[Purpose] The purpose of this study was to explore the immediate effects of different frequencies of auditory stimulation on the lower limb motor function of healthy people. [Subjects and Methods] The subjects were 7 healthy people (5 males and 2 females). The subjects’ lower limb function was measured without auditory stimulation (control), and with auditory stimulation of 500, 1,000, 1,500, and 2,000 Hz. The measured parameters were maximum knee extension torque, average knee extension torque, the Timed Up and Go test (TUG) time, Functional Reach (FR), and the 10-meter walking time. [Results] The TUG times of 500, 1,500, and 2,000 Hz auditory stimulation showed significant decreases compared to the control. The 10-m walking times of 1,000 and 2,000 Hz auditory stimulation showed significant decreases compared to the control. [Conclusion] The results show that auditory stimulation improved the TUG and 10-meter walking times of healthy people and that different frequencies of auditory stimulation had different effects on lower limb motor function.

[Purpose] To examine the effects of lumbopelvic sling and abdominal drawing-in exercises on the lung capacities of healthy subjects. [Subjects and Methods] Twenty-nine healthy subjects with no orthopedic history of the back were recruited. Subjects were randomly assigned to a experimental group and control group. Subjects were allocated to one of two groups; an experimental group that underwent lumbopelvic sling and abdominal drawing-in exercises and a control group that underwent treadmill and abdominal drawing-in exercises. Lung capacities were evaluated 4 weeks after exercises. [Results] The experimental group showed significant increments in EV, ERV, IRV, VT vs. pre-intervention results, and the control group showed significant increments in the EVC and IRV. Significant intergroup differences were observed in terms of post-training gains in EVC, IRV, and VT. [Conclusion] Combined application of lumbopelvic sling and abdominal drawing-in exercises were found to have a positive effect on lung capacity.

[Purpose] To investigate clinical measures as valid predictors and discriminators of the level of community ambulation of hemiparetic stroke survivors. [Subjects and Methods] Seventy-five hemiparetic stroke patients were separated into a community ambulation group (>0.8 m/s) and a limited community ambulation group (0.4–0.8 m/s). The dorsiflexor strength of the affected side, Sit to Stand (STS) test, Timed Up & Go (TUG) test, Berg Balance Scale (BBS), Fugl-Meyer Assessment (FMA), Falls Efficacy Scale (FES), 2-min step test (2mST), and 6-min walk test (6mWT) were used for evaluation. The discriminative powers of the tests and measures were investigated using the receiver-operating characteristic (ROC) curve, and odd ratios were calculated to predict the level of community ambulation. [Results] The cutoff values for predicting the level of community ambulation (>0.8 m/s) were <14.77 s for TUG, <12.6 s for STS, a score >46.5 for BBS, a score >25.5 for FMA, a score <13.5 for FES, >7.5 kg for dorsiflexor strength, >30 times for 2mST, and >318 m for 6mWT. All clinical measures except FES had moderate accuracy according to the area under the curve of 0.76–0.88 (70–93%). [Conclusion] Clinical measures (except FES) have moderate validity in predicting the level of community ambulation of stroke survivors.

[Purpose] The aim of this study was to investigate whether neuropathic pain is associated with femoral condylar cartilage thickness, electrical pain threshold, and clinical parameters in patients with knee osteoarthritis. [Subjects and Methods] Sixty patients over the age of 40 diagnosed with knee osteoarthritis were enrolled. The PainDETECT questionnaire, Western Ontario and McMaster Universities Osteoarthritis Index, Hospital Anxiety and Depression Scale, and Short Form-36 questionnaire were completed for all patients. Electrical sensory threshold and electrical pain threshold measurements were obtained. Femoral condylar cartilage thickness was determined by means of ultrasound. [Results] PainDETECT scores of 13 or greater were observed in 28 (46.7%) patients, indicating the presence of neuropathic pain. These patients were found to have greater average pain severity, Western Ontario and McMaster Universities Osteoarthritis Index, and depression and anxiety scores and lower Short Form-36 scores than patients without neuropathic pain. Patients with neuropathic pain showed lower knee electrical sensory threshold and pain threshold values on average than patients without neuropathic pain. Femoral condylar cartilage thickness was not different between the two groups. [Conclusion] Neuropathic pain is associated with increased pain severity and decreased functional capacity and adversely affects quality of life and mood in patients with knee osteoarthritis.

[Purpose] The aim of this study was to examine the long-term interventions effects of robot-assisted therapy rehabilitation on functional activity levels after anterior cruciate ligament reconstruction. [Subjects and Methods] The subjects were 8 patients (6 males and 2 females) who received anterior cruciate ligament reconstruction. The subjects participated in robot-assisted therapy lasting for one month. The Timed Up-and-Go test, 10-Meter Walk test, Functional Reach Test, surface electromyography of the vastus lateralis and vastus medialis, and extensor strength of isokinetic movement of the knee joint were evaluated before and after the intervention. [Results] The average value of the of vastus medialis EMG, Functional Reach Test, and the maximum and average extensor strength of the knee joint isokinetic movement increased significantly, and the time of the 10-Meter Walk test decreased significantly. [Conclusion] These results suggest that walking ability and muscle strength can be improved by robotic walking training as a long-term intervention.

[Purpose] The purpose of the present study was to investigate the relationship between the external knee adduction moment (KAM) during walking and the biomechanical characteristics of single-leg standing in healthy subjects. [Subjects and Methods] Twenty-eight healthy subjects were recruited for this study. Data were collected while the subjects performed walking and single-leg standing using a motion analysis system with six digital video cameras and two force plates. Pearson’s correlation coefficient was used to quantify the relationship between peak KAM during walking and single-leg standing. To determine whether the kinematic behavior of the pelvis and trunk during single-leg standing are associated with peak KAM during walking, Pearson’s correlation coefficients were calculated and stepwise linear regression was performed. [Results] The peak KAM during single-leg standing was significantly correlated with that during walking. The peak KAM during walking was significantly correlated with the peak lateral lean of the trunk and the peak lateral tilt of the pelvis during single-leg standing. The results of stepwise linear regression analysis show the peak KAM during walking was partially explained by the peak lateral lean of the trunk during single-leg standing. [Conclusion] Our findings suggest that single-leg standing might be a useful method for predicting the peak KAM during walking.

