[Purpose] The purpose of this study was to determine the effects of manual therapy on shoulder pain in office workers. [Subjects and Methods] Subjects included 38 office workers who were randomly divided into two groups: a manual therapy group of 19 subjects and a shoulder stabilization exercise group of 19 subjects. All subjects underwent evaluation of the pressure pain threshold in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy used in the study was designed to include soft-tissue mobilization, prone thoracic mobilization, prone selected thoracic mobilization, cervical mobilization, and thoracic manipulation. Both groups underwent training of two 40-minute sessions per week for 6 weeks. [Results] After the intervention, both groups showed significantly increased pressure pain thresholds in the splenius capitis and upper, middle, and lower trapezius muscles on both sides. The manual therapy group showed greater improvements than did the shoulder stabilization exercise group in the splenius capitis on both sides, left upper trapezius, middle trapezius on both sides, and right lower trapezius. [Conclusion] The results of this study suggest that manual therapy for shoulder pain is feasible and suitable for office workers and may be useful in clinical rehabilitation.
[Purpose] This study aimed to examine the effect of upper extremity training in the standing position on trunk alignment of patients with stroke. [Subjects and Methods] Twelve stroke patients were enrolled in the study and divided into two groups: a group of six patients in a sitting position and a group of six patients in a standing position. Upper extremity training for 30 min per day, five times a week for six weeks was given to subjects in both groups. In order to assess trunk alignment, lumbar lordosis and thoracic kyphosis were examined before and after upper extremity training using Formetric 4D. [Results] After training the standing position group had no significant change in lumbar lordosis but a significant change in thoracic kyphosis. The sitting position group showed no significant changes in either lumbar lordosis or thoracic kyphosis. The comparison between groups showed there was no significant difference in the change in lumbar lordosis but there was a significant difference in the change in thoracic kyphosis. [Conclusion] Examination of trunk alignment showed that upper extremity training conducted in a standing position reduced thoracic kyphosis more than in a sitting position.
[Purpose] The purpose of this study was to ascertain the kinematic characteristics on a horizontal plane, including knee joint rotation, when walking with a tandem gait on a sine wave walkway. [Subjects and Methods] Eighteen healthy adults were enrolled as subjects in this study. They walked with a tandem gait on a sine wave walkway. A three-dimensional motion analysis system was used to record data and calculate the trunk, hip joint, and knee joint rotation angles. [Results] The rotation angle ranges for the trunk, hip joint, and knee joint were 23.3°, 53.3°, and 47.3°, respectively. The trunk generally rotated towards the direction of movement, and when turning left using the left leg as the pivot, the hip joint was internally rotated and the knee joint was externally rotated. In contrast, when making a directional change to the right using the left leg as the pivot, the hip joint was externally rotated and the knee joint was internally rotated. [Conclusion] Through tandem gait analysis on a sine wave walkway, knee joint rotation was found to be important in changes of direction.
[Purpose] To investigate the effects of different ankle weights on knee joint repositioning sense in elderly individuals. [Subjects and Methods] Twenty-one subjects were divided for assessment as follows: young (20–30 years, n=10) and elderly (60–70 years, n=11). Knee joint repositioning error was measured by asking the subjects to reposition the target angle of their knee joints while wearing different ankle weights (0%, 0.5%, 1%, and 1.5%) in an open kinetic chain. The Hawk Digital System (60 Hz; Motion Analysis, Santa Rosa, CA, USA) was used to measure knee joint repositioning error. Differences in knee joint repositioning error between the young and elderly groups according to ankle weight load were examined by using two-way mixed repeated-measures analysis of variance. [Results] The knee joint repositioning error was lower with than without ankle weights in both groups. The error value was lowest with the 1.0% weight, though not significantly. Knee joint repositioning error was significantly higher in the elderly under all the ankle weight conditions. [Conclusion] Knee joint repositioning sense can be improved in elderly individuals by wearing proper ankle weights. However, weights that are too heavy might disturb knee joint positioning sense.
[Purpose] This study was performed to investigate the effect of the length of backpack shoulder straps on upper trapezius muscle pain threshold and craniovertebral angle. [Subjects and Methods] There were 25 participants, with ages from 15 to 23 years old. Upper trapezius pain threshold and craniovertebral angle were measured for all subjects without the backpack then re-measured after walking on a treadmill for 15 min under 2 conditions: 1) wearing a backpack with short straps; and 2) wearing a backpack with long straps. [Results] there was a significant reduction in upper trapezius pain threshold and craniovertebral angle while carrying a backpack with long shoulder straps, compared to use of a backpack with short shoulder straps or no backpack. [Conclusion] A backpack with short straps is less harmful than a backpack with long straps. This result should be considered in ergonomic design of backpacks to reduce the incidence of various physiological and biomechanical disorders.
[Purpose] Rhythmic auditory stimulation has been used in gait training for stroke patients. However, few studies have investigated its effects in relation to lesion sites. Therefore, this study examined the immediate effects of rhythmic auditory stimulation on gait in stroke patients with lesions in different regions. [Subjects and Methods] One hundred and five patients were recruited and divided into five groups according to the lesion site: cerebellum, pons and medulla, thalamus, putamen, and corona radiata. During training, participants walked to an auditory, continuous rhythmic beat, which was set to each individual’s cadence. [Results] Pre- versus post-test measures revealed significant increases in velocity and stride length in the cerebellum, pons and medulla, and thalamus groups. Although the putamen and corona radiata groups demonstrated increases in velocity and stride length, the increases were not significant. [Conclusion] Rhythmic auditory stimulation was effective in facilitating the prediction of motor timing and gait rhythm in stroke patients with lesions in the cerebellum, pons and medulla, and thalamus, which are associated with impairment of the timing mechanism.
