[Purpose] The purpose of this study was to investigate the effective strength levels of abdominal muscle contraction using the bracing contraction method. [Subjects] The experiment was conducted with 31 healthy male (M=15) and female (F=16) adults attending D University in Busan; all participants had less than obesity level BMI (BMI<30). [Methods] Bracing contraction was performed by the subjects in the hook-lying position at maximum and minimum pressure levels, five times each, using a Pressure Biofeedback Unit (PBU), and the mean measurement value was calculated. The maximum pressure level was set at 100% and the half maximum pressure level was set at 50%. Each subject’s left and right abdominal muscle thicknesses were then measured by ultrasound imaging in each state: at rest, 100% contraction, and 50% contraction. [Results] No significant differences were found between the left and right sides of the transversus abdominis (TrA) at rest, 50%, or 100% contraction. The external oblique abdominis (EO) and internal oblique abdominis (IO) showed no significant difference at rest or at the 50% contraction. However, a significant difference was noted at 100% contraction for the EO and IO. [Conclusion] Application of abdominal contraction using bracing can achieve symmetry in the left and right abdominal muscles at less than the maximum contractile strength. The occurrence of asymmetry in the left and right abdominal muscles at the maximum contractile strength suggests that the most suitable contractile strength in this exercise is less than the maximum contractile strength.

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[Purpose] This study compared the effectiveness of home exercise alone versus home exercise combined with ultrasound for patients with temporomandibular joint disorders. [Subjects and Methods] This study enrolled 23 female and 15 male patients who were divided randomly into two groups. The home exercise group performed a home exercise program consisting of an exercise program and patient education, and the home exercise combined with ultrasound group received ultrasound therapy in addition to the home exercise program. Pain intensity was evaluated using a visual analogue scale. Pain free maximum mouth opening was evaluated at baseline and 2 weeks after the treatment. [Results] There was no difference between the two groups in baseline values. After the treatment, the visual analogue scale decreased and pain free maximum mouth opening scores improved significantly in each group. Additionally, both values were higher in the home exercise combined with ultrasound group than in the home exercise group. [Conclusion] The combination of home exercise combined with ultrasound appears to be more effective at providing pain relief and increasing mouth opening than does home exercise alone for patients with temporomandibular joint disorders.

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[Purpose] The purpose of this study was to examine the different effects of long-term intervention between proprioceptive neuromuscular facilitation (PNF) and neuromuscular joint facilitation (NJF) patterns for the pelvis on chronic low back pain as assessed by the cross-sectional area of the multifidus muscle and the thickness of the transversus abdominis muscle. [Subjects] The subjects were 12 young people (five males, seven females) who had experienced chronic low back pain on one side for more than 6 months. [Methods] The subjects were treated by resting, PNF or NJF therapy, and each treatment was administered for one month. Ultrasonography was used to measure the changes in the transversus abdominis muscle thickness and the multifidus muscle cross-sectional area. [Results] The thickness of the transversus abdominis muscle and the cross-sectional area of the multifidus muscle in the NJF group, after resting, increased significantly and were higher than those in the PNF group. [Conclusion] The results show that significantly better improvement can be obtained for chronic low back pain by applying long-term intervention of NJF patterns.

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[Purpose] The purpose of this study was to examine the reliability of three isometric knee extension strength measurements (IKE) made with a hand-held dynamometer (HHD) and a belt of healthy elderly living in the community as subjects. [Subjects] The subject cohort consisted of 186 healthy elderly people, aged 65 to 79 years, living in local communities. [Methods] IKE of the leg subjects used to kick a ball was measured. IKE of each subject was measured three times using an HHD-belt at intervals of 30 seconds. The reliability of the larger of the first two measurements (LV2) as well as the third measurement (3V) was investigated. [Results] The intraclass correlation coefficients [ICC (1, 1)] for LV2 and 3V were 0.955. Bland-Altman analysis showed a fixed bias, and the limits of agreement ranged from −5.6 to 4.6. [Conclusion] The ICC results show that the test-retest reproducibility of IKE measurements of healthy elderly subjects using an HHD-belt is high. However, Bland-Altman analysis showed a fixed bias, suggesting the need for three measurements.

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[Purpose] The purpose of this study was to evaluate the lower limb muscle strength of the community-dwelling elderly, with or without cognitive decline, using isometric knee extension strength (IKES) and the 30-second chair stand test (CS-30). [Subjects] A total of 306 community-dwelling elderly participated in this study. Assessment items were the CS-30, IKES, Mini-Mental State Examination (MMSE), and Trail-Making Test Part A (TMT-A). [Methods] Participants were divided into three groups according to their MMSE score: cognitive impairment (MMSE ≤ 24), cognitive decline (MMSE 25 to 27), and normal (MMSE ≥ 28). We compared IKES and CS-30 among the three groups. [Results] IKES was not significantly different among the three groups. However, the CS-30 was significantly different among the three groups. Upon further analysis the CS-30 score of each group, when adjusted for age and TMT-A, did not indicate a significant difference. [Conclusion] These results suggest that the lower limb muscle strength of the elderly does not differ with cognitive decline. Moreover, we suggest that when using the CS-30 score as an indicator of lower limb muscle strength attentional function should be taken into account.

