[Purpose] The aim of the present study was to determine whether a multimodal treatment approach using spinal decompression via SpineMED and spinal mobilization as well as cervical stabilization exercises would benefit patients with neck pain with radiculopathy. [Subjects] A total of 10 patients with cervical radiculopathy ranging in age from 19 to 46 with an average age of 35.50 years participated in this study. [Methods] Patients received treatment in 85 minute sessions, 6 days per week for the first two weeks, and 4 days per week for two additional weeks. Treatment protocol consisted of spinal decompression via SpineMED and flexion-distraction mobilization of the cervical spine as well as cervical stabilization exercises. Physical therapy modalities including superficial heat, ultrasound, and interferential current were also delivered prior to administration of SpineMED. Differences between patients' pre-intervention and discharge outcome measures, pain on a visual analogue scale (VAS) and neck disability index (NDI), were examined using a paired t-test. [Results] Mean measures of patients' VAS and NDI demonstrated significant improvement after being treated with 20 sessions of combined treatment. [Conclusion] Findings of the present study provide significant evidence to support the efficacy of a multimodal treatment approach using spinal decompression via SpineMED and spinal mobilization as well as cervical stabilization exercises. A multimodal approach might be an asset in the management of cervical spine disorders.

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[Purpose] The purpose of this study was to examine the center of pressure (COP) trajectory variables while initiating gait under three different ankle support conditions: no external ankle support, ankle taping, and the use of a lace-up ankle brace. [Subjects] The study subjects were 7 healthy males (mean [SD] age, 22.4 [1.5]; range, 22-25 years) and 8 healthy females (mean [SD] age, 22.8 [0.8]; range, 22-24 years). [Methods] Subjects stood in a predetermined position on the floor in front of a force platform and then initiated gait on the force platform at a self-paced speed under the conditions of no external ankle support, ankle taping, and lace-up ankle brace. Changes in the COP trajectories were compared among the three test conditions using one-way repeated analysis of variance. [Results] The ankle external support devices, ankle taping and the lace-up ankle brace, significantly decreased the COP displacement in the mediolateral direction as compared to the no external support condition. However, there were no significant differences in the COP displacement in the anteroposterior direction, the average COP velocity, and the total length of the COP path among the three test conditions. [Conclusion] Intervention using a prophylactic ankle support device appears to be an effective means of reducing injuries because it provides increased mechanical stability.

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[Purpose] The purpose of this study was to investigate the differences of sensory nerve fiber degeneration rates with duration of diabetes mellitus, as well as the difference in the degeneration rate of nerve fibers by selectively providing stimulation to the A-beta, A-delta, C fibers and measuring the current perception threshold (CPT) of diabetic patients. [Subjects] The subjects of this study were diabetic patients complaining of significant neuropathy symptoms such as numbness, dullness and paraesthesia. [Methods] Stimulations of 5 Hz, 250 Hz, and 2,000 Hz of frequency were generated with a Neurometer CPT (Neurotron Inc., Baltimore, MD, U.S.A.) and delivered selectively to C fibers, A-delta fibers and A-beta fibers. The intensity of the stimulation of 5 Hz, 250 Hz and 2,000 Hz increased to 0.01 mA. The independent t-test was used to compare perception thresholds. [Results] In the case of the right lower limb, the threshold value of A-beta fibers varied with the duration of diabetes and was particularly higher in the group of patients with 10 years or longer duration. The threshold value of A-delta fibers also varied with diabetes duration. That of the group with diabetes duration from 5 years to less than 10 years was not significantly different from that group with diabetes of the duration of 10 years or longer. However, the threshold value of the group with diabetes duration of 10 years or longer was higher than that of the groups of other durations. [Conclusion] The perception thresholds varied with diabetes duration and showed that degeneration of A-beta fibers and A-delta fibers that have myelin was more rapid than that of C fibers that are without myelin. Therefore, therapeutic interventions should be applied at the early stage of neuropathy.

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[Purpose] This study was conducted to evaluate the influence of pelvic adjustment on functional leg length inequality (FLLI) and foot pressure. [Subjects] The study subjects were 40 adults who were healthy but had FLLI of at least 10 mm. Subjects were randomly assigned to two groups, an experimental group (n=20) and a control group (n=20). [Methods] The subjects of the experimental group underwent pelvic adjustment 3 times a week for 4 weeks. A tape- measure was used to measure FLLI, and F-Scan was used to measure the heel pressure difference (HPD) and the 1^st metatarsal pressur difference (MPD). For all subjects, the lengths of both legs were measured before the intervention, and at 2 weeks and 4 weeks after the intervention was started. [Results] Pelvic adjustment was effective at reducing FLLI , HPD and 1^st MPD. HPD and the 1^st MPD were reduced in proportion to the reduction in FLLI . FLLI was effectively reduced after 2 weeks of intervention and the reduction was more remarkable after 4 weeks. [Conclusion] We presume that pelvic adjustment reduces FLLI and foot pressure difference and that foot pressure difference is reduced in proportion to the reduction in FLLI. In conclusion, we consider that pelvic adjustment is suitable for reducing FLLI as well as foot pressure difference.

