[Purpose] The purpose of this study was to perform a quantitative assessment of neuromechanical adaptation in skeletal muscles and to propose the scientific underpinnings of the acute effects induced by resistance exercise. [Subjects] The subjects in this study were 11 healthy adult men in their 20s who had no orthopedic history at the time of the study. To examine any signs of resistance exercise-induced changes in the ankle plantar flexor, the subjects were directed to perform a standing barbell calf raise routine. [Methods] Subjects were to carry a load equal to their weights and to perform five sets of ten repetitions. The maximal voluntary isometric contraction torque, resting twitch torque, muscle inhibition, root mean square of muscular activation, contraction time, and half relaxation time were analyzed by synchronizing a dynamometer, an electrical stimulator, and an electromyography system. [Results] The maximal voluntary isometric contraction torque appeared to decline, but the change was not statistically significant. The decline of resting twitch torque, on the other hand, was found to be statistically significant. Muscle inhibition and root mean square of muscular activation were both reduced, but both changes were not statistically significant. Lastly, contraction time and half relaxation time both statistically decreased significantly after resistance exercise. [Conclusion] These results indicate that the acute effects of resistance exercise have a greater impact on the peripheral mechanical system itself, rather than on neurological factors, in terms of the generation of muscle force.

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[Purpose] It is well known that visual feedback is an important factor contributing to balance and postural control. Nevertheless, there has been little discussion about the effects of visual feedback on pulmonary function. This study was conducted to investigate the role of visual feedback on respiratory muscle activation and pulmonary function. [Subjects and Methods] The subjects were 37 healthy adults who consented to participate in this study. The study measured the muscular activation of the trunk and pulmonary function according to the absence or presence of visual feedback. [Results] The results revealed significant changes in muscular activation and pulmonary function with the use of visual feedback. [Conclusion] These findings suggest that visual feedback may play a role in increasing respiratory muscle activity and pulmonary function.

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[Purpose] The aim of this study was to investigate the effects of an ankle foot orthosis on weight-bearing abilities of stroke patients by comparing weight loading during performance of tasks in various standing positions on the affected side. [Subjects and Methods] This study was performed with 16 stroke patients. To measure the weight loading value and percentage of weight loading in affected lower extremities, 5 standing tasks were performed with and without an ankle foot orthosis in random order. [Results] In the rising from a chair, maintaining a standing position, and forward weight shifting tasks, the affected lower extremities showed a significantly higher percentage of weight loading with an ankle foot orthosis. In the tasks requiring weight shifting to one leg, weight shifting to the lateral side showed the best weight-bearing ability with or without an ankle foot orthosis, followed by the forward and backward weight shifting, respectively. There were statistically significant correlations in all 5 tasks with or without an ankle foot orthosis. [Conclusion] An ankle foot orthosis improves the weight-bearing ability, especially when shifting weight forward, resulting in increased weight-bearing ability in activities of daily living tasks such as quiet standing and rising from a chair. The 5 tasks in this study would be a fine assessment tool under clinical conditions to investigate the postural stability of the affected side with or without application of an ankle foot orthosis.

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[Purpose] The purpose of this study was to investigate the effects of Nordic walking and walking on spatiotemporal gait parameters and ground reaction force. [Subjects] The subjects of this study were 30 young adult males, who were divided into a Nordic walking group of 15 subjects and a walking group of 15 subjects. [Methods] To analyze the spatiotemporal parameters and ground reaction force during walking in the two groups, the six-camera Vicon MX motion analysis system was used. The subjects were asked to walk 12 meters using the more comfortable walking method for them between Nordic walking and walking. After they walked 12 meters more than 10 times, their most natural walking patterns were chosen three times and analyzed. To determine the pole for Nordic walking, each subject’s height was multiplied by 0.68. We then measured the spatiotemporal gait parameters and ground reaction force. [Results] Compared with the walking group, the Nordic walking group showed an increase in cadence, stride length, and step length, and a decrease in stride time, step time, and vertical ground reaction force. [Conclusion] The results of this study indicate that Nordic walking increases the stride and can be considered as helping patients with diseases affecting their gait. This demonstrates that Nordic walking is more effective in improving functional capabilities by promoting effective energy use and reducing the lower limb load, because the weight of the upper and lower limbs is dispersed during Nordic walking.