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[Purpose] This study was designed to study the correlation between biochemical tests and fatty liver. [Subjects and Methods] The study subjects were 242 people who received an abdominal ultrasound examination at a general hospital in Seoul, Korea, from March 2012 to March 2013. After the abdominal ultrasound examination, the subjects were categorized according to the presence or absence of fatty liver (n = 118 and 124, respectively). [Results] Comparison of biochemical markers revealed that glucose, total protein, aspartate transminase, alanine transaminase and triglyceride were higher in fatty liver patients. Risk analysis of general characteristics determined that hypertensive and diabetic patients had a 2.475- and 2.026-times greater risk of onset of fatty liver, respectively. The comparison of fatty liver with individual characteristics and biochemical markers revealed a 1.804-times greater chance of fatty liver when total protein was high, 0.964-times greater chance when high density lipoprotein was elevated and 1.204-times greater chance when triglyceride was elevated. When hypertension became severe, the chance of experiencing onset of fatty liver was 2.848 times higher. [Conclusion] Fatty liver is a representative disease of obese people in general and more active attention is necessary for its prevention and treatment. A direct cause of fatty liver was not found. Large-scale prospective studies will be required.

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[Purpose] The purpose of this study was to investigate how different standing surfaces alter somatosensory input and how postural control is affected by these changes during the performance of a dual task with a cognitive-motor aspect. [Subjects] The subjects were 20 chronic stroke patients: 18 males, 2 females. [Methods] COP total distance, sway velocity, and the weight load on the paretic leg were measured while subjects performed the following three tasks (somatosensory task, cognitive-motor task, and dual task). [Results] Both COP total distance and sway velocity significantly decreased during the performance of all tasks. COP total distance and sway velocity significantly decreased during the somatosensory task and the dual task. The weight load significantly increased during performance of the somatosensory task and the dual task. [Conclusion] Compensatory mechanisms in the non-paretic leg were limited by placing it on an air cushion, and we observed an increase in somatosensory input from the paretic leg due to an enhanced weight load.

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[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively.

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[Purpose] To compare outcomes of anterior cruciate ligament (ACL) reconstruction after open kinetic chain (OKC) exercises and closed kinetic chain (CKC) exercises. [Subjects and Methods] The subjects comprised 11 female and 47 male patients who are randomly divided into two groups: which performed a CKC exercise program Group I and Group II which performed an OKC exercise program. Pain intensity was evaluated using visual analogue scale (VAS). Knee flexion was evaluated using a universal goniometer, and thigh circumference measurements were taken with a tape measure at baseline and at 3 months and 6 months after the treatment. Lysholm scores were used to assess knee function. [Results] There were no significant differences between the two groups at baseline. Within each group, VAS values and knee flexion were improved after the surgery. These improvements were significantly higher in the CKC group than in the OKC group. There were increases in thigh circumference difference at the 3 and 6 month assessments post-surgery. A greater improvement in the Lysholm score was observed in the CKC group at 6 months. [Conclusion] The CKC exercise program was more effective than OKC in improving the knee functions of patients with ACL reconstruction.

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[Purpose] Forward walking (FW) and backward walking (BW) on a treadmill is a common tool for lower extremity rehabilitation in the clinical setting. The purpose of this study was to evaluate the effects on anaerobic performance and anthropometrical adaptations during FW and BW on a treadmill. [Subjects and Methods] A convenience sample of thirty healthy male subjects with a mean age of 20.93 ± 2.54 years participated in this study. Subjects were divided into 2 groups, a Forward Walking Group (FWG) (n=15) and a Backward Walking Group (BWG) (n=15), which performed FW and BW on a treadmill at 10° inclination, respectively. The training consisted of three sessions per week for 6 weeks. Study outcomes such as anaerobic performance and anthropometrical body composition were measured at pre- and post-intervention. [Results] Both FW and BW improved anaerobic performance significantly, and the BW group showed better performance than FW. However, changes in anthropometrical body composition were found to be not significant after six weeks of intervention in both the FW and BW groups. [Conclusions] BW training in rehabilitation can be considered more effective than FW at improving anaerobic performance. We also conclude that six weeks of FW and BW training is insufficient for eliciting changes in the body composition.

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[Purpose] The purpose of this study was to assess the correlation of gait parameters with fear of falling in stroke survivors. [Subjects] In total, 12 patients with stroke participated. [Methods] The subjects performed on a Biodex Gait Trainer 2 for 5 min to evaluate characteristic gait parameters. The kinematic gait parameters measured were gait speed, step cycle, step length, and time on each foot (step symmetry). All the subjects also completed a fall anxiety survey. [Results] Correlations between gait parameters and fear of falling scores were calculated. There was a moderate degree of correlation between fear of falling scores and the step cycle item of gait parameters. [Conclusions] According to our results, the step cycle gait parameter may be related to increased fall anxiety.

