Journal of Physical Therapy Science Vol. 29(2017) No. 9

[Purpose] The purpose of the present study was to investigate the relationship of health, sociodemographic, and economic factors and life satisfaction in young-old and old-old elderly groups. [Subjects and Methods] In the 2012 data from the Korean Longitudinal Study of Ageing, 4,134 of the final survey subjects aged 65 or older were analyzed. Multivaribale linear regression was performed to examine the degrees of explanatory power as factors (health, sociodemographic, and economic) in young-old (65 to 79 years) and old-old (80 years or older). [Results] Common variables that affected life satisfaction in both young-old and old-old subjects were health-related factors (depression, moderate to severe cognition, activities of daily living score), sociodemographic factors (level of education, familial communication, social activities), and economic factors (household assets, type of medical insurance). In the old-old group, age was an important associated factor. Mild cognitive impairment did not significantly affect life satisfaction in the old-old group, and only low-intensity social activities had an influence in the old-old group. [Conclusion] Difference in life satisfaction between the young-old and old-old elderly could be explained by gaps in the acceptance of the aging in health. Therefore, a personalized health consultation by life cycle could minimize these differences.

[Purpose] The purpose of this study was to determine whether place running exercises increase the pulmonary function of normal adults. [Subjects and Methods] Thirty normal adults in their 20s were randomly assigned to an experimental group (n=15) or a control group (n=15). Over the course of four weeks, the experimental group participated in place running exercise for 30 minutes five times per week. The control group only participated in moto-med exercise for 30 minutes five times per week. Subjects were assessed pre- and post-test by measuring the tidal volume, inspiratory reserve volume, expiratory reserve volume, and vital capacity. [Results] Our findings show significant improvements to vital capacity in the experimental group. The experimental group had higher pulmonary function than the control group. In the investigation of the differences between the intervention group and the control group before and after the experiment, significant differences were found for expiratory reserve volume and vital capacity. [Conclusion] Finally, the experimental group showed a greater improvement in pulmonary function than the control group, which indicates that place running exercises are effective at increasing the pulmonary function of normal adults.

[Purpose] The aim of this study was to investigate whether gaze stabilization exercise derives sensory reweighting of vestibular for upright postural control. [Subjects and Methods] Twenty-three healthy volunteers participated in this study. The center of pressure of the total trajectory length was measured before (pre), immediately after (post), and 10 min after (post10) gaze stabilization exercise, in the static standing position, with the eyes open or closed, on the floor or on foam rubber. The sensory contribution values of the visual, somatosensory, and vestibular systems were calculated using center of pressure of the total trajectory length value in these measuring conditions. [Results] The center of pressure of the total trajectory length on foam rubber in post and post10 were significantly lower than that in the pre. The sensory contribution values of vestibular in post10 stages were significantly higher than that in pre-stage. [Conclusion] Gaze stabilization exercise can improve the static body balance in a condition that particularly requires vestibular function. The possible mechanism involves increasing sensory contribution of the vestibular system for postural control by the gaze stabilization exercise, which may be useful to derive sensory reweighting of the vestibular system for rehabilitation.

[Purpose] Although some studies suggest the importance of getting adequate sleep for enhancing mood, there is not yet sufficient evidence on the relationship between sleep and mood states in athletes, especially for athletes with physical disability. The purpose of this study is to reveal relationships between sleep and psychological mood states in female wheelchair basketball players. [Subjects and Methods] Seventeen female wheelchair basketball players (30.9 ± 9.4 years old) on a Japanese national team participated. Sleep states were assessed with the Pittsburgh Sleep Quality Index (PSQI), and mood states with the Japanese version of the Profile of Mood States short form (POMS-SF). Spearman’s rank correlations were computed. [Results] The mean PSQI score was 5.4 ± 2.6 points, and 9 athletes (52.9%) exceeded the cutoff point (5.5) for insomnia. Higher sleep efficiency (r_S=0.58), fewer sleep disturbances (r_S=−0.58), and lower total PSQI score (r_S=−0.51) were significantly correlated with higher vigor. Lower likelihood of daytime dysfunction was also significantly correlated with lower tension (r_S=0.50). [Conclusion] Vigor was the mood state most frequently correlated with sleep variables. Because vigor is a known key psychological factor in optimal performance, the findings are valuable for wheelchair basketball players.

[Purpose] We compared the effectiveness of dry needling with a classical physiotherapy program in patients with chronic low-back pain caused by lumbar disc hernia (LHNP). [Subjects and Methods] In total, 34 subjects were allocated randomly to the study (n=18) and control groups (n=16). In the study group, dry needling was applied using acupuncture needles. The control group performed a home exercise program in addition to hot pack, TENS, and ultrasound applications. Pain was assessed with the short form of the McGill Pain Questionnaire. The number of trigger points and their pressure sensitivity were evaluated with a physical examination (palpation). The Beck Depression Inventory was used to assess depression. The Tampa Kinesiophobia Scale was used to assess fear of movement. [Results] In the study group, the calculated Cohen’s effect sizes were bigger than those in the control group in terms of pain, trigger point-related variables, and fear of movement. Effect sizes for reducing depressive symptoms were similar in both groups. [Conclusion] These results suggest that dry needling can be an effective treatment for reducing pain, number of trigger points, sensitivity, and kinesiophobia in patients with chronic low-back pain caused by lumbar disc hernia.

