[Purpose] The purpose of this study was to analyze muscle activation during hip flexion in the supine position to examine the activation characteristics of the rectus abdominis and rectus femoris. [Subjects] The subjects of this study were 20 healthy adults (10 males and 10 females). [Methods] Muscle activities of the rectus abdominis and rectus femoris while raising the leg from 0°–60° were measured in 15-degree divisions and their ratio was calculated. [Results] Statistically significant differences were found in the muscle activities of the rectus femoris and rectus abdominis were found among each division of during hip flexion in the supine position. The rectus abdominis and rectus femoris ratios increased as the angle of hip flexion increased. [Conclusion] During hip flexion from 0°–45° in the supine position, femur motion caused hip flexion. At angles greater than or equal to 45° hip flexion was accompanied by pelvic motion.

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[Purpose] This study aimed to examine the effects of muscle fatigue on skin sensation by looking at changes in two-point discrimination (2PD) after inducing muscle fatigue. [Subjects] Thirty-four young and healthy adults with no pathological symptoms (17 males; 17 females) participated in this study. [Methods] Continuous isometric contraction was applied to the upper and lower extremities with an intensity of 50% of the maximal muscle strength to trigger muscle fatigue, and then the 2PD test was conducted on the 3 cm medial area of the elbow and 5 cm area of the knee bone. [Results] After muscle fatigue was induced, the 2PD distance significantly increased in the upper and lower extremities of both males and females. Before triggering muscle fatigue, the 2PD distance was longer in males than females, but after causing muscle fatigue, there was no difference between males and females. The increase in 2PD distance after the experiment was more significant in females than males. [Conclusion] Muscle fatigue has an effect of reducing the skin’s sensory faculty by increasing the 2PD distance in the skin. There is a difference in the response of the skin according to body area and gender; therefore, caution is needed to avoid triggering fatigue during exercise.

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[Purpose] The aim of this study was to investigate whether lifestyle-related factors are associated with metabolic syndrome (MetS) in community-dwelling Korean adults. [Subjects and Methods] The subjects comprised 590 men and 1,138 women aged 20 years and above. The subjects visited a public health promotion center in Seoul, Republic of Korea to participate in a survey regarding sleep duration, mental stress, educational level, economic status, and frequency of alcohol consumption and smoking. MetS was defined according to the standard definition of the National Cholesterol Education Program’s Adult Treatment Panel III report. The relationship between lifestyle-related factors and MetS was assessed using multivariate logistic regression analysis after adjustments for age and sex. [Results] Sleep duration, educational level, economic status, and frequency of alcohol consumption and smoking were not associated with MetS. Mental stress was the only lifestyle-related factor associated with MetS. [Conclusion] Well-designed studies will be necessary in order to establish the lifestyle-related factors of MetS.

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[Purpose] This study sought to determine the effects of brain-computer interface-based functional electrical stimulation (BCI-FES) on brain activation in patients with stroke. [Subjects] The subjects were randomized to in a BCI-FES group (n=5) and a functional electrical stimulation (FES) group (n=5). [Methods] Patients in the BCI-FES group received ankle dorsiflexion training with FES for 30 minutes per day, 5 times under the brain-computer interface-based program. The FES group received ankle dorsiflexion training with FES for the same amount of time. [Results] The BCI-FES group demonstrated significant differences in the frontopolar regions 1 and 2 attention indexes, and frontopolar 1 activation index. The FES group demonstrated no significant differences. There were significant differences in the frontopolar 1 region activation index between the two groups after the interventions. [Conclusion] The results of this study suggest that BCI-FES training may be more effective in stimulating brain activation than only FES training in patients recovering from stroke.

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[Purpose] This study investigated changes in the thickness of the transversus abdominis muscle at various stages of the menstrual cycle. [Subjects] The subjects were 15 young healthy females with regular menstrual cycles. [Methods] A regular menstrual cycle was defined as a 28-day cycle comprising 3 phases: the menstrual phase, the follicular phase, and the luteal phase. For the purpose of the study, measurements were taken at day 3 (menstrual phase), day 12 (follicular phase), and day 21 (luteal phase) of the cycle. An ultrasonic imaging diagnostic device (MyLab 25) and a linear expression probe were used for measurement of the transversus abdominis muscle. [Results] There were no significant differences in the variation rate of the thickness of the muscle at any phase of the menstrual cycle. [Conclusion] The results suggested that the sex hormones associated with the menstrual cycle do not affect the contractility or changes in the thickness of the transversus abdominis muscle. For the reasons stated above, there is little need to consider the menstrual cycle when measuring muscle thickness in physical therapy scenarios because the transversus abdominis muscle does not depend on the menstrual cycle.

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[Purpose] The purpose of this research was to evaluate the change in muscle function induced by a Kinesio Tape application with no or moderate tension, to the dominant and non-dominant arms. [Subjects and Methods] This research was a quantitative study, in which 75 women participated. The subjects, aged 18–30 years, were divided into 3 groups, Kinesio, Kinesio without Tension, and Control, and they were assessed before the taping intervention and after 30 minutes, 24 hours, and 48 hours of taping. [Results] The Kinesio group subjects demonstrated an increase in handgrip strength after 30 minutes, 24 hours, and 48 hours of tape application compared to control. A statistically significant increase in strength was observed in the Kinesio group comparison to the Control after 24 hours and 48 hours for the right hand, and after 48 hours for the left hand. Improvement in the Kinesio group compared to the Kinesio without Tension was observed only after 24 hours of taping application, and only in the right hand. [Conclusion] The Kinesio Taping method augmented the handgrip strength of healthy women, and the increase in grip strength was maintained for 48 hours after its application; the dominant hand demonstrated the greatest strength values.

