[Purpose] This study was performed to investigate the effects of trunk stability exercise using the proprioceptive neuromuscular facilitation (PNF) technique on stroke patients’ muscle activation and their results in the functional reach test (FRT). [Subjects] Adult hemiplegia patients (n=40) were randomly allocated to two groups: an experimental group and a control group. [Methods] The experimental group performed a trunk stability exercise using the PNF, while the control group performed only a general exercise program for 6 weeks (5 times a week). Pre- and post-experiment measurements were made of the FRT. For measuring muscle activation, the quadriceps, hamstring, tibialis anterior, and soleus muscles were recorded by electromyography (EMG) in the FRT. [Results] The results of this study show that after performing the therapeutic exercise program, the experimental group showed significant improvements in FRT, activities of quadriceps, hamstring, and soleus muscles on the affected side, and activities of the quadriceps, and soleus muscles on the non-affected side, the control group showed significant improvements only in activities of the quadriceps, and soleus muscles on the non-affected side. [Conclusion] These results indicate that trunk stabilizing exercises using PNF performed by stroke patients were effective at improving FRT and the muscle activities of the soleus and quadriceps.

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[Purpose] The aim of this study was to investigate whether the performance of a combination of observation and motor imagery of chopstick use (complex task) increased corticospinal excitability more than the performance of observation alone. [Subjects and Methods] We recruited 10 healthy subjects with no history of neurological diseases. Corticospinal excitability was assessed with the participants seated in front of a computer screen performing three tasks: (1) control, the subjects were instructed to relax; (2) OBS, the subjects were told to observe an action depicted in the video, and (3) OBS + IMG, the subjects were told to imagine performing an action depicted in a video. During tasks (2) and (3), a video was displayed on the computer screen showing the hand of a male subject using chopsticks to move small items of food from one dish to another (first person perspective). Imagery was performed kinesthetically. [Results] The MEP amplitude in the first dorsal interosseous was significantly increased during OBS+IMG relative to that in the control condition, but not that in the OBS condition. The MEP amplitude in the thenar muscles was significantly different between OBS and OBS+IMG. [Conclusion] These results suggest that the combination of observation and motor imagery of a complex task may be more effective than observation alone for motor rehabilitation purposes.

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[Purpose] This study investigated the change in functional balance and weight bearing of stroke patients in a set-task balance training program and a selective-task balance training program. [Method] the participants were randomly allocated to either the set-task program or the selective-task program. We evaluated balance capacity using the Berg Balance Scale (BBS). Postural weight bearing was measured using a Tetrax Intractive Balance System, and the lower extremity function was evaluated using the Fugel-Meyer Assessment of Sensorimotor Impairment (FMLE). Both programs were performed three days a week for 30 min, 8 for weeks. The participants were assessed again at the end of the 8 weeks of training, and again after 3 months. [Results] The selective-task group showed significant improvments in BBS and plantar foot pressure after training. FMLS showed no significant difference in the set-task group after training; however, the selective-task group showed a significant improvement. At the 3-month follow-up BBS and Plantar foot pressure had maintained the significant improvement in both groups, but FMLS only showed a significant improvement in the selective-task group. [Conclusion] Based on this study, a selective-task program for stroke patients in which the patients choose tasks is more effective at improving balance, symmetric weight bearing by the lower extremities, and lower extremity function than a set-task program.

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[Purpose] The aim of this study was to determine the effects of motor dual-task training (MDT), cognitive dual-task training (CDT), and motor and cognitive dual-task training (MCDT) on balance and daily living abilities of stroke patients. In addition, the relationships among assessment tools such as center of pressure (COP), Korean version of Berg Balance Scale (K-BBS), and the Functional Independence Measure (FIM) were investigated. [Subjects and Method] Thirty-eight stroke patients were randomly allocated to a MDT group, a CDT group, and a MCDT group, and training was performed three times a week for six weeks. The patients’ balance was assessed with the mean area of COP movement and K-BBS, and the daily living abilities were evaluated with FIM before and after the training. [Results] Post-training, a significant difference in COP was found in each of the three groups, and between the CDT group and the MCDT group. K-BBS and FIM also showed a significant difference in each of the three groups, and comparison among the three groups showed that the improvement in the MCDT group was significantly better than those of the other two groups. Highly negative correlations were found between COP and K-BBS and between COP and FIM (r=—0.960, —0.874, respectively), and a highly positive correlation was found between K-BBS and FIM (r=0.870). [Conclusion] For effective training of balance and daily living abilities for stroke patients, it is more effective to implement both motor and cognitive dual-tasks than motor or cognitive dual-tasks alone.

