[Purpose] The purpose of this study was to show the effects of wearing a tight skirt on the VMO, VL, and TFL muscles during walking. [Subjects] Twelve female subjects were recruited. [Methods] The muscle activities of the VMO, VL, and TFL muscles were measured using a surface EMG system during walking while wearing a typical skirt and tight skirt. [Results] The VL and TFL muscle activities significantly increased, and VMO muscle activity significantly decreased when wearing a tight skirt. [Conclusion] We thought that a tight skirt might limit the normal gait. The abnormal gait movements resulting from wearing a tight skirt could cause imbalance of the VMO and VL.

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[Purpose] In some earlier studies of electromyography (EMG) of the upper arm biceps brachii (BB), researchers preferred to place the electrodes on the middle of the biceps muscle to analyze its function. This study investigated the BB muscle activity between the region of the endplate and distal tendon insertion (electrode placed on lower part of the BB muscle belly). [Subjects and Methods] Six right-arm dominant Asian subjects (n=6, 3 males and 3 females), age range 20–30 years, who were free from any musculoskeletal disorder in BB, participated in this study. EMG signals were recorded from 12 BB muscles (6 subjects × 2 arms) during two types of muscle contraction (concentric and eccentric). Mean ± SD was calculated and analysis of variance (ANOVA) was performed. [Results] The results indicate that, the dominant right arm (R) of both males (M) and females (F) showed significantly higher activity than non-dominant left arm (L). In addition, there were interactions between M(L) and M(R), F(L) and F(R), M(L) and F(L), M(R) and F(R), and both male BB and both female BB; but, no interactions were found between M(L) and F(R), and M(R) and F(L). We also discovered that eccentric contraction generates higher EMG signals than the concentric contraction of that muscle region. [Conclusion] These findings suggest that EMG data are random on the BB muscle area we investigated during arm movement. These results should be considered in biceps tendonitis rehabilitation, muscle coordination and other physiological measurements of the upper limb muscles.

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[Purpose] The purpose of the present study was to examine the effects of cervical mobilization combined with thoracic mobilization on neck pain patients’ recovery from forward head posture (FHP). [Subjects] Thirty neck pain patients with FHP were randomly assigned to an experimental group (n=15) and a control group (n=15). [Methods] The experimental group received cervical mobilization combined with thoracic mobilization and the control group received only cervical mobilization. Cranial vertical angle (CVA) and cranial rotation angle (CRA) were measured before and after the experiment. [Results] The experimental group had significantly greater improvements in CVA and CRA than the control group. [Conclusion] Therefore, we recommend cervical mobilization combined with upper thoracic mobilization for the improvement of FHP in neck pain patients.

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[Purpose] This paper reports the effects of orofacial myofunctional exercise using an oral cavity rehabilitation device on physiological parameters that include labial closure strength, tongue elevation strength, and the right and left facial skin elasticity. [Subjects] Seventeen females aged forty years old and above were initially recruited for this study. Thirteen performed the exercise for 14 weeks, and only 11 subjects continued the exercise for another 10 weeks. [Methods] Subjects were instructed to perform an orofacial myofunctional exercise using an oral rehabilitative device for three minutes, for four times a day. The non-parametric Wilcoxon test was conducted to examine the significance of physiological parameters induced by the orofacial myofunctional exercise. The measurements of the physiological parameters were carried out weekly for 14 weeks and 24 weeks after the intervention for 13 and 11 subjects, respectively. [Results] The findings showed that there were significant improvements in the median values of all parameters before and after performing the orofacial myofunctional exercise for 14 weeks or more. [Conclusion] These results suggest that the orofacial myofunctional exercise can be regarded as a potential non-invasive therapy for improvements of the labial closure strength and tongue elevation strength, which indirectly provide support for the facial tissue, and enhances facial skin elasticity.

