[Purpose] To study preoperative and postoperative hip circumference data of various types of congenital dysplasia of the hip treated with total hip replacement, including the femoral offset, femoral neck length, height, and hip abductor arm parameters. [Subjects and Methods] This study included seventy-eight cases of congenital dysplasia of the hip (I–III type). Furthermore, four parameters were measured, including the preoperative and postoperative femoral offset. Statistical data analysis was performed using the SPSS 13.0 software. [Results] The femoral offset was 33.3 ± 8.4 mm (preoperative) and 39.1 ± 7.1 mm (postoperative). The femoral head height was 59.5 ± 8.7 mm (preoperative) and 68.8 ± 11.0 mm (postoperative). The femoral neck length was 50.8 ± 10.8 mm (preoperative) and 61.5 ± 10.4 mm (postoperative). The hip abductor arm was 54.3 ± 9.6 mm (preoperative) 64.7 ± 10.1 mm (postoperative). The preoperative and postoperative parameters showed statistical differences. Furthermore, no significant differences were evidenced when comparing the postoperative hip parameters with the normal data parameters. [Conclusion] Total hip replacement on congenital dysplasia of the hip could lead to the rebuilt of an almost normal physiological anatomy for each hip case (type I–III).

[Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care.

[Purpose] This study investigated the flexion-relaxation phenomenon of the erector spinae in elderly women with chronic knee osteoarthritis and determined whether the flexion-relaxation phenomenon can be used as a pain evaluation tool in such cases. [Subjects and Methods] Seventeen elderly females with chronic knee osteoarthritis and 13 healthy young females voluntarily participated in this study. They performed three postural positions in 15 s: trunk flexion, complete trunk flexion, and trunk extension, each for 5 s. While these positions were held, muscle activation of the thoracic and lumbar erector spinae were measured using surface electromyography. The flexion-relaxation rate was determined by dividing the values for trunk extension by those of complete trunk flexion and by dividing the values for trunk flexion by those of complete trunk flexion. [Results] According to our results, the flexion-relaxation phenomenon was different between healthy young and elderly females with chronic knee osteoarthritis. Specifically, there was a difference in the left thoracic erector spinae muscle, but not in the left and right lumbar erector spinae or right thoracic spinae muscle. [Conclusion] Our study demonstrated that the erector spinae muscle flexion-relaxation phenomenon can be used as a pain evaluation tool in elderly females with chronic knee osteoarthritis.

[Purpose] Little is known about the effects of biomechanical foot orthoses in scoliosis, as determined by raster stereography. The objective of this study was to investigate the effect of individually manufactured biomechanical foot orthoses on scoliosis angle, trunk imbalance, and pelvic obliquity by comparing them with general insoles by using DIERS formetric 4 dimensional in patients with scoliosis. [Subjects and Methods] Twenty-six patients with scoliosis were recruited at Yeungnam University Hospital and allocated equally to one of two groups, the biomechanical foot orthoses group or the control group. Parameters, such as, trunk rotation, imbalance, and scoliosis angle, were obtained using a DIERS formetric 4D. [Results] Scoliosis angle, pelvic obliquity, and trunk imbalance were significantly different between the two groups and improved in the biomechanical foot orthoses group with time, but no significant improvement in any parameter was observed in the control group. [Conclusion] Biomechanical foot orthoses could be effective in patients with scoliosis, and DIERS formetric 4D provides a useful method for evaluating scoliosis parameters.

[Purpose] One of the characteristics of autistic children is social interaction difficulties. Although therapeutic toys can promote social interaction, however its related research remains insufficient. The aim of the present study was to build a set of cooperative play toys that are suitable for autistic children. [Subjects and Methods] This study used an innovative product design and development approach as the basis for the creation of cooperative play toys. [Results] The present study has successfully developed cooperative play toys. Compared to the traditional game therapy for autism, cooperative play toy therapy can significantly improve the interactions between autistic children and their peers. [Conclusion] The most critical design theme of cooperative play toys focuses on captivating the interest of autistic children. Based on the needs of the individual cases, the design of the therapeutic toy set was specifically tailored, i.e., by reinforcing the sound and light effects to improve the attractiveness of the toys. In the future, different play modes can be combined with this toy set to further enhance the degree of interaction of autistic children and improve their quality of life and social skills.

[Purpose] The aim of this study was to investigate the effects of sequential pneumatic compression therapy on venous blood flow, refilling time, pain level, and quality of life in women with varicose veins. [Subjects and Methods] Twenty-eight females with varicose veins were selected and randomly allocated to a control group, and experimental group. Maximum and mean venous blood velocities, the refilling time, pain by visual analog scale and quality of life by Aberdeen Varicose Veins Questionnaire were measured in all patients before and after six weeks of treatment. Both groups received lower extremity exercises; in addition, patients in the experimental group received sequential pneumatic compression therapy for 30 minutes daily, five days a week for six weeks. [Results] All measured parameters improved significantly in both groups, comparison of post treatment measurements between groups showed that the maximum and mean blood flow velocity, the pain level, and quality of life were significantly higher in the experimental group compared with the control group. On the other hand there was no significant difference between groups for refilling time. [Conclusion] Sequential pneumatic compression therapy with the applied parameters was an effective modality for increasing venous blood flow, reducing pain, and improving quality of women life with varicose veins.

[Purpose] This study was aimed to analyse the effects of short-term use of compression stockings (CS) on symptoms and QoL in patients with Chronic Venous Insufficiency (CVI). [Subjects and Methods] Based on the CEAP classification C2 and C3, 117 patients with CVI were enrolled in this study. The participants were divided into two groups. The control group refused to use CS, however, was advised to do exercises and take skin care whereas the CS group used CS and performed exercise. The data were collected by using Nottingham Health Profile (NHP), Venous Insufficiency Epidemiological and Economic Study (VEINES-QoL/Sym) and Beck Depression Inventory (BDI) at baseline and after four weeks of treatment and compared within and in between groups. [Results] The comparison of pre- and post-treatment differences between groups was statistically significant for all parameters. In the study group, pre- and post-treatment scores for each parameter were significantly different. However, elevated scores in the control group suggested worsening of the illness. [Conclusion] This study established that short-term use of CS in patients with CVI significantly improved disease specific and general QoL by reducing venous symptoms. Further studies with larger sample size are necessary to confirm these findings.