[Purpose] The aim of this study was to determine the bone mineral density, vitamin D level, and frequencies of osteopenia and osteoporosis in patients with Parkinson’s disease and to compare male and female patients with the controls separately. [Subjects and Methods] One hundred fifteen Parkinson’s disease patients (47 males, 68 females; age range: 55–85 years) and 117 age- and gender-matched controls (47 males, 70 females) were enrolled in the study. Bone mineral density measured by dual-energy X-ray absorptiometry and serum D vitamin levels of each participant were recorded. [Results] The mean lumbar spine, femur neck, and total femur bone mineral density levels, T-scores, and vitamin D levels were found to be significantly lower in Parkinson’s disease patients in both genders. Furthermore, osteoporosis rates were found be significantly higher only in female Parkinson’s disease patients compared with female controls. [Conclusion] Data from the present study revealed that while osteoporosis was significantly higher only in female Parkinson’s disease patients, all Parkinson’s disease patients had lower bone mineral density scores and vitamin D levels compared with the controls regardless of gender, suggesting that clinicians should pay attention to the osteoporosis risk in Parkinson’s disease and that adequate preventive measures should be taken in order to limit the future risk due to osteoporotic fractures.

[Purpose] The intra- and inter-examiner reliabilities of lumbar interspinous process distances measured by ultrasound imaging were examined. [Subjects and Methods] The subjects were 10 males who had no history of orthopedic diseases or dysfunctions. Ten lumbar interspinous images from 360 images captured from 10 subjects were selected. The 10 images were measured by nine examiners. The lumbar interspinous process distance measurements were performed five times by each examiner. In addition, four of the nine examiners measured the distances again after 4 days for test-retest analysis. In statistical analysis, the intraclass correlation coefficient was used to investigate relative reliability, and Bland-Altman analysis was used to investigate absolute reliability. [Results] The intraclass correlation coefficients (1, 1) for intra-examiner reliability ranged from 0.985 to 0.998. For inter-rater reliability, the intraclass correlation coefficient (2, 1) was 0.969. The intraclass correlation coefficients (1, 2) for test-retest reliability ranged from 0.991 to 0.999. The Bland-Altman analysis results indicated no systematic error. [Conclusion] The results indicate that ultrasound measurements of interspinous process distance are highly reliable even when measured only once by a single person.

[Purpose] The primary aim of this study was to assess rehabilitation outcomes for early and two-stage repair of hand flexor tendon injuries. The secondary purpose of this study was to compare the findings between treatment groups. [Subjects and Methods] Twenty-three patients were included in this study. Early repair (n=14) and two-stage repair (n=9) groups were included in a rehabilitation program that used hand splints. This retrospective evaluated patients according to their demographic characteristics, including age, gender, injured hand, dominant hand, cause of injury, zone of injury, number of affected fingers, and accompanying injuries. Pain, range of motion, and grip strength were evaluated using a visual analog scale, goniometer, and dynamometer, respectively. [Results] Both groups showed significant improvements in pain and finger flexion after treatment compared with baseline measurements. However, no significant differences were observed between the two treatment groups. Similar results were obtained for grip strength and pinch grip, whereas gross grip was better in the early tendon repair group. [Conclusion] Early and two-stage reconstruction of patients with flexor tendon injuries can be performed with similarly favorable responses and effective rehabilitation programs.

[Purpose] This study evaluated the effects of hippotherapy on seated postural balance, dynamic balance, and functional performance in children with cerebral palsy and compared the effects of 12 and 24 sessions on seated postural balance. [Subjects and Methods] This study included 15 children with cerebral palsy aged between 5 and 10 years. Interventions: A hippotherapy protocol was performed for 30 minutes, twice a week, for 12 weeks. Postural balance in a sitting position was measured using an AMTI AccuSway Plus force platform 1 week before initiating the hippotherapy program and after 12 and 24 weeks. The Berg Balance Scale (BBS) and Pediatric Evaluation of Disability Inventory (PEDI) were used before and after 24 sessions. [Results] Significant differences were observed for center of pressure (COP) variables, including medio-lateral (COPml), anteroposterior displacement (COPap), and velocity of displacement (VelCOP), particularly after 24 sessions. There were also significant differences in BBS scores and PEDI score increases associated with functional skills (self-care, social function, and mobility), caregiver assistance (self-care), social function, and mobility. [Conclusion] Hippotherapy resulted in improvement in postural balance in the sitting position, dynamic balance, and functionality in children with cerebral palsy, an effect particularly significant after 24 hippotherapy sessions.

[Purpose] This study examined the effects of exercise training on bone metabolism markers, inflammatory markers, and physical fitness in patients with osteoporosis from an osteoporosis-related immunological perspective. [Subjects and Methods] Twenty-nine elderly female subjects (age, 74.2 ± 3.2 years) were classified into normal, osteopenia, and osteoporosis groups based on the T-score measured using dual-energy X-ray absorptiometry. The exercise was performed voluntarily by the patients for 1 hour per day, three times per week, for 12 weeks. [Results] The differences between bone mineral content, bone mineral density, and osteocalcin concentrations increased significantly in the osteoporosis group after 12 weeks of exercise and were significantly higher than those in the normal and osteopenia groups. However, the homeostatic model assessment of insulin resistance score decreased significantly in the osteoporosis group after 12 weeks of exercise. High-sensitivity C-reactive protein concentrations tended to decrease in all groups after 12 weeks of exercise and showed an inverse correlation with osteocalcin concentration; however, no statistical significance was observed. [Conclusion] Our findings suggest that an exercise program in patients with osteopenia and osteoporosis effectively reduces the risk of osteoporotic fracture and related diseases since it improves bone density and physical fitness and reduces inflammatory marker levels.