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[Purpose] This study aimed to examine the 1 year incidence and identify biopsychosocial factors predicting the onset and persistence of thoracic spine pain in undergraduate students. [Subject] A 1 year prospective study was carried out among 684 healthy undergraduate students. [Methods] At baseline, a self-administered questionnaire and standardized physical examination were employed to gather biopsychosocial data. Follow-up data on the incidence of thoracic spine pain were collected every 3 months. Two regression models were built to analyze factors predicting the onset and persistence of thoracic spine pain. [Results] The 1 year incidence of thoracic spine pain was 27%, and 23% of subjects reported persistent symptoms. The onset of thoracic spine pain was predicted by female gender, poor neck extensor muscle endurance and high percentage duration of mouse use during computer work. Female students being in the second year of their studies and unsupported elbows during computer use were predictors of persistent symptoms. [Conclusion] Thoracic spine pain is quite common among undergraduate students and many of them may have persistent symptoms. Interventions aimed at reducing the occurrence of symptoms in undergraduate students should, at the least, include teaching 2nd year female students how to perform computer work safely.

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[Purpose] The purpose of this study was to compare the total segmental range of motion (ROM) of the thoracic-lumbar-sacral spine during multidirectional trunk movements between elderly subjects with degenerative spine disease (DSD) and healthy young adults. [Subjects] Twenty-five elderly subjects with DSD and 11 healthy young adults were recruited for this study. [Methods] Subjects performed five trunk movements, including forward flexion (FF), right and left anterior-lateral bending (Rt. and Lt. ALB), and right and left lateral bending (Rt. and Lt. LB). [Results] The total segmental ROM of FF, Rt. and Lt. ALB in the sagittal plane, and Rt. and Lt. ALB in the horizontal plane was significantly different between the groups. [Conclusion] We suggest that the decreased total segmental ROM resulted from degenerative joint structures, particularly facet joints, vertebral bodies, and discs. The present findings add to the evidence in support of a relationship between degenerative changes and three-dimensional spine kinematics in the elderly population with DSD.

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[Purpose] The purpose of the present study was to examine the effects of self-controlled feedback on the acquisition and retention of blocked balance training by patients with cerebrovascular accident (CVA). [Subjects] Twenty-four hemiplegics were randomly assigned to a self-controlled feedback, yoked feedback or control group. All subjects were ambulatory with or without an assistive device. The self-controlled feedback group was provided with feedback whenever they requested it, whereas the yoked feedback group had no influence on the feedback schedule. All subjects performed 10 acquisition trials per block × four blocks, and 10 retention trials per block × two blocks one-day later. The data were analyzed using one-way ANOVA and multivariate ANOVA. [Results] In the body sway amplitudes of acquisition phase which was used, to examine practice effect, the left/right (LR) and anterior/posterior (AP) both the self-controlled and yoked feedback groups were significantly smaller than those of the control group, but no significant differences were found between the self-controlled and yoked feedback groups. In the retention phase, to examine learning effect, the left/right (LR) and anterior/posterior (AP) body sway amplitudes of the self-controlled group were significantly smaller than those of both the yoked feedback and control groups. [Conclusion] These results are interpreted to mean that, for hemiplegic patients, self-controlled feedback is a more effective way of restoring balance than yoked feedback.

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[Purpose] This study examined postural stability and muscle activity when limitations were placed on the ankle and knee joints. [Subjects] Forty-eight healthy young adults were randomly assigned to one of three groups: a fixed-ankle group (6 males, 9 females), a fixed-ankle-and-knee group (9 males, 7 females), and a non-fixed group (7 males, 10 females). [Methods] The fixed-ankle subjects were limited using orthopedic fiberglass casting tape and elastic bandages and the fixed-ankle-and-knee subjects were additionally limited using a knee immobilizer. There were no limitations on the ankle and knee joints of the non-fixed group subjects. We measured postural stability and muscle activities of the ankle and knee muscles. [Results] There were differences in the muscle activities of the tibialis anterior, median gastrocnemius, and rectus femoris between the groups. The greatest muscle activity in the tibialis anterior was shown by the non-fixed group, and the fixed-ankle group showed the greatest rectus femoris and gastrocnemius activities. There were significant differences in the overall stability index, anterior-posterior stability index, and medial-lateral stability index. All three indices were the lowest for the non-fixed group. [Conclusion] A fixed ankle or knee reduces muscle activity which in turn lowers postural stability.