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[Purpose] The aim of this study was to determine the lower-limb muscle activities during muscle exercise using an on-the-bed muscle training device that utilizes the intermittent inflation of an oval rubber balloon placed against the sole. [Subjects and Methods] Ten healthy subjects were asked to adopt a semi-recumbent position with a flat oval chloridized polyvinyl balloon placed against the sole. The subjects were asked to extend both their legs when they felt the inflation of the balloon on their plantar surface. This exercise was defined as leg exercise against intermittent sole pressure stimulation (ExISPS). [Results] The root-mean-square (RMS)-EMG values of the vastus medialis during ExISPS in the semi-recumbent position were similar to those when standing up from 45-degree knee flexion and calf-raising. The RMS-EMG values of the biceps femoris showed no significant difference among these exercises. The RMS-EMG values of gastrocnemius medialis during ExISPS in the semi-recumbent position were higher than those when standing up from 45-degree knee flexion and standing up from a chair. [Conclusion] The findings of this study suggest that the muscle activities during ExISPS mimic or are greater than those required of the leg in daily life.

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[Purpose] The purpose of this research was to study the test-retest reliability of three continuous sets of measurements of isometric knee extension muscle strength of hemiplegic patients, using a handheld dynamometer (HHD) and a belt. [Subjects] The subjects were 26 hospitalized hemiplegic patients (12 men, 14 women) with an average age of 62.4 years. [Method] The subjects sat on a mat table, and three sets of measurements were taken, at intervals of 30 seconds, of isometric knee extension muscle strength with the knee joint at a flexion angle of 90 degrees using an HHD and a belt. The measurements were also taken in a second session on a different day. Reliability was examined using the intraclass correlation coefficient (ICC (1,1)) and multiple comparison as a post-hoc test of one-way variance through repeated measurement. [Results] The ICC of the measurement values taken on the same day on the paralyzed side was 0.98, while in Session 2 it was 0.99; on the non-paralyzed side, it was 0.98 in Session 1 and in Session 2 it was 0.99. On the paralyzed side, main effect was seen in Session 2; the values of the first measurement were significantly smaller than the values of the second and third measurements. And, the highest values were obtained from the third measurement. [Conclusion] The ICC results show the test-retest reliability was high in both sessions. We thought it would be sufficient for measurements to be conducted three times, taking the highest values of those three.

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[Purpose] The purpose of this study was to examine the influence of the probe reaction time (P-RT) during rhythmic stabilization (RS) on standing stability of patients with post-stroke hemiplegia. [Subjects] The subjects were 29 patients with post-stroke hemiplegia (males, mean age 56.2 ± 11.9 years), who had been receiving treatment at the Jilin Rehabilitation Medical Center in China. They were divided into two groups: the cerebral hemorrhage (CH) group and the cerebral infarction (CI) group. [Methods] We evaluated the simple reaction time (SRT), the P-RT during RS, the maximal resistance force of RS (Max. RF), the resistance force of RS during P-RT (RF during P-RT), and the timed up-and-go test (TUG). [Results] P-RT was significantly longer than SRT, and RF during P-RT was less than the Max. RF in both groups. P-RT of CH patients was significantly longer than that of CI patients. There were significant correlations between P-RT and SRT, P-RT and RF during P-RT, and Max. RF and RF during P-RT in both groups. [Conclusion] The results suggest that attention decreased more during the dual task in the CH group than in the CI group. Not only trunk muscle force but also attention maybe factors influencing the standing stability of patients with post-stroke hemiplegia.

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[Purpose] The purpose of this research was to investigate the occurrence and mechanism of floating toe from the viewpoint of the structure of foot arch.[Subjects and Methods] The subjects were 65 adult females who had no history of orthopedic disease. Subjects stood on a pedoscope and we took images of the soles. According to a floating-toe score which we created, we allocated subjects to a normal group and a floating-toe group using the obtained images. We measured the arch height percentage in the sitting position and standing position in the normal group and floating-toe group and found the difference of arch height percentage (value obtained by subtracting the arch height percentage in the standing position from that in the sitting position). Results of the measurements were compared between the two groups. [Results] Among 65 cases, 23 were allocated to the normal group and 18 were allocated to the floating-toe group. There was no significant difference between the two groups for the arch height percentage in the sitting and standing positions. The difference of arch height percentage in the floating-toe group was significantly smaller. [Conclusion] We presume that there are two types of foot - the type in which the arch rises and the type in which the arch lowers in the floating toe, and lifestyle, footwear and other factors are involved.

