Hsin-yi Cheng - Academia.edu (original) (raw)

Papers by Hsin-yi Cheng

Research paper thumbnail of Rapid repetitive passive movement improves knee proprioception

Clinical Biomechanics, 2011

Proprioception can be affected by many factors including exercise. Most exercises involve certain... more Proprioception can be affected by many factors including exercise. Most exercises involve certain degrees of repeated passive movements, and different velocities of these movements might affect proprioception differently. The purpose of this study was to evaluate the influences of different angular velocities of repeated passive movement on knee proprioception via active repositioning and kinesthesia measurement. A quasi-experimental design with repeated measure on movement velocity (0°/s, 2°/s, 90°/s, and 150°/s). Sixteen healthy young adults participated in the study. All of them received 30 times repeated passive knee movement intervention in four different knee angular velocities - 0°/s, 2°/s, 90°/s, and 150°/s - with counter-balanced sequence in four successive days. Knee active repositioning and kinesthesia were measured with error scores before and after the intervention. The results revealed a decrease in error scores in both active repositioning and kinesthesia measurement with the velocities of 90°/s and 150°/s (p<0.05); however no significant change was seen with the static condition (0°/s ) or with the velocity of 2°/s. We concluded that repeated passive movement with rapid angular velocities was capable of improving knee proprioception, specifically in active repositioning and kinesthesia measurements. These results would provide information on the effects of different movement velocities onto knee proprioception. Along with further investigations, the findings could potentially enhance our knowledge on knee injury prevention, treatment, and rehabilitation.

Research paper thumbnail of Bilateral femoral neuropathy after vaginal hysterectomy

Archives of Physical Medicine and Rehabilitation, 1998

Research paper thumbnail of Adaptation of vibration-induced postural sway in individuals with Parkinson's disease

Gait & Posture, 2002

Postural control requires accurate integration of visual, vestibular, cutaneous, and propriocepti... more Postural control requires accurate integration of visual, vestibular, cutaneous, and proprioceptive sensory information. Previous research suggests that patients with Parkinson's disease (PD) may have difficulty with this integration process, particularly involving incongruent visual information. The purpose of this study was to determine whether PD patients also show difficulty in adaptation to erroneous proprioceptive information. Postural reactions to soleus muscle vibration were explored in 8 PD patients, 8 healthy elderly, and 8 young adults. Postural sway was recorded using an electromagnetic motion analysis system in four conditions (2 vision ×2 vibration) with four trials in each condition to test subjects' adaptation to the vibrator stimulus. The results showed that PD patients did adapt to the vibration across trials, similar to those of both control groups. It was concluded that PD patients in the early stages of the disease could override inaccurate proprioceptive inputs, relying more on true vestibular and/or visual information. These results suggest that the basal ganglia are not critical for this adaptation process in postural control.

Research paper thumbnail of Stair-Walking Performance in Adolescents with Intellectual Disabilities

Sensors (Basel, Switzerland), Jan 11, 2016

Most individuals with intellectual disabilities (ID) demonstrate problems in learning and movemen... more Most individuals with intellectual disabilities (ID) demonstrate problems in learning and movement coordination. Consequently, they usually have difficulties in activities such as standing, walking, and stair climbing. To monitor the physical impairments of these children, regular gross motor evaluation is crucial. Straight-line level walking is the most frequently used test of their mobility. However, numerous studies have found that unless the children have multiple disabilities, no significant differences can be found between the children with ID and typically-developed children in this test. Stair climbing presents more challenges than level walking because it is associated with numerous physical factors, including lower extremity strength, cardiopulmonary endurance, vision, balance, and fear of falling. Limited ability in those factors is one of the most vital markers for children with ID. In this paper, we propose a sensor-based approach for measuring stair-walking performance...

Research paper thumbnail of Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review

Journal of Physical Therapy Science, 2015

Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to... more Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to improve pain and disability in short-term and midterm follow-ups. This study performed a literature review of the long-term effects of therapeutic exercise on subjects with nonspecific chronic neck pain. [Subjects and Methods] The databases of the CINAHL, MEDLINE, PEDro and PubMed were used. Randomized controlled trials (RCT) published from January 2000 to January 2014 and explicitly including a one-year follow-up were identified. [Results] Only six articles were included in this review. They had scores of 5 to 8 points on the PEDro scale, and the level of evidence was grade I. The study results show that the main exercises used were cervical strengthening and endurance training exercise. Short-term exercises (10 to 12 weeks) helped to improve the body function, structure, activity and participation immediately after the intervention, but not at the long-term follow-up. On the other hand, long-term interventions (1 year) resulted in improvements in body function and structure at the 3 year follow-up. [Conclusion] The results of the six high-quality studies suggest that long-term exercise have long-term benefits for patients with nonspecific neck pain in terms of body function and structure.

Research paper thumbnail of Effects of whole body vibration on spasticity and lower extremity function in children with cerebral palsy

Human movement science, 2015

The aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity... more The aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy (CP) with a complete crossover design. Sixteen participants aged 9.8(2.3) years received a 20-min WBV and a control condition in a counterbalanced order on two separate days. Change scores of each outcome variable were used to show the improvement. Repeated-measures analyses revealed significant differences in condition scores among variables including active range-of-motion (active ROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), and Six Minute Walk Test (6MWT, increased). Significant differences were also found in time change scores for MAS and 6MWT. Correlation results revealed that TUG was significantly correlated with RI (r=-.512, p=.042), and 6MWT (r=-.700, p=.003). This study suggested that WBV intervention can control the spasticity, en...