[Purpose] A simple rehabilitation device system for strengthening upper limb muscles in hemiplegic patients was developed. This system, which stimulates active exercise while accounting for intensity, time, and frequency, was examined in the present pilot study. [Subjects and Methods] Patients had shoulder pain and limited shoulder movement. Changes in range of motion (ROM) and scores of a visual analog scale (VAS) for pain were evaluated in the experimental and control groups every four weeks for twelve weeks. The modified motor assessment scale (MMAS) was used before and after experiments. [Results] Significant differences between experimental times in ROM for shoulder flexion, abduction, and adduction on the paralyzed side were observed in the experimental group at every time point. Pain VAS scores in the experimental group improved progressively and significantly with time, indicating a consistently increasing effect of exercise. There were significant differences between the MMAS scores before and after completion of the program in the experimental group. [Conclusion] Muscle strengthening is important in hemiplegic patients, and active exercise was more efficient than passive exercise in this regard. Rehabilitation with the Monkey Chair and Band system may represent an efficient and important tool in upper limb training and comprehensive modern rehabilitation therapy.

[Purpose] The purpose of this study was to analyze intra-rater and inter-rater reliabilities of the make test, a manual muscle testing measurement method, using a hand-held dynamometer in Korean young adults. [Subjects and Methods] A total of 42 university students participated in this study. The make test, a manual muscle testing method, was conducted. A hand-held dynamometer was used to measure elbow joint flexion during the make test. [Results] Both intra-rater (the intraclass correlation coefficient=0.992) and inter-rater reliabilities (the intraclass correlation coefficient=0.949) were excellent, with values over 0.9. [Conclusion] The make test is a useful manual muscle testing method with high intra-rater and inter-rater reliability.

[Purpose] This study assessed the relationships between peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Subjects and Methods] Eighteen healthy volunteers participated in the study. Each participant completed tests for peak toe flexor muscle strength, ankle dorsiflexion range of motion, and countermovement jump height. [Results] The results showed (1) a moderate correlation between ankle dorsiflexion range of motion and countermovement jump height and (2) a high correlation between peak first toe flexor muscle strength and countermovement jump height. Peak first toe flexor muscle strength and ankle dorsiflexion range of motion are the main contributors to countermovement jump performance. [Conclusion] These findings indicate that the measurement of peak first toe flexor muscle strength and ankle dorsiflexion range of motion may be useful in clinical practice for improving jump performance in athletes training for sports such as volleyball and basketball.

[Purpose] Proper pedaling posture can improve muscle strength and cardiopulmonary function. To investigate proper pedaling posture for the elderly, this study compared the pedaling efficiency of the elderly with that of the young by using an index of effectiveness (IE) and kinematic results. [Subjects and Methods] Eight adults in their twenties and eight in their seventies participated in 3-min, 40 rpm cycle pedaling tests, with the same load and cadence. The joint angle, range of motion (ROM), and IE were compared by measuring 3-dimensional motion and 3-axis pedal-reaction force during 4 pedaling phases (Phase 1: 330–30°, Phase 2: 30–150°, Phase 3: 150–210°, and Phase 4: 210–330°). [Results] The knee and ankle ROM, maximum knee extension, and maximum ankle dorsiflexion in the elderly were significantly decreased compared with those in the young. Moreover, there were significant differences in IE for the total phase, Phase 1, and Phase 4 between the elderly and young. IE of the young was greater than that of the elderly, except in Phase 3. [Conclusion] Joint movement in the elderly during pedaling was limited. This study provides information that will facilitate the proposal of an efficient pedaling method for the elderly.

[Purpose] The aim of this study was to investigate the effects of hypothyroidism on femoral cartilage thickness by using ultrasound, which has been found to be useful in the early diagnosis of knee osteoarthritis. [Subjects and Methods] Forty patients diagnosed with hypothyroidism and 30 age-, gender-, smoking status, physical activity-, and body mass index-matched healthy subjects were enrolled. The thickness of the femoral articular cartilage was measured using a 7- to 12-MHz linear probe. Three mid-point measurements were taken from each knee at the lateral condyle, intercondylar area, and medial condyle. [Results] Age, gender, body mass index, smoking status, and physical activity were similar between the groups, but patients with hypothyroidism had thinner femoral cartilage than the healthy controls at all measurement sites. Nonetheless, the differences were not statistically significant (except in the case of the left medial condyle). [Conclusion] Ultrasonographic measurement of femoral cartilage thickness may be useful in the early diagnosis of knee osteoarthritis in patients with hypothyroidism.

[Purpose] There have been no investigations into the improvement of activities of daily living among patients suffering from post-stroke depression on admission to convalescent rehabilitation wards in Japan. This study aimed to assess the improvement of activities in daily living in patients with or without post-stroke depression at the time of admission to a convalescent rehabilitation ward. [Subjects and Methods] This retrospective study included 108 stroke patients divided into two groups according to their Geriatric Depression Scale 15-item short form scores. Activities of daily living were assessed using the Functional Independence Measure. The degree of improvement on the Functional Independence Measure was defined as the difference between scores on admission and at discharge. [Results] The Functional Independence Measure gain score was significantly different from the Functional Independence Measure total score. There was a significant interaction between time period and post-stroke depression factors for the Functional Independence Measure total score. A multiple regression analysis revealed a significant association between Geriatric Depression Scale score and Functional Independence Measure total score. [Conclusion] The present study suggests that post-stroke depression has a negative impact on recovery of activities of daily living and on rehabilitation outcomes in a convalescent rehabilitation ward setting.

[Purpose] The purpose of this study was to determine the correlation between the Berg Balance Scale (BBS) and acceleration of postural sway in the Clinical Test of Sensory Interaction and Balance (CTSIB) by using a triaxial accelerometer for quantitative assessment. [Subjects and Methods] Twenty-seven stroke patients participated in this study. Balance ability was evaluated with the BBS, and postural sway was evaluated with a triaxial accelerometer. The data were then analyzed for frequency and correlation by using statistical software (SPSS 18.0). [Result] Acceleration in left-right and forward-backward directions in all conditions of the CTSIB assessment showed a significant correlation with BBS assessment. Acceleration in Signal Vector Magnitude values in condition 3 of the CTSIB assessment showed a significant correlation with BBS assessment. [Conclusion] This study revealed that postural sway represented balance ability as acceleration in the quantitative measurement of kinematic analysis. This finding suggests that the triaxial accelerometer could be used as a measurement tool in clinical conditions.

