[Purpose] Several studies found have that transcutaneous electrical nerve stimulation (TENS) is effective for reducing pain and improving physical function. But the influence of TENS on muscle fatigue is still unclear. The purpose of this study was to determine the influence of TENS on muscle fatigue. [Methods] The subjects were ten healthy males. To establish the muscle activity, subjects performed maximum isometric exertion 15 times and electromyography was recorded (TaskI). After this, subjects of the study group received TENS and subjects of the control group rested for 5 minutes. After the intervention each group again performed maximum isometric exertion as in Task1 (TaskII), and VAS and muscle elasticity were measured. [Results] We found that in the study group, the significant decrease in muscle activity during TaskII began later than in TaskI. Furthermore, we found that the fourth trial had a larger in muscle activity than that of the first trial in TaskI in both groups and TaskII of the study group. Conversely, In TaskII performed by the control group, we observed significant decreases. [Conclusions] From the result of this research, we believe that TENS electronically influenced the nervous system to prevent muscle fatigue.

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[Purpose] The aim of this study was to compare the vital capacity (FVC, FEV₁, MVV) of normal and underweight women in their 20s. [Subjects] Thirty-four healthy non-smoking young women (age 20-25 years) participated in this study. [Methods] Based on body mass index (BMI), subjects were divided into two groups: the normal weight group (n=18, 18.5<BMI≤25.0) and the underweight group (n=16, BMI≤18.5). FVC, FEV₁ and MVV were measured using a respiratory function instrument, Spiropalm (A-M systems, USA), which fulfills the American Thoracic recommendation for diagnostic spirometry. The independent t-test was used to compare vital capacities (FVC, FEV₁ and MVV) between the normal and underweight group. [Results] The underweight group had significantly lower FVC and FEV₁ than the normal weight group. MVV of the underweight group was also lower than that of the normal weight group, but the difference was not significant. [Conclusion] Our results indicate that low body weight is related to reduction of vital capacity in women. These results also suggest that the maintenance of adequate body weight may be important for improving the vital capacity of women.

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[Purpose] The purpose of this study was to identify the changes in abdominal muscle thickness during the abdominal drawing-in maneuver (ADIM) in patients with low back pain (LBP) and healthy subjects. [Subjects] The subjects were 40 volunteers: 20 healthy subjects and 20 patients with LBP. [Methods] In sitting, the subjects performed rest for 10 seconds and ADIM for 10 seconds as a set with 3 repetitions. Thickness measurements of the abdominal muscles were performed in triplicate while subjects were at rest and performing ADIM using B-mode ultrasound imaging. [Results] In patients with LBP there was no significant change in the thickness of the external oblique (EO), whereas the EO of healthy subjects significantly decreased during ADIM. The thickness of the internal oblique (IO) and transversus abdominis (TrA) significantly increased during ADIM as compared to at rest in both groups. [Conclusion] These findings suggest that ADIM increase the thickness of the deep abdominal muscles and that the change in the thickness of the deep abdominal muscles of patients with LBP increase less than that of healthy subjects. Therefore, ADIM should be used to train the deep abdominal muscles of patients with LBP.

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[Purpose] This studied examine the two-dimensional kinesis of swallowing by patients with dysphagia, based on the movements of contrast material using videofluorography, aiming to design curative programs for aspiration. Videofluorographic two-dimensional examinations of ten patients with aspiration, and another ten without aspiration were used for this study. [Methods] We converted the video record into static images and plotted hyoid bone and laryngeal kinesis on graphs, using two-dimensional image analysis software. Then, we conducted analyses of the trajectory patterns of the hyoid bone and the larynx, and pharyngeal transit time of the contrast material. [Results] Our two-dimensional method revealed significant differences between the two subject groups in maximal forward travel of the hyoid bone, maximal elevation of the larynx, and pharyngeal transit time. [Conclusion] Our findings suggest that aspiration may be caused by a weak pharyngeal contraction and weakened suprahyoid and infrahyoid muscles resulting in inferior kinesis of the epiglottis, and insufficient closure of the laryngeal introitus. For the treatment of aspiration, we believe the application of kinesiotherapy, electric stimulation therapy and replacement therapy should be clinically effective.