Research paper thumbnail of Managing lower extremity muscle tone and function in children with cerebral palsy via eight-week repetitive passive knee movement intervention

Research in developmental disabilities, 2013

This study used a repeated measures design to assess the effect of an eight-week repetitive passi... more This study used a repeated measures design to assess the effect of an eight-week repetitive passive movement (RPM) intervention on lower extremity muscle tone and function in children with cerebral palsy (CP). Eighteen children (aged 9.5 ± 2.1 years) with spastic CP were randomly assigned to a knee RPM intervention condition of 3 times a week for 8 weeks or a control condition. The 8 weeks were followed by 4 weeks of washout period, after which the participants were crossed over to the other group. In the RPM condition, each subject's knees were intervened with continuous passive motion device (at a velocity of 15°/s) for 20 min. The subjects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, after, 1 day after, and 3 days after each intervention. Repeated-measures statistical analyses found significant differences between condition variable on active range-of-motion of the knee (AROM, increased), relaxation index (RI, increased)...

Research paper thumbnail of The importance of the great toe in balance performance

The objective of this study was to evaluate function of the great toe in maintaining human static... more The objective of this study was to evaluate function of the great toe in maintaining human static and dynamic balance. Correlation among the great toe length, body height and balance performance parameters were also investigated. Thirty female subjects (aged 22.1±1.87 years) were tested in two great toe conditions, unconstrained and constrained. Balance testing was done in the orders listed: 1) static balance, single leg stance with right/left foot, eyes open and closed; 2) static balance, both feet, eyes open and closed; 3) dynamic balance, rhythmic weight shifting, left/right and forward/backward; 4) dynamic balance, target reaching test, eight targets within 90% limit of stability (LOS). The results demonstrated significant differences in sway velocity between the two toe conditions with either eyes open or closed in single leg standing (p<0.05). No difference was found between the two toe conditions while standing with both feet. For the rhythmic weight shifting, significant ...

Research paper thumbnail of Motor impairments screened by the Movement Assessment Battery for Children-2 are related to the visual-perceptual deficits in children with Developmental Coordination Disorder

Research in Developmental Disabilities, 2014

This study was to examine to what extent the motor deficits of children with Developmental Coordi... more This study was to examine to what extent the motor deficits of children with Developmental Coordination Disorder (DCD) verified by the Movement Assessment Battery for Children-2 (MABC-2) are linked to their visual-perceptual abilities. Seventeen children with DCD and seventeen typically developing children (TD) aged 5-10 years screened from a total of 250 children were recruited. The assessments included MABC-2, traditional test of visual perceptual skills (TVPS-R), and computerized test for sequential coupling of eye and hand as well as motion coherence. The results indicated that children with DCD scored lower than TD in MABC-2, and their total scores were highly correlated with manual dexterity component scores. DCD group also showed poor visual-perceptual abilities in various aspects. The visual discrimination and visual sequential memory from the TVPS-R, the sequential coupling of eye and hand, and the motion coherence demonstrated a moderate or strong correlation with the MABC-2 in the DCD rather than the TD group. It was concluded that the motor problems screened by MABC-2 were significantly related to the visual-perceptual deficits of children with DCD. MABC-2 is suggested to be a prescreening tool to identify the visual-perceptual related motor deficits.

Research paper thumbnail of The Correlates of Body Mass Index and Risk Factors for Being Overweight Among Preschoolers With Motor Delay

Adapted Physical Activity Quarterly, 2014

This cross-sectional study investigated the correlates of body mass index (BMI) and risk factors ... more This cross-sectional study investigated the correlates of body mass index (BMI) and risk factors for overweight among 91 children with motor delay (MD) aged 9–73 months. Anthropometric measurements and questionnaires regarding multiple risk factors were obtained. Simple correlations between BMI percentile classifications and potential predictors were examined using Spearman’s rank/Pearson’s correlations and χ2 analysis. Multiple predictors of overweight were analyzed using logistic regression. BMI was correlated positively with higher caloric intake (rs = .21, p < .05) and negatively with passive activity (rs = -.21, p < .05). When multiple predictors were considered, more severe dysphagia (odds ratio [OR], 2.81, p = .027, 95% confidence interval [CI], 1.13–7.04) and antiepileptic drug use (OR, 19.12, p = .008, 95% CI, 2.14–170.81) had significant partial effects on overweight status. Agencies supporting early development should consider caregiver education regarding the poten...

Research paper thumbnail of Effects of an eight-week whole body vibration on lower extremity muscle tone and function in children with cerebral palsy

Research in Developmental Disabilities, 2015

The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on l... more The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy with a complete crossover design. Sixteen participants aged 9.2 (2.1) years participated in this study. Half of the participants received a 10-min WBV, 3 times a week for 8 weeks. Then a 4-week washout period followed, after which they received a sham WBV 3 times a week for 8 weeks. The other half received the intervention in a reversed order. The participants were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, 1 day after, and 3 days after each intervention. Repeated-measures analyses revealed significant beneficial effects on most variables expect the passive range-of-motion measurement. Significant correlations were found between timed up-and-go and relaxation index, and between timed up-and-go and six-minute walk test. The results suggested that an 8-week WBV intervention normalized muscle tone, improved active joint range and enhanced ambulatory performance in children with cerebral palsy for at least 3 days. These indicated that regular WBV can serve as an alternative, safe, and efficient treatment for these children in both clinical and home settings.

