Purpose: This study examined the effects of wheelchair handle directions on the trunk muscle activity of adult males when climbing ramps. It also evaluated the wheelchair attendant’s physical discomfort during tasks. Methods: Healthy males aged over 20 years were chosen and the direction of wheelchair handle grip was randomly selected. The grips included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The trunk muscle activity was measured using surface electromyography. Furthermore, the physical discomfort of wheelchair attendants was subjectively evaluated using the Borg CR-10 Scale, which rates the perceived exertion. In addition, the SPSS 18.0 program was used perform repeated measure ANOVA to compare muscle activity and subjective discomfort during the interventions. The contrast test was also conducted with a significance level (α) of 0.05. Results: There was significant difference between the general grip and the medial grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). In addition, there was significant difference between the general grip and the neutral grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). Further, there was significant difference between the general grip and the neutral grip in subjective discomfort (p<0.05). Conclusion: In this study, adult male trunk muscle activity and subjective discomfort were lowest when using the neutral grip while climbing ramps. Accordingly, we suggest that neutral grips will help improve the function of the musculoskeletal system and reduce the subjective discomfort by putting less strain on the trunk muscles and maximizing efficiency with less force.

Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.

Purpose: Although multi-directional reaching exercises are commonly used clinically, the effects of specific movement directions on the muscle systems of the lower extremities have not been explored. We therefore investigated lower extremity muscle activity during reaching exercises with different sagittal and horizontal plane movements. Methods: The surface electromyography responses of the bilateral rectus femoris, tibialis anterior, peroneus longus, and gastrocnemius muscles were measured during reaching exercises in three directions in the horizontal plane (neutral, 45°horizontal shoulder adduction, and 45°abduction) and three directions in the sagittal plane (neutral, 120° flexion, and 60° flexion). A total of 20 healthy, physically active participants completed six sets of reaching exercises. Two-way repeated ANOVA was performed: body side (ipsilateral and contralateral) was set as the intra-subject factor and direction of reach as the inter-subject factor. Results: Reaching at 45° horizontal shoulder adduction significantly increased the activity of the contralateral rectus femoris and gastrocnemius muscles, while 45° horizontal shoulder abduction activated the ipsilateral rectus femoris and gastrocnemius muscles. The rectus femoris activity was significantly higher with reaching at a 120° shoulder flexion compared to the other conditions. The gastrocnemius activity decreased significantly as the shoulder elevation angle increased from 60° to 120°. Conclusion: Our results suggest that multi-directional reaching stimulates the lower extremity muscles depending on the movement direction. The muscles acting on two different joints responded to the changes in reaching direction, whereas the muscles acting on one joint were not activated with changes in reaching direction.