[Purpose] The job of secondary school teachers involves a lot of head down posture as frequent reading, assignment correction, computer use and writing on a board put them at risk of developing occupational related neck pain. Available studies of neck pain experienced by teachers are limited. The purpose of this study was to determine whether training of deep cervical flexor muscles with pressure biofeedback has any significant advantage over conventional training for pain and disability experienced by school teachers with neck pain. [Subjects] Thirty teachers aged 25–45 years with neck pain and poor craniocervical flexion test participated in this study. [Methods] A pretest posttest experimental group design was used in which experimental group has received training with pressure biofeedback and conventional exercises while control group received conventional exercises only. Measurements of dependent variables were taken at baseline, and after 2 and 4 weeks of training. Pain intensity was assessed using a numeric pain rating scale and functional disability was assessed using the neck disability index. [Results] The data analysis revealed that there was significant improvement in pain and disability in both the groups and the results were better in the experimental group. [Conclusion] Addition of pressure biofeedback for deep cervical flexor muscles training gave a better result than conventional exercises alone. Feedback helps motor learning which is the set of processes associated with practice or experience leading to permanent changes in ability to respond.

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[Purpose] The purpose of this study was to examine the effects of deep abdominal muscle strengthening exercises on respiratory function and lumbar stability. [Subjects] From among 120 male and female students, 22 whose thoraxes opened no more than 5 cm during inspiration and expiration and whose forced expiratory flow rates were around 300 m/L were recruited. The subjects were randomly divided into an experimental group of eleven, who performed deep abdominal muscle strengthening exercises, and a control group of eleven, who received no particular intervention. [Methods] The subjects were instructed to perform normal breathing in the hook-lying position. They were then directed to hold their breath for ten seconds at the end of inspiration. Ten repetitions of this breathing comprised a set of respiratory training, and a total of five sets were performed by the subjects. [Results] Deep abdominal muscle training was effective at enhancing respiratory function and lumbar stabilization. [Conclusion] The clinical application of deep abdominal muscle strengthening exercises along with lumbar stabilization exercises should be effective for lower back pain patients in need of lumbar stabilization.

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[Purpose] The purpose of this study was to investigate the effect of expiratory resistance load on the tongue area encompassing the suprahyoid and genioglossus muscles. [Subjects] The subjects were 30 healthy individuals (15 males, 15 females, mean age: 28.9 years). [Methods] Magnetic resonance imaging was used to investigate morphological changes in response to resistive expiratory pressure loading in the area encompassing the suprahyoid and genioglossus muscles. Images were taken when water pressure was sustained at 0%, 10%, 30%, and 50% of maximum resistive expiratory pressure. We then measured tongue area using image analysis software, and the morphological changes were analyzed using repeated measures analysis of variance followed by post hoc comparisons. [Results] A significant change in the tongue area was detected in both sexes upon loading. Multiple comparison analysis revealed further significant differences in tongue area as well as changes in tongue area in response to the different expiratory pressures. [Conclusion] The findings demonstrate that higher expiratory pressure facilitates greater reduction in tongue area.

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[Purpose] This study investigated the effect of open and closed kinetic chain exercise on the dynamic balance ability of healthy young adults. [Subjects] Thirty-three healthy adults participated in this study. [Methods] Subjects were randomly assigned to either an open kinetic chain exercise group (n=17) or a closed kinetic chain exercise group (n=16). Both the open kinetic chain and closed kinetic chain exercise groups performed 3 sets of exercises 3 times per week for 6 weeks. Dynamic balance was measured at the beginning and end of the 6-week training period, including anterior-posterior, medial-lateral, and total displacement of the center of pressure. [Results] Both exercise groups showed improvement in balance parameters but the improvement was only statistically significant in the closed kinetic chain group. [Conclusion] Closed kinetic chain exercise appears to be more effective at improving of dynamic balance ability than open kinetic chain exercise within a 6-week training period.