Research paper thumbnail of Seat surface inclination may affect postural stability during Boccia ball throwing in children with cerebral palsy

Research in Developmental Disabilities, 2014

The aim of the study was to examine how seat surface inclination affects Boccia ball throwing mov... more The aim of the study was to examine how seat surface inclination affects Boccia ball throwing movement and postural stability among children with cerebral palsy (CP). Twelve children with bilateral spastic CP (3 with gross motor function classification system Level I, 5 with Level II, and 4 with Level III) participated in this study. All participants underwent pediatric reach tests and ball throwing performance analyses while seated on 15° anterior- or posterior-inclined, and horizontal surfaces. An electromagnetic motion analysis system was synchronized with a force plate to assess throwing motion and postural stability. The results of the pediatric reach test (p = 0.026), the amplitude of elbow movement (p = 0.036), peak vertical ground reaction force (PVGRF) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and movement range of the center of pressure (COP) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.020) were significantly affected by seat inclination during throwing. Post hoc comparisons showed that anterior inclination allowed greater amplitude of elbow movement and PVGRF, and less COP movement range compared with the other inclines. Posterior inclination yielded less reaching distance and PVGRF, and greater COP movement range compared with the other inclines. The anterior-inclined seat yielded superior postural stability for throwing Boccia balls among children with bilateral spastic CP, whereas the posterior-inclined seat caused difficulty.

Research paper thumbnail of Muscle strength enhancement following home-based virtual cycling training in ambulatory children with cerebral palsy

Research in Developmental Disabilities, 2012

Cerebral palsy (CP) is the most common childhood motor disability. The term CP describes a group ... more Cerebral palsy (CP) is the most common childhood motor disability. The term CP describes a group of movement and posture disorders that limit activity and participation (Rosenbaum et al., 2007). Motor manifestations, including positive symptoms and negative symptoms, and developmental functions vary among children with different CP subtypes (Chen,

Research paper thumbnail of The effect of lower body stabilization and different writing tools on writing biomechanics in children with cerebral palsy

Research in Developmental Disabilities, 2013

Research paper thumbnail of Managing spastic hypertonia in children with cerebral palsy via repetitive passive knee movements

Journal of Rehabilitation Medicine, 2012

Most children with cerebral palsy have increased muscle tension in the lower extremities, which i... more Most children with cerebral palsy have increased muscle tension in the lower extremities, which inevitably leads to abnormal gait characteristics. Proper management of excessive muscle tension is therefore of great importance. The aim of this study was to explore the effects of continuous passive motion on children with cerebral palsy, regarding their lower extremity spastic hypertonia and ambulatory function. Design: A repeated measures design. Subjects: Sixteen children with cerebral palsy. Methods: Intervention was applied to the subject's knees with a continuous passive motion device (at velocities of 15 and 0º/s) for 20 min. Effects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, and 30 min after intervention. Results: For the 15º/s intervention, significant differences were found in time, intervention, and interaction among variables, including active range-of-motion of the knee (increased), relaxation index (increased), Modified Ashworth Scale (decreased), Timed Up-and-Go (decreased), and 6-Minute Walk test (increased). No difference was found in passive range of motion measurements. For the 0º/s control condition, none of the dependent variables demonstrated statistically significant differences. Conclusion: Repetitive passive movement can reduce lower extremity spastic hypertonia in children with cerebral palsy, and improve ambulatory function in terms of walking speed.

Research paper thumbnail of Altered Co-contraction of Cervical Muscles in Young Adults with Chronic Neck Pain during Voluntary Neck Motions

Journal of Physical Therapy Science, 2014

Muscle co-contraction is important in stabilizing the spine. The aim of this study was to compare... more Muscle co-contraction is important in stabilizing the spine. The aim of this study was to compare cervical muscle co-contraction in adults with and without chronic neck pain during voluntary movements. [Subjects and Methods] Surface electromyography of three paired cervical muscles was measured in fifteen young healthy subjects and fifteen patients with chronic neck pain. The subjects performed voluntary neck movements in the sagittal and coronal plane at slow speed. The co-contraction ratio was defined as the normalized integration of the antagonistic electromyography activities divided by that of the total muscle activities. [Results] The results showed that the co-contraction ratio of patients was greater during flexion movement, lesser during extension movement, slightly greater during right lateral bending, and slightly lesser during left lateral bending compared with in the controls. [Conclusion] The results suggested that neck pain patients exhibit greater antagonistic muscle activity during flexion and dominate-side bending movements to augment spinal stability, while neuromuscular control provides relatively less protection in the opposite movements. This study helps to specify the changes of the stiffness of the cervical spine in neck pain patients and provides a useful tool and references for clinical assessment of neck disorders.