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[Purpose] We investigated postoperative improvements in the knee joint function of 121 patients (17 males, 104 females) who received total knee arthroplasty (TKA). [Subjects and Methods] The evaluation criteria were: knee joint flexion range of motion, knee joint extension strength and flexion strength, pain in the knee joint, score on The Japanese Orthopedic Association knee criteria of “pain” and “ability to ascend and descend stairs”, and 6-minute walking distance. The time points for the evaluations were: prior to surgery, at the time of discharge, 3 months postoperative, 6 months postoperative, and 1 year postoperative. In addition, the level of satisfaction 1 year after the operation was also assessed. [Results] In the results, 6-minute walking distance and ability to ascend and descend stairs were significantly better at 3 months postoperative than before surgery. Knee joint range of motion at 3 months postoperative had improved to its preoperative status, and was significantly improved at 1 year postoperative. Knee joint extension strength at 3 months postoperative had recovered to its preoperative status, and was significantly improved at 6 months postoperative. Knee joint pain was significantly ameliorated at the time of discharge compared to before surgery. Knee joint pain had completely disappeared in approximately 30% of patients by 1 year after surgery, and 90% of patients were satisfied with the results of their surgery. Nevertheless, many of the patients still complained of knee discomfort from TKA. [Conclusion] The results of this study show that knee joint pain was reduced at the time of discharge, and that 6-minute walking distance and ability to ascend and descend stairs were significantly improved at 3 months postoperative. Moreover, these results suggest that there are improvements in knee joint extension strength after 6 months, and in knee joint range of motion at 1 year postoperative. The results show that knee joint function after TKA improves over the year after surgery.

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[Purpose] The purpose of this study was to investigate the effect of degree of obesity on the plantar pressure when middle-aged women walked over an obstacle. [Subjects] The subjects of this study were twenty-seven middle-aged female adults. The subjects were divided into a normal group (n=5), an overweight group (n=8), a lightobesity group(n=7), middleobesity group (n=7). The subjects were asked to step on a foot scanner immediately before crossing over an obstracle (height 0 cm, 10 cm, or 20 cm) while walking on a road 10 m course that was and 1 m wide at a speed of 80 m/min. The mean pressure value for each obstacle height was calculated from three trials. The pressure measurement was performed by dividing the sole into seven regions. [Result] Under the 0 cm height condition, the pressures at the hallux and heel were significantly greater in the overweight group, the lightobesity group, and moderateobesity group than in the normal group. Under the 10 cm height condition, the pressure at the hallux, the first metatarsal, and the heel in the moderateobesity group was significantly different from that in the normal group, overweight group, and the lightobesity group. Under the 20 cm height condition, there were no significant difference among any of the groups in any region. [Conclusion] An increase in weight in normal middle-aged women may result in an increase plantar pressure at certain regions when walking over obstructions that were 10 cm or higher, and may cause abnormal gait by inducing a motor abnormality at the ankle joint.

