Possibilities of Assessing Respiratory Muscle Strength and Trunk Muscle Mass in the Prevention of Sarcopenia in Older People Living in the Community

Objective: The purpose of this study was to clarify the relationship between respiratory muscle strength and skeletal muscle mass (trunk, upper limbs, and lower limbs) in older people who were certified as requiring nursing or supportive care. Methods: Thirty-five older people (65 years or older) who were certified as requiring nursing care or support were included in the study. The subjects were divided into a non-sarcopenic group (n = 12) and a sarcopenic group (n = 23) according to the sarcopenia diagnostic criteria proposed by the Asian Working Group for Sarcopenia. Maximum inspiratory pressure, maximum expiratory pressure, skeletal muscle mass (trunk, upper and lower limbs), and hand grip strength were measured. Pearson’s correlation coefficient and multiple regression analysis were used for statistical processing. Results: In the non-sarcopenic group, both expiratory muscle strength and hand grip strength were correlated with skeletal muscle mass. In the sarcopenia group, expiratory muscle strength was not correlated with skeletal muscle mass, and only hand grip strength was correlated with upper limb muscle mass. Multiple regression analysis revealed that, in the non-sarcopenic group, trunk muscle mass was the primary factor in expiratory muscle strength and upper limb muscle mass was the primary factor in hand grip strength. In the sarcopenia group, upper limb muscle mass was found to be the main factor in hand grip strength. Conclusion: Our results highlight the importance of assessing expiratory muscle strength and trunk muscle mass before sarcopenia develops in older people who require support and nursing care.

Myoelectric Activity of Selected Trunk Muscles Following the Use of Various Insole Wedges During Running

Purpose Insoles with various wedges have effects on the biomechanical aspects of human movement.The aim of the present study was to investigate the immediate effects of 9 insoles while running on the myoelectric activity of selected trunk mus-cles.The conditions were no wedge,posterior,anterior,medial,lateral,posterior-medial,posterior-lateral,anterior-medial,and anterior-lateral.Muscles included were rectus abdominis,external oblique,internal oblique,latissimus dorsi,thoracic erector spinae,lumbar erector spinae,multifidus,and quadratus lumborum during running.Methods Twenty-five(n=25)able-bodied males participated in this quasi-experimental study.Repeated measures analysis of variance test was used to compare dependent variables among various insole wedges.Results Significant differences(P=0.001)in normalized mean amplitude index between the following wedge conditions were measured while running:posterior-lateral/medial(5.67±1.01 vs.4.73±1.09)and posterior-lateral/anterior-medial(5.67±1.01 vs.4.52±1.20)for the internal oblique muscle along with posterior-lateral/anterior(11.44±2.42 vs.9.26±2.35)for the lumbar erector spinae muscle.Similarly,normalized peak amplitude index differences in the medial/anterior-lateral(9.79±3.3321 vs.12.03±3.16)and lateral/anterior-medial(11.6±2.56 vs.9.25±2.38)for the internal oblique muscle and posterior-lateral/anterior-medial(9.58±2.26 vs.8.78±2.15)for the quadratus lumborum muscle were measured.In con-trast,no significant difference was observed for the median frequency index among various insole wedges during running(P>0.0014).Conclusion Decreased activity in the medial wedged conditions may have important negative consequences for the spine,pelvis,and dynamic core.These results provide insights into the effect of various orthotic designs on the EMG activity of central core muscles.Higher activation in an anterior-lateral wedge and lower activation in a medial wedge for core muscles can have clinical relevance,where there is a need to increase,or avoid decrease,core muscle activity.

A review on assessment and treatment of the trunk in stroke A need or luxury

Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.

Observation on efficacy of acupuncture combined with rehabilitation training for post-stroke balance disorders

Objective To comparatively analyze clinical efficacy of treating post- stroke balance disorders with trunk muscles acupuncture combined with rehabilitation training and rehabilitation training alone. Methods In a randomized control study, 59 patients were randomly divided into two groups in sequence of admission. Both groups were given conventional medical treatment; the acupuncture combined with rehabilitation training group （group A, 30 cases） was treated with trunk muscles acupuncture combined with rehabilitation training, and the rehabilitation training group （group B, 29 cases） was treated with rehabilitation training alone. Both groups were treated six times per week with four weeks as a course of treatment, and a total of four courses were given. Before and after treatment, efficacy of balance function and integral of activities of daily living （ADL） of patients were evaluated. Results The score of balance function of patients in group A and in group B after treatment （38.47 ± 11.34, 32.55 ± 10.02） was higher than that in the two groups before treatment （14.56 ± 6.00, 13.51 ± 6.28）, and the differences were statistically significant （both P〈0.05）. After treatment, the score of balance function of patients in group A was higher than that in group B （P〈0.05）. The score of ADL of patients in group A and in group B after treatment （61.33 ± 18.47, 51.72 ± 17.28） was higher than that in the two groups before treatment （22.50 ± 6.79, 24.48 ± 7.23）, and the differences were statistically significant （both P〈0.05）. After treatment, the score of ADL of patients in group A was higher than that in group B （P〈0.05）. Conclusion The balance function and ADL of patients with post-stroke balance disorders could be improved with trunk muscles acupuncture combined with rehabilitation training, and its efficacy was superior to rehabilitation training alone.