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[Purpose] The aim of this study was to use surface electromyography (EMG) to investigate the effects of different foot positioning on bilateral erector spinae (ES) and gluteus maximus (GM) activation during sit-to-stand performed by individuals with stroke. [Subjects] Fifteen randomly selected participants with stroke were enrolled in this study. [Methods] All the participants were asked to perform sit-to-stand (STS) using three different strategies: (1) symmetric foot position, (2) unaffected foot placed behind the affected foot position (asymmetric-1), (3) affected foot placed behind the unaffected foot position (asymmetric-2). An EMG system was used to measure ES and GM muscle activities. The strategies were performed in a random order, and the mean values of five measurements were used in the analysis. One-way repeated measure ANOVA was used to determine the statistical significance of differences between the conditions. [Results] The affected ES muscle activity was significantly greater in asymmetric-2 (180.7±73.4) than in symmetrical foot placement (149.8±54.2). In addition, the affected ES, unaffected ES, and affected GM muscle activity were significantly greater in asymmetric-2 (180.7±73.4, 173.5±83.1, 98.3±90.3 respectively) than in asymmetric-1 foot placement (147.3±53.8, 151.2±76.5, 84.9±73.8 respectively). [Conclusion] Our results suggest that it may be more desirable for persons with stroke to place the affected foot behind the unaffected foot when performing STS to increase affected ES and GM muscle activation.

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[Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage.

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[Purpose] The purpose of this study was to determine how an exercise program focusing on muscular strength could aid firefighters with chronic lower back pain. [Subjects] The research subjects were randomly assigned to two groups, the experimental group (n=8) and the control (n=8). [Methods] The experimental group performed two types of exercise programs four times per week for 8 weeks under supervision. Tests were performed before and after the 8 weeks of exercise in accordance with the Korea Occupational Safety and Health Agency’s program. [Results] At the end of the 8 weeks of the rehabilitation program, abdominal muscular strength were significantly increased in the experimental group, and this indicates that the exercise therapy was effective for improvement of muscular strength. [Conclusion] We found that exercise therapy is an effective intervention that can reduce the pain of patients with chronic lower back pain. The firefighters with chronic lower back pain who participated in this study exhibited enhanced lower back muscular strength and obtained some additional benefits. They need regular exercise.

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[Purpose] This study aimed to determine the impact of aerobic exercise on aerobic capacity, balance, and treadmill time in patients with thermal burn injury. [Subjects and Methods] Burned adult patients, aged 20–40 years (n=30), from both sexes, with second degree thermal burn injuries covering 20–40% of the total body surface area (TBSA), were enrolled in this trial for 3 months. Patients were randomly divided into; group A (n=15), which performed an aerobic exercise program 3 days/week for 60 min and participated in a traditional physical therapy program, and group B (n=15), which only participated in a traditional exercise program 3 days/week. Maximal aerobic capacity, treadmill time, and Berg balance scale were measured before and after the study. [Results] In both groups, the results revealed significant improvements after treatment in all measurements; however, the improvement in group A was superior to that in group B. [Conclusion] The results provide evidence that aerobic exercises for adults with healed burn injuries improve aerobic physical fitness and balance.

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[Purpose] The purpose of this study was to investigate ability and muscle activities of elderly women after total knee arthroplasty (TKA) and compare them with those of healthy ones. [Subjects and Methods] Fifteen female patients with TKA due to advanced degenerative arthritis of the measured on knee joint and 19 healthy elderly females participated. Tibiofemoral angles of TKA patients were using a gait analysis system anterioposterior X-rays of the weight-bearing knee. The knee flexion angle and gait parameters were measured. Muscle activities and prolongation time were EMG system. The gait of the treated limb of each participant was evaluated in three consecutive trials at fast speed and comfortable speed. [Results] The knee flexion angle %stance phase, stride length, step length, speed, cadence, and gait cycle significantly decreased at both the fast speed and comfortable speeds, and the onset and duration time of rectus femoris activity was significantly increased at the comfortable speed in the TKA group. [Conclusion] In conclusion, elderly women who received TKA showed decreased gait ability and muscle activity compared to the healthy elderly women.

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[Purpose] This study sought to ascertain whether, in hemiplegic patients, the effect of a wheelchair cushion to suppress pelvic posterior tilt when initiating wheelchair propulsion would continue in subsequent propulsions. [Subjects] Eighteen hemiplegic patients who were able to propel a wheelchair in a seated position participated in this study. [Methods] An adjustable wheelchair was fitted with a cushion that had an anchoring function, and a thigh pad on the propulsion side was removed. Propulsion movements from the seated position without moving through three propulsion cycles were measured using a three-dimensional motion analysis system, and electromyography was used to determine the angle of pelvic posterior tilt, muscle activity of the biceps femoris long head, and propulsion speed. [Results] Pelvic posterior tilt could be suppressed through the three propulsion cycles, which served to increase propulsion speed. Muscle activity of the biceps femoris long head was highest when initiating propulsion and decreased thereafter. [Conclusion] The effect of the wheelchair cushion on suppressing pelvic posterior tilt continued through three propulsion cycles.

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[Purpose] To verify, using Rasch analysis, the applicability of the 36-Item Short Form Health Survey (SF-36) to elderly Koreans, as this instrument would be useful for determining elderly individuals’ overall performance and providing them with health information. [Subjects and Methods] The SF-36 was administered to a sample of 510 individuals aged over 60 living in the Seoul and Gyeonggi areas of South Korea. When testing for goodness-of-fit, we considered items with infit and outfit indexes of over 1.30 or less than 0.70 to be incongruent. SF-36 factors that contained over three items, including physical functioning, role limitations (physical and emotional), mental health, vitality, and general health, were analyzed. Each factor was examined through step calibration of the response categories in the probability curve. [Results] The response categories were found to be appropriate because the adjustment values of each factor increased. We found five items in physical functioning, two items in role limitation–emotion, one item in mental health, and one item in general health to be incongruent; all items in the role limitation–physical and vitality factors were congruent. [Conclusion] We conclude that the SF-36 could be revised to more accurately measure the health status of elderly Koreans.

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[Purpose] This study aimed to investigate the effects of horse-riding exercise on balance, gait, and activities of daily living (ADLs) in stroke patients. [Subjects] Among 20 participants with stroke, 10 were randomly assigned to the experimental group, and 10 were randomly assigned to the control group. The experimental group participated in horse-riding exercise for 30 minutes per day, 5 days a week for 6 weeks. Balance was tested with the Berg Balance Scale (BBS). Gait was measured using the 10-Meter Walk Test (10MWT). ADLs were tested with the Modified Barthel Index (MBI). Differences between pre- and post-experiment values within the two groups were compared using paired t-tests. Between-group differences were compared using independent t-tests. [Results] The experimental group showed significant improvements in balance, gait, and ADLs following horse-riding exercise. Additionally, the experimental group showed significant differences in balance, gait, and ADLs compared with in the control group. [Conclusion] These results support that horse-riding exercise enhances balance, gait, and ADLs in stroke patients. This study supports the need for further research on horse-riding exercise programs.