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[Purpose] The purpose of this study was to investigate the effect of handle type, which is a fundamental element determining rollator type and the part that directly connects the user to a rollator, on the plantar foot pressure of elderly people during gait, and to examine how the gait of elderly people is affected by variation of the rollator handle. [Subjects] The subjects of this study were 12 elderly women over the age of 65 and 10 young adults who were given sufficient explanation about the objectives and method of this study and volunteered to participate in the study. [Methods] The elderly women learned how to use different types of rollators and performed gait without a rollator and with two types of rollators in a random order on a course that was 10 m long. The young adults, who served as the reference for the plantar foot pressure during gait, performed gait in the same manner without a rollator. [Results] The plantar foot pressure of the elderly people was compared with that of the young adults. The results show that there was a significant difference at the rearfoot, lateral midfoot, lateral forefoot, and hallux regions. The plantar foot pressure at the rearfoot and hallux regions was highest in the young adults, while it was lowest when the elderly used a rollator with a transverse handle. The plantar foot pressure at the lateral midfoot and lateral forefoot regions was highest when the elderly group did not use a rollator. [Conclusion] The results suggest that selective use of the handle type according to the purpose is important even though the use of a rollator assists the gait of the elderly regardless of the handle type. Moreover, the high dependency on the transverse handle rollator means that there can be a greater risk of falling down when grip on the handle is lost, and the vertical handle is more appropriate for gait training since it reduces dependency on the rollator during gait.

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[Purpose] The aim of this study was to identify the factors related to the recovery of walking ability at the early stage after total hip arthroplasty (THA). [Subjects and Methods] The subjects of this study were 99 patients who had undergone unilateral THA. The hip abductor and knee extensor strengths were measured and the timed up and go (TUG) test was performed prior to THA. The number of days to achieve gait with a cane, an index of early-phase improvement in walking after THA, was retrospectively examined. [Results] A stepwise multiple regression analysis was performed with the number of days to achieve gait with a cane as the dependent variable, and other measurements as independent variables. The preoperative physical functions correlated with the number of days to achieve gait with a cane following THA. The stepwise multiple regression analysis selected three factors (preoperative TUG test, surgical approach, and mobility at the beginning of transfer training) as the significant variables affecting the number of days to achieve gait with a cane following THA. [Conclusion] The results of the present study suggest that preoperative TUG, surgical approach and mobility at the start of transfer training are useful indicators for predicting ambulation ability in the early stage after THA.

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[Purpose] The purpose of this study was to determine whether the location of the motor point (MP) identified with the gross anatomical method corresponds with that identified with electrical stimulation in the tibialis anterior muscle (TA) in order to test the validity of adopting the nerve entry point as the target for electrical stimulation. [Subjects] We used 16 lower limbs from 12 cadavers and 26 lower limbs from 13 healthy adults. [Methods] We identified the location where the thickest motor nerve entered the muscle belly of TA in cadavers as the anatomical MP and where the surface electrical stimulation threshold of TA was lowest in healthy adults as the electrical MP. We defined the line connecting the fibular head and the lateral malleolus as the reference line and drew a line perpendicular to this that intersected the MP. We measured each MP as the length from the fibular head to the perpendicular line, and expressed this as a proportion of the reference line length. The distribution of each MP was compared. [Results] There was significant unequal variance between the two types of MP. The electrical MP was significantly more distal than the anatomical MP. [Conclusion] The anatomical MP does not appear to correspond to the electrical MP, hence adopting the nerve entry point as the target of electrical stimulation is inappropriate.

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[Purpose] We investigated the influence of plantar hardness discrimination training on center-of-gravity sway while standing on one-leg. [Subjects] Twenty healthy adult volunteers were randomly divided into intervention (n = 10) and control groups (n = 10). [Methods] The intervention group subjects carried out 10-day plantar hardness discrimination studies on sponges with 5 different levels of hardness. The control group underwent the same training except that they were not instructed to discriminate sponge hardness. Center-of-gravity (COG) sway while standing on one-leg with the eyes open or closed was measured before and after the training. Statistical analyses were performed the COG path length, enveloped area and rectangular area values. [Results] The number of correct answers for hardness discrimination significantly increased with the number of training days. There were significant reductions in the COG path length, enveloped area and rectangular area values after training in the intervention group compared to their respective values prior to training. In contrast, the control group showed no significant changes in these 3 parameters. [Conclusion] Our results suggest that the ability of healthy individuals to regulate center-of-gravity sway while standing on one-leg improved with enhancement of plantar perceptual ability through hardness discrimination training.