[Purpose] This study was designed to examine the epidemiological background of Whiplash-associated disorders in Japanese adults and to investigate the psychological factors associated with prolonged treatment for Whiplash-associated disorders. [Subjects and Methods] An online survey was completed by 127,956 participants, of whom 4,164 had been involved in a traffic collision. A random sample of the collision participants (n=1,698) were provided with a secondary questionnaire. From the 974 (57.4%) participants who returned the questionnaire, 183 cases (intractable neck pain treated over a period of 6 months) and 333 controls (minor neck pain treated within 3 months) were selected. Among the control group, the psychological factors associated with prolonged treatment for Whiplash-associated disorders were investigated. [Results] Among the 4,164 collision participants, 1,571 (37.7%) had experienced Whiplash-associated disorders. The prevalence in the general population was 1.2% (1.3% in male and 1.0% in female). Significant differences were observed between the cases and controls for all psychological factors, although both groups had similar distributions of age and gender. [Conclusion] Poor psychological factors were associated with prolonged treatment for whiplash-associated disorders in Japanese adults. These psychological factors should be considered during the treatment of whiplash-associated disorders.

[Purpose] This study aimed to evaluate the effects of taping and hot packs on premenstrual syndrome, in an attempt to generate basic data for physical therapy intervention for premenstrual syndrome. [Subjects and Methods] Thirty-two females in their 20s with premenstrual syndrome were randomly assigned to a taping group (n=10), hot pack group (n=11), and taping with hot pack group (n=11). Premenstrual syndrome was assessed using the Menstrual Distress Questionnaire in each participant prior to intervention and was re-assessed after applying kinesio taping and/or hot pack from 10 days before the estimated date of menstruation until the first day of menstruation. [Results] Data revealed that the taping and taping with hot pack groups showed significantly reduced premenstrual syndrome following intervention. In terms of the differences in the Menstrual Distress Questionnaire total score among the groups, the taping with hot pack and hot pack groups showed a significant difference. [Conclusion] These findings indicate that kinesio taping is an easy, non-drug intervention for female college students with premenstrual syndrome.

[Purpose] The aim of this study was to compare immediate effects between new medical stretching (NMS) and conventional medical stretching (CMS) techniques on Hamstrings flexibility. [Subjects and Methods] Thirteen healthy adult males, with finger floor distance (FFD) less than zero centimeter, without known musculoskeletal and neurological impairment in spine or lower extremities, were included. The subjects were randomly allocated to two groups. The subjects were instructed to perform NMS and CMS (hold for 30 seconds once, twice for each side of lower extremity) for both sides (total two minutes, only one session for one day). The interval between the two techniques was one week. FFD was measured with digital standing trunk flexion meter at the pre-intervention and post-intervention of both techniques. [Results] The mean values of FFD improved at the post-interventions of both techniques. The tests of within subject effects indicated that the main effect of treatment was not significant but the main effect of time was significant and the interaction of treatment and time was also significant. [Conclusion] The results of this study indicated that both medical stretching techniques were effective on Hamstrings flexibility immediately after the intervention and NMS technique was more effective on improving flexibility.

[Purpose] Electromyography biofeedback therapy is applied to various diseases during physical therapy for motor learning. Our aim was to develop a low-cost electromyography biofeedback device kit that students could build by themselves in class and to evaluate whether this kit was an adequate educational tool for physical therapy students. [Subjects and Methods] This study included 34 volunteers from a 3 year physical therapy vocational school and a 4 year university course. All students were tasked with: 1) completing a pre-questionnaire; 2) attending basic lectures on electromyography biofeedback therapy and how to build the device; 3) building the device; and 4) completing a post-questionnaire. [Results] Mean time required to build the device was 50.8 ± 34.1 minutes for the vocational course students and 27.4 ± 8.8 minutes for university students. For both groups, there was a significant increase in the number of students stating “have an interest in,” “be involved with,” and “have knowledge of electromyography biofeedback” when pre- and post-questionnaires were compared. In the post questionnaire, the frequency of the “knowledge increased” response was higher. [Conclusion] Physical therapy students can easily build our new device in a classroom, and this kit is a useful educational tool to motivate learning in electromyography biofeedback.

[Purpose] Counteracting the systemic cytokine release and its inflammatory effects by improving respiratory muscle strength and controlling lung inflammation may be important for improving immune system in patients with chronic obstructive pulmonary disease, So the aim of the present study was to evaluate the effect of low level laser therapy and inspiratory muscle training on interleukin-6 (IL-6) as a marker of inflammation and CD4+/CD8+ ratio as a marker for T Lymphocytes in these patients. [Subjects and Methods] Forty male patients with stable COPD participated in the study, their ages ranged between 55−65 years. They were randomly divided into group (A) who received inspiratory muscle training and group (B) who received low level laser (LLL) acupuncture stimulation for about 8 week. [Results] There was a reduction in the concentration of plasma IL-6 associated with an increase in CD4+/CD8+ ratio in both groups, but laser was superior to inspiratory muscle training. IL-6 and CD4+/CD8+ were negatively correlated. [Conclusion] Both inspiratory muscle training and low level laser therapy are effective physical therapy modalities in promoting immune disturbances. The results also supported the superior role of LLLT over IMT in managing immune disturbances.

[Purpose] Recently, we demonstrated that the thicknesses of trunk muscles measured using ultrasonography were correlated strongly with the cross-sectional areas measured using magnetic resonance imaging in untrained subjects. To further explore the applicability of ultrasonography in the clinical setting, the present study examined the correlation between ultrasonography-measured thicknesses and magnetic resonance imaging-measured cross-sectional areas of trunk muscles in athletes with trained trunk muscles. [Subjects and Methods] The thicknesses and cross-sectional areas at total 10 sites of the bilateral sides of the upper, central, and lower parts of the rectus abdominis, abdominal wall, and multifidus lumborum in 30 male baseball batters were measured. [Results] Overall thicknesses and cross-sectional areas of the trunk muscles in baseball batters were higher than those in untrained subjects who participated in our previous study. The ultrasonography-measured thicknesses at all 10 sites of the trunk muscles correlated highly with the magnetic resonance imaging-measured cross-sectional areas in baseball batters. [Conclusion] These results suggest that the thicknesses of the trunk muscles measured using ultrasonography can be used as a surrogate marker for the cross-sectional area measured using magnetic resonance imaging, in athletes who have larger trunk muscles than that of untrained subjects.