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[Purpose] This study investigated the effect of neurological symptoms and/or signs after the occurrence of neurogenic intermittent claudication (NC) on postural sway during quiet standing of patients with lumbar spinal canal stenosis (LSS). [Subjects and Methods] Thirty-two female patients with LSS at the L4/5 level were studied. We measured the path of center of foot pressure (COP) during quiet standing with eyes open for 30 s using a stabilometer before and after the occurrence of NC. [Results] The total path length of COP (LC) and area surrounded by the outline of the path of COP (AC) significantly increased after NC. Body mass index (BMI) correlated with both the NC rate (after NC/before NC) of LC and that of AC. The average lateral COP displacement from the center of the base of support (COP_RL) before NC was located on the asymptomatic side from the center of the base of support in 29 of 32 patients. After NC, COP_RL moved to the symptomatic side in 31 patients. [Conclusion] These results suggest that patients with LSS are at risk of falling after NC, especially those with high BMI.

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[Purpose] This study investigated the changes in acromion and scapular position after short-term overhead work. [Subjects] Twelve males aged 20–27 years, were recruited. [Methods] We measured the acromial angle and scapular inferior distance using a palpation meter before and after overhead work. [Results] The acromion angle was significantly decreased after the overhead work compared to before. The scapular inferior distance was significantly increased after the overhead work compared to before. [Conclusion] Even though the overhead work was short-term work lasting less than one hour, it resulted in an abnormal scapular position.

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[Purpose] The purpose of the present study was to analyze the correlations of the thicknesses of the transversus abdominis muscle (Tra) and the internal obliquus abdominis muscle (Io) with static lumbar stability (SLS), dynamic lumbar stability (DLS), and balance. [Subjects] The subjects of the present study were 40 female university students who had no physical defects or pain. [Methods] The thicknesses of Tra and Io muscles were measured using an ultrasonic imaging diagnostic unit. SLS and DLS were measured using a Pressure Biofeedback Unit (PBU), and Weight Distribution Indexes (WDI) and stability scores (SS) were measured using a balance measuring unit. [Results] As the thickness of the Tra increased, SLS, DLS, WDI, and SS improved. As SLS improved, DLS and WDI were also improved. [Conclusion] To improve lumbar stability and balance, training is needed in order to increase the muscle mass of the transversus abdominis muscle.

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[Purpose] This study investigated the effect of the spacing of backpack shoulder straps on cervical muscle activity, acromion and scapular position, and upper trapezius (UT) pain. [Subjects] Fourteen males aged 20–32 years, were recruited. [Methods] We measured the MPS (midcervical paraspinal) activity, acromial angle, scapular distance, and UT pain after gait carrying a backpack with different shoulder strap spacings. [Results] The MPS, scapular inferior distance, and UT pressure pain threshold was significantly decreased and the acromion angle was significantly increased when carrying a backpack with wide shoulder straps compared to narrow shoulder straps. [Conclusion] A backpack with wide shoulder straps may cause scapular depression syndrome and chronic UT pain.

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[Purpose] The purpose of this study was to observe the effects of manual therapy on bowel function of patients with spinal cord injury. [Subjects] The participants were 20 patients with spinal cord injury. [Methods] Manual therapy was applied to the intestine and along the colon ascendens, transverse colon, colon descendens and colon sigmoidem on the surface of abdomen. The results before and after 60 sessions (5 times/week, continued for 12 weeks) of manual therapy were compared. [Results] It was found that there were significant effects both on shortening of bowel time and decreasing dosage of glycerine enema every time patients needed to excrete. [Conclusion] Manual therapy had significant effects on bowel function of patients with spinal cord injury.

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[Purpose] The purpose of this study was to compare the effects of bridge exercises applying the abdominal drawing-in method and modified wall squat exercises on deep abdominal muscle thickness and lumbar stability. [Subjects] A total of 30 subjects were equally divided into an experimental group and a control group. [Methods] The experimental group completed modified wall squat exercises, and the control group performed bridge exercises. Both did so for 30 minutes three times per week over a six-week period. Both groups’ transversus abdominis (Tra), internal oblique (IO), and multifidus muscle thickness were measured using ultrasonography, while their static lumbar stability and dynamic lumbar stability were measured using a pressure biofeedback unit. [Results] A comparison of the pre-intervention and post-intervention measures of the experimental group and the control group was made; the Tra and IO thicknesses were significantly different in both groups. [Conclusion] The modified wall squat exercise and bridge exercise affected the thicknesses of the Tra and the IO muscles. While the bridge exercise requirs space and a mattress to lie on, the modified wall squat exercise can be conveniently performed anytime.