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[Purposes] the aims of the present study were to quantitatively characterize upright static sagittal head posture and to determine differences among children according to their age and sex. [Subjects and Methods] This cross-sectional study was conducted on 186 Arabic school children of both sexes aged between 7 to 9 years. They were photographed with a digital camera while maintaining a natural static upright position. The value of craniovertebral angle was calculated using Able Image Analyzer software. [Results] The results revealed a non-significant effect of age and a highly significant effect of sex on head posture. Moreover, a significant effect of age × sex interaction was also shown. [Conclusion] Head posture varies considerably with the sex of children aged 7 to 9 years old. This study may serve as a guideline for physiotherapists and clinicians when conducting head posture assessments and in clinical decision making regarding possible interventions.

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[Purpose] This study examined whether people with Parkinson’s disease (PD) have postural instability while negotiating obstacles starting from a position of a quiet stance compared to healthy older adults. [Subjects] Ten participants (3 males, 7 females; mean age, 67.8 ± 6.16 years) diagnosed with idiopathic PD (Hoehn & Yahr disability scores ranging from 1 to 3) and ten healthy older adults (4 males, 6 females; mean age, 72.2 ± 4.83 years) were enrolled in this study. [Methods] For each trial, the participants stood quietly in a self-selected foot position with each foot on a force platform. The participants were then instructed to begin stepping over a 10 cm high obstacle or initiate gait at their self-selected pace with the right limb in response to the verbal cue “GO”, and continued to walk. The subjects’ performance was measured by calculating the changes in the center of pressure (COP) displacements in the anteroposterior (A-P) and mediolateral (M-L) directions using two force platforms. [Results] Using the data of both gait initiation (GI) and obstacle crossing tasks combined for both feet, the A-P and M-L displacements of the COP of the older adults were significantly higher than those of people with PD. On the other hand, the mean COP displacement in the A-P and M-L directions between GI and obstacle crossing were similar. [Conclusion] A decrease in the magnitude of the COP excursion in GI and obstacle avoidance reduced the ability of people with PD to generate forward momentum and maintain lateral stability and motion, factors which are highly related to lateral falling.

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[Purpose] The purpose of this study was to determine how a compound exercise program affected the elasticity of the blood vessels of middle aged obese women. [Methods] The research subjects were 40-50 year old women who had excess body fat (30%). The experimental group performed warm-up and cool-down: walking at 3.5-4.0 km/h for 5 minutes and exercised using nine kinds of machinery. A analysis of covariance (ANCOVA) was used for statistical analysis. [Results] In the experimental group, LH PWV, RH PWV, HF PWV, RF PWV significantly increased compared to the control. [Conclusion] The compound exercise program designed for middle aged obese women had affected the elasticity of the blood vessels.

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[Purpose] Tri-axial accelerometers have advantages, including portability, in clinical gait analysis. However, the gait parameters calculated by accelerometers cannot be used visualize the symmetry of trunk movement. The purposes of this study were to visualize the acceleration signals of the trunk during gait and to assess the usefulness of a new gait symmetry parameter derived from Lissajous figures of acceleration of the trunk. [Subjects and Methods] Trunk accelerations of 38 healthy young and 38 healthy elderly subjects were measured with a tri-axial accelerometer while walking at their preferred speed. Gait parameters assessed included: the symmetry index of the Lissajous figure (Lissajous Index; LI), and the root mean square (RMS) and harmonic ratio (HR) of the acceleration signals. [Results] Walking speed did not significantly differ between the two groups. However, LI was significantly higher, indicating less symmetry of motion, in the elderly subjects (young: 23.0%, elderly: 35.4%). RMS of the acceleration signals in the vertical and mediolateral directions were also significantly higher in the elderly subjects. [Conclusion] These results suggest that the LI may be useful for the evaluation of trunk movement in the frontal plane during gait analysis.

