[Purpose] Post-stroke motor recovery consists of both true recovery and compensatory movements. Although compensatory movements are learned more quickly early after stroke, the role of compensatory movement patterns in functional recovery is controversial. We investigated the role of compensatory movement patterns in the long-term functional motor recovery after stroke. [Subjects and Methods] Male Wistar rats were subjected to photothrombotic infarction to induce motor and sensorimotor cortex lesions. The rats were given task-specific training. Behavior tests and analyses of compensatory movement patterns (head lift, limb withdrawal impairment, phantom grasps, and pellet chasing) during the single-pellet reaching test were performed 2, 7, 14, 21, 28, and 35 days post stroke. [Results] Successful retrieval during the single-pellet reaching test was significantly correlated with compensatory movement patterns in stroke groups. Motor cortex stroke showed significant correlation in limb withdrawal impairment and pellet chasing. But, sensorimotor cortex stroke was significant correlation in pellet chasing. [Conclusion] The data suggest that compensatory movements after stroke are correlated with spontaneous recovery. Since some compensatory movement patterns are detrimental to functional recovery, the correct timing of training and control of compensatory movement patterns might be important.
[Purpose] To explore the differences in bilateral trunk muscle activation between chronic stroke patients and healthy controls, this study investigated the symmetry index and cross-correlation of trunk muscles during trunk flexion and extension movements. This study also assessed the differences in trunk reposition error between groups and the association between trunk reposition error and bilateral trunk muscle activation. [Subjects and Methods] Fifteen stroke patients and 15 age- and gender-matched healthy subjects participated. Bilateral trunk muscle activations were collected by electromyography during trunk flexion and extension. Trunk reposition errors in trunk flexion and extension directions were recorded by a Qualisys motion capture system. [Results] Compared with the healthy controls, the stroke patients presented lower symmetrical muscle activation of the bilateral internal oblique and lower cross-correlation of abdominal muscles during trunk flexion, and lower symmetry index and cross-correlation of erector spinae in trunk extension. They also showed a larger trunk extension reposition error. A smaller trunk reposition error was associated with higher cross-correlation of bilateral trunk muscles during trunk movements in all subjects. [Conclusion] Trunk muscle function during symmetrical trunk movements and trunk reposition sense were impaired in the chronic stroke patients, and trunk position sense was associated with trunk muscle functions. Future studies should pay attention to symmetrical trunk movements as well as trunk extension position sense for patients with chronic stroke.
[Purpose] The purpose of this study was to elucidate whether skin extensibility decreases when a contracture develops as a result of joint immobilization. [Subjects] This study was conducted on six female Wistar rats. [Methods] The rats were divided into two experimental groups. In the immobilized group, the right ankle joints were immobilized in complete plantar flexion by plaster casts for two weeks. In the control group, the left ankle joints had no intervention. On the final day, skin extensibility was determined from a length-tension curve by collecting skin from the posterior aspect of the ankle joint and using a tensile strength tester. [Results] Compared with the control group, the immobilized group showed a significant decrease in skin extensibility. [Conclusion] The results demonstrated that the extensibility of the skin itself decreases when joint contracture develops.
[Purpose] The purpose of the present study was to determine whether there was a correlation between basic physical fitness and pulmonary function in Korean school students, to present an alternative method for improving their pulmonary function. [Subjects and Methods] Two hundred forty healthy students aged 6–17 years performed physical fitness tests of hand-grip strength, sit and reach, Sargent jump, single leg stance, and pulmonary function tests of forced vital capacity (FVC) and forced expiratory volume in one second (FEV1) using a Quark PFT. [Results] Muscle strength and power of boys improved in the late period of elementary school and middle school. Muscle strength of girls improved in the late period of elementary school. Analysis of factors affecting pulmonary function revealed that height, weight, BMI, and body fat significantly correlated with spirometric parameters. Right hand-grip strength, left hand-grip strength, and Sargent jump also significantly correlated with FVC and FEV1. [Conclusion] In order to improve the pulmonary function of children and adolescents, aerobic exercise and an exercise program to increase muscle strength and power is needed, and it should start in the late period of elementary school when muscle strength and power are rapidly increasing.
[Purpose] After an anterior cruciate ligament injury and subsequent reconstruction, quadriceps muscle weakness and disruption of proprioceptive function are common. The purpose of this study was to examine the effects of a 4 weeks preoperative exercise intervention on knee strength power and function post-surgery. [Subjects and Methods] Eighty male patients (27.8±5.7 age), scheduled for reconstruction surgery, were randomly assigned to two groups, the preoperative exercise group (n=40) and a no preoperative exercise group (n=40). The preoperative exercise group participated in a 4-week preoperative and 12-week post-operative programs, while the no preoperative exercise group participated only in the 12-week postoperative exercise program. Isokinetic measured of quadriceps strength were obtained at 4 weeks before and 3 months after surgery. [Results] The knee extensor strength deficits measured at 60°/s and 180°/s was significantly lower in the preoperative exercise group compared with the no preoperative exercise group. At 3 months after surgery, the extensor strength deficit was 28.5±9.0% at 60°/sec and 23.3±9.0% at 180°/sec in the preoperative exercise group, whereas the no preoperative exercise group showed extensor strength deficits of 36.5±10.7% and 27.9±12.6% at 60°/sec and 180°/sec, respectively. The preoperative exercise group demonstrated significant improvement the single-leg hop distance. [Conclusion] Four week preoperative exercise may produce many positive effects post reconstruction surgery, including faster recovery of knee extensor strength and function, as measured by single-leg hop ability.
[Purpose] Diabetic peripheral neuropathy can often lead to balance impairment. The spinal reflex is a mechanism that is reportedly important for balance, but it has not been investigated in diabetic peripheral neuropathy patients. Moreover, inhibitory or facilitatory behavior of the spinal reflex—known as presynaptic inhibition—is essential for controlling postural sway. The purpose of this study was to compare the differences in as presynaptic inhibition and balance in subjects with and without diabetic peripheral neuropathy to determine the influence of presynaptic inhibition on balance in diabetic peripheral neuropathy patients. [Subjects and Methods] Presynaptic inhibition and postural sway were tested in eight patients (mean age, 58±6 years) and eight normal subjects (mean age, 59±7 years). The mean percent difference in conditioned reflex amplitude relative to the unconditioned reflex amplitude was assessed to calculate as presynaptic inhibition. The single-leg balance index was measured using a computerized balance-measuring device. [Results] The diabetic peripheral neuropathy group showed lower presynaptic inhibition (47±30% vs. 75±22%) and decreased balance (0.65±0.24 vs. 0.38±0.06) as compared with the normal group. No significant correlation was found between as presynaptic inhibition and balance score (R=0.37). [Conclusion] Although the decreased as presynaptic inhibition observed in diabetic peripheral neuropathy patients may suggest central nervous system involvement, further research is necessary to explore the role of presynaptic inhibition in decreased balance in diabetic peripheral neuropathy patients.
