[Purpose] Postural stability is the ability of to maintain the position of the body within the support area. This function is affected in cerebral palsy. The aim of the present study was to compare static and dynamic postural stability between children with hemiplegic cerebral palsy and healthy controls. [Subjects and Methods] Thirty-seven children between the ages of 5 and 14 diagnosed with hemiplegic cerebral palsy (19 right, 18 left) and 23 healthy gender- and age-matched controls were included in the study. Postural stability was evaluated in both of the groups using a Neurocom Balance. Sway velocity was measured both with the eyes open and closed. Sit to stand and turning abilities were also assessed. [Results] The sway velocities with the eyes open and closed were significantly different between the groups. The weight transfer time in the Sit to Stand test was also significantly slower in children with cerebral palsy. Children with cerebral palsy also showed slower turning times and greater sway velocities during the Step and Quick Turn test on a force plate compared with their healthy counterparts. [Conclusion] Both static and dynamic postural stability parameters are affected in hemiplegic cerebral palsy. Further research is needed to define rehabilitation interventions to improve these parameters in patients.

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[Purpose] The purpose of this study was to compare the gait abilities and motor recovery abilities in stroke patients following overground gait training with or without rhythmic auditory stimulation. [Subjects and Methods] Forty patients with hemiplegia resulting from stroke were divided into a rhythmic auditory stimulation gait training group (n=20) and a gait training group (n=20). The rhythmic auditory simulation gait group and gait training group both performed gait training. Rhythmic auditory stimulation was added during gait training in the rhythmic auditory stimulation gait training group. The gait training was performed in 30 minute sessions, five times a week, for a total four weeks. [Results] Gate ability significantly improved in both groups, and the rhythmic auditory stimulation gait training group showed more significant increases in cadence, step length, and Dynamic Gait Index. [Conclusion] The results of this study showed that gait training with rhythmic auditory stimulation was more effective at improving gait ability.

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[Purpose] In this study, the effects of low-level laser therapy (LLLT), electroacupuncture (EA), and radiofrequency (RF), which are used in physical therapy, on the pigmentation and skin tone of adult women’s faces were investigated to provide basic data for skin interventions. [Subjects and Methods] Thirty adult females were assigned to either an LLLT group (n=10), an EA group (n=10), or an RF group (n=10). The intervention was performed in two 15-minute sessions per week for six weeks. Subjects’ skin tone and pigmentation were observed before and after the intervention. [Results] The EA group showed significant reductions in pigmentation in the left and right eye rims, as well as in the left cheek. The RF group showed significant post-intervention reductions in pigmentation under the left eye, as well as in the left and right eye rims and the left cheek. The LLLT group showed significant increases in skin tone in the forehead and both eye rims. The RF group showed significant increases in skin tone under both eyes. [Conclusion] The application of LLLT, EA, and RF had positive effects on pigmentation and skin tone of adult women’s faces.

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[Purpose] Osteoarthritis is a chronic and degenerative joint disease and is considered to be one of the most common musculoskeletal disorders. This study evaluated the differences in the quality of life of females treated with supervised physiotherapy and a standardized home program after unilateral total knee arthroplasty. [Subjects and Methods] From January 2012 to May 2015, a total of 40 females were examined at the Central Military Hospital in Ruzomberk, Slovakia. Quality of life was assessed with the Short Form-36. Quality of life and intensity of pain after normal daily activity, according to the visual analog scale, were assessed before total knee arthroplasty, immediately after physiotherapy, 3 months after total knee arthroplasty, and 6 months after total knee arthroplasty. [Results] We found statistically significant improvement of the quality of life results and a decreased intensity of pain at each time point compared with before total knee arthroplasty. [Conclusions] The results of this study provide further evidence indicating that patients who undergo total knee arthroplasty for primary osteoarthritis of the knee can achieve a significant improvement in the quality of life by using supervised physiotherapy compared with a standardized home program.

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[Purpose] The purpose of this study was to provide the data for constructing an integrated exercise program to help restore muscle strength and stability through extension strength exercise in adult females with lumbar disc herniation. [Subjects and Methods] An 8-week exercise program for lumbar muscle extension strength and stabilization was performed by 26 females older than 20 with lumbar disc herniation findings. [Results] Significant differences were found in lumbar extension muscle strength at every angle of lumbar flexion after participation in the 8-week stabilization exercise program; but there was no significant difference in the weight distribution index. [Conclusion] An integrated exercise program aiming to strengthen lumbar spine muscles, reduce pain and stabilize the trunk can help to maintain muscle strength and balance. In addition, improvement in extension strength is expected to be helpful in daily life by securing the range of joint motion and improving the strength and stability.

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[Purpose] The aim of this study was to assess the effects of 8 weeks of Wii Fit balance game training on the balance abilities of students with intellectual disabilities. [Subjects and Methods] Twenty-four students with intellectual disabilities were selected and randomly divided into Wii Fit balance game training, physical education, and sedentary activity groups. The Wii Fit balance game training group received two 40-minute Wii Fit balance game training sessions per week for a total of 8 weeks. Kruskal-Wallis one-way analysis of variance and the Wilcoxon signed rank test were used to compare differences. [Results] After eight weeks of training, the Wii Fit balance game training group showed significant differences between the pre- and post-training parameters, including the duration of standing on one leg with the eyes closed, average anteroposterior movement speed, swing area per unit time, and speed strength index. The physical education group showed significant differences between the pre- and post-training speed strength index values. The sedentary activity group did not show any significant differences between the pre- and post-training parameters. [Conclusion] Wii Fit balance game training can improve static balance and lower extremity muscle strength in students with intellectual disabilities.