[Purpose] This study aimed to examine the inter- and intra-rater reliability and validity of the modified functional ambulation category (mFAC) scale. [Subjects and Methods] The participants were 66 stroke patients with hemiparalysis. The inter- and intra-rater validity of the mFAC was calculated using the Spearman correlation coefficient. A score comparison of the stable or maximum gait speed with regard to mFAC and modified Rivermead Mobility Index (mRMI) performances was performed as a univariate linear regression analysis to determine how the Kruskal-Wallis test affects the mRMI and stable/maximum gait speed with regard to mFAC. [Results] The inter-rater reliability of the mFAC (intraclass coefficient [ICC]) was 0.982 (0.971–0.989), with a kappa coefficient of 0.923 and a consistency ratio of 94%. In contrast, the intra-rater reliability of the mFAC (ICC) was 0.991 (0.986–0.995), with a kappa coefficient of 0.961 and a consistency ratio of 96%, showing higher reliability. Moreover, there was a significant difference in stable/maximum gait speed between the mFAC and the mRMI. [Conclusion] Since the mFAC has sufficient inter- and intra-reliability and high validity, it can be used as an assessment tool that reflects the gait performance and mobility of stroke patients.

[Purpose] This study aimed to investigate the relationship between balance function and community participation in stroke survivors. [Subjects and Methods] Sixty-three patients diagnosed with hemiparetic stroke participated in this study (36 males, 27 females, aged 58.6 ± 15.2 years). The participants were assessed for balance function and their level of participation in the community, using activity card sorting and the Berg Balance Scale. A regression analysis was used to identify the influence of balance function on instrumental activities of daily living and leisure and social activities. [Results] The results of the regression analysis indicated that balance function measured by using the Berg Balance Scale affected community participation of patients with hemiparetic stroke. Participation in instrumental activities of daily living and leisure and social activities was affected by balance function. [Conclusion] This study provides useful information for designing efficient programs and identifying their effectiveness for enhancement of community participation in stroke survivors.

[Purpose] This study examined the effects of a medio-lateral unstable sole on invertor and evertor activation while descending stairs. [Subjects and Methods] The subjects were 30 university students with no history of ankle sprain. They descended stairs while wearing the medio-lateral unstable sole or with bare feet. Electromyography was used to record the activity of the tibialis anterior and peroneus longus and brevis muscles and paired t-tests were used to assess statistical significance. [Results] The medio-lateral unstable sole group showed increased tibialis anterior and peroneus longus and brevis muscle activation compared to the barefoot group. [Conclusion] Medio-lateral unstable sole can be used with exercises to prevent further ankle damage by activating both the inversion and eversion muscles.

[Purpose] To prospectively assess the effectiveness of neutral wrist nocturnal splinting in patients with carpal tunnel syndrome (CTS) by using clinical scores and nerve conduction studies (NCS). [Subjects and Methods] Forty-one patients enrolled in the study were clinically evaluated by a symptom severity scale (SSS) and functional status scale (FSS), and were electrophysiologically evaluated by conventional NCS; distal motor latency (DML), sensory conduction velocity (SCV), and difference in sensory latency between the median and ulnar nerves (ΔDSL) were measured. Subjects were treated with wrist splinting. Patients who showed no improvement in symptoms were treated with other conservative treatments, the remaining patients continued to wear splints. SSS, FSS, and NCS were evaluated after splinting as well. [Results] The follow-up was completed in 20 patients (31 wrists) with splinting. SSS and FSS decreased, the DML shortened and ΔDSL decreased significantly after splinting for 3.03 ± 1.16 months. There were significant correlations between SSS and DML, SCV of wrist digit 2, and SCV of wrist digit 4. No correlations were found between SSS and ΔDSL, and FSS and the parameters of NCS. [Conclusion] Neutral wrist nocturnal splinting is effective in at least short term for CTS patients. There is a weak correlation between clinical scores and NCS, which suggests that both approaches should be used to effectively assess the therapeutic effect of CTS treatment.

[Purpose] To determine whether the Gross Motor Performance Measurement is useful in predicting the future score of the Pediatric Balance Scale, this study examined the correlation between the 2 measurement tools with respect to movement disorder in children with cerebral palsy. [Subjects and Methods] A total of 38 study subjects with cerebral palsy were divided into 3 groups (spastic, dyskinetic, and ataxic) by means of systematic proportional stratified sampling in accordance with the characteristics of their movement disorders. [Results] The spastic Pediatric Balance Scale had an intermediate level of positive correlation with dissociated movement (r=0.411), alignment (r=0.518), and weight shift (r=0.461). The dyskinetic Pediatric Balance Scale had a strong positive correlation with dissociated movement (r=0.905), coordination (r=0.882), alignment (r=0.930), and stability (r=0.924). The ataxic Pediatric Balance Scale had an intermediate level of positive correlation with the overall Gross Motor Performance Measurement (r=0.636), and a strong positive correlation with dissociated movement (r=0.866), coordination (r=0.871) and stability (r=0.984). [Conclusion] Gross Motor Performance Measurement is important in evaluating the quality of movement, and can be considered an excellent supplementary tool in predicting functional balance.

[Purpose] The aim of this study was to assess the efficacy of noninvasive ventilation (NIV) in acute respiratory distress syndrome (ARDS). [Subjects and Methods] The clinical data of 58 patients with ARDS that required mechanical ventilation in two intensive care units (ICU) was reviewed. [Results] Endotracheal intubation was performed in 55.17% of the total patients and in 39.53% of the patients who received NIV treatment. The APACHE II score for patients who only received IV was significantly higher than those who only underwent NIV (25.67 ± 5.30 vs. 18.12 ± 7.20). However, there were no significant differences in 28-day/90-day survival rates, duration of mechanical ventilation, and length of ICU stay between these two groups. For patients from a NIV-to-IV group, the APACHE II scores before endotracheal intubation were higher than the scores from IV patients (26.12 ± 4.08 vs. 21.94 ± 6.10). The 90-day survival rate in the NIV-to-IV group was significantly lower than that of the IV-only group (23.5% vs. 73.3%), although there was no difference in the 28-day survival rate between the two groups. [Conclusion] The application of NIV reduces the percentage of patients requiring endotracheal intubation.