[Purpose] The aims of this study were twofold. The first was to compare the functional capacity and pain of patients with knee osteoarthritis (KOA), with or without pes anserine tendino-bursitis (PATB). The second is to compare the efficacy of two treatment methods (physical therapy and corticosteroid injection) for patients with PATB. [Subjects and Methods] Sixty patient with KOA and PATB (Group 1) and 57 patients with KOA but without PATB (Group 2) were enrolled in the study. The patients’ visual analog scale (VAS), Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scores and three-meter timed-up and go scores were measured. The PATB group was randomly divided into two groups (Group A and B). Physical therapy (PT) modalities were applied to the first group (Group A), and the second group (Group B) received corticosteroid injections to the pes anserine area. Eight weeks later, patients’ parameters were measured again. [Results] Initial WOMAC scores and timed up-and-go times were significantly higher in Group 1 than in Group 2. Both treatments resulted in significant improvements in all measured parameters, but no significant difference was detected between Group A and B. [Conclusion] Patients with PATB tend to have more severe pain, more altered functionality, and greater disability than those with KOA but without PATB. Both corticosteroid injection and PT are effective methods of treatment for PATB. Injection therapy can be considered an effective, inexpensive and fast therapeutic method.

[Purpose] The aim of this study was to compare the unaffected upper extremity of patients with hemiparesis with that of healthy subjects in terms of function, pain, and tactile sense. [Subjects and Methods] Upper extremity evaluation parameters of 20 patients with hemiparesis were compared with an age-matched control group of 20 healthy subjects. A shorter version of the Disability of Arm and Shoulder Questionnaire, Upper Extremity Functional Index, and Simple Shoulder Test were used to evaluate the upper extremity functionality. The Visual Analog Scale was used to measure pain severity at rest, at night, and during activity. Tactile sensation levels were assessed by Semmes-Weinstein monofilaments at four palmar areas. [Results] A statistically significant difference was found in the upper extremity functionality between the groups. Pain severity at rest was significantly higher in the hemiparetic group. There was no significant difference in night and activity pain severities or tactile sensation levels between the groups. [Conclusion] According to our results, the unaffected side of patients with hemiparesis differs in functionality and pain at rest compared with that of healthy persons. Studies with larger sample size and various evaluation tests are needed to further investigate the unaffected side of patients with hemiparesis.

[Purpose] The aim of the present study was to determine whether repetitive transcranial magnetic stimulation can improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients. [Subjects and Methods] This study was conducted on 20 subjects with diagnosed paraplegia due to spinal cord injury. These 20 subjects were allocated to an experimental group of 10 subjects that underwent active repetitive transcranial magnetic stimulation or to a control group of 10 subjects that underwent sham repetitive transcranial magnetic stimulation. The SCI patients in the experimental group underwent active repetitive transcranial magnetic stimulation and conventional rehabilitation therapy, whereas the spinal cord injury patients in the control group underwent sham repetitive transcranial magnetic stimulation and conventional rehabilitation therapy. Participants in both groups received therapy five days per week for six-weeks. Latency, amplitude, and sensory nerve conduction velocity were assessed before and after the six week therapy period. [Results] A significant intergroup difference was observed for posttreatment velocity gains, but no significant intergroup difference was observed for amplitude or latency. [Conclusion] repetitive transcranial magnetic stimulation may be improve sensory recovery of the lower extremities in subacute-stage spinal cord injury patients.

[Purpose] Spondyloarthritis is a major inflammatory disease followed-up in the rheumatology clinics, foot involvement in spodyloarthritis is common. The functional states of patients with spondyloarthritis are usually evaluated globally. The aim of this study was to assess the foot involvement-related functional limitations in patients with spondyloarthritis. [Subjects and Methods] Patients with ankylosing spondylitis and psoriatic arthritis with foot pain more than 4 weeks who underwent anteroposterior and lateral feet radiography were enrolled into the study. A “clinical findings score” was calculated by assigning 1 point for every finding of swelling, redness, and tenderness. C-reactive protein and erythrocyte sedimentation rate were used as serum markers for disease activity. Foot radiograms were evaluated using the spondyloarthropathy tarsal radiographic index and the foot-related functional state of patients was determined by the Turkish version of the Foot and Ankle Outcome Score. [Results] There were no relationships between Foot and Ankle Outcome Score subscales and clinical findings score, serum markers, or radiologic score. Pain and symptoms subscale scores were result positively correlated with activity of daily living, sport and recreation, and quality of life subscale scores. [Conclusion] Pain and symptoms are the main determinants of foot-related functional limitations in spondyloarthritis.

[Purpose] This study compared the effects of pilates and an exercise program on the craniovertebral angle, cervical range of motion, pain, and muscle fatigue in subjects with a forward head posture (FHP). [Subjects and Methods] A total of 28 sedentary females (age 20 to 39 years) with FHP were randomly assigned to pilates (n=14) and combined (n=14) exercise groups. The study was a randomized, controlled, double-blind study with the two groups performing exercise 50 min/day, 3 days/week, with an intensity of 11–15 rating of perceived exertion (RPE) for ten weeks. The main outcome measures were craniovertebral angle, cervical range of motion (ROM), pain levels assessed by visual analog scale (VAS), and neck disability index (NDI). Surface electromyography was also used to measure muscle fatigue. [Results] There were significant increases in craniovertebral angle and cervical ROM in the pilates group, but none in the control group. The only significant differences in muscle activity were recorded in the sternocleidomastoid muscle in the pilates group. Both exercise programs had positive effects on pain measures, as VAS and NDI were significantly decreased. [Conclusion] The results suggest that pilates could be recommended as an appropriate exercise for treatment of FHP in sedentary individuals.