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[Purpose] The aim of this study was to compare the efficacy of passive motion exercise and active motion exercise on functional fitness in elderly nursing home residents. [Subjects and Methods] Twenty-three (female 22 and male 1) nursing home residents (84.8±4.3 yr) volunteered for this study. They were divided into a passive motion exercise group (n=12) and an active motion exercise group (n=11) and performed 30-min sessions of training twice a week for 12 weeks. Functional fitness (Arm Curl, Chair Stand, Up & Go, Sit & Reach, Back Scratch, functional Reach, and 12-min Walk tests) was evaluated before and after the intervention. [Results] No significant baseline difference was noted between the groups in measured variables. Following the 12 week intervention, no significant interaction (group × time) was noted in functional fitness variables between the groups, except for the functional reach scores (active motion exercise 40%, passive motion exercise 9%). Significant improvement over time was noted in passive motion exercise group in Arm Curl (19%), Chair Stand (15%), Up & Go (6%), and 12-min Walk (12%) scores; and in the active motion exercise group in Arm Curl (14%), Chair Stand (19%), Up & Go (11%), functional Reach (40%) and 12-min Walk (13%) scores. The adherence rates in the passive and active motion exercise groups were 95.8% and 93.1% respectively. [Conclusion] Passive motion exercise and active motion exercise were found to be similarly effective for improving the functional fitness of elderly nursing home residents.

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[Purpose] Multidisciplinary treatments are recommended for treatment of chronic low back pain. The aim of this study was to show the associations among multidisciplinary treatment outcomes, pretreatment psychological factors, self-reported pain levels, and history of pain in chronic low back pain patients. [Subjects and Methods] A total of 221 chronic low back pain patients were chosen for the study. The pretreatment scores for the 10-cm Visual Analogue Scale, Hospital Anxiety and Depression Scale, Pain Catastrophizing Scale, Short-Form McGill Pain Questionnaire, Pain Disability Assessment Scale, pain drawings, and history of pain were collected. The patients were divided into two treatment outcome groups a year later: a good outcome group and a poor outcome group. [Results] One-hundred eighteen patients were allocated to the good outcome group. The scores for the Visual Analogue Scale, Pain Disability Assessment Scale, and affective subscale of the Short-Form McGill Pain Questionnaire and number of nonorganic pain drawings in the good outcome group were significantly lower than those in the poor outcome group. Duration of pain in the good outcome group was significantly shorter than in the poor outcome group. [Conclusion] These findings help better predict the efficacy of multidisciplinary treatments in chronic low back pain patients.

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[Purpose] The aim of the present study was to assess the knowledge of the spine and posture among adolescent female students and to determine if they had access to postural education in or outside school. [Subjects and Methods] This was an epidemiological survey of a representative sample of 495 female students aged 14 to 18 years attending a regular secondary school in São Leopoldo, RS, Brazil. Data were collected through a questionnaire. [Results] The results showed that 16.8% of teens did not know what a spine was, 8.3% had no knowledge of posture, and 61% reported receiving no posture education. Posture awareness was associated only with posture while using a computer, while having postural education class was not associated with any postural behavior. [Conclusion] The results showed that, although most students are familiar with the spine and posture, a sizable group is not, and over half had no postural education. These findings suggest that inclusion of postural education programs in schools should be encouraged in order to promote health and prevent diseases related to the spine.

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[Purpose] This study examined the effects of the application of elastic taping over the ankle joints of healthy subjects on their gait, balance ability, and muscle strength. [Subjects] Fifty healthy subjects with no orthopedic history of the ankle joint were selected and elastic taping was applied to their ankle joints. [Methods] Before and after application of the elastic taping, gait and balance ability of the subjects were evaluated. [Results] After the taping application, gait velocity significantly increased and there were significant differences in all variables of balance ability. [Conclusion] Application of elastic taping aimed at improving stability of the ankle joint had a positive effect on gait speed and balance ability.

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[Purpose] The purpose of the present study was to determine the effect of a jump rope and ball combined exercise program on the physical fitness the neurotransmitter (epinephrine, serotonin) levels of children with attention-deficit hyperactivity disorder. [Subjects and Methods] The subjects were 12 boys attending elementary school, whose grade levels ranged from 1–4. The block randomization method was used to distribute the participants between the combined exercise group (n = 6) and control group (n = 6). The program consisted of a 60-min exercise (10-min warm-up, 40-min main exercise, and 10-min cool down) performed three times a week, for a total of 12 weeks. [Results] The exercise group showed a significant improvement in cardiorespiratory endurance, muscle strength, muscle endurance and flexibility after 12 weeks. A significant increase in the epinephrine level was observed in the exercise group. [Conclusion] The 12-week combined exercise program in the current study (jump rope and ball exercises) had a positive effect on overall fitness level, and neurotransmission in children with attention-deficit hyperactivity disorder.