Research paper thumbnail of The role of the great toe in balance performance

Journal of Orthopaedic Research, 2009

The objective of this study was to evaluate great toe function in maintaining static and dynamic ... more The objective of this study was to evaluate great toe function in maintaining static and dynamic balance. Correlation among great toe length, body height, and balance performance parameters were also investigated. Thirty females (aged 22.1 +/- 1.9 years) were tested in two great toe conditions: unconstrained and constrained. Balance testing was done in the following order: (1) static balance, single-leg stance with right or left foot, eyes open or closed; (2) static balance, stance with both feet, eyes open or closed; (3) dynamic balance, left/right or forward/backward, rhythmic weight shifting; and (4) dynamic balance, target reaching test, eight targets within 90% limit of stability. Significant differences were found in sway velocity between the two toe conditions with eyes open or closed in single-leg stance (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No difference was found between the two conditions while standing with both feet. For rhythmic weight shifting, significant differences in sway velocity were found in toe conditions and in weight-shifting directions (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). As to target reaching, significance was only noted in directional control scores. Great toe length was correlated with subject&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s height (r = 0.553, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Our results indicate that constraining the great toe deteriorated the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; single-leg stance performance and worsened the directional control ability during forward/backward weight shifting. The importance of the great toe in balance may be taken into account in toe amputation or transfer in the future.

Research paper thumbnail of Work-Related Musculoskeletal Disorders in Athletic Trainer

Journal of Occupational Rehabilitation, 2011

Introduction Athletic trainers often work for elongated and irregular hours or days, and need to ... more Introduction Athletic trainers often work for elongated and irregular hours or days, and need to react in emergency situations. These professionals are at risk for work-related musculoskeletal disorders (WMSDs). This study investigated the WMSDs experienced by athletic trainers (ATs), plus related personal and occupational factors. Methods A customized questionnaire with subject's demographic and WMSDs information was constructed and administered in all accessible ATs in Taiwan. In addition to descriptive analysis of demographics and WMSDs, the relationship between personal/occupational-related factors and WMSD symptoms were also evaluated. Results A total of 146 effective questionnaires were returned. The results indicated that a 48.5% prevalence rate of athletic trainers in Taiwan, and these disorders are mainly located in low back (42%), finger (38%) and shoulder (26%) regions. Logistic regression revealed that average work hour (odds ratio (OR) = 1.834, 95% confidence interval (CI): 1.066-3.156) and continue education participation (OR = 0.346, 95% CI: 0.140-0.854) were the most significant predictors for WMSDs occurrence. Performing taping was the most significant predictor for the low back (OR = 28.274, 95% CI: 2.568-311.423) and finger (OR = 19.535, 95% CI:2.273-167.912) symptoms; while performing providing first aid (OR = 12.128, 95% CI:3.881-37.899) was the most significant predictor for the shoulder's. Conclusion This study revealed that athletic trainers in Taiwan area suffered from high rate of WMSDs, and the relationship between WMSDs and specific job features were reported. Preventive and therapeutic modifications of the work environment to decrease the occurrence of WMSDs are in need for athletic trainers and other similar professions. Further research examining safe patient handling ergonomics, proper equipment in the context of athletic training and professional development strategies must be pursued.

Research paper thumbnail of Finite element analysis of plantar fascia under stretch—The relative contribution of windlass mechanism and Achilles tendon force

Journal of Biomechanics, 2008

Stretching plays an important role in the treatment of plantar fasciitis. Information on the inte... more Stretching plays an important role in the treatment of plantar fasciitis. Information on the internal stresses/strains of the plantar fascia under stretch is useful in enhancing knowledge on the stretch mechanisms. Although direct measurement can monitor plantar fascia changes, it is invasive and gathers only localized information. The purpose of this paper was to construct a three-dimensional finite element model of the foot to calculate the stretch effects on plantar fascia and monitor its stress/strain distributions and concentrations. A three-dimensional foot model was developed and contained 26 bones with joint cartilages, 67 ligaments and a fan-like solid plantar fascia modeling. All tissues were idealized as linear elastic, homogeneous and isotropic whilst the plantar fascia was assigned as hyperelastic to represent its nonlinearity. The plantar fascia was monitored for its biomechanical responses under various stretch combinations: three toe dorsiflexion angles (windlass effect: 15 degrees , 30 degrees and 45 degrees ) and five Achilles tendon forces (100, 200, 300, 400 and 500N). Our results indicated that the plantar fascia strain increased as the dorsiflexion angles increased, and this phenomenon was enhanced by increasing Achilles tendon force. A stress concentration was found near the medial calcaneal tubercle, and the fascia stress was higher underneath the first foot ray and gradually decreased as it moved toward the fifth ray. The current model recreated the position of the foot when stretch is placed on the plantar fascia. The results provided a general insight into the mechanical and biomechanical aspects of the influences of windlass mechanism and Achilles tendon force on plantar fascia stress and strain distribution. These findings might have practical implications onto plantar fascia stretch approaches, and provide guidelines to its surgical release.