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[Purpose] This study compared the bilateral thicknesses of the semispinalis capitis muscle and neck motions between subjects with and without unilateral posterior neck pain (UPNP). [Subjects] The study recruited 20 young subjects with UPNP at the end-range of neck extension and 20 age- and sex-matched subjects without neck pain as a control group. [Methods] The bilateral thicknesses of the semispinalis capitis in a relaxed prone position were measured bilaterally using ultrasonography. A three-dimensional motion-analysis system was used to measure the asymmetry of neck motions at 45° of prone neck extension. [Results] We found that the asymmetry of the semispinalis capitis muscle was greater in the UPNP group than in the controls. Neck rotation to the painful side and lateral bending to the non-painful side were greater in the UPNP group at 45° of prone neck extension than in the controls. [Conclusion] Asymmetric thickness of the semispinalis capitis muscles might be the cause of asymmetric neck motions in subjects with UPNP.

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[Purpose] The purpose of this study was to examine the locus of the center of pressure (COP) of standing postures with different feet positions. [Subjects] Sixty healthy young adults participated in the experiments as subjects. [Methods] The COP was measured using a force plate. Subjects stabilized themselves on the force plate, and the change of the COP trajectory was measured for 30 s. The COP was measured in three standing postures: wide-base, tandem, and one-foot standing. The relative center of anterior-posterior sway was examined as a proportion of the base of support length. [Results] Using one foot length, l, measured from the heel to the toe of the foot as a standard, the mean of the center of anterior-posterior sway was 44.5 ± 5.5% of l in the wide-base stance, 50.2 ± 4.4% of l in the one-foot dominant stance, and 50.4 ± 4.3% of l in the one-foot non-dominant stance. Since the length of the feet is 2l in the tandem posture, the mean of the center of anterior-posterior sway was 41.0 ± 7.0% of 2l with the dominant foot in front and 41.5 ± 6.0% of 2l with the non-dominant foot in front. [Conclusion] The mean of the center of anterior-posterior sway was inclined toward the anterior position in single leg standing compared to the wide base standing. In tandem standing, the COP was located on the rear foot. The results of this study might be useful in considering the mechanism of postural control of patients with hemiplegia.

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[Purpose] The purpose of this study was to investigate the effects of tight-fitting high-heeled shoes on vastus medialis oblique (VMO), biceps femoris (BF), and gastrocnemius (GCM) during stair ascent. [Subjects] Fifteen female subjects were recruited. [Methods] The subjects ascended stairs with a step height of 20 cm wearing loose- and tight-fitting high-heeled shoes, and the activities of the VMO, BF and GCM muscles were recorded using EMG. [Results] The normalized EMG data of the VMO muscle significantly decreased when wearing the tight high-heeled shoes during ascend the stair when compared to the loose high-heeled shoes. The normalized EMG data of the BF, and GCM muscles significantly increased when wearing the tight high-heeled shoes during stair ascent compared to the loose high-heeled shoes. [Conclusion] We think that tight-fitting high-heeled shoes may more easily cause muscle imbalance; therefore, tight-fitting high-heeled shoes would raise the risk of musculoskeletal disorders in young women.

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[Purpose] The purpose of this study was to evaluate the anti-inflammatory and analgesic efficacy of low-intensity laser therapy (LILT) on adjuvant-induced arthritis in a rat model. [Subjects] Thirty Sprague-Dawley rats were randomly divided into 3 groups: normal, placebo, and LILT groups. The arthritis group was treated with low intensity laser therapy using a gallium-aluminum-arsenide diode laser device for 3 weeks. Each group had 10 rats. All treatments were applied once a day, 5 days a week, for a total experimental period of 21 days. The hind paw volume and articular index of the knee joint along with TNF-α and IL-6 levels in the serum were used as outcome measures. [Results] Hind paw volume and the arthritis index of rats in the placebo group were significantly higher than those in the normal group (p<0.05). In the laser treatment group, the hind paw volume, the arthritis index, and TNF-α and IL-6 concentrations were significantly decreased than those in the placebo group. [Conclusion] We concluded that LILT is effective at in alleviating RA symptoms such as edema, arthritic index, and the expression profiles of inflammation cytokines in adjuvant-induced arthritic rats.