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[Purpose] The purpose of this study was to investigate the effects of indoor gateball exercise on life satisfaction and the prevention of falls by the elderly. [Subjects] Sixteen elderly subjects aged 65 or more, residents in nursing care facilities, were randomly divided into two groups. [Methods] One group performed indoor gateball exercise for 30 minutes a day, five times per week. The Tetrax fall index and life satisfaction were measured before and after four weeks of gateball exercise. [Results] The indoor gate ball exercise group showed significant improvements in the fall index and life satisfaction. [Conclusion] The indoor gateball exercise used in this study should be considered as a therapeutic method for the elderly, for improving their life satisfaction and because of its effectiveness in preventing falls.

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[Purpose] Based on the relationship between obesity and physical activity, several recent studies have reported that level of exercise is associated with household income. Hence, the purpose of this study is to explore the relationship between household income and physical activity in Korea. [Subjects and Methods] In 2012, 9,000 Koreans (4,479 men and 4,521 women) aged 10–89 years participated in the Korean Survey of Citizens’ Sports Participation project. This survey provided us with information on the amount of physical activity undertaken each week and the household incomes of a nationally representative sample of respondents. The relationship between household income and physical activity was then evaluated by conducting multiple logistic regression analysis after controlling for participant age. [Results] The present findings show a strong relationship between household income and physical activity for Korean men and women. [Conclusion] Further well-designed studies should be performed in order to determine the individual effects of household income on physical activity.

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[Purpose] This study aimed to determine whether muscle atrophy induced by ischemic reperfusion injury in rats can be prevented by the administration of antioxidants and exercise. [Subjects] Rats were randomly divided into five groups: non-treated, ischemic, exercise, ascorbic acid and exercise, and tocopherol and exercise. [Methods] The relative weight ratio of the soleus muscle and the length of the soleus muscle fiber cross-section minor axis were used for the evaluation of muscle atrophy. Pain was assessed as the weight-bearing ratio of the ischemic side. A multiple comparison test and the paired t-test were used for the statistical analyses. [Results] Compared with the non-treated group, the relative weight ratios of the soleus muscle and the lengths of the soleus muscle fiber cross-section minor axis significantly decreased in the other groups. Excluding the non-treated group, the relative weight ratios of the soleus muscle were heaviest in the tocopherol and exercise group. Excluding the non-treated group, the lengths of the soleus muscle fiber cross-section minor axis were longest in the tocopherol and exercise group, followed by the ischemic, exercise, and ascorbic acid and exercise groups. The amount of antioxidant substances did not decrease on the weight-bearing ratio of the ischemic side. [Conclusion] In this study, using an experimental rat model, we confirmed that antioxidants and exercise effect muscle atrophy induced by ischemic reperfusion. The results show that muscle regeneration was facilitated by phagocytosis in the tocopherol and exercise group.

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[Purpose] This study investigated the selective activation of the gluteus maximus during a prone hip extension with knee flexion exercise, with the hip joint in different positions. [Subjects] The subjects were 21 healthy, male volunteers. [Methods] Activities of the right gluteus maximus, right hamstrings, bilateral lumbar erector spinae, and bilateral lumbar multifidus were measured using surface electromyography during a prone hip extension with knee flexion exercise. Measurements were made with the hip joint in each of 3 positions: (1) a neutral hip joint position, (2) an abduction hip joint position, and (3) an abduction with external rotation hip joint position. [Results] Gluteus maximus activity was significantly higher when the hip was in the abduction with external rotation hip joint position than when it was in the neutral hip joint and abduction hip joint positions. Gluteus maximus activity was also significantly higher in the abduction hip joint position than in the neutral hip joint position. Hamstring activity was significantly lower when the hip was in the abduction with external rotation hip joint position than when it was in the neutral hip joint and abduction hip joint positions. [Conclusion] Abduction and external rotation of the hip during prone hip extension with knee flexion exercise selectively activates the gluteus maximus.

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[Purpose] The purpose of this study was to measure the cervical flexion-relaxation ratio (FRR) and intensity of neck pain and identify the differences according to postures adopted while using smartphones. [Subjects] Fifteen healthy adults with no neck pain, spinal trauma, or history cervical surgery participated in this study. [Methods] The activity of the cervical erector spinae muscle was recorded while performing a standardized cervical flexion-extension movement in three phases (flexion, sustained full flexion, extension). And neck pain intensity was recorded using a visual analog scale (VAS) with values between 0 and 10. Postures held while using a smartphone are distinguished between desk postures and lap postures. The FRR was calculated by dividing the maximal muscle activation during the extension phase by average activation during the complete flexion phase. [Results] No significant differences were found in the FRR between desk posture, lap posture, and baseline, though the intensity of the neck pain increased in the lap posture. [Conclusion] The FRR could be a significant criterion of neuromuscular impairment in chronic neck pain or lumbar pain patients, but it is impossible to distinguish neck pain that is caused by performing task for a short time. Prolonged lap posture might cause neck pain, so the use of smartphones for a long time in this posture should be avoided.