Research paper thumbnail of Effects of biaxial pencil on writing biomechanics among children in kindergarten and early elementary school years

research.cgu.edu.tw

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright

Research paper thumbnail of Rapid repetitive passive movement improves knee proprioception

Clinical Biomechanics, 2011

Proprioception can be affected by many factors including exercise. Most exercises involve certain... more Proprioception can be affected by many factors including exercise. Most exercises involve certain degrees of repeated passive movements, and different velocities of these movements might affect proprioception differently. The purpose of this study was to evaluate the influences of different angular velocities of repeated passive movement on knee proprioception via active repositioning and kinesthesia measurement. A quasi-experimental design with repeated measure on movement velocity (0°/s, 2°/s, 90°/s, and 150°/s). Sixteen healthy young adults participated in the study. All of them received 30 times repeated passive knee movement intervention in four different knee angular velocities - 0°/s, 2°/s, 90°/s, and 150°/s - with counter-balanced sequence in four successive days. Knee active repositioning and kinesthesia were measured with error scores before and after the intervention. The results revealed a decrease in error scores in both active repositioning and kinesthesia measurement with the velocities of 90°/s and 150°/s (p&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;0.05); however no significant change was seen with the static condition (0°/s ) or with the velocity of 2°/s. We concluded that repeated passive movement with rapid angular velocities was capable of improving knee proprioception, specifically in active repositioning and kinesthesia measurements. These results would provide information on the effects of different movement velocities onto knee proprioception. Along with further investigations, the findings could potentially enhance our knowledge on knee injury prevention, treatment, and rehabilitation.

Research paper thumbnail of Bilateral femoral neuropathy after vaginal hysterectomy

Archives of Physical Medicine and Rehabilitation, 1998

Research paper thumbnail of Adaptation of vibration-induced postural sway in individuals with Parkinson's disease

Gait & Posture, 2002

Postural control requires accurate integration of visual, vestibular, cutaneous, and propriocepti... more Postural control requires accurate integration of visual, vestibular, cutaneous, and proprioceptive sensory information. Previous research suggests that patients with Parkinson's disease (PD) may have difficulty with this integration process, particularly involving incongruent visual information. The purpose of this study was to determine whether PD patients also show difficulty in adaptation to erroneous proprioceptive information. Postural reactions to soleus muscle vibration were explored in 8 PD patients, 8 healthy elderly, and 8 young adults. Postural sway was recorded using an electromagnetic motion analysis system in four conditions (2 vision ×2 vibration) with four trials in each condition to test subjects' adaptation to the vibrator stimulus. The results showed that PD patients did adapt to the vibration across trials, similar to those of both control groups. It was concluded that PD patients in the early stages of the disease could override inaccurate proprioceptive inputs, relying more on true vestibular and/or visual information. These results suggest that the basal ganglia are not critical for this adaptation process in postural control.

Research paper thumbnail of Stair-Walking Performance in Adolescents with Intellectual Disabilities

Sensors (Basel, Switzerland), Jan 11, 2016

Most individuals with intellectual disabilities (ID) demonstrate problems in learning and movemen... more Most individuals with intellectual disabilities (ID) demonstrate problems in learning and movement coordination. Consequently, they usually have difficulties in activities such as standing, walking, and stair climbing. To monitor the physical impairments of these children, regular gross motor evaluation is crucial. Straight-line level walking is the most frequently used test of their mobility. However, numerous studies have found that unless the children have multiple disabilities, no significant differences can be found between the children with ID and typically-developed children in this test. Stair climbing presents more challenges than level walking because it is associated with numerous physical factors, including lower extremity strength, cardiopulmonary endurance, vision, balance, and fear of falling. Limited ability in those factors is one of the most vital markers for children with ID. In this paper, we propose a sensor-based approach for measuring stair-walking performance...

Research paper thumbnail of Long-term effects of therapeutic exercise on nonspecific chronic neck pain: a literature review

Journal of Physical Therapy Science, 2015

Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to... more Nonspecific neck pain is a common musculoskeletal disease. Therapeutic exercise has been shown to improve pain and disability in short-term and midterm follow-ups. This study performed a literature review of the long-term effects of therapeutic exercise on subjects with nonspecific chronic neck pain. [Subjects and Methods] The databases of the CINAHL, MEDLINE, PEDro and PubMed were used. Randomized controlled trials (RCT) published from January 2000 to January 2014 and explicitly including a one-year follow-up were identified. [Results] Only six articles were included in this review. They had scores of 5 to 8 points on the PEDro scale, and the level of evidence was grade I. The study results show that the main exercises used were cervical strengthening and endurance training exercise. Short-term exercises (10 to 12 weeks) helped to improve the body function, structure, activity and participation immediately after the intervention, but not at the long-term follow-up. On the other hand, long-term interventions (1 year) resulted in improvements in body function and structure at the 3 year follow-up. [Conclusion] The results of the six high-quality studies suggest that long-term exercise have long-term benefits for patients with nonspecific neck pain in terms of body function and structure.

Research paper thumbnail of Effects of whole body vibration on spasticity and lower extremity function in children with cerebral palsy

Human movement science, 2015

The aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity... more The aim of this study was to evaluate the effect of whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy (CP) with a complete crossover design. Sixteen participants aged 9.8(2.3) years received a 20-min WBV and a control condition in a counterbalanced order on two separate days. Change scores of each outcome variable were used to show the improvement. Repeated-measures analyses revealed significant differences in condition scores among variables including active range-of-motion (active ROM, increased), relaxation index (RI, increased), Modified Ashworth Scale (MAS, decreased), timed up-and-go (TUG, decreased), and Six Minute Walk Test (6MWT, increased). Significant differences were also found in time change scores for MAS and 6MWT. Correlation results revealed that TUG was significantly correlated with RI (r=-.512, p=.042), and 6MWT (r=-.700, p=.003). This study suggested that WBV intervention can control the spasticity, en...