[Purpose] To compare measurements of knee extensor and flexor muscle strength performed using a hand-held dynamometer and an isokinetic dynamometer in apparently healthy subjects. [Subjects and Methods] Thirty adult volunteers underwent knee muscle strength evaluation using an isokinetic or a hand-held dynamometer. [Results] Strong positive correlations were found between the 2 methods, with correlation coefficients r ranging from 0.72 (95% confidence interval [CI], 0.48−0.86) to 0.87 (95% CI, 0.75−0.94), depending on the muscle group and the isokinetic evaluation mode. The reproducibility of the hand-held dynamometer findings was good, judged by a coefficient of variation of 3.2–4.2%. However, the correlation between the 2 methods for the assessment of flexor/extensor ratios ranged from −0.04 to 0.46. [Conclusion] Knee extensor and flexor muscle strength recorded with a hand-held dynamometer is reproducible and significantly correlated with the isokinetic values, indicating that this method may in some cases be a useful replacement for isokinetic strength measurement. However, for strength ratio assessment, and when judged against the isokinetic standard, a hand-held dynamometer is not a valid option.
[Purpose] The purpose of the present study was to investigate the relationship between the duration of the car transfer (CT) movement and trunk inclination and hip angles during this movement in individuals with tetraplegia. [Subjects and Methods] Eleven adult males with C6 tetraplegia participated in this study. The CT movement was recorded from the passenger side of the car using a digital video camera. From the video, the duration and trunk inclination and hip joint angle were recorded, and correlation coefficients were calculated. [Results] No correlation was found between the trunk inclination angle and the duration of the CT movement. However, a significant correlation was found between the hip angle and the duration of the CT movement: when the duration was short, the hip flexion angle was substantial. [Conclusion] The trunk inclination angle probably showed no effect on the duration of the CT movement because the movement was performed in a limited space and because the trunk muscles of the subjects were paralyzed. In contrast, C6 tetraplegia enabled smooth CT by allowing for control of trunk inclination, such as placing the lower extremities in the car, whereby the pelvis backward tilt angle increased.
[Purpose] The purpose of this study was to compare the center of mass during sit-to-stand and stand-to-sit activities in the timed up and go test between healthy subjects and patients with stroke. [Subjects and Methods] Thirty healthy participants and thirty patients with stroke volunteered for this study. Acceleration of the center of mass was measured using a wireless tri-axial accelerometer during sit-to-stand and stand-to-sit activities in the timed up and go test. Accelerometer data were analyzed using BTS G-studio software. [Results] The phase duration was significantly longer and the anterior-posterior, mediolateral, and vertical acceleration ranges were significantly lower during sit-to-stand for patients with stroke than for healthy controls. Further, phase duration and the mediolateral acceleration range during stand-to-sit differed significantly between healthy controls and subjects with stroke. [Conclusions] During training for the sit-to-stand activity, the focus should be all three balance dimensions, but during training for the stand-to-sit activity, the focus should be on improving mediolateral balance and asymmetrical foot positioning should be recommended.
[Purpose] Kinematic and kinetic characteristics of the limb during side-hopping and hip/knee interaction during this motion have not been clarified. The purposes of this study were to examine the biomechanical parameters of the knee during side hop and analyze its relationship with clinical measurements of hip function. [Subjects and Methods] Eleven male college rugby players were included. A three-dimensional motion analysis system was used to assess motion characteristics of the knee during side hop. In addition, hip range of motion and muscle strength were evaluated. Subsequently, the relationship between knee motion and the clinical parameters of the hip was analyzed. [Results] In the lateral touchdown phase, the knee was positioned in an abducted and externally rotated position, and increasing abduction moment was applied to the knee. An analysis of the interaction between knee motion and hip function showed that range of motion for hip internal rotation was significantly correlated with external rotation angle and external rotation/abduction moments of the knee during the lateral touchdown phase. [Conclusion] Range of motion for hip internal rotation should be taken into consideration for identifying the biomechanical characteristics in the side hop test results.
[Purpose] The aim of this study was to compare hamstring-to-quadriceps ratio between the accelerating and decelerating sections for anterior cruciate ligament protection during squat exercise. [Subjects and Methods] Nine asymptomatic males were enrolled in this study. The hamstring (medial part) and quadriceps (rectus femoris) muscle activities during squat exercise were measured, and the squat exercises were classified into two sections (accelerating and decelerating) by using an accelerometer. [Results] The hamstring-to-quadriceps ratio was significantly higher in the decelerating section than in the accelerating section during the squat exercise. [Conclusion] Application of an increasing decelerating section strategy during the squat exercise can prevent damage in patients with a weakened anterior cruciate ligament due to sports activities.
[Purpose] Clarification of the differences in the compression volume of the lungs by the heart (CVLH) between postures may facilitate the selection of optimal postures in respiratory care. Determining CVLH in the supine, semi-prone (Sim’s position), and side-lying positions was the aim of this study. [Subjects and Methods] Eight healthy volunteers (six males, two females; mean age, 29.0 ± 9.2 years) were enrolled in the study. Measurements were performed in the supine, right and left semi-prone, and right and left side-lying positions. semi-prone position was inclined 45° ventrally from the side-lying position. A 1.5-T system with a fast advanced spin-echo sequence in the coronal plane was used for magnetic resonance imaging. [Results] CVLH and heart compression ratio were significantly lower in the semi-prone position on both sides than the other positions. The heart was displaced ventrally when semi-prone and a larger area of the heart leaned on the ventral chest wall, localizing compression to part of the ventral region of the dependent lung. [Conclusion] The region of lungs compressed by the heart is reduced in the semi-prone position due to ventral displacement of the heart. These results suggest that maintaining expansion of the dependent lung is easier in the semi-prone position.
