[Purpose] We examined the changes in skin temperature before and after application of wet or dry heat to regions of the bodies of healthy volunteers. [Methods] Sixteen healthy subjects (eight female and eight male volunteers) with no past history of disease were selected for this study. The heat was applied to the shoulder, knee, and back regions for 30 minutes. Time-dependent changes in skin temperature of the knee joint in the suprapatellar, patellar, and infrapatellar regions were also intensively measured after 10, 20, and 30 min of wet or dry heat application. We used an IRIS-5000 digital infrared thermographic imaging (DITI) device for temperature measurements. [Results] In an anthropometric statistic analysis, body mass index (BMI) and Röhrer’s index were significantly decreased in women compared with men. Skin temperatures in the suprapatellar, patellar, and infrapatellar regions of the knee after application of wet and dry heat in both men and women significantly increased in a time-dependent manner. We heat in particular produced a marked time-dependent increase in skin temperature in women compared with men in all regions. On the other hand, dry heat produced a noticeable increase in skin temperature in men compared with women in all regions. In analysis of comparison between wet and dry heat, women showed no differences, but dry heat produced a significant time-dependent increase in skin temperature in the men compared with wet heat in all regions. [Conclusion] The effects of dry and wet heat application on the distribution and variation of skin temperature may differ in part by gender.

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[Purpose] The aim of this study was to examine the effects of noninvasive transcranial direct current stimulation (tDCS) on functional movement performance and balance of the lower extremities in normal people. [Subjects and Methods] The study randomly divided thirty normal adults into an experimental group and a pseudo-control group in order to look at the effects of noninvasive tDCS on their agility, power, and balance. Each group also performed a treadmill exercise to evaluate whether brain activation was sustained. [Results] According to the intragroup comparison result, the experimental group showed significant differences in agility and balance, and significant differences occurred in balance in the pseudo-control group. In intergroup comparison, both groups significantly differed in agility and power. [Conclusion] tDCS activates the cerebral cortex, and therefore, is effective in improving functional movements of the lower extremities; it also significantly influences agility among functional movement elements of the lower extremities by maintaining activation of the premotor area during the next movement.

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[Purpose] The purpose of this study was to establish the concurrent validity of electromyography (EMG) activity and muscle strength scores obtained by manual muscle testing (MMT), handheld dynamometer (HHD), and the gold standard stationary dynamometer (SD). [Subjects] Forty healthy young adults (17 men, 23 women) volunteered to participate in this study. [Methods] Subjects performed maximal voluntary isometric contraction (MVIC) of the quadriceps for 5 seconds in three successive trials. Surface EMG was used for recording the muscle activity during the maximal MMT, HHD, and SD measurements. [Results] The mean and peak EMG amplitudes (ICC_3,k = 0.968 to 0.980) of the three MVIC methods and muscle strength scores (Pearson r = 0.868) measured by HHD and SD showed good concurrent validity. The intra-trial reliability of mean EMG activity was also good (ICC_3,1 = 0.960 to 0.989), reflecting consistent measurement between trials. [Conclusion] Our EMG results imply that MMT and HHD are useful and simple methods of measuring MVIC for EMG normalization. Considering cost, time, and clinical utility, we suggest that the use of HHD to measure MVIC for EMG normalization is highly valuable and should generate more meaningful information associated with pathological conditions or interventions for all patients.

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[Purpose] The purpose of this study was to examine the degrees of changes in the gait and feet when walking on a treadmill using Nordic poles and without Nordic poles for 30 minutes. [Subjects] The participants of this study were 30 young adult males. The subjects were divided into a Nordic pole walking group of 15 subjects and a normal walking group of 15 subjects. [Methods] The subjects in both groups were encouraged to face forward and walk in comfortable postures on the treadmill. They did not wear any shoes during walking, and the speed of the treadmill was set to the average of the speeds at which the subjects could comfortably walk in both groups. We measured the gait and feet. [Results] In the Nordic pole group, step length was significantly increased. The rate of each segment from heel contact to foot flat and foot flat to heel off during the stance phase after gait showed significant differences between before and after the experiment. [Conclusion] The results of this study indicate that Nordic pole walking increases the stride and can be considered as helping patients with a disease affecting their gait. Since the use of Nordic poles shortens the time from foot flat to heel off, it is considered that the use of Nordic poles can shorten the midstance during the stance phase.