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[Purpose] This study compared the motor development characteristics of preterm and full term infants, for utilization basic material for the mediation of the early physiotherapy of high-risk infants. [Subjects and Methods] The subjects were preterm and full-term infants who were hospitalized at the nursery of Busan M Hospital from March 30th, 2010 to December 31st, 2010. The group of mature infants (male: 8; female: 9; postconceptional age: 39.24 weeks) and premature infants (male: 10; female: 7; postconceptional age: 40 weeks) were measured for movement and posture using the Test of Infant Motor Performance (ver. 5.0) and the assessment was performed at the postconceptional age of 40 weeks (mean age: 39.75 weeks). [Results] In some items of the observed scale and elicited items, the mature group exhibited better motor development than the premature group. Also, in the overall score of the observed scale, the performance of the premature group was below that of the mature group. [Conclusion] Even healthy premature infants with no neurological issues show reduced levels of development compared to mature infants.

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[Purpose] The purpose of this study was to investigate clinical aspects of screen test tools for central neuropathic pain in thalamic stroke patients. [Subjects and Methods] Seven thalamic stroke patients were recruited as subjects. To classify the subjects into central neuropathic pain and non-neuropathic pain groups, the Leeds assessment of neuropathic symptoms and signs (LANSS) was used. Four patients were classified as having central neuropathic pain. To evaluate the central neuropathic pain, the quantitative somatosensory test, the median nerve somatosensory evoked potentials (SEPs), magnetic resonance imaging (MRI), and functional MRI (fMRI) were performed on average 31.5 months after stroke. [Results] The quantitative somatosensory test did not show a correlation between the central neuropathic pain group and the non-neuropathic pain group. The SEPs on the affected side showed a response in one of the patients without central neuropathic pain, and responses on the unaffected side were normal for all of the patients. MRI-based thalamic localization data indicate that this method is limited in its ability to distinguish the central neuropathic pain in thalamic stroke patients. Results of fMRI show that the secondary somatosensory areas of the central neuropathic pain group were more activated than those of non-neuropathic pain group. [Conclusion] Based on the results, we verified that functional MRI is useful for evaluating the central neuropathic pain in thalamic stroke patients.

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[Purpose]The purpose of this study was to examine the effects of upper thoracic joint mobilization on the dynamic stability of patients with chronic neck pain. [Subjects]The subjects of this study were 37 patients diagnosed with chronic neck pain. They were divided into a group for joint mobilization after conservative physical therapy (JCPTG, n=19) and a self-stretching group after conservative physical therapy (SCPTG, n=18). [Methods] To see changes in dynamic stability, we analyzed and compared images using a picture archiving and communication system (PACS). [Results]Over the course of the treatment period, decreases in pendular movements (PM) and translational movements (TM) appeared between the JCPTG and SCPTG. Between the JCPTG and SCPTG, there were no significant differences in PM during flexion and extension and in TM during flexion before the treatment, although there were statistically significant differences at four weeks and eight weeks. There was no significant difference in TM of extension in any case. [Conclusion]We consider that upper thoracic joint mobilization is an effective intervention for the dynamic stability of patients with chronic neck pain.

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[Purpose] This study compared the association between the Inter-Recti Abdominis Distance (IRD) and respiratory muscle strength in primiparous women and determined the prevalence of IRD rise in primiparous compared to nulliparous women. [Subjects] One hundred and twenty pregnant women and forty non-pregnant women participated in this study. IRD was measured by a digital caliper 4.5 cm above and below the umbilicus, as well as at the umbilical level. Respiratory strength was measured as maximum inspiratory (PImax) and expiratory (PEmax) pressures using a digital pressure transducer. [Results] There was no correlation between PImax and PEmax at any of the abdominal anatomical levels assessed, despite a positive correlation being found for IRD and the length of the gestation weeks. Nulligesta IRD of nulliparous women values were lower than those of pregnant women at all the three umbilical levels. Prevalence values varied from 27.5% to 99% depending on the literature values used. IRD rises with duration of pregnancy but doesnÅft interfere with the PImax and PEmax. [Conclusion] Since there is no evidence in the literature for an accurate cutoff point to identify pathological IRD there is a need to define reliable patterns as a reference for diagnosing pathologic IRD according to age and gender.