[Purpose] The purpose of this study was to determine the functional differences of the plantar flexion muscles of the hallux and lesser toes during the single leg stance by comparing postural sway in different conditioning contraction interventions. [Subjects] Thirty-four healthy, young males and females participated in this study. [Methods] The front-back and right-left direction components of maximal displacement and postural sway velocity during the single leg stance were measured in various conditioning contraction interventions for the plantar flexion muscles of the hallux or lessor toes. [Results] The main findings of this study were as follows: 1) the front-back direction component of maximal displacement was reduced by conditioning contraction of the plantar flexion muscles of the hallux, and 2) the front-back direction component of the postural sway velocity was reduced by conditioning contraction of the plantar flexion muscles of the lesser toes during the single leg stance. [Conclusion] The plantar flexion muscles of the lesser toes control the postural sway velocity. Furthermore, the plantar flexion muscles of the hallux appear to control the amplitude of postural sway.
[Purpose] The purpose of this study was to investigate the relationship of knee proprioception with muscle strength and spasticity in stroke patients. [Subjects and Methods] The subjects were 31 stroke patients. The subjects received an explanation of the procedures and methods and provided informed consent before the experiment. A measurement board was used to determine the the proprioception deficit of the knee as a proprioception test. The proprioception test consisted of a passive and active angle reproduction test. A manual muscle test and modified Ashworth scale were used to evaluate knee muscle strength and spasticity level. The data were analyzed using an independent t-test and Spearman correlation. [Results] The results of this study revealed a significant difference between the affected side and non-affected side in the passive angle reproduction test and a significant difference in the correlation of the proprioception level with muscle strength and spasticity level. [Conclusion] This study indicates that the knee proprioception level is associated with spasticity and muscle strength in stroke patients.
[Purpose] The purpose of this study was to investigate the effects of bodyweight-based exercise with blood flow restriction on isokinetic muscular function and thigh circumference in college students. [Subjects and Methods] The subjects were 17 college students who were recruited and randomly assigned to bodyweight-based exercise with blood flow restriction and bodyweight-based exercise groups. Participants performed front lunges and squats at ratings of perceived exertion of 11–13 three times a week during a 6-week training period. The peak torque/ body weight (%) of the knee flexor and extensor was measured using a HUMAC NORM System (Cybex 770-NORM®, Cybex International, Medway, MA, USA), and the circumference of the thigh was measured. PASW Statistics was used for data analysis. [Results] There were significant differences in the peak torque/ body weight (%) of the flexors in both thighs (at 180°/sec) after bodyweight-based exercise with blood flow restriction. In addition, the circumference changes in both thighs were significant after bodyweight-based exercise with blood flow restriction and between the two groups. [Conclusion] This study suggests that bodyweight-based exercise with blood flow restriction may be an effective method to improve the muscle power and hypertrophy of the lower extremity in a clinical setting.
[Purpose] This study aimed to examine the relationship between maximal lateral reaching distance on the affected side and weight shifting using the Multi-directional Reach Test in persons with stoke. [Subjects] Fifty-one chronic stroke participants were recruited from two rehabilitation hospitals. This study administered the Berg Balance Scale, Timed Up-and-Go, Trunk Impairment Scale, Modified Barthel Index and measured different maximal reaching distances. [Results] The maximal lateral reaching distance on the affected side was correlated with the BBS (r=0.571), TUG (r=−0.478), TIS (r=0.561), and MBI scores (r=0.499), the lateral reaching distance in all directions on the non-affected side (r=0.785), the maximal backward reaching distance (r=0.723), and the maximal forward reaching distance (r=0.673). The maximal reaching distance on the affected side was also affected by that on the non-affected side, in addition to the maximal backward reaching distance and MBI score. The final step model of stepwise multiple regression was explained 69.5%. [Conclusion] Maximal lateral reaching distance on the affected side as determined by the Multi-directional Reach Test is a good method of assessing functional performance in stroke patients. Data regarding maximal reaching distance on the non-affected side can be used to measure functional impairment on the affected side in clinical settings.
[Purpose] This study compared the activity of trunk and hip muscles during different degrees of lumbar and hip extension. [Subjects] The study enrolled 18 participants. [Methods] Two exercises (hip and lumbar extension) and two ranges (180° and <180°) were studied. [Results] Differences in degree of extension affected the percentage maximal voluntary isometric contraction of the lumbar erector spinae and biceps femoris muscles, with significantly higher average values at >180° than at 180° lumbar extension. No significant differences were found in gluteus maximus activity according to exercise type or range. [Conclusion] Hip extension may be more effective and safer for lumbar rehabilitation than lumbar extension.
[Purpose] This study aims to examine the effects of the extension of the fingers (distal upper limb) on the activity of the shoulder muscles (proximal upper limb). [Subjects and Methods] This study involved 14 healthy male adults with no musculoskeletal disorder or pain related to the shoulders and hands. The subjects in a sitting posture abducted the angle of the shoulder joints at 60° and had their palms in the front direction. Electromyography (EMG) was comparatively analyzed to look at the activities of the infraspinatus (IS) and rhomboid major (RM) when the fingers were extended and relaxed. [Results] The activity of the IS was statistically significantly higher when the fingers were extended than when they were relaxed. [Conclusion] According to the result of this study, finger extension is considered to affect the muscles for connected shoulder joint stability.
[Purpose] The purpose of this study was to analyze cervical muscle activity at different traction forces of an air-inflatable neck traction device. [Subjects] Eighteen males participated in this study. [Methods] The subjects put on an air-inflatable neck traction device and the traction forces administered were 40, 80, and 120 mmHg. The electromyography (EMG) signals of the splenius capitis, and upper trapezius were measured to assess the muscle activity. [Results] The muscle activity of the splenius capitis was significantly higher at 80, and 120 mmHg compared to 40 mmHg. The muscle activity of the upper trapezius did not show significant differences among the traction forces. [Conclusion] Our research result showed that the air-inflatable home neck traction device did not meet the condition of muscle relaxation.