Research paper thumbnail of Managing lower extremity muscle tone and function in children with cerebral palsy via eight-week repetitive passive knee movement intervention

Research in developmental disabilities, 2013

This study used a repeated measures design to assess the effect of an eight-week repetitive passi... more This study used a repeated measures design to assess the effect of an eight-week repetitive passive movement (RPM) intervention on lower extremity muscle tone and function in children with cerebral palsy (CP). Eighteen children (aged 9.5 ± 2.1 years) with spastic CP were randomly assigned to a knee RPM intervention condition of 3 times a week for 8 weeks or a control condition. The 8 weeks were followed by 4 weeks of washout period, after which the participants were crossed over to the other group. In the RPM condition, each subject's knees were intervened with continuous passive motion device (at a velocity of 15°/s) for 20 min. The subjects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, after, 1 day after, and 3 days after each intervention. Repeated-measures statistical analyses found significant differences between condition variable on active range-of-motion of the knee (AROM, increased), relaxation index (RI, increased)...

Research paper thumbnail of The importance of the great toe in balance performance

The objective of this study was to evaluate function of the great toe in maintaining human static... more The objective of this study was to evaluate function of the great toe in maintaining human static and dynamic balance. Correlation among the great toe length, body height and balance performance parameters were also investigated. Thirty female subjects (aged 22.1±1.87 years) were tested in two great toe conditions, unconstrained and constrained. Balance testing was done in the orders listed: 1) static balance, single leg stance with right/left foot, eyes open and closed; 2) static balance, both feet, eyes open and closed; 3) dynamic balance, rhythmic weight shifting, left/right and forward/backward; 4) dynamic balance, target reaching test, eight targets within 90% limit of stability (LOS). The results demonstrated significant differences in sway velocity between the two toe conditions with either eyes open or closed in single leg standing (p<0.05). No difference was found between the two toe conditions while standing with both feet. For the rhythmic weight shifting, significant ...

Research paper thumbnail of Motor impairments screened by the Movement Assessment Battery for Children-2 are related to the visual-perceptual deficits in children with Developmental Coordination Disorder

Research in Developmental Disabilities, 2014

This study was to examine to what extent the motor deficits of children with Developmental Coordi... more This study was to examine to what extent the motor deficits of children with Developmental Coordination Disorder (DCD) verified by the Movement Assessment Battery for Children-2 (MABC-2) are linked to their visual-perceptual abilities. Seventeen children with DCD and seventeen typically developing children (TD) aged 5-10 years screened from a total of 250 children were recruited. The assessments included MABC-2, traditional test of visual perceptual skills (TVPS-R), and computerized test for sequential coupling of eye and hand as well as motion coherence. The results indicated that children with DCD scored lower than TD in MABC-2, and their total scores were highly correlated with manual dexterity component scores. DCD group also showed poor visual-perceptual abilities in various aspects. The visual discrimination and visual sequential memory from the TVPS-R, the sequential coupling of eye and hand, and the motion coherence demonstrated a moderate or strong correlation with the MABC-2 in the DCD rather than the TD group. It was concluded that the motor problems screened by MABC-2 were significantly related to the visual-perceptual deficits of children with DCD. MABC-2 is suggested to be a prescreening tool to identify the visual-perceptual related motor deficits.

Research paper thumbnail of The Correlates of Body Mass Index and Risk Factors for Being Overweight Among Preschoolers With Motor Delay

Adapted Physical Activity Quarterly, 2014

This cross-sectional study investigated the correlates of body mass index (BMI) and risk factors ... more This cross-sectional study investigated the correlates of body mass index (BMI) and risk factors for overweight among 91 children with motor delay (MD) aged 9–73 months. Anthropometric measurements and questionnaires regarding multiple risk factors were obtained. Simple correlations between BMI percentile classifications and potential predictors were examined using Spearman’s rank/Pearson’s correlations and χ2 analysis. Multiple predictors of overweight were analyzed using logistic regression. BMI was correlated positively with higher caloric intake (rs = .21, p < .05) and negatively with passive activity (rs = -.21, p < .05). When multiple predictors were considered, more severe dysphagia (odds ratio [OR], 2.81, p = .027, 95% confidence interval [CI], 1.13–7.04) and antiepileptic drug use (OR, 19.12, p = .008, 95% CI, 2.14–170.81) had significant partial effects on overweight status. Agencies supporting early development should consider caregiver education regarding the poten...

Research paper thumbnail of Effects of an eight-week whole body vibration on lower extremity muscle tone and function in children with cerebral palsy

Research in Developmental Disabilities, 2015

The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on l... more The aim of this study was to evaluate the effect of an eight-week whole body vibration (WBV) on lower extremity spasticity and ambulatory function in children with cerebral palsy with a complete crossover design. Sixteen participants aged 9.2 (2.1) years participated in this study. Half of the participants received a 10-min WBV, 3 times a week for 8 weeks. Then a 4-week washout period followed, after which they received a sham WBV 3 times a week for 8 weeks. The other half received the intervention in a reversed order. The participants were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, 1 day after, and 3 days after each intervention. Repeated-measures analyses revealed significant beneficial effects on most variables expect the passive range-of-motion measurement. Significant correlations were found between timed up-and-go and relaxation index, and between timed up-and-go and six-minute walk test. The results suggested that an 8-week WBV intervention normalized muscle tone, improved active joint range and enhanced ambulatory performance in children with cerebral palsy for at least 3 days. These indicated that regular WBV can serve as an alternative, safe, and efficient treatment for these children in both clinical and home settings.