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[Purpose] The purpose of this study was to investigate how the foot plantar pressure varied as males wore shoes with insole heights of 0 cm, 2.5 cm and 5 cm. [Subjects] The subjects of this study 20 young adult males who voluntarily consented to participate in the study and had no disease history or any problem with walking. [Methods] The subjects rested for 20 minutes in the laboratory in advance and walked on flat ground for 30 minutes. Then, the foot plantar pressure was measured three times. The mean value was calculated for the analysis. The subjects rested for 30 minutes again and carried out the same experiment in the same manner, wearing height-increasing insoles of 2.5 cm and 5 cm. Gait Analyzer was used to measure the foot plantar pressure of the individual subjects. [Results] In the F4, F5, F6, R3 and R4 regions, the plantar pressure was significantly increased, but there was no significant difference foot regions. [Conclusion] In conclusion, the height-increasing insoles used by young adult males, who consider their outer appearance important, possibly cause anomalies of the feet, the foot plantar pressure was changed by the insole height.

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[Purpose] We investigated the gait velocity and cadence using the gait quality chart (GQC), and verified the accuracy of the GQC which is often used by therapists in the evaluation. [Subjects] Participants who met the criteria for this study (n=30). [Methods] To evaluate the gait velocity, cadence and assessment by GQC in this study, the patients were asked to walk a distance of 13 m. Mean values were used in the analysis, and measurements were repeated three times. [Results] There was a significant, positive correlation between gait velocity and cadence, showing that cadence increased as the gait velocity increased. For the correlations between the gait velocity and the GQC items, and cadence and the GQC items, significant, positive correlations were found with the ankle, knee, and the trunk/arm items, but not with the hip/pelvic ratio, indicating that the gait quality was higher as the gait velocity increased. [Conclusion] The results show that the items that are observed at the hip/pelvis cannot be accurately observed because of the small angular joint movement and rapid motion, even though the general qualitative displacements of the GQC provide subjective data that can give results similar to those obtained by the scientific measurement tools.

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[Purpose] This study investigated the effects of differences in the touch height and touch load on center of pressure (COP). [Subjects] Subjects were 40 healthy young. [Methods] We measured COP sway at different touch heights and touch loads during tandem standing. [Results] Although the total sway length in light touch contact (LT) was comparable with that of no contact (NC), the environmental area and root-mean-square area in LT were significantly lower than in NC. In addition, the total sway length / environmental area was significantly greater in LT than in NC. The COP sway length was reduced in LT, although the COP sway length was comparable to that of NC. Furthermore, differences in the height at which LT was performed (the greater trochanter, acromion, and midpoint of the trochanter-acromion) did not result in significant differences. [Conclusion] We consider that sway is reduced by feedback from tactile sensations at the fingertips and proprioception. This suggests that LT could be used to increase stability in daily living regardless of the height at which LT is performed between the height of the acromion and greater trochanter.

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[Purpose] Evaluation of motion strategy during FRT is not generally included in physical assessment aiming at rehabilitation and promotion of good health. We believe that measuring only reach distance during FRT is insufficient for evaluating gait; therefore, examining motion strategy during FRT is also necessary. [Subjects] The subjects were 83 healthy university students (46 men and 37 women; range, 19—21 years), and 128 elderly persons (42 men and 86 women; range, 70—87 years). [Methods] We investigated and compared the motion strategy during FRT in both the young and elderly subjects and examined the influence of aging on motion strategy. [Results] Elderly persons used patterns of movement with ankle plantar flexion more often than the young persons. [Conclusion] The ankle plantar flexion pattern was dominant among the elderly subjects because the center of gravity in FRT was located within the base of support. We would like to use FRT as an index for fall prevention. To do that, we would need to devise a method to measure the ability to control the body in the situation in which center of gravity starts deviating from the base of support.