[Purpose] We investigated the difference in onset time between the vastus medialis and lateralis according to knee alignment during stair ascent and descent to examine the effects of knee alignment on the quadriceps during stair stepping. [Subjects] Fifty-two adults (20 with genu varum, 12 with genu valgum, and 20 controls) were enrolled. Subjects with > 4 cm between the medial epicondyles of the knees were placed in the genu varum group, whereas subjects with > 4 cm between the medial malleolus of the ankle were placed in the genu valgum group. [Methods] Surface electromyography was used to measure the onset times of the vastus medialis and vastus lateralis during stair ascent and descent. [Results] The vastus lateralis showed more delayed firing than the vastus medialis in the genu varum group, whereas vastus medialis firing was more delayed than vastus lateralis firing in the genu valgum group. Significant differences in onset time were detected between stair ascent and descent in the genu varum and valgum groups. [Conclusion] Genu varum and valgum affect quadriceps firing during stair stepping. Therefore, selective rehabilitation training of the quadriceps femoris should be considered to prevent pain or knee malalignment deformities.
[Purpose] This study aimed to determine the effects of horseback riding simulator exercise on the muscle activities of the lower extremities according to changes in arm posture. [Subjects] The subjects of this study were 30 normal adult males and females. [Methods] The horseback riding simulator exercise used a horseback riding simulator device; two arm postures were used, posture 1 (holding the handle of the device) and posture 2 (crossing both arms, with both hands on the shoulders). Electromyography was used to compare the muscle activities of the rectus femoris, biceps femoris, and hip adductors in the lower extremities. [Results] Posture 2 had significantly higher muscle activity than posture 1. [Conclusion] Posture 2, which entailed crossing both arms with both hands on the shoulders, was an effective intervention for improved muscle activity in the hip adductors.
[Purpose] The purpose of this study was to examine the intra- and inter-rater reliabilities of the Short Form Berg Balance Scale in institutionalized elderly people. [Subjects and Methods] A total of 30 elderly people in a nursing facility in Y city, South Korea, participated in this study. Two examiners administered the Short Form Berg Balance Scale to one subject to investigate inter-rater reliability. After a week, the same examiners administered the Short Form Berg Balance Scale once more to investigate intra-rater reliability. [Results] The intra-rater reliability was 0.83. The inter-rater reliability was 0.79. Both reliabilities were high (more than 0.7). [Conclusion] The Short Form Berg Balance Scale is a version of the Berg Balance Scale shortened by reducing the number of items, but its reliabilities were not lower than those of the Berg Balance Scale. The Short Form Berg Balance Scale can be useful clinically due to its short measurement time.
[Purpose] Among the non-pharmacological interventions for dementia, spaced retrieval training (SRT) is a good method for rehabilitating cognition. The purpose of this study was to examine effects of SRT with errorless learning (EL) in the rehabilitation of patients with dementia. [Subjects and Methods] Twenty-nine participants with vascular dementia (VD) and Alzheimer’s disease (AD) participated in the present study. The Korean version of the Consortium to Establish a Registry for Alzheimer’s disease (CERAD-K) and Modified Barthel Index (MBI) were performed to assess the changes in the neuropsychological performance and the independent activities of daily living after SRT with EL. All tests were administered both before and after SRT with EL. Each SRT with EL intervention was performed for 30 minutes per day for 5 weeks. SPSS for Windows version 18.0 was used for statistical analysis. [Results] All items of the CERAD-K score of the VD group except for constructional praxis increased significantly after the SRT with EL intervention, but no significant differences from the AD group were found. The Korean version of the geriatric depression scale (GDS-K) of the VD group increased significantly after the SRT with EL intervention. The mean MBI scores of each group showed no significant difference after the intervention. [Conclusion] SRT with EL is an effective intervention for memory training of patients with dementia. Future research using sufficient sample sizes will be needed to obtain strong evidence for comparing not only the before and after intervention data but also between the groups.
[Purpose] The purpose of this study was to determine the influence of horseback riding training on the physical function and psychological problems of stroke patients. [Subjects and Methods] Thirty stroke patients were divided evenly into an experimental group and a control group. Both groups carried out neurodevelopmental treatment. The experimental group additionally performed mechanical horseback riding training for 30 minutes a day, 5 days a week, for 6 weeks. Physical function was evaluated using the Berg Balance Scale (BBS) and the Timed Up and Go Test (TUGT). Psychological problems were assessed using the Beck Depression Inventory (BDI). In order to compare differences within groups between before and after the experiment, the paired t test was conducted. In order to compare differences between groups before and after the experiment, the independent t test was conducted. [Results] In the experimental group, the BBS, TUGT, and BDI showed significant improvements after the intervention. The experimental group’s BBS, TUGT, and BDI post-intervention changes were significantly better than those observed in the control group. [Conclusion] According to our results, horseback riding training has a positive effect on the physical function and psychological problems of stroke patients.
[Purpose] Post mastectomy lymphedema is common among breast cancer survivors. It leads to physical discomfort and functional impairment. Rehabilitation forms the mainstay of treatment and is multidisciplinary. [Subjects and Methods] Sixty post mastectomy patients were allocated randomly and assigned to either a conventional treatment group (n=30) or a complete decongestive therapy (CDT) group (n=30). The conventional treatment group received manual lymphatic drainage, wore a low elastic compression garment, received glenohumeral mobilization, and performed deep breathing exercises, and the complete decongestive therapy group received CDT from a trained physiotherapist and a daily home program along with the conventional treatment, 5 days a week for 6 weeks. [Results] Arm circumference measurements were taken at five levels: the wrist, mid forearm, elbow, mid-upper arm, and axilla. The upper extremity function was evaluated using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire, and pain was assessed using the visual analogue scale. Measurements were taken at baseline, and at 4th and 6th weeks after the start of intervention. Within and between group comparisons showed significant improvements in the CDT group. [Conclusion] Complete decongestive therapy and a home program assists breast cancer related lymphedema survivors in regaining their lost functions. It also helps to improve their independence in daily activities, reduce their need for caregivers, and thereby improving their quality of life. Therefore, the results of this study showed that the CDT with a home program is an effective treatment for reducing post mastectomy lymphedema.