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[Purpose] The purpose of the present study was to conduct Computer-Assisted Cognitive Rehabilitation (COMCOG) to examine the effects of COMCOG on Alzheimer’s dementia patients’ memories. [Subjects] Thirty-five patients diagnosed with Alzheimer’s dementia received COMCOG for 30 minutes per day, five days per week for four weeks. [Methods] Before and after the COMCOG intervention, subjects’ cognitive functions were evaluated using the Cognitive Assessment Reference Diagnosis System (CARDS) and Mini-Mental State Examination-Korea (MMSE-K) test. [Results] According to the results of the evaluation, among the CARDS scores of the subjects who received COMCOG, the scores of the delayed 10-word list, delayed 10-object list, recognition 10-object, and recent memory significantly increased while the scores of recognition 10-word significantly decreased after intervention compared to before intervention. In addition, among the MMSE-K items, the orientation, registration, and recall showed significant increases. [Conclusion] Based on these results, delay in the progress of memory deterioration can be expected when COMCOG is conducted for Alzheimer’s dementia patients who show declines in cognitive functions.

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[Purpose] To assess the effects of sensorimotor foot stimulation on the symmetry of weight distribution on the feet of patients in the chronic post-stroke phase. [Subjects and Methods] This study was a prospective, single blind, randomized controlled trial. In the study we examined patients with chronic stroke (post-stroke duration > 1 year). They were randomly allocated to the study group (n=8) or to the control group (n=12). Both groups completed a standard six-week rehabilitation programme. In the study group, the standard rehabilitation programme was supplemented with sensorimotor foot stimulation training. Each patient underwent two assessments of symmetry of weight distribution on the lower extremities with and without visual control, on a treadmill, with stabilometry measurements, and under static conditions. [Results] Only the study group demonstrated a significant increase in the weight placed on the leg directly affected by stroke, and a reduction in asymmetry of weight-bearing on the lower extremities. [Conclusion] Sensorimotor stimulation of the feet enhanced of weight bearing on the foot on the side of the body directly affected by stroke, and a decreased asymmetry of weight distribution on the lower extremities of patients in the chronic post-stroke phase.

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[Purpose] The purpose of the present study was to observe changes in physical activity (PA) from before surgery to after discharge among elderly patients with gastrointestinal cancer and to examine the relationships between PA, function, and physique after discharge in these patients. [Subjects and Methods] The study participants were 18 elderly patients who underwent surgical treatment for gastrointestinal cancer [10 males and 8 females, aged 71.4 ± 4.2 years (mean ± SD)]. We evaluated patients’ PA, function, and physique before surgery and after discharge. Calorie consumption as calculated using the International Physical Activity Questionnaire (IPAQ) short version was measured for PA. Isometric knee extension force (IKEF), the timed up and go test (TUGT), and the 6-minute walk distance (6MWD) were measured for function. The body mass index (BMI) was calculated for physique. [Results] Significant declines in PA and BMI were observed after discharge among the study participants. In addition, a significant correlation between PA and IKEF was observed in the discharge phase. [Conclusion] These results suggest that PA after discharge is significantly less than that before surgery and related to the functioning of the lower extremities in the same period in elderly patients who undergo surgical treatment for gastrointestinal cancer.

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[Purpose] The purpose of this study was to compare the effect of treadmill walking with the eyes closed and open on the gait and balance abilities of chronic stroke patients. [Subjects and Methods] Thirty patients with chronic stroke participated in this study. The treadmill gait training for each group lasted 40 minutes, and sessions were held 3 times a week for 4 weeks. Gait ability was measured using a Biodex Gait Trainer Treadmill System. Balance ability was measured using a Biodex Balance System. [Results] After the treadmill training‚ the treadmill training with eyes closed (TEC) group showed significant improvements in walking distance‚ step length‚ coefficient of variation‚ and limit of stability (overall‚ lateral affected‚ forward lateral unaffected) compared to the treadmill training with eyes open (TEO) group. [Conclusion] The walking and balance abilities of the TEC participants showed more improvement after the treadmill walking sessions than those of the TEO participants. Therefore‚ treadmill walking with visual deprivation may be useful for the rehabilitation of patients with chronic stroke.