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[Purpose] The objective of this study was to determine the effect of indoor horseback riding and virtual reality exercises on the dynamic balance ability of normal adults. [Subjects] This study enrolled 24 normal adults and divided them into two groups: an indoor horseback riding exercise group (IHREG, n = 12) and a virtual reality exercise group (VREG, n = 12). [Methods] IHREG exercised on indoor horseback riding equipment and VREG exercised using the Nintendo Wii Fit three times a week for six weeks. The Biodex Balance System was used to analyze dynamic balance as measured by the overall stability index (OSI), anteroposterior stability index (APSI), and mediolateral stability index (MLSI). [Results] In the within-group comparison, IHREG and VERG both showed significant decreases in the dynamic balance indexes of OSI, APSI, and MLSI after the intervention, but no significant difference was found between the groups. [Conclusion] Both indoor horseback riding and virtual reality exercises were effective at improving the subjects’ dynamic balance ability as measured by OSI, APSI, and MLSI, and can be used as additional exercises for patients with conditions affecting postural control.

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[Purpose] In this study, we examined problematic behaviors of independent-walking and non-independent-walking handicapped children in the infant, school child and adolescent development phases, using the Japanese version of the Aberrant Behavior Checklist (ABC-J) to determine if such behaviors relate to their gross motor abilities. [Subjects and Methods] The subjects were 86 handicapped children who were receiving physical therapy. The subjects were classified into three groups by age. Using the Gross Motor Function Classification System (GMFCS), each group was further divided into an independent-walking group and non-independent-walking group. Thirteen physical therapists and 8 occupational therapists, who were treating the subject children, rated the subjects using the ABC-J. [Results] Significant differences were observed between the independent-walking and the non-independent-walking groups in the stereotypy and lethargy scores of infants. [Conclusion] For schoolchildren and adolescents, no significant differences were observed between the independent-walking and the non-independent-walking groups in their problematic behavior scores.

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[Purpose] The aim of this study was to evaluate the musculoskeletal symptoms, pain and risk of postures as well as the effects of stretching exercise on the work-related symptoms and pain of bus drivers. [Subjects and Methods] Eighty-one drivers were randomly recruited from a bus corporation for this study. Information about pain levels, painful regions, and general characteristics of subjects was obtained using the symptom research form (KOSHA Code H-30-2003). The level of pain was assessed on a scale of numeric rating scale (NRS) which is divided by 10. Ergonomic posture assessment was conducted using the rapid upper limb assessment (RULA). Self-stretching exercise was performed for 4 weeks by the bus drivers who suffered from neck and shoulder pain. [Results] Musculoskeletal symptoms were present in the order of shoulder, neck, lower back and lower extremities. Compared with other jobs, the final score, and the action level of bus drivers were very high, showing 57.6% of action levels 3 and 4. A statistically significant decrease of pain was shown after the self-stretching intervention. There was also a significant decrease of musculoskeletal symptoms in the neck and shoulders after the self-stretching exercise. [Conclusion] Performing stretching for musculoskeletal symptoms had a positive influence on the symptoms and reduced pain.

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[Purpose] The present study aimed to determine the changes in the muscle activities of the gluteus medius, latissimus dorsi, and gluteus maximus at different gait speeds, to collect basic data for the study of the gluteus medius. [Subjects and Methods] The subjects were 18 young and healthy male adults whose mean age, height, and weight were 26.4 years, 173.37 cm, and 72.5 kg, respectively. Electromyograpy was used to measure the maximum voluntary isometric contraction of each muscle three times and the values averaged. Then, the subjects walked on a treadmill at gait speeds of 1.5 m/s, 2.5 m/s, and 3.5 m/s and the muscle activity of each muscle was measured. [Results] The gluteus medius showed no significant difference in muscle activity among the different gait speeds. [Conclusion] For selectively strengthening the gluteus medius, to establish the external stability of the pelvis during walking, weight loading or sloped treadmills are effective interventions. However, different gait speeds exert no significant effect on the selective strengthening of the gluteus medius.

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[Purpose] The purpose of this study was to demonstrate the effects of expiration on abdominal muscle activity during maximum trunk flexion. [Subjects] Twenty-one healthy university students (10 men, 11 women) participated in this study. [Methods] Electromyography (EMG) was used to quantify the activity of the right rectus abdominis, external oblique, and internal oblique muscles. The paired t-test was used to examine the significance of differences in the abdominal muscles between maximum trunk flexion with breath holding and slow expiration. [Results] There was a significantly lower EMG activity in the external oblique muscle during maximum trunk flexion with slow expiration. [Conclusion] The results of this study indicate that slow expiration reduces external oblique muscle activity during maximum trunk flexion performed by healthy young subjects.

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[Purpose] The purpose of the present study was to examine the effects of progressive body weight supported treadmill forward and backward walking training (PBWSTFBWT), progressive body weight supported treadmill forward walking training (PBWSTFWT), progressive body weight supported treadmill backward walking training (PBWSTBWT), on stroke patients’ affected side lower extremity’s walking ability. [Subjects and Methods] A total of 36 chronic stroke patients were divided into three groups with 12 subjects in each group. Each of the groups performed one of the progressive body weight supported treadmill training methods for 30 minute, six times per week for three weeks, and then received general physical therapy without any other intervention until the follow-up tests. For the assessment of the affected side lower extremity’s walking ability, step length of the affected side, stance phase of the affected side, swing phase of the affected side, single support of the affected side, and step time of the affected side were measured using optogait and the symmetry index. [Results] In the within group comparisons, all the three groups showed significant differences between before and after the intervention and in the comparison of the three groups, the PBWSTFBWT group showed more significant differences in all of the assessed items than the other two groups. [Conclusion] In the present study progressive body weight supported treadmill training was performed in an environment in which the subjects were actually walked, and PBWSTFBWT was more effective at efficiently training stroke patients’ affected side lower extremity’s walking ability.