[Purpose] The purpose of this study was to investigate the effect of bridge exercises on the Oswestry disability index (ODI) scores and proprioception among patients with chronic low back pain (CLBP). [Subjects and Methods] A total of 38 patients participated in this study. After eight weeks of bridge exercise, the joint position angle of the body trunk was measured and the ODI was used in survey form to investigate the intensity of the patients’ low back pain. [Results] After eight weeks of exercise, the ODI showed significant differences in all three groups. Subjects’ joint position sense of the trunk in both lumbar flexion and extension was also significantly different after completing the exercise program; this was true for all three groups. [Conclusion] Performing the prone bridge exercise for eight weeks improved proprioceptive function and reduced pain and impediment of activity, showing it a more effective exercise than other bridge exercises.
[Purpose] The purpose of present study was to investigate the effects of exercise intensity on hypertension prevalence in Korean men with high sodium intake. [Subjects and Methods] This study was based on the data collected from 2007 to 2013 in the Korean National Health and Nutritional Examination Survey. A total of 8853 male adults were included in the analysis. The odds ratios for hypertension according to exercise groups were assessed by using logistic regression of each sodium intake group. [Results] Among the 8853 subjects, 6243 had an eating habit of 4000 mg or more sodium consumption per day, and 2619 had less than 4000 mg. Among the 2619 subjects with less than 4000 mg sodium consumption, 16.7% subjects were diagnosed as having hypertension. In the subjects with 4000 mg or more sodium consumption, compared to the no-exercise group, the moderate-exercise group showed a lower likelihood of developing hypertension, with an odds ratio of 0.63 (95% confidence interval, 0.47–0.85) after adjusting for age. In multivariate models 1 and 2, odds ratios for the likelihood of developing hypertension in the moderate-exercise group decreased to 0.63 (0.43–0.91) and 0.66 (0.45–0.96), respectively. [Conclusion] Moderate exercise is significantly associated with a lower likelihood of developing hypertension in cases of high sodium intake.
[Purpose] To investigate the effects of a combination of transcranial direct current stimulation (tDCS) and feedback training (FT) on subacute stroke patients with unilateral visuospatial neglect. [Subjects] The subjects were randomly assigned to a tDCS + FT group (n=6) and a FT group (n=6). [Methods] Patients in the tDCS + FT group received tDCS for 20 minutes and then received FT for 30 minutes a day, 5 days a week for 3 weeks. The control group received FT for 30 minutes a day, 5 days a week for 3 weeks. [Results] After the intervention, both groups showed significant improvements in the Motor-Free Visual Perception Test (MVPT), line bisection test (LBT), and modified Barthel index (MBI) over the baseline results. The comparison of the two groups after the intervention revealed that the rDCS + FT group showed more significant improvements in MVPT, LBT, and MBI. [Conclusion] The results of this study suggest that tDCS combined with FT has a positive effect on unilateral visuospatial neglect in patients with subacute stroke.
[Purpose] This study aimed to identify the impact of physiotherapy using complex manual therapy as a part of an integrated treatment for sequelae in the musculoskeletal system of torture survivors. [Subjects] This study reviewed 30 male torture survivors presenting with chronic low back pain. They were randomly selected and divided into two groups: an experimental group and a control group. [Methods] For the experimental group, complex manual therapy was performed twice a week for 8 weeks to improve the physical sequelae of patients. Improvement was measured using the PDS-K for Post-traumatic Stress Disorder (PTSD), the Visual Analog Scale (VAS) for pain examination, the Korean Oswestry Disability Index (KODI) for back function assessment, and the Balance System SD as a dynamic balance test. The total period of the intervention for both groups was 8 weeks. [Results] For the experimental group, PDS-K, VAS, KODI, and the dynamic balance test all showed significant improvements after the intervention, which they did not for the control group. In the comparison of the groups, PDS-K, VAS, KODI, and the dynamic balance test all showed significant differences. [Conclusion] Complex manual therapy for torture survivors with chronic low back pain contributes to functional recovery by reducing back pain. The treatment can be considered to have positive effects on sequelae in the musculoskeletal system of torture survivors as they age.
[Purpose] This study aimed to examine the effects of neuromuscular electrical stimulation on masticatory muscle activation in elderly stroke patients. [Subjects and Methods] The subjects included 20 elderly patients diagnosed with stroke and 10 healthy elderly individuals. The neuromuscular electrical stimulation group received stimulation on the masseter muscle in the affected side for 30 min each day, 3 times per week for 8 weeks. In all the subjects, surface electromyography was used to measure activity of the masseter and temporal muscles in both sides under resting and clenching conditions. [Results] In the neuromuscular electrical stimulation group, after the intervention, an increase in the activity of all of the masticatory muscles was observed during clenching, with a significant increase in the activity of the masseter muscle in the affected side. Significant differences between the groups were not observed after the interventions. [Conclusion] The results of this study suggest that application of neuromuscular electrical stimulation effectively improves muscle activity in elderly stroke patients during clenching, and that this technique can be applied particularly for the improvement of the clenching activity of the masseter muscle in the affected side.
[Purpose] This study aimed to investigate the differential effects of high-intensity and low-intensity transcutaneous electrical nerve stimulation on the contralateral side on the pain threshold in healthy subjects. [Subjects and Methods] Twenty-five healthy adults, volunteers received two intensity levels (motor-level, 1.5 times the muscle motor threshold; sensory-level, sensory threshold of the common peroneal nerve), for 30 s on separate days. Pressure pain threshold was recorded on the contralateral tibialis anterior and deltoid muscle before, during, and after stimulation. [Results] Motor-level stimulation significantly increased the pressure pain threshold at both muscle sites, while effects of sensory-level stimulation on pressure pain thresholds were significant only at the deltoid site. The percent change in pressure pain thresholds at both sites was significantly higher during motor-level stimulation. [Conclusion] Motor-level stimulation, applied unilaterally to one leg, produced immediate contralateral diffuse and segmental analgesic effects. This may be of therapeutic benefit in patients for whom transcutaneous electrical nerve stimulation cannot be directly used at the painful site.