[Purpose] The purpose of this study was to identify the effects of trunk stability exercise using proprioceptive neuromuscular facilitation with changes in chair heights on the gait of stroke patients. [Subjects and Methods] The subjects of this study were 11 stroke patients. The intervention method was trunk stability exercise using proprioceptive neuromuscular facilitation with different chair heights (50, 60, and 70 cm). These exercises were performed 5 times per week for 6 weeks. Gait velocity, cadence, stride length, gait cycle, and stance phase duration were used to measure gait function. [Results] Significant changes in gait velocity, cadence, and stride length were observed on the affected side. However, no significant changes in gait cycle and stance phase were observed on the affected side. [Conclusion] These results indicate that trunk stability exercise using proprioceptive neuromuscular facilitation with change in chair heights were effective in improving gait velocity, cadence, and stride length on the affected side. However, in this study, no significant changes were observed in gait cycle and stance phase on the affected side. Therefore, various interventions for stroke patients should be investigated in further studies.

[Purpose] This study was aimed at investigating the preliminary therapeutic efficacy and usefulness of canoe game-based virtual reality training for stroke patients. [Subjects and Methods] Ten stroke patients were randomly assigned to an experimental group (EG; n=5) or a control group (CG; n=5). Patients in both groups participated in a conventional rehabilitation program, but those in the EG additionally participated in a 30-min canoe game-based virtual reality training program 3 days a week for 4 weeks. Therapeutic efficacy was assessed based on trunk postural stability, balance, and upper limb motor function. In addition, the usefulness of canoe game-based virtual reality training was assessed in the EG and therapist group (TG; n=20), which consisted of physical and occupational therapists, by using the System Usability Scale (SUS). [Results] Improvements in trunk postural stability, balance, and upper limb motor function were observed in the EG and CG, but were greater in the EG. The mean SUS scores in the EG and TG were 71 ± 5.2 and 74.2 ± 4.8, respectively. [Conclusion] Canoe game-based virtual reality training is an acceptable and effective intervention for improving trunk postural stability, balance, and upper limb motor function in stroke patients.

[Purpose] This study investigated the effects of gait time and trunk acceleration ratio in old-old adult females during stair climbing. [Subjects and Methods] Twenty-five older adult females who were able to walk independently volunteered for this study and were categorized into two age groups (older adults or old-old adults). Gait time and trunk acceleration ratio were measured using an accelerometer during stair climbing. [Results] Gait time and trunk acceleration ratio when climbing stairs were significantly higher in the old-old age group than in the older adults group. [Conclusions] These findings suggest that old-old females have decreased upper trunk control. In addition, gait time and the trunk acceleration ratio during stair climbing are useful clinical markers for predicting function and balance control ability in old-old elderly populations.

[Purpose] This study investigated the clinical efficacy of the compound gouteng tincture combined with Zhoubo (GT-ZB) in treating the sequelae of cerebral concussion (CC) in children. [Subjects and Methods] Sixty children with CC-sequelae were randomily divided into a treatment group and a control group, with 30 cases in each group. The treatment group was treated using GT-ZB, and the control group was treated using the standard method of venoruton, dibazol, and Vitamin B6. The efficacies of the two treatments were compared. [Results] Compared with the control group, the clinical symptoms and signs in the treatment group were significantly mitigated. [Conclusion] GT-ZB demonstrated efficacy in treating the sequelae of CC in children, and it is worthy of further studies and possible clinical recommendations.

[Purpose] The purpose of this study was to examine the immediate effects of robot-assisted therapy on functional activity level after anterior cruciate ligament reconstruction. [Subjects and Methods] Participants included 10 patients (8 males and 2 females) following anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy and treadmill exercise on different days. The Timed Up-and-Go test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and maximal extensor strength of isokinetic movement of the knee joint were evaluated in both groups before and after the experiment. [Results] The results for the Timed Up-and-Go Test and the 10-Meter Walk Test improved in the robot-assisted rehabilitation group. Surface electromyography of the vastus medialis muscle showed significant increases in maximum and average discharge after the intervention. [Conclusion] The results suggest that walking ability and muscle strength can be improved by robotic training.

[Purpose] To evaluate the short-term effects of kinesio tape on joint position sense, isokinetic measurements, kinesiophobia, symptoms, and functional limitations in patients with patellofemoral pain syndrome. [Subjects and Methods] A total of 90 patients (112 knees) with patellofemoral pain syndrome were randomized into a kinesio tape group (n=45) or placebo kinesio tape group (n=45). Baseline isokinetic quadriceps muscle tests and measurements of joint position sense were performed in both groups. Pain was measured with a Visual Analog Scale, kinesiophobia with the Tampa kinesiophobia scale, and symptoms and functional limitations with the Kujala pain scale. Measurements were repeated 2 days after kinesio tape application. [Results] No differences were found between baseline isokinetic muscle measurements and those taken 2 days after application. However, significant improvements were observed in the kinesio tape group, with regard to joint position sense, pain, kinesiophobia, symptoms, and functional limitations after treatment. Examination of the differences between pre- and post-treatment values in both groups revealed that the kinesio tape group demonstrated greater improvements compared to the placebo kinesio tape group. [Conclusion] Although short-term kinesio tape application did not increase hamstring muscle strength, it may have improved joint position sense, pain, kinesiophobia, symptoms, and daily limitations.

[Purpose] This study aimed to examine the effects of mental practice on the balance abilities of normal individuals. [Subjects and Methods] Thirty subjects were randomly assigned to an experimental or control group (n=15 each). Participants in both groups performed balance training in a seated position on a gym ball for 20 minutes per session, five sessions per week, for 4 weeks. Members of the experimental group also performed mental practice for 10 minutes before the balance training. After the intervention, balance measuring equipment (Good Balance, Metitur, Finland) was used to quantitatively measure balance ability. [Results] Significant post-training gains were observed in the mediolateral, index of balance function, and time variables of participants of the experimental group. [Conclusion] The application of mental practice with balance training positively affected balance ability.

[Purpose] The purpose of this study was to determine the effect of aquatic dual-task training on balance and gait in stroke patients. [Subjects and Methods] Twenty stroke patients were divided into the experimental (n=10) and control (n=10) groups. Both groups underwent neurodevelopmental treatment. The experimental group additionally underwent aquatic dual-task training for 30 minutes a day, 5 days a week, for 6 weeks. Balance was measured using the Berg balance scale, Five Times Sit-to Stand Test, and Functional Reach Test. Gait was measured using the 10-Meter Walk Test, Timed Up and Go Test, and Functional Gait Assessment. [Results] For intragroup comparison, the experimental group showed a significant change after the experiment in all balance and gait assessment tests. For intergroup comparison, the experimental group showed relatively more significant change after the experiment in all balance and gait assessment tests. [Conclusion] Our results showed that aquatic dual-task training has a positive effect on balance and gait in stroke patients.