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[Purpose] The purpose of this study was to identify the distribution of stages of change in the exercise behavior of university students the transtheoretical model. [Subjects and Methods] Study subjects at four universities in G city were surveyed. A total of 1,000 questionnaires were distributed, and 959 responses were analyzed. The collected data was analyzed using descriptive statistics and multiple logistic regression analysis. [Results] Factors that contributed to the transition from the pre-contemplation stage to the contemplation stage included change-experimental processes (C-EP) and change-behavioral processes (C-BP). Factors that contributed to the transition from the contemplation stage to the preparation stage were C-BP and decisional decisional balance-cons (DB-C). Self-efficacy was the factor that contributed to the transition from the preparation stage to the action stage. However, there was no factor that contributed to the transition from the action stage to the maintenance stage. [Conclusion] When exercise behavior change is low, strategies such as giving one-to-one training, having the subjects read relevant books, and providing information are needed. When exercise behavior change is high, it is necessary to heighten self-efficacy by having subjects select and freely conduct appropriate kinds of exercises.

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[Purpose] The purpose of this study was to investigate the effects of exercise therapy on glucose, TNF-α and IL-6 blood levels in middle-aged women. [Subjects] A total of 46 participants were assigned to four groups: Type D personality+Exercise (n=12), Type D+no-Exercise (n=12), not-Type D+Exercise (n=12), and not-Type D+no-Exercise (n=10). [Methods] Blood glucose was measured by the hexokinase method. An enzyme-linked immunosorbent assay (ELISA) was used to measure the circulating plasma levels of TNF-α and IL-6 (Quantikine HS, R&D Systems, Minneapolis, USA). An aerobic exercise program and meditation were conducted in parallel by the Exercise groups for 10 months. Stretching was performed for 10 min as a warm-up, and then walking and running on a treadmill at 60 to 70% of HRmax were performed for 40 min three times a week. Blood samples were processed according to standard laboratory procedures. [Results] Fasting glucose showed a significant interaction effect among groups, group×time, and post-test. TNF-α showed a significant difference among groups, and was lower in the not-Type D personality+Exercise group than in the other three groups. IL-6 showed a significant difference among the groups. [Conclusion] In conclusion, personality may affect the established effect of exercise on cytokine activity. Type D personality was independently associated with significant immune activation, and increase in TNF-α activity was observed among Type D participants.

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[Purpose] The purpose of this study was to examine correlations between muscle activities and strap length and type of the school bag during walking. [Subjects and Methods] The subjects of this study were 20 healthy students. An 8-channel electromyograph (8-EMG) (Pocket EMG, BTS, Italy) was used to measure the muscle activities of the right upper trapezius, left upper trapezius, right erector spinae and left erector spinae during walking with the bag. The collected data were analyzed using Kendall’s coefficient of concordance. [Results] The muscle activities of the right upper trapezius, left upper trapezius, right erector spinae and left erector spinae were significantly higher when walking with a shoulder bag than when walking with a backpack. No significant correlations were found between muscle activities and strap lengths of the bag. [Conclusion] While carrying a bag, the activities of the trunk muscles were influenced more by the type of the bag than by the strap length. These results indicate that a backpack is a better method of carrying a load than a shoulder bag.

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[Purpose] Gait function after a stroke is an important factor for determining a patient’s ability to independently perform activities of daily living (ADL). The objective of this study was to elucidate the factors associated with gait function in post-stroke patients. [Subjects] Thirty-nine stroke patients (16 females and 23 males; average age 67.82 ± 10.96 years; post-onset duration: 200.18 ± 27.14 days) participated in this study. [Methods] Their gait function, motor function (Manual Muscle Test [MMT] and Brünnstrom stage), level of cognition (Mini-Mental State Examination score [MMSE], and the Loewenstein Occupational Therapy Cognitive Assessment for the Geriatric Population [LOTCA-G]), and ADL (Korean modified Barthel index [K-MBI]) were assessed. [Results] The degree of gait function showed significant positive correlations with the following variables: MMT of the elbow, knee, ankle and wrist; Brünnstrom stage; MMSE; LOTCA-G subscores except motor praxis; K-MBI. Stepwise linear regression analysis revealed the Brünnstrom stage was the only explanatory variable closely associated with gait level. [Conclusion] Gait function of post-stroke patients was related to motor function, cognition, and ADL. In particular, there is a significant association between gait level and the Brünnstrom stages, reflecting the importance of monitoring the motor recovery of gait function in post-stroke patients.

