[Purpose] This study compared the isolated contraction ratios of the hip extensors, erector spinae muscles of the lumbar region, and thoracic muscles during different back extension exercises. [Subjects] Twelve males participated in this study. [Methods] The subjects performed various back extension exercises. The activities of the T7 erector spinae muscles, L3 erector spinae muscles, and the gluteus maximus were measured, and the isolation contraction ratios were calculated. [Results] The isolated contraction ratio of the T7 erector spinae muscles significantly increased during exercise 2. The isolated contraction ratio of the gluteus maximus increased by a significant degree during exercise 1 compared with the other exercises. [Conclusion] This study demonstrated that the back extension exercises 1 and 2 can be applied to selectively exercise the hip extensors, thoracic muscles, and muscles of the lumbar region.

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[Purpose] The aim of this study was to investigate the clinical usefulness of a novel apparatus intended to improve the consistency and reliability of the deep tendon reflex (DTR) test. [Subjects] The participants included 50 healthy adults (25 male and 25 female) between 20 and 31 years of age who showed no knee abnormalities upon physical examination. [Methods] The intraclass correlation coefficient (ICC) was used to verify inter-rater reliability for two parameters examined in the DTR test using a newly designed apparatus. These parameters were the patellar reflex amplitude and first knee extension angle. Pearson’s product correlation coefficient was then used to examine the correlation between these two parameters. [Results] The inter-rater reliability analysis showed a high correlation between the examiners for both DTR parameters (ICCs = 0.91–0.96). In addition, a significant positive correlation was observed between the two parameters (r = 0.91). [Conclusion] The results show that it is possible to use the novel apparatus described herein to obtain reliable results in the DTR test.

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[Purpose] This study investigated the association between the weight-bearing ratio (WBR) and gait ability of a paretic lower limb while walking using a shoe-type load-measuring apparatus. [Subjects] The Subjects comprised 17 stroke patients who were classified into the following two groups: the independent walking group, and the non-independent walking group. [Methods] The 10-m walking time (inside and outside parallel bars) and the Berg Balance Scale (BBS) were measured. The WBR of the paretic lower limb was measured during static standing and while walking inside and outside parallel bars, and the coefficient of variation (CV) was calculated. WBR was evaluated using the Step Aid. [Results] The BBS and WBR were significantly decreased in the non-independent walking group, while the 10-m walking time and the CV were significantly increased in the non-independent walking group. [Conclusion] The CV and WBR of a paretic lower limb while walking appear to be important indices of achievement of independent gait in hemiplegic stroke patients, and they may be used in gait rehabilitation for diseases requiring weight-bearing training to follow the course of training using a shoe-type load-measuring apparatus.

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[Purpose] We aimed to determine the effects of ventilation feedback using electrical stimulation on ventilation pattern during exercise in patients with chronic obstructive pulmonary disease (COPD), and develop new rehabilitation methods. [Subjects] This randomized double-blind placebo-controlled trial included 24 patients with COPD. [Methods] Phasic electrical stimulation during expiration (PESE) or a placebo was given to all the cases. Minute ventilation (VE), tidal volume (TV), respiratory rate (RR), expiratory time (Te), total respiratory time (Ttot), dead-space gas volume to tidal gas volume (VD/VT), oxygen uptake (VO₂), carbon dioxide output (VCO₂), Borg scale (Borg), and percutaneous oxygen saturation (SpO₂) during rest and exercise were assessed. [Results] The placebo group showed no obvious change in ventilation measurements at rest or during exercise. However, in the PESE group, TV, Te, and Ttot significantly increased, while RR and VD/VT significantly decreased during exercise compared with the baseline measurements. Borg scores, SpO₂, VO₂, or VCO₂ did not differ significantly. [Conclusion] PESE improves the ventilation pattern during rest and exercise. Furthermore, PESE does not increase VO₂, which may indicate an increased workload. Biofeedback may contribute to PESE effects. Stimulation applied during expiration may evoke sensations increasing prolonged expiration awareness, facilitating prolongation.

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[Purpose] The aim of this study was to determine fall incidence and explore clinical factors of falls among older Chinese veterans in military communities. [Subjects and Methods] We carried out a 12-month prospective study among 13 military communities in Beijing, China. Fall events were obtained by self-report to military community liaisons and monthly telephone interviews by researchers. [Results] Among the final sample of 447 older veterans, 86 fell once, 25 fell twice or more, and 152 falls occurred altogether. The incidence of falls and fallers were 342/1,000 person-years and 249/1,000 person-years. In Cox regression models, independent clinical factors associated with falls were visual acuity (RR=0.47), stroke (RR=2.43), lumbar diseases (RR=1.73), sedatives (RR=1.80), fall history in the past 6 months (RR=2.77), multiple chronic diseases (RR=1.53), multiple medications (RR=1.34), and five-repetition sit-to-stand test score (RR=1.41). Hearing acuity was close to being statistically significant. [Conclusion] The incidences of falls and fallers among older Chinese veterans were lower than those of Hong Kong and western countries. The clinical risk factors of falls were poor senses, stroke, lumbar diseases, taking sedatives, fall history in the past 6 months, having multiple chronic diseases, taking multiple medications, and poor physical function. The preventive strategies targeting the above risk factors are very significant for reducing falls.

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[Purpose] The purpose of the study was to investigate the effects of action observation training on the static balance and walking ability of patients who had suffered a stroke. [Subjects] Forty patients with hemiplegia resulting from a stroke were divided into an action observation gait training group (AOGT group, n=20) and a general gait training group (GGT group, n=20). [Methods] The AOGT group watched a training video on flatland gait, slope gait, and stair gait. The GGT group watched a video on nature. Both groups watched their respective video for 10 minutes and then had gait training for 20 minutes per day, five times per week, for eight weeks. [Results] The static balance and gait ability of both groups significantly improved. Although there were significant differences between the groups, the AOTG group showed greater improvements in sway speed, limit of stability, and gait ability. [Conclusion] We recommend action observation training over general gait training for patients with hemiplegia. Action observational training had a positive effect on static balance and gait ability in stroke patients’ static balance and gait ability. Further research is needed to generalize the results of this study.

