Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model
Abstract
:1. Introduction
2. Methods
2.1. Participants
2.2. Training Method
2.3. Measurement
2.4. Data Analysis
2.4.1. Null Model
2.4.2. Research Model
3. Results
3.1. General Characteristic of Research Subjects
3.2. Variables Used in the Analysis
3.3. Null Model
3.4. Research Model
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Deep Neck Flexor Muscle | ||
---|---|---|
Rectus capitis anterior | Origin | Anterior surface of the lateral mass of the atlas (C1 vertebra) and the root of its transverse process |
Insertion | The inferior surface of the occipital bone anterior to the foramen magnum | |
Action | Aids in flexion of the head and the neck | |
Rectus capitis lateralis | Origin | Superior surfaces of the transverse processes of the atlas |
Insertion | Inferior surface of the jugular process of the occipital bone | |
Action | Stabilizes the head; Weakly assists with lateral flexion of the head | |
Longus capitis | Origin | Anterior tubercles of transverse processes of C3–C6 vertebrae |
Insertion | Inferior surfaces of the basilar portion of the occipital bone. | |
Action | Acting bilaterally: flexion of the cervical vertebrae and head; Acting unilaterally: rotation and lateral flexion of the cervical vertebrae and head to the same side | |
Longus colli | Origin | Upper fibers: anterior tubercles of the transverse processes of C3–C5; Central fibers: anterior surface of vertebral bodies of C5–T3 vertebrae; Lower fibers: anterior surface of vertebral bodies of T1–T3 vertebrae |
Insertion | Upper fibers: anterior tubercle of C1 (atlas); Central fibers: anterior surface of vertebral bodies of C2–C4 vertebrae; Lower fibers: anterior tubercles of the transverse processes of C5 and C6 | |
Action | Bilaterally, longus capitis acts as a weak flexor of the head and cervical vertebrae alone; unilateral action of the longus capitis muscle serves to rotate and tilt the cervical vertebrae and head to the ipsilateral side |
Variable | Model | Formulas in the Model |
---|---|---|
FVC | Level-1 model | FVCmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + 𝑢0j ψ1j = γ10 + 𝑢1j | |
FEV1 | Level-1 model | FEV1mj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + 𝑢0j ψ1j = γ10 + 𝑢1j | |
FEV1/FVC | Level-1 model | FEV1/FVCmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + 𝑢0j ψ1j = γ10 + 𝑢1j | |
PCF | Level-1 model | PCFmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + 𝑢0j ψ1j = γ10 + 𝑢1j |
Variable | Model | Formulas in the Model |
---|---|---|
FVC | Level-1 model | FVCmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + γ01 × (PARETICj) + 𝑢0j ψ1j = γ10 + γ11 × (PARETICj) + 𝑢1j | |
FEV1 | Level-1 model | FEV1mj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + γ01 × (PARETICj) + 𝑢0j ψ1j = γ10 + γ11 × (PARETICj) + 𝑢1j | |
FEV1/FVC | Level-1 model | FEV1/FVCmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + γ01 × (PARETICj) + 𝑢0j ψ1j = γ10 + γ11 × (PARETICj) + 𝑢1j | |
PCF | Level-1 model | PCFmj = ψ0j + ψ1j × (TIMEmj) + 𝑒mj |
Level-2 model | ψ0j = γ00 + γ01 × (PARETICj) + 𝑢0j ψ1j = γ10 + γ11 × (PARETICj) + 𝑢1j |
Total (n = 21) | Rt. Side (n = 8) | Lt. Side (n = 13) | t | p | |
---|---|---|---|---|---|
Sex (M/F) | 4/17 | 1/7 | 3/10 | ||
Age (years old) | 76.00 ± 10.19 | 78.13 ± 9.08 | 74.69 ± 10.97 | 0.741 | 0.468 |
Height (cm) | 159.86 ± 6.93 | 161.73 ± 4.95 | 158.72 ± 7.88 | 0.964 | 0.347 |
Weight (kg) | 53.56 ± 9.27 | 49.85 ± 5.40 | 55.84 ± 10.55 | −1.714 | 0.103 |