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[Purpose] The purpose of the present study was to investigate the effects of portable EMG-based combined biofeedback for the rectus femoris, biceps femoris, and tibialis anterior muscles on gait parameters of patients. [Subjects] For the study, we recruited ten volunteers who were survivors of strokes. [Methods] We measured the gait parameters in with and without the portable EMG-based combined biofeedback device. Gait parameters were measured with a GAITRite system. [Results] The portable EMG-based combined biofeedback device significantly improved the affected step length, less-affected step length, affected stride length, and less-affected stride length in stroke patients. [Conclusion] The portable EMG-based combined biofeedback device enabled facilitation of the rectus femoris, biceps femoris, and tibialis anterior muscles. The training enabled the patients to dorsiflex the ankle, attain heel strike at ground contact, and increase in hip and knee flexion during swing.

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[Purpose] This study analyzed the effect of Maras powder on bone mineral density. [Subjects and Methods] One hundred and eighty-three healthy male subjects (93 Maras powder users, 90 nonusers) were included in the study. The information on demographics, health history, alcohol and tobacco use and medication use were obtained by an interviewer-administered questionnaire. Subjects who had any pathology that might affect bone mineral density, were excluded from the study. Mesurements of bone mineral density were obtained by phalangeal radiographic absorbtiometry of the nondominant hand. The bone mineral density values (g/cm²) of Maras powder users were compared with those of nonusers. [Results] The mean duration of Maras powder use was 26 ± 13 years, and the mean age of Maras powder users was 59 ± 11 years. The mean age of nonusers was 58 ± 11 years. The mean phalangeal bone mineral density in Maras powder users (0.32 ± 0.03 g/cm², range 0.22–0.39 g/cm²) was significantly lower than that in the nonusers (0.34 ± 0.03 g/cm², range 0.25–0.43 g/cm², p=0.00). [Conclusion] Bone mineral density is lower in the Maras powder users than in the nonusers. Maras powder appears to be a potential risk factor for low bone mineral density in populations where its use is prevalent.

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[Purpose] Kinesio taping has been postulated to reduce injuries by improving proprioception. To date there remain few studies that have assessed the impact of Kinesio taping on postural stability and by inference proprioception in team sports. The aim of this study was to establish if bilateral application of Kinesio taping of the ankles would improve postural stability in rugby union players. [Subjects] The participants were 31 healthy semiprofessional rugby players (age 19.57 ± 0.76 y; body mass 91.87 ± 11.81 kg; stature 1.82 ± 0.08 m). [Methods] Postural stability was measured using an experimental crossover study design. [Results] Significant improvements in overall stability, anterior-posterior stability, and medial-lateral stability were observed under the taped versus non-taped conditions. A secondary finding was that differences in postural stability may be associated with playing position, in that backline players exhibited significantly better overall stability under the non-taped condition compared with forward players. [Conclusion] These results suggest that Kinesio taping may enhance postural stability in a position-dependant manner in semiprofessional rugby players. From a mechanistic point of view, these findings may help to explain why Kinesio taping may be beneficial; however, the impact that the tape may have in contributing towards the prevention of ankle injuries is yet to be established.

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[Purpose] The present study examines how PNF-based walking exercise on a ramp affects gait performance of stroke patients. [Methods] Forty stroke patients were randomly divided into an experiment group and a control group. For the former group, patients went through a half-hour of training therapy and a half-hour of PNF-based walking exercise on a ramp. For the latter group, patients went through 30 minutes of training therapy and a half-hour of walking exercise on a ramp. All participants had five training sessions each week for four weeks. For measurement, a GAITRite system was used to examine temporal parameters, spatial parameters, and functional ambulation performance before and after the training. [Results] Regarding temporal parameters, step time, double support, and stance phase decreased more significantly in the experiment group than in the control group after the walking exercise on a ramp, while mean velocity increased significantly. In terms of spatial parameters, step length, and heel-to-heel base of support increased significantly in the experiment group after the walking exercise, and step-to-extremity ratio decreased significantly in the same group. Lastly, FAP rose more significantly in the experiment group than in the control group following the walking exercise on a ramp. [Conclusion] The experiment results showed that PNF-based walking exercise on a ramp is effective in enhancing gait performance. It is expected that the same exercise can be applied to patients of other types of neurological disorders to improve their gait performances.