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[Purpose] The aim of this study was to investigate the effects of balneotherapy on immunological parameters, trace metal elements and mood states in pilots. [Subjects] Thirty-six healthy male pilots were enrolled into this study. [Methods] All subjects received therapy for 3 weeks. They took entire-body immersion baths in thermomineral water for 30 min a day for 3 weeks. Blood samples were taken 1 day before and after the balneotherapy treatment. Blood concentrations of trace metal elements were measured using a BH5100 atomic absorption spectrometer. Blood serum concentrations of immunoglobulins and complements were measured with an automatic biochemical analyzer. The Profile of Mood States test was conducted to determine changes in mood states. [Results] After 3 weeks of balneotherapy, the concentrations of immunoglobulin A and complement component 4 increased significantly and the blood concentration of lead significantly decreased. The mood scores of tension-anxiety, anger-hostility, fatigue-inertia and confusion-bewilderment decreased. The mood score of vigor-activity significantly rose. [Conclusion] The findings indicate that balneotherapy over a 3-week period may exert a beneficial influence on the immune system and play an assistive role in improving the mood states of pilots.

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[Purpose] This study sought to determine the prevalence of work-related musculoskeletal disorders (WRMDs) their associated work risk factors and the coping strategies used to reduce their risk among physical therapists in Korea. [Subjects] Korean physical therapists with at least 1 year of working experience. [Methods] A self-administered questionnaire was distributed to 234 physical therapists working in different hospitals, and 180 questionnaires were returned yielding a 76.9% response rate. Twenty-three of the returned questionnaires were excluded from the analysis because of incomplete data. [Results] The overall prevalence of WRMDs during the past 12 months was 92.4%. Female physical therapists reported a significantly higher prevalence of WRMDs than male physical therapists (p=0.028). The most injured body areas were the low back (53.5%) and shoulders (45.2%). Treating an excessive number of patients in 1 day (90.4%) and a lack of rest breaks (89.8%) were the most perceived work risk factors for WRMDs. The most commonly adopted coping strategies were modification of the therapist’s or patients’ positions and use of a different part of the therapist’s body to administer a manual technique (51.6%). [Conclusion] WRMDs are significantly higher among physical therapists in Korea compared to many other countries. Education programmes on prevention and coping strategies for WRMDs are recommended for physical therapists in order to reduce the risk of further injury.

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[Purpose] The main objective of this study was to provide basic data on the functional dysphagia scale after Neuromuscular Electrical Stimulation (NMES). [Subjects] Subjects were divided into normal persons aged over 70 (N=18) and normal persons younger than 30 (N=10). [Method] Each group underwent videofluoroscopy and the Functional Dysphagia Scale (FDS) was used to evaluate subjects’ swallowing characteristics. The aged group underwent a second videofluoroscopy and FDS evaluation after NMES. NMES was administered 60 minutes a day, 5 days a week for 2 weeks to the aged group’s suprahyoid and infrahyoid muscles using four electrodes. [Results] The average value of FDS after NMES of the aged group was significantly lower than before NMES. The average values of FDS before and after the NMES showed a significant statistical difference. [Conclusion] After NMES, the average value of FDS was very low in the older group, being only slightly lower than the average of the young group.

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[Purpose] The main purpose of this study was to examine the relationship between pelvic tilt angle and disability associated with low back pain in adults. [Subjects] The subjects were 119 adults (56 males and 63 females) ranging in age from 18 to 55 years. Subjects with marked posterior pelvic tilt (PPT group) and marked anterior pelvic tilt (ATP group) were identified. The PPT group consisted of 6 males and 6 females with pelvic tilts of at least one standard deviation below the mean of healthy back subjects. There were 22 males 30 females in the APT group with pelvic tilt greater than one standard deviation above the mean. [Methods] Subjects completed a questionnaire about dominant working position and demographic variables. Pelvic tilt angle was measured using a modified inclinometer. [Results] Median disability scores of both males (9.1%) and females (10.9%) showed subjects were minimally disabled. Spearman correlation coefficients for the between pelvic tilt angle and the Oswestry disability index of male and female subjects in the PTT group, the APT group, and of all subjects were not significant. However, in the post hoc analysis a small but significant difference in pelvic tilt angle (p<0.001) between the normal and disability groups was discovered. Subjects with low back pain showed a significantly greater median pelvic tilt angle (6.0°) than those with healthy backs (3.5°). [Discussion and Conclusion] The results might indicate that low back pain suffers change their posture by increasing anterior pelvic tilt or it could mean that those with increasing pelvic tilt are more at risk of having back pain. Further study is recommended to investigate this relationship in subjects with moderate to severe disability.