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[Purpose] The purpose of this study was to investigate differences in jumping ability and lower limb balance ability elicited by plyometric training and vibration exercise, of volleyball players with and without ankle injuries, which frequently occur among Korean professional volleyball players. [Subjects and Methods] Twenty-eight volleyball players were divided into the following groups: plyometric with ankle injury (PAI) group; plyometric with non-ankle injury (PAN) group; vibrator with ankle injury (VAI) group; and vibrator with non-ankle injury (VAN) group. After exercise and whole body vibration stimulation, their vertical jumping abilities, side step, and static equilibrium ability were measured. [Results] The vibration exercise group which had experienced ankle injuries showed significant improvements in the sidestep test after the intervention compared to before the intervention. In vertical jumping as well, significant improvements were observed in the VAI group and the VAN group following vibration exercise. In the balance ability test, significant improvesments in the PAN group and the PAI group were observed after the intervention. According to the results of the right side, there was significant change in the left/back side test and the right/back side test before and after the intervention; and in the test of one-leg standing with eyes closed, there were significant group, timing, and interaction effects. [Conclusions] The training method which effectively improved the jumping ability of volleyball players was plyometric training, and for balance ability improvement, whole body vibration exercise was effective.

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[Purpose] The aim of this study was to investigate the functional capacity of trauma survivors one year after hospital discharge and to identify associations with trauma- and hospital stay-related aspects in a developing country. [Subjects and Methods] This study included severe trauma patients (Injury Severity Score ≥16; ≥18 years old) who were admitted to an intensive care unit in Sao Paulo, Brazil. Hospital stay data were collected from the patients’ records. Functional capacity was assessed using the Glasgow Outcome Scale and Lawton Instrumental Activities of Daily Living Scale one year after hospital discharge. Patients were asked if they had returned to work/school. [Results] Forty-nine patients completed follow-up. According to the Glasgow Outcome Scale data, most patients had moderate or mild/no dysfunction. The Lawton Instrumental Activities of Daily Living Scale showed that 60–70% of the subjects performed most activities independently. Multiple linear regression of the Glasgow score, Acute Physiology and Chronic Health Disease Classification System II score, length of mechanical ventilation, and hospital length of stay revealed an association between the Lawton Instrumental Activities of Daily Living Scale and hospital length of stay. Overall, 32.6% of the subjects had returned to work/school. [Conclusion] Most severe trauma patients experienced functional recovery, although only one-third had returned to work/school one year after hospital discharge. Hospital length of stay was identified as a significant predictor of functional recovery.

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[Purpose] The aim of this study was to analyze the crutch position in the horizontal plane to confirm the stability of the axillary pad during double-crutch walking. [Subjects] Twelve healthy young subjects (6 males and 6 females). [Methods] The subjects were asked to walk in a straight line, using double crutches, for a distance of 5 m, 5 times. Crutch position data were obtained using four infrared reflective markers attached to both crutches (two markers each on both crutches). The crutch angles of each subject were compared across three time points during the crutch stance phase (crutch contact, mid stance, and crutch off). [Results] Crutch angles of each of the two crutches were significantly different across the crutch stance phase of 11 of the 12 subjects. Phasic differences were shown by 4 of the 12 subjects, and a strong correlation was observed between the left and right crutch angles of all subjects. [Conclusion] External rotation of the crutch throughout the stance phase was very important for keeping the axillary pad in the axilla, not only for single-crutch walking, but also for double-crutch walking. In addition, symmetry of the crutch positioning is one of the most important factors for safe double-crutch walking.

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[Purpose] The aim of the present study was to construct an integrated rehabilitation exercise program to prevent chronic pain and improve motor ability in cases of ankle injury and re-injury. [Subjects and Methods] Twenty-six male soccer players who required functional strength exercises due to repeated ankle injury were the subjects. A 12-week rehabilitation exercise program was constructed with the aim of improving muscle strength in the ankle and dynamic coordination of the lower limb. Muscle strength and dynamic coordination were evaluated using the Y Balance Test, and isokinetic muscle strength of ankle dorsiflexion, plantarflexion, inversion, and eversion were measured before and after the 12-week program. [Results] Following 12 weeks of rehabilitation exercise, there were statistically significant improvements in the ratios of dorsiflexor strength to plantarflexor strength, eversion strength, and inversion strength on the left side. The other variables showed no significant changes. [Conclusion] The rehabilitation exercise program for chronic ankle instability helped to reduce pain, and to restore normal joint range of motion, muscle strength and endurance, and functional ability. Active protocols to improve complex functions need to be developed to complement these results.

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[Purpose] The purpose of this study was investigated the effect of tight clothes on cervical and thoracic spine muscles activities during shoulder abduction. [Subjects and Methods] The subjects of this study were 10 healthy males. The subjects performed two shoulder abduction trials for each of two jacket-wearing conditions. The right upper, middle, and lower trapezius and serratus anterior muscles activities were measured using a surface electromyography system during right shoulder abduction. [Results] The upper and middle trapezius muscle activities during shoulder abduction were significantly increased under the tight-jacket conditions compared with the general-jacket conditions. The lower trapezius and serratus anterior muscle activities were significantly decreased under the tight-jacket conditions compared with the general-jacket conditions. [Conclusion] The results of this study suggest that normal scapular movements did not occur sufficiently when wearing a tight jacket.

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[Purpose] Disabilities after stroke are known to have adverse effects on the quality of life. This study investigated the relationship between Communication Activities of Daily Living (C-ADL) and quality life of elderly stroke patients to provide basic data for use in enhancing the quality of life. [Subjects and Methods] One hundred sixty five elderly over the age of 60, who were diagnosed as having stroke and receiving treatment in rehabilitation departments of general hospitals were surveyed. Stroke patients’ basic communication ability to survive in daily living was measured using the C-ADL Second Edition, and stroke patients’ quality of life was measured with the Stroke-Specific Quality of Life (SSQOL). The relationship between C-ADL and SSQOL was analyzed using multiple regression analysis. [Results] C-ADL had a significant positive relationship with SSQOL. [Conclusion] This result implies that it is necessary to enhance stroke patients’ communication ability in daily living in order to raise their quality of life.