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[Purpose] The purpose of the present study was to examine the effect of intensive gait training using a constrained induced movement therapy (CIMT) technique applied to the non-paretic upper extremity on the balance ability of stroke patients. [Subjects and Methods] Twenty stroke patients were randomly assigned to an experimental group or a control group. The experimental group received gait training with CIMT for 30 minutes per session, three sessions per week for four weeks, and the control group received gait training alone. [Results] The experimental group showed improvements in dynamic balance and the degree of improvement in this group was greater than that observed in the control group. Furthermore, the experimental group showed improvements in movement distances to the paretic side. On the other hand, the control group showed no significant improvements in balance indices after the intervention. [Conclusion] Gait training of stroke patients using CIMT techniques should be regarded as a treatment that can improve the balance of stroke patients.

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[Purpose] To investigate the changes in body balance under ametropic conditions induced by spherical lenses in an upright position. [Subjects and Methods] Twenty subjects (10 males, 10 females) of average age 23.4±2.70 years participated and they were fully corrected by subjective refraction. To induce ametropic conditions (binocular myopia and hyperopia), lenses of ±0.50 D, ±1.00 D, ±1.50 D, ±2.00 D, ±3.00 D, ±4.00 D and ±5.00 D were used. General stability (ST), fall risk index (FI), and sway path (SP) were analyzed through changes in synchronization of left/right and toe/heel, as measured by the biofeedback system, TETRAX. Measurement was performed for 32 seconds for each condition. [Results] ST increased significantly from +0.50 D-induced myopia and from −1.00 D-induced hyperopia as compared with corrected emmetropia. FI increased significantly from +4.00 D-induced myopia and from −1.50 D-induced hyperopia as compared with corrected emmetropia. In SP, which means a change of body balance, toe/heel was significantly greater than left/right in all ametropic conditions. SP of right/left synchronization was not affected by the side of the dominant eye. [Conclusion] An uncorrected hyperope may cause subjects to have a higher risk of falling than an uncorrected myope. Therefore, clinical specialists should consider the refractive condition, especially hyperopia, when analyzing body balance.

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[Purpose] Through core strength training, patients with chronic low back pain can strengthen their deep trunk muscles. However, independent training remains challenging, despite the existence of numerous core strength training strategies. Currently, no standardized system has been established analyzing and comparing the results of core strength training and typical resistance training. Therefore, we conducted a systematic review of the results of previous studies to explore the effectiveness of various core strength training strategies for patients with chronic low back pain. [Methods] We searched for relevant studies using electronic databases. Subsequently, we evaluated their quality by analyzing the reported data. [Results] We compared four methods of evaluating core strength training: trunk balance, stabilization, segmental stabilization, and motor control exercises. According to the results of various scales and evaluation instruments, core strength training is more effective than typical resistance training for alleviating chronic low back pain. [Conclusion] All of the core strength training strategies examined in this study assist in the alleviation of chronic low back pain; however, we recommend focusing on training the deep trunk muscles to alleviate chronic low back pain.

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[Purpose] The objective of this study was to determine the effect of transcranial direct current stimulation (tDCS) during task-related training (TRT) on the gait ability of patients with chronic stroke. [Subjects and Methods] The participants were 24 patients who were diagnosed with hemiplegia due to stroke. Three groups were created: subjects who performed TRT for general exercise therapy (TRT), subjects who received sham tDCS during TRT for general exercise therapy (TST), and subjects who received tDCS during TRT for general exercise therapy (TT). [Results] The stance phase symmetry profile, the swing phase symmetry profile, and gait velocity all decreased significantly in the TT group compared with the TRT group. However, there was no significant difference in the step length symmetry profile among the groups. [Conclusion] A application of tDCS, that affects the excitatory regulation in the cortical motor area, is an effective rehabilitation method for gait improvement.

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This article has been retracted at the request of all authors. This original article is a duplicated article which was previously published in Rigakuryouhoukagaku (Y. Nanba et al., Rigakuryouhoukagaku 29 (5): 799-803). In accordance with policies and procedures governing academic publication we concluded that the above-mentioned article published in J. Phys. Ther. Sci. be retracted. We apologize to readers of the journal that this was not detected during the submission and reviewing process.

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[Purpose] The aim of the present study was to investigate the possibility of an interaction between stretching induced deficit (SFD) and bilateral deficits (BLD) during maximal voluntary isometric hand flexion under PNF stretch and no-stretch conditions through measurement of EMG and force production. [Subjects and Methods] Ten physically active male Caucasian students (age, 24.1±2.38 years; body mass, 79.48±11.40 kg; height, 174.15±0.8 cm) volunteered to participate in this study. EMG and force measurements of the subjects were recorded during either unilateral or bilateral 3-second maximal voluntary isometric hand flexion (MVC) against a force transducer. The paired sample t-test was used to examine the significance of differences among several conditions. Pearson product-moment correlation was used to evaluate the associations between different parameters. [Results] Stretching-induced deficits correlated with bilateral deficits in both force (r=0.85) and iEMG (r=0.89). PNF stretching caused significant decrements in the bilateral and unilateral conditions for both the right and left sides. [Conclusion] Since both force and iEMG decreases were observed in most measurements; it suggests there is a neural mechanism behinnd both the BLD and the SFD.