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[Purpose] The purpose of this study was to evaluate the correlation between the lumbar lordosis curve (LLC) and temperature differences of the lower extremity regions in lumbar herniated nucleus pulposus (L-HNP) cases. [Subjects] We divided the study subjects into patients with L-HNP (n=15) and normal persons (n=15). [Methods] Both the L-HNP group and control group were measured for LLC and temperature differences of the lower extremity regions by X-ray and digital infrared thermal imaging (DITI). [Results] The LLC and temperature differences of the lower extremity regions of the L-HNP group were significantly different from the control group. The LLC and temperature differences of the lower extremity regions of the L-HNP group showed strong positive correlations. [Conclusion] We found that as the LLC decreased, the difference in the temperature of the lower extremity regions in the L-HNP cases increased.

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[Purpose] The purpose of this study was to evaluate the effect of shoulder stabilizer muscle activity using the contraction of the finger flexor muscle. [Subjects] We divided the study subjects into a grasp group (n=17) and a non-grasp group (n=17). [Methods] The shoulder muscle activities of both the grasp group and the non-grasp group were measured by electromyography. [Results] Both the grasp group that used the contraction of the finger flexor muscle and the non-grasp group that did not use the contraction of the finger flexor muscle showed a state where shoulder stabilizer muscle activation increased as the weight borne by them increased. The serratus anterior muscles and rhomboid muscles showed differences between the two groups. [Conclusion] Exercises using finger flexor muscle activation is a more effective method for patients who need shoulder stabilizer muscle strengthening exercises because of shoulder stabilizer muscle weakness.

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[Purpose] This study examined physical factors associated with urinary incontinence (UI) in women. We hypothesized that, women with UI would show decreased thickness of the transverse abdominal muscle (TA) during maximal co-contraction of both TA and the pelvic floor muscle (PFM) compared with the women with no history of UI. [Subjects] The subjects were thirty-two women who subjects were divided into two groups: the UI group and the No-UI group. [Methods] We evaluated the thickness of TA by ultrasound, and hand-grip strength and the muscular strength of adduction in flexion of hip joint. The thickness of TA was measured during performance of 4 tasks: (1) at rest, (2) maximal contraction of TA, (3) maximal contraction of PFM, and (4) maximal co-contraction of both TA and PFM. [Results] The No-UI group had thicknesses of TA that were greater than those seen in the UI group in the tasks 3 and 4. In logistic regression analysis with UI as the dependent variable, the thickness of TA during maximal co-contraction was identified as an independent factor, and the cut-off value of the thickness of TA was 2.55 mm as determined by the Receiver-Operating-Characteristic (ROC) curve. [Conclusion] We found that the thickness of TA during maximal co-contraction of both TA and PFM is reliable and useful for the evaluating the risk of UI in women.

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[Purpose] We analyzed the evaluation of facial motor paralysis employing Yanagihara's 40-point method for patients diagnosed with Bell's palsy, aiming to obtain some prognostic findings. [Subjects and Methods] The subjects were 33 patients diagnosed with Bell's palsy referred to us by the otorhinolaryngology outpatient clinic of our hospital. The onset age, timing of initiation of rehabilitation after onset, accessory symptoms, and facial motor paralysis were investigated. Facial motor paralysis was evaluated at the time of the first rehabilitation session and every 1-2 weeks thereafter. The scores were divided into upper and lower facial muscle groups. [Results] On the basis of outcome, patients were divided into 3 groups: the most favorable group, the favorable group, and the poor group. In the comparison of the 3 groups, the score of the first evaluation and the mean weekly score change were significantly greater in patients with favorable outcomes. In the comparison between the upper and lower facial muscles, the score for the upper facial muscles was significantly higher from the early phase, and the muscles recovered from paralysis more rapidly. [Conclusion] We evaluated facial motor paralysis of patients with peripheral facial palsy employing Yanagihara's method as a prognostic index, and obtained some prognostic findings.

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[Purpose] This study examined the adjustment of work load in the sit-to-stand exercise (STSE). [Subjects] The subjects were twenty-nine healthy young males, average age of nineteen. [Methods] Subjects did STSE and cycle ergometer exercise on the same day. The STSE protocol was standing-up frequencies set from 6 to 30 (times per minute),with an exercise time of three minutes at each frequency. The anaerobic threshold (AT) was determined on a cycle ergometer with a ramp protocol. The items measuring work load were oxygen uptake and heart rate. Cardiopulmonary function was measured from resting time to the end of the exercise. Oxygen uptake volume and heart rate relative to their AT values were calculated. [Results] Oxygen uptake volume and heart rate relative to their AT values frequencies from 6 to 30 times per minute ranged from 45.9 to 119.8 (%), and from 67.6 to 106.9 (%), respectively. [Conclusion] In case of STSE, the work load intensity of a subject cannot be quantitatively determined. Heart rate and oxygen uptake at standing exercise frequencies setting from 6 to 30 times/min relative to their anaerobic threshold values were 67.6-106.9 (%) and 45.9-119.8 (%), respectively. It was clarified that 30 times or less were anaerobic threshold that corresponded to work load . It is appropriate to adjust work load based on this standing up frequency only for young subjects.