[Purpose] The soleus H-reflex is depressed at stimulation rates greater than 0.1 Hz. This reflex depression is referred to as postactivation depression. Postactivation depression reflects the reduced efficacy of the Ia-motoneurons synapses when they are evaluated after a previous activation. The aim of this study was to determine whether the recovery of motor functions in the lower extremities affects the PAD of the soleus H-reflex in patients with subacute stroke undergoing rehabilitation. [Subjects and Methods] Eight patients with subacute stroke patients were recruited. Postactivation depression, Fugl-Meyer score (lower-limb portion), walking velocity, the Modified Ashworth Scale, and center of pressure sway during standing were measured within three days of admission to rehabilitation and 50 days later. [Results] After rehabilitation, Fugl-Meyer scores, center of pressure path length, and walking velocity were significantly improved, and postactivation depression had significantly increased. There was a significant positive correlation between the rates of change of postactivation depression and center of pressure path length. [Conclusion] The results demonstrated that postactivation depression is partially normalized after rehabilitation in patients with subacute stroke, and suggested that the recovery in lower extremity function after stroke particularly standing stability is affected by spinal synaptic plasticity.

[Purpose] The purpose of this research was to verify the reliability and validity of measuring respiration movement using a wearable strain sensor (WSS) which has been developed newly for clinical objective assessment. [Subjects and Methods] The 21 healthy male students were advised to conduct a breathing movement using measuring tape (MT) and WSS respectively, which was the measured at four locations on chest and abdomen wall. The different degree of chest expansion from maximal end of expiration to maximal end of inspiration was confirmed at each location. The intra-rater ICC (1,1) with 95% confidence interval was used to assess the test-retest reliability, Pearson’s correlation analysis was performed to establish the validity. [Results] All ICC values for intra-rater reliability were from 0.94 to 0.98 at all locations, which means that there is a high correlation. All values for validity showed significantly positive, indicating that there is a correlation between the measuring tape and WSS at four locations. [Conclusion] Compared to the measuring tape, WSS has been proved to have high reliability and validity. The finding of this research indicated that WSS is reliable to use for objective measurement of respiratory movements on the chest and abdomen wall in clinical assessment.

[Purpose] The purpose of study was to investigate the effect of taping applied before magnetic field therapy. [Subjects and Methods] Thirty patients who diagnosed with knee arthritis by a specialist in the rehabilitation department were divided into three groups using the random allocation method. The control group received 15 min general physiotherapy. For the experimental group 1, non-elastic taping was applied to the medial side of the knee after general physiotherapy, followed by a 15 min magnetic field therapy. For the experimental group 2, elastic taping was applied to the medial side of the knee after general physiotherapy, followed by a 15 min magnetic field therapy. This study used visual analog scale to evaluate pain. This study used Western Ontario and McMaster Universities to evaluate the knee function. [Results] Experimental group 1 and experimental group 2 showed a significant difference visual analog scale and Western Ontario and McMaster Universities from the control group. However, no significant difference was observed between experimental group 1 and experimental group 2. [Conclusion] Choosing the applicable taping method according to the condition of the patients and applying it to therapy is necessary to reduce pain and improve the function of the patients with knee osteoarthritis.

[Purpose] This study was conducted to compare the swallowing function and quality of life (QOL) in stroke patients with dysphagia by oral intake level. [Subjects and Methods] Seventy-nine stroke patients with dysphagia were enrolled. All subjects were evaluated by using the Swallowing Function Test (SFT) and the Swallowing Quality of Life (SWAL-QOL) questionnaire. The subjects were divided into two group based on the SFT score: oral intake (OI) and non-oral intake (NOI) groups. The SFT and SWAL-QOL scores were then compared between the groups. [Results] There were significant differences in items in the SFT, except for the respiratory item, between the OI group and the NOI group. There were significant differences in all items on the SWAL-QOL, except for the sleep item, between the OI group and the NOI group. [Conclusion] Oral intake was positively associated the swallowing function and QOL in stroke patients with dysphagia. Safe intervention using oral intake treatments during dysphagia rehabilitation may have a positive effect on the patients’ swallowing function and QOL.

[Purpose] In sports physical therapy, video of a patient’s movement or of a skilled model’s movement has been used as observational learning methods for injury prevention and movement modification. Positive effects of model video observation have been reported. This study aimed to clarify the effect on motor skill learning using a combination of model-observation and self-observation, which is thought to act as an enhanced method for active error detection by comparing model-observation and self-observation alone for acquisition of correct sports movement. [Subjects and Methods] Forty-five healthy females were randomly allocated into three groups comprising model- and self-observation, model-observation, and self-observation. The motor task performed was a half golf swing using an elastic club. Shoulder grip angle between both shoulder lines and the acromia grip strength were measured as an index of body rotation using a three-dimensional motion analyzer. Change in the shoulder grip angle in the three groups was analyzed at pre-, immediate delayed retention, and delayed retention tests. [Results] A significant difference in shoulder grip angle was observed among the three groups for the immediate delayed retention test. The combined model and self-observation group had a value closer to 90 degrees compared to the other two groups. [Conclusion] Observation combining model and self-observation exerted a positive effect on short-term motor skill learning.

[Purpose] The purpose of this study was to investigate which of the four chair-rising methods has low-load and the highest success rate, and whether the GRF parameters in that method are useful for measuring lower extremity function among physically frail Japanese older adults. [Subjects and Methods] Fifty-two individuals participated in this study. The participants voluntarily attempted four types of Sit-to-stand test (one variation without and three variations with the use of their arms). The following parameters were measured: peak reaction force (F/w), two force development rate parameters (RFD1.25/w, RFD8.75/w) and two time-related parameters (T1, T2). Three additional commonly employed clinical tests (One-leg balance with eyes open, Timed up and go and 5-meter walk test) were also conducted. [Results] “Hands on a chair” chair-rising method produced the highest success rate among the four methods. All parameters were highly reliable between testing occasions. T2 showed strongly significant associations with Timed up and go and 5-meter walk test in males. RFD8.75/w showed significant associations with Timed up and go and 5-meter walk test in females. [Conclusion] Ground reaction force parameters in the Sit-to-stand test are a reliable and useful method for assessment of lower extremity function in physically frail Japanese older adults.