[Purpose] This study aimed to investigate the effect of trunk stability on isometric knee extension muscle strength measurement while sitting by performing simultaneous measurements with a handheld dynamometer (HHD) and an isokinetic dynamometer (IKD) in the same seated condition. [Subjects and Methods] The subjects were 30 healthy volunteers. Isometric knee extension muscle strength was simultaneously measured with a HHD and an IKD by using an IKD-specific chair. The measurement was performed twice. Measurement instrument variables and the number of measurements were examined by using the analysis of variance and correlation tests. [Results] The measurement instrument variables and the number of measurements were not significantly different. The correlation coefficients between the HHD and IKD measurements were ≥0.96. [Conclusion] Isometric knee extension muscle strength measurement using the HHD in the sitting position resulted in a lower value than that using the IKD, presumably because of the effect of trunk stability on the measurement. In the same seated posture with trunk stability, no significant difference in measurement values was observed between the HHD and IKD. The present findings suggest that trunk stability while seated during isometric knee extension muscle strength measurement influenced the HHD measurement.
[Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon.
[Purpose] The aim of this study was to examine the effects of increased heel height and gait velocity on balance control and knee joint position sense. [Subjects and Methods] Forty healthy adults were randomly allocated to 4 groups: low-heel, low-speed group (3 cm, 2 km/h), low-heel, high-speed group (3 cm, 4 km/h), high-heel, low-speed group (9 cm, 2 km/h), high-heel, and high-speed group (9 cm, 4 km/h), with 10 subjects per group. Static and dynamic balance was evaluated using the I-Balance system and knee joint position sense using a goniometer. Measurements were compared using a pre- and posttest design. [Results] Increasing heel height and gait velocity decreased knee joint position sense and significantly increased the amplitude of body sway under conditions of static and dynamic balance, with highest sway amplitude induced by the high-heel, high-speed condition. [Conclusion] Increased walking speed in high heels produced significant negative effects on knee joint sense and balance control.
[Purpose] The risk of falls in the elderly is an important public health problem. Suitable tests may help detect those at risk of falling. This study determined which balance test for older adults generates the most reliable results in terms of fall risk assessment, based on the number of falls over the last 12 months. [Subjects and Methods] A total of 153 individuals (31 males, 122 females, aged 76.67 ± 8.3 years; median 76.5, range 65–94) were investigated. The subjects were subdivided between fallers (a fall over the last 12 months) and non-fallers (no falls over the last 12 months). All participants were assessed with the following: Barthel Scale, Mini-Mental State Examination, Timed Up and Go, Tinetti Performance-Oriented Mobility Assessment), Berg Balance Test, and One-Legged Stance Test. [Results] Statistically significant differences were detected between fallers and non-fallers in TUG, POMA, BBS, and OLST scores. The number of falls correlated positively with the results for TUG, POMA, and OLST. [Conclusion] TUG and POMA were the most useful screening tests for balance and gait impairment in elderly nursing home residents. Two or more tests should be performed for more precise assessment of the risk of falling.
[Purpose] Evaluating the effect of brain-computer interface (BCI)-based functional electrical stimulation (FES) training on brain activity in children with spastic cerebral palsy (CP) was the aim of this study. [Subjects and Methods] Subjects were randomized into a BCI-FES group (n=9) and a functional electrical stimulation (FES) control group (n=9). Subjects in the BCI-FES group received wrist and hand extension training with FES for 30 minutes per day, 5 times per week for 6 weeks under the BCI-based program. The FES group received wrist and hand extension training with FES for the same amount of time. Sensorimotor rhythms (SMR) and middle beta waves (M-beta) were measured in frontopolar regions 1 and 2 (Fp1, Fp2) to determine the effects of BCI-FES training. [Results] Significant improvements in the SMR and M-beta of Fp1 and Fp2 were seen in the BCI-FES group. In contrast, significant improvement was only seen in the SMR and M-beta of Fp2 in the control group. [Conclusion] The results of the present study suggest that BCI-controlled FES training may be helpful in improving brain activity in patients with cerebral palsy and may be applied as effectively as traditional FES training.
[Purpose] Respiratory physiotherapy is an effective approach to improving lung function in patient, including athletes with respiratory dysfunction caused by sports injury. The purpose of this study was to analyze the differences in the respirograms between taekwondo poomsae athletes and nonathletes according to the respirogram phase. [Subjects and Methods] Respiratory measurements for 13 elite taekwondo poomsae athletes were obtained. Respiratory function was measured using spirometry while the participant was seated. [Results] In respirogram phasic analysis, the inspiratory area of forced vital capacity were significantly increased in the athletes than in the nonathletes. The slopes of the forced vital capacity for athletes at slopes 1, 2, and 3 of the A area were significantly higher than those for the nonathletes. In correlation analysis, chest circumference was significantly correlated with slope 1 of the A area of the forced vital capacity. [Conclusion] Results indicate that differences in respirogram phasic changes between athletes and nonathletes may contribute to better understanding of respiratory function, which is important to sports physiotherapy research.
[Purpose] This study aimed to evaluate the effectiveness of mirror therapy combined with a conventional rehabilitation program on upper extremity motor and functional recovery in stroke patients. [Subjects and Methods] Thirty-one hemiplegic patients were included. The patients were randomly assigned to a mirror (n=16) or conventional group (n=15). The patients in both groups underwent conventional therapy for 4 weeks (60–120 minutes/day, 5 days/week). The mirror group received mirror therapy, consisting of periodic flexion and extension movements of the wrist and fingers on the non-paralyzed side. The patients in the conventional group performed the same exercises against the non-reflecting face of the mirror. The patients were evaluated at the beginning and end of the treatment by a blinded assessor using the Brunnstrom stage, Fugl-Meyer Assessment (FMA) upper extremity score, and the Functional Independence Measure (FIM) self-care score. [Results] There was an improvement in Brunnstrom stage and the FIM self-care score in both groups, but the post-treatment FMA score was significantly higher in the mirror therapy group than in the conventional treatment group. [Conclusion] Mirror therapy in addition to a conventional rehabilitation program was found to provide additional benefit in motor recovery of the upper extremity in stroke patients.