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[Purpose] The purpose of this study was to identify effects of acute maximal workload on oxidative stress of obesity. This study investigates the differences in expression of oxidative stresses between an obese group and a group with normal health after an acute maximal workload.[Subjects] Eighteen men were randomly assigned to one of two groups: an obese group (n=8), and a normal group (n=8). All members of the acute maximal load that participated in the study were between the ages of 20 and 30 years old. The baseline level of obesity was determined as 25% of the fat and body mass index (BMI) 25. [Methods] The treadmill grade was increased 2% every 1 minute (Balke protocol) while speed (3.3mph) was kept constant. The speed was individualized so that exhaustion occurred in approximately 8—12 minutes. Standard criteria for an acceptable VO₂max test included a leveling off of VO₂ with increasing workload, a respiratory exchange ratio (RER) above 1.15 and a peak HR similar to age-predicted maximal values. Both groups stopped eating, smoking, drinking and exercising 21 hours before the test concerning circadian rhythm. After 50 minutes, 10 ml of blood was collected at three different times at rest, at exhaustion, and after 30 minutes of recovery. [Results] There was no significant difference in malondialdehyde assay (MDA) which is a common test for evaluation of lid peroxidation between the normally healthy group and the obesity group after exhaustion and 30 minutes of recovery. [Conclusion] The reason why acute maximal load did not have a significant effect on the MDA activation which is an indicator of lipid peroxidation is that acute maximal load raised the free radical level and the lipid peroxide level; and had a defense mechanism against the generation of free radicals; thus restrained lipid peroxides from being generated by free radicals; consequently they could not have any effect on antioxidation capability.

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[Purpose] The purpose of this study was to analyze the effect of exercise intensity and recovery times on the extension of Neuropeptide Y in mice hypothalamus. [Subjects] The mice (ICR) were housed per cage in a temperature (20—23°C) and light controlled environment with a 12:12h light-dark cycle.[Methods] ICR were divided into ten groups, 8 mice each group: rest time group, low-intensity exercise, moderate-intensity and high-intensity. The exercise was carried out on a treadmill adapted in order to permit 2 animals to run at the same. Neuropeptide Y transcript contents were estimated by RT-PCR and Real Time PCR. DNA laddering was used to detect DNA fragmentation as an indicator of Neuropeptide Y. [Results] The Neuropeptide Y mRNA relationship to exercise intensity showed significant differences immediately after exercise. The Neuropeptide Y mRNA relationship to exercise intensity showed differences on low-intensity, moderate-intensity and high-intensity. Neuropeptide Y mRNA showed differences between exercise levels of low-intensity to moderate-intensity and low-intensity to high-intensity. [Conclusion] It is noteworthy that the expression of NPY mRNA can be effected by stability time and the intensity of exercise. Neuropeptide Y mRNA expression is connected with recovery times at moderate-intensity and high-intensity. The present results suggest the possibility that exercise intensity and recovery times regulated of the desire for food.

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[Purpose] The purpose of this study was to myoelectrically verify the effect of exercise on a bicycle ergometer with a newly developed toe-heel pedal. [Subjects and Methods] The subjects of this study were 12 healthy adults (24 limbs) without any disability in the lower limbs. We evaluated the integrated electromyograms (iEMG) of the quadriceps femoris and the flexor digitorum brevis during the pressing down on the toe-heel pedal and compared them with those recorded on the flat pedal. [Results] The average iEMG of the quadriceps femoris during the pedaling action was significantly higher for the toe-heel pedal at 5.49 ± 3.06 than that for the flat pedal at 1.75 ± 2.17. The average iEMG of the flexor digitorum brevis during the pedaling action was higher for the toe-heel pedal at 2.39 ± 0.73 than that for the flat pedal at 1.86 ± 1.83. [Conclusion] We showed that exercise on an ergometer with the toe-heel pedal can effectively achieve facilitation of muscle contraction throughout the lower limb including the thighs as well as muscular training of the plantar muscles.