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[Purpose] The aim of this study was to standardize the timing of breathing, pressure and direction of pressing for removing secretions retained in the airway. [Methods] Nine respiratory therapists with work experience of 5 to >21 years cooperated to establish the standard values. A model to record the timing, pressure, and direction of pressing during compression was prepared. Sixty sensors were arranged corresponding to a handprint on the right chest, the site of pressing, on a mannequin, and the respiratory therapists performed compression using this model. [Results] Timing: Based on the waveforms, the subjects gradually increased the pressure, held their position after reaching the peak, and then sharply reduced the force. Pressure: The compression strength varied among the subjects, but the mean peak sensor value was 400–900, corresponding to about 1–2 kg/cm². Direction of pressing: The pressure was transmitted from the shoulder side toward the bronchial bifurcation. [Conclusion] In compression performed by 9 respiratory therapists, increasing the pressure to the peak and a subsequent reduction with the respiratory cycle were the main points regarding timing. The mean peak pressure was within the range of 1–2 kg/cm². The direction of pressing was from the upper region of the lung toward the bronchial bifurcation.

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[Purpose] The purpose of this study was to examine changes in the carpal tunnels and median nerves appearing due to frequent movements of fingers by ultrasonography in young adults who frequently use smartphones. [Subjects] The subjects of this study were 20 young male and female adults who had no limitation in the range of movement of neck, shoulder, and arm joints, musculoskeletal disorder of the arm, or neurological symptoms such as paraesthesia and agreed to participate in the study. [Methods] The subjects who agreed to participate in this study were asked to use a smartphone for 30 minutes while maintaining comfortable sitting postures on a chair. They were asked to maintain the position of their shoulders comfortably while maintaining an angle of around 90° at the elbow. Some values measured before and after the experiment using a smartphone for 30 minutes were compared. The carpal tunnel was measured using ultrasonography. [Results] There were significant differences in median nerve circumference length, area of the median nerve area, distance between the highest point of the median nerve to the lunate, and distance between the bottom point of the median nerve to the lunate between before and after the experiment(p<0.05). [Conclusion] In conclusion, the use of smartphones for too long can be considered to adversely affect the wrist, and continued use can be considered to induce muscle fatigue.

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[Purpose] The purpose of this study was to investigate the effect of the use of smartphones on the upper extremity and determine whether there were differences in these changes between smartphone and computer use. [Subject] Forty healthy young adults (18 male, 25 female) took part in this study. [Methods] The pressure pain threshold measurement was assessed at the center of the upper trapezius of the dominant upper limb of the subjects. Electrodes were attached to the subjects in the two experiment groups, who then continuously performed a typing task on their own personal smartphone or computer keyboard for ten minutes. [Results] Regarding the pressure pain threshold of the upper trapezius, the smartphone and computer use groups showed significant decreases after performing the task compared with before it. Regarding muscle fatigue in the four monitored muscles, the smartphone and computer use groups showed deceases in median frequencies in all muscles measured after performing the tasks. The smartphone use group showed statistically significant differences in the brachioradialis, and the computer use group showed statistically significant differences in the upper trapezius when compared with the control group (p <0.05). [Conclusion] We found feasible relationships between smartphone use and musculoskeletal symptoms of the upper extremity and neck and identified physical differences between the smartphone use and computer use.

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[Purpose] The present study was intended to examine the effect of excessive use of smartphones on the carpal tunnel and median nerve in the wrist. [Subjects and Methods] A questionnaire was used to determine the degree of addiction to smartphones in 125 normal adults who used smartphones; then, ultrasonography of the median nerve, Phalen’s tests, and reverse Phalen’s tests were conducted on the subjects. [Results] Based on the results of the experiment, the thickness of the median nerve did not change in relation to duration of smartphone use per day, duration of continuous smartphone use, periods of the use of smartphones, or the degree of addiction; however, statistically significant shortening of time to wrist tingling was identified in the Phalen’s tests and reverse Phalen’s tests conducted to examine clinical symptoms. [Conclusion] In conclusion, excessive use of smartphones may act as a cause to trigger carpal tunnel syndrome due to pressure on the carpal tunnel in the wrist joint; thus, precautions are necessary when using smartphones.

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[Purpose] The purpose was to clarify how community-based classes affected students, community staff, and elderly people. [Methods] Students collaborated in exercise classes for community-dwelling elderly people (participants) with teachers and community staff. After classes, questionnaires were completed by 60 participants, 9 community staff, and 24 students. Questionnaires consisted of a five-grade evaluation, a visual analogue scale (VAS), and impressions described in freely written sentences. All sentences written by participants and students were analyzed by text-mining method and cluster analysis. [Results] The results showed that the participants and community staff rated the classes as either 5 (very good) or 4 (good) in the five-grade evaluation. The results of VAS evaluation showed that the students rated the program and the elderly people as 86.5 ± 13.3 and 91.6 ± 9.9, respectively. Extracted words from participants’ impressions were categorized into five clusters: “youth / young people,” “exercise,” “fun,” and “good” formed each independent cluster. Extracted words from students’ impressions were categorized into four clusters that implied positive feelings. [Conclusion] Interchange between elderly people and students achieved positive effects for both.