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[Purpose] This study compared the analgesic effects of transcutaneous electrical nerve stimulation (TENS) and interferential currents (IFC) on induced ischemic pain in healthy volunteers. [Subjects] The subjects were 36 volunteers (18 male, 18 female) without known pathology that could cause pain. Their mean age was 24.5±2.2 years. [Methods] A single-blind and parallel-group method was used. Subjects were randomly allocated to receive each 50 Hz TENS, 50 Hz IFC, 100 Hz TENS, and 100 Hz IFC. This study experimentally induced ischemic pain in otherwise pain-free subjects using a modified version of the submaximal effort tourniquet technique. Subjects completed twelve cycles of the ischemic-induced pain test. The primary outcome measure was the change in self-reported of pain intensity during one of four possible treatments. [Results] There were significant effects for Time, which were attributed to a significant reduction in pain intensity for all groups. There were no significant effects for groups or group-time interaction. The 50 Hz IFC treatment was more comfortable than the other treatments in the present study, and it is likely to be better accepted and tolerated by patients. [Conclusion] We conclude that there were no differences in the analgesic effects of the four treatments under the present experimental conditions. The 50 Hz IFC treatment is more comfortable than the other treatments.

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[Purpose] The purpose of the present study was to investigate the effects of robot-assisted gait training combined with functional electrical stimulation on locomotor recovery in patients with chronic stroke. [Subjects] The 20 subjects were randomly assigned into either an experimental group (n = 10) that received a combination of robot-assisted gait training and functional electrical stimulation on the ankle dorsiflexor of the affected side or a control group (n = 10) that received robot-assisted gait training only. [Methods] Both groups received the respective therapies for 30 min/day, 3 days/week for 5 weeks. The outcome was measured using the Modified Motor Assessment Scale (MMAS), Timed Up-and-Go Test (TUG), Berg Balance Scale (BBS), and gait parameters through gait analysis (Vicon 370 motion analysis system, Oxford Metrics Ltd., Oxford, UK). All the variables were measured before and after training. [Results] Step length and maximal knee extension were significantly greater than those before training in the experimental group only. Maximal Knee flexion showed a significant difference between the experimental and control groups. The MMAS, BBS, and TUG scores improved significantly after training compared with before training in both groups. [Conclusion] We suggest that the combination of robot-assisted gait training and functional electrical stimulation encourages patients to actively participate in training because it facilitates locomotor recovery without the risk of adverse effects.

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[Purpose] The purpose of the present study was to investigate the limb position at which the maximum toe-grip strength could be exerted as well as measurement reproducibility. [Subjects] Twenty healthy young women were selected. [Methods] We measured toe-grip strength under three conditions: 90° hip and knee flexion while sitting, 90° hip flexion and knee extension while sitting, and a standing position. [Results] We found that toe-grip strength was significantly lower in the 90° hip flexion and knee extension sitting position than in the 90° hip and knee flexion sitting position and standing position. Moreover, the 90° hip and knee flexion sitting position produced the best intraclass correlation coefficient (r = 0.813). [Conclusion] The results suggest that 90° hip and knee flexion while sitting is the most suitable limb position for measuring toe-grip strength, as this position allows maximum strength to be exerted and allows measurements to be repeated.

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[Purpose] The purpose of this study was to investigate the relationship between age and the maximum pelvic anteversion and retroversion angles, as well as the associated pelvic range of motion, measured in a sitting position with free knee movement. [Subjects] A total of 132 healthy volunteers (74 women, 58 men; age range, 20–79 years) were divided into six groups based on age (20–29, 30–39, 40–49, 50–59, 60–69, and 70–79 years). [Methods] The maximum pelvic anteversion and retroversion angles were measured manually five times by a goniometer in a sitting position that allowed free movement of the knee joints. [Results] There was a significant effect of age group on the maximum pelvic anteversion and retroversion angles and pelvic range of motion (the difference between these angles). There was a significant correlation between age and the maximum pelvic anteversion angle, maximum pelvic retroversion angle, and pelvic range of motion. [Conclusion] The maximum pelvic anteversion and retroversion angles and pelvic range of motion were significantly correlated with age. The maximum pelvic anteversion angle and pelvic range of motion were most affected by age.

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[Purpose] The purpose of this study was to compare the activation of the gluteus medius (Gmed), rectus femoris (RF), and biceps femoris (BF) muscles during neutral (N) sit to stand (STS) and STS involving hip abduction (ABD) in elderly females. [Subjects] We recruited 16 healthy elderly females with no pain in the knee joint or any other orthopedic problems of the lower limbs. [Methods] The activities of the dominant lower extremity muscles were measured using a wireless electromyography (EMG) system. Subjects then undertook a total of six STS trials: three for neutral STS and three for STS involving hip abduction. [Results] In the pre-TO phase, activation of the RF muscle was significantly increased during hip ABD. In the post-TO phase during hip ABD, Gmed muscle activation was significantly increased, and RF muscle activation was significantly decreased. [Conclusion] This study suggests that STS involving hip ABD is more effective in decreasing Gmed activation and reducing RF effort in elderly females.