[Purpose] Histopathological investigation of the effects of low-intensity pulsed ultrasound (LIPUS) on joint components using a rat knee joint contracture model. [Subjects and Methods] Nineteen, 9-week-old Wistar male rats were divided into a control group (n=6) and an experimental group. Rats in the experimental group underwent cast immobilization of the right rear limb for 8 weeks. They were then randomly divided into a non-treatment group (n=6), which was raised under normal conditions for 4 weeks, and a treatment group (n=7), which underwent LIPUS for 4 weeks. LIPUS irradiation was performed at a frequency of 3 MHz, an intensity of 30 mW/cm², and a pulse rate of 20% duty cycle. Irradiation was performed once daily for 10 min, 5 days per week. At the end of this period, tissue specimens in which the knee sagittal plane could be observed were prepared and observed using an optical microscope. [Results] The extension-limiting angle of the knee joint was significantly less in the treatment group compared with the non-treatment group. The posterior joint capsule was significantly thicker only in the non-treatment group, and the density was 53.5 ± 7.5% for the control group, 77.2 ± 5.7% for the non-treatment group, and 69.2 ± 2.9% for the treatment group, with significant differences existing across all groups. [Conclusion] LIPUS may widen the space between collagen fiber bundles of the joint capsule, thereby improving the range of motion.

[Purpose] The aim of our study was to explore the changes in the blood of servicemen in sub-health conditions during a 21-day balneotherapy program. [Subjects and Methods] For this study, 129 servicemen in sub-health condition were recruited. The subjects were randomly divided into either the balneotherapy group (70) or the control group (59). Subjects in the balneotherapy group received whole-body immersion bath therapy in thermomineral water (30 min daily) for 21 days. Their blood samples were examined 1 day before and after balneotherapy. The parameters studied included mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell (WBC), lactic acid (LAC), alanine aminotransferase (ALT), glucose (GLU), and triglycerides (TG) levels. [Results] After 21 days of balneotherapy, MCH levels and MCHC increased significantly and WBC counts increased significantly. LAC levels decreased significantly. ALT, GLU, and TG levels decreased significantly. In the control group, there were no statistical differences before and after tap water baths following the same procedure. [Conclusion] A 21-day balneotherapy program significantly improved blood cell counts and blood biochemical indexes and reduced ponogen levels in servicemen in sub-health condition.

[Purpose] In this paper, hamstring stretching and nerve mobilization are conducted on patients with radicular lower back pain, and changes to pain levels, pressure thresholds, angles of knee joint extension, and disorder levels of lower back pain were studied. [Subjects and Methods] The subjects were divided into two groups: one group conducted hamstring stretches and was comprised of 6 male and 5 female subjects, and the other group received nerve mobilization treatment and was comprised of 5 male and 6 female subjects. [Results] Pain level and the disorder index of lower back pain were significantly alleviated after the intervention in both groups. Pressure threshold and angles of knee extension were significantly increased after the intervention in both groups. Comparing the two groups, the alleviation of pain was more significant in the nerve mobilization group. [Conclusion] Patients with radicular lower back pain showed significant differences in pain level, pressure threshold, knee extension angle, and disorder index of lower back pain for both the hamstring stretching group and nerve mobilization group after the treatment. Hamstring stretching and nerve mobilization can be usefully applied for the therapy of patients with radicular lower back pain.

[Purpose] To investigate sports injuries in Korean national ice hockey players by surveying parts, times, types, frequency, cure, and prevention types of sports injuries and provide basic data for injury prevention and performance improvement of ice hockey players. Another purpose of this study was to evaluate the incidence of ice hockey injuries according to age and the relationship between etiological factors and injuries in high school students. [Subjects and Methods] This was a cross-sectional study. Eighteen female ice hockey players in Korean elite athletes were recruited for this study. This study was conducted by a self-administered questionnaire survey using Knee Injury and Osteoarthritis Outcome Score (KOOS) of national ice hockey players. [Results] Participants were injured mainly during training. Injuries were caused by skate, puck-contact, and body check. Five subscales of KOOS were significantly correlated with each other except that the correlation between activities of daily living and quality of life was insignificant. [Conclusion] For injury prevention in national team ice hockey players, full gear is recommended. In addition, therapist in the field needs to conduct injury prevention through consistent observations and counseling in order to prevent injury and improve performance. Ice hockey players also need sufficient rest with systematic and scientific training for injury prevention and performance improvement.

[Purpose] To determine the effect of augmented reality (AR)-based otago exercise on muscle strength, balance, and physical factors in falls of elderly women. [Subjects and Methods] Thirty subjects were randomly assigned to AR group (AR, n=10), yoga group (yoga, n=10), and self-exercise group (self, n=10). For 12 weeks, these groups were given lessons related to AR-based otago exercise including strengthening, balance training, or yoga three times a week (60 minutes each time) and self-exercise using elastic band exercise program. [Results] Knee flexion and ankle dorsiflexion strength were significantly improved in all three groups (AR, yoga, and self-exercise groups). Regarding balance, eye open center of pressure-x (EO CoP-x) was significantly decreased in AR group and yoga group. However, eye close CoP-x, eye open standard deviation-x (EO SD-x), and eye open height of ellipse (EO HoE) were only significantly decreased in AR group. AR group also showed meaningfully improved results in morse fall scale. [Conclusion] Augmented reality-based otago exercise can improve muscle strength, balance, and physical factors in elderly women to prevent falls.