[Purpose] We often perform physical therapy using motor imagery of muscle contraction to improve motor function for healthy subjects and central nerve disorders. This study aimed to determine the differences in the excitability of spinal motor neurons during motor imagery of a muscle contraction at different contraction strengths. [Subjects] We recorded the F-wave in 15 healthy subjects. [Methods] In resting trial, the muscle was relaxed during F-wave recording. For motor imagery trial, subjects were instructed to imagine maximal voluntary contractions of 50% and 100% while holding the sensor of a pinch meter, and F-waves were recorded for each contraction. The F-wave was recorded immediately after motor imagery. [Results] Persistence and F/M amplitude ratio during motor imagery under maximal voluntary contractions of 50% and 100% were significantly higher than that at rest. In addition, the relative values of persistence, F/M amplitude ratio, and latency were similar during motor imagery under the two muscle contraction strengths. [Conclusion] Motor imagery under maximal voluntary contractions of 50% and 100% can increase the excitability of spinal motor neurons. Differences in the imagined muscle contraction strengths are not involved in changes in the excitability of spinal motor neurons.
[Purpose] The aim of this study was to determine the effects of thoracic region self-mobilization on chest expansion and pulmonary function in healthy adults. [Subjects] Nineteen healthy adults were randomly allocated to either an intervention group (n = 8) or a control group (n = 11). [Methods] Subjects in the intervention group performed self-mobilization of the thoracic region 3 times per week for 6 weeks (18 sessions). The outcome measures included chest expansion when breathing, pulmonary function, and predicted pulmonary function. [Results] There was a significant difference in chest expansion between the intervention group and the control group. However, there was no significant difference in pulmonary function between the intervention group and the control group. [Conclusion] Thoracic region self-mobilization may be beneficial for increasing chest expansion in healthy adults.
[Purpose] This study was performed to examine the relationship between physical performance and muscle properties during police cadet training. The study’s hypothesis was that improved physical performance brought about by training, would in turn cause a reduction in muscle flexibility. [Subjects and Methods] Fifty-nine police cadets were included in this study. Standard fitness tests and quantitative assessments of muscular biomechanical properties were conducted before, during and after the 20-week cadet training. [Results] General fitness had improved at the end of the police cadet training. There was no significant decrease in muscle flexibility as measured by the Sit-and-Reach test. However, muscle compliance of the non-dominant leg measured by the relaxation coefficient had decreased at the end of the police cadet training. [Conclusion] The increased sit-and-reach distance could be due in part to strengthening of the abdominal muscles. On the other hand, the biomechanical test, which was specific to muscle extensibility, showed a reduction in the relaxation coefficient of the non-dominant leg. Our data suggests that changes in muscle compliance as a result of lower extremity training should be considered. This data may be useful in the design of a training protocol that prevents the potential injuries caused by reduced muscle flexibility.
[Purpose]This study aimed to examine the effects of task-oriented exercise therapy and cognitive exercise therapy on the recovery of hand function and the quality of life in chronic stroke patients. [Subjects and Methods] A total of 16 patients with chronic stroke were selected and divided into two groups. Group I (n = 8) received task-oriented exercise therapy and Group II (n = 8) received cognitive exercise therapy. This study was conducted for eight weeks. Upper limb function was assessed using the Fugl-Meyer assessment (FMA) and manual function test (MFT); activities of daily living were assessed using the motor activity log (MAL); and the quality of life was assessed using the stroke impact scale (SIS). The pre- and post-intervention results of these tests were analyzed. [Results] There were significant differences in all areas of upper limb function, activities of daily living, and quality of life between the two groups. There were significant differences between the two groups in the post-intervention upper limb function and quality of life. [Conclusion] Application of cognitive exercise therapy was found to effect functional recovery in stroke patients. Future research should focus on application of cognitive exercise therapy in diverse populations, and assess its clinical utilization.
[Purpose] The purpose of this study is to examine the effects of Juchumseogi and Juchumseo Jireugi motions on muscle activation of the paraspinal muscles. [Subjects] The subjects of this study were 20 healthy male students who listened to an explanation of the study methods and the purpose of the experiment, and agreed to participate in the study. [Methods] Muscle activation measurements of the paraspinal muscles at C3, T7, and L3 were taken while standing still and while performing Juchumseogi and Juchumseo Jireugi movements. The Juchumseogi and Juchumseo Jireugi motions were performed 3 times, and its mean value was used for analysis. [Results] The right and left muscle activation of paraspinal muscles induced by Juchumseogi and Juchumseo Jireugi motions in C3 and T7 were significantly higher than those induced by just standing. Muscle activation of paraspinal muscles induced by Juchumseo Jireugi motions in C3, T7, and L3 were significantly higher than those induced by Juchumseogi alone. The right and left muscle activation of paraspinal muscles induced by Juchumseo Jireugi motion in C3, T7, and L3 were significantly higher than those induced by standing and Juchumseogi alone. [Conclusion] This study demonstrated that Juchumseogi and Juchumseo Jireugi motions of Taekwondo could increase muscle activation of paraspinal muscles, and Juchumseo Jireugi motions were more effective for enhancing muscle activation of paraspinal muscles.
[Purpose] The present study aimed to find out the scoliosis prevalence 11–15 years old children and to create awareness about scoliosis. [Subjects and Methods] All of the children were assessed using the Adams Forward Bendings Test and a scoliometer. Sagittal plane changes such as kyphosis, lordosis, hypokyphosis, hypolordosis and anterior head tilt were screened. Children with trunk rotation angles (ATR) of 4 degrees or more were suspected of having scoliosis, and were evaluated for a second time for gibbosity height, arm-trunk distance, and ATR. [Results] A total of 2,207 children were screened and the evaluation revealed there were 11 girls (0.49%) with a Cobb angle of 10 degrees and more. The maximum Cobb angle was 43° (right thoracic-left lumbar) and the maximum ATR was 12°. Two children had kyphosis and lordosis, and one had hypokyphosis and was diagnosed as having idiopathic scoliosis. [Conclusion] Families should regularly check their children, even if they are not diagnosed as having scoliosis in school screenings. It is our opinion that our study increased the awareness of the families about scoliosis by screening, brochures and posters. In the future, if school screenings were performed as a routine procedure and scoliotic students were followed over the long term, the actual effectiveness of screening would be able to be detected.
[Purpose] The purpose of this study was to determine the prevalence, symptoms of, and risk factors for low back pain among dentists as well as to discover the possible correlation of these factors with working posture and how to reduce their prevalence. [Subjects and Methods] The study was conducted among 60 dentists (28 male and 32 female) with a mean age of 25.7 years. Dentists were evaluated with the self-administered Nordic musculoskeletal evaluation chart, postural discomfort chart, and a self-prepared questionnaire. [Results] The data showed a 70% incidence of back pain among dentists, with low back pain predominating in 47.6% of cases. Most of the subjects (90.5%) had a mild-to-moderate level of severity, and only 9.5% had a severe level of low back pain. The majority of the dentists (57%) treated 1–3 patients per day. Only a few dentists (17%) exercised during their rest period even though 57% of them reported taking a break during their working hours. Although 63% of the dentists were aware of the advantages of assistive tools, only 40% of them used any kind of assistive devices. [Conclusion] Dental professionals demonstrate a high prevalence of low back pain.