[Purpose] The purpose of this study was to examine the correlation between quadriceps muscle activity and balance and gait in stroke patients. [Subjects and Methods] Fifty-five stroke patients (30 males 25 females; mean age 58.7 years; stroke duration 4.82 months; Korean mini-mental state examination score 26.4) participated in this study. MP100 surface electromyography, BioRescue, and LUKOtronic were used to measure the quadriceps muscle activity, balance, and gait, respectively. [Results] There was a significant correlation between quadriceps muscle activity (vastus lateralis % reference voluntary contraction, vastus medialis % reference voluntary contraction) and balance (limits of stability) and gait (gait velocity) but there was none between vastus lateralis % reference voluntary contraction, vastus medialis % reference voluntary contraction. [Conclusion] An increase in quadriceps muscle activity will improve balance and gait ability. To improve function in stroke patients, training is needed to strengthen the quadriceps muscles.

[Purpose] The purposes of this study were to evaluate whether the therapeutic games developed by the study team are significantly effective for upper limb rehabilitation of patients with cerebral palsy and to assess the development of the games and the evolution of patients throughout the therapy sessions. [Subjects and Methods] This study demonstrates the results of using therapeutic games in patients with infantile cerebral palsy. The therapies were performed in 30-minute sessions for about 1 to 4 months. This study shows the progress of five children with cerebral palsy during the sessions. The time it took the children on each road and the times required to complete a task were measured. In addition, the level of difficulty of the games was gradually increased at each session. [Results] Results have shown good progress on the accuracy of the movements and an increase in concentration level during the execution of the games, showing an improvement in the patients’ performance by 40–55% faster. [Conclusions] Health games encourage children to comply with therapy. The advantage of the game is that the patient can perform the therapy at home, which could help achieve further progress in patients.

[Purpose] This study compared the functional and kinematic changes associated with two rehabilitation protocols: bilateral and unilateral movement training. [Subjects and Methods] Twenty-five patients with chronic stroke were randomly assigned to two training protocols for four weeks of training. Each training session consisted of three tasks. The tasks were performed with either the impaired and unimpaired arms moving synchronously (bilateral training) or with the impaired arm alone (unilateral training). To compare the changes associated with each rehabilitation protocol, functional and kinematic assessments were performed before and after the interventions. The functional state of each patient was measured by the Box and Block Test, and the kinematic variables were assessed by three-dimensional motion analysis. The Box and Block Test was used to assess the functional abilities of the affected upper limb. Kinematic measurements of upper limb movement were measured with a 3-dimensional motion analysis system. [Results] Results showed that the bilateral movement group had significantly improved motion of the shoulder compared to the unilateral movement group. [Conclusion] Bilateral movement training should be used to improve upper limb function in patients with chronic stroke.

[Purpose] The purpose of this study was to examine the immediate effects of therapeutic keyboard music playing on the finger function of subjects’ hands through measurements of the joint position error test, surface electromyography, probe reaction time, and writing time. [Subjects and Methods] Ten subjects were divided randomly into experimental and control groups. The experimental group used therapeutic keyboard music playing and the control group used grip training. All subjects were assessed and evaluated by the joint position error test, surface electromyography, probe reaction time, and writing time. [Results] After accomplishing therapeutic keyboard music playing and grip training, surface electromyography of the two groups showed no significant change, but joint position error test, probe reaction time, and writing time obviously improved. [Conclusion] These results suggest that therapeutic keyboard music playing is an effective and novel treatment for improving joint position error test scores, probe reaction time, and writing time, and it should be promoted widely in clinics.

[Purpose] The aim of this study was to translate and adapt the Community Balance and Mobility Scale (CB&M) into Korean (K-CB&M) and to verify the reliability and validity of scores obtained with Korean patients. [Subjects and Methods] A total of 16 subjects were recruited from St. Vincent’s Hospital in South Korea. At each testing session, subjects completed the K-CB&M, Berg balance scale (BBS), timed up and go test (TUG), and functional reaching test. All tests were administered by a physical therapist, and subjects completed the tests in an identical standardized order during all testing sessions. [Results] The inter- and intra-rater reliability coefficients were high for most subscores, while moderate inter-rater reliability was observed for the items “walking and looking” and “walk, look, and carry”, and moderate intra-rater reliability was observed for “forward to backward walking”. There was a positive correlation between the K-CB&M and BBS and a negative correlation between the K-CB&M and TUG in the convergent validity assessments. [Conclusion] The reliability and validity of the K-CB&M was high, suggesting that clinical practitioners treating Korean patients with hemiplegia can use this material for assessing static and dynamic balance.

[Purpose] The aim of this study was to determine the reliability of a newly designed dynamometric device for use in frequent force producing/reproducing tasks on the knee joint. [Subjects and Methods] In this cross-sectional study (Development & Reliability), 30 young healthy males and females (age 23.4 ± 2.48 years) were selected among students of Tabriz University of Medical Sciences by simple randomized selection. The study instrument was designed to measure any isometric contraction force exerted by the knee joint flexor/extensor muscles, known as the ipsilateral and contralateral methods. Participant knees were fixed in 60° flexion, and each participant completed the entire set of measurements twice, 72 hours apart. [Results] The findings showed a good intraclass correlation coefficient of 0.73 to 0.81 for all muscle groups. The standard error of measurement and smallest detectable difference for flexor muscle groups were 0.37 and 1.02, respectively, while the values increased to standard error of measurement=0.38 and smallest detectable difference=1.05 for extensor muscle groups. [Conclusion] The device designed could quantify the forces producing/reproducing tasks on the knee joint with a high rate of reliability, and can probably be applied for outcome measurements in proprioceptive assessment of the knee joint.

[Purpose] The correlations of peak vertical ground reaction force and sagittal angles during single-leg lateral jump-landing with noncontact anterior cruciate ligament injury remain unknown. This study aimed to clarify the correlations between kinematics and impact force during lateral jump-landing. [Subjects and Methods] Twenty active males were included in the analysis. A sagittal-view movie camera and force plate were time synchronized. Trunk and lower extremity sagittal angles were measured 100 ms before initial contact and at peak vertical ground reaction force. Peak vertical ground reaction force, time between initial contact and peak vertical ground reaction force, and loading rate were calculated. [Results] The mean sagittal angle was 40.7° ± 7.7° for knee flexion during the flight phase and 16.4° ± 6.3° for pelvic anterior inclination during the landing phase. The mean peak vertical ground reaction force was four times the body weight. The median time to peak vertical ground reaction force was 63.8 ms. The knee flexion during the flight phase and pelvic anterior inclination angles during the landing phase were related to the peak vertical ground reaction force. [Conclusion] Increasing knee flexion and decreasing pelvic anterior inclination might reduce the impact during single-leg lateral jump-landing.