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[Purpose] The purpose of this study was to compare hip range of motion between a lumbar stability group and a lumbar instability group, and to evaluate the effectiveness of hip exercises for low-back pain patients with lumbar instability. [Subjects] Seventy-eight patients with chronic low-back pain were the subjects. [Methods] The patients were divided into two groups: a lumbar stability group (n=45) and a lumbar instability group (n=33). They were assessed using the Korean version of the Oswestry Disability Index (KODI) to determine the level of disability of the patients with low-back pain. A 100 mm visual analog scale (VAS) was used to assess low-back pain. [Results] The limitation of hip range of motion of the lumbar instability group was significantly greater than that of the lumbar stability group. Comparisons among four groups at three weeks and six weeks after the start of hip exercises revealed that the VAS score of each group had significantly decreased. Comparisons among four groups at three weeks and at six weeks after the start of hip exercises revealed that the KODI score of each group had significantly decreased. [Conclusion] These findings suggest that the performance of hip exercises by chronic low-back pain patients with lumbar instability is more effective than conventional therapy at reducing low-back pain and levels of disability.

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[Purpose] The purpose of this study was to compare differences in hip range of motion between a lumbar stability group and a lumbar instability group of patients with chronic low-back pain. [Subjects] Sixty-nine patients with chronic low-back pain were divided into two groups: a lumbar stability group (n=39) and a lumbar instability group (n=30). [Methods] The patients were assessed using a goniometer to evaluate the hip range of motion at pre-test. Data were analyzed using SPSS 18.0 software for Windows. The experimental data were analyzed using one-way ANOVA, repeated one-way ANOVA, and the t-test, and a significance level of 0.05. [Results] The limitation of hip range of motion of the lumbar instability group was significantly greater than that of the lumbar stability group. [Conclusion] The chronic low-back pain patients showed greater limitation of hip range of motion than healthy persons, and among them, those who had lumbar instability showed greater limitation than those with lumbar stability.

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[Purpose] The present study aimed to determine changes in muscle activity while moving on a treadmill at various speeds. [Subjects] The activities of the left vastus lateralis, vastus medialis, hip adductors, lateral head of gastrocnemius, medial head gastrocnemius, soleus, and tibialis anterior of 10 healthy male university students were analyzed. [Methods] University students walked, jogged, and ran for 10 minutes each in random order, and then myogenic potentials were measured 10 minutes later for 30 seconds. The flexion angle of the lower limb upon initial contact, mid stance, and toe off were measured. [Results] The average walking, jogging, and running speeds were 3.6 ± 0.4, 6.7 ± 0.6, and 10.4 ± 1.3 km/h, respectively. The average electromyographic activities of the vastus medial, tibialis anterior, medial head of gastrocnemius, and lateral head of gastrocnemius significantly differed. All muscles were more active during jogging and running than walking. Only the soleus was more active during running than walking, and the activities of the hip adductors and vastus lateralis did not significantly differ. [Conclusion] Velocity is faster and the angles of the lower limbs and ground reaction force (GRF) are larger during running than walking. The vastus medialis and soleus worked more easily according to the angle of the knee joint, whereas the tibialis anterior worked more easily at faster velocities and the medial and lateral heads of the gastrocnemius worked more easily with an increased GRF.

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[Purpose] The purpose of this study was to clarify the difference in gait parameters of at-home walking and the 10-meter walking test results of individuals with hemiparesis. [Subjects] A total of 14 hemiparetic stroke recovery patients participated in this study. Inclusion criteria were: living at home, the ability to walk independently, and demonstrated low extremity on recovery stages III–V on the Brunnstrom Approach. The average age of the subjects was 66 years. [Methods] We used video surveillance and the inked footprint technique to record usual walking speed and maximum speed patterns both in subjects’ homes and during the 10-meter walking test. From these methods, walking speed, stride length, and step rate were calculated. [Results] While both usual and maximum walking speeds of the 10-meter walking test correlated with stride length and step rate, at-home walking speeds only significantly correlated with stride length. [Conclusion] Walking patterns of the 10-meter walking test are quantifiably distinct from those demonstrated in patients’ homes, and this difference is mainly characterized by stride length. In order to enhance in-home walking ability, exercises that improve length of stride rather than step rate should be recommended.

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[Purpose] The aim of this study was to access the flexibility of the spine in women practicing yoga as a part of the “University for Health” project. [Subjects and Methods] The study included 56 women ranging in age between 50–79 and attending 90 minutes hatha yoga sessions once a week. The measurements were performed twice-at the beginning of the project and after its completion, i.e., after 20 weeks of classes. The range of spine mobility in three planes was measured using a Rippstein plurimeter. The range of motion in the sagittal and frontal planes was measured in a standing position with the feet hip-width apart. The torsional range of motion of the subjects was measured with the trunk bent at a right angle and the legs apart. The flexibility ranges of the spine and hamstrings were also measured by the toe-touch test in a standing position. [Results] This study showed that the applied yoga exercises increased spinal mobility and flexibility of the hamstring muscles regardless of age. [Conclusion] Yoga exercises should be recommended to the elderly to make their muscles more flexible and to increase the range of motion in the joints, which is particularly important for improving their life quality.

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[Purpose] The purpose of this study was to examine the effects of selective exercise for the deep abdominal muscles (SEDA) and lumbar stabilization exercise (LSE) on the thickness of the transversus abdominis and postural maintenance on an unstable base of support. [Subjects and Methods] The subjects of this study were 20 male and 10 female adults in their 20s without lumbar pain. They were equally and randomly assigned to a SEDA group and a LSE group. The thickness of the transversus abdominis was measured using ultrasound imaging during rest and drawing-in. The thickness of the transversus abdominis was measured when subjects raised their right and left legs while lying on a Swiss ball. [Results] Initially, there were no differences between the two groups. After the intervention, significant differences were observed in all parameters. A significant interaction between group and period was not found for any parameters. [Conclusion] In conclusion, both SEDA and LSE thickened the transversus abdominis, which is a deep abdominal muscle, thereby adjusting posture, and stabilizing the trunk. These exercises increased the thickness of the deep abdominal muscles. They are important exercises for improving the stability of athletes or patients who need postural adjustment.