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[Purpose] The selection of a college major is a struggle that high school students undergo every year; however, there is a dearth of studies examining the role of cognitive ability tests as a tool for determining the aptitude of prospective students. Hence, the purpose of this study was to assess cognitive ability differences among students. [Subjects and Methods] A convenience sample of 60 college students (30 health science and 30 art students) with a mean age of 19 ± 1.6 years, voluntarily participated in this study. Cognitive ability was assessed using the self-administered Cognitive Assessment of Minnesota (CAM) scale under the supervision of a researcher. [Results] The findings indicated that there was a significant cognitive ability difference between health science and art students, especially in the cognitive components of knowledge, calculation, and thinking. However, the difference in the social cognitive component of both the health science and art students was not significant. [Conclusion] The results indicate that the health science students’ cognitive abilities were better than those of the art students. This finding implies that it is important for high school graduates to undertake a cognitive ability assessment prior to choosing a subject major. Hence, it is recommended that cognitive scales should be included as an aptitude assessment tool for the decision-makers and prospective students to determine an appropriate career, since it might reduce the percentage of university drop-out ratio.

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[Purpose] The time-series waveforms of mechanical energy generation, absorption, and transfer through the joints indicate how movements are produced and controlled. Previous studies have used these waveforms to evaluate and describe the efficiency of human movements. The purpose of this study was to examine the influence of trunk flexion on mechanical energy flow in the lower extremities during gait. [Subjects and Methods] The subjects were 8 healthy young males (mean age, 21.8 ± 1.3 years, mean height, 170.5 ± 6.8 cm, and mean weight, 60.2 ± 6.8 kg). Subjects walked at a self-selected gait speed under 2 conditions: normal gait (condition N), and gait with trunk flexion formed with a brace to simulate spinal curvature (condition TF). The data collected from initial contact to the mid-stance of gait was analyzed. [Results] There were no significant differences between the 2 conditions in the mechanical energy flow in the knee joint and negative mechanical work in the knee joint. However, the positive mechanical work of the knee joint under condition TF was significantly less than that under condition N. [Conclusion] Trunk flexion led to knee flexion in a standing posture. Thus, a strategy of moving of center of mass upward by knee extension using less mechanical energy was selected during gait in the trunk flexed posture.

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[Purpose] The aim of this study was to evaluate the effect of oscillating electrical field stimulation on motor function recovery and myelin regeneration in rats with spinal cord injury. [Subjects and Methods] A rat model of spinal cord injury was constructed by using the Allen weight-drop method. These rats were randomly divided into normal, spinal cord injury, and spinal cord injury + oscillating electrical field stimulation groups. The experimental group received the intervention with oscillating electrical field stimulation, and the control group received the intervention with an electrical field stimulator without oscillating electrical field stimulation. Each group was then randomly divided into seven subgroups according to observation time (1, 2, 4, 6, 8, 10, and 12 weeks). Basso-Beattie-Bresnahan score and inclined plate test score evaluation, motor evoked potential detection, and histological observation were performed. [Results] In the first 2 weeks of oscillating electrical field stimulation, the oscillating electrical field stimulation and inclined plate test scores of spinal cord injury group and spinal cord injury + oscillating electrical field stimulation group were not significantly different. In the fourth week, the scores of the spinal cord injury group were significantly lower than those of the spinal cord injury + oscillating electrical field stimulation group. The motor evoked potential incubation period in the spinal cord injury + oscillating electrical field stimulation group at the various time points was shorter than that in the spinal cord injury group. In the sixth week, the relative area of myelin in the spinal cord injury + oscillating electrical field stimulation group was evidently larger than that in the spinal cord injury group. [Conclusion] Oscillating electrical field stimulation could effectively improve spinal cord conduction function and promote motor function recovery in rats with spinal cord injury, as well as promote myelin regeneration.

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[Purpose] To compare the toe flexor, hand grip and knee extensor strengths of young and elderly men, and to examine the association between toe flexor strength and physical activity or inactivity levels. [Subjects and Methods] Young (n=155, 18–23 years) and elderly (n=60, 65–88 years) men participated in this study. Toe flexor, hand grip, and knee extensor strength were measured. Physical activity (time spent standing/walking per day) and inactivity (time spent sitting per day) were assessed using a self-administered questionnaire. [Results] Toe flexor, hand grip, and knee extensor strength of the elderly men were significantly lower than those of the young men. Standing/walking and sitting times of the elderly men were lower than those of the young men. Toe flexor strength correlated with hand grip and knee extensor strength in both groups. In elderly men, toe flexor strength correlated with standing/walking time. In comparison to the young men’s mean values, toe flexor strength was significantly lower than knee extensor and hand grip strength in the elderly group. [Conclusion] The results suggest that age-related reduction in toe flexor strength is greater than those of hand grip and knee extensor strengths. An early loss of toe flexor strength is likely associated with reduced physical activity in elderly men.

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[Purpose] To analyze the electromyographic (EMG) activities of several lower extremity muscles during ground walking and pedaling using the Pedalo Reha-Bar device. [Subjects and Methods] Fifteen healthy adults aged 20–29 year participated in this study. The subjects’ surface EMG signals while walking and Pedalo Reha-Bar riding were recorded. The subjects performed 20 steps on flat ground and 20 cycles on the Pedalo Reha-Bar. During the tasks, EMG signals of the rectus femoris, biceps femoris, tibialis anterior, soleus, and gastrocnemius within a 20-second period were recorded. The mean EMG signals within the 10 seconds from 6 to 15 seconds were used for the data analysis. [Results] There was a significant increase in the bilateral use of the rectus femoris and a significant decrease in the use of the left tibialis anterior and left soleus in pedaling using the Pedalo Reha-Bar device compared to ground walking. [Conclusion] Level walking and the Pedalo Reha-Bar riding utilize different types of muscles activities. These results suggest that Pedalo Reha-Bar riding may be used for neuromuscular activation, especially of the rectus femoris.