BMI (kg/m2) | 20.96 ± 3.45 | 19.18 ± 2.91 | 22.05 ± 3.39 | −1.987 | 0.061 |
Mean (Standard Deviation, SD) Minimum to Maximum | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 | ||
Rt. Side | FVC | 1388.75 (435.15) 960~2210 | 1252.50 (298.56) 920~1690 | 1326.25 (297.08) 970~1770 | 1403.75 (319.37) 1000~1860 | 1422.50 (294.07) 1100~1900 | 1456.25 (334.28) 1110~2000 | 1503.75 (400.39) 1160~2360 | 1547.50 (394.92) 1200~2360 | 1555.00 (392.17) 1230~2400 | 1598.75 (429.43) 1200~2550 | 1657.50 (438.92) 1240~2600 | 1783.75 (543.93) 1260~2980 |
FEV1 | 1105.00 (263.60) 800~1620 | 1138.75 (276.79) 780~1490 | 1201.25 (301.64) 720~72 | 1222.50 (312.81) 740~1600 | 1278.75 (269.73) 830~1630 | 1271.25 (306.61) 820~1700 | 1345.00 (378.04) 840~2040 | 1370.00 (351.73) 1050~2040 | 1390.00 (347.85) 980~2020 | 1433.75 (406.59) 1000~2270 | 1445.00 (389.73) 980~2210 | 1522.50 (460.74) 1040~2450 | |
FEV1/FVC | 80.88 (10.38) 56~88 | 90.88 (6.94) 78~98 | 90.13 (8.03) 72~97 | 86.75 (8.00) 74~99 | 89.88 (7.83) 75~99 | 87.13 (7.06) 74~98 | 89.13 (8.82) 70~99 | 89.00 (5.98) 80~98 | 89.25 (7.48) 75~98 | 89.50 (7.33) 75~98 | 87.13 (8.17) 75~98 | 85.50 (9.75) 71~97 | |
PCF | 115.00 (62.96) 60~230 | 118.13 (59.46) 55~220 | 124.38 (59.67) 60~220 | 143.13 (68.76) 60~245 | 158.13 (78.28) 60~260 | 165.63 (80.38) 65~275 | 181.25 (84.12) 70~285 | 188.75 (82.71) 70~290 | 193.75 (79.36) 80~290 | 200.63 (79.93) 75~300 | 209.38 (81.96) 80~310 | 211.25 (84.97) 80~315 | |
Lt. Side | FVC | 1620.77 (509.39) 900~2750 | 1473.08 (534.09) 840~2750 | 1530.00 (496.96) 880~2830 | 1547.69 (512.22) 890~2880 | 1610.77 (547.81) 880~2910 | 1633.85 (505.05) 920~2830 | 1662.31 (529.89) 960~2950 | 1693.08 (549.63) 990~2970 | 1716.92 (556.77) 1050~3000 | 1756.92 (548.70) 1000~2970 | 1803.85 (535.76) 1130~2970 | 1884.62 (574.10) 1190~3250 |
FEV1 | 1350.77 (502.92) 650~2460 | 1334.62 (491.00) 710~2420 | 1353.08 (482.67) 700~2620 | 1396.15 (508.32) 700~2720 | 1457.69 (547.31) 700~2740 | 1476.15 (472.08) 740~2520 | 1468.46 (499.73) 830~2750 | 1528.46 (520.08) 800~2670 | 1562.31 (516.17) 950~2700 | 1513.15 (619.40) 810~2570 | 1578.62 (617.86) 920~2570 | 1692.31 (545.85) 950~2810 | |
FEV1/FVC | 82.00 (11.92) 63~97 | 90.38 (7.22) 77~99 | 87.85 (8.02) 75~99 | 88.54 (6.86) 76~97 | 89.31 (6.13) 78~98 | 89.77 (5.67) 80~98 | 88.38 (6.68) 74~98 | 90.69 (6.92) 74~98 | 90.77 (5.95) 76~98 | 89.08 (6.22) 80~98 | 91.08 (5.92) 70~290 | 89.31 (6.47) 79~98 | |
PCF | 112.69 (50.23) 60~220 | 108.08 (43.04) 50~180 | 115.77 (54.23) 55~240 | 126.54 (56.91) 60~250 | 131.92 (59.78) 65~250 | 145.77 (63.60) 70~250 | 153.46 (62.96) 70~250 | 166.92 (62.10) 70~250 | 176.92 (62.70) 70~270 | 184.23 (71.58) 70~280 | 189.62 (73.58) 70~290 | 193.85 (75.34) 70~300 |
Variable | Fixed Effect | Coefficient | Standard Error | t-Ratio |
---|---|---|---|---|
FVC | Initial value average (ψ0j) | 1413.071 | 94.740 | 14.915 ** |
Linear growth rate average (ψ1j) | 33.345 | 4.834 | 6.898 ** | |
Random Effect | Variance Component | Standard Deviation | ||
Within the group (𝑢0) | 195,160.550 | 441.770 | 1437.965 ** | |
Intergroup (𝑢1) | 449.946 | 21.212 | 157.849 ** | |
Error variance (𝑒) | 9335.194 | 96.619 | ||
Variable | Fixed Effect | Coefficient | Standard Error | t-Ratio |
FEV1 | Initial value average (ψ0j) | 1241.894 | 88.829 | 13.981 ** |
Linear growth rate average (ψ1j) | 31.086 | 5.823 | 5.339 ** | |
Random Effect | Variance Component | Standard Deviation | ||
Within the group (𝑢0) | 170,456.050 | 412.863 | 985.404 ** | |
Intergroup (𝑢1) | 663.913 | 25.767 | 178.554 ** | |
Error variance (𝑒) | 11,975.679 | 109.433 | ||