[Purpose] The aim of study was to evaluate the impact of physical therapy on the recovery of motor and mental status in patients who sustained a severe traumatic brain injury, according to coma duration in acute and post-acute rehabilitation. [Subjects and Methods] The study population comprised patients with levels of consciousness ranging from 3 to 8 according to Glasgow Coma Scale score. The patients were divided into 2 groups based on coma duration as follows: group 1, those who were in a coma up to 1 week, and group 2, those who were in a coma for more than 2 weeks. The recovery of the patients’ motor function was evaluated according to the Motor Assessment Scale and the recovery of mental status according to the Mini-Mental State Examination. [Results] The evaluation of motor and mental status recovery revealed that the patients who were in a coma up to 1 week recovered significantly better after physical therapy during the acute rehabilitation than those who were in a coma for longer than 2 weeks. [Conclusion] The recovery of motor and mental status of the patients in acute rehabilitation was significantly better for those in a coma for a shorter period.

[Purpose] The purpose of this study was to examine the effect of virtual reality-based eccentric training on lower extremity muscle activity and balance in stroke patients. [Subjects and Methods] Thirty stroke patients participated, with 15 patients allotted to each of two eccentric training groups: one using a slow velocity (group I) and one using a fast velocity (group II). The virtual reality-based eccentric training was performed by the patients for 30 minutes once a day, 5 days a week, for 8 weeks using an Eccentron system. Surface electromyography was used to measure the lower extremity muscle activity, while a BioRescue was used to measure balancing ability. [Results] A significant difference in lower extremity muscle activation and balance ability was observed in group I compared with group II. [Conclusion] This study showed that virtual reality-based eccentric training using a slow velocity is effective for improving lower extremity muscle activity and balance in stroke patients.

[Purpose] The purpose of this study was to examine how carrying methods and load affects pelvic movement while walking. [Subjects and Methods] Sixteen healthy subjects (age 20.68 ± 1.95 years, height 167.56 ± 8.46 cm, weight 60.25 ± 9.37 kg) volunteered. The items carried included a hand bag, shoulder bag, cross bag, and a back pack. The load weights were 0%, 5%, 10% and 15% of body weight. G-Walk was used to record and analyze pelvic movement while the participants walked with different loads. [Results] In the case of hand bags and shoulder bags, pelvic tilt increased along with weight. In particular, when compared with the 0%, 5% and 10% load conditions, the 15% load of a hand bag induced a significant increase. Pelvic rotation showed a tendency to decrease as the weight increased. [Conclusion] Lateral pelvic tilt is thought to increase when the weight exceeds 15% of body weight, thereby resulting in decreased efficiency of gait. The pelvic rotation is thought to decrease as the weight increases, causing restricted upper limb movements.

[Purpose] The aim of this study was to investigate the cardiovascular autonomic acute response, during recovery after handcycle training, in quadriplegics with spinal cord injury (SCI). [Subjects and Methods] Seven quadriplegics (SCIG −level C6–C7, male, age 28.00 ± 6.97 years) and eight healthy subjects (CG −male, age 25.00 ± 7.38 years) were studied. Their heart rate variability (HRV) was assessed before and after one handcycle training. [Results] After the training, the SCIG showed significantly reduced: intervals between R waves of the electrocardiogram (RR), standard deviation of the NN intervals (SDNN), square root of the mean squares differences of sucessive NN intervals (rMSSD), low frequency power (LF), high frequency power (HF), and Poincaré plot (standard deviation of short-term HRV −SD1 and standard deviation of long-term HRV −SD2). The SDNN, LF, and SD2 remained decreased during the recovery time. The CG showed significantly reduced: RR, rMSSD, number of pairs of adjacent NN intervals differing by more than 50 ms (pNN50), LF, HF, SD1, and sample entropy (SampEn). Among these parameters, only RR remained decreased during recovery time. Comparisons of the means of HRV parameters evaluated between the CG and SCIG showed that the SCIG had significantly lower pNN50, LF, HF, and SampEn before training, while immediately after training, the SCIG had significantly lower SDNN, LF, HF, and SD2. The rMSSD30s of the SCIG significantly reduced in the windows 180 and 330 seconds and between the windows 300 seconds in the CG. [Conclusion] There was a reduction of sympathetic and parasympathetic activity in the recovery period after the training in both groups; however, the CG showed a higher HRV. The parasympathetic activity also gradually increased after training, and in the SCIG, this activity remained reduced even at three minutes after the end of training, which suggests a deficiency in parasympathetic reactivation in quadriplegics after SCI.

[Purpose] The aim of this study was to compare improvements in swallowing function by the intervention of the Masako maneuver and neuromuscular electrical stimulation in patients with dysphagia caused by stroke. [Subjects and Methods] The Masako maneuver (n=23) and neuromuscular electrical stimulation (n=24) were conducted in 47 patients with dysphagia caused by stroke over a period of 4 weeks. Swallowing recovery was recorded using the functional dysphagia scale based on videofluoroscopic studies. [Results] Mean functional dysphagia scale values for the Masako maneuver and neuromuscular electrical stimulation groups decreased after the treatments. However, the pre-post functional dysphagia scale values showed no statistically significant differences between the groups. [Conclusion] The Masako maneuver and neuromuscular electrical stimulation each showed significant effects on the improvement of swallowing function for the patients with dysphagia caused by stroke, but no significant difference was observed between the two treatment methods.