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[Purpose] The purpose of this study was to investigate the effects of balancing exercises on unstable surfaces on the balance ability of stroke patients in a comparison with balancing exercises on stable surfaces. [Methods] The study subjects were 30 stroke patients (16 males and 14 females). They were separated into two groups; a stable surface exercise group (n=15) and an unstable surface exercise group (n=15). The balance ability of patients was measured using the Berg balance scale (BBS) and parameters of sway of the center of pressure (COP). The balancing exercises were modified from preceding studies and consisted of 6 difference exercises. Exercises were conducted six times a week for six weeks. [Results] Only the velocity moment decreased in the stable surface exercise group, whereas mediolateral and anteroposterior movement distances and the velocity moment decreased in the unstable surface exercise group. Thus, exercises on the unstable surface were more effective than on the stable surface. The degree of balance on both stable and unstable surfaces was lower with eyes closed than with eyes opened. The BBS scores of both groups increased, indicating improved balance ability. [Conclusion] This study found that balancing exercise on an unstable surface was more effective than on a stable surface at improving the balance of stroke patients.

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[Purpose] This study investigated the correlations among sacral angle (SA), lumbar lordosis (Lo), maximum contractility of the transverse abdominis (TrA), and the static and dynamic lumbar stability (SLS and DLS) in college students in their 20s. [Subjects] The subjects were 40 college students (20 males and 20 females) in their 20s. [Methods] Lateral view radiographs were used to analyze the SA, Lo, flexion (Fle), extension (Ex), and the range of Fle and Ex motions (RFEM). The PBU (Pressure biofeedback unit) was used to examine SLS and DSL. The Oswestry Disability Index (ODI) was used to evaluate lumbar pain and physical functions. [Results] As SA increased, Lo, Ex and RFEM increased. As Fle increased, RFEM increased while ODI decreased. The results of this study indicate that as Ex increases, RFEM and DLS also increase, and as RFEM increases, DLS increases while ODI decreases. [Conclusion] The results indicate that the lumbar spine’s posture and range of motion affects DLS rather than SLS. In particular, it is thought that therapeutic approaches for increasing Ex and RFEM should be considered.

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[Purpose] The temporal changes of pain scale and sensory threshold after the application of a moist hot-pack (HP) were investigated in chronically painful body regions of geriatric patients. [Methods] The subjects were 74 geriatric patients (45 female; 29 male) with pain in the low back, knee, or shoulder regions. HP was applied to each of the painful regions for 30 min. Pain was assessed using a Visual Analogue Scale (VAS), the Faces Pain Rating Scale (FPRS), and the Iowa Pain Thermometer (IPT), before and 0, 1, 3, 6, 12, and 24 h after HP application. The sensory threshold was measured, before and 0, 1, and 24 h after HP application using an electro-stimulator. [Results] The level of pain was significantly decreased by HP application for 30 min, as shown by VAS, FPRS and, IPT, and the effect was maintained for at least for 3 h. The effect of HP gradually wore off and pain had returned to the basal level at 24 h. The effect of HP was more potent and long term in the shoulder region of male patients than in that of females. Moreover, the sensory threshold also increased after HP application for 30 min in all regions. [Conclusion] These results suggest that the application of HP alone may be effective for treating chronic pain experienced by geriatric patients.

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[Purpose] The purpose of this study was to evaluate the balance ability of older adults from many points of view, and to evaluate fall risk. The effects of various parameters on the frequency of falls were also investigated using discriminant analysis. [Subjects and Methods] Subjects were 79 elderly (73.2 ± 4.2 yrs) with no serious disease living independently at home and 70 healthy young adults (20.7 ± 1.4 yrs). We conducted a posturographic evaluation, a two-point discrimination of pressure sensation at the plantar sole, measured grip strength and range of motion of the lower extremities, and conducted a clinical balance test (Berg Balance Test). [Results] The following relationship was obtained: Z (discriminant function) = 0.002×the total value of the Limit of Stability test + 0.139×Grip Strength —4.15. Moreover, the female group showed a significantly higher fall rate than the male group, and had a higher center of pressure speed than the male group. [Conclusion] Total score of the limit of stability test and grip strength were related to the frequency of falls, suggesting that these parameters may be useful in screening for falls.