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[Purpose] The purpose of this study was to examine the effects of aquatic and ground exercises on postural control in normal young adults. [Subjects] Thirty normal adult subjects participated in the study, and 10 adults were assigned to each exercise group, i.e., the aquatic exercise group, ground exercise group, and control exercise group (n=10). The subjects performed exercises using the rhythmic initiation technique in 2 different environments, i.e., on land and in water. Outcomes were measured when the subjects performed exercises under the following 4 conditions: (1) with the eyes kept open, (2) with the eyes kept closed, (3) with the eyes kept open and simultaneous galvanic vestibular stimulation (GVS), and (4) with the eyes kept closed and simultaneous GVS. [Results] The balance index significantly improved in the aquatic exercise group after training under all experimental conditions, excluding the condition with the eyes kept closed and simultaneous GVS. The balance index significantly improved in the ground exercise group after training under all experimental conditions, excluding the condition with the eyes closed. The balance index of the subjects in the control group did not improve significantly under any condition. [Conclusion] The results of this study showed that aquatic exercise and ground exercise training improve postural control in normal young adults.

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[Purpose] The purpose of the present study was to investigate changes in activation ratios of the transversus abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO) at knee angles of 60, 90, and 120 degrees when an abdominal drawing-in maneuver (ADIM) was introduced to a bridge exercise. [Subjects] A total of 44 healthy people agreed to participate in the study, and based on age, height, and weight, these subjects were matched and randomly assigned to either the bridge exercise group (n=22) or the bridge exercise with ADIM group (n=22). [Methods] The thickness of the abdominal muscles was measured using a SonoAce X4 (Samsung Medison Co., Ltd., Seoul, South Korea). The main outcome variables were the ratios of the TrA, IO, and EO thickness during the exercise versus in the relaxed position (TrA, IO, and EO activation ratios). [Results] Differences were found in the TrA and IO activation ratios at knee angles of 90 and 120 degrees between the groups. The TrA and IO activation ratios increased at angles of 90 and 120 degrees compared with 60 degrees, within the bridge exercise with ADIM group. [Conclusion] In conclusion, a knee angle of 90 degrees might be a more effective angle during the hooklying bridge exercise with an ADIM when spinal stabilization exercises are performed or when studies are prepared in this area.

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[Purpose] The aim of this study was to investigate whether hippotherapy could improve the functional performance of preschool- and school-aged children with spastic bilateral CP. We assessed whether the therapeutic effects of hippotherapy would be different according to the functional statuses of the recipients. [Methods] Thirty-three children, aged four years or older, with spastic bilateral CP were enrolled in this study. The children received thirty minutes of hippotherapy twice a week for eight consecutive weeks. Gross Motor Function Measure (GMFM) and Pediatric Balance Scale (PBS) values were determined during the pre-riding control period, at the onset of hippotherapy, and after hippotherapy. The subjects served as their own controls. [Results] Total GMFM scores and PBS did not change during the pre-riding control period; however, the GMFM and PBS of children with CP improved significantly after hippotherapy. Specifically, dimensions D and E of the GMFM were significantly increased after hippotherapy compared with the pre-riding period. [Conclusions] Hippotherapy can improve gross motor function and balance in pediatric CP patients without adverse effects. Therefore, it may be considered as an effective therapeutic method for rehabilitation of preschool- and school-aged children with spastic CP.

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[Purpose] The purpose of this study was to show the effects of different transfer directions of manual material handling on strain in trunk and lower extremity muscles. [Subjects] Fourteen workers were recruited. [Methods] The EMG activities of the L4 erector spinae, gluteus maximus, and biceps femoris muscles were measured under three manual material handling conditions: conditions 1, 2, and 3. [Results] The EMG activities of the left erector spinee and left biceps femoris muscles significantly increased in the order of conditions 2<3<1. The EMG activities of the right erector spinae and right biceps femoris muscles significantly increased in the order of conditions 2<3<1. [Conclusion] We suggest that industrial workers can more effectively transfer to the non dominant direction during manual material handling as a way to prevent the occurrence of low back pain.