Research paper thumbnail of Seat surface inclination may affect postural stability during Boccia ball throwing in children with cerebral palsy

Research in Developmental Disabilities, 2014

The aim of the study was to examine how seat surface inclination affects Boccia ball throwing mov... more The aim of the study was to examine how seat surface inclination affects Boccia ball throwing movement and postural stability among children with cerebral palsy (CP). Twelve children with bilateral spastic CP (3 with gross motor function classification system Level I, 5 with Level II, and 4 with Level III) participated in this study. All participants underwent pediatric reach tests and ball throwing performance analyses while seated on 15° anterior- or posterior-inclined, and horizontal surfaces. An electromagnetic motion analysis system was synchronized with a force plate to assess throwing motion and postural stability. The results of the pediatric reach test (p = 0.026), the amplitude of elbow movement (p = 0.036), peak vertical ground reaction force (PVGRF) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.001), and movement range of the center of pressure (COP) (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.020) were significantly affected by seat inclination during throwing. Post hoc comparisons showed that anterior inclination allowed greater amplitude of elbow movement and PVGRF, and less COP movement range compared with the other inclines. Posterior inclination yielded less reaching distance and PVGRF, and greater COP movement range compared with the other inclines. The anterior-inclined seat yielded superior postural stability for throwing Boccia balls among children with bilateral spastic CP, whereas the posterior-inclined seat caused difficulty.

Research paper thumbnail of Muscle strength enhancement following home-based virtual cycling training in ambulatory children with cerebral palsy

Research in Developmental Disabilities, 2012

Cerebral palsy (CP) is the most common childhood motor disability. The term CP describes a group ... more Cerebral palsy (CP) is the most common childhood motor disability. The term CP describes a group of movement and posture disorders that limit activity and participation (Rosenbaum et al., 2007). Motor manifestations, including positive symptoms and negative symptoms, and developmental functions vary among children with different CP subtypes (Chen,

Research paper thumbnail of The effect of lower body stabilization and different writing tools on writing biomechanics in children with cerebral palsy

Research in Developmental Disabilities, 2013

Research paper thumbnail of Managing spastic hypertonia in children with cerebral palsy via repetitive passive knee movements

Journal of Rehabilitation Medicine, 2012

Most children with cerebral palsy have increased muscle tension in the lower extremities, which i... more Most children with cerebral palsy have increased muscle tension in the lower extremities, which inevitably leads to abnormal gait characteristics. Proper management of excessive muscle tension is therefore of great importance. The aim of this study was to explore the effects of continuous passive motion on children with cerebral palsy, regarding their lower extremity spastic hypertonia and ambulatory function. Design: A repeated measures design. Subjects: Sixteen children with cerebral palsy. Methods: Intervention was applied to the subject's knees with a continuous passive motion device (at velocities of 15 and 0º/s) for 20 min. Effects were evaluated via variables measuring range-of-motion, muscle tone, and ambulatory function before, immediately after, and 30 min after intervention. Results: For the 15º/s intervention, significant differences were found in time, intervention, and interaction among variables, including active range-of-motion of the knee (increased), relaxation index (increased), Modified Ashworth Scale (decreased), Timed Up-and-Go (decreased), and 6-Minute Walk test (increased). No difference was found in passive range of motion measurements. For the 0º/s control condition, none of the dependent variables demonstrated statistically significant differences. Conclusion: Repetitive passive movement can reduce lower extremity spastic hypertonia in children with cerebral palsy, and improve ambulatory function in terms of walking speed.

Research paper thumbnail of Altered Co-contraction of Cervical Muscles in Young Adults with Chronic Neck Pain during Voluntary Neck Motions

Journal of Physical Therapy Science, 2014

Muscle co-contraction is important in stabilizing the spine. The aim of this study was to compare... more Muscle co-contraction is important in stabilizing the spine. The aim of this study was to compare cervical muscle co-contraction in adults with and without chronic neck pain during voluntary movements. [Subjects and Methods] Surface electromyography of three paired cervical muscles was measured in fifteen young healthy subjects and fifteen patients with chronic neck pain. The subjects performed voluntary neck movements in the sagittal and coronal plane at slow speed. The co-contraction ratio was defined as the normalized integration of the antagonistic electromyography activities divided by that of the total muscle activities. [Results] The results showed that the co-contraction ratio of patients was greater during flexion movement, lesser during extension movement, slightly greater during right lateral bending, and slightly lesser during left lateral bending compared with in the controls. [Conclusion] The results suggested that neck pain patients exhibit greater antagonistic muscle activity during flexion and dominate-side bending movements to augment spinal stability, while neuromuscular control provides relatively less protection in the opposite movements. This study helps to specify the changes of the stiffness of the cervical spine in neck pain patients and provides a useful tool and references for clinical assessment of neck disorders.