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[Purpose] Oxygenated hemoglobin (oxy-Hb) concentrations in the prefrontal cortex are closely associated with dyspnea. Dyspnea is influenced not only by physical activity, but also by visual stimuli, and several studies suggest that oxy-Hb concentrations change in response to certain external stimuli. However, the effects of internal psychological states on dyspnea have not been reported. This study explored the influence of anticipation triggered by previous episodes of dyspnea on brain activity. [Subjects] The subjects were 15 healthy volunteers with a mean age of 25.0 ± 3.0 years. [Methods] The subjects were shown a variety of photographs and instructed to expect breathing resistance matched to the affective nature of the particular photograph. After viewing the images, varying intensities of breathing resistance that were identical to, easier than, or harder than those shown in the images were randomly administered to the subjects; in fact, the image and resistance were identical 33% of the time and discordant 66% of the time. [Results] The concentrations of oxy-Hb in the right medial prefrontal cortex (rMPFC) increased significantly with an inspiratory pressure that was 30% of the maximum intensity in the subjects shown a pleasant image compared to the concentrations in subjects shown an unpleasant image. Moreover, rMPFC activity was significantly correlated with the magnitude of the dyspnea experienced. [Conclusion] These results suggest that a correlation exists between increased oxy-Hb in the rMPFC and the effects of expectations on dyspnea.

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[Purpose] The purpose of this study was to investigate the effects of strengthening exercises for the hip extensors on the gait performance and stability of patients with hemiplegia. [Subjects and Methods] The subjects were fifteen stroke patients (ten males, five females). The experimental subjects performed a hip extensor strengthening exercise (HESE) program for a total of four weeks. [Results] The experimental subjects showed significant improvements after the HESE program. Especially, walking speed and the affected side stance phase time significantly increased after the HESE program. Furthermore, the affected side stride length and symmetry index in the stance phase significantly increased after HESE program. [Conclusion] These results suggest that the HESE program may, in part, help to improve gait performance ability and stabilize physical disability after stroke.

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[Purpose] The aim of this study was to observe the relationships among heart rate, rate of perceived exertion, and oxygen consumption in stroke patients and the effectiveness of improving aerobic capacity during routine rehabilitation therapy. [Subjects and Methods] Thirty-six stroke patients participated in the study. A K4b² pulmonary function device was used to record heart rate (beats per minute), oxygen consumption (Equation Section (Next)ml·min⁻¹·kg⁻¹), and rate of perceived exertion. Results were recorded after completing the following activities continuously: (1) silent sitting, (2) sit-to-stand transfers, (3) hip extension while standing against a wall, (4) weight loading on the affected leg, (5) upward and downward leg movements on a stall bar, (6) walking up and down a flight of stairs, and (7) a 60-meter walk. Correlation analyses were performed to demonstrate the relationship of oxygen consumption with HR and RPE. [Results] Moderate correlation was found between HR and oxygen consumption, and low correlation was found between rate of perceived exertion and oxygen consumption. The routine rehabilitation therapy could reduce the accumulation of lactate. [Conclusion] HR is a better index than rate of perceived exertion in evaluating exercise intensity in stroke patients. The routine rehabilitation therapy can improve the aerobic capacity of stroke patients.

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[Purpose] Obesity and hyperglycemia play roles in the impairment of pulmonary function in type 2 diabetes mellitus (T2DM) patients. Low-intensity exercise is known to reduce body fat and improve hyperglycemia. The arm swing exercise (ASE), a low-intensity exercise, is easy and convenient to perform without any equipment and is suitable for daily practice. Therefore, we aimed to investigate the effects of ASE on lung function and obesity in overweight T2DM patients. [Subjects and Methods] Twenty-four subjects continued their daily life routines for 8 weeks (control period), and then performed ASE for 8 weeks (30 minutes per day, 3 days per week) (ASE period). Pulmonary function tests were performed, and fasting blood glucose, haemoglobin A1c (HbA1c), lipid profiles, high-sensitive C-reactive protein (HSCRP), insulin concentration, and anthropometric parameters were measured before and after each period. [Results] After the ASE period, the forced vital capacity, forced expiratory volume in the first second of expiration, and maximal voluntary ventilation were increased when compared with after the control period. HbA1c, a low-density lipoprotein, malondialdehyde, oxidized glutathione, and the percent body fat were significantly decreased when compared with after the control period. However, other parameters, such as lung volume, anthropometric parameters, and fasting blood glucose, insulin, high-density lipoprotein, triglycerides, total cholesterol and glutathione concentrations, showed no differences between the two periods. [Conclusion] These data suggest that there is improvement of pulmonary functions in T2DM patients after ASE training.

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[Purpose] We aimed to examine the effectiveness of a community-based virtual reality treadmill training (CVRTT) program on static balance abilities in patients with stroke. [Subjects and Methods] Patients (n = 20) who suffered a stroke at least 6 months prior to the study were recruited. All subjects underwent conventional physical therapy for 60 min/day, 5 days/week, for 4 weeks. Additionally, the CVRTT group underwent community-based virtual reality scene exposure combined with treadmill training for 30 min/day, 3 days/week, for 4 weeks, whereas the control group underwent conventional physical therapy, including muscle strengthening, balance training, and indoor and outdoor gait training, for 30 min/day, 3 days/week, for 4 weeks. Outcome measurements included the anteroposterior, mediolateral, and total postural sway path lengths and speed, which were recorded using the Balancia Software on a Wii Fit^™ balance board. [Results] The postural sway speed and anteroposterior and total postural sway path lengths were significantly decreased in the CVRTT group. Overall, the CVRTT group showed significantly greater improvement than the control group. [Conclusions] The present study results can be used to support the use of CVRTT for effectively improving balance in stroke patients. Moreover, we determined that a CVRTT program for stroke patients is both feasible and suitable.

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[Purpose] The purpose of this study was to determine the effect of the cocontraction of masticatory muscles during neck stabilization exercises on changes in the thickness of the neck flexors. [Subjects and Methods] Twenty subjects performed neck stabilization only exercise and neck stabilization exercise with simultaneous contraction of the masticatory muscles. Changes in the thickness of the longus colli and sternocleidomastoid were then measured by ultrasound. [Results] The thickness of the longus colli increased significantly fallowing cocontraction of the masticatory muscles and neck stabilization exercise, whereas the exercise method used had no significant effect on the thickness of the sternocleidomastoid. [Conclusion] Cocontraction of the masticatory muscles during neck stabilization exercise is helpful in increasing the thickness of longus colli muscle.