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[Purpose] Insufficient exercise leads most middle-aged women to have a higher risk of depression arising from menopausal symptoms. We hypothesized that heart rate variability (HRV) would show the adjustment of the autonomic nervous system reflecting degrees of depression in menopausal women with low exercise behaviors, and the aim of this study was to compare HRV between mild and severe depression cases to explore the potential of HRV as a diagnostic tool for depression. [Subjects and Methods] This was a cross-sectional study, and subjects were community-recruited menopausal women with low exercise behaviors. After subjects had completed the Taiwanese depression questionnaire (TDQ), electrocardiographic signals of the subjects with mild and severe depression were recorded for analysis of the HRV variables, and to create receiver operating characteristic curves. [Results] Twenty-eight women with mild depression (TDQ score: 11.62 ± 1.81) and 20 women with severe depression (TDQ score: 24.71 ± 1.57) agreed to analysis of their electrocardiographic signals. The between-group comparisons of high frequency (HF), low frequency (LF) and the LF/HF ratio showed statistically significant differences, and provided significant contributions to predicting depression in both groups. The area under the receiver operating characteristic curve for LF was significantly greater than that of HF. [Conclusions] LF and the LF/HF ratio better distinguish between subjects of different severity of depression than HF. This means that observation of the tone of sympathetic activity and the balance of the autonomic nervous system are better at distinguishing the severity of depression.

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[Purpose] The aim of this research was to determine the reliability of: the Gross Motor Functional Measure (GMFM-88), the Pediatric Evaluation of Disability Index (PEDI) and the Timed Up and Go (TUG) test for children with cerebral palsy. [Subjects] Twenty children with CP took part in the research (7 with tetraplegia, 6 with diplegia and 7 with right hemiplegia). The children’s mean age was 4. 85 ± 2. 49 years, their mean height was 1. 06 ± 0. 17 m and their mean body mass 18. 58 ± 7. 5 kg. [Methods] All three tests were conducted twice on two separate days, under the same conditions. The intra-class correlation coefficient (ICC), mean RMS difference, standard error of measurement (SEM) and the coefficient of variation (CV) were used to quantify the reliabilities of the tests. [Results] The GMFM, PEDI and TUG tests presented very high reliability scores (ICC=0. 99). [Conclusion] These findings are in accordance with the findings of other studies concerning the reliability of the three tests for children with cerebral palsy or other patient populations. Therefore, it was concluded that all the three tests should be applied in order to reliably estimate the mobility and functional ability of children with cerebral palsy.

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[Purpose] This aim of this study was to determine the difference in the magnitude of upper extremity movement according to the type of compression device used as determined by three-dimensional motion analysis. [Subjects] The subjects selected for this study were 40 healthy adults. Out of the 40 participants, 9 were excluded from the study. [Methods] For the experimental procedure subjects randomly wore acompression garment, a bandage or neither. During each motion analysis, subjects performed elbow flexion and extension in a fixed range, 10 times, using their dominant hand. [Results] The wrist marker movement distances on the Z axis while wearing the compression garment and bandage were significantly lower than that of wearing nothing. The elbow marker movement distance on the Y axis and range of motion while wearing the compression bandage was significantly greater than that of wearing nothing or the compression garment. The shoulder marker movement distance on the X axis while wearing the compression bandage was significantly greater than that of wearing nothing or the compression garment. [Conclusion] Wearing a compression bandage reduces wrist and elbow movement and increases shoulder movement compared to wearing a compression garment or wearing neither. The appropriate use for a compression garment or a compression bandage must now be determined.