[Purpose] This study investigated the association between floating toe and toe grip strength. [Subjects and Methods] A total of 635 Japanese children aged 9–11 years participated in this study. Floating toe was evaluated using footprint images, while toe grip strength was measured using a toe grip dynamometer. All 1,270 feet were classified into a floating toe group and a normal toe group according to visual evaluation of the footprint images. Intergroup differences in toe grip strength were analyzed using the unpaired t-test and logistic regression analysis adjusted for age, gender, and Rohrer Index. [Results] There were 512 feet (40.3%) in the floating toe group. Mean toe grip strength of the feet with floating toe was significantly lower than that of normal feet (floating toe group, 12.9 ± 3.7 kg; normal toe group, 13.6 ± 4.1 kg). In addition, lower toe grip strength was associated with floating toe on logistic regression analysis after adjustment for age, gender, and Rohrer Index (odds ratio, 0.954; 95% confidence interval, 0.925–0.984). [Conclusion] This study revealed that lower toe grip strength was significantly associated with floating toe. Therefore, increasing toe grip strength may play a role in preventing floating toe in school age children.

[Purpose] We examined the effectiveness of Mulligan’s mobilization with movement (MWM) technique on spatiotemporal variables of gait in individuals who had a stroke. [Subjects and Methods] Twenty-four subjects were randomly divided into 2 groups: Mulligan’s mobilization with movement group (n=12) and “weight-bearing with placebo” mobilization with movement group (n=12). The subjects in the mobilization with movement group performed 5 sets of 10 glides a day, 5 times a week for 4 weeks. The mobilization with movement technique comprised grade III movements that involved gliding and resting. The control group subjects performed lunges in the same conditions as those of the experimental group. Gait function was measured in terms of spatiotemporal parameters to determine the effect of mobilization with movement. [Results] The mobilization with movement group showed significant improvements in velocity, cadence, stride length, single-support time, and step length of the affected side, and step length and stride length of the non-affected side. Overall, the mobilization with movement group showed significantly greater improvements than the control group in terms of velocity, cadence, and single-support time of the affected side. [Conclusion] Mobilization with movement can be used to improve the gait function of patients recovering from stroke.

[Purpose] Gait velocity and trunk acceleration during semicircular turning gait with and without carrying a hand-held bag were compared in females of very advanced age. [Subjects and Methods] Ten female volunteers of very advanced age who could walk independently were recruited for this study. Gait velocity and trunk acceleration were measured using an accelerometer during semicircular turning gait with and without carrying a hand-held bag. [Results] Gait velocity during semicircular turning gait was greater with the bag than without the bag. [Conclusions] Trunk stability during semicircular turning gait was higher when the subjects carried a bag. Additional arm load could be considered during gait training in females of very advanced age.

[Purpose] The purpose of this study was to examine the effects of increasing physical activity on foot structure and ankle muscle strength in adults with obesity and to verify whether the rate of change in foot structure is related to that in ankle muscle strength. [Subjects and Methods] Twenty-seven adults with obesity completed a 12-week program in which the intensity of physical activity performed was gradually increased. Physical activity was monitored using a three-axis accelerometer. Foot structure was assessed using a three-dimensional foot scanner, while ankle muscle strength was measured using a dynamometry. [Results] With the increasing physical activity, the participants’ feet became thinner (the rearfoot width, instep height, and girth decreased) and the arch became higher (the arch height index increased) and stiffer (the arch stiffness index increased); the ankle muscle strength also increased after the intervention. Additionally, the changes in the arch height index and arch stiffness index were not associated with changes in ankle muscle strength. [Conclusion] Increasing physical activity may be one possible approach to improve foot structure and function in individuals with obesity.

[Purpose] This study investigated the serologic factors associated with metabolic syndrome and gallstones. [Subjects and Methods] The study evaluated subjects who visited a health promotion center in Seoul from March 2, 2013 to February 28, 2014, and had undergone abdominal ultrasonography. Height, weight, and blood pressure were measured. Blood sampling was performed for high-density lipoprotein cholesterol, triglyceride, fasting blood glucose, total bilirubin, direct bilirubin, indirect bilirubin, aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, uric acid, total cholesterol, low-density lipoprotein cholesterol, thyroid stimulating hormone, and red and white blood cell counts. We conducted logistic regression analysis to assess the risk factors associated with metabolic syndrome. [Results] The risk factors for metabolic syndrome in men, in order of decreasing weight, were red blood cell count, body mass index, maximum size of gallstones, white blood cell count, waist circumference, and uric acid level. The factors in women, in order of decreasing weight, were red blood cell count, presence/absence of gallstones, uric acid level, body mass index, fasting blood glucose, and waist circumference. [Conclusion] Most serum biochemical factors and gallstone occurrence could be used to indicate the presence or absence of metabolic syndrome, independent of gender.

[Purpose] To examine the variations in the lumbopelvic rhythm and lumbar-hip ratio in the frontal plane. [Subjects and Methods] Markers were placed on the T10 and T12 spinous processes, bilateral paravertebral muscles at the T11 level, the pelvis, and the femur. Lumbar spine and hip angles were measured during lateral trunk bending using three-dimensional motion analysis. Data from the trunk lateral bending movement were categorized into descending (start of hip movement to when the hip angle reached its maximum value) and ascending (from the maximum hip angle to the end of movement) phases. The lumbar-hip ratio was calculated as the ratio of the lumbar spine angle to the hip angle. [Results] The lumbar-hip ratio decreased from 5.9 to 3.6 in the descending phase, indicating lumbar spinal movement was less than hip movement. In the ascending phase, the lumbar-hip ratio was reversed. The lumbopelvic rhythm was better expressed by a cubic or quadratic function rather than a linear function. These functions indicate that when the hip inclines by 1° that the lumbar spine bends laterally by 2.4°. [Conclusion] The lumbopelvic rhythm and lumbar-hip ratio indicate lumbar lateral bending instead of a limitation of hip inclination.