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[Purpose] Walking with the feet turned inward or outward often causes issues for the people with these walking patterns. The purpose of this study was to examine the influence of in-toeing and out-toeing on maximum force and the center of pressure (COP) trajectory length during stair walking. [Subjects and Methods] The subjects were 30 female university students without orthopedic diseases of the foot. The foot angle was divided into three types: in-toeing, normal, and out-toeing. A plantar pressure measurement instrument was used, and the maximum force was obtained by dividing the foot into six regions covering the anterior medial-lateral, middle medial-lateral, and posterior medial-lateral regions. The COP trajectory length was statistically calculated by measuring the medial-lateral, anterior-posterior, and total travel distances. [Results] During stair climbing, the maximum force was significantly different in the anterior lateral region. During stair descending, the maximum force was significantly different in the anterior lateral, middle medial, middle lateral, posterior medial, and posterior lateral regions. The COP trajectory length showed a statistically significant difference in the medio-lateral travel distance. [Conclusion] Walking with abnormal foot angles causes deformed foot structures and can result in musculoskeletal disabilities in the long term. Therefore, therapeutic intervention is required to maintain normal foot angles.

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[Purpose] The aims of this study were to determine (1) the significance of walking and foot pressure in stroke patients, and (2) the association between changes in postural alignment of stroke patients. [Subjects and Methods] Foot pressure and walking ability based on postural alignment were measured in 50 stroke patients. Trunk imbalance, trunk rotation, pelvic tilt, kyphosis, lordosis were measured using DIERS formetric4D (DIERS International GmbH, Schlangenbad, Germany), which anlalyzes 3-dimensional spinal structure in order to measure postural alignment. To determine foot pressure, the support rate of weight and, average foot pressure were measured using DIERS pedoscan (DIERS International GmbH, Schlangenbad, Germany) apparatus as a pressure platform. [Results] DIERS formetric 4D, DIERS pedoscan, and a 10 m walking test were utilized to measure foot pressure and walking ability relative to changes in postural alignment in participating stroke patients. [Conclusion] This study confirmed the significance of foot pressure and walking ability as related postural alignment, indicating that postural alignment education and a recovery therapy program for functional improvement of stroke patients should be provided together.

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[Purpose] The motor paralysis-improving effect on the hemiplegic lower limb was compared among mirror therapy, integrated volitional-control electrical stimulation, therapeutic electrical stimulation, repetitive facilitative exercises, and the standard training method in post-stroke hemiplegia patients. [Subjects and Methods] Eighty one stroke patients admitted to a convalescent rehabilitation ward were randomly allocated to the above 5 treatment groups. Each patient performed functional training of the paralytic lower limb for 20 minutes a day for 4 weeks, and changes in the lower limb function were investigated using the Stroke Impairment Assessment Set. [Results] The hip and knee joint functions did not significantly improve in the standard training control group, but significant improvements were observed after 4 weeks in the other intervention groups. Significant improvement was noted in the ankle joint function in all groups. [Conclusion] Although the results were influenced by spontaneous recovery and the standard training in the control group, the hip and knee joints were more markedly improved by the interventions in the other 4 groups of patients with moderate paralysis, compared to the control group.

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[Purpose] The aim of this study was to ascertain the prevalence of chronic widespread musculoskeletal pain in patients with obstructive sleep apnea syndrome and to assess the relationship between sleep disorder and pain, quality of life, and disability. [Subjects and Methods] Seventy-four patients were included in the study and classified as having mild, moderate, or severe obstructive sleep apnea. Chronic widespread pain, quality of life, and disability were evaluated. [Results] Forty-one patients (55.4%) had chronic widespread pain. Female patients had a higher incidence of chronic pain, and female patients with chronic pain had higher body mass indexes, pain levels, and disability scores than did male patients. Physical component scores of female patients with chronic pain were lower than those of male patients. No correlation was observed between the degree of sleep disorder and severity of pain, pain duration, disability, or quality of life in obstructive sleep apnea patients with pain. [Conclusion] This study showed a 55.4% prevalence of chronic widespread pain in patients with obstructive sleep apnea and a greater risk of chronic pain in female than in male patients. Female patients with obstructive sleep apnea and chronic pain have higher pain and disability levels and a lower quality of life.