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[Purpose] We sought to examine the relationship between lifestyle behavior and physical fitness in middle-aged and elderly laborers. [Subjects] In total, 2,469 male laborers between 45 and 64 years of age residing in eight cities in South Korea were studied between January and December 2007. [Methods] Age, height, and weight were evaluated as general characteristics. Lifestyle behavior items included exercise, dietary habits, smoking, drinking, and sleeping hours. Physical fitness was assessed by measuring muscle strength, muscle endurance, flexibility, reflexes, and agility. [Results] In terms of physical fitness status, all items except handgrip strength showed significant changes according to exercise frequency. Dietary habits were associated with significant differences in the Sargent jump and whole-body reaction time between groups. Smoking and drinking were associated with significant differences in sit-ups between subgroups. Sleeping hours demonstrated significant differences in the Sargent jump and whole-body reaction time between groups. [Conclusion] Although there were differences according to physical fitness status, exercise frequency, dietary habits, smoking, drinking, and sleeping hours showed significant associations with physical fitness. Thus, healthy lifestyle behaviors, such as regular exercise, regular dietary habits, not smoking, moderate drinking, and adequate sleep, are important for physical fitness management and work capacity improvement in middle-aged and elderly laborers.

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[Purpose] This study aimed to examine the validity and internal consistency of the Japanese version of a performance evaluation tool for activities of daily living (ADL) based on the modified Barthel Index (PET-MBI) among elderly people at home. [Subjects] The subjects were elderly people living at home in Japan. [Methods] A cross-sectional study was performed at five home care facilities for elderly people in Japan. ADL performance was evaluated for 128 participants using the PET-MBI, which included 10 self-care items. We used confirmatory factor analysis to estimate the factorial validity. We assessed data model fitness with the χ² statistic, the Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), and Root Mean Square Error of Approximation (RMSEA). Cronbach’s alpha coefficient was used to determine the internal consistency. [Results] The mean age of the participants was 79.1±8.9 years. Among the 126 participants included in the analysis, 67 were women (53.2%). The single-factor model demonstrated a fair fit to the data, with the χ² statistic = 74.9 (df =35), GFI = 0.88, AGFI = 0.81, and RMSEA = 0.096, and the path coefficients of each item ranged from 0.44 to 0.95. The alpha coefficient of the 10-item scale was 0.93. [Conclusion] The PET-MBI for elderly people at home was well validated.

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[Purpose] Cast immobilization- and cell starvation-induced loss of muscle mass are closely associated with a dramatic reduction in the structural muscle proteins. Heat shock proteins are molecular chaperones that are constitutively expressed in several eukaryotic cells and have been shown to protect against various stressors. However, the changes in the phosphorylation of atrophy-related heat shock protein 27 (HSP27) are still poorly understood in skeletal muscles. In this study, we examine whether or not phosphorylation of HSP27 is changed in the skeletal muscles after cast immobilization and serum-free starvation with low glucose in a time-dependent manner. [Methods] We undertook a HSP27 expression and high-resolution differential proteomic analysis in skeletal muscles. Furthermore, we used western blotting to examine protein expression and phosphorylation of HSP27 in atrophied gastrocnemius muscle strips and L6 myoblasts. [Results] Cast immobilization and starvation significantly upregulated the phosphorylation of HSP27 in a time-dependent manner, respectively. [Conclusion] Our results suggest that cast immobilization- and serum-free starvation-induced atrophy may be in part related to changes in the phosphorylation of HSP27 in rat skeletal muscles.

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[Purpose] Older adults experience exhaustion-induced health problems, such as poor physical function and low physical activity levels. The associations between self-reported exhaustion and physical function and activity are not clear in older adults with mild cognitive impairment (MCI). The aim of this study was to investigate the relationships between self-reported exhaustion and physical function and activity in older adults with mild cognitive impairment. [Subjects] A total of 356 older adults with mild cognitive impairment (mean age = 71.6 ± 0.3 years, 50.8% women) were included in this study. [Methods] Self-reported exhaustion was identified by one item from the Study of Osteoporotic Fractures index. Gait speed, gait endurance, and life space were also assessed. [Results] Sixty-two participants reported having exhaustion, giving a 17.4% prevalence of self-reported exhaustion among these individuals. Logistic regression analysis showed that the Life-Space Assessment score was the only parameter significantly independently associated with exhaustion status (adjusted odds ratio 0.97, 95% confidence interval 0.95–0.99). [Conclusion] These results suggest that self-reported exhaustion is associated with life space. Future research is needed to identify ways for older people with MCI to improve their exhaustion status.

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[Purpose] The purpose of this study was to determine the effects of lumbar joint mobilization on the joint position sense (JPS) of normal adults. [Subjects] A total of 30 normal adults were divided into an experimental group (n = 15) and a control group (n = 15). [Methods] The experimental group received lumbar joint mobilization and massage, and the control group received massage only. Both the experimental and control groups were evaluated for joint position error (JPE) by using a digital dual inclinometer before and after the experiment. [Results] In the before and after comparison for the experimental group, statistically significant differences were found in flexion, extension, left lateral flexion, and right lateral flexion. There was no statistically significant difference in the before and after comparison for the control group. [Conclusion] Because lumbar joint mobilization can reduce JPE and improve JPS, its use in the treatment of patients with lumbar problems is recommended.