[Purpose] This study investigated the effects of spring-loaded crutches on gastrocnemius muscle activity and upper body displacement in the sagittal plane during gait. [Subjects and Methods] The study involved 12 healthy males. All subjects performed crutch gait by using spring-loaded crutches and axillary crutches. During this gait, the gastrocnemius muscle activity was measured using a wireless electromyography system, and upward displacement of the body was measured using a three-dimensional motion analysis system. [Results] The gastrocnemius activity was significantly lower but upward displacement of the body was significantly greater with the spring-loaded crutches than with axillary crutches. [Conclusion] Spring-loaded crutches allow efficient crutch gait and involve less effort from the gastrocnemius muscle.

[Purpose] This study aimed to determine the correlation between center of pressure and functional balance in non-faller elderly practitioners of Tai Chi. [Subjects and Methods] For the study, nine non-faller elderly practitioners of Tai Chi who were able to maintain a standing posture and walk independently were recruited. Timed one-leg standing and timed up-and-go tests were used as functional balance tests and force platform to measure the center of pressure. The Pearson correlation coefficient was calculated for the timed up-and-go/timed one-leg standing test scores and center of pressure parameter values. [Results] None of the correlations was statistically significant, but moderate correlations were observed between the pairs timed one-leg standing/sway area of center of pressure, timed one-leg standing/standard deviation of center of pressure in the mediolateral direction, timed one-leg standing/mean velocity of center of pressure in the anteroposterior direction, and timed up-and-go test sway area of center of pressure. [Conclusion] Timed one-leg standing is more appropriate than timed up-and-go test for the measurement of functional balance in non-faller elderly practitioners of Tai Chi.

[Purpose] To investigate the effects of a 30-day rehabilitation program using a slant board on walking function in post-stroke hemiparetic patients. [Subjects and Methods] Six hemiparetic patients with gait disturbance were studied. The patients were instructed to perform a home-based rehabilitation program using a slant board, thrice daily for 30 days, the exercise included standing on the slant board for 3 minutes, with both ankles dorsiflexed without backrest. For all patients, the Brunnstrom Recovery Stage, Barthel Index, range of motion of the ankle joint, modified Ashworth scale scole for calf muscle, sensory impairments with Numeral Rating Scale, maximum walking speed, number of steps, and Timed “Up and Go” test were serially evaluated at the beginning and end of the 30-day program. [Results] The program significantly increased walking velocity, decreased the number of steps in the 10-m walking test, and decreased Timed “Up and Go” test performance time. [Conclusion] This rehabilitation program using the slant board was safe and improved walking function in patients. The improvement in walking function could be due to a forward shift of the center of gravity, which can be an important part of motor learning for gait improvement.

[Purpose] This study was conducted to provide basic data for solutions to reduce the turnover rate of physical therapists. It should help create efficient personnel and organization management by exploring the impact of the work environment and work-related stress on turnover intention and analyzing the correlation between them. [Subjects and Methods] A survey was conducted with 236 physical therapists working at medical institutions in the Daejeon and Chungcheong areas. For the analysis on the collected data, correlational and linear regression analyses were conducted using the SPSS 18.0 program and Cronbach’s alpha coefficient. [Results] The results showed a statistically significant positive correlation between turnover intention and work-related stress but a statistically significant negative correlation respectively between turnover intention and work environment. Work-related stress (β=0.415) had a significant positive impact on turnover intention and work environment (β=−0.387) had a significant negative impact on turnover intention. [Conclusion] To increase satisfaction level with the profession as well as the workplace for physical therapists, improvement of the work environment was the most necessary primary improvement.

[Purpose] The purpose of the present study was to examine the validity of functional reach models by comparing actual values with estimated values. [Subjects and Methods] Twenty-eight volunteers were included in this study (male: 14, female: 14, age: 21 ± 1 years, height: 166.8 ± 9.0 cm, and body mass: 60.1 ± 8.5 kg). The maximum forward fingertip position and joint angles were measured using the original equipment. In addition, the maximum forward fingertip position, shoulder joint angle, and knee or ankle joint angle were estimated using the functional reach model. [Results] The correlation coefficients between actual data and estimated data for the maximum forward fingertip position, shoulder joint angle, and ankle joint angle while standing were 0.93, 0.83, and 0.73, respectively. The correlation coefficients between actual data and estimated data for the maximum forward fingertip position, shoulder joint angle, and knee joint angle while kneeling were 0.86, 0.81, and 0.72, respectively. [Conclusion] The validity of both functional reach models in estimating optimal posture was confirmed. Therefore, the functional reach model is useful for evaluation of postural control and optimal postural control exercises.

[Purpose] It is believed that eccentric high-intensity exercise can decrease performance in subsequent exercise. However, with repetition, the deleterious effects can be minimized. Thus, this study evaluated the influence of repeated bouts of eccentric exercise on subsequent high-intensity aerobic performance. [Subjects and Methods] Seven healthy and sedentary male volunteers were recruited. a) Visit 1: determination of maximum oxygen uptake (VO_2max) and speed associated with maximum oxygen uptake (vVO_2max) in incremental treadmill testing; b) Visit 2: run to exhaustion at vVO_2max (Tlim control); c) Visit 3: 10 sets of 10 depth jumps, followed by a run to exhaustion at vVO_2max (Tlim 1); d) Visit 4: after 6 weeks without any physical training, the volunteers carried out the same procedures as on the third visit (Tlim 2). Data were analyzed using one-way analysis of variance (ANOVA) with the post-hoc Tukey test. [Results] Significant differences were found between Tlim control and Tlim 1 (283.4 ± 47.7 s vs. 125.2 ± 64.1 s, respectively), these were not different from Tlim 2. [Conclusion] Eccentric exercise showed deleterious effects on subsequent high-intensity aerobic performance. These effects were minimized after the exercise protocol was repeated 6 weeks after the first event.