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[Purpose] The distribution of force on the foot changes in rheumatoid arthritis (RA) patients to compensate for foot pain. [Subjects] We recruited patients with an RA diagnosis. Subjects were grouped according to the primary symptomatic foot area, the presence of forefoot pain (F group: n = 29) and hindfoot pain (H group: n = 25). [Methods] Disease duration, degree of pain and number of joint erosions were recorded. Spatiotemporal parameters were measured using a gait analysis system. In addition, plantar pressure parameters (pressure time integral (PTI) and average velocity of center of pressure (COP) (VCOPave)) were measured using a pressure platform. [Results] There were no significant differences between the two groups in terms of disease duration, pain and spatiotemporal variable values, with the exception of stride length. The PTI of RA patients in the F group was significantly higher in the 1st ∼ 4th metatarsal area and significantly lower in the midfoot. VCOPave for the F group was significantly faster in the midfoot and significantly slower in the metatarsal area compared to the H group. [Conclusion] PTI in the midfoot or metatarsal area of RA patients increases even in the context of decreased COP velocity.

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[Purpose] This study was designed to compare the ankle dorsiflexion range of motion and muscle density of the tibialis anterior among different age groups. [Methods] The study subjects were 30 and 30 female elderly persons. Their ankle dorsiflexion range of motion in the sitting position was measured with a goniometer and muscle density was measured using the transverse ultasonographic images of the tibialis anterior in flexion with the bent atknee to 90 degrees. [Results] There were significant differences in the ankle dorsiflexion range of motion and in the muscle density of the tibialis anterior among the different age groups. [Conclusion] These results suggest that dorsiflexion at the ankle joint and the tibialis anterior play important roles in maintaining balance. Therefore, clinical research into the roles of the ankle joint and the tibialis anterior to in maintaining the balance of the elderly will be helpful.

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[Purpose] This study examined whether age, lesion side or location are strong predictive factors of the functional recovery of stroke patients. [Subjects and Methods] Fifty-six stroke inpatients were recruited within 3 months after onset. All participants enrolled were treated with physical and occupational therapy consisting of two 30 minute sessions per day. [Results] After physical and occupational therapy for 2 months, the stroke participants showed functional improvement on the Functional Independence Measure (FIM), Berge Balance scale (BBS) and Functional Ambulatory Categories (FAC) scores without any relation to age, lesion side or location. On the Berg balance scale, cortical lesion patients showed greater improvement in those older than 65 years (p<0.05). [Conclusion] Physical and occupational therapy is effective for the functional recovery of stroke patients without any relation to age, lesion side or location.

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[Purpose] The purpose of this study was to compare the effects of land exercise and aquatic exercise on chronic stroke patients. [Subjects and Methods] The subjects were randomly divided into a land exercise group (12 males and 10 females; average age: 56.09 ± 7.22 years) and an aquatic exercise group (15 males and 7 females; average age: 51.55 ± 8.27 years). Subjects from both groups received general conventional treatment during the experimental period. In addition, all subjects engaged in extra treatment sessions. This extra treatment consisted of trunk stability strengthening exercises and balance training exercises in the land exercise group, whereas in the aquatic exercise group subjects participated in balance board exercises and walking exercises using buoyancy equipment in the hospital swimming pool. [Results] The joint position sense test and performance oriented mobility assessment showed significant improvements in both groups. However, the joint position sense test and performance oriented mobility assessment showed there was more improvement in the aquatic exercise group than in the land exercise group. [Conclusion] The results suggest that aquatic exercise is more effective than land exercise at improving the joint position sense and clinical functions of stroke patients.

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