Variable | Fixed Effect | Coefficient | Standard Error | t-Ratio |
FEV1/FVC | Initial value average (ψ0j) | 87.068 | 1.514 | 57.494 ** |
Linear growth rate average (ψ1j) | 0.269 | 0.127 | 2.114 * | |
Random Effect | Variance Component | Standard Deviation | ||
Within the group (𝑢0) | 43.581 | 6.602 | 144.742 ** | |
Intergroup (𝑢1) | 0.191 | 0.438 | 43.103 ** | |
Error variance (𝑒) | 23.696 | 4.868 | ||
Variable | Fixed Effect | Coefficient | Standard Error | t-Ratio |
PCF | Initial value average (ψ0j) | 107.210 | 11.612 | 9.233 ** |
Linear growth rate average (ψ1j) | 9.043 | 1.091 | 8.291 ** | |
Random Effect | Variance Component | Standard Deviation | ||
Within the group (𝑢0) | 2925.032 | 54.084 | 1234.095 ** | |
Intergroup (𝑢1) | 25.085 | 5.008 | 459.039 ** | |
Error variance (𝑒) | 163.409 | 12.783 |
Variable | Fixed Effect | Side | Coefficient | Standard Error | t-Ratio |
---|---|---|---|---|---|
FVC | Initial value average (ψ0j) | Rt. | 1278.349 | 103.405 | 12.363 ** |
Lt. | 217.627 | 169.343 | 1.285 | ||
Linear growth rate average (ψ1j) | Rt. | 38.728 | 9.620 | 4.026 ** | |
Lt. | −8.696 | 10.782 | −0.806 | ||
Random Effect | Variance Component | Standard Deviation | |||
Within the group (𝑢0) | 193,232.184 | 439.582 | 1352.756 ** | ||
Intergroup (𝑢1) | 457.354 | 21.386 | 152.112 ** | ||
Error variance (𝑒) | 9335.194 | 96.619 | |||
Variable | Fixed Effect | Side | Coefficient | Standard Error | t-Ratio |
FEV1 | Initial value average (ψ0j) | Rt. | 1114.904 | 89.207 | 12.498 ** |
Lt. | 205.138 | 155.889 | 1.316 | ||
Linear growth rate average (ψ1j) | Rt. | 35.529 | 11.040 | 3.218 ** | |
Lt. | −7.176 | 12.755 | −0.563 | ||
Random Effect | Variance Component | Standard Deviation | |||
Within the group (𝑢0) | 168,644.686 | 410.664 | 926.388 ** | ||
Intergroup (𝑢1) | 689.840 | 26.265 | 175.508 ** | ||
Error variance (𝑒) | 11,975.679 | 109.433 | |||
Variable | Fixed Effect | Side | Coefficient | Standard Error | t-Ratio |
FEV1/FVC | Initial value average (ψ0j) | Rt. | 87.454 | 1.929 | 45.342 ** |
Lt. | −0.623 | 2.878 | −0.217 | ||
Linear growth rate average (ψ1j) | Rt. | 0.086 | 0.209 | 0.411 | |
Lt. | 0.296 | 0.259 | 1.142 | ||
Random Effect | Variance Component | Standard Deviation | |||
Within the group (𝑢0) | 46.141 | 6.793 | 144.467 ** | ||
Intergroup (𝑢1) | 0.187 | 0.433 | 40.493 ** | ||
Error variance (𝑒) | 23.696 | 4.868 | |||
Variable | Fixed Effect | Side | Coefficient | Standard Error | t-Ratio |
PCF | Initial value average (ψ0j) | Rt. | 114.095 | 20.600 | 5.539 ** |
Lt. | −11.121 | 24.736 | −0.450 | ||
Linear growth rate average (ψ1j) | Rt. | 9.701 | 1.508 | 6.431 ** | |
Lt. | −1.063 | 2.118 | −0.502 | ||
Random Effect | Variance Component | Standard Deviation | |||
Within the group (𝑢0) | 3049.280 | 55.220 | 1221.383 ** | ||
Intergroup (𝑢1) | 26.171 | 5.116 | 454.143 ** | ||
Error variance (𝑒) | 163.409 | 12.783 |
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Kim, S.-H.; Cho, S.-H. Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model. Medicina 2021, 57, 1312. https://doi.org/10.3390/medicina57121312
Kim S-H, Cho S-H. Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model. Medicina. 2021; 57(12):1312. https://doi.org/10.3390/medicina57121312
Chicago/Turabian StyleKim, So-Hyun, and Sung-Hyoun Cho. 2021. "Neck Stabilization Exercises Enhance Respiratory Function after Stroke: Respiratory Function Index Change Trajectory Analyzed Using a Hierarchical Linear Model" Medicina 57, no. 12: 1312. https://doi.org/10.3390/medicina57121312