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[Purpose] This study aimed to investigate the relationships among trunk impairment, functional performance, and muscle activity during forward reaching tasks in patients with chronic stroke. [Subjects and Methods] Twenty-three chronic stroke patients participated in this study. Trunk impairment and functional performance were evaluated using the Trunk Impairment Scale, Berg Balance Scale, Timed Up and Go Test, and 10-Meter Walk Test. All subjects were asked to perform 3 different forward reaching tasks (affected side reaching, forward reaching, and less-affected side reaching), and measurements were taken during these 3 tasks by using surface electromyography. Correlation analyses were performed to assess the relationships among trunk impairment, functional performance, and muscle activity during the forward reaching tasks. [Results] Spearman’s correlation analysis revealed a strong, significant correlation between the Trunk Impairment Scale and functional performance, that was associated with balance and gait ability. During the 3 different forward reaching tasks, muscle activities of the less-affected lower extremity were significantly correlated with functional performance. [Conclusion] This study revealed the correlations among trunk impairment, functional performance, and muscle activity during forward reaching tasks in patients with chronic stroke and emphasized the importance of trunk rehabilitation.

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[Purpose] Medial knee osteoarthritis, a degenerative joint disease, affects adults. The external knee adduction moment, a surrogate knee-loading measure, has clinical implications for knee osteoarthritis patients. Tai Chi is a promising intervention for pain alleviation in knee osteoarthritis; however, the characteristics of external knee adduction moment during Tai Chi have not been established. [Subjects and Methods] During normal and Tai Chi walking, a gait analysis was performed to compare the external knee adduction moment moment-arm characteristics and paired t-tests to compare moment-arm magnitudes. [Results] A significant difference was observed in the average lateral direction of moment-arm magnitude during Tai Chi walking (−0.0239 ± 0.011 m) compared to that during normal walking (−0.0057 ± 0.004 m). No significant difference was found between conditions in average medial direction of moment-arm magnitude (normal walking: 0.0143 ± 0.010 m; Tai Chi walking: 0.0098 ± 0.014 m). [Conclusion] Tai Chi walking produced a larger peak lateral moment-arm value than normal walking during the stance phase, whereas Tai Chi walking and normal walking peak medial moment-arm values were similar, suggesting that medial knee joint loading may be avoided during Tai Chi walking.

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[Purpose] This study aimed to examine whether motor abilities of children with cerebral palsy are related to their problematic behaviors. [Subjects] The subjects were children with mental retardation who were undergoing physical therapy. [Methods] Twenty-one examiners, 13 physical therapists, and 8 occupational therapists treated and examined the subjects by using the Japanese version of the Aberrant Behavior Checklist. The Japanese version of the Aberrant Behavior Checklist scores were compared between the Gross Motor Function Classification System I to III (12 subjects) and Gross Motor Function Classification System IV and V groups (17 subjects). [Results] Lethargy and stereotypy scores significantly differed between the groups, proving that patients with Gross Motor Function Classification System levels IV and V have more severe problematic behaviors. [Conclusion] In this study, only five types of problematic behaviors, namely irritability, lethargy, stereotypy, hyperactivity, and inappropriate speech, were examined. Despite this limitation, the study clarifies that problematic behaviors of children with cerebral palsy, except lethargy and stereotypy, have little relationship with their motor abilities.

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[Purpose] This study aimed to examine the correlation of visfatin level to pancreatic endocrine hormone level, homeostasis model assessment of insulin resistance (HOMA-IR) index, and HOMA β-cell index in hydraulic resistance exercise. Furthermore, it investigated the relationship between visfatin level and other variables affected by exercise in overweight women. [Subjects and Methods] The exercise group trained for 12 weeks, 70 minutes/day, 5 days/week. Visfatin level, pancreatic endocrine hormone level, HOMA-IR index, and HOMA β-cell index were measured before and after the intervention. Based on the blood insulin and glucose concentrations, HOMA-IR index, the indicator of insulin resistance, and HOMA β-cell index, the indicator of insulin secretion level, were assessed. [Results] Interaction effects on visfatin level, insulin level, HOMA-IR index, and HOMA β-cell index were observed. Interaction effects on glucagon and glucose levels were not observed between the intervention groups. The correlations of visfatin level to insulin, glucagon, and glucose levels, and HOMA-IR and HOMA β-cell indexes were not significant for any of the subjects. [Conclusion] Therefore, the 12-week resistance exercise affected body composition, visfatin level, insulin level, HOMA-IR index, and HOMA β-cell index. Finally, visfatin was not related to insulin, glucagon, and glucose levels, and HOMA-IR and HOMA β-cell indexes.