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[Purpose] The purpose of this study was to investigate the validity of an evaluation index of the vertical (VT), anteroposterior (AP), and mediolateral (ML) directions of trunk acceleration during walking. [Methods] Twenty-nine subjects volunteered for this study. Trunk acceleration and ground reaction force (GRF) during normal walking were measured. The root mean square (RMS), stride regularity (SR), and step symmetry (SS) were calculated on the basis of trunk acceleration. The displacement of COG was calculated by the double integration of GRF. The components of RMS, SS, SR, and COG were calculated in the AP, VT, and ML directions. We analyzed the correlation between RMS and COG and assessed differences among the three directions in SR and SS. [Results] We observed a significant correlation between RMS and COG in VT. SS and SR in the VT and AP directions were significantly higher than those in the ML direction. [Conclusion] These results suggest that RMS in the VT direction is useful in the gait analysis, SS and SR in the AP and VT directions were useful as indices showing the degree of deviation from normal gait.

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[Purpose] The purpose of this study was to investigate the activation of subdivisions of the gluteus medius during modified unilateral weight-bearing exercises using a pressure-biofeedback unit in order to suggest the most effective exercise method. [Subjects] We recruited 15 healthy adult females with no pain in the gluteus medius and no other orthopedic problems in the lower limbs. [Methods] The enrolled individuals performed four modified unilateral biofeedback exercises: wall-press with adduction force, WP-ADD; wall-press with abduction force, WP-ABD; wall-squat with adduction force, WS-ADD; and wall-squat with abduction force. [Results] The anterior and middle fibers of the gluteus medius were highly activated during WP-ADD, and the posterior fiber of the gluteus medius was activated during WS-ABD. [Conclusion] These results suggest that weight-bearing exercises for gluteus medius strengthening should be more specific, and chosen based on the characteristics of each subdivision.

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[Purpose] This study was conducted to find out the immediate effects of dermatomal stimulation combined with functional tasks of the hand, and to determine whether it could be used as a modality for functional task training for chronic hemiplegic patients. [Subjects] Ten stroke patients with spasticity of the paretic finger flexors greater than or equal to G1 on the Modified Ashworth Scale (MAS), a Manual Muscle Testing (MMT) score greater than or equal to poor⁺, Brunnstrom stage higher or equal to stage 3, and stroke onset more than 12 months ago were recruited. [Methods] Subjects performed three given tasks (Box and Block test, Velcro pegboard, and stacking cones) in a random sequence with and without dermatomal electrical stimulation, which was applied to the C8 dermatome. Each task was repeated 6 times. [Results] The immediate effects of applying task-oriented movements combined with dermatomal electrical stimulation resulted in a significant improvement in hand function. [Conclusion] Electrical stimulation of the dermatomes combined with task-oriented movements has the potential to improve the hand functions of chronic hemiplegic patients.

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[Purpose] This study investigated which frequency levels of vibration affect the knee joint reposition error of elderly women. [Subjects] The subjects of this study were 13 healthy elderly women who had no orthopedic or neurological problems. [Methods] Oscillators were attached to the e bellies of the tibialis anterior, gastrocnemius, biceps femoris, and rectus femoris muscles on the dominant-side lower limbs of the subjects. In order to identify the effects of vibration stimuli on elderly women’s knee joint position sense, knee joint reposition error tests were conducted under randomly selected different conditions (open kinetic chain or closed kinetic chain) and frequencies of vibration (control condition, placebo condition, 10 Hz, 60 Hz, and 120 Hz). [Results] In the open kinetic chain, the knee joint reposition errors were significantly different among conditions (control, placebo, 10 Hz, 60 Hz, and 120 Hz). The knee joint reposition error of 60 Hz vibration was the smallest, but that of 120 Hz was higher than those of the other conditions. In the closed kinetic chain, there were no significant differences among the conditions. [Conclusion] Vibration of 60 Hz is an appropriate frequency for decreasing knee joint reposition error, and for stimulating the proprioceptive sense of the human body. Further studies will be required of the effects of vibration stimulation in future.