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[Purpose] The purpose of this study was to investigate whether ten weeks of aquatic therapy exercise would increase low back muscle strength and reduce low back pain in 19 elderly subjects. [Subjects] Nineteen low back disorder patients were randomly assigned to one of two groups: an aquatic therapy exercise group (n=9), and a control group (n=10). [Methods] The aquatic therapy group participated five times a week for ten weeks in an aquatic exercise designed to strengthen the low back muscles. Data collection was done using a Cybex-770 system. [Results] The results show that the aquatic exercise significantly reduced visual analog scale pain by 52.1%. Significant improvements in low back muscle strength were found in the aquatic therapy group on peak torque of flexor in 180/sec by 48.31% and on peak torque of extensor in 180/sec by 152.85% . [Conclusion] Based on the results, we conclude that the ten weeks of aquatic therapy exercise can enhance low back muscle strength and reduce low back pain in elderly women.

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[Purpose] The results of studies investigating the role of Helicobacter pylori (HP) in osteoporosis are contradictory. In this study we investigated HP seropositivity in postmenopausal osteoporotic and non-osteoporotic females to elucidate the role of HP in postmenopausal osteoporosis. [Subjects and Methods] Serum was collected from fifty-eight osteoporotic patients and forty-seven nonosteoporotic subjects, whose status was diagnosed with dual-energy X-ray absorptiometry (DEXA). None of the subjects had received any prior treatment for osteoporosis. Subjects' sera were assessed for HP antibodies (Immunoglobulin A and G) by enzyme-linked immunoabsorbent assay (ELISA). Patients were interviewed about risk factors of osteoporosis. Prior fractures of patients and familial fracture history were also noted. [Results] Fifty-eight patients with osteoporosis and forty-seven nonosteoporotic patients, as determined by lumbar total or collum femoris in DEXA, were evaluated in this study. The familial fracture history was significantly higher in the osteoporotic patients than in the nonosteoporotic group. There was no significant difference in HP seropositivity between the osteoporotic and nonosteoporotic groups. [Conclusion] There was no difference in HP seropositivity between the groups, therefore HP infection seems not to be an important risk factor for postmenopausal osteoporosis.

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[Purpose] The aim of this study was to determine when cortical activation of targeted neurons is induced by the ongoing effects of anodal transcranial direct current stimulation (tDCS), and how temporal change is processed, using functional magnetic resonance image (fMRI). [Subjects and Methods] Eleven healthy right-handed subjects were recruited. Functional MRI was performed for five consecutive 1-minute phases (control, tDCS1, tDCS2, tDCS3, tDCS4). During four tDCS phases, direct current with 1.0 mA was delivered to the hand knob of the precentral gyrus, and the resting phase served as a control session. [Results] Our findings show that cortical neurons below the anodal tDCS were activated from the second through the fourth tDCS phase. However, there was no activation in the first tDCS phase. In addition, the amount of cortical activation (peak voxels) tended to fluctuate from the second phase through fourth phases. [Conclusion] We demonstrated that the a continuous effect of tDCS was induced after 1 minute since the direct current is injected to target neurons. The effect was maintained during the application tDCS, although it fluctuated.

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[Purpose] In this study, we investigated the motor imagery ability of hemiplegic stroke patients. [Subjects] The subjects were 29 healthy individuals (average age, 63.5 ± 11.7), and 31 hemiplegic stroke patients (average age, 64.5 ± 9.5). [Method] Motor imagery was evaluated using the reaction time of mental rotation in response to photographs of a rotated hand.[Results] The reaction time was delayed in stroke patients compared to healthy individuals, and post-stroke mental rotation was better when viewing photographs of the unaffected than of the affected side. Impaired attention is associated with mental rotation ability; in contrast, motor function, deep sensory factor, lapsed days from onset and the brain damaged side were less associated with rotation ability in stroke patients. [Conclusion] Therapeutic intervention using motor imagery is expected to have a high therapeutic effect because of its affect on impaired attention.

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[Purpose] The purpose of this study was to investigate the effects of feedback respiratory training on chest expansion and pulmonary function in patients with stroke. [Subjects and Methods] Twenty- seven patients with stroke were randomly assigned to two groups: the feedback respiratory training group (experimental) (n=13) and the control group (control) (n=14). Feedback respiratory training and conventional physical therapy were performed by the experimental group. Conventional physical therapy was performed by the control group. Both groups received training three times per week for four weeks. [Results] Significant improvements were observed in chest expansion after training in the experimental group. Gains in chest expansion were greater in the experimental than in control group. Values of forced vital capacity, forced expiratory volume at one second, peak expiratory flow, vital capacity, expiratory reserve volume, and inspiratory reserve volume in pulmonary function tests increased post-training in the experimental group. With the exception of expiratory reserve volume, all of these pulmonary function test measures showed greater gains in the experimental group than in the control group. [Conclusion] Feedback respiratory training is effective for the improvement of chest expansion and pulmonary function in patients with stroke.