[Purpose] To evaluate the efficacy of pre-exercise on immobilization and subsequent recovery of white gastrocnemius (WG) and soleus (SOL) muscles of female rats. [Subjects and Methods] Thirty, 8-month-old, female Wistar rats were randomly and evenly allocated to six groups: sedentary (S); immobilized sedentary (IS); immobilized/rehabilitated sedentary (IRS); trained (T); immobilized trained (IT); and immobilized/rehabilitated trained (IRT). For four months, T, IT and IRT group animals performed swimming exercise (three sessions per week, 60 minutes per session), while S, IS and IRS groups animals remained housed in cages. After this period, the left hindlimb of the animals from the IS, IRS, IT and IRT groups was immobilized for five days, with the ankle at 90°. After removal of the orthosis, animals from the IRS and IRT groups followed a rehabilitation program based on swimming (five sessions per week, 60 minutes per session) for two weeks. [Results] Immobilization significantly reduced the cross-sectional area of the white gastrocnemius muscle; no changes were observed in the soleus muscles of the trained animals. Transforming growth factor-β1 protein levels were similar among the trained groups. [Conclusion] Prior swimming prevents hypotrophy of the soleus muscle after immobilization, and protein levels reflected the adaptive capacity of the skeletal muscle.

[Purpose] Trochanteric bursitis is a disease for which there are no effective standardized therapy protocols. Very often pain persists in spite of applying all therapeutic treatments. The purpose of this study was to determine whether treatment of trochanteric bursitis with a local injection of bicomponent corticosteroid and 2% lidocaine would improve patients’ conditions and relieve pain symptoms in the trochanteric area. [Subjects and Methods] A retrospective observational study was conducted of 2,217 patients in a 6 year follow-up period at the Special Hospital “Agens”, Mataruska Banja, Serbia. [Results] Of 2,217 examined patients, 58 (2.6%) patients were found to suffer from trochanteritis associated with low back pain, and 157 (7%) were found to suffer from trochanteric pains without low back pains. Local corticosteroid therapy followed by physical therapy was effective in 77 (49%) of these patients, and only corticosteroid injection in 61 (39%) patients. A single injection was given to 47 (29.9%) of the patients. Two injections were given to 9 (5.7%) patients, and from 3 to 5 injections were given repeatedly every 4–6 weeks to 7 (4.5%) patients. [Conclusion] For most patients, local injections of corticosteroids with lidocaine alone or followed by physical therapy gave satisfactory results.

[Purpose] This study investigated intra-rater reliability when using a tympanic thermometer under different self-measurement conditions. [Subjects and Methods] Ten males participated. Intra-rater reliability was assessed by comparing the values under three conditions of measurement using a tympanic thermometer. Intraclass correlation coefficients were used to assess intra-rater reliability. [Results] According to the intraclass correlation coefficient analysis, reliability could be ranked according to the conditions of measurement. [Conclusion] The results showed that self-measurement of body temperature is more precise when combined with common sense and basic education about the anatomy of the eardrum.

[Purpose] The aim of this study was to examine the immediate effects of neuromuscular joint facilitation (NJF) on the functional activity level after rehabilitation of anterior cruciate ligament (ACL) reconstruction. [Subjects and Methods] Ten young subjects (8 males and 2 females) who underwent ACL reconstruction were included in the study. The subjects were divided into two groups, namely, knee joint extension muscle strength training (MST) group and knee joint extension outside rotation pattern of NJF group. Extension strength was measured in both groups before and after the experiment. Surface electromyography (sEMG) of the vastus medialis and vastus lateralis muscles and joint position error (JPE) test of the knee joint were also conducted. [Results] JPE test results and extension strength measurements in the NJF group were improved compared with those in the MST group. Moreover, the average discharge of the vastus medialis and vastus lateralis muscles on sEMG in the NJF group was significantly increased after MST and NJF treatments. [Conclusion] The obtained results suggest that NJF training in patients with ACL reconstruction can improve knee proprioception ability and muscle strength.

[Purpose] This study evaluated the effects of 12 weeks combined aerobic and resistance exercise on heart rate variability in patients with Type 2 diabetes mellitus. [Subjects and Methods] The subjects were 16 female patients with Type 2 diabetes mellitus selected among the participants of a chronic disease management exercise class at C Region Public Health Center in South Korea. Subjects were randomly assigned to the exercise group (n=8; age, 55.97 ± 7.37) or the control group (n=8; age, 57.53 ± 4.63) The exercise group performed aerobic and resistance exercises for 60 minutes per day, 3 times per week for 12 weeks. Anthropometric measurements, biochemical markers, physical fitness, and heart rate variability were examined. [Results] After 12 weeks of exercise, weight, body fat percentage, waist circumference, blood glucose, insulin resistance, glycated hemoglobin level, systolic blood pressure, and diastolic blood pressure significantly decreased and cardiorespiratory fitness and muscular strength significantly increased in the exercise group. Although heart rate variability measures showed favorable changes with the exercise program, none were significant. [Conclusion] Although the exercise program did not show notable changes in heart rate variability in patients with Type 2 diabetes within the timeframe of the study, exercise may contribute to the prevention and control of cardiovascular autonomic neuropathy.

[Purpose] Differences in scores on the Functional Movement Screen between patients with chronic lower back pain and healthy control subjects were investigated. [Subjects and Methods] In all, 20 chronic lower back pain patients and 20 healthy control subjects were recruited. Chronic lower back pain patients and healthy controls performed the Functional Movement Screen (deep squat, hurdle step, inline lunge, shoulder mobility, active straight leg raise, trunk stability pushup, and rotary stability). The Mann-Whitney test was used to analyze differences in Functional Movement Screen scores between the two groups. [Results] Chronic lower back pain patients scored lower on the Functional Movement Screen total composite compared with healthy control subjects. Chronic lower back pain patients scored lower on Functional Movement Screen subtests including the deep squat, hurdle step, active straight leg raise, and rotary stability tests. [Conclusion] The deep squat, hurdle step, active straight leg raise, and rotary stability tasks of the Functional Movement Screen can be recommended as a functional assessment tools to identify functional deficits in chronic lower back pain patients.

[Purpose] The aim of the present study was to examine the effects of respiratory muscle warm-up on anaerobic power. [Subjects and Methods] Thirty male field hockey players (age, 20.5 ± 2.0 years) each participated in a control (C_AN) trial and an experimental (E_AN) trial. The E_AN trial involved respiratory muscle warm-up, while the C_AN trial did not. Anaerobic power was measured using the Wingate protocol. Paired sample t-tests were used to compare the E_AN and C_AN trials. [Results] There were significant increases in peak power and relative peak power, and decreases in the time to peak after the E_AN trial by 8.9%, 9.6%, and 28.8% respectively. [Conclusion] Respiratory muscle warm-up may positively affect anaerobic power due to faster attainment of peak power.