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[Purpose] The purpose of this study was to determine the effect of proprioceptive training on foot progression angle, weight-bearing ratio, and knee adduction moment in patients with degenerative osteoarthritis of the knee. [Subjects] The subjects were 37 patients diagnosed with Kellgren-Lawrence grade 2 or 3 degenerative knee osteoarthritis. They were randomly allocated to three groups: a proprioceptive training group (PT group), quadriceps strengthening group (QS group), and control group. [Methods] The study parameters of the three groups were compared before and after a 12-week training period. Therapeutic exercises were performed twice per week for 12 weeks. Outcomes included the foot progression angle, weight-bearing ratio, and knee adduction moment. [Results] First, a significant difference in the foot progression angle was observed among the groups, significantly increasing in the PTG compared with the CG. Second, a significant difference in the weight-bearing ratio was observed among the groups, significantly increasing in the PTG compared with the CG. Third, a significant difference in the first peak knee adduction moment was observed among the groups, significantly decreasing in the PTG compared with the CG. [Conclusion] The results of the present study indicate that proprioceptive training increased the foot progression angle and weight-bearing ratio and decreased the first peak knee adduction moment. Moreover, incorporating proprioceptive training into a physical therapy exercise program could improve functional ability and delay the progression of degenerative osteoarthritis.

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[Purpose] The purpose of this study was to compare the relative levels of activation of the gluteus medius (Gmed) and rectus femoris (RF) muscles during natural (N) sit-to-stand (STS) and STS with hip abduction (ABD) in young and elderly females. [Subjects] We recruited 15 healthy young females and 15 healthy elderly females. [Methods] The activities of the dominant lower extremity gluteus medius (Gmed) and rectus femoris (RF) muscles were measured using a wireless electromyography (EMG) system for natural STS and STS with hip abduction. [Result] In the elderly subjects, the Gmed increased significantly and RF decreased significantly when STS was performed with hip ABD compared with when it was performed naturally. The Gmed in the elderly subjects was significantly increased during natural STS compared with in the young subjects. [Conclusion] These results indicate that the Gmed was recruited to compensate for weakened RF muscle function in the elderly adults.

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[Purpose] The aim of current study was to investigate the effect of external cues using vibratory stimulation on spatiotemporal gait parameters in patients with chronic stroke. [Subjects] Thirty patients, who had suffered a stroke, were selected from general hospitals in Seoul, Republic of Korea. [Methods] Each participant was subjected to six walking trials: three trials with vibratory stimulation of the tibialis anterior muscle and three trials without any stimulation. The spatiotemporal gait parameters were measured with a GAITRite system. [Results] The global gait parameters—velocity and cadence—were significantly more increased, and the temporal parameters—step time, stride time, and double limb support—were significantly more decreased with vibratory stimulation of the tibialis anterior muscle than with no stimulation. While single limb support was increased under vibratory stimulation, the difference was not significant between the two groups. The spatial gait parameter—stride length—showed a significant improvement; however, there was no significant enhancement in gait symmetry with regard to step length and step time [Conclusion] These results indicate that the application of external cues using vibratory stimulation during gait may control gait parameters and improve gait performance. Thus, this intervention could be used for gait rehabilitation in chronic stroke patients.

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[Purpose] The purpose of this study was to compare the effects of an abdominal drawing-in maneuver (ADIM), measured using a pressure bio-feedback unit, on the activities of the hamstring, gluteus maximus, and erector spinae muscles during prone hip extension. [Subjects and Methods] Thirty healthy adult subjects (14 male, 16 female), were recruited. Subjects’ lumbar lordosis and pelvic tilt angles were measured, and based on the results, the subjects were divided into two groups: a hyperlordotic lumbar angle (HLLA) group (n=15) and a normal lordotic lumbar angle (NLLA) group (n=15). The muscle activities of the hamstring and gluteus maximus, and of the erector spinae on the right side of the body, were recorded using surface electromyography. [Results] When performing ADIM with prone hip extension, the muscle activity of the gluteus maximus of the HLLA group significantly improved compared with that the NLLA group. [Conclusion] This study demonstrated that ADIM with prone hip extension was more effective at eliciting gluteus maximus activity in the HLLA group than in the NLLA group. Therefore, ADIM with prone hip extension may be useful for increasing the gluteus maximus activity of individuals with lumbar hyperlordosis.

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[Purpose] The purpose of this study was to investigate gait velocity and center of mass (COM) during square and semicircular turning gaits between two groups of elderly people with differing visual acuity. [Subjects] Twenty elderly Korean women who could walk independently and who lived in the community were recruited. [Methods] We measured gait velocity and COM using an accelerometer during two different turning gaits. [Results] The velocity during square and semicircular turning gaits of participants with good binocular visual acuity (GBVA) was significantly higher than that of participants with poor binocular visual acuity (PBVA). The COM during square and semicircular turning gaits of the GBVA group was significantly decreased compared with that of the PBVA group. [Conclusion] These findings suggest that visual acuity affects velocity and COM during square and semicircular turning gaits of elderly people.

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[Purpose] The aim of the present study was to analyze the psychometric properties of the Stroke Specific Quality of Life (SS-QOL) scale for the assessment of social participation following a stroke. [Methods] A preliminary analysis was performed of the SS-QOL items that address the participation category. For this, the scoring patterns of the answers of individuals and internal consistence were determined using the Rasch model. Reliability was assessed by intraclass correlation coefficients (ICC). [Results] The reliability coefficients analyzed by the Rasch model were 0.91 for the items and 0.87 for the patients. The separation index was 3.19 for the items and 2.58 for the patients. The findings indicate that the items separated the patients into three levels of participation: low, medium, and high. Among the 26 items addressing participation, three did not fit the model. All items showed adequate reliability (ICC ≥ 0.60). [Conclusion] The Rasch analysis detected three items with erratic behavior; however, the erratic patterns of these items may be explained by individual peculiarities among the patients. These items should be monitored to determine if the problems found in the present study persist. If so, the items should also be revised or possibly even eliminated.

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[Purpose] The purpose of the current study was to clarify problems associated with swallowing, related to nutrition and activities of daily living (ADL), in elderly individuals with sarcopenia. [Subjects and Methods] Seventy-seven subjects were assigned to a sarcopenia or a non-sarcopenia group according to a definition used by the European Working Group on Sarcopenia in Older People. Analyses were conducted including and excluding subjects with a central nervous system disorders in order to focus on the influence of sarcopenia. The swallowing ability, ADL, and nutrition levels were compared between the 2 groups. [Results] Swallowing function as well as ADL and nutrition levels were significantly lower in the sarcopenia group than in the non-sarcopenia group. [Conclusion] It is important to include dimensions of swallowing, nutrition, and ADL in the assessment and treatment of swallowing problems in elderly individuals with sarcopenia.