[Purpose] The elderly are susceptible to dysphagia, and complications can be minimized if high-risk groups are screened in early stages and properly rehabilitated. This study provides basic material for the early detection and prevention of dysphagia by investigating the risks of dysphagia and related factors in community-dwelling elders. [Subjects and Methods] Participants included 325 community-dwelling elderly people aged 65 or older. The modified dysphagia risk assessment for the community-dwelling elderly was used to assess dysphagia risk. [Results] Approximately 52.6% (n=171) of participants belonged to the high-risk group for dysphagia. After adjusting for confounding variables, people aged 75+, who used dentures, and who needed partial help in daily living had a significantly higher risk of dysphagia. [Conclusion] It is necessary to develop guidelines for dysphagia for early detection and rehabilitation.
[Purpose] To clarify the characteristics of postural control in badminton players by examining their lower-limb muscle activity during upper-limb elevation. [Subjects and Methods] Fourteen badminton players and 14 non-players were studied. The subjects were instructed to perform an upper-limb elevation task in order to measure the activities of the biceps femoris and biceps brachii. [Results] When elevating the dominant hand, the mean biceps femoris integrated electromyogram showed markedly higher values in the player group, for the contralateral compared with the ipsilateral leg. Similarly, when elevating the dominant hand, the difference in the maximum integrated electromyogram response time between the ipsilateral and contralateral legs was significantly smaller in the players compared with non-players. [Conclusion] It may be possible to reduce the time needed to elevate the dominant hand by shifting lower-limb activity from the ipsilateral to the contralateral leg more quickly, while increasing the rate of rise in contralateral leg muscle activity.
[Purpose] Evaluation of the reliability of smartphones as measuring equipment for dynamic balance ability was the goal of this study. [Subjects and Methods] Subjects were 30 healthy young students in their 20s. The first and second rounds of measurements were taken at a one-day interval to confirm test-retest reliability. The subjects stood on the footboard of the Biodex Balance System. Balance was measured using a smart phone. [Results] Acceleration rates corresponding to subjects with open eyes were 2.7 ± 2.2 (first measurement) and 3.3 ± 1.5 (second measurement), and the interclass correlation coefficient ICC (1,1) was 0.8. Acceleration rates corresponding to subjects with closed eyes were 4.1 ± 2.4 (first measurement) and 4.5 ± 1.8 (second measurement), and the ICC (1,1) was 0.9. Gyroscope rates corresponding to subjects with open eyes were 1.7 ± 1.2 (first measurement) and 2.3 ± 1.5 (second measurement), and the ICC (1,1) was 0.7. Gyroscope rates corresponding to subjects with closed eyes were 6.7 ± 2.4 (first measurement) and 6.6 ± 2.3 (second measurement), and the ICC (1,1) was 0.6. [Conclusion] The results of this study suggest that smartphones have sufficient potential as measuring equipment for dynamic balance ability.
[Purpose] This study was intended to examine the most effective feedback method for contracting the musculus transversus abdominis muscle by using basic training, a pressure biofeedback unit, and real-time ultrasonographic imaging during abdominal hollowing exercise training. [Subjects and Methods] The subjects in this study were 30 healthy young students in their twenties. Thirty subjects were divided randomly and equally into the basic training, the pressure biofeedback unit, and real-time ultrasonographic imaging groups. All of the subjects received abdominal hollowing exercise training for 15 minutes. The subjects in the pressure biofeedback unit group were trained by using a pressure biofeedback unit. Those in the real-time ultrasonographic imaging group received training with monitoring of possible contraction of their musculus transversus abdominis muscles on ultrasonography. [Results] In all the three groups, the musculus transversus abdominis became significantly thicker, but more significantly in the real-time ultrasonographic imaging group than in the basic training group. [Conclusion] The feedback method using real-time ultrasonographic imaging may be more effective in thickening the musculus transversus abdominis muscle during exercise than the traditional feedback method with manual contact only. However, it is insufficient in terms of overall qualitative improvement of exercise outcome.
[Purpose] This study aimed to analyze the effect of extracorporeal shock wave therapy on the shoulder function of patients with calcific tendinitis through a 12-week follow-up. [Subjects and Methods] A total of 34 patients with calcific tendinitis participated in this study. In the extracorporeal shock wave therapy group, 18 patients received 6-week extracorporeal shock wave therapy and 12-week follow-up. The Constant-Murley scale was used to evaluate shoulder joint function. [Results] Analysis of variance showed a significant difference between the measurement periods. The independent t-test showed significant differences between the groups at 2, 6, and 12 weeks. [Conclusion] Extracorporeal shock wave therapy can be an effective treatment method for calcific tendinitis that affects patients’ shoulder function.
[Purpose] This study aimed to determine the extent of lower extremity muscle activity before and after walking based on rain boot shaft length. [Subjects and Methods] The subjects, 12 young and healthy females, were divided into three groups based on rain boot shaft length (long, middle, and short). They walked on a treadmill for 30 minutes. Activity of the rectus femoris, vastus lateralis, semitendinosus, tibialis anterior, peroneus longus, and gastrocnemius was measured using electromyography before and after walking. Two-way repeated measures analysis of variance was performed to compare the muscle activities of each group. [Results] There were no significant differences in terms of the interactive effects between group and time for all muscles, the main effects of group, or the main effects of time. [Conclusion] The results of this study may indicate that movement of the lower extremities was not significantly limited by friction force based on the characteristics of the boot material or the circumference of the boot shaft. Thus, it may be helpful instead to consider the material of the sole or the weight of the boots when choosing which rain boots to wear.