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[Purpose] The purpose of the present study was to examine the effects of ankle joint muscle strengthening and proprioceptive exercises accompanied by functional electrical stimulation on stroke patients’ balance ability. [Methods] For six weeks beginning in April 2015, 22 stroke patients receiving physical therapy at K Hospital located in Gyeonggi-do were divided into a functional electrical stimulation (FES), ankle proprioceptive exercise and ankle joint muscle strengthening exercise group (FPS group) of 11 patients and an FES and stretching exercise group (FS group) of 11 patients. The stimulation and exercises were conducted for 30 min per day, five days per week for six weeks. Balance ability was measured using a BioRescue and the Berg balance scale, functional reach test, and the timed up-and-go test were also used as clinical evaluation indices. Repeated measures ANOVA was conducted to examine differences between before the exercises and at three and six weeks after beginning the exercises within each group, and the amounts of change between the two groups were compared. [Results] In the comparison within each group, both groups showed significant differences between before and after the experiment in all the tests and comparison between the groups showed that greater improvement was seen in all values in the FPS group. [Conclusion] In the present study, implementing FES and stretching exercises plus ankle joint muscle strengthening and proprioceptive exercises was more effective at improving stroke patients balance ability than implementing only FES and stretching exercises.

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[Purpose] This study aimed to determine the predictive values of the trunk control test (TCT) and functional ambulation category (FAC) for independent walking up to 6 months post stroke. [Subjects] Twenty-seven subjects with hemiplegia secondary to a unilateral hemisphere stroke were included. [Methods] The protocol was started at 45 days post stroke, with the TCT and FAC as walking predictors. At 90, 120, and 180 days post stroke, the subjects’ independent walking ability was assessed by using the Wald test. [Results] The TCT was identified as an independent predictor of ambulation at 90, 120, and 180 days. Subjects who scored ≥ 49 in the initial test had 93.8% probability of achieving independent gait at 6 months. The FAC proved that 100% of the subjects who scored 2 at 45 days post stroke walked independently at 90 days, 100% of the subjects who scored 1 walked independently at 120 days, and only 33.3% of the subjects who scored 0 walked independently at 180 days. [Conclusion] The TCT and FAC can predict independent walking at 45 days post stroke. In subjects with FAC 0, the TCT should be used to predict patients who will be able to walk independently.

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[Purpose] The purpose of this study was to determine alterations of spinal range of motion while sitting, in hemiplegic patients with or without gait available. [Subjects] There was a gait group (GG) of 6 subjects, and a non-gait group (NGG) of 6 subjects, both with hemiplegia after a stroke. [Methods] The subjects in both groups were given an intervention focusing on ankle dorsi-flexion of the affected foot only once for 30 minutes. The Spinal Mouse was used to gain data of the spinal range of motion before and after the intervention and 30 minutes later for follow-up test. [Results] Only in the gait group, lumbar spinal range of motion showed a significant difference when using flexion extension. Sacral hip and inclination were both increased gradually when upright flexion and flexion extension were used. [Conclusion] Facilitating foot for ankle dorsi-flexion is effective on spinal range of motion especially sacrohip, lumbar spine and inclination only for the subjects in the gait group. The results suggested that ankle dorsi-flexion exercise influences spinal range of motion in a sitting position.

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[Purpose] This study aimed to determine whether a task-oriented training program improved balance, activities of daily living (ADL) performance, and self-efficacy in stroke patients. Twenty patients with stroke were recruited from a hospital in Cheongju, Korea. [Subjects] Ten of the subjects were assigned to an experimental group that participated in the task-oriented training program, and the other 10 were assigned to a control group that received traditional rehabilitation therapy. [Methods] In the two groups, balance was measured with the Berg Balance Scale (BBS), ADL performance with the Modified Barthel Index (MBI), and self-efficacy with the Self-Efficacy Scale (SES), before and after 4 weeks of training. [Results] Comparative analysis of the experimental group’s pretest and post-test results showed statistically significant differences in the BBS, MBI, and SES scores. There were also significant between-group differences in the BBS, MBI, and SES scores. [Conclusion] The results suggest that a task-oriented training program can be an effective intervention to improve balance ability, ADL performance, and self-efficacy in stroke patients.

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[Purpose] We assessed the effects of a suspension seat support chair on the trunk flexion angle and gluteal pressure during computer work. [Subjects] Ten males were recruited. [Methods] The suspension seat support was developed to prevent abnormal gluteal pressure and a slumped sitting posture during computer work. The gluteal pressure was measured with a TekScan system and the trunk flexion angle was measured with a video camera, to compare the differences between a general chair and the suspension seat support. [Results] The gluteal peak pressures were decreased significantly in the suspension seat support versus the general chair. The trunk flexion angle was also decreased significantly in the suspension seat support compared with the general chair. [Conclusions] This study suggests that the suspension seat support chair contributes to preventing abnormal gluteal pressure and a slumped sitting posture.