[Purpose] This study examined the immediate effects of keyboard-based music therapy on Probe Reaction Time. [Subjects and Methods] Probe Reaction Time was determined in 10 subjects by self-evaluation before and after music therapy intervention. The Probe Reaction Time was separately measured 4 times. [Results] After completion of music therapy intervention, the Probe Reaction Time in the 10 subjects was significantly decreased. [Conclusion] The results suggest that keyboard-based music therapy is an effective and novel treatment, and should be applied in clinical practice.

[Purpose] This study aimed to examine that therapeutic efficacy of an unstable surface on balance and gait ability in normal individuals. [Subjects and Methods] Forty subjects participated in the experiment and were randomly assigned to an experimental group of 20 subjects and a control group of 20 subjects. The experimental group performed balance exercise on an Aero-Step device (Aero-Step XL, TOGU, Prien-Bachham, Germany). The control group performed balance exercise on rigid ground. All subjects performed balance training 30 minutes a day, 5 days a week, for 4 weeks. After the intervention, balance measuring equipment (Good Balance, Metitur, Jyvaskyla, Finland) was used to quantitatively measure balance ability. [Results] Significant differences in post-training gains in the variables of static balance, dynamic balance, and velocity were observed between the experimental group and the control group. [Conclusion] Unstable surface training aimed at improving balance ability is considered to have a positive effect.

[Purpose] This study aimed to investigate correlations between lumbar bone mineral density (BMD) and general characteristics of postmenopausal females, including body composition, knee extensor strength, standing balance, and femur BMD. [Subjects and Methods] A total of 40 postmenopausal females (55.6 ± 4.6 years) who were caregivers or guardians of patients in the K hospital were included in the study. The weight, height, body composition, left and right knee extensor strength, standing balance, femur BMD, and lumbar BMD measurements of the subjects were obtained. [Results] The effect of measurement variables on lumbar BMD was examined. Increases in age and menopausal duration were observed to significantly increase lumbar BMD, whereas an increase in height was found to significantly decrease lumbar BMD. An increase in soft lean mass, skeletal muscle mass, fat-free mass, and femur BMD was also associated with significantly decreased lumbar BMD. [Conclusion] Age, menopausal duration, soft lean mass, skeletal muscle mass, and fat-free mass were factors that decreased lumbar BMD in menopausal females. This study is expected to provide basic knowledge for osteoporosis prevention and treatment programs for postmenopausal females.

[Purpose] This study examined the cut-off point of the Trail Making Test in predicting the risk of unsafe driving in stroke patients. [Subjects and Methods] A total of 81 stroke patients with a driver’s license participated in this study. The DriveABLE Cognitive Assessment Tool, Trail Making Test-A, and Trail Making Test-B evaluations were conducted in all participants. All participants were classified into the safety or risk groups based on the DriveABLE Cognitive Assessment Tool evaluation results. The Trail Making Test results underwent a receiver operating characteristic analysis in each group. [Results] The results of the receiver operating characteristic curve analysis showed that the cut-off point for Trail Making Test-A was 32 seconds and the cut-off point for Trail Making Test-B was 79 seconds. The positive predictive values of the Trail Making Test-A and Trail Making Test-B were 98.3% and 98.3%, respectively, and the negative predictive values of the Trail Making Test-A and Trail Making Test-B were 81.0% and 73.9%, respectively. [Conclusion] The Trail Making Test is a useful tool for predicting the risk of unsafe driving in stroke patients. This tool is expected to be used more actively for screening stroke drivers with respect to their cognitive function.

[Purpose] The appropriate exercise prescription is crucial for achieving scapular stability and providing successful rehabilitation, and the Push-up Plus (PuP) exercise has an important role in shoulder rehabilitation. Consequently, this study examined the effect of support surface stability, hand positioning, and phase of exercise, on the trapezius and serratus anterior muscle contractions as well as on the EMG ratio of the upper/lower trapezius. [Subjects and Methods] Thirteen healthy male volunteers participated in this study. The subjects performed the PuP exercise on stable and unstable supporting surfaces with three different hand orientations. During the PuP exercise, the muscle activities of the upper (UT) and lower (LT) trapezius, as well as the serratus anterior (SA) were measured and expressed as percentages of maximum voluntary isometric contraction (%MVIC). [Results] The EMG activities of UT and LT were statistically greater during the push-up phase compared to the plus phase of the exercise. The contrary was recorded for the activity of the SA. SA was affected by the support surface as well as by the hand positioning. [Conclusion] The results suggest that different phases of the PuP exercise require different muscle stability actions with corresponding activations of appropriate muscle fibers. A detailed prescription of the required phase of the exercise can more effectively activate the scapula-thoracic musculature.

[Purpose] The purpose of this study was to investigate the effect of co-stabilizer muscle activation on knee joint position sense. [Subjects and Methods] This study was a pre-post, single-blinded randomly controlled trial (angle sequence randomly selected) design. Seven healthy adults with no orthopaedic or neurological problems participated in this study. Knee joint position sense was measured by a target matching test at target angles of 30°, 45° and 80° of knee flexion a using digital inclinometer under two conditions: erect sitting, which is known to highly activate co-stabilizer muscle and slump sitting, which is known to little activate the co-stabilizer muscle. [Results] A significant difference in joint position matching error at the knee flexion angle of 45° was founded between two conditions erect sitting: (3.83 ± 1.47) and slump sitting: (1.00 ± 0.63). There were no significant differences in joint position matching error at the other target angles. [Conclusion] Knee joint position sense at 45° is likely to be affected by activation of co-stabilizer muscle, and this value is suitable for facilitation of joint position sense with skilled movement.