[Purpose] This study was performed to assess the effect of daily sitting time during media consumption on physical fitness, total energy expenditure (TEE), and body composition indices of Saudi school children. [Subjects and Methods] A total of 180 healthy Saudi school students (8–18 years) were included in this study. Sitting time, total energy expenditure, and levels of physical activity were evaluated with pre-validated internet based questionnaires. Body composition indices were evaluated using anthropometric analysis. [Results] Out of the studied participants, only 22.2% of students were physically inactive. Children with moderate and active physical scores demonstrated less sedentary behavior (TV viewing and computer usage), lower body composition values (BMI, WC, WHtR), and higher TEE than sedentary or mild activity level participants. Boys showed higher fitness scores and less sedentary behavior than girls. Media sitting time among the studied subjects correlated negatively with physical scores and positively with body composition. [Conclusion] The data presented here suggests that poor physical fitness, lower TEE, and longer sitting times differentially influence normal body composition indices among school children which may lead to overweight or obese individuals. Thus, decreasing sitting time during media consumption and enhancing physical activity may play a pivotal role in preventing obesity in young children.
[Purpose] The purpose of this study was to develop an algorithm to predict the comfort of a subject seated in a wheelchair, based on common clinical measurements and without depending on verbal communication. [Subjects] Twenty healthy males (mean age: 21.5 ± 2 years; height: 171 ± 4.3 cm; weight: 56 ± 12.3 kg) participated in this study. [Methods] Each experimental session lasted for 60 min. The clinical measurements were obtained under 4 conditions (good posture, with and without a cushion; bad posture, with and without a cushion). Multiple regression analysis was performed to determine the relationship between a visual analogue scale and exercise physiology parameters (respiratory and metabolism), autonomic nervous parameters (heart rate, blood pressure, and salivary amylase level), and 3D-coordinate posture parameters (good or bad posture). [Results] For the equation (algorithm) to predict the visual analogue scale score, the adjusted multiple correlation coefficient was 0.72, the residual standard deviation was 1.2, and the prediction error was 12%. [Conclusion] The algorithm developed in this study could predict the comfort of healthy male seated in a wheelchair with 72% accuracy.
[Purpose] The aim of the present study was to determine whether different neck and trunk rotation speeds influence standing postural stability or frontal and temporal cortical activity during rotation in healthy young adults. [Subjects and Methods] Twelve healthy volunteers participated in this study. A custom turn-table operated by one of the experimenters was placed on a platform to assess postural perturbation. Subjects were asked to stand barefoot on the turn-table in an upright position with their feet together, and measurements were obtained during high- and low-speed rotations. Postural stability was tested using a force platform and a head sensor. Cerebral cortex activity was measured using functional near-infrared spectroscopy. Brain activity, center of pressure, and head perturbation were measured simultaneously for each subject. [Results] Significant differences were found in the center of pressure and the head angular velocity between high- and low-speed rotations. However, compared to baseline, oxygenated hemoglobin levels were not significantly different during high- or low-speed rotations. [Conclusion] Automatic postural responses to neck and trunk rotation while standing did not significantly activate the cerebral cortex. Therefore, the response to stimuli from the feet may be controlled by the spinal reflex rather than the cerebral cortex.
[Purpose] The purpose of this study was to investigate how a stretching torque affects muscular contractures. [Subjects] The subjects of this study were 48 male Wistar rats. [Methods] Subjects were divided into 4 groups as follows: Group 1 was the control; Group 2 had muscles in continuous fixation; Group 3 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 0.3N for a period of 30 minutes after continuous fixation; and Group 4 had muscles stretched in the direction of dorsiflexion by a spring balancer set at a torque of 3.0N for a period of 30 minutes after continuous fixation. Joint fixation periods were for 2 and 4-weeks. Ankle joint range of motion and soleus flexibility were analyzed. [Results] For the 2-week joint fixation, soleus flexibility in Group 4 showed an increase compared with that of Group 3. For both fixation periods, range of motion in Group 4 showed an increase compared with that of Group 3. [Conclusion] For both fixation periods, stretching improved joint range of motion. In the 2-week joint fixation, soleus flexibility improved. However, soleus flexibility did not improve in the 4-week joint fixation.
[Purpose] The present study aimed to investigate whether the effects of rehabilitation exercise performed after anterior cruciate ligament reconstruction on proprioceptive sensory and dynamic balancing functions differ between males and females. [Subjects and Methods] Eighteen subjects aged between 20–30 years enrolled in this study. The ages did not significantly differ between the males and females. The rehabilitation exercise program was performed three times per week for 12 weeks (3 months), and was initiated immediately after anterior cruciate ligament reconstruction. Thereafter, the patients visited the hospital once per week to perform rehabilitation exercise during weeks 12–24 (3–6 months), and education on self-exercise and assessments were conducted during the visits. Self-exercise was performed two times per week according to the determined program. [Results] The extension active joint position sense, extension passive joint position sense, and flexion passive joint position sense of the affected and unaffected knees did not show any interaction effects between the measurement periods or between the groups. In the case of the affected knee, the results of two-way repeated-measures analysis of variance showed no significant difference between the measurement periods or between the groups; moreover, no, interaction effects were observed between the measurement periods or between the groups. In the case of the unaffected knee, although no significant difference was observed between the measurement periods, significant differences were observed between the groups. [Conclusion] In conclusion, this study revealed that most knee rehabilitation exercise training programs can be applied to both genders during the recovery period after ACL reconstruction, except for the knee rotational feedback/feedforward function exercise that may exhibit different effects based on the gender.
[Purpose] The purpose of this study was to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis in patients with hemiplegic stroke. [Subjects] Fifty-five community-dwelling hemiplegic stroke patients were selected as participants. [Methods] Data were analyzed using the Winsteps program (version 3.62) with the Rasch model to confirm the unidimensionality through item fit, reliability, and appropriateness of the rating scale. [Results] There were no misfit persons or items. Furthermore, infit and outfit statistics appeared adjacent. The person separation value was 3.07, and the reliability coefficient was 0.90. The reliability of all items was at an acceptable level for patients with hemiplegic stroke. [Conclusion] This was the first study to investigate the psychometric properties of the Falls Efficacy Scale using Rasch analysis. The results of this study suggest that the 6-point Falls Efficacy Scale is an appropriate tool for measuring the self-perceived fear of falling in patients with hemiplegic stroke.