[Purpose] This study was conducted to investigate the effects of ankle control balance training (ACBT) on postural balance and gait ability in community-dwelling older adults. [Subjects and Methods] Fifty-four subjects were randomly divided into two groups, with 27 subjects in the ACBT group and 27 subjects in the control group. Subjects in the ACBT group received ACBT for 60 minutes, twice per week for 4 weeks, and all subjects had undergone fall prevention education for 60 minutes, once per week for 4 weeks. The main outcome measures, including the Berg balance scale; the functional reach test and one leg stance test for postural balance; and the timed up-and-go test and 10-meter walking test for gait ability, were assessed at baseline and after 4 weeks of training. [Results] The postural balance and gait ability in the ACBT group improved significantly compared to those in the control group, except BBS. [Conclusion] The results of this study showed improved postural balance and gait abilities after ACBT and that ACBT is a feasible method for improving postural balance and gait ability in community-dwelling older adults.

[Purpose] The purpose of this study was to compare the changes in isolation ratios of the trunk muscles during hip adduction. [Subjects and Methods] In total, 15 males aged 27–35 years were recruited for the present study. Electromyography data of the external oblique, internal oblique, and erector spinae muscles were collected during hip adduction exercise. [Results] With respect to the internal oblique muscles, the isolation ratio during hip adduction was significantly higher than during no adduction. With respect to the external oblique muscles, the isolation ratio during hip adduction was significantly lower than during no adduction. [Conclusion] Therefore, hip adduction would be a proper exercise for isolated training of the internal oblique muscles, rather than the external oblique muscles, for trunk stability.

[Purpose] Seated side tapping test (SST) performance is associated with mobility impairment in the elderly. Although this test was developed to assess trunk function, interpretation of its results may be confounded by the upper-limb movements in its protocol. Here, this study aimed to validate the association between trunk function and gait function by means of the Arms Crossed SST (AC-SST), a modified version of the SST in which the arms are crossed over the chest, to exclude the effects of the upper limbs. [Subjects and Methods] A total of 116 community-dwelling elderly people were enrolled in the study (mean age: 75.1 ± 5.5 yrs). Measurement categories were gait function (gait speed and TUG), lower extremity strength (knee extension and flexion strength), trunk muscle endurance (trunk extension and flexion endurance), and trunk function (SST and AC-SST). [Results] AC-SST performance significantly correlated with gait function items, as did SST performance. Moreover, AC-SST was one of the significant predictor variables of gait function selected in stepwise multiple regressions. [Conclusion] Gait function associated with performance on the AC-SST, a test of trunk function in which the effects of upper limb function were excluded, reinforcing the importance of trunk function to elderly mobility.

[Purpose] This study was conducted to predict the risks of standing on mediolateral ramps by identifying the ratios of the multifidus muscles on the two sides of the spine when standing postures are maintained on mediolateral ramps of diverse angles. [Subjects and Methods] The study was conducted with 15 healthy adult males. All subjects participated voluntarily. Mediolateral ramps at five angles (0°, 5°, 10°, 15°, and 20°) were used. Ultrasonography was used to determine the thicknesses of the multifidus muscles under individual conditions. [Results] The ratio of the left/right multifidus muscles showed statistically significant differences as the angle of the mediolateral ramp increased. Post-hoc test results showed that the use of the two multifidus muscles was asymmetric on mediolateral ramps at angles equal to or larger than 10°. [Conclusion] The asymmetric use of the multifidus muscles began on a mediolateral ramp at an angle of 10°, suggesting that subjects with instability in body control might have risk factors such as falls on mediolateral ramps with angles equal to or larger than 10°. Therefore, caregivers must be attentive and/or assist patients and older adults when they are walking on ramps at angles of approximately 10° and up in their daily lives.

[Purpose] The purpose of this study was to investigate adapting wheelchair cushions to hemiplegic individuals based on trunk function and a single-leg driving motion. [Subjects and Methods] Subjects were 18 hemiplegic adults who were able to use and sit up in a wheelchair. Subjects were grouped into Able and Unable groups according to the Functional Assessment for Control of the Trunk (FACT). The posterior pelvic tilt angle and the driving speed and muscle activity at the long head of the biceps femoris at the start of wheelchair use were measured for three wheelchair cushion conditions, and FACT factors and cushion factors were then analyzed. [Results] The cushion with anchoring functionality and no thigh pad on the driving side resulted in significantly lower posterior pelvic tilt and muscle activity of the long head of the biceps femoris. No significant difference was found among the FACT factors. The Unable group did not exhibit a difference in driving speed between no cushion and a single-layer urethane foam cushion. [Conclusion] The results suggest that the cushion with anchoring functionality and thigh pad removed on the driving side was well adapted to hemiplegic wheelchair users and particularly effective for those with low trunk control ability.

[Purpose] This study aimed to investigate how closed and open kinetic chain exercises differed in their impact on bone mineral density (BMD) and fall risk in postmenopausal women with osteoporosis. [Subjects and Methods] The research sample consisted of 40 postmenopausal women with osteoporosis with ages between 51 and 58 years old. They were divided at random into two groups of 20 each, respectively receiving closed and open kinetic chain exercises. These exercises were administered three times per week over a period of four sequential months. Prior to and following the treatment, Dual X-ray Absorptiometry (DEXA) was used to measure the BMD of the femur neck in every participant, while the Biodex Stability System (BSS) was used to estimate how likely each participant was to sustain a fall. [Results] The strongest effect on BMD and fall risk was recorded by the closed kinetic chain exercise. [Conclusion] Osteoporotic postmenopausal women should be prescribed closed kinetic chain exercise to diminish the effects of the disease and minimise their risk of fall.