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[Purpose] The acquisition of motor skills are fundamental to human life. There is a lack of research on whether knowledge of performance or knowledge of result as augmented feedback is more effective. The objective of this study was to compare the effectiveness of knowledge of result and knowledge of performance in the learning of a skilled motor activity by healthy young adults. [Subjects and Methods] A total of thirty healthy young adult males and females without any neurological or musculoskeletal impairment, between the age of 18–30 years were the subjects of the study. They were randomly allocated to 2 groups: group 1 was given knowledge of result as feedback, and knowledge of performance was given as feedback to group 2. Both the groups practiced the task of throwing a soft spongy ball for 6 days per week for 4 weeks, with 40 trials each day. The outcome measure used was the distance of the throw. [Results] The results were analyzed using the t-test. The mean distances thrown by both the groups showed highly significant improvements and throwing distance of group 2 showed better improvement than that of group 1. [Conclusion] Both types of augmented feedback were effective at improving skilled motor activity, but the knowledge of performance group showed better improvement than the knowledge of result group.

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[Purpose] The aim of this study was to determine the variations in the blood muscular damage indicators post application of two complex training programs for back squats. [Subjects and Methods] Seven military athletes were the subjects of this study. The study had a quasi-experimental cross-over intra-subject design. Two complex training protocols were applied, and the variables to be measured were cortisol, metabolic creatine kinase, and total creatine kinase. For the statistical analysis, Student’s t-test was used. [Results] Twenty-four hours post effort, a significant decrease in cortisol level was shown for both protocols; however, the metabolic creatine kinase and total creatine kinase levels showed a significant increase. [Conclusion] Both protocols lowered the indicator of main muscular damage in the blood supply (cortisol). This proved that the work weight did not generate significant muscular damage in the 24-hour post-exercise period.

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[Purpose] The purpose of this study was to investigate the effects of the thickness of a wheelchair backrest provided for support and comfort on upper arm and trunk muscle load during wheelchair propulsion by using accelerometers. [Subjects and Methods] The Fourteen healthy participants were enrolled in this study. The study compared effects of three backrest conditions including no pad, a 3-cm-thick lumbar pad, and a 6-cm-thick lumbar pad. The instruments used for measurement were used two accelerometers. The participants were asked to propel their wheelchairs, which had been equipped with two accelerometers, 30 times. [Results] The intensity of muscle movement with the 3-cm-thick lumbar pad was significantly lower than the intensities with no lumbar pad and the 6-cm-thick lumbar pad. The muscle intensity did not differ significantly between the no pad and 6-cm-thick lumbar pad conditions. [Conclusion] An appropriately thick backrest has good effects on upper arm and trunk muscles during wheelchair propulsion. In the future, we must consider the appropriate backrest thickness for providing wheelchair users with a comfortable wheelchair.

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[Purpose] The purpose of this study was to investigate respiratory function in different sitting postures while using a smartphone. [Subjects and Methods] Fifty healthy volunteers were recruited. Participants were divided into 2 groups, a control group of participants who spent time as they liked for 1 hour, and a smartphone group of participants who spent time using a smartphone in a sitting position for 1 hour. To investigate changes in respiratory function, we measured forced vital capacity, forced expiratory volume in 1 second, ratio of forced expiratory volume in 1 second to forced vital capacity, and peak expiratory flow. [Results] There was a statistically significant difference in forced vital capacity and forced expiratory volume in 1 second between the control group and smartphone group. [Conclusion] The clinical implication of our findings is that the posture assumed while using a smartphone leads to reduced respiratory function.

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[Purpose] To examine whether resistance training for elderly community-dwellers performed with an interocclusal splint resulted in greater lower extremity muscle strength and better balance than resistance training performed without an interocclusal splint. [Subjects and Methods] Eighty-eight elderly persons using Japanese community day centers were randomly divided into two groups: an intervention group (n=45), which performed resistance training with an interocclusal splint; and a control group (n=43), which performed resistance training without an interocclusal splint. The resistance training program comprised a 40-min session performed twice a week for 12 weeks. Outcome measures were the chair stand test (CST), timed up and go test (TUG), and one-leg standing test (OLST). Assessments were conducted before the intervention and every 2 weeks after the start of the intervention. [Results] There was a significant group × time interaction for the OLST, with the intervention group showing significant improvement from 8 to 12 weeks compared to the control group. For the CST and TUG, no significant differences were found between the two groups throughout the 12 weeks. [Conclusion] Resistance training with an interocclusal splint improved the balance ability of elderly community-dwellers more effectively than resistance training without an interocclusal splint.

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[Purpose] Understanding the normal movements of the pharyngeal stage is important in the assessment of dysphagia. This study classified an elderly population into young-elderly and mid-elderly individuals and investigated the difference in stage transition duration between the two groups to provide basic material for assessment of dysphagia in old age. [Subjects and Methods] The subjects of the study were 12 middle-aged individuals (40–49 years), young-elderly individuals (65–74 years), and 9 mid-elderly individuals (75–84 years). Stage transition duration was defined as the time from the moment food boluses passed the ramus of the mandible until the start of upward movement of the hyoid. All image data were measured using a videofluoroscopic study. Difference in measured values for stage transition duration between the groups were confirmed with one-way analysis of variance. [Results] Although analysis of variance was significantly longer in the young-elderly and mid-elderly individuals than in the middle-aged individuals, there was no significant difference in stage transition duration between the young-elderly and mid-elderly individuals. [Conclusion] In this study, there was no significant difference between the young-elderly and mid-elderly individuals in the movement speed of muscles related to pharyngeal swallowing.

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[Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r=0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula.

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[Purpose] The tendinous inscription divides the semitendinosus muscle into the proximal and distal compartments. It was hypothesized that there are functional differences between those compartments. [Subjects and Methods] Seven adult males performed knee flexion and hip extension in the prone position. An ultrasound device measured the decrease in the length of muscle fibers in the two compartments during these movements. The knee and hip joint angles were concurrently measured using a video camera. Pearson’s correlation coefficients were calculated between the decrease in muscle fiber length in each compartment and joint angle. [Results] During knee flexion, decreased muscle fiber length was significantly correlated with increased knee flexion angle. During hip extension, there were no significant correlations for either compartment. Only the decrease in muscle fiber length in the distal compartment during hip extension tended to be negative; the other decreases in muscle fiber length tended to be positive. [Conclusion] Correlations did not reveal any functional differences. However, only the distal compartment elongated during hip extension. This result might show a functional difference and could be applied in clinical contexts during hip extension.