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[Purpose] This study aimed to understand how office workers’ obesity, anxiety and health-related quality of life (HRQOL) affect each other. [Subjects] The study was conducted from February 1 of 2013 to March 31 of 2014 and targeted a total of 143 office workers working in Seoul, Republic of Korea. [Methods] The study collected data using both an assessment tool and questionnaire in order to learn the subjects’ obesity index, anxiety and HRQOL. [Results] The study revealed a significant difference in the total scores in regard to how the obesity index influences anxiety, mental HRQOL and total HRQOL. The more overweight and the heavier the subjects were, the more severe was the anxiety observed, which resulted in decreased scores for mental HRQOL and total HRQOL. Obesity turned out to be significantly correlated with anxiety, mental HRQOL and total HRQOL, and in terms of how much anxiety the subjects felt, there was a significant correlation with the total scores for physical HRQOL, mental HRQOL and total HRQOL. [Conclusion] The present study found that overweight and obese office workers are more anxious than office workers with normal weights, as the former have a lower mental HRQOL. It also suggests that overweight and obese office workers should improve their mental HRQOL through professional workout programs, which would help with their obesity problem. The study also suggests that subsequent research should be carried out to observe the results of any such workout programs applied in the future.

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[Purpose] The aim of this study was to investigate the effects of Ving Tsun (VT) Chinese martial art training on radial bone strength, upper- and lower-limb muscular strength, shoulder joint mobility, balance performance, and self-efficacy in elderly participants. [Subjects and Methods] Twelve seniors voluntarily joined the VT training group, and twenty-seven seniors voluntarily joined the control group. The VT group received VT training for three months, while the control group received no training. The bone strength of the distal radius was assessed using an ultrasound bone sonometer. Muscular strength in the limbs was evaluated using a Jamar handgrip dynamometer and the five times sit-to-stand test. Shoulder joint mobility was examined using a goniometer. Balance performance and self-efficacy were evaluated using the Berg Balance Scale and the Chinese version of the Activities-specific Balance Confidence Scale, respectively. [Results] The results revealed a nonsignificant group-by-time interaction effect, group effect, and time effect for all outcome variables. However, general trends of maintenance or improvement in all outcome parameters were observed to a greater extent in the VT group than in the control group. [Conclusion] VT training might be a potential fall-prevention exercise that can be used to maintain general physique, balance, and confidence in the elderly population. A further randomized controlled trial is needed to confirm this postulation.

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[Purpose] This study investigated a brain wave and visual perception changes in stroke subjects using neurofeedback (NFB) training. [Subjects] Twenty-seven stroke subjects were randomly allocated to the NFB (n = 13) group and the control group (n=14). [Methods] Two expert therapists provided the NFB and CON groups with traditional rehabilitation therapy in 30 thirst-minute sessions over the course of 6 weeks. NFB training was provided only to the NFB group. The CON group received traditional rehabilitation therapy only. Before and after the 6-week intervention, a brain wave test and motor free visual perception test (MVPT) were performed. [Results] Both groups showed significant differences in their relative beta wave values and attention concentration quotients. Moreover, the NFB group showed a significant difference in MVPT visual discrimination, form constancy, visual memory, visual closure, spatial relation, raw score, and processing time. [Conclusion] This study demonstrated that NFB training is more effective for increasing concentration and visual perception changes than traditional rehabilitation. In further studies, detailed and diverse investigations should be performed considering the number and characteristics of subjects, and the NFB training period.

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[Purpose] The aim of this study was to examine the effects of upper limb robot-assisted therapy in the rehabilitation of stroke patients. [Subjects and Methods] Fifteen stroke patients with no visual or cognitive problems were enrolled. All subjects received robot-assisted therapy and comprehensive rehabilitation therapy for 30 minutes each. The experimental group received a conventional therapy and an additional half hour per weekday of robot therapy. The patients participated in a total of 20 sessions, each lasting 60 minutes (conventional therapy 30 min, robot-assisted therapy 30 min), which were held 5 days a week for 4 weeks. [Result] The patients showed a significant difference in smoothness and reach error of the point to point test, circle size and independence of the circle in the circle test, and hold deviation of the playback static test between before and after the intervention. On the other hand, no significant difference was observed in the displacement of the round dynamic test. The patients also showed significant improvement in the Fugl-Meyer Assessment and Modified Barthel Index after the intervention. [Conclusion] These kinematic factors can provide good information when analyzing the upper limb function of stroke patients in robot-assisted therapy. Nevertheless, further research on technology-based kinematic information will be necessary.

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[Purpose] The effects of a cognitive enhancement group training program on daily living activities, cognition, and depression in the demented elderly population of a local Korean community were investigated. [Subjects and Methods] The study included 22 elderly subjects who were 65 years of age or older, had been diagnosed with dementia, and were attending a daily care center in K City, Republic of Korea. Eleven subjects participated in the program, which was conducted twice a week for 8 weeks for a total of 16 sessions. Eleven subjects in a non-training group did not receive any interventions. [Results] The MMSE-K, MBI and KDS scores of all of the eleven subjects who participated in the program improved, and the improvements were statistically significant. [Conclusion] Cognitive enhancement group training programs may have positive effects on daily living activities, cognition, and depression.

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[Purpose] We developed and assessed improved underpants allowing patients to easily and completely open the crotch by pulling upward a string on the back of the underpants while seated. [Subjects and Methods] Healthy subjects tested commercial open-crotch underpants for disabled people and our improved open-crotch underpants by opening the crotch while seated. Measurement parameters included the percentage of crotch opening and the degree of genital or anal exposure before and after opening the crotch, as well as fit. The percentage of crotch opening and the degree of genital or anal exposure were recorded with a digital camera, and fit was determined with a visual analog scale. The measurements for both types of underpants were then compared. [Results] The commercial underpants for disabled people allowed opening of the crotch while seated, but the exposure of the genital and anal areas was insufficient to allow waste elimination. The improved underpants allowed sufficient opening of the crotch while seated and adequately exposed the genital and anal areas. The fit score of the improved underpants was significantly better than that of the commercial underpants. [Conclusion] The improved open-crotch underpants may allow for more effective opening of the crotch while seated than commercial open-crotch underpants for disabled people.