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[Purpose] This research investigated the relationship between balance measured by a TETRAX and activities of daily living (ADL) assessed by NEI-VFQ 25. The results should provide basic data for rehabilitation therapy for low-vision patients. [Methods] We used the NEI-VFQ-25 vision-related Activities of Daily Living evaluation, MMSE-K, and TETRAX to evaluate 30 low-vision outpatients at K hospital in Daejeon, South Korea from July 5 to July 23, 2012. We performed linear regression analysis using a statistical significance level of 0.05. [Results] Balance in the normal eyes open (NO) posture correlated with the normal eyes closed posture and age, but showed no correlation with NEI-VFQ 25. The ADL level correlated with monocular vision, female gender, cognition, and NO posture. These variables explained 54.4% of the aspects of their ADL. [Conclusion] This research proves that low vision adversely affects balance ability, and is influenced by type of vision, gender, and cognitive assessment.

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[Purpose] This study investigated the effects of hamstring stretching on leg rotation during active knee extension. [Subjects] Subjects were 100 bilateral legs of 50 healthy women without articular disease. [Methods] Hamstring hardness, leg rotation and muscle activities of the knee extensors during active knee extension were measured before and after hamstring stretching. [Results] Hamstring hardness was significantly decreased after hamstring stretching. The leg rotation angle, variation in leg rotation angle, variation in leg external rotation angle, and muscle activities of the vastus lateralis and rectus femoris were significantly increased after hamstring stretching. A moderate positive correlation was found between variation in leg rotation and variation in muscle hardness in hamstring. [Conclusion] Leg rotation during active knee extension was increased by hamstring stretching. Hamstring stretching would be effective as a pretreatment for restoring proper leg rotation when knee extension is conducted as a therapeutic exercise.

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[Purpose] High resting blood pressure and heart rate are associated with the risk of cardiovascular events. In patients with decreasing amounts of slow twitch muscle fiber, hypertension may develop and resting heart rate may increase. Measurement of the amount of slow twitch muscle fiber and capillary density using muscle biopsy is inconvenient and expensive. Therefore, a better screening test is required to determine these parameters for prevention of cardiovascular events. In this study, relationships among calf circumference, resting blood pressure, and pulse rate in the soleus muscle were investigated. [Subjects] Healthy elderly women (n=19, 61–84 years of age) living in the community were the subjects of this study. [Methods] Blood pressure was measured using an automatic hemodynamometer on the left arm. The calf circumference was measured, and pulse rate was measured on the left radial artery for 1 min by palpation. [Results] No correlations were observed between calf circumference, resting systolic or diastolic pressure, pulse pressure, or mean blood pressure. However, an inverse correlation was observed between calf circumference and resting pulse rate. [Conclusion] Calf circumference measurement may be used as a screening test for resting pulse rate. This test may be useful for the prevention of cardiovascular events.

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[Purpose] We reported that carbon dioxide (CO₂) water bathing accelerates skeletal muscle regeneration; however, the underlying mechanism was unclear. MyoD and myogenin play roles in muscle regeneration, and the purpose of this study was to determine changes in MyoD and myogenin caused by CO₂ water bathing after injury. [Subjects] Sixteen female Wistar rats (n = 4 per group) were used. [Methods] The rats were divided into four groups: no-injury (NI), injury (IC), injury + tap water bathing (ITW), and injury + CO₂ water bathing (ICO₂). Muscle injury was induced by injection of bupivacaine hydrochloride into the left tibial anterior (TA) muscles. Tap water and CO₂ (1,000 ppm) water bathing were performed at 37 °C for 30 minutes once a day. The left TA muscles were removed 4 days after injury, and the expressions of MyoD and myogenin were measured. [Results] MyoD and myogenin were increased in the IC, ITW, and ICO₂ groups compared with the NI group. Although the MyoD level was similar in the IC, ITW, and ICO₂ groups, myogenin increased more in the ICO₂ group than in the IC and ITW groups. [Conclusion] CO₂ water bathing after muscle injury appears to induce an increase in the expression of myogenin.