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[Purpose] Patellofemoral pain syndrome is a frequent musculoskeletal disorder, which can result from core muscles instability that can lead to pain and altered dynamic balance. The objective of this study is to assess the effect of core muscle strengthening on pain and dynamic balance in female patients with patellofemoral pain syndrome. [Subjects and Methods] Twenty female patients with age ranging from 16 to 40 years with patellofemoral pain syndrome were divided into study (N=10) and control (N=10) groups. Both groups were given 4 weeks of conventional physical therapy program and an additional core muscle strengthening for the study group. The tools used to assess the outcome were Visual Analogue Scale and Star Excursion Balance Test. [Results] The results of the study show that participants in the study group revealed a significantly greater improvement in the intensity of pain and dynamic balance as compared to the control group. [Conclusion] Adding a core muscle-strengthening program to the conventional physical therapy management improves pain and dynamic balance in female patients with patellofemoral pain syndrome.

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[Purpose] Proper pelvic floor function is important to avoid serious dysfunctions including incontinence, prolapse, and sexual problems. The current study evaluated the knowledge of young nulliparous women about their pelvic floor and identified what additional information they wanted. [Subjects and Methods] In this cross-sectional survey, a validated, 36 item questionnaire was distributed to 212 nulliparous women. The questionnaire addressed demography, pelvic floor muscles, pelvic floor dysfunction, and possible information sources. Descriptive statistics were generated for all variables. Stability and validity testing were performed using Kappa statistics and intra class correlation coefficients to define agreement for each question. The study was approved by the ethics Committee (B300201318334). [Results] Using a VAS scale (0 to 10), the women rated their knowledge about the pelvic floor as a mean of 2.4 (SD 2.01). A total of 93% of the women were insufficiently informed and requested more information; 25% had concerns about developing urinary incontinence, and 14% about fecal incontinence. Many of the women were unaware what pelvic floor training meant. [Conclusion] There was a significant lack of knowledge about pelvic floor function among nulliparous women. The majority of nulliparous women expressed a need for education, which might offer a way to reduce dysfunction.

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[Purpose] The aim of this study was to determine the frequency of prosthetic applications and to appraise the importance of amputee rehabilitation in Turkey. [Subjects and Methods] Questionnaires were administered to owners or employees of 36 institutions and the obtained data were evaluated. [Results] While 75% of institutions had no physiotherapist, 25% had 1 or 2 physiotherapists; there were 4 or fewer technicians in 86.1%, and the majority of employees were out of profession in almost all institutions. A total of 83.3% of institutions reported falls, 75% reported complications, 58.3% of them occasionally noted the need of repair; 55.6% of institutions made preprosthetic assessments, 63.9% used gait analysis, and 50% performed prosthetic rehabilitation frequently. [Conclusion] The results of this study reveal the need for more physiotherapists in these centers, the utilization of standardized-objective assessment methods, and development of rehabilitation processes for successful prosthetic applications and amputee rehabilitation in Turkey.

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[Purpose] The effects of various rhythmic auditory stimulation tempos on stroke gait pattern changes when training patients with a smartphone-based rhythmic auditory stimulation application were investigated. [Subjects and Methods] Fifteen patients with chronic stroke were included. Cadence during comfortable walking was measured (baseline). After the baseline findings were recorded, rhythmic auditory stimulation with five different tempos (i.e., −10%, −5%, 0%, +5%, and +10% change from baseline) was randomly applied. Finally, comfortable walking without rhythmic auditory stimulation was initiated to evaluate gait pattern changes. [Results] As the tempo increased, the spatiotemporal gait parameters of the stroke patients changed significantly. Gait speed, cadence, and gait cycle duration showed the greatest improvement in the +10% rhythmic auditory stimulation condition compared to baseline. After gait training with rhythmic auditory stimulation, gait speed, cadence, stride length, gait cycle duration, and step length of the affected and unaffected sides improved significantly compared to baseline. [Conclusion] Significant changes in the gait pattern of stroke patients were noted for various tempos after training with rhythmic auditory stimulation. These findings could be used to customize rehabilitative gait training for patients who experience stroke with hemiplegia.

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[Purpose] The purpose of the present study was to examine the types of injuries associated with mixed martial arts and their location in order to provide substantial information to help reduce the risk of these injuries during mixed martial arts. [Subjects and Methods] Data were collected from 455 mixed martial arts athletes who practiced mixed martial arts or who participated in mixed martial arts competitions in the Seoul Metropolitan City and Gyeongnam Province of Korea between June 3, 2015, and November 6, 2015. Questionnaires were used to collect the data. The convenience sampling method was used, based on the non-probability sampling extraction method. [Results] The arm, neck, and head were the most frequent locations of the injuries; and lacerations, concussions, and contusions were the most frequently diagnosed types of injuries in the mixed martial arts athletes in this study. [Conclusion] Reducing the risk of injury by establishing an alert system and preventing critical injuries by incorporating safety measures are important.

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[Purpose] Physical therapy for recovery of function in people with stroke is known to be effective, but which type of physical therapy intervention is most effective is uncertain because a concrete and detailed record of interventions is done. This study aimed to record, analyze, and describe the content of physical therapy interventions for recovery of function after stroke using stroke physiotherapy intervention recording tool (SPIRIT). [Subjects and Methods] A convenience sample of 23 physical therapists from a rehabilitation hospital in Chung-nam recorded the interventions for 73 patients with stroke who were treated for 30 minutes in 670 treatment sessions. Treatment session contents were recorded using SPIRIT. Descriptive statistics were used to describe the interventions accurately and to investigate the differences according to time since stroke. [Results] Facilitation techniques were the most frequently used interventions (n=1,342, 35.1%), followed by practice (n=1,056, 27.6%), and exercise (n=748, 19.6%) in the physical therapists’ clinical practice. [Conclusion] This pattern shows that physical therapists were focused on functional activity. Organizing or teaching patient activities for independent practice interventions (n=286, 7.5%) were used to encourage patient activity and independence outside the treatment sessions. Interventions according to time since stroke were not significantly different.

