (odds ratio = 0.242). Conclusions Multiple predictors–especially individual characteristics and the abnormalities from the proximal region (other than foot and ankle)–contributed to the development of plantar fasciitis among Thai novice conscripts.

Objective To evaluate the factors that influence gait by comparing lower extremity kinematics during the stance phase of the gait cycle between individuals with and without plantar fasciitis. Design A cross-sectional study. Setting Motion analysis research laboratory. Participants Thirty subjects with plantar fasciitis and 30 aged-matched controls. Main outcome measure(s) Range of motion of the lower extremity and multi-segment foot during gait using a three-dimensional motion analysis system. Results The plantar fasciitis group showed significant differences in motion in the multi-segment foot, ankle, knee, and hip from the control group during various subphases of the stance phase. Specifically, relative to the control group, the plantar fasciitis group had more rearfoot adduction, forefoot eversion, ankle abduction, and hip abduction. They also had less midfoot dorsiflexion, forefoot dorsiflexion, knee extension, knee external rotation, and hip extension (all Ps Conclusions Individuals with plantar fasciitis exhibited more flexibility in the ankle-foot complex and poorer quality of lower-extremity movement than the group that did not have plantar fasciitis. Thus, differences in structures in both the ankle-foot complex as well as those in the hip and knee joints appear to be associated with the presence of plantar fasciitis.

The present study aimed to compare the effects of chair height and anterior seat inclination on sit-to-stand (STS) performance in children with spastic diplegic cerebral palsy (SDCP). Twelve children with SDCP were tested with three conditions of STS task: low chair with horizontal seat (control), low chair with anterior seat inclination (AiC), and high chair with horizontal seat (HiC) conditions. A 3D motion analysis system and two force plates were used to collect and analyze the movement time, mechanical work, kinematics, and kinetics. The results showed that in the AiC and HiC conditions, movement time and mechanical work during STS were significantly reduced when compared with the control condition. In addition, in the AiC condition, trunk alignment at the beginning of the STS task improved and the range of pelvis movement reduced, whereas in the HiC condition, the range of movement of hip, knee, and ankle joint and maximum hip and knee extension moment were reduced in children with SDCP when compared with the control condition. These results suggest that chair height and anterior seat inclination may have a positive effect on STS ability in children with SDCP. Trial register No. TCTR20170619003.

Background The Timed Up and Go (TUG) test is one of the most popular functional dynamic balance tests in children with typical and atypical development. However, the TUG protocol varies in terms of turning-point markers and verbal commands. Research question Would the outcomes of TUG be different if a different TUG protocol, especially turning-point markers and verbal commands, was used in different age and gender? Methods Two hundred and ten typically developing children aged 6–12 years participated in the study. They were separated into 7 groups according to age. All participants were randomly selected to perform the TUG test in 6 conditions of a cone, a line, and a picture as turning-point markers under nonqualitative and qualitative verbal instructions in terms of the walking speed. The best TUG score (in seconds) of 3 trials in each condition was obtained for analysis. Results The time to complete the TUG test was decreased by age. The fastest time was found in the picture condition under qualitative and nonqualitative verbal instructions in all age groups. Additionally, using qualitative verbal instruction resulted in faster times than nonqualitative verbal instruction for all turning-point markers and in all age groups. Significance This study provided evidence that the outcome of the TUG test was influenced by turning-point markers and verbal instructions in all age groups. Therefore, a reliable TUG test protocol should be considered in order to measure the change in functional dynamic balance of children.

[Purpose] It is well known that vision is an important factor contributing to postural control. However, there has been little discussion about the effect of vision on sit-to-stand movement. The purpose of this study was to evaluate the effect of constrained vision on sit-to-stand movement. [Subjects and Methods] Twenty-three healthy subjects (11 males, 12 females) aged 18–23 years with normal body mass indices were recruited for this study. Each participant was asked to stand as quickly as possible from a height-adjustable chair 3 times under 2 conditions: with eyes closed (EC) and eyes open (EO). The weight transfer time, rising index, and center of gravity sway velocity were measured using a NeuroCom Balance Master. [Results] The results show there were significant differences between the EC and EO conditions in the weight transfer time and the centre of gravity sway velocity. No significant difference was found between the EC and EO conditions in the rising index. These findings suggest that visual perception may play a role in balance control while performing sit-to-stand movement.

To study the immediate effects of interferential current stimulation (IFC) on shoulder pain and pain-free passive range of motion (PROM) of the shoulder in people with hemiplegic shoulder pain (HSP).Double-blind, placebo-controlled clinical trial.Institutional physical therapy clinic, neurologic rehabilitation center.A population-based sample of people with HSP (N=30) was recruited.Participants were divided into 2 groups--an IFC group and a placebo group--by using a match-paired method (age, sex, and Brunnstrom motor recovery stage). In the IFC group, participants received IFC for 20 minutes with an amplitude-modulated frequency at 100 Hz in vector mode. The current intensity was increased until the participants felt a strong tingling sensation.Pain intensity and pain-free PROM of the shoulder until the onset of pain were measured at baseline and immediately after treatment.Participants reported a greater reduction in pain during the most painful movement after treatment with IFC than with placebo (P.05). The IFC group showed a greater improvement in posttreatment pain-free PROM than the placebo group in shoulder flexion (P.01), abduction (P.01), internal rotation (P.01), and external rotation (P.01).This study provides evidence that IFC is effective for the relief of pain during movement and also increases the pain-free PROM of the shoulder in people with HSP.