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[Purpose] The present study examined the effects of treatment using PNF extension techniques on the pain, pressure pain, and neck and shoulder functions of the upper trapezius muscles of myofascial pain syndrome (MPS) patients. [Subjects] Thirty-two patients with MPS in the upper trapezius muscle were divided into two groups: a PNF group (n=16), and a control group (n=16) [Methods] The PNF group received upper trapezius muscle relaxation therapy and shoulder joint stabilizing exercises. Subjects in the control group received only the general physical therapies for the upper trapezius muscles. Subjects were measured for pain on a visual analog scale (VAS), pressure pain threshold (PPT), the neck disability index (NDI), and the Constant-Murley scale (CMS). [Results] None of the VAS, PPT, and NDI results showed significant differences between the groups, while performing postures, internal rotation, and external rotation among the CMS items showed significant differences between the groups. [Conclusion] Exercise programs that apply PNF techniques can be said to be effective at improving the function of MPS patients.

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[Purpose] Rheobase and chronaxie are used to confirm muscle degeneration. For stroke patients, however, the uses of rheobase and chronaxie in determining paretic side muscle degeneration is not yet fully understood. Thus, in this study, we examined the electrical properties of the quadriceps muscles of stroke patients’ paretic side and compared them with their respective values on the non-paretic side. [Method] The subjects were six stroke patients (three females, three males). The pad of an electrical stimulator was applied to the vastus lateralis and vastus medialis regions to measure rheobase and chronaxie until the contractive muscle response to electrical stimulation became visible. [Result] Rheobase was significantly increased on the paretic side compared to that of the non-paretic side of hemiplegic stroke patients. Furthermore, chronaxie was significantly increased on the paretic side compared to the non-paretic side of hemiplegic stroke patients. [Conclusion] These results suggest that stroke affects the sensitivity of skeletal muscle contraction. Therefore, this data may contribute to our understanding of the muscle status of stroke patients.

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[Purpose] The purpose of this study was to identify the effects of cervical joint manipulation on joint position sense (JPS) of normal adults. [Subjects] Thirty normal adults were divided into a test group of 15 subjects and a control group of 15 subjects. [Methods] The test group was treated with cervical joint manipulation and massage, whereas the control group received only massage. Both groups were evaluated in terms of joint position error (JPE) using a digital dual clinometer before and after the interventions. [Results] The comparision of the pre- and post-test results revealed the test group exhibited statistically significant changes in flexion, extension, left lateral flexion, right lateral flexion, left rotation, and right rotation. On the other hand, the control group showed no statistically significant changes in any of the variables. [Conclusion]Cervical joint manipulation reduced JPE and improved joint position sence. Therefore, we consider its application to the treatment of patients with cervical problems in clinical practice is desirable.

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[Purpose] The present study examined whether electro-acupuncture therapy reduces post-stroke depression (PSD) and whether motor function impairments interact with the effects of the therapy. [Subjects] Twenty-eight PSD patients were assessed and assigned to either a good or poor motor function group depending on their motor grade. [Methods] The Beck Depression Inventory (BDI), Hamilton Depression Rating Scale (HDRS) and Manual Muscle Test (MMT) were administered at the screening and initial phases of the study, and at the 4th, 8th, 12th and 16th week of the daily electro-acupuncture treatment. [Results] The electro-acupuncture treatment reduced PSD (as assessed by BDI and HDRS) of the patients. In particular, the depression of the good motor function group was significantly more reduced than that of the poor motor function group. The degree of motor function impairment did not change throughout the study in either group. [Conclusion] The results of the present study demonstrate that electro-acupuncture therapy can improve PSD, and that the treatment effect varies depending on the degree of motor function impairment.

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[Purpose] The purpose of this study was to compare H-reflex characteristics during gait of hemiplegic stroke patients. [Subjects] Twenty-five patients and age-matched twenty-five volunteers in good health were studied. All the subjects could walk independently. [Methods] An MP150 (BIOPAC Systems, Inc., Goleta, CA, USA) was used to record the electromyography (EMG) data collected with Ag-Ag/Cl measurement electrodes (BIOPAC, diameter of 2 cm). [Results] The comparison showed significant differences of H_max/M_max ratio (%) in all gait cycles between the stroke group and the control group. [Conclusion] In conclusion, this study furnished basic reference data for gait strategies and functional training programs for hemiplegic stroke patients.