[Purpose] The purpose of this research is to take a look at the influences of the mental practice on the quality of life of stroke patients. [Subjects and Methods] Through a randomization of 32 stroke patients, this research allocated the experimental group (n=15) and the control group (n=17). Regarding the experimental group, the imagination practice intervention and the ordinary rehabilitation therapy had been applied 1 time a day and 5 times a week for 4 weeks. Regarding the control group, the ordinary rehabilitation therapy had been provided during the same session as that of the experimental group. In order to measure the quality of life, the SS-QOL was used. [Results] The mental practice and CON groups showed significant differences with the SS-QOL scores. [Conclusion] Through the result of this research, we were able to find out that the mental practice intervention is effective with regard to the improvement of the quality of life of the stroke patients. Regarding the researches that will take place later on, the researches which achieved the securing of even more experiment subjects and the control of the diverse variables of the quality of life will be needed.

[Purpose] The purpose of this study was to investigate not only the effects of stimulatory vibration but also the retained effects 2 weeks after the last session of the intervention. [Subjects and Methods] Ten subjects with post-stroke hemiplegia were recruited in this study. The experimental group (EG) received vibratory stimulation for 30 minutes in each session, three times a week for 2 weeks. Grip strength (GS), box-and-block test (BBT), and Weinstein monofilament were used to assess hand strength, dexterity, and sensory in the affected hand, respectively. [Results] A significant difference was found between the pre- and post-follow-up BBT. Significant differences were found among the pre-posttest, post-follow-up test, and pre-follow-up test results for GS and BBT. [Conclusion] This study was conducted with 10 subjects, without a control group, to verify the pure effect of the intervention. As a result, significant positive effects were observed in the post-test and follow-up test of GS and BBT. Therefore, repeated vibratory stimulation influenced GS and BBT after the 2-week intervention and retained the effect for 2 more weeks.

[Purpose] The purpose of the present study was to investigate the effectiveness on the educational procedure development for physical therapist assistant in Quang Tri province of Vietnam. [Subjects and Methods] The subjects consisted of 10 lecturers for the education of physical therapist assistant in Quang Tri medical college. To compare with satisfaction and educational effectiveness according to the participation of educational procedure, the lecturers conducted the survey research. [Results] In the descriptive values of participant satisfaction in educational procedure, most of the scored were higher than 4. There was no significance in the difference between the satisfaction in educational procedure according to gender and degree. However, there was some significance in class according to major. To investigate the educational effectiveness, 5 domains about knowledge of physical therapist assistant included 4 questions each were evaluated the understanding level before and after the education. In all domains, the understanding level after education was notably higher than before. [Conclusion] The present study was to the satisfaction and effectiveness of the educational procedure for physical therapist assistant reflecting the regional specialty in this area. The development of educational procedure for physical therapist assistant helps to improve the situation where the medical specialists for rehabilitation are insufficient.

[Purpose] Locomotive syndrome (LS) is a condition by which older people may require care service because of problems with locomotive organs. This study examined whether the loco-check, a 7-item questionnaire, is useful for quantitatively assessing the severity of LS. [Subjects and Methods] Seventy-one community dwelling Japanese females aged 64–96 years (81.7 ± 8.0 years) participated in this study. The associations of the loco-check with thigh muscle mass measured by X-ray CT, physical performance, nutritional status, and quality of life (QOL) were investigated. [Results] The results showed that the number of times that “yes” was selected in the loco-check was significantly correlated with thigh muscle mass, major measures of physical performance, nutritional status, and QOL. This number was also significantly larger in the participants experiencing falling, fracture, and lumbar pain than in those without these episodes. [Conclusion] These results suggest that the loco-check might be useful for quantitatively evaluating LS.

[Purpose] The aim was to evaluate the effect of therapeutic ultrasound on the pain, joint mobility, muscle strength, physical function, and quality of life of people with knee OA. [Subjects and Methods] One-site, one-arm, before-after study that included people with Grade II or III tibiofemoral osteoarthritis. Ten therapeutic ultrasound sessions (duty cycle=20%, ERA=10 cm², BNR=6:1, SATP=2.2 W/cm², SATA=0.44 W/cm², frequency=1 MHz, time=4 minutes) were applied. Assessments of primary outcome variables: pain intensity and function, and secondary variables: joint mobility, muscle strength and quality of life, were performed at onset and end of therapy; an additional intermediate evaluation was included for the primary variables. [Results] Means of repeated measurements of pain intensity (pain at rest, pain on palpation and pain after functional activities) and function showed significant differences. There was a significant reduction in pain intensity at the end of functional activities as well as a significant increase in function and in quadriceps muscle strength. [Conclusion] Therapeutic ultrasound applied in accordance with the parameters used, could be recommended during the treatment of individuals with knee osteoarthritis, because it significantly decreased the intensity of pain after the 5th session, and this reduction was maintained until the end of the intervention.

[Purpose] Handgrip strength is a surrogate indicator for assessing disease-related and age-related skeletal muscle loss. Clinical utility as such a surrogate can be at least partially explained by the close relationship between handgrip strength and whole-body skeletal muscle mass. The handgrip strength is related to hand muscle size. Thus, the present study examined whether hand muscle thickness is associated with whole-body skeletal muscle mass. [Subjects and Methods] Thirty healthy male adults participated in this study. All subjects were right-hand dominant. Two muscle thicknesses (lumbrical and interosseous muscles) in the right hand were measured using ultrasonography. Whole-body and appendicular skeletal muscle masses were assessed using dual-energy X-ray absorptiometry. [Results] Although lumbrical muscle thickness was not correlated with whole-body skeletal muscle mass, there was a significant correlation with appendicular skeletal muscle mass. Furthermore, interosseous muscle thickness was significantly correlated with both whole-body and appendicular skeletal muscle masses. [Conclusion] The present findings suggest that two muscle thicknesses in the hand are related to whole-body and/or appendicular skeletal muscle mass in healthy adults. Therefore, we propose that despite being smaller than other limb muscles, hand muscle thickness may be useful as surrogate indicator for assessing disease-related and age-related skeletal muscle loss.