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[Purpose] Whole body cryotherapy has been shown to have many benefits, yet nothing is known if and how this modality can improve neuromuscular performance and retain those improvements. [Subjects and Methods] Joint position sense based on the bilateral knee joint matching test and simple reaction time was investigated in 25 young healthy adults who underwent an extended period of whole body cryostimulation. The measurements were taken at baseline and after 10, 20, and 30 whole body cryotherapy sessions, with three days elapsing after the last treatment, and comparing the results with 24 control subjects. [Results] Only when 20 sessions were completed did joint position sense and simple reaction time improve in the intervention group. After 30 sessions, the outcome was similar. Equal results were found at baseline and after 10 sessions in both groups, but the intervention group outstripped controls after 20 and 30 sessions in both joint position sense and simple reaction time. [Conclusion] These results indicate that the common standard of 10 sessions is insufficient, while approximately 20 sessions of whole body cryotherapy may efficiently enhance neuromuscular performance with an ability to sustain the effects for at least three days.

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[Purpose] This study aimed 1) to assess whether a prediction model for whole body skeletal muscle mass that is based on a sedentary population is applicable to young male athletes, and 2) to develop a new skeletal muscle mass prediction model for young male athletes. [Subjects and Methods] The skeletal muscle mass of 61 male athletes was measured using magnetic resonance imaging (MRI) and estimated using a previous prediction model (Sanada et al., 2006) with B-mode ultrasonography. The prediction model was not suitable for young male athletes, as a significant difference was observed between the means of the estimated and MRI-measured skeletal muscle mass. Next, the same subjects were randomly assigned to a development or validation group, and a new model specifically relevant to young male athletes was developed based on MRI and ultrasound data obtained from the development group. [Results] A strong correlation was observed between the skeletal muscle mass estimated by the new model and the MRI-measured skeletal muscle mass (r=0.96) in the validation group, without significant difference between their means. No bias was found in the new model using Bland-Altman analysis (r=−0.25). [Conclusion] These results validate the new model and suggest that ultrasonography is a reliable method for measuring skeletal muscle mass in young male athletes.

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[Purpose] Increased plantar pressure during walking is a risk factor for foot ulcers because of reduced range of motion at the ankle and first metatarsophalangeal joints. However, the range of motion in patients undergoing hemodialysis has not yet been determined. A cross-sectional study was performed to investigate the factors affecting the range of motion of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis who walk daily. [Subjects and Methods] Seventy feet of 35 patients receiving hemodialysis therapy were examined. Measurements included the passive range of motion of plantar flexion and dorsiflexion of the ankle joint, and flexion and extension of the first metatarsophalangeal joint. [Results] Hemodialysis duration was not associated with ankle and first metatarsophalangeal joint range of motion in patients undergoing hemodialysis. Diabetes duration was significantly associated with limited ankle joint mobility. Finally, blood hemoglobin levels, body mass index, and age were associated with first metatarsophalangeal joint range of motion. [Conclusion] The present study identified age, diabetes, and decreased physical activity, but not hemodialysis duration, to be risk factors for limited joint mobility of the ankle and first metatarsophalangeal joints in patients undergoing hemodialysis.

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[Purpose] Many assumptions have been made about taping and several studies have considered tape application methods; however, the true effect of taping on muscle strength remains unclear. Most previous studies compared application techniques using Kinesio tape (KT), but studies that compared muscle strength using non-elastic tape (NT) are limited. Moreover, no studies have applied KT and NT in the same way to assess grip strength in normal subjects. The purpose of this study was to evaluate the immediate effect of application of two tapes with different elastic properties on maximal grip strength in healthy adults. [Subjects and Methods] Twenty healthy adults were divided into two groups (KT and NT). Maximal grip strength was measured with a dynamometer. Forearm extensor muscles of the dominant hand were then taped and subjects were immediately asked to perform hand grip movement with maximum strength in the same standardized manner. [Results] In the KT group, maximal grip strength was significantly increased compared to the initial value; however, in the NT group, there was no significant difference in maximal grip strength. [Conclusion] This study suggests that only Kinesio tape can increase maximal grip strength immediately after application on the extensor region of the forearm.

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[Purpose] This study investigated the effects of forward and backward walking using different treadmill incline positions on lower muscle activity in children with cerebral palsy, to provide baseline data for gait training intensity. [Subjects and Methods] Nineteen subjects with cerebral palsy walked forward and backward at a self-selected pace on a treadmill with inclines of 0%, 5%, 10%, and 15%. Activation of the rectus femoris, biceps femoris, tibialisanterior, and lateral gastrocnemius was measured using surface electromyography during the stance phase. [Results] As treadmill incline increased during forward walking, muscle activation of the paralyzed lower limbs did not significantly change. However, as treadmill incline increased during backward walking, rectus femoris activation significantly increased and a significant difference was found between treadmill inclines of 0% and 10%. A comparison of backward and forward walking showed a significant difference in rectus femoris activation at treadmill inclines of 0%, 5%, and 10%. Activation of the tibialis anterior was only significantly higher for backward walking at the 10% gradient. [Conclusion] Backward walking may strengthen the rectus femoris and tibialis anterior in walking training for cerebral palsy. Gradient adjustment of the treadmill can be used to select the intensity of walking training.

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[Purpose] This study investigated the effect of the use of trekking poles on muscle and cartilage damage and fatigue during downhill walking in obese women. [Subjects and Methods] Subjects included eight obese women who had a body fat percentage greater than 30. Subjects performed downhill walking without a trekking pole (NP) and with a trekking pole (TP) at 50% heart rate reserve for 30 minutes on a treadmill. The treadmill was set at a 15% downhill declination. Blood samples were collected to examine muscle damage (serum creatine kinase [CK] and lactate dehydrogenase [LDH] levels), cartilage damage (serum cartilage oligomeric matrix protein [COMP] levels), and fatigue (plasma lactate levels) at the pre-walking baseline (PWB), immediately after walking (IAW), and 2 hours post-walking (2HPW). [Results] The CK, LDH, COMP, and lactate levels were significantly increased IAW when compared with those at the PWB in both trials. In addition, in the NP trial, the CK, LDH, and COMP levels were significantly increased at 2HPW when compared with those at the PWB. [Conclusion] Downhill walking can cause muscle and cartilage damage, and our results suggest that the use of a trekking pole can reduce temporary muscle and cartilage damage after downhill walking.