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[Purpose] The purpose of this study was to investigate the reliability and validity of the kinematic analysis of trunk and pelvis movement during gait and standing as measured by two smartphones (in the present study, we used iPod touches because of their weight). [Methods] Thirty-eight healthy adults (mean age, 21.4 ± 1.2 years) were instructed to stand and walk on a treadmill at three different speeds. The tilt angle of the trunk and pelvis were measured using both an iPod touch and an optoelectronic motion capture system (Optotrak). [Results] The error between the iPod touch and Optotrak was small during standing and walking at low speed. However, as the walking speed was increased, the error between the iPod touch and Optotrak increased. There were no significant differences between the test and retest measurement values of each device, nor were there any significant differences between the days of the analyses. [Conclusions] The iPod touch has good accuracy, since the variations in the test and retest and for different days were small. This suggests that the iPod touch can be used instead of the Optotrak for the kinematic analysis of trunk and pelvis movement at low walking speeds.

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[Purpose] This study investigated the progress of standardization of “clinical competencies evaluation with definition” in the education of physical therapists and occupational therapists by searching for relevancies between performance in Objective Structured Clinical Examination (OSCE), university and practical training. [Subjects and Methods] Subjects were 227 students who graduated between 2007 and 2009, and 174 students who graduated between 2010 and 2011. For data analyses, comparisons among different timings of practical training as well as between before and after reform of the OSCE compliant education system were performed. In addition, relationships among different timings of practical training with performance were also examined. [Results] Because of reform of OSCE compliant education system, performance in practical training (attitude, skills, knowledge) generally improved. Moreover, relationships between the performances in OSCEs and practical training became higher each year. [Conclusion] We would like to promote standardization of the clinical techniques for postgraduate education aiming to further extend the OSCE compliant education system.

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[Purpose] The purpose of this study was to investigate the effects of balneotherapy on the cardiopulmonary function and physical capacity of pilots. [Subjects] Thirty-six healthy male pilots were recruited. [Methods] All subjects received entire-body immersion bath therapy in thermomineral water for 30 min a day for 21 days. Electrocardiograms, carotid pulse traces, and phonocardiograms were recorded using a cardiac function measuring device. Pulmonary function tests were performed using a Pony FX spirometer. The physical capacity of pilots was examined 1 day before and after balneotherapy. [Results] After 21 days of treatment, isovolumetric contraction time and the ratio of isovolumetric contraction time/left ventricular ejection time were reduced. Forced vital capacity, peak expiratory flow, the ratio of forced expiratory volume in 1 second/ forced expiratory volume and forced expiratory flow at 25–75% were elevated. The exercise numbers of pull-ups and sit-ups in 1 min were boosted. [Conclusion] The findings imply that balneotherapy for 21 days has a significant effect on the cardiopulmonary function and physical capacity of pilots.

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[Purpose] The purpose of the present study was to examine the immediate effects of passive hamstring stretching exercises on cervical spine range of motion and balance. [Subjects] The present study was conducted with 60 healthy university students without any musculoskeletal dysfunction as subjects. They were divided into an experimental group consisting of 30 subjects and a control group consisting of 30 subjects. [Methods] Cervical spine range of motion was measured using a cervical range of motion goniometer, and the stability test was conducted to assess balance. The experimental group were administered hamstring stretching with ankle dorsiflexion for 30 seconds three times, whereas the control group received the same treatment without ankle dorsiflexion. [Results] Cervical spine range of motion and balance immediately increased in the experimental group while there was no change in the control group. [Conclusion] The results show that hamstring muscle stretching exercises the fascia of the skeletal muscles of the human body and that the fascia are connected to each other by interactions of force. The human skeletal muscles interacted with each other to increase the flexion and extension range of motion of the cervical spine. In addition, the transfer of these forces to the stabilizer muscles of the pelvis and spine were the most important factor in the improvement of the subjects’ balance.