[Purpose] This study investigated lumbar muscle fatigue before and after maintaining a seated position for one hour, lumbar and pelvic inclination angle change, in subjects with and without active lumber support. [Subjects and Methods] Fourteen healthy subjects randomized into two groups sat on a floor chair, placed on an office chair, that cyclically changed its lumbar supporting shape to provide active lumbar support (ALS) or no ALS for one hour. Before and after, we measured the frequency of muscle waveforms of the trunk extensor muscles when the subjects lifted an object weighing 10% of their body weight, using both hands while seated. In addition, ROMt (Range of motion test) of trunk rotation, degree of fatigue and muscle stiffness were analyzed. [Results] Muscle frequency while lifting the weight decreased significantly without ALS compared to with ALS. Mean muscle stiffness increased, ROMt decreased in desk work task significantly without ALS compared to with ALS. [Conclusion] These results suggest that the lumbar muscles became fatigued, because low frequencies, increased muscle stiffness, and decreased ROMt without ALS. We suggest lumbar muscle fatigue was maintained low for subjects seated in a chair with ALS.

[Purpose] The purpose of this study was to analyze the effect of various shoes on the static and dynamic balance of young women in their 20s. [Subjects and Methods] The subjects of the study were 15 healthy young women and repeated measured design. The subjects walked on the treadmill at a speed of 4 km/h for 30 minutes wearing three types of shoes: sneaker, rain boots, and combat boots. Balance was measured by a Romberg test and a limits of stability test. One-way ANOVA was used for statistical analysis. [Results] As the results of the Romberg test, the main effect of time was shown in the EO-COG area, EO-COG length, and EO-COG velocity. As the results of the limits of stability test, the main effects of time in LT, RT, FW, and total. There were significant differences in the LT in the sneaker group, the rain boots group, and the LT and RT in the combat boots group between the pre- and post-test. [Conclusion] The characteristics of shoes such as the materials, hardness, and thickness of the soles, the coefficient of friction of the outsoles, and the collar height affected the static and dynamic balance.

[Purpose] To detect H-reflex asymmetry and investigate the effect of direction sensitive exercise therapy protocol among patients with thoracolumbar and/or lumbar scoliosis. [Subjects and Methods] Fifty patients (10–17 years), Cobb’s angle 10–20 degrees with thoracolumbar and lumbar scoliosis participated in the study. Soleus H-reflex was tested on both sides during prone lying position and standing position. Patients were randomly assigned into two groups. Group I received direction sensitive exercise therapy while the participants in group II received traditional exercise. Exercises were applied three times per week for twelve successive weeks. [Results] There were significant differences indicating asymmetry in the H-reflex amplitude on concave side. Cobb’s angle significantly decreased and the H-reflex amplitude on concave side as well as H concave/convex ratios in both lying and standing significantly increased in both groups. Direction sensitive exercise therapy showed a more significant increase in the measured outcomes than traditional exercises therapy protocol. [Conclusion] H-reflex test was effective in discovering the asymmetry between concave and convex sides. Based on H-reflex test, direction-sensitive exercise therapy was more effective than traditional exercises in decreasing Cobb’s angle and increasing H-reflex values as well as H/H percent in concave side in patients with adolescent idiopathic scoliosis.

[Purpose] Current studies report that patients with chronic obstructive pulmonary disease (COPD) may also have arteriosclerosis. This study aimed to investigate the relationship between respiratory function and arterial stiffness in healthy workers using the brachial-ankle pulse wave velocity (baPWV). [Subjects and Methods] This study included 104 male Japanese workers without COPD. We collected participant information and measured hemodynamics, body composition, and respiratory function. [Results] In the correlation analysis, baPWV showed a significant positive correlation with age, smoking index, systolic blood pressure, diastolic blood pressure, and heart rate, and a significant negative correlation with height, fat free mass, lower limb muscle mass, forced vital capacity (FVC), and forced expiratory volume in one second (FEV1). In multiple regression analysis using factors other than baPWV and respiratory function as adjustment variables, both FVC and FEV1 showed a significant negative relationship with baPWV (p=0.009 and p=0.027, respectively). FEV1/FVC was not significantly related to baPWV (p=0.704). [Conclusion] The results of this study indicated that FEV1/FVC and the proportion of FEV1 predicted, which are indicators of airflow limitation, are not predictors of baPWV in workers without airflow limitation. However, since baPWV showed a significant negative relationship with FVC and FEV 1, the reduction in respiratory function that does not cause airflow limitation, such as FVC or FEV1 decline, may be related to an increase in the risk of arterial stiffness.

[Purpose] The purpose of this study was to investigate the relationship between the patellar movement and the standing backward leaning perceptibility. [Subjects and Methods] Fourteen volunteers who were confirmed presence of upward patellar movement during backward leaning from the quiet standing posture participated in this study. The quiet standing position, the standing backward leaning position at patellar movement onset and standing position perceptibility were measured. The position of the center of pressure in the anteroposterior direction in standing is represented as the percentage distance from the hindmost point of the heel in relation to the foot length (%FL). [Results] The mean value of the center of pressure on anteroposterior direction positions in quiet standing was 43.2%FL. The patellar movement onset position was 35.1%FL. The individual mean value of standard deviations for the onset position was 2.5%FL. The absolute error at the onset position is specifically and significantly small. [Conclusion] For the subjects whose patellas move during backward leaning in this study, the standing position near the onset position was perceived accurately, probably by the substantial change in sensory information associated with the onset of patellar movement while backward leaning.