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[Purpose] The aim of the present study was to determine whether eye movement in conjunction with functional electrical stimulation (FES) could improve balance ability in stroke patients with neglect syndrome. [Subjects and Methods] The subjects consisted of 15 stroke patients with neglect syndrome. The intervention was eye movement in conjunction with FES. The program was conducted 5 times per week, for 6 weeks. Static balance (eyes-open and eyes-closed) and dynamic balance were measured before and after testing. [Results] In measurement of static balance, subjects showed significant differences in sway length and sway area when examined in the eyes-open condition, but not the eyes-closed condition. In measurement of dynamic balance, the subjects showed significant differences in limit of stability (forward/backward and left/right). [Conclusion] These results indicate that eye movement in conjunction with FES had a positive effect on the static and dynamic balance in the eyes-open condition, but not in the eyes-closed condition of stroke patients with neglect syndrome. Further studies should therefore investigate various interventions in stroke patients with neglect syndrome.

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[Purpose] This study investigated the effects of the bridging plus exercise with heel lift on lower extremity muscles. [Subjects and Methods] Nine healthy males participated. The subjects performed bridging exercises under two conditions. Surface electromyography was used to measure the electrical activities of the medial hamstring (MH) and the gluteus maximus (GM) muscles. [Results] Activation of the MH muscle during bridging with heel lift decreased, and activation of the GM muscle during bridging with heel lift increased compared to those with the bridging exercise. [Conclusion] This result showed that bridging plus exercises with heel lift could be an effective exercise for patients with compensatory mechanisms during bridging exercises, such as weak GM with hamstring tightness.

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[Purpose] The improvements in gait of the patients with lower limb disease who used a temporomandibular joint (TMJ) exerciser were verified. [Subjects and Methods] Eleven subjects were included. Their mean age was 53.2 years. The lower limb joint angles before and after using the TMJ exerciser were measured using a gait analyzer. Before the gait experiment, the TMJ exerciser setting process and one-leg stance balance test (OLST) were repeated until the balance maintenance time improved. [Results] Because of the OLST, the mean change in the body center point after the subjects used the exerciser improved from 5.76 mm to 4.20 mm. When the TMJ exerciser was used, the joint angle range of the subjects approached that of the normal individuals. [Conclusion] According to the gait experiments, the angles of the subjects’ hips, knees, and ankle joints approached to those of the normal individuals after the subjects used the TMJ exerciser; however, the results did not completely match. The changes in the hip, knee, and ankle joint angles were statistically significant, which confirm the usefulness of the TMJ exerciser.

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[Purpose] The aim of this study was to examine the intra-observer reliability for Prechtl’s General Movements Assessment in Taiwanese infants. This includes the global General Movements Assessment, the Optimality List for Preterm General Movements and Writhing Movements, and the Assessment of Motor Repertoire—3 to 5 Months. [Subjects and Methods] Fifty-nine videos of 37 infants were observed and rated by one physical therapist twice. [Results] The intra-observer reliability ranged from good to very good for the global General Movements Assessment. The overall intra-observer reliabilities for the total score of the Optimality List from preterm up to postmenstrual age 46 weeks and the total score of the Assessment of Motor Repertoire for postmenstrual age 49 to 60 weeks were both good. [Conclusion] The results suggest that the intra-observer reliability of a certified physical therapist was satisfactory for Prechtl’s method in Taiwanese infants.

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[Purpose] Strength-duration (SD) curves are used in electrical diagnosis by physiotherapists to confirm muscle degeneration. However, the usefulness of SD curves in comparing muscle degeneration in DJ-1 homozygous knockout (DJ-1^−/−) and wild-type mice (DJ-1^+/+) is not yet fully understood. The electrical properties of the gastrocnemius muscles of DJ-1^−/− and DJ-1^+/+ mice were compared in the current study. [Subjects and Methods] The electrode of an electrical stimulator was applied to the gastrocnemius muscle to measure the rheobase until the response of contractive muscle to electrical stimulation became visible in mice. [Results] The rheobase of DJ-1^−/− mice showed a significant increase in a time-dependent manner, compared to that of DJ-1^+/+ mice. [Conclusion] These results demonstrate that the DJ-1 protein may be implicated in the regulation of neuromuscular activity of gastrocnemius muscles of mice.

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[Purpose] The purpose of this study was to examine immediate effects of strength training and NJF distal resistance training in wrist joints by using writing time and evaluation of proprioception using the JPE test. [Subjects and Methods] The subjects were 12 young healthy people (24.2 ± 3.1 y, 169.7 ± 6.5 cm, 65.3 ± 12.6 kg). Two isotonic contraction techniques were applied on the wrist joint: wrist joint extension muscle strength training (MST) and the wrist joint extension pattern of NJF. The uppercase English alphabet writing time and joint position errors of the left upper limb were measured before and after one intervention session of MST and NJF. [Results] The decrease in errors in wrist extension angle repetition and the writing time represented the improvement resulting from NJF. [Conclusion] This result suggests that the subdominant hands wrist joint proprioception and writing function can be improved by NJF together with proximal resistance training.

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[Purpose] This study was aimed at investigating the influence of seat height and body posture on the activity of the superior trapezius and longissimus muscles. [Subjects and Methods] Twenty two healthy subjects were instructed to perform a total of eight different body postures, varying according three main factors: seat height (low and high seat); trunk inclination (upright and leaning forward at 45°); and the hips in abduction and adduction. Electromyography of the superior trapezius and longissimus was collected bilaterally, and the average values were obtained and compared across all the postures. [Results] The activity of the superior trapezius and longissimus significantly changes according to the seat height and trunk inclination. For both seat heights, sitting with trunk leaning forward resulted in a significant increase in the activity of both muscles. When sitting in a high seat and the trunk leaning forward, the superior trapezius activity was significantly reduced when compared to the same posture in a low seat. [Conclusion] This study contributes to the knowledge on the influence of the body posture and seat configuration on the activity of postural muscles. Reducing the biomechanical loads on the postural muscles must be targeted in order to improve users’ comfort and safety.