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[Purpose] The purpose of this study was to prepare a scale for promoting sense of self-efficacy in physical therapy students in e-learning and to examine the scale items with factor analysis. [Subjects and Methods] Thirty-seven physical therapy students were asked to participate in e-learning and we measured the effect of e-learning using a Self-efficacy Stimulative Scale which we developed for this research. [Results] Factor analysis identified 3 factors, which were named "sense of accomplishment", "accumulation of experience" and "inquisitive mind". Coefficients of reliability were 0.89, 0.81 and 0.86, respectively, for each of the three factors. Furthermore, among the subscales, a significant correlation was found between "sense of accomplishment" and "accumulation of experience". [Conclusion] The results indicate that the Self-efficacy Stimulative Scale is structurally stable and has high factorial validity.

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[Purpose] The aim of this study was to examine the center of pressure (COP) trajectory variables and response time when young adults descended stairs while simultaneously performing a concurrent secondary Stroop task that required direct attention. [Subjects and Methods] Twenty healthy young adults (10 males and 10 females) participated in the study. Each subject first completed a Stroop task while standing (baseline). Next, they stood in a predetermined position at the top of a custom-built 3-step staircase and negotiated the stairs at a self-paced speed with and without performance of a concurrent secondary Stroop task. Subjects were asked to place only one foot on each step (foot-over-foot). The response times to the secondary task and the COP trajectory with and without performance of the concurrent secondary Stroop task were measured. [Results] The Stroop task response time while descending stairs was significantly longer than the Stroop task response time during static standing. The mediolateral and anteroposterior displacements of COP and the length of COP path, as well as the average velocity of the COP, were significantly greater when subjects performed the secondary task than without the secondary task. [Conclusion] The study suggests that subjects' ability to descend stairs is lessened with the addition of the concurrent secondary attention-demanding task, and that the addition of divided attention tasks places an apparently higher demand on balance control that may prove to be challenging for subjects at high risk of falling.

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[Purpose] The purposes of the present study were to understand and to analyze the current situation, including lifestyle and environmental factors, of type 2 diabetes patients receiving treatment, in order to identify factors facilitating the continuation of exercise therapy and thereby determine the optimal focus of care instructions. [Methods] The subjects were patients with type 2 diabetes admitted to Hachinohe City Hospital for instructional purposes, for whom individual exercise therapies were prescribed. All the subjects were discharged from the hospital 3 years or more before participating in the study. The subjects were asked via telephone interview whether they were still exercising after discharge from hospital. Based on the results of the telephone survey, a univariate analysis (bivariate logistic regression analysis of parameters affecting the continuation or discontinuation of exercise) was performed to determine the significance of each parameter. [Results] The following factors were identified as facilitating the continuation of exercise therapy: 1) goal setting, 2) absence of impeding factors, 3) operant conditioning, 4) self-monitoring, 5) presence of someone providing instruction on how to exercise, 6) confidence in exercising even when busy doing household duties or working, 7) suffering no disadvantage from exercising, 8) use of exercise facilities and 9) age (advanced age was associated with a higher continuation rate). [Conclusion] To our knowledge, no previous study has focused on which instruction method is optimal based on follow-up survey results. Targeted care instruction can be provided by statistically analyzing differences between patients who continue exercising and those who do not and incorporating the results of the analysis into exercise instruction.

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[Purpose] Little is known about the detailed anatomical connections of the neural network related to hand movement in the human brain. We investigated the neural network using diffusion tensor tractography (DTT) data analyzed in conjunction with functional MRI (fMRI) activation results. [Subjects and Method] We recruited 19 healthy volunteers for this study. Probabilistic tractography was used to analyze diffusion tensor imaging (DTI) data that were collected using fMRI activation induced by grasp-release movements of the hand at a rate of 1 Hz. [Results] The brain areas connected to the primary sensorimotor cortex (SM1), which is activated by hand movements, were the premotor cortex (100%), superior parietal lobule (100%), intraparietal sulcus (100%), supramarginal gyrus (97.37%), supplementary motor area (89.47%), thalamus (86.84%), putamen (81.58%), pars opercularis (81.58%), pars triangularis (68.42%), angular gyrus (65.79%), and cerebellum (60.53%) in the same hemisphere and the contralateral primary motor cortex (60.53%) in the opposite hemisphere. No significant difference was observed in the total incidence of connected tracts between hemispheres. [Conclusion] These results reveal that more brain areas are involved in hand movements than were previously thought necessary for motor planning and execution in the human brain.