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[Purpose] This study compared the differences between sitting with or without a backrest of shoulder, and trunk muscle activities during computer work. [Subjects] Fifteen healthy adults participated in this study. The participants had no history of injury to, or neurologic deficits of the neck muscles and upper extremities at the time of participation. [Methods] Surface electromyography (EMG) of the upper trapezius, serratus anterior, middle trapezius, external abdominal oblique, gluteus maximus muscles were recorded of 15 adults while they performed computer work. The recorded signals were averaged and normalized to the mean amplitude of the EMG signal obtained during submaximal reference voluntary contractions. [Results] The upper trapezius muscle activity significantly increased in sitting with a backrest. The muscle activities of the serratus anterior, middle trapezius muscle, external abdominal oblique, and gluteus maximus significantly decreased in sitting with a backrest. [Conclusion] The selection of a backrest is a very important factor for preventing work-related disorders.

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[Purpose] This study was undertaken to quantify the effects of ankle joint position on unstable and stable surfaces during push up exercises on shoulder and trunk muscle activities. [Subjects] The study subjects were 45 healthy adults in their twenties with normal ranges of motion (ROM) and without disorders of the shoulder complex, musculoskeletal disease of the upper limbs, or low back pain. [Methods] Push-up exercises were performed under the following four conditions: (1) on an unstable surface created by placing a 65-cm diameter exercise ball under the ankle joints in full dorsiflexion; (2) on an unstable surface created by placing a 65-cm diameter exercise ball under the ankle joints in full plantarflexion; (3) on a stable surface created by placing a bench with a height of a 65-cm under the ankle joints in full dorsiflexion; and (4) on a stable surface created by placing a bench with a height of 65-cm under the ankle joints in full plantarflexion. To prevent bias, the exercise conditions were randomly arranged. [Results] Muscle activities were compared among the four different conditions. The erector spinae, rectus abdominis, external oblique abdominal, serratus anterior, deltoid middle fiber, and triceps brachii muscles showed significant differences among the four conditions. [Conclusion] These differences may have been resulted from increased trunk and shoulder muscle activations during push-up exercise with full ankle dorsiflexion on unstable ground.

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[Purpose] The objective of this study was to identify preoperative and early postoperative factors contributing to the Oswestry Disability Index (ODI) score one month after lumbar discectomy, to help with future physiotherapy. [Subjects] The 98 subjects included in our study were diagnosed lumbar disc herniation (LDH) and underwent initial discectomy at our hospital. [Methods] Factors investigated included sex, age, height, weight, hernia level, surgical procedure, smoking habit, profession, leg muscle strength, and degree of back pain, leg pain and numbness, ODI score, and ODI sub-scores. A stepwise multiple regression analysis was used for statistical analysis, with the dependent variable being the one month postoperative ODI score, and independent variables comprising the other factors monitored preoperatively listed above, on resumption of activity (5th postoperative day), and on discharge (9th postoperative day). [Results] Factors contributing to the ODI score one month after lumbar discectomy were profession (desk work), back pain before surgery, leg pain on resumption of activity, ODI score, ODI traveling sub-score, and leg pain on discharge. [Conclusion] Early postoperative physiotherapy should comprise ongoing physical therapy to alleviate residual symptoms, patient education focusing on sitting posture, and exercise therapy.

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[Purpose] The purpose of this study was to clarify the effect of cervical stabilizing exercises in the standing position and the supine position on the strength and endurance of deep neck muscles (DNM). [Subjects] Twenty subjects performed cervical stabilizing exercises in the standing position (standing group) and 20 subjects performed cervical stabilizing exercises in the supine position (supine group). [Methods] The subjects did cervical stabilizing exercises in the standing or the supine position three times a week for a total of six weeks. Before and after the experiment, strength and endurance were measured. [Results] Both the standing group and the supine group showed increased strength and endurance after the intervention. However, there was no significant difference in the strength and endurance of the two groups before or after the intervention, or in the pre-post intervention differences. [Conclusion] For cervical strength and endurance improvement, treatment is generally given in the supine position. However, the exercise in the standing position was also effective. Therefore, if there are spatial or equipment limitations, the exercise in the standing position should be taught as an exercise method for the home or office.