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[Purpose] The purpose of this study was to examine the effects of extracorporeal shock wave therapy on pain, disability, and depression of chronic low back pain patients. [Subjects] In this study, 30 chronic low back pain patients were divided into an extracorporeal shock wave therapy group (ESWTG, n=15) and a conservative physical therapy group (CPTG, n=15). [Methods] The ESWTG received extracorporeal shock wave therapy and the CPTG received general conservative physical therapy two times per week for six weeks. Pain was measured using a visual analog scale (VAS), the degree of disability of the patients was assessed using the Oswestry Disability Index (ODI), and their degree of depression was measured using the Beck depression index (BDI). [Results] In intra-group comparisons, ESWTG and CPTG showed significant decreases in VAS, ODI, and BDI scores. Intergroup comparisons revealed that these decreases in VAS, ODI, and BDI scores were significantly larger in ESWTG than in CPTG. [Conclusion] Extracorporeal shock wave therapy is an effective intervention for the treatment of pain, disability, and depression in chronic low back pain patients.

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[Purpose] The purpose of this study was to determine differences in respiratory pressure and pulmonary function among children with spastic diplegic and hemiplegic cerebral palsy (CP) in comparison with children with normal development. [Subjects and Methods] Fourteen children with spastic diplegic CP, 11 children with hemiplegic CP, and 14 children with normal development were recruited. Respiratory pressure was measured and the pulmonary function test (PFT) was performed to evaluate the strength of the respiratory muscles and lung volumetric capacity. [Results] Regarding respiratory pressure, children with spastic diplegic and hemiplegic CP showed significantly lower functions in terms of MIP and MEP compared with children with normal development, although no significant differences were found between children with the two types of CP. In the pulmonary function test, children with spastic diplegic CP showed significantly higher pulmonary function than children with normal development in terms of only FVC and FEV₁. [Conclusion] Children with CP showed relatively lower function in terms of respiratory pressure and lung capacity, in comparison with children with normal development. Therefore, respiratory function in children with CP should be carefully evaluated and should receive more attention in a rehabilitation setting.

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[Purpose] The purpose of this study was to investigate satisfaction in major among physical therapy students and to identify the sub-factors of satisfaction in major affecting academic achievement. [Subjects and Methods] We distributed a self-administered questionnaire, comprising items relating to satisfaction in major and academic achievement to 369 physical therapy students located in Seoul, Daejeon, Jinju, Pohang, and Gunsan. [Results] General satisfaction and academic achievement showed the greatest correlation (r = 0.235), followed by course satisfaction (r = 0.123). [Conclusion] Several sub-factors were found to affect academic achievement. The results of this study can be used as the basis for programs that aim at development of satisfaction in major and academic achievement among clinical physical therapists.

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[Purpose] The purpose of this study was to find the effects of a visual perceptual intervention on visual-motor integration and activities of daily living performance of children with cerebral palsy as subjects. [Methods] This study was conducted with 56 children who were diagnosed as having cerebral palsy. The visual perceptual intervention was implemented for 8 weeks, 3 times a week, for 30 minutes per session, for a total of 24 sessions. All children were assessed using the VMI and WeeFIM to evaluate visual motor integration and activities of daily living skills, immediately before and after the 8-week intervention. [Results] The VMI and WeeFIM scores of all of the 56 children with CP who participated in the study improved, and the improvements were statistically significant. [Conclusion] Visual perceptual intervention had a positive influence on the visual-motor integration and activities of daily living performance of children with cerebral palsy.

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[Purpose] This study was performed to examine how the balance of lower limbs and the muscle activities of the tibialis anterior (TA), the medial gastrocnemius (GCM), and the peroneus longus (PL) are influenced by isotonic and isokinetic exercise of the ankle joint. [Subjects] The subjects of this study were healthy adults (n=20), and they were divided into two groups (isotonic=10, isokinetic=10). [Methods] Isotonic group performed 3 sets of 10 contractions at 50% of MVIC and Isokinetic group performed 3 sets of 60°/sec. Muscle activity was measured by EMG and balance was measured by one-leg standing test. [Results] For muscle activity, a main effect of group was found in the non-dominant TA, and the dominant TA, GCM and PL. For balance, a main effect of time was found in both groups for the sway area measured support was provided by the non-dominant side. [Conclusion] In terms of muscle activity, the two groups showed a significant difference, and the isokinetic group showed higher muscle activities. In terms of balance, there was a significant difference between the pre-test and the post-test. The results of this study may help in the selection of exercises for physical therapy, because they show that muscle activity and balance vary according to the type of exercise.

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[Purpose] The purpose of this study was to investigate the effects of a forced-use training program on gait, mobility and quality of life of post-acute stroke patients. [Subjects] Twenty-one individuals with unilateral stroke participated in this study. All participants had suffered from first-ever stroke with time since onset of at least 3 months. [Methods] A single-blinded, non-equivalent, pre-post controlled design with 1-month follow-up was adopted. Participants received either a forced-use or a conventional physical therapy program for 2 weeks. The main outcomes assessed were preferred and fastest walking velocities, spatial and temporal symmetry indexes of gait, the timed up and go test, the Rivermead Mobility Index, and the Stroke-Specific Quality of Life Scale (Taiwan version). [Results] Forced-use training induced greater improvements in gait and mobility than conventional physical therapy. In addition, compared to pre-training, patients in the conventional physical therapy group walked faster but more asymmetrically after training. However, neither program effectively improved in-hospital quality of life. [Conclusion] The forced-use approach can be successfully applied to the lower extremities of stroke patients to improve mobility, walking speeds and symmetry of gait.