[Purpose] The purpose of the present study was to investigate differences in plantar pressure between individuals with normal and pronated feet according to 3 static squat depths. [Subjects and Methods] Study subjects were 10 young adults with normal and pronated feet. Plantar pressures were measured in the standing position and static squat positions at 45° (semi-squat) and 90° (half-squat) knee flexion using the F-Mat. Subjects’ plantar pressures were analyzed by dividing the foot into 4 areas: forefoot medial, forefoot lateral, midfoot, and heel. [Results] In the half-squat position, the pronated foot group showed a higher foot pressure in the forefoot medial than was seen in the normal group, whereas the normal group exhibited a higher foot pressure in the heel than was seen in the pronated foot group. [Conclusion] An increase in squat depth led to the transfer of plantar pressure to the heel in normal feet and to the forefoot medial in pronated feet.
Byoung-Sun Park, Mee-Young Kim, Lim-Kyu Lee, Seung-Min Yang, Won-Deok Lee, Ji-Woong Noh, Yong-Sub Shin, Ju-Hyun Kim, Jeong-Uk Lee, Taek-Yong Kwak, Tae-Hyun Lee, Ju-Young Kim, Jaehong Park, Junghwan Kim
[Purpose] The purpose of this study was to evaluate the effects of a progressive resistance training (PRT) program on the walking ability of chronic stroke patients with hemiparesis following chronic stroke. [Subjects and Methods] The participants of this study were fifteen hemiplegic patients. The main outcomes measured for this study were the peak torque of the knee extensor; the gait ability as measured by electric gait analysis of walking speed, walking cycle, affected side stance phase, affected side stride length, symmetry index of stance phase, and symmetry index of stride length; and 10-m walking speed; and the Berg balance scale test. [Results] Walking speed and affected side stride length significantly increased after the PRT program, and 10-m walking time significantly decreased after RPT in stroke patients. [Conclusion] These results suggest that the progressive resistance training program may, in part, improve the stride of the affected side leg of stroke patients after stroke and also positively impact walking speed.
[Purpose] This study compared the differences in electrophysiological characteristics of normal muscles versus muscles with latent or active myofascial trigger points, and identified the neuromuscular physiological characteristics of muscles with active myofascial trigger points, thereby providing a quantitative evaluation of myofascial pain syndrome and clinical foundational data for its diagnosis. [Subjects] Ninety adults in their 20s participated in this study. Subjects were equally divided into three groups: the active myofascial trigger point group, the latent myofascial trigger point group, and the control group. [Methods] Maximum voluntary isometric contraction (MVIC), endurance, median frequency (MDF), and muscle fatigue index were measured in all subjects. [Results] No significant differences in MVIC or endurance were revealed among the three groups. However, the active trigger point group had significantly different MDF and muscle fatigue index compared with the control group. [Conclusion] Given that muscles with active myofascial trigger points had an increased MDF and suffered muscle fatigue more easily, increased recruitment of motor unit action potential of type II fibers was evident. Therefore, electrophysiological analysis of these myofascial trigger points can be applied to evaluate the effect of physical therapy and provide a quantitative diagnosis of myofascial pain syndrome.
[Purpose] The purpose of the present study was to determine whether vibrations should be applied before resistance exercises by examining changes in stress hormone levels with vibrations applied before different exercise intensities. [Subjects] Eighteen male subjects in their 20s were included, and were randomly divided into one-repetition maximum (1RM) 50% group (50% RMG, n = 6), 1RM 70% group (70%RMG, n = 6), and 1RM 90% group (90% RMG, n = 6). [Methods] Three sets of Smith squats were performed at 1RM 50%, 70%, and 90% according to resistance intensities, and vibrations were applied for 1 min at a fixed frequency of 30 Hz before each set. Epinephrine, norepinephrine, and dopamine stress hormone levels were analyzed. [Results] Epinephrine levels were significantly higher immediately after exercise than at rest in the 50%RMG; however, no significant changes were noted in the 70%RMG and 90%RMG. Norepinephrine levels were significantly higher immediately after exercise than at rest in all three groups. However, no significant changes in dopamine levels were noted in the three groups. [Conclusion] The application of vibrations at a frequency of 30 Hz before 70%RM and 90%RM resistance exercises suppressed increases in the stress hormone epinephrine levels immediately after exercise.
Gusthavo Augusto Alves Rodrigues, Danilo De Souza Felipe, Elisangela Silva, Wagner Zeferino De Freitas, Wonder Passoni Higino, Fabiano Fernandes Da Silva, Wellington Roberto Gomes De Carvalho, Renato Aparecido de Souza
[Purpose] This investigation evaluated the acute cardiovascular responses that occur while playing virtual games (aerobic and balance) emulated by Nintendo Wii®. [Subjects] Nineteen healthy male volunteers were recruited. [Methods] The ergospirometric variables of maximum oxygen consumption, metabolic equivalents, and heart rate were obtained during the aerobic (Obstacle Course, Hula Hoop, and Free Run) and balance (Soccer Heading, Penguin Slide, and Table Tilt) games of Wii Fit Plus® software. To access and analyze the ergospirometric information, a VO2000 analyzer was used. Normalized data (using maximum oxygen consumption and heart rate) were analyzed using repeated measures analysis of variance and Scheffe’s test. [Results] Significant differences were found among the balance and aerobic games in all variables analyzed. In addition, the Wii exercises performed were considered to be of light (balance games) and moderate (aerobic games) intensity in accordance with American College Sports Medicine exercise stratification. [Conclusion] Physical activity in a virtual environment emulated by Nintendo Wii® can change acute cardiovascular responses, primarily when Wii aerobic games are performed. These results support the use of the Nintendo Wii® in physical activity programs.