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[Purpose] We examined the effects of an abdominal drawing-in bridge exercise using a pressure biofeedback unit on different bases on the thickness of trunk and abdominal muscles, and lumbar stability. [Subjects] Thirty healthy young adults (2 males, 28 females) took part in this study. The subjects were randomly and equally assigned to a stable bridge exercise group and an unstable bridge exercise group. [Methods] The subjects performed bridge exercises using an abdominal drawing-in method on a stable base and on an unstable base, and changes in their abdominal muscle thickness and on the stable and on unstable bases lumbar stability were evaluated. [Results] After the intervention, the stable bridge exercise group showed a statistically significantly increased muscle thickness in the transversus abdominis, and the unstable bridge exercise group showed significantly increased muscle thicknesses of the transversus abdominis and internal obliques in static and dynamic lumbar stability. The unstable bridge exercise group showed significant increase after performing the exercise. [Conclusion] Lumbar stability exercise, with the compensation of the lumbar spine minimized, using an abdominal drawing-in method on an unstable support of base is effective and efforts to prevent the compensation may induce a greater exercise effect.

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[Purpose] Assessment of posture is an important goal of physical therapy interventions for preventing the progression of forward head posture (FHP). The purpose of this study was to determine the inter- and intra-rater reliabilities of the assessment of FHP. [Subjects and Methods] We recruited 45 participants (20 male subjects, 25 female subjects) from a university student population. Two physical therapists assessed FHP using images of head extension. FHP is characterized by the measurement of angles and distances between anatomical landmarks. Forward shoulder angle of 54° or less was defined as FHP. Intra- and inter-rater reliabilities were estimated using Kendall’s Taub correlation coefficients. [Results] Intra-class correlation of intra-rater measurements indicated an excellent level of reliability (0.91), and intra-class correlation of inter-rater measurements showed a good level of reliability in the assessment of FHP (0.75). [Conclusion] Assessment of FHP is an important component of evaluation and affects the design of the treatment regimen. The assessment of FHP was reliably measured by two physical therapists. It could therefore become a useful method for assessing FHP in the clinical setting. Future studies will be needed to provide more detailed quantitative data for accurate assessment of posture.

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[Purpose] The purpose of this study was to examine the effects on stroke patients of trunk stabilization exercise on different support surfaces. [Subjects and Methods] Sixteen stroke patients with onset of stroke six months earlier or longer were randomly and equally assigned to group I (exercise performed on a stable support surface) and group II (exercise performed on an unstable support surface). The two groups conducted the trunk stabilization exercises on the respective support surfaces, in addition to existing rehabilitation exercises five times per week for 12 weeks. Changes in the cross-sectional area (CSA) of the muscles were examined using computed tomography (CT), and changes in the balance ability were assessed using a measuring system and the trunk impairment scale (TIS). [Results] In group I, there was a significant increase in the CSA of the mulifidus muscle on the side contralateral to the brain lesion and in the paravertebral and multifidus muscles on the side ipsilateral to the brain lesion. In group II, there was a significant increase in the CSA of the paravertebral and multifidus muscles on the side contralateral to the brain lesion and on the side ipsilateral to the brain lesion. In terms of changes in balance ability, the sway path (SP) and TIS significantly improved in group I, and the SP, sway area (SA), and TIS significantly improved in group II . [Conclusion] Exercise on the unstable support surface enhanced the size of the cross-sectional area of the trunk muscles and balance ability significantly more than exercise on the stable support surface.

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[Purpose] The purpose of this study was to perform kinematic and kinetic analyses of the ankle during both forward and backward walking using three-dimensional motion analysis. [Subjects] The subjects were 11 healthy adults. [Methods] Measurements of forward and backward walking motions were taken using a three-dimensional motion analysis device and 3 ground reaction force plates. The analysis segment was the standing phase and the items analyzed were walking time, maximum dorsal flexion of the ankle, maximum angle of plantar flexion, peak ankle power in the sagittal plane, workload of the ankle, and work rate. Statistical analysis consisted of comparisons using the t-test for each of the items measured during both forward and backward walking. [Results] The backward walking group had significantly lower ankle power, workload, and work rate. [Conclusion] The propulsive force in backward walking must come from some factor other than the ankle. The analysis of joint power is an important index for understanding the motion.

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