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[Purpose] The purpose of this study was to examine the relationship between factors such as stress and fatigue on musculoskeletal symptoms experienced by radiologists who were working in clinics and hospitals. [Subjects and Methods] A survey was conducted for radiologists in clinics, general hospitals, and university hospitals across the nation in a 20-day period from July 10–31, 2011. [Results] According to the comprehensive results of this study, job stress, psychosocial stress, and fatigue felt by radiologists had impacts on musculoskeletal disease in multiple body regions. First, according to the analysis results, job stress was scored at 2.48 on average on a 4-point Likert scale, while psychosocial stress was scored at 2.27 on average on the same scale, which demonstrated that job stress had a slightly higher score than psychosocial stress. Second, job stress, psychosocial stress, and fatigue had impacts on musculoskeletal symptoms experienced by radiologists; the possibility of musculoskeletal symptoms on the neck area increased as the physical environment got worse, interpersonal conflicts got serious, stress from organizational system increased, and psychosocial stress went up. [Conclusion] We expect that the results of this study would be useful as basic data for systematic and efficient management of resources when taking preventative measures against musculoskeletal disease experienced by radiologists in the future.

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[Purpose] The purpose of this study was to investigate the effect of aquatic exercises on nonspecific low back pain (LBP) in elderly males. [Subjects and Methods] Thirty-two elderly men aged 65 or older were recruited and randomly allocated to two groups: aquatic training (3 d/wk for 12 wk) or a control group. Body mass index (BMI), percentage of body fat (PBF), waist-hip ratio (WHR), and trunk muscle mass were measured before and after training. [Results] The results suggested that all obesity variables including BMI, WHR, and PBF of the aquatic training group were decreased significantly, while the trunk muscle mass of the aquatic training group was increased significantly. Furthermore, low back pain was decreased in the subjects after the intervention. [Conclusion] The water-based program improved LBP and body composition in the elderly men.

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[Purpose] The main purpose of our study was the evaluation of the effects of long-term volleyball practice on knee joint proprioception and balance of young female athletes. [Subjects and Methods] An observational case-control study was performed. The study enrolled 19 female volleyball players in the experimental group and 19 sedentary counterparts as controls. A Biodex balance system and dynamometer were used for the evaluations. The paired t-test was used to determine the significance of differences between the performance of athletes and controls. [Results] The knee proprioception analysis showed a significant difference at 60° joint position in active and passive tests. A similar trend, but without significance, was found for the 20° joint position. In the postural stability tests both groups showed similar results with no significant differences between them. [Conclusion] In conclusion, the results indicate a significant influence on joint proprioception is elicited by long-term exposure to a team sport like volleyball. However, the postural stability indexes showed similar trends in both groups, highlighting the analogous ontogenesis of the subjects investigated and the low influence of volleyball practice on postural stability.

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[Purpose] The aim of this study was to elucidate the difference in hip external and internal rotation ranges of motion (ROM) between the prone and sitting positions. [Subjects] The subjects included 151 students. [Methods] Hip rotational ROM was measured with the subjects in the prone and sitting positions. Two-way repeated measures analysis of variance (ANOVA) was used to analyze ipsilateral hip rotation ROM in the prone and sitting positions in males and females. The total ipsilateral hip rotation ROM was calculated by adding the measured values for external and internal rotations. [Results] Ipsilateral hip rotation ROM revealed significant differences between two positions for both left and right internal and external rotations. Hip rotation ROM was significantly higher in the prone position than in the sitting position. Hip rotation ROM significantly differed between the men and women. Hip external rotation ROM was significantly higher in both positions in men; conversely, hip internal rotation ROM was significantly higher in both positions in women. [Conclusion] Hip rotation ROM significantly differed between the sexes and between the sitting and prone positions. Total ipsilateral hip rotation ROM, total angle of external rotation, and total angle of internal rotation of the left and right hips greatly varied, suggesting that hip joint rotational ROM is widely distributed.

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[Purpose] The purpose of this study was to examine the test-retest reliability of the modified Thomas test using lumbo-pelvic stabilization. [Subjects] Thirteen subjects (male=10, female=3) with hip flexor tightness voluntarily participated in the study. [Methods] The participants underwent the modified Thomas test under three conditions: 1) the general modified Thomas test (GM), 2) active lumbo-pelvic stabilization (ALS), and 3) passive lumbo-pelvic stabilization (PLS). Intra-class correlation coefficients (ICC) were used to determine the test-retest reliability of the knee joint angle measurement under three conditions. The standard error of measurement (SEM) and minimal detectable difference (95% confidence interval) (MDD⁹⁵) were calculated for each measurement to assess absolute consistency. [Results] The ALS (ICC = 0.99) and PLS (ICC = 0.98) methods for the modified Thomas test were more reliable than GM method (ICC = 0.97). The MDD⁹⁵ score for the ALS method, 2.35 degrees, indicated that a real difference existed between two testing sessions compared with the scores for the PLS (3.70 degrees) and GM methods (4.17 degrees) [Conclusion] Lumbo-pelvic stabilization is one of the considerations for precise measurement and may help to minimize measurement error when evaluating hip flexor tightness using the modified Thomas test.

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[Purpose] The aim of this study was to examine the initial effects of chest expansion resistance exercise (CERE) applied to chronic stroke patients on their pulmonary functions, chest expansion, and functional gait ability. [Subjects] Forty chronic stroke patients without any respiration-related rehabilitation program experience (21 men and 19 women; times elapsed since occurrence of stroke: 21.8 ± 5.3 months) were randomly and equally allocated to a CERE group (experimental group) and a control group. [Methods] An ordinary stroke rehabilitation program was performed on the subjects. While the experimental group received a CERE intervention, the control group performed passive range of motion exercise with automatic instruments. [Results] The CERE group’s chest expansion significantly increased after the intervention, whereas the control group did not see any significant difference. As regards VC (vital capacity), FVC (forced vital capacity), and FEV₁ (forced expiratory volume in one second), there were no significant changes in either the CERE or control group. In the 10MTWT (10-meter timed walking test), there were no significant changes in either group, but in the 6MWT (6-minute walk test), while there were no significant differences in the control group, the CERE group saw significant changes. [Conclusion] The results of application of CERE to chronic stroke patients demonstrated the importance of respiratory exercise in an approach to stroke rehabilitation treatment intervention and the need to add respiratory exercise to a rehabilitation intervention program.

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[Purpose] This study compared and analyzed use of an existing ankle ramp and a newly developed ankle ramp for stretching exercises. [Subjects] Fourteen subjects were included; they were stroke patients more than 6 months after onset, with no orthopedic or biological problems in the legs, so independent gait was possible. [Methods] The subjects performed stretching exercises for 5 min with an existing ankle ramp and a newly developed ankle ramp; foot pressure was then measured. [Results] The averaged percentage and kilopascal data for weight bearing and foot pressure on the affected side with the newly developed ankle ramp for stretching exercises were significantly higher than those with the existing ankle ramp. [Conclusion] Our results suggest that stretching exercises using the newly developed ankle ramp more effectively increase foot pressure than the existing ankle ramp.