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[Purpose] To assess knowledge among nephrologists at hemodialysis services about routine intradialytic therapeutic exercise, in the city of Recife. [Subjects and Methods] A cross-sectional study, consisting of 49 nephrologists working in public and/or private hemodialysis services, who responded to a semi-structured questionnaire about their academic background, medical residency, and knowledge about exercise during the intradialytic period. [Results] About 56.3% practiced for more than 10 years as nephrologists, 69.4% did not receive information about intradialytic physical exercise while in residency, 81.6% considered intradialytic exercise to be important, and 53.0% did not prescribe exercise during hemodialysis. About 61.2% consider the level of physical activity among their patients to be poor. Nephrologists graduating within 2 years were 10 times more likely to prescribe exercise, compared to those with more than 2 years since graduation. [Conclusion] Our study found that the nephrologists interviewed do not usually prescribe intradialytic therapeutic exercise, despite understanding its importance as part of the treatment process. It is necessary to update doctors about the importance of exercise for patients during the intradialytic period, as well as to incorporate this knowledge at the undergraduate level.

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[Purpose] This study investigated the effects of bar thickness on shoulder stabilizer muscle activation during push-up exercise. [Subjects] Twenty-six healthy male adults in their twenties. [Methods] The study had four experimental conditions (grip thicknesses of 0%, 50%, 75%, and 100% of the subjects’ hand size). Measurements were conducted from the start to the end of push-up for deltoid anterior fiber, deltoid posterior fiber, infraspinatus, serratus anterior, and pectoralis major muscle activation. [Results] The deltoid anterior fiber muscle activity was 4,852.6 ± 975.2 in the 0%, 5,787.3 ± 1,514.1 in the 50%, 5,635.3 ± 1,220.1 in the 75%, and 5,032.9 ± 841.0 in the 100% condition. The infraspinatus muscle activity was 1,877.2 ± 451.3 in the 0%, 2,310.9 ± 765.4 in the 50%, 2,353.6 ± 761.9 in the 75%, and 2,016.8 ± 347.7 in the 100% condition. The pectoralis major muscle activity was 1,675.8 ± 355.1 in the 0%, 2,365.5 ± 1,287.3 in the 50%, 2,125.3 ± 382.5 in the 75%, and 1,878.8 ± 419.7 in the 100% condition, showing significant differences respectively. [Conclusion] The use of push-up bars with different thicknesses customized to personal characteristics, rather than the conventional standard, could be more effective for training and rehabilitation.

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[Purpose] The purpose of this review was to investigate various types of VR programs and their use in cognitive evaluations and interventions for patients with brain injury. [Subjects and Methods] PubMed, Cochrane, and OTseeker electronic databases were searched with the search terms. At of 350 titles and abstracts were retrieved, and 17 articles were selected for this review. Selected articles were assessed on the level of evidence using the Physiotherapy Evidence Database (PEDro) scale. [Results] Articles assessing the impact of cognitive impairments in memory were most commonly found, and VR interventions elicited positive effects in patients with brain injury. [Conclusion] VR can be considered a new tool for cognitive rehabilitation after brain injury. VR interventions also have a number of advantages, e.g. cost-effectiveness, compared to other interventions.

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[Purpose] The purpose of this study was to investigate the degree of collaboration between practitioners and researchers through research papers related to the implementation of electrical stimulation (ES) for stroke patients. [Methods] A systematic review of the literature was conducted to collect data from ES studies published before January 7, 2015. Five databases were searched for search terms related to stroke and ES. Inclusion criteria were original papers that reported on ES of the upper or lower limbs following stroke, after the exclusion of case reports, brain stimulation studies, and papers written in any languages other than English or Japanese. The outcome was the prevalence of research papers that included a practitioner as an author, that included a practitioner as an author or in the acknowledgements, and in which the practitioner was the first author. [Results] Based on the selection criteria, 165 papers were included in the final analysis. The prevalence of papers in which a practitioner was included as an author was 39%. The prevalence of papers in which a practitioner was included as an author or in the acknowledgements was 50%. A practitioner was the first author of 34% of the papers. [Conclusion] Collaboration on research papers related to ES for stroke patients is limited.