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[Purpose] This study examined the effects of passive lower limb and trunk exercises (PELT) and diaphragmatic breathing exercise (DBE) on intestinal motility in order to devise new techniques to effectively encourage intestinal motility. [Subjects and Methods] The subjects were 18 healthy adult males. Their peristaltic sounds were recorded at rest. Subjects then randomly received either PELT or performed DBE for 10 min, and their peristaltic sounds were recorded afterwards. Several days later, the sounds were recorded again. An electronic stethoscope with recording capability was used to record peristaltic sounds. Recorded peristaltic sounds were passed through an amplifier and a data acquisition and analysis system and uploaded to a PC. The integral of the primary frequency range of sounds; was calculated every 10 sec. [Results] Following PELT, peristaltic sounds increased significantly from the levels at rest, but significant differences between peristaltic sounds after DBE and sounds at rest were not noted. For 20 sec after either intervention, sounds increased significantly compared to the sounds at rest, but subsequently significant differences were not noted. [Conclusion] Both techniques had an immediate effect but no sustained effect. In future clinical settings, interventions should be performed several times for patients with decreased intestinal motility.

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[Purpose] The aim of this study was to identify how the lumbar stabilizer muscles respond to increased lifting loads. Twenty-four healthy subjects (10 males, 14 females) participated in this study. [Subjects and Methods] The thicknesses of the internal oblique (IO), transverse abdominis (TrA), and lumbar multifidus (LM) muscle were measured by ultrasonography during lifting of loads 10%, 20%, and 30% of body weight. The data was analyzed measured by one-way repeated measures analysis of variance (ANOVA). [Results] There were statistically significant increases in thicknesses of the TrA and LM muscles when lifting a load of 20% of subject’s body weight. The thickness of IO was not significantly different at different loads. [Conclusion] The findings of this study suggest that TrA and LM play important roles as lumbar spine stabilizers during lifting activities of less than 20% of body weight. Further study is needed to find the mechanisms of lumbar stability during stoop lifting of loads greater than 20% of body weight.

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[Purpose] The purpose of the present study was to examine the effects of changes in hand position on the electromyographic activities of the shoulder stabilizer muscles during push-up plus exercises (PUPE) on unstable surfaces. [Subjects] The subjects of the present study were normal adults in their 20s (n=15). PUPEs were performed with the hands in the neutral positions (NP), internal rotation positions (IRP), and external rotation positions (ERP) using a sling device for the unstable surface. [Methods] We measured the electromyographic activities of the wrist flexor (WF), the wrist extensor (WE), the biceps brachii (BB), the triceps brachii (TB), the upper trapezius (UT), the lower trapezius (LT), the serratus anterior (SA), and the pectoralis major (PM). The muscle activites were compared and analyzed using electromyography. [Results] When hand position changed, WF activity in NP, and SA activity in ERP, were significantly different from their respective activities in the other positions. [Conclusion] To selectively enhance the electromyographic activity of the SA during PUPE using a sling device as an unstable surface, we consider performance of PUPE in ERP is an effective intervention.

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[Purpose] An understanding of smooth muscle contraction is important in the study of specialized physical therapy. In this paper, we summarize the contraction mechanisms of smooth muscle and suggest their applications in physical therapy. [Method] This review focuses on the signaling pathways that control smooth muscle contraction and its mechanisms. We include results reported by our laboratory in a wider literature review. [Results] Our results and the literature show that various mechanisms of smooth muscle contraction exist. [Conclusions] In this review article, we carefully discuss the signal transduction in smooth muscle contraction based on our studies and with reference to physical therapy.

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[Purpose] Memory impairment is a common sequela in patients with traumatic brain injury (TBI). Little is known about applications for memory training for patients with TBI. We investigated the effect of a memory training application in a patient with TBI. [Subjects and Methods] A 37 year-old male patient presented with memory impairment since onset of TBI resulting from a traffic accident. We developed a memory training application for use with a tablet PC. It consists of six stages. Each stage is composed of visual and auditory memory training parts. Two training sessions were conducted per day, five days per week, for a period of three months from nine months after onset to 11 months after onset. [Results] The patient’s scores on the Memory Assessment Scale showed improvement after participating in the memory training program for a period of three months: global memory, 56.6%; short-term memory, 13.2%; visual memory, 75.0%; and verbal memory, 37.9%. [Conclusions] We observed significant improvement of memory function of this patient after memory training using this application. As a result of these findings, we believe that this application could be useful for improving memory impairment of patients with TBI.

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