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[Purpose] This study aimed to confirm the effects of kinesio taping (KT) on muscle function and pain due to delayed onset muscle soreness (DOMS) of the biceps brachii. [Subjects and Methods] Thirty-seven subjects with induced DOMS were randomized into either Group I (control, n=19) or Group II (KT, n=18). Outcome measures were recorded before the intervention (application of KT) and at 24, 48, and 72 hours after the intervention. DOMS was induced, and muscle thickness was measured using ultrasonic radiography. Maximal voluntary isometric contraction (%MVIC) was measured via electromyography (EMG). Subjective pain was measured using a visual analogue scale (VAS). [Results] Group I exhibited a positive correlation between muscle thickness and elapsed time from intervention (24, 48, and 72 hours post induction of DOMS); they also showed a significant decrease in MVIC (%). Group II showed significant increases in muscle thickness up to the 48-hour interval post induction of DOMS, along with a significant decrease in MVIC (%). However, in contrast to Group I, Group II did not show a significant difference in muscle thickness or MVIC (%) at the 72-hour interval in comparison with the values prior to DOMS induction. [Conclusion] In adults with DOMS, activation of muscles by applying KT was found to be an effective and faster method of recovering muscle strength than rest alone.

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[Purpose] The purpose of this study was to assess the outcomes of asymmetry in infants with congenital muscular torticollis (CMT). [Subjects] A total of 102 patients with CMT under the age of 6 months were studied. [Methods] Asymmety was evaluated by determining the difference in the thicknesses of the two sternocleidomastoid muscles (DTSM) using ultrasonography, head tilt (HT) based on a physical examination, and the torticollis overall assessment (TOA). Patients received ultrasound and massage therapy for 30 minutes, in conjunction with passive stretching exercises, 3 times a week. [Results] The DTSM, HT, and TOA scores were significantly different after treatment. Pretest DTSM, HT, and TOA scores and pre-posttest change scores for DTSM, HT, and TOA scores were correlated with treatment duration in infants with CMT. [Conclusion] The findings of this study suggest that treatment duration is correlated with asymmetry evaluation parameters (DTSM, HT, and TOA) in infants with CMT. We propose that these results will help in reducing the treatment duration, and also in improving communication between doctors and therapists during the diagnosis and evaluation of torticollis.

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[Purpose] The objective of the study was to evaluate the symmetry of the thickness of the abdominal muscles at rest and while standing in patients with adolescent idiopathic scoliosis. [Subjects and Methods] An ultrasound assessment was performed of the side-to-side differences of the external oblique (EO), internal oblique (IO), and transversus abdominalis (TrA) muscles in the supine and standing positions in adolescent idiopathic scoliosis (AIS) and control groups. [Results] In the AIS group, 64.3% of the patients had left scoliosis with a mean Cobb angle of 10.7°, and 35.7% of the patients had right scoliosis with a mean Cobb angle of 10°. In the supine position, the thickness asymmetry of the TrA was greater in the AIS compared with the control group by an average of 14% (95% CI 3.9–24.2). [Conclusion] Among the abdominal muscles examined, patients with AIS exhibited more asymmetry only for the TrA. In the standing position, the TrA was as symmetric in the patients as in the control group. Mild scoliosis has no impact on the symmetry of the thickness of the OE and OI in the supine and standing positions. The direction of curvature had no effect on the symmetry of the abdominal muscles studied.

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[Purpose] The purpose of this study was to investigate the influence of fingertip light touch on the postural control in poststroke patients. [Subjects] In the study, the subjects were recruited through a rehabilitation hospital, and 21 patients were screened from among 30 volunteers. [Methods] The subjects participated in an experiment that measured postural sway during the static standing posture without light touch and postural sway during the static standing posture with light touch as follows: visual information not blocked without light touch, visual information blocked without light touch, visual information blocked with light touch using fingertips, and visual information not blocked with light touch using fingertips. The measurements were performed using a force platform. The variables measured by the force platform included sway velocities of the COP in the anterior and posterior directions and, medial and lateral directions and sway velocity moments. [Results] In the results of the study, there were significant differences between the state without light touch and state with light touch in terms of the postural sway velocity and velocity moment under all conditions. The rate of decease of the sway velocity and moment velocity under the eyes closed condition were higher compared with those under the eyes open condition. [Conclusion] Through this study, we confirmed the influence of fingertip light touch on the decrease in postural sway. The results show that active light touch may be supplemental means of improving postural sway in stroke patients.

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[Purpose] This study was conducted to investigate the effect of four spine stability exercises on the thickness of the internal and external oblique abdominal muscles, the transverses abdominis, and the multifidus muscles. [Subjects and Methods] Forty healthy adults were enrolled and randomly allocated to four groups. Ten participants performed bridge exercises (BE) while lying on their back; 10 others performed the same exercises with their right legs up (BERL); another 10 performed the same exercises on their side (SBE); and the remaining 10 performed them in a quadruped position with left arm and right leg lifts (QLARL). The participants performed the exercises three times a week for five weeks. The thicknesses of the muscles before and after the interventions were measured using ultrasound. [Results] The results show that the normal bridge exercise significantly thickened the TrA; BERL, the LM; QLARL, the IO; and SBE, the EO and the IO. [Conclusion] All four spine stability exercises were effective. The normal bridge exercise and BERL selectively strengthened the local muscles at the early stage of the treatment. We consider SBE and QLARL should be used in the later stages of treatments because they strengthen both the local and global muscles.