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[Purpose] In this study, the brachial-ankle PWV (baPWV) was measured continuously from before to after a single bout of cycling exercise in healthy middle-aged individuals to evaluate the immediate changes associated with short-time exercise. [Subjects] We examined the effects of a bout of low-intensity leg cycling exercise (60 watt, 5 min) on pulse wave velocity from the brachial to the ankle arteries (baPWV) in 7 healthy middle-aged individuals. [Methods] The baPWV and heart rate (HR) were measured using a Form PWV/ABI (Nihon Colin) twice at 5-minute intervals during the rest before exercising, every 3 minutes for 15 minutes from immediately after the end of exercise, and 20 minutes after the end of exercise. The reproducibility of the resting baPWV before exercise was examined using Pearson’s correlation coefficient, and changes in baPWV between before and after exercise were examined by Wilcoxon’s rank sum test. [Results] After the exercise, baPWV remained significantly decreased 7% for 20 min, despite the recoveries of the heart rate and blood pressure to pre-exercise levels. [Conclusion] These results suggest that a single bout of low-intensity cycling exercise decreases arterial stiffness following of normal subjects dynamic exercise.

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[Purpose] To describe the immediate changes of mobility of intervertebral motion after lumbar side bending mobilization. [Subject and Method] Ten volunteers (10 men, aged 26-43 years) with no history of significant low back pain were recruited to participate in this study. Consenting volunteers were referred for radiographs. Three radiographs, neutral position, right side bending position prior to mobilization and right side bending position after mobilization, were taken. The L3/4 segment was chosen for mobilization. The mobilization was performed by one physical therapist. Frontal angular rotation of each lumbar spinal motion segment was measured on the pre- and post-mobilization radiographs by a blinded investigator (radiologist) using SYNAPSE software (FUJIFILM). Data were analyzed with the SPSS package, version 13.0. Within-group differences were assessed with the paired t test. [Results] Analysis of the pre- and post-mobilization radiographs showed a significant increase at the L3/4 segment from an average 5.6 to 7.1 degrees, and no significant increase at other segments, L1/2, L2/3, L4/5. [Conclusion] Our results suggest that lumbar segmental side bending mobilization targeting the L3/4 segment results in an immediate increase in the angular motion of the L3/4 segment.

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[Purpose] The purpose of this study was to analyze the effect of load change on the foot arch in different foot positions using a Vicon motion analysis system and clinical assessment using a goniometer and calipers. The reliabilities of the measurements taken by the Vicon motion analysis system and clinical assessment were analyzed. [Subjects and Methods] The study (24.8 ± 2.1 years). Two methods were used to measure the foot arch: (1) Vicon motion analysis and (2) a goniometer and calipers. Measurements were taken bilaterally in six different positions: standing on both feet, standing on one leg, cuff raise, medial weight shift, lateral weight shift, and toe dorsiflexion. [Results] The heights of the medial longitudinal, lateral longitudinal, and transverse arches in dynamic positions were significantly greater than that in the static standing position. The results of the Vicon motion analysis system correlated highly with those of measurements obtained via clinical assessment only in the static position. [Conclusion] When the foot and ankle joints were in dynamic and unstable positions, the arches were higher than those in the static position because of the windlass mechanism. Simultaneous assessment of all three foot arches in various positions is needed for effective evaluation.

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[Purpose] This study examined the effects of therapeutic ultrasound on the inhibition of disuse atrophy progression in rat gastrocnemius muscles. [Subjects and Methods] Male Wistar rats were randomly divided into control, ultrasound (US) and sham treatment groups. In the US and sham group, bilateral ankle joints of each rat were fixed in full plantar flexion with a plaster cast over a 2-week period. Continuous ultrasonic energy (frequency, 1 MHz; intensity, 1.0 W/cm²) was delivered to the gastrocnemius muscle of the US group over a 2-week immobilization period. [Results] In the US and sham groups, type IIa and IIb mean muscle fiber diameters decreased significantly relative to the control group. In the US group, muscle fiber diameters of all fiber types were markedly larger than those of the sham group. Heat shock protein 70 (HSP70) content of the US group increased significantly in comparison with the sham group. The levels of basic fibroblast growth factor were substantially higher in the US group relative to the control and sham groups. However, meaningful differences in insulin-like growth factor I level were not evident between the groups. [Conclusion] Continuous therapeutic ultrasound inhibits the progression of disuse muscle atrophy via elevation of HSP70 levels in skeletal muscle.