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[Purpose] This study examined the effects of stabilization exercises on patients’ pain levels and functional activities and compared the treatment effects of stabilization exercises with the application of taping therapy before stabilization exercises to provide more effective therapeutic methods for patients with myofascial pain syndrome (MPS). [Subjects] Thirty-two patients with MPS in the trapezius muscle were divided into two groups: stabilization exercise group (n=16), and a group that had taping applied before performing stabilization exercises (n=16). [Methods] The degree of pain was measured using a visual analog scale (VAS). Pressure pain threshold (PPT) was measured at trigger points the trapezius muscle using a pressure algometer, and the Constant-Murley Scale (CMS) was used for functional evaluation. [Results] The changes in the VAS and PPT in the upper trapezius muscle resulting from treatment in the stabilization exercise group and the group with taping applied before stabilization exercises were statistically significant in both groups. The changes in CMS in the group that had taping applied before the stabilization exercises showed statistically significant differences in all items. Comparison of CMS between the groups showed significant differences in pain and ability to perform activities of daily living. [Conclusion] Applying taping before stabilization exercises is more effective at relieving pain and improving the ability to perform activities of daily living of patients with myofascial pain syndrome in the upper trapezius muscle than treatment that uses only stabilization exercises.

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[Purpose] The aim of this study was to clarify the association between the muscle tone of the ankle plantar flexors and duration of illness in patients with cerebrovascular disease (CVD). [Subjects] Seventy-four patients with CVD were the subjects of this study. [Methods] The tone of the ankle plantar flexors on the paretic side was measured in terms of the stretch reflex (SR), middle range resistance (MR), and final range resistance (FR) of the ankle plantar flexors tone scale (APTS). All APTS parameters were measured in 2 limb positions with the knee extended and flexed. The subjects were classified according to the duration of illness after onset into short- (<180 days) and long-term (≥180 days) groups. The associations between the duration of illness and SR, MR, and FR were analyzed. [Results] In the short-term group, SR was weakly correlated with the duration of illness in both the knee extended and flexed positions. However, in the long-term group, there was no association between the SR and duration of illness in either position. [Conclusion] The results of this study suggested an increase in the stretch reflex of the gastrocnemius muscle in the patients with a duration of illness <180 days.

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[Purpose] The purpose of this study was to investigate whether CO₂ water bathing accelerates skeletal muscle regeneration after injury. [Subjects] Wistar female rats (n=4/ each group) were used in this study.[Methods] The rats were divided into non-injury (NI), injury (IC), injury + tap water bathing (ITW), and injury + CO₂ water bathing (ICO₂) groups. Skeletal muscle injury was induced by injection of bupivacaine hydrochloride in left tibial anterior (TA) muscles. Tap and CO₂ water (1,000 ppm) bathing was performed at 37 °C for 30 minutes once a day. Left TA muscles in all groups were removed at 2 weeks after injury, and then myonuclear number, myofiber size, and the expression of MyoD and myogenin were measured. [Results] Myonuclear number was increased in the ICO₂ group compared with the IC and ITW groups. Myofiber size in the IC, ITW, and ICO₂ groups was smaller than in the NI group, but it was larger in the ICO₂ group than in the IC group. The levels of expression of MyoD and myogenin were the same in all groups. [Conclusion] CO₂ water bathing may accelerate skeletal muscle repair after injury.

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[Purpose] To analyze the impact of a combined physiotherapeutic exercise program for type 2 diabetic adults with obesity and poor health-related quality of life strongly linked to pain. [Subjects] Twenty-five patients, mean age 58 ± 7.8, referred from an endocrinology service, were included. [Methods] They performed 12 weeks of supervised physiotherapeutic exercise for 180-minutes/week. Anamnesis, anthropometric, clinical and laboratory data were recorded before and after the intervention. [Results] Among the participants, 84% had musculoskeletal dysfunction associated with pain, 8% had neuropathic complications and 4% vascular complications. Fibrinogen (mg/dl) (T1: 404.7 ± 77.3; T2: 321.7 ± 99.4), hip circumference (cm) (T1: 118.5 ± 21.7; T2: 113.7 ± 14), skinfold sum (mm) (T1: 208.5 ± 90.2; T2: 202.5 ± 86.9) and visual analog scale (T1: 6.1 ± 2.5; T2: 3.1 ± 2.2) decreased significantly after treatment. From quality of life charts, only the outcomes related to social activities did not improve significantly. There were significant improvements in physical condition data, with the exceptions of upper limb strength resistance and balance related measurements. [Conclusion] The intervention substantially improved cardiovascular risk, quality of life and physical condition and composition of middle-aged type 2 diabetic adults with obesity and neuromusculoskeletal disorders.