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[Purpose] The purpose of the current study was to investigate the relationship between postural sway and dynamic balance in post stroke patients. [Subjects] Thirty-one stroke patients (20 men and 11 women; age 64.25 years; stroke duration 12.70 months; MMSE-K score 26.35) participated in this study. [Methods] This study applied a cross-sectional design. A Good Balance system was used for measurement of the postural sway velocity (anteroposterior and mediolateral) and velocity moment of subjects under the eyes open and eyes closed conditions in a standing posture. The postural sway of subjects was measured under two surface conditions (stable and unstable surfaces). [Results] On the unstable surface (foam), no significant correlation was observed between postural sway and dynamic balance except for the berg balance scale (BBS) score and anteroposterior postural sway velocity under the eyes open condition, anteroposterior postural sway velocity under the eyes closed condition, and postural sway velocity moment. In addition, in the stable condition, no significant correlation was observed between postural sway and dynamic balance. [Conclusion] Our results indicate that a decrease in postural sway does not necessarily reflect improvement of dynamic balance ability. We believe that this finding may be useful in balance rehabilitation for prevention of falls after a stroke.

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[Purpose] This study performed a systematic literature review of the ability of lumbar stabilization exercises (LSE) to improve the balance ability of stroke patients. [Subjects and Methods] A systematic review was conducted of four databases. The papers retrieved were evaluated based on the following inclusion criteria: 1) design, a controlled clinical trial; 2) intervention, LSE; 3) outcome, change in balance ability; and 4) year of publication, 2000 to 2013. [Results] The findings of 6 papers were compared to determine the effects of lumbar stabilization exercises on stroke patients’ balance abilities. The papers had methodological quality scores of 5–8 on the PEDro scale. [Conclusion] Lumbar stabilization exercises have a positive influence on stroke patients’ balance abilities.

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[Purpose] This study examined the effects of the intrinsic foot muscle exercise combined with interphalangeal flexion exercise on metatarsalgia with Morton’s toe. [Subject] A 38-year-old male with Morton’s toe, who complained of pain in his left metatarsophalangeal joints was the subject. [Methods] The pressure pain threshold, peak contact pressure of the metatarsophalangeal region during gait, and the navicular drop were measured before and after the intrinsic foot muscles exercises combined with interphalangeal flexion exercise. [Results] After exercising for 2 weeks, the pressure pain threshold increased from 1 to 1.5 kg, while the peak contact pressure decreased from 0.63 to 0.50 kg/cm², and the navicular drop improved from 5 to 8 mm. [Conclusion] The results show that the combined exercises alleviated the pain while walking by reducing the excessive pressure on the metatarsophalangeal region, and the improvement of gait with Morton’s toe.

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[Purpose] This study aimed to identify the effects of cervical deep muscle strengthening (CDS) on neck pain in a patient with Klippel-Feil syndrome (KFS). [Subjects and Methods] The subjects was a 39 year-old woman with neck pain and KFS that included incomplete block vertebrae in the C2–3 segments and block vertebrae in the C6–7 segments. The subject performed an exercise program including cervical strengthening exercise (level 1) and CDS exercise (level 2) for 6 weeks. Neck pain intensity was measured using the visual analogue scale (VAS) and the pressure pain threshold (PPT). All measurements were obtained before and after the CDS exercise program. [Results] The VAS and PPT measurements decreased; range of motion in the cervical joint increased. [Conclusion] CDS exercises were effective interventions for reducing neck pain in a patient with Klippel-Feil syndrome.

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[Purpose] This study was performed to investigate the effects of yogic exercises on life stress and blood glucose levels in nursing students. [Subjects and Methods] The study was a randomized controlled trial. Twenty-seven undergraduate nursing students were randomly selected, with 12 assigned to an exercise group and 15 assigned to a control group. The yogic exercises intervention was undertaken for 60 minutes one day a week for 12 weeks. It consisted of physical exercise (surya namaskara) combined with relaxation and meditation (shavasana and yoga nidra). Life stress was measured by the Life Stress Scale for College Students, and postprandial blood glucose levels were measured with a digital glucometer. [Results] The exercise group measurements were significantly decreased in both life stress and postprandial blood glucose levels compared with the control group. [Conclusion] These findings indicate that yogic exercises would reduce life stress and lower postprandial blood glucose levels in nursing students.

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[Purpose] The purpose of this study was to investigate the effect of a complex exercise program for elderly people who had experienced a fall on their balance, gait, vestibular senses, and proprioceptive senses when their visual sense was blocked. [Subjects and Methods] The subjects were 30 healthy elderly people aged 65 or older. They were equally and randomly divided into a visual block (VB) group (those whose eyes were covered) and a visual permission (VP) group. The subjects performed the complex exercise program for 30 minutes, twice a day, five day a week for 4 weeks a total of 20 times. Outcome measures were the10 meter walking test (10MWT), stair up/down test (SUDT), Berg balance scale (BBS), vestibular stepping test (VST), proprioception test (PT). [Results] After the intervention, the VB group showed improvements in 10MWT, VST, and PT. The VP group showed improvements in 10MWT and PT. The significant improvement in VST observed in the VB group was significantly greater than that in the VP group. [Conclusion] The complex exercise program for elderly people helped enhance their balance ability and gait, and improved their vestibular sense.

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