[Purpose] This study aimed to investigate changes in activation of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius muscles during one-legged squats performed at various angles of ankle flexion. With the use of wedges, the muscles were activated at different angles of ankle flexion angles to establish the appropriate posture necessary for muscle strengthening and rehabilitation. [Subjects and Methods] Healthy adults aged 20–40 years were recruited from Good Morning Hospital in Ulsan City. Of the 22 participants, two dropped out during the tests, leaving a final sample of 20 participants. The wedges were 100 mm wide and 200 mm long and had inclinations of 10°, 30°, and 50°. EMG Analyzer software was used to measure muscle activation. [Results] A significant difference in the activation of the rectus femoris muscle at various angles of ankle flexion was seen. The gastrocnemius muscle exhibited significant differences in activation among the 0°–30°, 0°–50°, and 10°–50° inclinations. [Conclusion] Wedge-assisted muscle activation under different ankle flexion angles can be introduced as an effective exercise option under clinical conditions.
[Purpose] This study investigated the influence of exercise on balance ability and gait function in stroke patients after applying non-elastic tape, which can stabilize muscles and joints, to the lower extremities of the affected side. [Subjects and Methods] The subjects were 30 patients diagnosed with stroke. They were divided into an experimental group (n = 15) and a control group (n = 15). The experimental group performed mat and treadmill exercises three times a week for six weeks with non-elastic tape applied to the lower extremities of the affected side. The control group performed the same exercises but without taping. [Results] The intervention significantly improved Berg balance scale scores and timed up and go (TUG) test scores as well as reduced stance duration and stride duration in the experimental group. In the control group, statistically significant improvements were observed in TUG test scores. [Conclusion] Although some differences did not reach the level of statistical significance, the application of non-elastic tape stabilized the joints of the lower extremities, thereby increasing balance and reducing stance duration and one step duration, which resulted in a reduction of overall gait duration.
[Purpose] This study investigated the effects of the slow speed-targeting squat exercise on the vastus medialis oblique/vastus lateralis ratio. [Subjects] Ten asymptomatic men were recruited. [Methods] The EMG activities of the vastus medialis oblique and vastus lateralis muscles were recorded using surface electrodes. The subject performed the squat exercise under 3 different conditions. [Results] The vastus medialis oblique/vastus lateralis ratio in condition 2 (1.5 ± 0.7) was significantly higher than that in conditions 1 and 3 (1.0 ± 0.5, 1.1 ± 0.8, respectively) [Conclusion] Therefore, an effectively slow movement speed is recommended for selective strengthening of vastus medialis oblique using a slow speed-targeting device that provides biofeedback.
[Purpose] This study evaluated the acute cardiovascular responses during a session of Zumba® Fitness in a virtual reality environment. [Subjects] Eighteen healthy volunteers were recruited. [Methods] The following cardiovascular variables: heart rate, systolic blood pressure, diastolic blood pressure, and double product were assessed before and after the practice of virtual Zumba®, which was performed as a continuous sequence of five choreographed movements lasting for 22 min. The game Zumba Fitness Core®, with the Kinect-based virtual reality system for the XBOX 360, was used to create the virtual environment. Comparisons were made among mean delta values (delta=post-Zumba® minus pre-Zumba® values) for systolic and diastolic blood pressure, heart rate, and double product using Student’s t-test for paired samples. [Results] After a single session, a significant increase was noted in all the analyzed parameters (Systolic blood pressure=18%; Diastolic blood pressure=13%; Heart rate=67%; and Double product=97%). [Conclusion] The results support the feasibility of the use of Zumba Fitness Core® with the Kinect-based virtual reality system for the XBOX 360 in physical activity programs and further favor its indication for this purpose.
[Purpose] The purpose of this study was to identify the effect of purposeful action observation on upper extremity function in patients with stroke. [Subjects and Methods] Twelve subjects were randomly to either the experimental group or control group. The experimental group underwent occupational therapy and a purposeful action observation program. The control group underwent occupational therapy and placebo treatment in which the subjects performed a purposeful action observation program without actually observing the purposeful actions. The Wolf Motor Function Test was used to measure upper extremity function before and after the intervention in both groups. [Results] Both the experimental and control groups demonstrated improved upper extremity function after the intervention, but there was no significant difference between groups. Compared with before the intervention, the experimental group showed significantly improved upper extremity function after the intervention. [Conclusion] Based on these results, a purposeful action observation program can improve upper extremity function in patients with stroke. In future research, more subjects should be included for evaluation of different treatments.
[Purpose] This study investigated the effects of underwater treadmill walking training on the peak torque of the knee in hemiplegic patients. [Subjects and Methods] Thirty-two subjects, who were randomly allocated to an experimental group (n=16) and a control group (n=16), performed underwater treadmill walking training and overground treadmill walking training, respectively, for 30 minutes/session, 3 sessions/week, for 6 weeks. An isokinetic dynamometer was used to assess the peak torque. [Results] The subjects in the experimental group showed an increase in the peak knee extension torque compared to the control group. [Conclusion] The results suggested that underwater treadmill walking training has a greater effect on peak knee extension torque at velocities of 60°/sec and 120°/sec than overground treadmill walking training.
[Purpose] The purpose of this study is to apply cognitive rehabilitation according to Alzheimer’s disease (AD) patients’ level of cognitive functioning to compare changes in Cognitive Assessment Reference Diagnosis System performance and present standards for effective intervention. [Subjects] Subjects were 30 inpatients diagnosed with AD. Subjects were grouped by Clinical Dementia Rating (CDR) class (CDR-0.5, CDR-1, or CDR-2, n = 10 per group), which is based on level of cognitive functioning, and cognitive rehabilitation was applied for 50 minutes per day, five days per week, for four weeks. [Methods] After cognitive rehabilitation intervention, CARDS tests were conducted to evaluate memory. [Results] Bonferroni tests comparing the three groups revealed that the CDR-0.5 and CDR-1 groups showed significant increases in Delayed 10 word-list, Delayed 10 object-list, Recognition 10 object, and Recent memory performance compared to the CDR-2 group. In addition, the CDR-0.5 group showed significant decreases in Recognition 10 word performance compared to the CDR-1 group. [Conclusion] Cognitive rehabilitation, CDR-0.5 or CDR-1 subjects showed significantly greater memory improvements than CDR-2 subjects. Moreover, was not effective for CDR-2 subjects.
Printing PDF files for JPTS Vol. 22 No. 3-Vol. 24 No. 9 is not available.
If you wish to print these PDF files, please access the following
publisher’s website and download.
J-STAGE will undergo scheduled maintenance as follows. Year 2015 Oct 24(Sat) 10:00 - 15:00(JST) (Oct 24(Sat) 01:00 - 06:00(UTC))