[Purpose] This study aimed to investigate the relatedness, reliability, and validity of isometric muscle strength measurements of hip abduction and abduction with an external hip rotation in a bent-hip position using a handheld dynamometer with a belt. [Subjects and Methods] Twenty healthy young adults, with a mean age of 21.5 ± 0.6 years were included. Isometric hip muscle strength in the subjects’ right legs was measured under two posture positions using two devices: a handheld dynamometer with a belt and an isokinetic dynamometer. Reliability was evaluated using an intra-class correlation coefficient (ICC); relatedness and validity were evaluated using Pearson’s product moment correlation coefficient. Differences in measurements of devices were assessed by two-way ANOVA. [Results] ICC (1, 1) was ≥0.9; significant positive correlations in measurements were found between the two devices under both conditions. No main effect was found between the measurement values. [Conclusion] Our findings revealed that there was relatedness, reliability, and validity of this method for isometric muscle strength measurements using a handheld dynamometer with a belt.

[Purpose] This study examines the effect of concentric and eccentric control training of the paretic leg on balance and gross motor function in children with spastic hemiplegia. [Subjects and Methods] Thirty children with spastic hemiplegia were randomly divided into experimental and control groups. In the experimental group, 20 min of neurodevelopmental therapy and 20 min of concentric and eccentric control exercise were applied to the paretic leg. In the control group, 40 min of neurodevelopmental therapy was applied. The Pediatric Balance Scale test and standing and gait items of the Gross Motor Function Measure were evaluated before and after intervention. [Results] In the experimental group, Gross Motor Function Measure and Pediatric Balance Scale scores statistically significantly increased after the intervention. The control group showed no statistically significant difference in either score after the intervention. [Conclusion] Concentric and eccentric control exercise therapy in children with spastic hemiplegia can be effective in improving gross motor function and balance ability, and can be used to solve functional problems in a paretic leg.

[Purpose] The purpose of this study was to develop the Korean version of the PedsQL^TM 3.0 Cerebral Palsy Module to evaluate the health-related quality of life of children with cerebral palsy and to test the reliability and validity. [Subjects and Methods] The study included 108 caregivers of children with cerebral palsy aged 2 to 4 years and 72 caregivers of children aged 5 to 7 years, who visited multiple sites between February and August 2015. The Translation Commission performed the first translation with the approval of the Mapi Research Trust Company to create a Korean-version of the PedsQL^TM. Afterwards, back-translation was performed by one translator specializing in health and medical treatment who was a native English-speaker fluent in Korean, and one native Korean-speaker fluent in English. The consistency of each question was confirmed and a translation-integrated version was created. Test components were explained to caregivers during a one-on-one interview; caregivers then completed the PedsQL^TM questionnaire and a Pediatric Evaluation Disability Inventory (PEDI) questionnaire. Subjects contributing to test-retest measures were asked to repeat the PedsQL questionnaire one week later and return it by mail. To assess data quality for the survey question results, non-response rate, ceiling effect, and floor effect were analyzed. Test-retest reliability and internal consistency reliability were assessed. For test-retest reliability, an intraclass correlation coefficient (ICC) was calculated, and for internal consistency reliability, Cronbach’s alpha was used. To test criterion-related validity, Pearson’s correlation coefficient was used. [Results] The content validity of the PedsQL 3.0 Cerebral Palsy Module was high for both age groups, and demonstrated significant internal consistency (>0.7) in all areas. For test-retest reliability, both groups demonstrated a significant ICC (>0.61). Correlation with the PEDI was statistically significant in all areas except pain and hurt. [Conclusion] The Korean version of the PedsQL^TM 3.0 Cerebral Palsy Module was found to be reliable and valid, and is expected to contribute greatly to the evaluation of the quality of life of children with cerebral palsy.

[Purpose] This study examined the clinical usefulness of the clock drawing test applying Rasch analysis for predicting the level of cognitive impairment. [Subjects and Methods] A total of 187 stroke patients with cognitive impairment were enrolled in this study. The 187 patients were evaluated by the clock drawing test developed through Rasch analysis along with the mini-mental state examination of cognitive evaluation tool. An analysis of the variance was performed to examine the significance of the mini-mental state examination and the clock drawing test according to the general characteristics of the subjects. Receiver operating characteristic analysis was performed to determine the cutoff point for cognitive impairment and to calculate the sensitivity and specificity values. [Results] The results of comparison of the clock drawing test with the mini-mental state showed significant differences in according to gender, age, education, and affected side. A total CDT of 10.5, which was selected as the cutoff point to identify cognitive impairement, showed a sensitivity, specificity, Youden index, positive predictive, and negative predicive values of 86.4%, 91.5%, 0.8, 95%, and 88.2%. [Conclusion] The clock drawing test is believed to be useful in assessments and interventions based on its excellent ability to identify cognitive disorders.

[Purpose] This study was undertaken to investigate the effects of the balance exercises with a Swiss ball on static and dynamic balance abilities in elderly (≥65 years) subjects. [Subjects and Methods] Twenty elderly subjects with no relevant orthopedic history of a back condition were selected for trunk stabilization exercises with a Swiss ball (Thera-Band, USA). The subjects performed these trunk stabilization exercises for 20 minutes, five times per week for 4 weeks. The experimental group (n=10) was blindfolded during these balance exercises, while the control group control group (n=10) was not. [Results] The experimental group showed significant improvements in velocity in the evaluation of static balance and in time, total distance, and left/right movement distance in the evaluation of dynamic balance after the intervention, whereas the control group showed significant improvements in time in the evaluation of dynamic balance. A significant intergroup difference was observed after the intervention for velocity gain. [Conclusion] Exercising with a blindfold stimulates other senses by blocking visual information, and hence it enhances improvements in balance ability.

[Purpose] This study attempted to examine the impact on the pattern of walking on both level ground and stairs after restricting the movement of the spine and the trunk of the body by using a spinal orthosis. [Subjects and Methods] Forty healthy males in their 20s were selected as the sample, which was randomly and evenly divided into two groups: (1) the WT group (with a thoracolumbosacral orthosis group) and (2) the WOT group (Without a thoracolumbosacral orthosis group). The spinal orthosis used in this study was a thoracolumbosacral orthosis called a plastic body jacket. [Results] In walking on level ground, step width showed a significant difference, but no statistically significant difference was found between the WT group and the WOT group with respect to the other variables. In walking on stairs, the double stance phase showed a statistically significant difference during stair descent in the WT group compared with the WOT group. [Conclusion] It was proven that wearing a TLSO increased walking stability in the case of walking on level ground and stairs. Hence, it is believed that proper use of a spinal orthosis can play an ancillary role in daily life and therapeutic interventions.