[Purpose] The purpose of this study was to investigate the preventive effects of stretching and stabilization exercises on muscle fatigue of the neck erector spine and upper trapezius muscles. [Subjects and Methods] The subjects of this study were 26 healthy university students (14 males and 12 females). Each subject was assigned randomly to each of three study groups in order to prevent order effect. The three groups included in this study were the no-exercise, stretching exercise, and neck stabilization exercise groups. The median electromyographic frequency was used as a gauge of muscle fatigue. [Results] Decreased muscle fatigue was demonstrated by an increase in the median electromyographic frequency values in all the four muscle groups in the comparison between conditions 1 and 3. In particular, statistically significant differences were found between the two conditions in the right upper trapezius muscle group. [Conclusion] These findings suggest that the effect of stretching and stabilization exercises can reduce muscle fatigue in mobile phone users.
[Purpose] This study evaluated differences between healthy elderly individuals and stroke patients by comparing their dominant and nondominant sides. [Subjects and Methods] Thirty-five elderly individuals participated in this study and divided into a stroke group and a control group. The outcome measures were general characteristics and bone mineral density. Bone mineral density was evaluated by using the osteoporosis index. OsteoPro, T score, and Z score were used for the calcaneus region of the dominant side, and OsteoPro was used for that of the nondominant side. Data were analyzed by using the SPSS 12.0 software, paired-samples t-test, and independent-samples t-test. [Results] The T and Z scores showed no significant differences between the dominant and recessive sides in the control group. However, the stroke group showed significant differences in osteoporosis index, T score, and Z score between the paretic and nonparetic sides. Changes in the scores between the recessive and dominant sides showed significant differences between the two groups. [Conclusion] A positive relationship was found between physical activity and bone mineral density in the stroke patients. Therefore, improved physical activity can be beneficial by reducing osteoporosis in stroke patients.
[Purpose] This study compared abdominal and hip extensor muscle activity during a bridge exercise with various knee joint angles. [Subjects and Methods] Twenty-two healthy male subjects performed a bridge exercise in which the knee joint angle was altered. While subjects performed the bridge exercise, external oblique, internal oblique, gluteus maximus, and semitendinosus muscle activity was measured using electromyography. [Results] The bilateral external and internal oblique muscle activity was significantly higher at 0° knee flexion compared to 120°, 90°, and 60°. The bilateral gluteus maximus muscle activity was significantly different at 0° of knee flexion compared to 120°, 90°, and 60°. The ipsilateral semitendinosus muscle activity was significantly increased at 90° and 60° of knee flexion compared to 120°, and significantly decreased at 0° knee flexion compared with 120°, 90°, and 60°. The contralateral semitendinosus muscle activity was significantly higher at 60° of knee flexion than at 120°, and significantly higher at 0° of knee flexion than at 120°, 90°, and 60°. [Conclusion] Bridge exercises performed with knee flexion less than 90° may be used to train the ipsilateral semitendinosus. Furthermore, bridge exercise performed with one leg may be used to train abdominal and hip extensor muscles.
[Purpose] The aim of this study was to investigate the effect of neuromuscular electrical stimulation on facial muscle strength and oral function in stroke patients with facial palsy. [Subjects and Methods] Nine subjects received the electrical stimulation and traditional dysphagia therapy. Electrical stimulation was applied to stimulate each subject’s facial muscles 30 minutes a day, 5 days a week, for 4 weeks. [Results] Subjects showed significant improvement in cheek and lip strength and oral function after the intervention. [Conclusion] This study demonstrates that electrical stimulation improves facial muscle strength and oral function in stroke patients with dysphagia.
[Purpose] The purpose of this study was to provide basic data for research on selective muscle strengthening by identifying mean muscle activities and calculating muscle ratios for use in developing strengthening methods. [Subjects and Methods] Twenty-one healthy volunteers were included in this study. Muscle activity was measured during a one-leg stance under 6 conditions of slope angle: 0°, 5°, 10°, 15°, 20°, and 25°. The data used in the analysis were root mean square and % total muscle activity values. [Results] There were significant differences in the root mean square of the gluteus medius, the hamstring, and the medial gastrocnemius muscles. There were significant differences in % total muscle activity of the medial gastrocnemius. [Conclusion] Future studies aimed at developing selective muscle strengthening methods are likely to yield more effective results by using muscle activity ratios based on electromyography data.
[Purpose] The purpose of this study was to investigate the effects of thoracic spinal manipulation therapy on respiratory function including forced vital capacity and forced expiratory volume in one second in young healthy individuals. [Subjects and Methods] Thirty young healthy subjects recruited from a local university participated in this study. Subjects were randomly allocated into an experimental group (n=15) and a control group (n=15). The experimental group received thoracic spinal manipulation and the control group received placebo thoracic spinal manipulation. Respiratory function tests, including forced vital capacity and forced expiratory volume in one second, were measured before and after intervention. [Results] The values for both tests were significantly higher in the experimental group. The control group showed no changes after the intervention. Differences in pre- and post-intervention values for both tests were significantly different between the 2 groups. [Conclusion] Spinal manipulation therapy applied to the thoracic region improved respiratory function test results of participants in this study.
[Purpose] This study aimed to categorize the internal and external rotation range of motion (ROM) of ipsilateral hip joints into specific patterns based on the differences between them, and clarify the distribution of these patterns. [Subjects and Methods] A total of 222 healthy Japanese medical students (162 males, 60 females) with a mean age of 21.2 ± 4.0 years were enrolled. The ROM of internal and external rotation at the hip were randomly measured with the subjects in the prone position. Thereafter, the difference between internal and external rotations was assessed. Hip ROM patterns were classified into 3 types based on the differences in the rotation ROM on each side. A total of 9 overall patterns were then determined based on the combination of patterns on both sides. [Results] Although all the subjects were healthy, an asymmetrical ROM between internal and external rotation in ipsilateral hip joints could be detected via pattern classification. Moreover, the distribution of each hip ROM pattern was clarified. [Conclusion] Pattern classification based on differences in internal and external rotation ROM could serve as a useful evaluation method for clinical manipulative therapy.