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[Purpose] The purpose of this study was to investigate the changes in hip, knee and ankle kinematic variables of the lower extremities at different gait speeds. [Subjects and Methods] Forty healthy subjects who had no previous history of neurological, musculo-skeletal or other medical conditions that could affect gait were recruited. The subjects were asked to walk 10 m down a walkway at three different gait speeds: normal gait speed, and self-selected fast, and slow speeds. The experimental order was randomly chosen across these gaits. The hip, knee and ankle kinematic data were evaluated using a VICON 3D motion analysis system and force plates. [Results] The flexion peak and external rotation peak of the knee joint significantly increased with the increase of gait speed. The plantarflexion peaks of the ankle joint significantly increased with increase of gait speed. However, none of the kinematic data of the hip joint were significantly dependent on increase of gait speed. [Conclusion] The relationship of the knee and ankle joint can be described as coupling motion which is dependent on gait speed. Our present findings suggest that coupling motion of the knee joint and plantarflexion of the ankle joint significantly increase with increase of gait speed. These results will provide important insight into gait mechanisms for the evaluation of pathological populations.

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[Purpose] The purpose of this study was to identify how spinal decompression therapy and general traction therapy influence the pain, disability, and straight leg raise (SLR) ability of patients with intervertebral disc herniation. [Subjects] The subjects were 30 patients with chronic lumbar pain who were divided into a spinal decompression therapy group (SDTG, n=15), and a general traction therapy group (GTTG, n=15). [Methods] The SDTG used a spinal decompression device, and the GTTG used a lumbar traction device. Both groups received conservative physical therapy three times a week for four weeks. A visual analog scale (VAS) was used to measure the degree of pain the patients with chronic lumbar pain. The Oswestry Disability Index (ODI) was used to measure the degree of functional disability. A goniometer was used to measure the patients’ SLR ability. [Results] Both SDTG and GTTG showed statistically significant decreases in VAS and ODI scores and a statistically significant increase in SLR angle. A comparison of the two groups found no statistically significant differences. [Conclusion] Spinal decompression therapy and general traction therapy are effective at improving the pain, disability, and SLR of patients with intervertebral disc herniation. Thus, selective treatment may be required.

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[Purpose] The aim of this study was to explore the effects of different frequencies of rhythmic auditory cueing (RAC) on stride length, cadence, and gait speed in healthy young females. The findings of this study might be used as clinical guidance of physical therapy for choosing the suitable frequency of RAC. [Subjects] Thirteen healthy young females were recruited in this study. [Methods] Ten meters walking tests were measured in all subjects under 4 conditions with each repeated 3 times and a 3-min seated rest period between repetitions. Subjects first walked as usual and then were asked to listen carefully to the rhythm of a metronome and walk with 3 kinds of RAC (90%, 100%, and 110% of the mean cadence). The three frequencies (90%, 100%, and 110%) of RAC were randomly assigned. Gait speed, stride length, and cadence were calculated, and a statistical analysis was performed using the SPSS (version 17.0) computer package. [Results] The gait speed and cadence of 90% RAC walking showed significant decreases compared with normal walking and 100% and 110% RAC walking. The stride length, cadence, and gait speed of 110% RAC walking showed significant increases compared with normal walking and 90% and 100% RAC walking. [Conclusion] Our results showed that 110% RAC was the best of the 3 cueing frequencies for improvement of stride length, cadence, and gait speed in healthy young females.

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[Purpose] The purpose of this study was to evaluate the effects of a pulmonary rehabilitation education program for caregivers on patients who underwent lung resection surgery. [Subjects] Subjects who underwent lung resection by visual assisted thoracotomy (VATs) were selected and divided into a control group of 19 and an experimental group of 22. [Methods] The experimental group received a pulmonary rehabilitation education program for caregivers, while the control group received typical care for 4 weeks. This study assessed the subjects 2 weeks (baseline) and 6 weeks after surgery (4 weeks). The forced vital capacity (FVC) and forced expiratory volume in 1 sec (FEV1) were measured to evaluate pulmonary function. A visual analogue scale (VAS) was utilized to evaluate pain. [Results] Pulmonary function (FVC and FEV1) increased more in the experimental group compared with the control group. Furthermore, VAS scores were lower in the experimental group compared with the control group. [Conclusion] A pulmonary rehabilitation education program for caregivers had a positive effect on pulmonary function in patients with lung cancer after lung resection.

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[Purpose] The purposes of this study were to investigate the influences of position on %MVIC of spinal stability muscles to establish for the most effective breathing pattern for activation of spinal stability muscles in order to provide an additional treatment method for use in spinal stability exercise programs. [Subjects and Methods] Thirty-three healthy subjects performed quiet breathing and four different forced respiratory maneuvers (FRM); [pursed lip breathing (PLB), diaphragmatic breathing (DB), combination breathing (CB) and respiration muscle endurance training (RMET)] in both standing and sitting positions. %MVIC of them (the multifidus (MF), erector spinae (ES), internal oblique/transversus abdominis (IO/TrA), external oblique (EO), rectus abdominis (RA) measured. [Results] IO/TrA, MF and EO showed greater activation in standing than in sitting, while RA and ES showed greater activation in sitting than in standing. RMET induced significantly greater activation of spinal stability muscles then other breathing patterns. %MVIC changes of muscle activities induced by FRM were independent of position with a few exceptions. [Conclusion] The increased respiratory demands of FRM induced greater activation of spinal stability muscles than QB. RMET was found to be the most effective breathing pattern for increasing the activation of the spinal stability muscles.

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[Purpose] This study aimed to determine the effectiveness of joystick-controlled video console games in enhancing subjects’ ability to control power wheelchairs. [Subjects and Methods] Twenty healthy young adults without prior experience of driving power wheelchairs were recruited. Four commercially available video games were used as training programs to practice joystick control in catching falling objects, crossing a river, tracing the route while floating on a river, and navigating through a garden maze. An indoor power wheelchair driving test, including straight lines, and right and left turns, was completed before and after the video game practice, during which electromyographic signals of the upper limbs were recorded. The paired t-test was used to compare the differences in driving performance and muscle activities before and after the intervention. [Results] Following the video game intervention, participants took significantly less time to complete the course, with less lateral deviation when turning the indoor power wheelchair. However, muscle activation in the upper limbs was not significantly affected. [Conclusion] This study demonstrates the feasibility of using joystick-controlled commercial video games to train individuals in the control of indoor power wheelchairs.

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[Purpose] The purpose of this study was to investigate the differences in symmetry of sitting posture between typical developmental (TD) children and hemi-cerebral palsy (CP) children. [Subjects and Methods] A school chair mounted on a force platform was used to assess the quiet-sitting pressure distribution of 10 TD and 10 CP children. [Results] The symmetry index of the TD children was significantly closer to zero than that of the CP children irrespective of the latter group’s hemiparetic side. [Conclusions] Sitting posture on school chairs of CP children was more asymmetrical than that of TD children.