[Purpose] To investigate the effect of high intensity laser therapy, alone or combined with exercise on pain, health related quality of life and fall risk in male with osteopenia or osteoporosis. [Subjects and Methods] 100 male patients with osteopenia or osteoporosis participated in the study. They had T-scores ≤−1.5. Patients were randomly assigned into four groups and treated with laser plus exercise, placebo laser plus exercise, laser alone and placebo laser in groups I, II, III, and IV respectively. Laser was applied to the lower back and hip regions. Exercises included aerobic exercises, weight-bearing, flexibility, and strengthening and balance exercises. Treatment were performed 3 times/week for 12 weeks. The measured outcomes were pain, health related quality of life and fall risk. [Results] All measured outcomes were significantly decreased post-treatment in all treatment groups. Laser plus exercises showed a higher significant effect than exercises with a least significant effect in the laser group in reduction of pain and quality of life. [Conclusion] High intensity laser is an effective modality for male patients with osteopenia or osteoporosis. Laser combined with exercise is more effective than exercises or laser alone in decreasing pain, fall risk an increasing quality of life after 12 weeks of treatment.

[Purpose] The purpose of this study was to investigate the effects of interferential current therapy on the waist circumference and visceral fat length in obese women. [Subjects and Methods] In this study, we selected 30 patients whose body mass index was over 25 kg/m². The subjects were randomly assigned to receive interferential current therapy three times a week for four weeks (n=15) and transcutaneous electrical nerve stimulation three times a week for four weeks (n=15). Waist circumference was measured in cm using a tape measure with the participant in an upright posture, and the length of visceral fat was measured using a high-resolution, B-mode ultrasound machine. [Results] There was a statistically significant difference between the group of waist circumference and visceral fat length. The change of waist circumference and visceral fat length was larger the experimental group than the control group. [Conclusion] These results can be used as a basis for reducing the risk factors that increase mortality due to diseases and can prevent cardiovascular and other adult diseases caused by obesity.

[Purpose] The aim of this study was to investigate the effect of whole-body vibration training on perception thresholds in type 2 diabetic patients with peripheral neuropathy. [Subjects and Methods] Fifty-nine patients with diabetic neuropathy participated in the study. They were randomly divided into the experimental group (n=29) and the control group (n=30). The experimental group performed whole-body vibration training, whereas the control group performed only lower body training in the same posture without using whole-body vibrator for 6 weeks. Perception threshold variables were measured to examine the effect of training. [Results] Warm and cold pain thresholds did not show significant changes in both groups before and after training. Vibration perception threshold showed significant improvement in the experimental group. [Conclusion] Our findings suggest that whole-body vibration training can improve vibration perception threshold of type 2 diabetic patients with peripheral neuropathy.

[Purpose] The aim of this study is to investigate the effectiveness of physical therapy interventions in the treatment of sacroiliac joint dysfunction (SIJD). [Subjects and Methods] MEDLINE, PUBMED, CINAHL, AMED, PEDro, and CIRRIE databases were searched and only relevant data from studies that matched the inclusion criteria were included. CASP tools for critical appraisal were used to assess the quality of studies included. [Results] Nine articles met the inclusion criteria, of which, three examined the effect of exercise on SIJD, three used kinesio tape and four studies examined the effect of manipulation. Various outcomes were used including the visual analogue pain scale (VAS), Oswestry disability questionnaire (ODQ), numerical pain rating scale (NPRS) and pelvic position measurement (PALM, pelvimeter and photogrammetry). The quality of included studies ranged from low to average as the CASP tools revealed several limitations that affect the validity of the studies. The results showed that physiotherapy interventions are effective in reducing pain and disability associated with SIJD, with manipulation being the most effective approach and most commonly used within physical therapy clinics. [Conclusion] Manipulation, exercise and kinesio tape are effective in the treatment of pain, disability and pelvic asymmetry in SIJD.

[Purpose] The purpose of this study was to determine the effects of resistance exercise using elastic bands on flexibility and balance among the elderly people living in the community. [Subjects and Methods] Database search was conducted by using PubMed, CINAHL, Embase, RISS, NDSL, NANET, DBpia, and KoreaMed. The meta-analysis, which was based on 19 studies, covered a total of 649 participants and used either the fixed effects or random effects model. [Results] The effect size estimates showed that resistance exercise using elastic bands have significantly increased the functional reach test score (Standard Mean Difference: 1.18, 95% CI 0.48 to 1.89) and timed up and go test score (Mean Difference: 2.89, 95% CI 2.55 to 3.22). [Conclusion] The review findings suggest that resistance exercise using elastic bands is effective for improving the flexibility and balance of the elderly people living in the community. However, further research is deemed necessary by using a large sample size or follow-up measure in order to provide evidence-based recommendations.

[Purpose] Homonymous hemianopia is one of the most common symptoms following neurologic damage leading to impairments of functional abilities and activities of daily living. There are two main types of restorative rehabilitation in hemianopia: “border training” which involves exercising vision at the edge of the damaged visual field, and “blindsight training,” which is based on exercising the unconscious perceptual functions deep inside the blind hemifield. Only border effects have been shown to be facilitated by transcranial direct current stimulation (tDCS). This pilot study represents the first attempt to associate the modulatory effects of tDCS over the parieto-occipital cortex to blindsight treatment in the rehabilitation of the homonymous hemianopia. [Subjects and Methods] Patients TA and MR both had chronic hemianopia. TA underwent blindsight treatment which was combined with tDCS followed by blindsight training alone. MR underwent the two training rounds in reverse order. [Results] The patients showed better scores in clinical-instrumental, functional, and ecological assessments after tDCS combined with blindsight rehabilitation rather than rehabilitation alone. [Conclusion] In this two-case report parietal-occipital tDCS modulate the effects induced by blindsight treatment on hemianopia.

[Purpose] To investigate the effects of combined chest expansion and breathing exercises in a patient with sternal pain. [Subject and Methods] The study subject was a 36-year-old female employed as a babysitter who complained of sternal pain at the T1–4 level. The subject performed the combined chest expansion and breathing exercises. [Results] The thoracic kyphosis angle after combined chest expansion and breathing exercises decreased compared with the initial angle. The sternal pain after these exercises also decreased compared with the initial value. [Conclusion] This study suggests that combined chest expansion and breathing exercises can be effective in treating sternal pain.