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[Purpose] This study used radiometry to examine the effects of cervical lordosis and forward head posture (FHP) angles on vital capacity, equilibrium and ROM of the thoracic spine, and to explore the correlations between each of these factors.[Subjects]The subjects of this study were 36 college students in their twenties (male=16, female=20). [Subjects and Methods]Cervical lordosis angles and FHPs were analyzed with lateral view radiographs. Measures were taken of vital capacity, equilibrium and the range of motion of the thoracic spine and the results were analyzed. [Results]As the absolute rotation angle (ARA) decreased, the anterior weight-bearing angle (AWB) increased while vital capacity (VC) decreased. The results of this study indicate that as the range of motion of the thoracic spine from neutral to flexion increases, the ROM from neutral to extension also increases, and as the ROM from neutral to extension increases, the angle from flexion to extension also increases. [Conclusion]As faulty head and neck postures of subjects affected not only the dynamic stress of their neck but also their vital lung capacity, it is recommended that ARA and AWB angles should be considered when aligning posture in the treatment of impaired vital capacity.

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[Purpose] This study investigated the effects and safety of whole body cryotherapy (WBC) and spinal decompression on the pain, cervical function, and body surface temperature of cervical herniated nucleus pulposus (C-HNP) patients. [Subjects] The subjects were 20 patients (6 males and 14 females) with cervical disc herniation (C_5-6) who visited Hospital S in Daejeon, Korea. [Methods] Treatment Group 1 (3 males and 7 females) received interference current therapy, ultrasonic therapy, spinal decompression therapy, and WBC. Treatment Group 2 (2 males and 8 females) received interference current therapy, ultrasonic therapy, and spinal decompression therapy. [Results] Visual Analog Scale (VAS), Neck Disability Index (NDI), and differences in body surface temperatures between left and right upper extremity muscles decreased after treatment compared to prior to treatment. The group receiving spinal decompression and WBC application had a greater degree of change in VAS and NDI. However, change of body surface temperatures of the upper extremities after treatment between the two treatment groups was not statisticaly significant. [Conclusion] A combination of spinal decompression therapy and WBC offers a safe and appropriate treatment for cervical disc herniation.

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. [Purpose] The purpose of this study was to analyze the activation of the muscles around the shoulder in relation to the cervical flexion and extension during the push-up plus exercise in order to provide the fundamental data to establish the posture that can maximize the effect of the shoulder stabilizer exercise. [Subjects] The subjects of the experiment were 18 healthy people, male adults in their age of twenties with normal ROM and without musculoskeletal disease at the shoulder complex and upper limb. [Methods] Muscular activity of the shoulder stabilizer muscles in cervical flexion and extension and the neutral position were measured by electromyogramphy (EMG). [Results] The muscle activations among the cervical positions were compared and the results showed that there were a significant differences for the serratus anterior muscle, sternocleidomastoid muscle, cervical paraspinalis muscle and pectoralis major muscle. [Conclusion] These results show that different shoulder stabilizers are activated during the push-up plus exercise depending on not only the location of the neck but also the internal or external rotation and abduction/adduction angle of the shoulder joint, suggesting that establishment of an accurate position for the strengthening of each muscle is necessary.

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[Purpose] We evaluated the impact of disease severity on symptoms, functional status of hand and depression of patients diagnosed as having carpal tunnel syndrome (CTS). [Subjects and Methods] Ninety-nine patients with diagnosis of unilateral CTS in the dominant extremity were enrolled in the study. Patients' clinical parameters, grip strength, lateral, tip and tripod pinch strengths, two-point discrimination (2-PD), Semmes Weinstein Monofilament test and Purdue Pegboard test (PPT) were evaluated. The Beck Depression Scale (BDS) was used to evaluate patients. The patients were divided into 3 groups, mild, moderate and advanced CTS, according to electrophysiological parameters. [Results] Thirty-three patients had mild, 34 patients had moderate and 32 patients had advanced CTS. There were statistically significant decreases in tripod and tip pinch strength and a statistically significant increase in the score of the 2-PD test in the advanced CTS group compared to the mild and moderate CTS groups. While there was a significant decrease in the dominant hand subtest of PPT in the advanced CTS group compared to the mild CTS group, no differences in the other subtests of PPT were found. The BDS scores of patients with advanced CTS were significantly higher than those of patients with mild CTS. [Conclusion] Tip and tripod pinch strength decreased, sense of touch and fine motor skill deteriorated and depression status increased with disease severity.