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[Purpose] The purpose of this study was to investigate the effects of the abdominal hollowing exercise on trunk muscle activity during the curl-up exercise on an unstable surface by measuring electromyography (EMG) activity. [Subjects] Fourteen young healthy adults (nine male, five female) voluntarily participated in this study. [Methods] Each subject was asked to perform a curl-up exercise on two supporting surfaces (stable and unstable surfaces) combined with the abdominal hollowing exercise on an unstable surface. The muscle activities of the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) were measured using surface EMG during performance of the curl-up exercise. [Results] The EMG activity of the RA and EO was significantly higher on an unstable surface than on a stable surface during the curl-up exercise. The EMG activities of the TrA and IO were greater in combination with the abdominal hollowing exercise on an unstable surface than during the curl-up exercise on both a stable and unstable surface. [Conclusion] These findings suggest that the local trunk muscle activity during the curl-up exercise is more strongly affected by combination with the abdominal hollowing exercise than by performance on an unstable supporting surface.

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[Purpose] The aim of this study was to determine the effects of Thai massage on physical fitness in soccer players. [Subjects and Methods] Thirty-four soccer players were randomly assigned to receive either rest (the control group) or three 30-minute sessions of Thai massage over a period of 10 days. Seven physical fitness tests consisting of sit and reach, hand grip strength, 40 yards technical agility, 50-meter sprint, sit-ups, push-ups, and VO_{2, max} were measured before and after Thai massage or rest. [Results] All the physical fitness tests were significantly improved after a single session of Thai massage, whereas only the sit and reach, and the sit-ups tests were improved in the control group. [Conclusion] Thai massage could provide an improvement in physical performance in soccer players.

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[Purpose] The effects of core training using slings and Togus on the improvement of posture control in Taekwondo club students, that is, balance ability, were investigated. To that end, changes in the Taekwondo players’ balance ability resulting from active core training for eight weeks were examined through fitness and foot pressure. [Subjects] The present study was conducted with 13 male Taekwondo players of K University in Deagu, South Korea. Once the experiment process was explained, consent was obtained from those who participated voluntarily. [Methods] Air cushions (Germany), Jumpers (Germany), and Aero-Steps (Germany) were used as lumbar stabilization exercise tools. As a method of training proprioceptive senses by stimulating somatesthesia in standing postures, the subjects performed balance squats, supine pelvic lifts, and push-up plus exercise using slings while standing on an Aero-Step and performed hip extension parallel squats (Wall Gym Ball), and standing press-ups on a Togu using their own weight. The subjects performed four sets of these isometric exercises while maintaining an exercise time per set at 30 seconds in each session and repeated this session three times per week. [Result] Left grip strength significantly increased and number of sit-ups, which indicates muscle endurance, also significantly increased after the eight weeks exercise compared with before the exercise. The values measured during the sit and reach test, which indicate flexibility, also significantly increase after the eight weeks of exercise compared with before the exercise but only in the left foot. [Conclusion] The result of present study suggest that active core exercise using Slings and Togus can be applied as a very effective exercise program for enhancing balance, which is an important physical factor for Taekwondo club students.

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[Purpose] The purpose of this study was to determine the effects of brain-computer interface (BCI)-based functional electrical stimulation (FES) on balance and gait function in patients with stroke. [Subjects] Subjects were randomly allocated to a BCI-FES group (n=5) and a FES group (n=5). [Methods] The BCI-FES group received ankle dorsiflexion training with FES according to a BCI-based program for 30 minutes per day for 5 days. The FES group received ankle dorsiflexion training with FES for the same duration. [Results] Following the intervention, the BCI-FES group showed significant differences in Timed Up and Go test value, cadence, and step length on the affected side. The FES group showed no significant differences after the intervention. However, there were no significant differences between the 2 groups after the intervention. [Conclusion] The results of this study suggest that BCI-based FES training is a more effective exercise for balance and gait function than FES training alone in patients with stroke.

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[Purpose] We tested the reliability and validity of the Japanese version of the Short Questionnaire to Assess Health-enhancing Physical Activity scale in asymptomatic older adults and sought to confirm discriminator validity in women with osteoarthritis. [Subjects] The participants included an asymptomatic comparison group (men and women) and women with knee or hip osteoarthritis. [Methods] The test-retest method was used to assess reliability. The International Physical Activity Questionnaire was chosen to assess criterion-related validity. Discriminator validity was assessed by comparing the asymptomatic and osteoarthritis groups. [Results] Mean age for the asymptomatic groups was 63 ± 6 years for men (n = 23) and 61 ± 7 years for women (n = 51), and it was 63 ± 9 years for the osteoarthritis group (n = 32). The total score and scores for all items, except for heavy housework items, were significantly correlated with the retest. Criterion-related validity showed significantly weak to moderate correlations between the respective scale categories. For discriminator validity, the total scores and scores for bicycle commuting, light housework, and three leisure items differed significantly between the asymptomatic and osteoarthritis groups. [Conclusion] The Short Questionnaire to Assess Health-enhancing Physical Activity scale is a reliable and valid measure in asymptomatic older adults, and can discriminate between osteoarthritic and asymptomatic women.

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[Purpose] The purpose of this research was to analyze the efficacy of extracorporeal shock wave therapy for the treatment of stroke patients with plantar fasciitis. [Subjects and Methods] This study included 10 stroke patients diagnosed with plantar fasciitis who were administered 3 sessions of extracorporeal shock wave therapy per week. After the last session, they performed stretching exercises for their Achilles tendon and plantar fascia for 30 min/day, 5 times a week for 6 months. The following parameters were measured and compared prior to therapy, 6 weeks after therapy, and 6 months after therapy: thickness of the plantar fascia, using an ultrasonic imaging system; degree of spasticity, using a muscle tension measuring instrument; degree of pain, using the visual analogue scale; and gait ability, using the Functional Gait Assessment. [Results] Decreased plantar fascia thickness, spasticity, and pain and increased gait ability were noted after therapy. These changes were significantly greater at 6 months after therapy than at 6 weeks after therapy. [Conclusion] These results indicated that extracorporeal shock wave therapy reduced tension in the plantar fascia, relieving pain and improving gait ability in stroke patients.

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