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[Purpose] The purpose of this study was to examine how a leg-length discrepancy contributes to the pelvic position and spinal posture. [Subjects and Methods] A total of 20 subjects (10 males, 10 females) were examined during different artificially created leg-length inequalities (0–4 cm) using a platform. The pelvic tilt and torsion and the sagittal deviation of the spine were measured using the rasterstereographic device formetric 4D. [Results] Changes in platform height led to an increase in pelvic tilt and torsion, while no changes in the spinal posture were found with the different simulated leg-length inequalities. [Conclusion] Our study showed that a leg-length discrepancy may cause pelvic deviation and torsion, but may not lead to kyphosis and lordosis. Therefore, we consider that an artificially created leg-length discrepancy has a greater effect on pelvic position than spine position.

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[Purpose] The purpose of this study was to observe the long-term change in physical function and physique from perioperative to discharge of patients with gastrointestinal cancer. [Subjects and Methods] Subjects were 47 perioperative patients with gastrointestinal cancer [25 men and 22 women aged 61.3 ± 11.0 years (mean ± SD)]. Six-minute walk distance was measured for physical function and body mass index and calf circumference were measured for physique. These items were evaluated at three time points: before surgery, after surgery, and after discharge. [Results] Significant declines in physical function and physique were observed temporarily after surgery. Physical function improved equally before surgery in after discharge. On the other hand, postoperative physique was significantly lower than that observed pre-operatively. [Conclusion] These results suggest that the perioperative changes in physical function and physique follow different courses in patients with gastrointestinal cancer.

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[Purpose] This study compared the energy expenditure during the Y-balance test (YBT) between elderly women with good binocular visual acuity (BVA) and those with poor BVA. [Subjects] Twenty-one elderly women who could walk independently were recruited from a community dwelling. Eleven participants had a BVA equal to or less than 0.4 logarithm of the minimum angle of resolution (logMAR), and the other 10 participants had a BVA equal to or better than 0.3 logMAR. [Methods] The participants had an accelerometer attached over the L3 spinous process for measurement of energy expenditure and performed the YBT in the anterior, posteromedial, and posterolateral directions. [Results] The normalized reach distance in the good BVA group during the YBT in three directions and composite reach distance were significantly longer compared with the values in the poor BVA group. The energy expenditure in the good BVA group during the YBT in the three directions was significantly reduced compared with the values in the poor BVA group. [Conclusion] We suggest that visual acuity in the elderly influences dynamic balance and energy expenditure. Elderly subjects with poor BVA showed poor dynamic balance control and an inefficient biomechanical cost strategy compared to subjects with good BVA.

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[Purpose] The purpose of this study was to compare the muscle activities of upper extremities during a drinking task between the stroke-affected and less-affected sides. [Subjects] Eight stroke patients (8 men; age 45.3 years; stroke duration 21.9 months) participated in this study. [Methods] Electromyography (EMG) was used to measure nine muscle activities of the upper extremity. The drinking task was divided into 5 phases. [Results] Analysis of the EMG data showed that the percentage of maximum voluntary isometric contraction (%MVIC) across all phases of drinking differed between the affected and less-affected sides. Participants used relatively higher levels of %MVIC in the anterior deltoid, flexor muscles, brachioradialis, and infraspinatus on the stoke-affected side. [Conclusion] The difference in muscle activation across all phases of the drinking movement allowed us to determine how upper extremity muscle activation may influence drinking performance on the stroke-affected and less-affected sides.

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[Purpose] The aim of this study was to compare age-related differences in balance and anthropometric posture measurements of the foot and to determine any relationship between them. [Subjects and Methods] Sixty-eight older and 42 younger adults participated in this study. Foot posture was tested for four domains: 1) hallux flexion and extension range of motion using a goniometer, 2) navicular height and 3) length of the foot using a pachymeter, and 4) footprint (width of forefoot, arch index and hallux valgus). Balance was tested under two conditions on a force platform: bipodal in 60-s trials and unipodal in 30-s trials. The sway area of the center of pressure and velocity in the anteroposterior and mediolateral directions were computed. [Results] Older individuals showed significantly poorer balance compared with younger adults under in the unipodal condition (center of pressure area 9.97 vs. 7.72 cm²). Older people presented a significantly lower hallux mobility and higher values for width of the forefoot and transverse arch index than younger adults. The correlations between all foot posture and center of pressure parameters varied across groups, from weak to moderate (r −0.01 to −0.46). Low hallux mobility was significantly related to higher center of pressure values in older people. [Conclusion] These results have clinical implications for balance and foot posture assessments.

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[Purpose] The purpose of this study was to analyze the effect of superficial trunk muscle exercise and deep trunk muscle exercise on the foot pressure of healthy adults. [Subjects] The subjects were 30 healthy females and males who agreed to participate in this study. There were two groups, a superficial trunk muscle exercise group and a deep trunk muscle exercise group, with 15 participants in each. [Methods] The exercises were conducted 5 times a week for 4 weeks for both groups. A gait analyzer was used to measure foot plantar pressure while walking on a plate. Participants were measured before starting the exercise and after 4 weeks. The paired t-test was used to analyze the pre-and post-test results. [Results] There were no significant differences in foot pressure in any region in the superficial trunk muscle exercise group. In the deep trunk muscle exercise group, there were statistically significant increase in F1, F4, F5, R1 and R3. In addition, there were significant decreases in R2 and R4. [Conclusion] After the 4-week deep trunk muscle exercise group decreases in foot pressure on the inner foot and increases on the outside of the feet indicate normal and overall even distribution of body weight on the feet.

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[Purpose] The difficulty levels of level-2 OSCE (examination and measurement skills) items were examined, with a view to providing reference data for the determination of students’ skills. [Subjects] A total of 284 graduates of physical (PT) and occupational (OT) therapy classes of 2011 (59 and 40), 2012 (46 and 36), and 2013 (61 and 42, respectively) were studied, with PT or OT faculty members as OSCE examiners and a simulated patient. [Methods] Scores for 11 level-2 OSCE items were compared between before and after clinical training. [Results] Scores markedly increased after clinical training. On comparison among the items, scores for sensory examination were the highest, and those for interviews were the lowest. [Conclusion] The results of this study indicate the necessity of considering an appropriate combination of different difficulty levels when adopting OSCE-based educational approaches.