Research paper thumbnail of The role of the great toe in balance performance

Journal of Orthopaedic Research, 2009

The objective of this study was to evaluate great toe function in maintaining static and dynamic ... more The objective of this study was to evaluate great toe function in maintaining static and dynamic balance. Correlation among great toe length, body height, and balance performance parameters were also investigated. Thirty females (aged 22.1 +/- 1.9 years) were tested in two great toe conditions: unconstrained and constrained. Balance testing was done in the following order: (1) static balance, single-leg stance with right or left foot, eyes open or closed; (2) static balance, stance with both feet, eyes open or closed; (3) dynamic balance, left/right or forward/backward, rhythmic weight shifting; and (4) dynamic balance, target reaching test, eight targets within 90% limit of stability. Significant differences were found in sway velocity between the two toe conditions with eyes open or closed in single-leg stance (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). No difference was found between the two conditions while standing with both feet. For rhythmic weight shifting, significant differences in sway velocity were found in toe conditions and in weight-shifting directions (p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). As to target reaching, significance was only noted in directional control scores. Great toe length was correlated with subject&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s height (r = 0.553, p &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). Our results indicate that constraining the great toe deteriorated the subjects&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; single-leg stance performance and worsened the directional control ability during forward/backward weight shifting. The importance of the great toe in balance may be taken into account in toe amputation or transfer in the future.

Research paper thumbnail of Work-Related Musculoskeletal Disorders in Athletic Trainer

Journal of Occupational Rehabilitation, 2011

Introduction Athletic trainers often work for elongated and irregular hours or days, and need to ... more Introduction Athletic trainers often work for elongated and irregular hours or days, and need to react in emergency situations. These professionals are at risk for work-related musculoskeletal disorders (WMSDs). This study investigated the WMSDs experienced by athletic trainers (ATs), plus related personal and occupational factors. Methods A customized questionnaire with subject's demographic and WMSDs information was constructed and administered in all accessible ATs in Taiwan. In addition to descriptive analysis of demographics and WMSDs, the relationship between personal/occupational-related factors and WMSD symptoms were also evaluated. Results A total of 146 effective questionnaires were returned. The results indicated that a 48.5% prevalence rate of athletic trainers in Taiwan, and these disorders are mainly located in low back (42%), finger (38%) and shoulder (26%) regions. Logistic regression revealed that average work hour (odds ratio (OR) = 1.834, 95% confidence interval (CI): 1.066-3.156) and continue education participation (OR = 0.346, 95% CI: 0.140-0.854) were the most significant predictors for WMSDs occurrence. Performing taping was the most significant predictor for the low back (OR = 28.274, 95% CI: 2.568-311.423) and finger (OR = 19.535, 95% CI:2.273-167.912) symptoms; while performing providing first aid (OR = 12.128, 95% CI:3.881-37.899) was the most significant predictor for the shoulder's. Conclusion This study revealed that athletic trainers in Taiwan area suffered from high rate of WMSDs, and the relationship between WMSDs and specific job features were reported. Preventive and therapeutic modifications of the work environment to decrease the occurrence of WMSDs are in need for athletic trainers and other similar professions. Further research examining safe patient handling ergonomics, proper equipment in the context of athletic training and professional development strategies must be pursued.

Research paper thumbnail of Finite element analysis of plantar fascia under stretch—The relative contribution of windlass mechanism and Achilles tendon force

Journal of Biomechanics, 2008

Stretching plays an important role in the treatment of plantar fasciitis. Information on the inte... more Stretching plays an important role in the treatment of plantar fasciitis. Information on the internal stresses/strains of the plantar fascia under stretch is useful in enhancing knowledge on the stretch mechanisms. Although direct measurement can monitor plantar fascia changes, it is invasive and gathers only localized information. The purpose of this paper was to construct a three-dimensional finite element model of the foot to calculate the stretch effects on plantar fascia and monitor its stress/strain distributions and concentrations. A three-dimensional foot model was developed and contained 26 bones with joint cartilages, 67 ligaments and a fan-like solid plantar fascia modeling. All tissues were idealized as linear elastic, homogeneous and isotropic whilst the plantar fascia was assigned as hyperelastic to represent its nonlinearity. The plantar fascia was monitored for its biomechanical responses under various stretch combinations: three toe dorsiflexion angles (windlass effect: 15 degrees , 30 degrees and 45 degrees ) and five Achilles tendon forces (100, 200, 300, 400 and 500N). Our results indicated that the plantar fascia strain increased as the dorsiflexion angles increased, and this phenomenon was enhanced by increasing Achilles tendon force. A stress concentration was found near the medial calcaneal tubercle, and the fascia stress was higher underneath the first foot ray and gradually decreased as it moved toward the fifth ray. The current model recreated the position of the foot when stretch is placed on the plantar fascia. The results provided a general insight into the mechanical and biomechanical aspects of the influences of windlass mechanism and Achilles tendon force on plantar fascia stress and strain distribution. These findings might have practical implications onto plantar fascia stretch approaches, and provide guidelines to its surgical release.

Research paper thumbnail of Effects of biaxial pencil on writing biomechanics among children in kindergarten and early elementary school years

research.cgu.edu.tw

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/copyright