[Purpose] This study was conducted to determine whether acute aerobic exercise (climbing) is associated with changes in the dietary intake pattern. [Subjects and Methods] Food intake and physical activity data for 15 female college students were sampled for 3 days and categorized according to routine activity or high-intensity activity such as hiking. Nutrient intake based on the data was analyzed using a nutrition program. [Results] Carbohydrate and protein intake was significantly decreased after exercise compared to before acute aerobic exercise, but lipid intake showed no significant difference. Calorie intake was significantly decreased after exercise compared to before exercise; however, calorie consumption was significantly increased after exercise. [Conclusion] Aerobic exercise causes a decrease in total calories by inducing reduction in carbohydrate and protein intake. Therefore, aerobic exercise is very important for weight (body fat) control since it causes positive changes in the food intake pattern in female students.
[Purpose] Here we investigated the activity of the cerebral cortex after resistance training in the elderly. We evaluated the clinical neuropsychological basis of 2 contractile types, and determined the usefulness of a movement-related cortical potential (MRCP) from an electroencephalography (EEG). [Subjects and Methods] The subjects were 11 females and 11 males aged between 65 and 70 years. The subjects were randomly assigned into a group that performed an eccentric contraction exercise (experimental group I, n=11) and a group that performed a concentric contraction exercise (experimental group II, n=11). We measured activities of the rectus femoris, vastus medialis, and vastus lateralis in the non-dominant lower extremity by using surface electromyography (EMG), and measured brain activity using EEG before conducting an intervention. An intervention was conducted 40 minutes per session, once a day, 3 times a week for 4 weeks. [Results] After the intervention, activity in C4, the Cz area and rectus femoris were significantly different. [Conclusion] Our results demonstrate that MRCP from an EEG has the advantage of being non-invasive and cost-effective. Nonetheless, prospective studies are needed to reveal the specific mechanism underlying eccentric contraction exercise, which can provide baseline data for research related to aging and neural plasticity.
[Purpose] The purpose of this study was to investigate the effects of hand strength on upper extremity function and activities of daily living in patients with right hemiplegia, as well as to provide important fundamental data for rehabilitation after stroke. [Subjects and Methods] This study was conducted from May 1 to December 30, 2013, at the Department of Rehabilitation of P Hospital in Seoul and included subjects hospitalized with a diagnosis of stroke. Patients with right hemiplegia were selected, and their hand strength, upper extremity function, and activities of daily living were evaluated. Hand strength was measured by grip, lateral pinch, and three-point pinch strength. [Results] The effects of hand strength on upper extremity function were evaluated. The results showed that all types of hand strength significantly influenced upper extremity function. However, only grip strength influenced activities of daily living. [Conclusion] In rehabilitation of stroke patients, it is necessary to first improve their general physical condition and basic activities of daily living, and then improve hand movement and hand muscle strength for instrumental activities of daily living training, which requires detailed hand movements.
[Purpose] The purpose of this study was to establish the reliability and validity of the Short Musculoskeletal Function Assessment questionnaire, which was translated into Korean, for patients with musculoskeletal disorder. [Subjects and Methods] Fifty-five subjects (26 males and 29 females) with musculoskeletal diseases participated in the study. The Short Musculoskeletal Function Assessment questionnaire focuses on a limited range of physical functions and includes a dysfunction index and a bother index. Reliability was determined using the intraclass correlation coefficient, and validity was examined by correlating short musculoskeletal function assessment scores with the 36-item Short-Form Health Survey (SF-36) score. [Results] The reliability was 0.97 for the dysfunction index and 0.94 for the bother index. Validity was established by comparison with Korean version of the SF-36. [Conclusion] This study demonstrated that the Korean version of the Short Musculoskeletal Function Assessment questionnaire is a reliable and valid instrument for the assessment of musculoskeletal disorders.
[Purpose] The purpose of this study was to examine the effects of transcranial direct current stimulation (tDCS) on visual perception and performance of activities of daily living in patients with stroke. [Subjects and Methods] Thirty subjects were assigned equally to a tDCS plus traditional occupational therapy group (experimental group) and a traditional occupational therapy group (control group). The intervention was implemented five times per week, 30 minutes each, for six weeks. In order to assess visual perception function before and after the intervention, the motor-free visual perception test (MVPT) was conducted, and in order to compare the performance of activities of daily living, the Functional Independence Measure scale was employed. [Results] According to the results, both groups improved in visual perception function and in performance of activities of daily living. Although there was no significant difference between the two groups, the experimental group exhibited higher scores. [Conclusion] In conclusion, the application of tDCS for the rehabilitation of patients with stroke may positively affect their visual perception and ability to perform activities of daily living.
[Purpose] This study investigated the effect of the Weight-bearing Exercise for Better Balance program on the strength of hip flexors, extensors, abductors, adductors, and knee flexors and extensors and balance in osteopenia. [Subjects and Methods] Twenty-four postmenopausal females with osteopenia volunteered to participate in this study and were randomly assigned into two equal groups of 12: the experimental and control groups. The Weight-bearing Exercise for Better Balance program was applied to the experimental group, while the control group did not receive any treatment. Isokinetic peak torque per body weight values of the hip flexors, extensors, abductors, adductors, and knee flexors and extensors were measured by Biodex System 3 isokinetic dynamometer for both groups before and after six weeks of the program. Balance was assessed in both groups using the Berg Balance Scale. [Results] There was a statistically significant increase in post-intervention mean values of all measured variables compared with pre-intervention values in the experimental group. Also, there was a statistically significant increase in post-intervention mean values of all measured variables except for those of the hip extensors in the experimental group compared with the control group. [Conclusion] The weight-bearing exercise for better balance program has significant effects on lower extremity muscle strength and body balance in postmenopausal females with osteopenia.