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[Purpose] This study examined the effects of rhythmic auditory stimulation (RAS) gait training on dynamic balance and gait ability of patients with subacute stroke using a smartphone metronome application. [Subjects] A total of 20 patients with subacute stroke were randomly divided into a rhythmic auditory stimulation gait training group (RAS group, n=10) and a control group (n=10). [Methods] Both groups received a two daily 30-min sessions of conventional physical therapy. Patients in the RAS group practiced rhythm auditory stimulation gait training using a smartphone metronome application, with a 30-minute training period three times per week for five weeks. The Activities-specific Balance Confidence (ABC) Scale, Dynamic Gait Index (DGI), Four Square Step Test (FSST), Functional Ambulation Category (FAC), Timed Up and Go test (TUG test), Up stair and Down stair times, and the GAITRite system were used for performance improvements measurements. [Results] Increases in dynamic balance and spatiotemporal gait parameters were observed in both groups. Compared with the control group, the RAS group showed significant improvements in scores on the ABC scale, DGI, TUG, and Up stair and Down stair times (p<0.01). [Conclusion] RAS gait training using a smartphone metronome application improved the dynamic balance and gait abilities of patients with subacute stroke.

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[Purpose] The purpose of our study was to measure the onset timing of the vastusmedialis oblique (VMO) relative to the vastuslateralis (VL) and the VMO/VL electromyographic (EMG) ratio in subjects with and without patellofemoral pain syndrome (PFPS) while they completed a functional task (stair stepping). [Subjects] Ten patients with PFPS and ten subjects without PFPS were included in this study. [Methods] The subjects performed stair stepping while surface electrodes were used to record the EMG signal amplitude of the VMO and VL. [Results] During stair ascent and descent, significant differences in VMO/VL EMG ratios were observed between participants with and without PFPS. Significant differences were also observed for the VMO-VL timing among participants with and without PFPS while ascending and descending the stairs. [Conclusion] Our findings indicate that PFPS patients have a VMO/VL imbalance and delayed onset of VMO relative to VL.

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[Purpose] In order to develop a more effective treatment method for pain and function in myofascial pain syndrome, we examined the effects of ESWT, stability exercises, and combined treatment. [Subjects] The subjects were randomly divided into a stabilization exercise group (n=12), an ESWT (Extracorporeal Shock Wave Therapy) group (n=12), and a combined treatment group (n=12). [Methods] The stabilization exercise group performed shoulder joint stabilization exercises. The ESWT group received ESWT for the upper trapezius. The combined treatment group received a combined treatment of shoulder joint stabilization exercises and ESWT. Pain and function were measured using the visual analog scale (VAS), pressure pain threshold (PPT), neck disability index (NDI), and the Constant Murley Scale (CMS). [Results] The VAS Score showed statistically significant improvements in all of the groups. All of the CMS evaluation items except muscle strength in the stabilization exercise group, and all of the CMS items in the ESWT group and the combined treatment group, exhibited statistically significant improvements. The combined treatment group of ESWT and stabilization exercises showed statistically significant improvements in all VAS of CMS evaluation items, and the NDI test after the four-week intervention. [Conclusion] The combined treatment was more effective at reducing pain than ESWT, and stabilization exercise would be useful for physical therapists treating myofascial pain syndrome in a clinical setting.

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[Purpose] The purpose of this study was to compare the immediate changes in cervical and lumbar repositioning errors and pain threshold in asymptomatic persons following performance of computer work. [Subjects] Fifteen asymptomatic computer users were recruited. [Methods] The pressure pain of the upper trapezius and L4 erector spinae muscles, and the cervical and lumbar repositioning errors of subjects were measured at before, and after 1 hour and 2 hours of computer work. [Results] The pressure pain threshold of the upper trapezius muscle significantly decreased with increasing duration of computer work: after 2 hours of computer work < after 1 hour of computer work < before computer work. The pressure pain threshold of the L4 erector spinae muscle was significantly decreased after 2 hours of computer work. The cervical repositioning error significantly increased with the duration of computer work: after 2 hours of computer work > after 1 hour of computer work > before computer work. The lumbar repositioning error significantly increased after 2 hours of computer work. [Conclusion] We suggest that the cervical repositioning error may be a useful index or screening test for forecasting or detecting cervical dysfunction or pain in asymptomatic persons in clinical practice.