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[Purpose] This study’s purpose was to determine the effects of a home-based exercise program on functional fitness and total cholesterol in elderly women. [Methods] Twenty-two elderly women were divided into an exercise group (12 females; average age: 71.00 years; average height: 151.75 cm; average weight: 55.05 kg) and a control group (10 females; average age: 72.42; average height: 149.71 cm; average weight: 58.14 kg) and the exercise group performed a home-based exercise program three times per week for 8 weeks. For the exercise program, a 10-minute warm-up, 40-minute main exercise, and 10-minute cool-down were conducted. Functional fitness (upper extremity muscle strength, lower extremity muscle strength, upper extremity flexibility, lower extremity flexibility, static balance, and cardiorespiratory endurance) and total cholesterol were measured prior to and after the exercise intervention. [Results] The exercise group, which performed the home-based exercise program, showed improvements in their upper and lower extremity muscle strengths, flexibility, and cardiorespiratory endurance. On the other hand, the upper extremity flexibility, static balance, and cardiorespiratory endurance of the control group decreased. There were no significant changes in total cholesterol in either group. [Conclusion] Proper guidance is necessary to ensure elderly people continue to exercise independently after an exercise program ends, since it is important for elderly people in the local community to engage in exercise on their own, even if it only consists of simple exercises.

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[Purpose] This study was designed to evaluate the clinical utility of the Brief Pain Inventory-12, 23 (BPI-12, 23) for predicting shoulder pain in stroke patients and to compare the functional ability of the BPI-12, 23 test to discriminate between subgroups with and without shoulder pain. [Subjects] The subjects were 62 persons who were chronic stroke survivors with shoulder pain. [Methods] The patients answered questions on shoulder pain using the BPI question 12 (BP1-12) and Pain-related Quality of life (BPI-23). Therapists measured the performance of combined upper-limb movements including the hand behind the neck (HBN) maneuver, and added passive pain-free shoulder external rotation range of motion, and the Modified Ashworth Scale (MAS) score of the elbow flexors. Physical performance assessments were used to measure basic activities of daily living (Modified Barthel Index, MBI), the motor function of the upper limb (Fugl-Meyer Upper/Lower Extremity, FM-U/E). [Results] A BPI-12 score of > 4.25 and a BP1-23 score of > 5.5 showed high probability of the presence of hemipelgic shoulder pain (respectively, Sensitivity = 77%, 77%; Specificity = 77%, 69%; Receiver Operating Characteristic [ROC] =0.81, 0.76; 95% Confidence Interval [CI] = 0.70-0.92, 0.64-0.88). [Conclusion] The BPI-12 and 23 both have potential as screening tools for risk factors of shoulder pain. They can be performed during evaluation to increase the likelihood of determining those who complain of hemiplegic shoulder pain after stroke. However they first require confirmation in a prospective study.

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[Purpose] This study was designed to compare ultrasonic images of knee extension range of motion and the quadriceps femoris between a healthy elderly group and a knee osteoarthritis group. [Methods] The study subjects were 30 healthy elderly people and 30 elderly people diagnosed as having knee osteoarthritis. Their knee extension range of motion in a prone position was measured with goniometer and muscle density and white area index was measured by transverse images of the rectus femoris and vastus medialis in a flexion position with the knee bent at 90 degrees using ultrasonic diagnostic equipment. [Results] There were significant differences in the knee extension range of motion and in muscle density and white area index of the rectus femoris and vastus medialis between the thalthy elderly and knee osteoarthritis groups. [Conclusion] There were significant differences in the knee extension range of motion of healthy elderly people and knee osteoarthritis subjects, and the quadriceps femoris played an important role in the knee function of knee osteoarthritis.

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