[Purpose] Primary care is considered the gateway to the Brazilian public health system and is responsible for managing the most prevalent problems in the population. In this study, the effects of Back School on pain, functionality, and the performance of activities of daily living (ADL) in users with chronic musculoskeletal pain were evaluated. [Subjects and Methods] Forty-four users (33 females and 11 males) participated in Back School, with five two-hour theoretical and practical meetings held once a week. The assessment instruments used were as follows: (a) a circuit evaluation of posture dynamics recorded on video, (b) an observational instrument of ADL using video, (c) anamnesis, (d) the visual analogue scale, and (e) the Oswestry Disability Index. [Results] The results showed decreased pain intensity, improved functionality, and the recovery of ADL. [Conclusion] The Back School program is an effective health education strategy for users with chronic musculoskeletal pain.
[Purpose] This study was conducted to examine the effects of age and body mass index on plantar cutaneous sensation in healthy women. [Subjects and Methods] Two hundred and three healthy female volunteers over the age of 20 were included in the study. The statistical analyses were performed by considering the age and body mass index values of the individuals. The individuals were divided according to their ages and body mass index values. Foot pain was measured with a visual analogue scale and plantar cutaneous sensation using Semmes-Weinstein monofilaments. [Results] Fifty-six (27.5%) of the participants had normal weights, 67 (33%) were overweight, and 80 (39%) were obese. Statistical analysis revealed that as age and body mass index values increased, plantar sensitivity decreased and the frequency and severity of pain increased. [Conclusion] It is possible that healthy women may experience a decrease in foot plantar sensation with increasing weight and age. If women do not have any health problems, proprioception and sensory training must be focused on in order to prevent balance and falling problems.
[Purpose] This study aimed to investigate the effects of ankle biofeedback training on muscle strength of the ankle joint, balance, and gait in stroke patients. [Subjects and Methods] Twenty-seven subjects who had had a stroke were randomly allocated to either the ankle biofeedback training group (n=14) or control group (n=13). Conventional therapy, which adhered to the neurodevelopmental treatment approach, was administered to both groups for 30 minutes. Furthermore, ankle strengthening exercises were performed by the control group and ankle biofeedback training by the experimental group, each for 30 minutes, 5 days a week for 8 weeks. To test muscle strength, balance, and gait, the Biodex isokinetic dynamometer, functional reach test, and 10 m walk test, respectively, were used. [Results] After the intervention, both groups showed a significant increase in muscle strength on the affected side and improved balance and gait. Significantly greater improvements were observed in the balance and gait of the ankle biofeedback training group compared with the control group, but not in the strength of the dorsiflexor and plantar flexor muscles of the affected side. [Conclusion] This study showed that ankle biofeedback training significantly improves muscle strength of the ankle joint, balance, and gait in patients with stroke.
[Purpose] The purpose of this study was to examine the effects of ankle exercises on balance ability when using shoe height insoles. [Subjects and Methods] Thirty adults in their 20s, who were students, were randomly divided into an experimental group and a control group (n=15/group). Individuals in the experimental group wore height-adjustable silicon insoles measuring 3, 5, and 7 cm three times per week for four weeks. The ankle exercise program consisted of stretching exercises, resistance training, and a balance exercise. [Results] There was a significant improvement in the balance ability of the experimental group for all height insoles (3, 5, and 7 cm) following the exercise program, as compared with before the exercise program. There was no significant improvement in the balance ability of the control group for all height insoles following the exercise program as compared with before the exercise program. The experimental group exhibited a significant improvement in balance ability following the exercise program for all the height insoles as compared with the control group. [Conclusion] According to the results of this study, active ankle exercises are helpful in preventing ankle joint damage, as they improve balance ability.
[Purpose] The purpose of this study was to examine the effects of galvanic vestibular stimulation on event-related potentials. [Subjects and Methods] Forty normal female adult subjects were randomly distributed to a galvanic vestibular stimulation application group (20 subjects) and sham group (20 subjects). For galvanic vestibular stimulation application, a positive electrode was applied to the right mastoid process, and a negative electrode was applied to the left mastoid process; simulation was applied for 10 minutes. A test was conducted on the N100 and P300 components of the event-related potentials before and after galvanic vestibular stimulation. [Results] The N100 latency showed statistically significant differences in interaction effects between time and group in the F3, F4, Fz, and Pz areas. The P300 latency showed the same results in the Fp1 and Fp2 areas, the N100 amplitude showed the same results in the Fp2, Fz, and Pz areas; and the P300 amplitude showed the same results in the Pz area. [Conclusion] These results suggest that galvanic vestibular stimulation may play a positive role in the N100 and P300 components of the event-related potentials of the cerebral cortex related to decision-making in matching words with images.
[Purpose] The aim of this study was to identify how to effectively use elastic stockings. [Subjects and Methods] Ten young healthy men participated in this study. Time-averaged maximum flow velocity in the common femoral vein was measured for 20 seconds using a pulse Doppler method with a diagnostic ultrasound system under six conditions (three different positions and with and without stockings). Changes of blood flow velocity were compared. [Results] Elastic stockings did not affect the blood flow velocity in the common femoral vein. For both the with stockings condition and without stockings condition, the time-averaged maximum flow velocity in the head-up position was significantly lower than that in the supine and leg-up positions. Time-averaged maximum flow velocity showed no significant difference between the supine position and leg-up position. [Conclusion] Elastic stockings did not affect the blood flow velocity in the common femoral vein, but ankle positions did affect it. Further studies of patients with venous insufficiency are needed.