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[Purpose] This study assessed the effect of stretching and strengthening exercises for the cervical muscles on the respiratory gas transport system in allergic rhinitis patients. [Subjects] The research subjects were those who had been diagnosed with allergic rhinitis by an otorhinolaryngologist and had at least one distinctive symptom such as sneezing, rhinorrhea, nasal obstruction, or pruritus whose severity level was higher than mild according to the diagnostic criteria test of ARIA (allergic rhinitis and its impact on asthma). [Methods] After sufficiently explaining about the research to the subjects before the experiment, the experimental group carried out three sets of stretching exercises for the sternocleidomastoid and scalene and strengthening exercises for the upper trapezius and suboccipitals ten times a day for five days a week with the aim of rectifying muscle imbalances. Respiratory gas was analyzed after eight weeks of exercises using a wireless metabolic measurement system (K4b2, Cosmed, Italy). The independent t-test and paired t-test were used to compare respiratory gas results. [Results] Tidal volume (Vt), oxygen uptake (VO2), carbon dioxide emission (VCO2), minute ventilation (VE), breathing frequency (BF), and heart rate (HR) significantly increased after the experiment in experimental group, while respiratory parameters did not significantly change in the control group except for VE. [Conclusion] A combination of postural and breathing exercises were effectively rectified muscle imbalances and posture in the experimental group as measured by changes in cardiopulmonary function.

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[Purpose] The purpose of this study was to investigate the effect of using trunk control pelvic movement (TCPM) exercises with changes in the body position on the relative impulse in hemiplegic patients. [Subjects] Thirty-seven hemiplegic patients were randomly divided into 3 groups: control group (CG, n=12), sitting exercise group (SIEG, n=12), and standing exercise group (STEG, n=13) [Methods] A F-Scan System was used to measure the relative impulse of foot pressure on the hemiplegic side during walking. [Results] After the exercise, the relative impulses of the hallux and 2nd, 3rd metatarsal heads in SIEG and STEG were significantly increased during walking. [Conclusion] These results suggest that TCPM exercise in the sitting and standing positions is effective at improving foot pressure on the hemiplegic side. In addition, propulsion during push off was increased in the standing position.

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[Purpose] We compared the differences in individual toe flexor muscle strength and balancing ability between elderly fallers and non-fallers and determined the correlation between individual toe flexor muscle strength and the functional reach test (FRT). [Subjects] Thirty community-dwelling older adults (15 fallers and 15 age- and sex-matched non-fallers) between 65 and 83 years of age participated in this study. [Method] Individual toe flexor muscle strength was measured using a dynamometer, and balance ability was assessed with the FRT, Berg balance scale, and a sensory organization test (SOT). [Results] The hallux and second toe flexor muscle strengths in the non-faller group were significantly stronger bilaterally than those in the faller group, whereas no significant differences in the third and fourth toe flexor muscle strengths were found. The individual toe plantar flexor muscle strengths were moderately correlated with FRT(r = 0.489-0.765). The non-faller group showed significantly greater balance ability in the FRT and SOT than the faller group. [Conclusion] The results of this study suggest that the force-generating capability of the hallux and second toe flexor muscle are related to the incidence of falls among elderly individuals.

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[Purpose] The purpose of this study was to examine the effects of group-exercise and individualized exercise programs on factors associated with physical function, activities of daily living (ADL), and quality of life (QOL) among nursing home residents. [Subjects and Methods] This study examined differences in changes of physical function, ADL, and QOL levels among participants undergoing 2 exercise intervention programs. The participants were drawn from a geriatric nursing home population and were randomly divided into 2 groups: group exercise intervention (n=14; mean age, 85.7 ± 3.9 years) and individual exercise intervention (n=12; mean age, 85.8 ± 7.8 years). Group therapy consisted of individualized rehabilitation along with a group outdoor walking program; individual therapy consisted of individualized rehabilitation alone. Physical function, ADL, and QOL levels were measured 4 times (approximately once per month). [Results] For both measures of QOL, an interaction was seen between the group exercise intervention group and the individual exercise intervention group. No interactions were seen between groups for physical function or ADL. [Conclusion] In designing a physical exercise program for residents in geriatric nursing home, it is important to conduct part of the program outside and to include social activity elements.

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[Purpose] We evaluated the level of patient satisfaction for community-based rehabilitation programs using a modified questionnaire to identify subjective preferences and plan an optimal clinical program. [Subjects and Methods] Over a period of 12 weeks, 13 patients who had suffered a stroke participated in three exercise programs and two educational programs. The three exercise programs included a circuit exercise program, mat exercise program, and a game activity program, and they were performed weekly. The educational programs consisted of tapping and stress-education programs. After 12 weeks, the satisfaction level for each program was analyzed using a five-point scale, with higher points meaning a higher level of satisfaction. [Results] Satisfaction was the highest in the mat exercise program and the lowest in the stress-education program, with a significant difference between these programs. There was no significant difference between the educational programs or among the exercise programs. [Conclusion] The findings suggest that patients prefer direct rehabilitation programs to improve function after a stroke. A mat exercise program could be used in clinical rehabilitation to increase the rate of participation and improve the therapeutic efficacy.