[Purpose] The multi-directional reach test (MDRT) is a simple, inexpensive, reliable and valid screening tool for assessing the limits of stability in the anterorposterior and mediolateral directions. The aim of this study was to quantify the limits of stability of people aged between 20 and 79 years using the MDRT. [Subjects] One hundred and eighty subjects were divided into the following 6 age groups: 20–29, 30–39, 40–49, 50–59, 60–69 and 70–79 years (n=30 per group). [Methods] The MDRT was used to measure the limits of stability in four directions: forward, backward, leftward and rightward. Subjects performed maximal outstretched arm reach in each direction with their feet flat on the floor. [Results] All age groups performed the greatest values of the limit of stability in the forward direction. The 60–79 year group demonstrated significantly lower limits of stability in the forward, leftward and rightward directions compared to the 20–39 year group. [Conclusion] The limits of stability declined with age mainly in the forward, leftward and rightward directions. The MDRT appears to be a useful assessment tool for postural control and balance of those aged 60 years and over.

The purpose of this study was to investigate the effects of exercise using a mung bean bag (MB) for balance ability. Thirty-nine healthy female young adults (aged 18-25 years with normal body mass index) were randomly assigned into three groups (n for each group = 13): control group, firm surface (FS) exercise group, and MB exercise group. The FS and MB groups were trained with static and dynamic balance exercises (20 minutes × 3 times/week × 6 weeks). Participants' balance abilities were measured using a Balance Master 4 times: at pre-training (baseline) and at the second, fourth, and sixth weeks post-training. Three tests were assessed: unilateral stance test, modified clinical test for sensory integrations on balance (mCTSIB), and limits of stability (LOS) test. The MB group significantly improved unilateral stance balance in both eyes-open and eyes-closed conditions, whereas the FS group improved only in the eyes-closed condition. No significant difference was found across groups in the mCTSIB parameters. Only the FS group significantly improved LOS parameters. These results suggest the MB exercise could be used to improve unilateral stance balance, but not the LOS or mCTSIB, in healthy young adults.

Summary Objective This study investigated the effects of an acupoint-stimulating lumbar backrest on pain and disability in office workers who suffering from low back pain (LBP) as well as the preference influence on pain and disability. Methods Sixty-four participants were randomly assigned to two groups: one with no intervention ( n =32) and another with 1 month of backrest use ( n =32). An additional group ( n =37) who wished to try 1 month of acupressure backrest were recruited to indicate the preference effect. Pain and disability were two key outcomes. Results Significant differences between control and randomized acupressure backrest groups were found at 2 week period for disability and at 4 weeks for pain after the backrest use. Also, significant differences were found in both groups for 3 month period with an increase of the treatment effect on pain and disability. Both control and randomized acupressure backrest groups showed greater improvement in pain and disability scores which were more than the minimal clinically important change (30% improvement for both outcomes). No significant difference was found for pain and disability between the randomized and preferred backrest groups. Conclusion These findings suggested 1-month of acupressure backrest use could improve LBP conditions. Preference was not a powerful moderator to the significant treatment effect.

A B S T R A C T The purpose of this study was to investigate the typical development of postural control in younger (5– 6 yrs) and older (7–16 yrs) children (YTD and OTD) during two gait tasks, including level walking and obstacle-crossing, using a dual-task paradigm, and to compare the results of the children’s performance with that of healthy young adults (HYA). Our findings revealed that gait control in typical children requires attentional resources to maintain stability. Moreover, dual-task interference was less in HYA compared to YTD and OTD. Gait performance decrements in the dual-task context were greater in YTD compared to OTD, whereas cognitive performance decrements in YTD and OTD were similar. In addition, dual-tasking affected cognitive performance more in YTD when gait task difficulty was increased. Results suggest a developmental trend in attentional resources used to control gait in typical children. Postural control during gait under dual-task conditions was improved when children were more mature, as attentional resources increased with age.

The study investigated the influence of lumbar flexibility exercise on the lumbar angle among patients with non-specific low back pain (LBP). Pre-experimental one-group pretest-posttest design trial was conducted at Health Service Center, Chulalongkorn University, Thailand. Thirty-five non-specific LBP patients with limitation in lower back range of motion and without neurological deficits were recruited (based on the LBP guidelines by RCGP 1999). Lumbar flexibility exercise program developed based on McKenzie therapy was performed individually each day for 2 weeks. Patients attended an exercise program daily in the first week under the supervision of a physiotherapist. The exercise program consisted of 7 sets a day (3-2-2 in the morning-afternoon-evening) in series of 10 repetitions for each set for 2 weeks. Lumbar angle was measured at the beginning and at the end of 2 weeks in order to determine the range of motion improved. The results indicated that the low back pain symptom improved as well as the angle.

[Purpose] The aim of the present study was to compare the effects of unstable support surfaces, i.e. foam pad, mung bean bag, and plastic bead bag, on postural stability disturbance. [Subjects and Methods] Twenty-two healthy young adults (11 male and 11 female; aged 21.09 ± 1.44 years; BMI 20.40 ± 1.40 kg/m(2)) participated in the study. The Balance Master™ was used to evaluate the limit of stability and the unilateral stance performance. Each participant was assessed while standing on the following surfaces: 1) a firm surface, 2) a foam pad, 3) a mung bean bag, and 4) a plastic bead bag. The order of surfaces was randomly assigned. [Results] The mung bean bag and plastic bead bag showed greater disturbances in limit of stability and unilateral stance than the foam pad. There was no significant difference in postural stability disturbance between the mung bean bag and plastic bead bag. [Conclusion] These results suggested that both the mung bean bag and plastic bead bag could be used as a low-cost tool for balance assessment instead of a foam pad in healthy young adults.