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[Purpose] The six-minute walk test (6MWT) is increasingly being used as an important tool for analyzing functional capacity in patients with multisystem disorders. The aim of this study was to evaluate the effect of body composition, peripheral muscle function, and pulmonary function on the six-minute walk distance (6MWD) in acromegalic patients. [Subjects and Methods] Thirty-two patients with active acromegaly, with a mean age of 48.6 ± 12.1 years, underwent an evaluation of body composition using electrical bioimpedance, isometric dynamometry with surface electromyography, tests of pulmonary function, and the 6MWT. [Results] The mean ± SD values for the 6MWD, fat-free mass (FFM), and maximal expiratory pressure (MEP) were 65.5 ± 11.7% predicted, 55.1 ± 10.6 kg, and 55.2 ± 16.8% predicted, respectively. There was a significant correlation between the 6MWD and the following parameters: the angle of the linear regression line obtained using the values of the median frequency electromyography signal over time during the fatigability test for the vastus medialis muscle (MDF, r=0.65), FFM (r=0.62), MEP (r=0.60), height⁽²⁾/resistance index (r=0.52), resistance (r=−0.50), and forced expiratory volume in 1 second (r=0.50). Multivariate analysis showed that MDF, FFM, and MEP were independent predictors of the 6MWD (R²=0.52). [Conclusion] The fatigability of the peripheral muscles, FFM, and MEP are the primary determinants of the 6MWD in acromegalics.

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[Purpose] This study was conducted in order to examine the effects of t’ai chi on females in their 20s with acute low back pain. The subjects were 30 females in their 20s with acute low back pain. [Subjects and Methods] They were equally and randomly divided into a t’ai chi group and a stretching group. The intervention was applied three times per week, one hour each time, for a total of eight weeks. During the one hour, the subjects conducted warm-up exercises for 10 min, primary exercises for 40 min, and cool-down exercises for 10 min. In order to examine changes in low back pain in the patients according to the intervention method, muscle activity, pain, and balance elements (left and right side movement distance, forward and backward movement distance) were measured. [Results] Muscle activity and the visual analog scale score significantly decreased in both the t’ai chi group and the stretching group. Regarding changes in balance elements, the t’ai chi group’s left and right side movement distance decreased, which was statistically significant. However, the t’ai chi group’s forward and backward movement distance and the stretching group’s forward and backward movement distance and left and right side movement distance did not change. [Conclusion] According to the results of this study, t’ai chi is considered an appropriate exercise program to reduce acute low back pain in females in their 20s. This is because when compared with stretching, it enables posture maintenance with lesser force due to decreased muscle activity, it is more helpful for improvements in balance ability, and it is effective in decreasing pain.

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[Purpose] The aim of this study was to investigate the effects of combined application of progressive resistance training and Russian electrical stimulation on quadriceps femoris muscle strength in elderly women with osteoarthritis of the knee. [Subjects] Thirty women over 65 years of age diagnosed with knee osteoarthritis participated in the present study. The subjects were randomly assigned to a control group (n=10), a progressive resistance training group (n=10), or a Russian electrical stimulation group (n=10). [Methods] Each group was treated 3 times weekly for 8 weeks, and each session lasted 45 minutes. Muscle strength was assessed by measuring the peak torque of the quadriceps femoris muscle. Outcome measurements were performed at baseline and at the fourth and eighth weeks of the treatment period. [Results] All groups showed significant intragroup differences in the quadriceps femoris muscle peak torque after the treatment intervention. There were significant intergroup differences between the Russian electrical stimulation group and the other groups. [Conclusion] The results of this study suggest that combined application of progressive resistance training and Russian electrical stimulation can be effective in strengthening the quadriceps femoris muscle in elderly women with knee osteoarthritis.

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[Purpose] The purpose of this study was to investigate the effects of treadmill training with a horizontal impeding force applied to the center of upper body mass on the gait and balance of post-stroke patients. [Subjects and Methods] Twenty-four subjects with hemiplegia less than 3 months after stroke onset were randomly assigned to 2 groups: an applied horizontal impeding force on treadmill training (experimental) group (n = 12), and a control group (n = 12). Both groups walked on a treadmill at a comfortable or moderate speed for 20 minutes per day, 3 sessions per week for 8 weeks after a pre-test. The experimental group also had a horizontal impeding force applied to the center of their upper body mass. [Results] All groups demonstrated significant improvement after 8 weeks compared to baseline measurements. In intra-group comparisons, the subjects’ gait ability (CGS, MGS, cadence, and step length) and balance ability (TUG, BBS, and FRT) significantly improved. In inter-group comparisons, the experimental group’s improvement was significantly better in CGS MGS, cadence, step length, TUG, and BBS, but not in FRT. [Conclusion] Treadmill training was identified as an effective training method that improved gait and balance ability. A horizontal impeding force applied during treadmill training was more effective than treadmill walking training alone at improving the gait and dynamic balance of patients with stroke.

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[Purpose] This study was conducted on adolescent subjects whose brains are still developing with the purpose of identifying the effect of 8 weeks duration of aerobic exercises on the expression of BDNF, IGF-1 and cortisol, to identify effect of aerobic exercise on the expression of cortisol, BDNF and IGF-1 related to nerve cell growth. [Subjects and Methods] The subjects were 20 junior-high school students with no history of physical illness. The students were divided into an exercise group and a control group. The exercise group performed 3 treadmill exercise times per week for 8 weeks. The exercise time for the consumption of 200 kcal was calculated and the exercises were performed by each individual for 8 weeks. [Results] The exercise group showed statistically significant in increases serum BDNF and IGF-1 after 8 weeks, but cortisol showed no significant change. There were statistically significant differences between the groups in serum BDNF and IGF-1 after 8 weeks, but the difference in cortisol levels was not significant. [Conclusion] We found that long-term regular aerobic exercises has a positive effect on the enhancement of serum BDNF levels at rest and IGF-1 of adolescents who are still undergoing through brain developments.