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[Purpose] The present study was designed to examine the effects of movement speed on tracking accuracy of patients with stroke. [Subjects] Thirty stroke patients (16 patients with right hemiparesis and 14 patients with left hemiparesis, mean age = 56.2 yrs, mean period after stroke = 19.2 months) volunteered to participate in the study. [Subjects and Methods] Participants were required to track a continuous sinusoidal signal with rhythmic 3rd metacarpophalangeal (MCP) joint flexion-extension movements. The oscillation frequency of the signal was set at 0.2 Hz or 0.4 Hz with a total of 12 cycles per trial. The sinusoidal tracking signal and the participant's MCP motion signal were displayed overlapping together on a computer monitor. Participants performed 3 trials at each, 0.2 Hz and 0.4 Hz, frequency condition. [Result] Tracking accuracy was significantly less accurate under the slower 0.2 Hz condition when tracking the tracking signal with the paretic finger. [Conclusion] Participants were unable to efficiently track the external signal with the paretic side, suggesting that motor execution on the paretic side was significantly impaired. Moreover, the decline in the execution of the tracking movement with decreasing movement frequency might result from a failure of the feedback system to frequently update the impaired finger's movements.

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[Purpose] The purpose of this study was to investigate whether clinical findings can be used to predict lower extremity complications associated with deep venous thrombosis (DVT) after total hip arthroplasty (THA). [Subjects and Methods] In all, 37 female patients (mean age, 63.4 ± 10.2 years) with osteoarthritis of the hip who had undergone THA were included in this study. We evaluated pain (Homans sign or tenderness) and edema on the postoperative day when physical therapy was restarted. [Results] Venography revealed that 12 patients had DVT (group D) and 25 patients did not (group N). The intensity of calf pain was significantly higher in group D than in group N. The positive predictive value of pain for DVT was 62.5%, and the negative predictive value of pain was 75.9% (sensitivity, 41.7%; specificity, 88.0%). Patients with proximal DVT tended to have fewer clinical findings than those with distal DVT. [Conclusion] These results suggest that clinical findings are more apparent in patients with DVT; however, proximal DVT would be overlooked because it has few clinical findings.

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[Purpose] It is suggested that walking with Masai Barefoot Technology (MBT) shoes will increase oxygen uptake and result in greater consumption of energy relative to walking with conventional shoes, but this has not been sufficiently investigated. [Methods] To examine this supposition, ten subjects walked on a treadmill with different types of shoes (jogging or MBT shoes), treadmill inclinations (zero or 10 % inclination) and walking speeds (i.e. self-selected walking speed or fast walking speed). Oxygen uptake, heart rate, lung ventilation, ratings of perceived exertion and energy expenditure were measured during all walking conditions by a stationary metabolic cart. [Results] On a flat treadmill at self-selected and fast walking speeds, physiological responses were similar for jogging and MBT shoes. In contrast, fast uphill walking with MBT shoes significantly increased oxygen uptake by about 5% relative to jogging shoes. The calculated energy expenditure for 60 minutes of fast, uphill walking was about 6% higher when using MBT shoes. [Conclusion] The magnitude of increases in oxygen uptake and energy expenditure when using MBT shoes were quite small, and the clinical relevance regarding reductions in body weight may be negligible.

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[Purpose] The aim of the present study was to evaluate whether quality of life (QOL) was improved in gynecological cancer patients with lymphedema following Complex Decongestive Physical Therapy (CDPT), and whether edema volume change as a result of treatment correlated with change in QOL. [Subjects and Methods] Forty-six patients who had unilateral lower leg lymphedema were treated with CDPT for 2-4 weeks. Percentage excess volume (PCEV) and QOL were recorded at baseline, 1 month, and 6 months after CDPT. [Results] PCEV was significantly decreased at 1 month. There was a statistically significant difference in physical functioning, role-physical, mental health, and general health in the Korean version of the Short Form-36 (SF-36) Health Survey. [Conclusion] The results of this study suggest that QOL was significantly improved for gynecological cancer patients with lower leg lymphedema during the maintenance phase, and was necessarily correlated with the PCEV.

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[Introduction] Local hypoxia plays a favorable role in muscle regeneration. [Subjects and Methods] The effect of hypoxia on cell growth, differentiation, and motility was examined in differentiating and growing C2C12 mouse myoblasts cells, respectively. [Results] Hypoxia induced growth suppression in the growth phase, but the suppression diminished in the differentiation phase. Hypoxia inhibited the expression of differentiation marker proteins, accompanying MyoD mRNA suppression. Expression of HIF-1α protein was induced only in the induction phase, regardless of oxygen concentration. Hypoxia did not alter motile activity in the growing phase, but augmented the motile property in the differentiation phase. Expression of autocrine motility factor mRNA was augmented under hypoxic conditions. [Conclusion] In differentiating cells, HIF-1α induced by myogenic differentiation may compensate for the cell growth suppression due to hypoxia, and support the motility augmentation. Hypoxia may shift differentiating cells into the growth phase which provides the ability to translocate to an appropriate area.

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