[Purpose] This study investigated whether a shoulder reaching exercise was beneficial for restoring the standing balance of patients with hemiplegia after stroke. [Subjects and Methods] There were 13 subjects in the experimental group (EG) and 14 subjects in the control group (CG), all with hemiplegia following stroke. The shoulder reaching exercise intervention was performed by the EG and conventional physical therapy was administered to the CG for 30 minutes, 3 times a week for 4 weeks. Virtual reality (RM, BioRescue −AP 1153, France) was used as an assessment tool. All data were analyzed using SPSS version 18 (Statistical Package for the Social Science). [Results] After the intervention, the EG showed significant differences in the distances moved in the anteroposterior and mediolateral directions. The length and velocity were reduced after the intervention in both the EG and the CG. There were significant differences in the distances moved in the north, south and west directions between the groups. The sway path lengths of the subjects in the Romberg test were reduced under both the eyes open and closed conditions in the EG. There was no significant variation in sway velocity in the EG and the CG. [Conclusion] The shoulder reaching exercise had beneficial effects on the distances moved in the anteroposterior and mediolateral directions.

[Purpose] This study investigated the effects of neurofeedback (NFB) and computer-assisted cognitive rehabilitation (CACR) on the relative brain wave ratios and activities of daily living (ADL) of stroke patients. [Subjects and Methods] Forty-four participants were randomly allocated to the NFB (n=14), CACR (n=14), or control (CON) (n=16) groups. Two expert therapists provided the NFB, CACR, and CON groups with traditional rehabilitation therapy in 30-minute sessions, 5 times a week, for 6 weeks. NFB training was provided only to the NFB group and CACR training was provided only to the CACR group. The CON group received traditional rehabilitation therapy only. Before and after 6 weeks of intervention, brain wave and ADL evaluations were performed, and the results were analyzed. [Results] The relative ratio of beta waves, only showed a significant increase in the frontal and parietal areas of the NFB group. Significant changes in ADL were shown by all three groups after the intervention. However, there were no significant differences between the NFB and CACR groups and the CON group. [Conclusion] Our results suggest that CACR and NFB are effective at improving cognitive function and ADL of stroke patients.

[Purpose] The effects of vitamin D on the circulating levels of IL-17 and IL-13 were investigated in patients with diabetic peripheral neuropathy, patients with diabetes mellitus type 2 without neuropathy, and healthy controls. [Subjects and Methods] A single-blind controlled clinical study was performed, including70 type 2 diabetic patients with or without diabetic peripheral neuropathy and 33 healthy volunteer controls. The 25(OH)D levels were evaluated using ultra-performance liquid chromatography, and IL-17 and IL-13 levels were assessed using enzyme-linked immunosorbent assays. [Results] The 25(OH) vitamin D concentration was lower in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy and healthy controls. Similarly, 25(OH)D levels were lower in diabetes mellitus patients than healthy controls. IL-17 and IL-13 levels were higher in diabetes mellitus patients than in controls. Additionally, IL-13 levels were higher in diabetic peripheral neuropathy patients than in diabetes mellitus patients without neuropathy. These differences were statistically significant. There was a significant positive correlation between 25(OH)D and IL-13,and a negative correlation between 25(OH)D andIL-17 in the diabetic and diabetic neuropathy groups. [Conclusion] Vitamin D is a potential modifiable risk factor for diabetic peripheral neuropathy and may regulate inflammatory mediators, e.g., IL-17 and IL-13.

[Purpose] The purpose of this study was to conduct a systematic review of the available evidence on sleep disorders in patients with end stage renal disease (ESRD) undergoing hemodialysis (HD). [Subjects and Methods] Two independent reviewers performed a computer-assisted search of the MEDLINE, SciELO, LILACS, and BIREME Virtual Health Library medical databases from their inception to November 2015. [Results] One thousand one hundred twenty-six articles were found that met the inclusion criteria. Articles were excluded if they were not in English, the patients did not undergo HD, or the studies were not cross-sectional or clinical trials. After reading the full text, a further 300 studies were excluded because they did not use polysomnography. The remaining 18 studies with ESRD patients undergoing HD comprised 8 clinical trials and 10 cross-sectional studies. This systematic review followed the criteria outlined by the PRISMA declaration. [Conclusion] In this systematic review, a high prevalence of sleep disorders was observed in ESRD, including sleep-disordered breathing. This knowledge may enable health professionals to devise new strategies for the diagnosis and treatment of these patients, in order to reduce morbidity and mortality and improve their quality of life.

[Purpose] The aim of this study was to investigate the effectiveness of yoga in the management of chronic neck pain. [Subjects and Methods] Five electronic databases were searched to identify randomized controlled trials (RCTs) of yoga intervention on chronic neck pain. The trials were published in the English language between January 1966 and December 2015. The Cochrane Risk of Bias Tool was used to assess the quality of the trials. [Results] Three trials were identified and included in this review. A critical appraisal was performed on the trials, and the result indicated a high risk of bias. A narrative description was processed because of the small number of RCTs. Neck pain intensity and functional disability were significantly lower in the yoga groups than in the control groups. [Conclusion] Evidence from the 3 randomly controlled trials shows that yoga may be beneficial for chronic neck pain. The low-quality result of the critical appraisal and the small number of trials suggest that high-quality RCTs are required to examine further the effects of yoga intervention on chronic neck pain relief.

[Purpose] This study aimed to determine the effect of pain scrambler therapy on shoulder joint pain and range of motion in patients who had undergone arthroscopic rotator cuff repair for the first time. [Subjects and Methods] Pain scrambler therapy was administered once a day every 40 minutes for 10 days to patients that had undergone arthroscopic rotator cuff repair for the first time. The visual analog scale was used to measure pain, and a goniometer was used to measure shoulder range of motion. [Results] After 10 sessions of pain scrambler therapy, pain was significantly reduced from that before the treatment. In addition, shoulder range of motion was increased after 10 treatment sessions. [Conclusion] Thus, pain scrambler therapy greatly reduced pain and increased should range of motion in the patients who had undergone arthroscopic rotator cuff repair for the first time.