[Purpose] The purpose of this study was to investigate the effect of isometric hip adduction and abduction on trunk muscle activity during plank exercises. [Subjects and Methods] Nineteen healthy male subjects were recruited for this study. All subjects performed the traditional plank exercise (TP), plank exercise with isometric hip adduction (PHAD), and plank exercise with isometric hip abduction (PHAB) by using an elastic band. Electromyographic (EMG) activities of the internal oblique (IO) and external oblique (EO) were measured during the 3 plank exercises by using an Electromyography system. [Results] Internal oblique and external oblique muscle activities were significantly greater during plank exercise with isometric hip adduction and plank exercise with isometric hip abduction than during traditional plank exercise. Internal oblique and external oblique muscle activities did not differ between the plank exercise with isometric hip adduction and plank exercise with isometric hip abduction conditions. [Conclusion] These findings demonstrate that loaded isometric hip movements may be a useful strategy to increase trunk muscle activity during plank exercises.

[Purpose] The aim of this study was to examine the effects of a complex exercise program on the body composition and cardiorespiratory system of female college students. [Subjects and Methods] This study included 20 female college students who had not participated in any particular sports in the last 3 months. The complex exercise program consisted of two parts, aerobic exercise and weight training. First, aerobic exercise was implemented (30 min 5 times a week for 12 weeks) according to the participants’ exercise tolerance. Second, weight training was implemented (40 min 5 times a week for 12 weeks) with 60% of 1 repetition maximum (RM). [Results] The t-test results showed significant differences in body composition between the before and after the complex exercise program. The subjects’ body weights and body fat percentages were decreased, and their skeletal muscle masses were increased. Increased levels of maximal oxygen uptake (VO_2max), maximal expiratory volume (VE_max), and maximal heart rate (HR_max) were also observed. [Conclusion] In conclusion, the 12-week complex exercise program, including aerobic and weight training, had positive effects on the body composition and cardiorespiratory system of the female college students.

[Purpose] This study compared the hamstring/quadriceps ratio in females during squat exercise using various foot wedges. [Subjects and Methods] Nine females participated in this study. Surface electrodes measurements were taken over the hamstring and quadriceps under 3 squat exercise conditions, and the hamstring/quadriceps ratio was calculated. [Results] The hamstring/quadriceps ratio was significantly increased during squat exercise in inclined wedge condition (7.4 ± 1.8), compared to the declined wedge condition (5.3 ± 2.2) and no wedge condition (6.4 ± 3.2). [Conclusion] This study suggests that squat exercise in the inclined wedge condition may be effective for increasing the hamstring/quadriceps ratio in females.

[Purpose] To investigate the effects of intensive aerobic exercise on respiratory capacity and walking ability in chronic stroke patients. [Subjects and Methods] The subjects were randomly assigned to an experimental group (n=6) or a control group (n=6). Patients in the experimental group received intensive aerobic exercise for 30 minutes and traditional physical therapy once a day, five days a week, for four weeks. The control group received aerobic exercise for 30 minutes and traditional physical therapy for 30 minutes a day, five days a week, for four weeks. [Results] After the intervention, both groups showed significant improvements in the forced vital capacity, forced expiratory volume in one second, 10-meter walking test, and six-minute walking test over the baseline results. The comparison of the two groups after the intervention revealed that the experimental group showed more significant improvements in the forced vital capacity, forced expiratory volume in one second, and six-minute walking test. There was no significant difference in saturation pulse oximetry oxygen and 10-meter walking test between the groups. [Conclusion] The results of this study suggest that intensive aerobic exercise has a positive effect on respiratory capacity and walking endurance in patients with chronic stroke.

[Purpose] Kinesio taping is a therapeutic method used in the treatment of various musculoskeletal and neuromuscular deficits, but there is limited evidence of the effects of trunk kinesio taping in neurologic patients. Therefore, this study aimed to determine the effects of trunk kinesio taping on balance ability and gait function in persons after a stroke. [Subjects and Methods] Twenty-five post-stroke patients were included in this study. Kinesio tape was applied to four trunk muscles. Before and after the taping, in all subjects, the balance ability was measured using the Wii Balance Board, and gait function was assessed using the GAITRite system. [Results] The difference in gait function before and after trunk taping was not statistically significant. However, a variability of balance ability showed statistically significant differences. [Conclusion] These results suggest that taping may be a helpful method during rehabilitation programs for stroke patients. Its application to the trunk muscles is especially useful for improving balance ability.

[Purpose] The purpose of this study was to investigate the relationship between mobility assessed by the Modified Rivermead Mobility Index and variables associated with physical function in stroke patients. [Subjects and Methods] One hundred stroke patients (35 males and 65 females; age 58.60 ± 13.91 years) participated in this study. Modified Rivermead Mobility Index, muscle strength (manual muscle test), muscle tone (Modified Ashworth Scale), range of motion of lower extremity, sensory function (light touch and proprioception tests), and coordination (heel to shin and lower-extremity motor coordination tests) were assessed. [Results] The Modified Rivermead Mobility Index was correlated with all the physical function variables assessed, except the degree of knee extension. In addition, stepwise linear regression analysis revealed that coordination (heel to shin test) was the explanatory variable closely associated with mobility in stroke patients. [Conclusion] The Modified Rivermead Mobility Index score was significantly correlated with all the physical function variables. Coordination (heel to shin test) was closely related to mobility function. These results may be useful in developing rehabilitation programs for stroke patients.

[Purpose] This study aimed to develop a clinical protocol for the treatment of frozen shoulder using applied hydraulic distension plus manual therapy. [Subjects and Methods] Patients were randomly assigned to 2 groups: 60 patients in group A were treated with hydraulic distension plus manual therapy, and 61 in group B were treated with hydraulic distension alone. Treatment effects were assessed using the Visual Analog Scale (VAS) (pain and satisfaction), and active range of motion of the shoulder (forward flexion, internal and external rotation) before treatments and at 2, 6, 12, 24 weeks, and 1 year after the last injections. [Results] Patients in group A achieved faster pain relief and better satisfaction than patients in group B during the 6 weeks after treatment. However, no significant difference in VAS was observed between the groups at final follow-up. AROM of the shoulder was improved at final follow-up in both groups. [Conclusion] Hydraulic distension plus manual therapy provided faster pain relief, a higher level of patient satisfaction, and an earlier improvement in AROM of the shoulder than hydraulic distension alone in patients with frozen shoulder.