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[Purpose] Poor posture in children and adolescents is a well-known problem. Therefore, early detection of incorrect posture is important. Photometric posture analysis is a cost-efficient and easy method, but needs reliable reference values. As children’s posture changes as they grow, the assessment needs to be age-specific. This study aimed to investigate the development of both one-dimensional posture parameter (body inclination angle) and complex parameter (posture index) in different age groups (childhood to adolescence). [Subjects and Methods] The participants were 372 symptom-free children and adolescents (140 girls and 232 boys aged 6–17). Images of their habitual posture were obtained in the sagittal plane. High-contrast marker points and marker spheres were placed on anatomical landmarks. Based on the marker points, the body inclination angle (INC) and posture index (PI) were calculated using the Corpus concepts software. [Results] The INC angle significantly increased with age. The PI did not change significantly among the age groups. No significant differences between the corresponding age groups were found for PI and INC for both sexes. [Conclusion] When evaluating posture using the body inclination angle, the age of the subject needs to be considered. Posture assessment with an age-independent parameter may be more suitable.

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[Purpose] The purpose of this study was to examine the correlation between lower extremity muscle thickness and gait ability through the 10-meter walk and timed up and go tests. [Subjects and Methods] A total of 28 children (20 males and 8 females) with spastic cerebral palsy undergoing physical therapy at D hospital in D city, South Korea participated in this study. Partial correlation analysis was performed to analyze the correlation between lower extremity muscle thickness and gait ability (10-meter walk test and timed up and go test). [Results] There was a positive correlation between muscle thickness and the 10-meter walk test (RF=0.41 and VL=0.52). Correlation between the muscle thickness and the timed up and go had a negative correlation (VL=−0.45, MG=−0.51, and LG=−0.39). [Conclusion] In children with cerebral palsy, knee extensor muscles that are more developed increased gait ability and calf muscles that are more developed increased sit to stand ability.

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[Purpose] Tripping is a frequent cause of falls among aging adults. Appropriate limb movements while negotiating obstacles are critical to trip avoidance. The aim of our study was to investigate the mechanics of obstacle crossing in older adults at low or high risk of falling. [Subjects and Methods] Twenty community-dwelling adults aged ≥55 years, were evaluated with the Tinetti Balance and Gait scale and classified as being at high or low risk of falling. Between-group comparisons of kinematics were evaluated for obstacle heights of 10%, 20%, and 30% of leg length. [Results] The high-risk group demonstrated greater toe-obstacle clearance of the leading leg. Increasing obstacle height led to increased maximal toe-obstacle clearance, toe-obstacle distance, and shortened swing phase of the leading limb. Adaptation of clearance height was greater for the trailing leg. Individuals at high risk of falling demonstrated less symmetry between the leading and trailing legs and a narrower step width, features that increase the likelihood of tripping. [Conclusion] Kinematic parameters of obstacle clearance, including the symmetry index described in our study, could provide clinicians with a quick screening tool to identify patients at risk of falling and to evaluate outcomes of training programs.

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[Purpose] Observational study investigating the influence of various ankle-foot orthoses on the spatiotemporal gait parameters and functional balance in chronic stroke patients. [Subjects and Methods] Fifteen chronic stroke patients participated in this study after providing informed consent. Two groups of patients were differentiated based on the Timed Up and Go Test. Patients were tested in three different conditions: with standard prefabricated ankle-foot orthosis (Maramed), with individualized ankle-foot orthosis (Y-tech), and without any ankle-foot orthrosis. Spatiotemporal gait parameters were obtained by walking on an instrumented walkway (GAITRite^®) at usual and fastest speed. Balance was assessed with Timed Up and Go Test, Step Test, and Four Square Step Test. [Results] Maramed and Y-tech significantly improved the spatiotemporal parameters while walking at usual and maximal speed (single support time affected side; double support time affected side and step length unaffected side). The Y-tech in addition improved velocity and cadence. Among the balance tests, only the Timed Up and Go test showed improvements in favor of Maramed and Y-tech. [Conclusion] Patients benefited from wearing orthosis at both usual and maximal speed, irrespective of whether they wore Maramed or Y-tech. Only severe stroke patients benefited from wearing an orthoses compared to mild impaired group.

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[Purpose] This study examined the effects of balance training by applying knee joint movements on muscle activity in male adults with functional ankle instability. [Subjects and Methods] 28 adults with functional ankle instability, divided randomly into an experimental group, which performed balance training by applying knee joint movements for 20 minutes and ankle joint exercises for 10 minutes, and a control group, which performed ankle joint exercise for 30 minutes. Exercises were completed three times a week for 8 weeks. Electromyographic values of the tibialis anterior, peroneus longus, peroneus brevis, and the lateral gastrocnemius muscles were obtained to compare and analyze muscle activity before and after the experiments in each group. [Results] The experimental group had significant increases in muscle activity in the tibialis anterior, peroneus longus, and lateral gastrocnemius muscles, while muscle activity in the peroneus brevis increased without significance. The control group had significant increases in muscle activity in the tibialis anterior and peroneus longus, while muscle activity in the peroneus brevis and lateral gastrocnemius muscles increased without significance. [Conclusion] In conclusion, balance training by applying knee joint movements can be recommended as a treatment method for patients with functional ankle instability.

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[Purpose] This study investigated whether hip adductor activity was influenced by electrical stimulation of the tensor fascia lata muscle. [Subjects and Methods] The subjects were 16 nondisabled males. Each subject was asked to adduct the hip joint with maximum effort. The electromyogram of the adductor longus was recorded under two experimental conditions, with and without electrical stimulation of the tensor fascia lata. [Results] In the presence of electrical stimulation, muscle activity decreased to 72.9% (57.8–89.3%) of that without stimulation. [Conclusion] These results suggested that inactivation of the adductor group was promoted by electrical stimulation of the tensor fascia lata.

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