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[Purpose] Excessive pronation of the subtalar joint while walking or running is the most frequent cause of injury to lower limb joints. The purpose of this study was to evaluate the effect of an arch pad on changes of three-dimensional (3D) ankle joint kinematics while walking and running at three different treadmill speeds (5, 7, and 10 km/h). [Subjects] Nine healthy male students with no history of lower-extremity injury were chosen as subjects in this study. [Methods] Walking (5 km/h) and running (7 km/h and 10 km/h) on a treadmill with and without medial arch pads in the shoes were analyzed using a Vicon-MX 10 camera motion-capture system. [Results] Medial arch pads were found to be effective for foot eversion at all treadmill speeds. Additionally, the interaction between shoe conditions and gait speeds on eversion angle was significant. [Conclusion] It is important to choose an arch pad with an appropriate size and construction to reduce pain and to prevent running injuries.

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. [Purpose] The purpose of the present study was to examine differences in ankle joint muscles’ electromyographic activities at different instability levels of unstable surfaces in order to provide a scientific basis for unstable surface training. [Subjects and Method] Sixty healthy adult males and females participated in the present study, and they were equally and randomly assigned to a 2.0 psi group, a 1.5 psi group, and a 1.0 psi group. The subjects were instructed to take a standing posture on a 13 inch diameter rubber air disc inflated at different air pressure for 15 seconds. While the participants maintained their standing posture, the EMG signals of the tibialis anterior, the peroneus longus, and the medial gastrocnemius of the dominant lower limb were recorded to assess the muscle activities. [Results] The muscle activity of the tibialis anterior was the highest at 1.0 psi and showed significant differences from its muscle activities at 1.5 psi and 2.0 psi. The muscle activities of the peroneus longus and the medial gastrocnemius were highest at 1.0 psi and showed significant differences from the muscle activities at 2.0 psi. At all the pressures, the muscle activity of the tibialis anterior was the highest and that of the medial gastrocnemius was the lowest, although the differences were not statistically significant. [Conclusion] The results of the present study show that to trigger the co-contraction of all muscles involved in ankle joint stability, 1.0 psi or lower instability should be provided.

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[Purpose] The purpose of this study was to determine the effects of nerve mobilization applied in conjunction with electromagnetic diathermy, in patients with lower back pain. [Subjects] Twenty-two subjects with lower back pain participated in this study. They had had chronic pain in the lower back area for over six months. [Methods] The subjects were selected based on selection criteria, and randomly divided into two groups. The experimental group (n=11) were given electromagnetic diathermy in conjunction with nerve mobilization to patients. The control group (n=11) were applied with only electromagnetic diathermy. [Results] The Oswestry Disability Index, location of symptom scale and knee joint extensor strength showed significant improvements in the experimental group and control group after the intervention. [Conclusion] Nerve mobilization applied in conjunction with electromagnetic diathermy was more effective at improving function and strength, than nerve mobilization alone.

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[Purpose] Stress is a common factor of several diseases. Stress can be reduced through appropriate stress management and relaxation methods. In this study, variation in skin temperature (ST) was investigated as a primary measure for identifying changes in stress levels. Our results should be helpful for the development of a stress measurement tool based on multimodal signals. [Subjects] Sixty healthy volunteers (30 females and 30 males) of three different races (Malay, Chinese, and Indian) with a mean age of 22.5±2.5 years participated in this study. [Methods] The Stroop color word test was used to design a data acquisition protocol of 12.36 min for this experiment. ST variation was measured continuously during the Stroop colour word test and statistical features were computed. Further, descriptive analysis and stress levels were classified using a Probabilistic Neural Network (PNN) to find the optimum features. [Results] Among the 60 subjects, the mean ST of 48 subjects (80%) rose linearly from the normal state to the high-stress state. In addition, Malay subjects were more sensitive to stress than other two races as measured by the mean skin temperature. A maximum mean classification rate of 88% was achieved for the four different stress levels on all the subjects using PNN. [Conclusion] Our investigation proves that the mean ST is a reliable measure for identifying stress level changes and may be useful for designing a multimodal stress measurement system.