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[Purpose] This study examined the effects of lumbar stability exercises on chronic lower back pain by using a therapeutic climbing program on lumbar muscle activity and function. [Subjects and Methods] Thirty adult subjects with chronic back pain participated. The subjects were assigned to 2 exercise groups, namely the lumbar stabilization (Mat Ex) and therapeutic climbing exercise groups (TC Ex). Each group trained for 30 minutes, 3 times a week for 4 weeks. The Short-form 36-item Questionnaire (SF-36) was administered and the surface electromyographic (sEMG) activities of the lumbar muscles were measured. [Results] Both therapy groups showed significant increases in the SF-36 score, and the increase was greater in the TC Ex group. Significant increases in the sEMG activities of the lumbar muscles were found in both groups. The increases in the sEMG activities of the rectus abdominis and internal and external oblique muscles of the abdomen were greater in the TC Ex group than in the Mat Ex group. [Conclusion] These findings demonstrate that TC Ex, which is similar to normal lumbar stabilization exercise, is effective at activating and improving the function of the lumbar muscles. These results suggest that TC Ex has a positive impact on the stabilization of the lumbar region.

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[Purpose] In the present study, we aimed to determine the effects of backpack position on foot weight distribution of standing school-aged children. [Subjects] Thirty school-aged children volunteered to participate in this study. [Methods] The subjects randomly performed four types of carrying a backpack: no backpack (condition-1), carrying a backpack at C7 (condition-2), carrying a backpack at 10 cm below C7 (condition-3), and carrying a backpack at 20 cm below C7 (condition-4). [Results] Statistically significant differences were noted in the anterior and posterior pressure values, and in the anterior-to-posterior ratio, among the four conditions (p < 0.05). Post-hoc analysis indicated that the pressure value of condition-4 was significantly lower in the anterior foot region and higher in the posterior foot region than in condition-2 and condition-3. In addition, the anterior-to-posterior ratio was lower in condition-4 than in condition-2 and condition-3. [Conclusion] These findings suggest that carrying a backpack in a higher position, with fastening of the shoulder strap, may be more favorable for normalizing the foot weight distribution.

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[Purpose] This study investigated the recovery of arm function and the functional use of the affected limb in real life of stroke patients after bilateral arm training. [Subjects] Twenty patients with stroke were randomly allocated to the BT (bilateral training group, n=10) and UT (unilateral training group, n=10) groups. [Methods] The BT group performed functional tasks with both hand symmetrically, the UT group performed tasks with only the affected hand for 30 minutes a session 5 times a week over 6 weeks. Before and after the intervention, accelerometers (Actisleep), functional independence measure (FIM) and manual function test (MFT) were used to assess subjects’ abilities. [Results] The BT group showed a significant improvement in FIM total score, motor subtotal score and MFT score of affected side compared to the UT group. The BT group showed a more quantitative increase in the amount of activity of the affected side than the UT group. Regarding activity intensity, the BT group showed a decrease in the sedentary level and an increase of the moderate level on the affected side compared to the UT group. [Conclusion] We found that programs tailored to the characteristics of stroke patients and continuous monitoring of physical activity using an accelerometer minimized possible future disability and improved the patients’ quality of life.

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[Purpose] The purpose of the study was to investigate the effects of exercise using rehabilitational sliding machine training and ergometer bicycle training on the balance and gait of patients with stroke. [Subjects] Forty patients with hemiplegia resulting from stroke were divided into a sliding training group (STG, n=20) and ergometer bicycle training group (ETG, n=20). [Methods] STG and ETG respectively performed rehabilitational sliding training and cycle ergometer training in 30 minute sessions, five times a week, for a total of eight weeks. [Results] The balance and gait ability of both groups significantly improved. Both groups showed improvements in balance and gait ability, and the ETG showed anterior and posterior ranges of the limit of stability following standing. [Conclusion] Training on a rehabilitational sliding machine and an ergometer is effective at increasing a patient’s balance and gait ability during nontreatment time in their daily time without therapist.

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[Purpose] Lower-limb spasticity after stroke may be associated with worse functional outcome. Our study aim was to establish whether a low-dose botulinum toxin A (BTX-A) injection in subacute stroke patients can improve spasticity, gait, and daily living abilities. [Subjects] Twenty-three subacute stroke patients were randomly allocated to BTX-A treatment group (11 patients) and control group (12 patients). [Methods] In the BTX-A treatment group patients, 200 units BTX-A was injected into the triceps surae (150 iu) and posterior tibial (50 iu) by electrical stimulation-guided. The patients in the control group received the same volume of placebo solution into the same injection locations. Gait analysis (step length, cadence, speed), the 6-min walking test, Fugl-Meyer Assessment (FMA) of the lower limbs, modified Ashworth scale assess (MAS) assessment of the lower limbs, surface electromyography (sEMG), and modified Barthel index (MBI) assessment were performed before and at 4,8 weeks after treatment. [Results] We found that the FMA of the low limbs and MBI were significantly improved in both groups. The gait analysis, FMA, and MBI results in the BTX-A treatment group were better than those in the control group. MAS and surface electromyography (sEMG) showed better improvement of spasticity in the treatment group. [Conclusion] Early low-dose botulinum toxin A (BTX-A) injection in subacute stroke patients into the lower-limb may improve gait, spasticity, and daily living abilities.

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[Purpose] The aim of the present study was to investigate the effects of a single session of transcranial direct current stimulation combined with virtual reality training on the balance of children with cerebral palsy. [Subjetcs and Methods] Children with cerebral palsy between four and 12 years of age were randomly allocated to two groups: an experimental group which performed a single session of mobility training with virtual reality combined with active transcranial direct current stimulation; and a control group which performed a single session of mobility training with virtual reality combined with placebo transcranial direct current stimulation. The children were evaluated before and after the training protocols. Static balance (sway area, displacement, velocity and frequency of oscillations of the center of pressure on the anteroposterior and mediolateral axes) was evaluated using a force plate under four conditions (30-second measurements for each condition): feet on the force plate with the eyes open, and with the eyes closed; feet on a foam mat with the eyes open, and with the eyes closed. [Results] An increase in sway velocity was the only significant difference found. [Conclusion] A single session of anodal transcranial direct current stimulation combined with mobility training elicited to lead to an increase in the body sway velocity of children with cerebral palsy.

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