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[Purpose] This review article is designed to expose the application of sonography in shoulder pain after stroke. [Methods] A range of databases was searched to identify articles that address sonography examination, with or without ultrasound guided corticosteroid injection for hemiplegic shoulder pain (HSP). The electronic databases of PubMed, CENTRAL, CINAHL, Cochrane Library, Medline were searched. [Results] According to the articles identified in our databases research, sonographic technique has potential to provide objective measurements in patients with HSP. The main sonography finding of HSP included subacromial subdeltoid (SASD) bursal effusion, tendinosis of the supraspinatus and subscapularis tendon, long head of biceps tendon sheath effusion, and shoulder subluxation. Our analysis also revealed significantly decreased pain score (VAS) and increased passive external rotation degree in the steroid injection group than control group. [Conclusion] The sonography examination is useful for HSP assessment and ultrasound guided technique is recommended for HSP injection treatment.

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[Purpose] Cervical radiculopathy is a clinical condition associated with pain, numbness and/or muscle weaknesses of the upper extremities due to a compression or irritation of the cervical nerve roots. It is usually managed conservatively but surgical intervention is sometimes required for those who fail to respond adequately. This study performed a literature review to determine the effects of exercise on non-operative and post-operative cervical radiculopathy patients. [Methods] The PubMed, MEDLINE, CINAHL and Scopus databases were searched to identify relevant articles published from January 1997 to May 2014, which explicitly stated that an exercise program was employed as an intervention for cervical radiculopathy. The therapeutic effectiveness and outcomes were then classified based on the International Classification of Functioning, Disability and Health (ICF) model. [Results] Eleven studies were identified and included in the final analysis. In these studies, the main forms of exercise training were specific strengthening and general stretching exercises. Levels of evidence were graded as either I or II for all studies according to the Oxford Centre for Evidence-based Medicine. The PEDro Scale score of these studies ranged from 5 to 8. [Conclusion] A review of eleven high-level evidence and high-quality studies revealed that, based on the ICF model, exercise training is beneficial for improving the body function as well as activity participation of cervical radiculopathy patients.

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[Purpose] We investigated whether waist and mid-thigh circumference correlated with cardiovascular fitness (VO₂max) in a selected sample of Korean college students. [Subjects and Methods] The subjects were 41 college students (25 males, 16 females; age, > 19 years) who visited the sports medicine laboratory at the Korea National University of Transportation in Chungju-si, Republic of Korea, to undergo measurements of body composition, cardiovascular fitness, and waist and mid-thigh circumference. [Results] VO₂max did not correlate with waist circumference or mid-thigh circumference in males, whereas VO₂max was negatively correlated with mid-thigh circumference, but not waist circumference, in females. [Conclusion] Mid-thigh circumference was not associated with cardiovascular fitness or waist in male college students. However, it was associated with cardiovascular fitness in female college students. Well-designed studies are needed to investigate this further.

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[Purpose] Strength training is recommended for children with cerebral palsy. However, it is difficult for moderately impaired children with cerebral palsy, who require crutches for ambulation, to participate in this type of training. The purpose of this study was to investigate whether whole-body vibration training is an effective method of strengthening in a moderately impaired child with cerebral palsy. [Subject and Methods] This report describes an 8-year-old Japanese boy with cerebral palsy, who was ambulatory with crutches. The subject participated in physical therapy twice a week for 5 weeks. Whole-body vibration training was selected to complement the standing practice. The patient’s crutch-walking ability, gross motor function, and spasticity were evaluated. [Results] The number of steps and walking duration were reduced in a 5-m walk test with crutches and gross motor function was improved. Further, the spasticity was reduced. [Conclusion] Whole-body vibration training is an effective physical therapy intervention in moderately impaired children with cerebral palsy, who are unable to walk without crutches.

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[Purpose] This study examined spinal shape in professional golfers with chronic back pain, and analyzed the effects of a 4-week regimen of semi-weekly manipulation and corrective core exercises on spinal shape. [Subjects] Two golfers with chronic back pain. [Methods] The pelvis and spinal vertebrae were corrected using the Thompson “drop” technique. Angle and force were adjusted to place the pelvis, lumbar spine, and thoracic vertebrae in neutral position. The technique was applied twice weekly after muscle massage in the back and pelvic areas. The golfers performed corrective, warmup stretching exercises, followed by squats on an unstable surface using the Togu ball. They then used a gym ball for repetitions of hip rotation, upper trunk extension, sit-ups, and pelvic anterior-posterior, pelvic left-right, and trunk flexion-extension exercises. The session ended with cycling as a cool-down exercise. Each session lasted 60 minutes. [Results] The difference in height was measured on the left and right sides of the pelvic bone. The pelvic tilt changed significantly in both participants after the 4-week program. [Conclusion] In golfers, core muscles are critical and are closely related to spinal deformation. Core strengthening and spinal correction play a pivotal role in the correction of spinal deformation.

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