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[Purpose] The purpose of this study was to investigate the effect of jumping exercise on the muscle strength and balance of elderly people. [Subjects] Participants were randomly allocated to one of two groups: a jumping exercise group (n=16) or a control group (n=15). [Methods] Both groups participated in a therapeutic exercise program for 30 minutes, five days a week, for 4 weeks. The experimental group performed an additional jumping exercise for 20 minutes a day, five days a week, for 4 weeks. A forceplate (PDM, Multifunction Force Measuring Plate, Zebris, Germany, 2004) was used to evaluate postural sway. The Berg Balance Scale (BBS) and the Timed Up-and-Go test (TUG) were used to assess dynamic abilities, and a Commander^TM Muscle Tester (J Tech Medical) was used to measure muscle strength. [Results] Postural sway amplitudes (anteroposterior and mediolateral), dynamic balance abilities (BBS and TUG), and muscle strength (hip, knee, and ankle) showed significant inprovements in both groups, after the intervention. In addition, changes in dynamic balance abilities (BBS and TUG) and muscle strength (hip, knee, and ankle) differed significantly between the experimental group and the control group. [Conclusion] Performance of the jumping exercise resulted in improvements in muscle strength and balance ability. Therefore, we recommend jumping exercise as an effective exercise for elderly people.

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[Purpose] Systematic reviews that confirm the positive effect of exercise intervention on fracture risk factors in people with osteoporosis (OP) have included few randomized controlled trials (RCTs) on subjects with OP from Japan, which has the lowest level of obesity among developed countries. We performed a systematic review and meta-analysis of RCTs to investigate the effect of exercise intervention on bone mineral density (BMD) and bone metabolic markers as risk factors in Japanese subjects with OP. [Subjects and Methods] Studies were identified by searching PubMed, CENTRAL, PEDro, CINAHL and Ichushi-Web. We used the Review Manager 5.1 software in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement protocol (PRISMA). [Results] Three studies (4 exercise groups) were included in our review. No studies showed that the effect of exercise was better significantly than that observed in the control group. Results of pooled data did not show a positive effect of exercise intervention on BMD. [Conclusion] We could not provide high-quality evidence that BMD and bone metabolic markers in Japanese subjects with OP can be improved by exercise intervention.

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[Purpose] The aim of this study was to examine the test-retest reliability of the Action Research Arm Test for persons with Parkinson’s disease. This study also aimed to examine the feasibility of the Action Research Arm Test for measuring the upper extremity function for Parkinson’s disease patients. [Subjects] Twenty idiopathic Parkinson’s disease patients participated in this study. To investigate the test-retest reliability of the Action Research Arm Test, assessments were made by clinical observation. The Action Research Arm Test was assessed in two sessions that were three days apart. [Results] Test-retest reliability (0.99) of the Action Research Arm Test was high, indicating excellent agreement. All Action Research Arm Test items showed very high reliability with intracorrelation coefficient values, from 0.93 to 0.99. [Conclusion] The Action Research Arm Test was shown to be a reliable measure for evaluating the functional activities of the upper extremity, and the ability of the Action Research Arm Test to assess functional activities of the Parkinson’s disease population should be acceptable in research and clinical settings.

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[Purpose] There are three mechanomyography terminologies that are commonly used: acoustic myography, vibromyography, and phonomyography. There is no clear evidence concerning the sensors used among these terminologies. Thus the purpose of this review is to identify these three terminologies in terms of the implemented sensors, frequency ranges, and muscle assessment applications. [Methods] Thus, we first performed a systematic search of all the articles published up to April 15, 2012 in the IEEE, Elsevier, PubMed, SpringerLink, and Wiley Online Library databases using various combinations of the focused keywords. We then read the articles found in the search and selected papers related to these three technologies. After analysis, 32 articles were extracted to meet our objective. [Results] In turn, we determined that 100% and 54% of the studies of phonomyography and acoustic myography, respectively, utilized a microphone as the sensory device, whereas 91% of the articles on vibromyography detected the signal through an accelerometer. The remaining 46% of the acoustic myography studies recorded the signal through different types of sensors. In addition, acoustic myography was mostly applied to the study of muscle fatigue and the control of externally powered prostheses. Similarly, vibromyography was implemented in the monitoring of muscle fatigue, balance, contraction force, and effort. Phonomyography, however, was generally performed to study neuromuscular blockade in a clinical environment. Furthermore, no specific and distinct frequency ranges were found for the sensors associated with the terminologies. [Conclusion] Hence, the findings of this review may prove useful in the selection of suitable sensors for assessing different muscles.

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