[Purpose] Measurement of the diadochokinetic rate can provide useful information on swallowing rehabilitation in the oral phase by elucidating the speed and regularity of movement of muscles related to the lips, tongue, and chin. This study investigated the effect of a three-week period of orofacial myofunctional exercise on the improvement of cheek, tongue, and lip muscle strength and diadochokinetic rate in dysphagia patients. [Subjects and Methods] This study employed a pretest-posttest control group design. Both orofacial myofunctional exercise and the temperature-tactile stimulation technique were applied to the experimental group (n=23), while only the temperature-tactile stimulation technique was applied to the control group (n=25). [Results] Tongue elevation, tongue protrusion, cheek compression, lip compression, and alternating motion rate were more significantly improved in the experimental group than in the control group. [Conclusion] Orofacial myofunctional exercise is effective in the rehabilitation of swallowing function in the oral phase in dysphagia patients by improving orofacial muscle strength and response rate.
[Purpose] The purpose of this study was to investigate the effects of an 8-week program of Pilates exercise on gait in chronic hemiplegia patients and to determine whether or not it can be used for rehabilitation in postsrtoke patients. [Subjects and Methods] Twenty individuals with unilateral chronic hemiparetic stroke (age, 66.1 ± 4.4 yrs; height, 162.3 ± 8.3 cm; weight, 67.4 ± 12.3 kg) participated in this study and were randomly allocated equally to either a Pilates exercise group or a control group. To identify the effects of Pilates exercise, a 3-D motion analysis with 8 infrared cameras was performed. [Results] For the gait parameters, improvements were found in the Pilates exercise group for all variables, and statistical significance was observed for stride length, gait velocity, knee range of motion and hip range of motion. For the asymmetry indexes, insignificant improvements were found for all variables in the Pilates exercise group. [Conclusion] In conclusion, an 8-week program of Pilates exercise had a positive influence on improving the gait ability of poststroke patients, and the intervention could be applied to poststroke patients with various levels of physical disability by adjusting the intensity of training.
[Purpose] The aim of this study was to investigate the usefulness of ultrasonography for the diagnosis of polyneuropathy in diabetic patients by examination of the median and ulnar nerves. [Subjects and Methods] Sixty-three diabetic patients and fourteen controls were enrolled in the study. Nerve conduction studies were performed on both upper and lower limbs. Median and ulnar nerve cross-sectional areas were measured at the wrist and forearm levels in 140 hands by ultrasound. [Results] The median nerve cross-sectional area was increased at the hook of hamatum, pisiform bone, and radioulnar joint levels in patients with carpal tunnel syndrome. The ulnar nerve area at the medial epicondyle was significantly increased in the diabetic polyneuropathy (9.2 ± 1.6), diabetic polyneuropathy plus carpal tunnel syndrome (9.3 ± 1.4), and carpal tunnel syndrome (9.2 ± 1.9) groups compared with the control group (7.7 ± 1.1). In receiver operating characteristics analysis, the cutoff value of the ulnar nerve was 8.5 mm2 at ulnar epicondyle with 71.4% specificity and 70.4% sensitivity, corresponding to the highest diagnostic accuracy for diabetic polyneuropathy. [Conclusion] Ultrasonographic examination of the median and ulnar nerves can be an alternative or additional diagnostic modality for the evaluation of neuropathies in diabetic patients.
[Purpose] This study investigated the changes in the muscle activities of the trunk and lower limbs of healthy adults during a one-legged bridge exercise using a sling, and with the addition of hip abduction. [Subjects and Methods] Twenty-seven healthy individuals participated in this study (14 males and 13 females). The participants were instructed to perform the bridge exercises under five different conditions. Trunk and lower limb muscle activation of the erector spinae (ES), external oblique (EO), gluteus maximus (GM), and biceps femoris (BF) was measured using surface electromyography. Data analysis was performed using the mean scores of three trials performed under each condition. [Results] There was a significant increase in bilateral EO and contralateral GM with the one-legged bridge compared with the one-legged bridge with sling exercise. Muscle activation of the ipsilateral GM and BF was significantly less during the one-legged bridge exercise compared to the one-legged bridge with sling exercise, and was significantly greater during the one-legged bridge with hip abduction compared to the one-legged bridge exercise. The muscle activation of the contralateral GM and BF was significantly greater with the one-legged bridge with hip abduction compared to the general bridge exercise. [Conclusion] With the one-legged bridge with hip abduction, the ipsilateral EO, GM and BF muscle activities were significantly greater than those of the one-legged bridge exercise. The muscle activation of all trunk and contralateral lower extremity muscles increased with the bridge with sling exercises compared with general bridge exercises.
[Purpose] The purpose of this study was to compare the differences in muscle strength and postural balance between fallers and non-fallers. We also compared the difference between normal and impaired balance groups using the same subjects and the same variables. [Subjects and Methods] Seventy-one healthy elderly females (age: 75.1 ± 75 years; weight: 57.3 ± 57 kg; height: 150.1 ± 15 cm) who had high levels of physical activity participated [25 fallers (FG) vs. 46 non-fallers (NG); and 52 healthy balance group (HBG) and 19 impaired balance group (IBG) subjects]. To compare the groups, the muscle strengths of 9 muscle groups, and 20 variables of the instrumented standing balance assessment (2 area variables, 9 time-domain variables, and 9 frequency-domain variables) were assessed. [Results] The FG and NG could only be categorized based on the frequency-domain variables of the instrumented standing balance assessment. On the other hand, there were significant differences between HBG and IBG in height, 6 muscle strength, and 2 time-domain variables of the instrumented standing balance assessment. [Conclusion] These results suggest that muscle strength and standing balance are reflected in physical balance ability (i.e., BBS); however they are in sufficient for determining the actual occurrence of falls.
[Purpose] Stroke survivors exhibit abnormal pelvic motion and significantly deteriorated gait performance. Although the gait of stroke survivors has been evaluated at the primary level pertaining to ankle, knee, and hip motions, secondary deviations involving the pelvic motions are strongly related to the primary level. Therefore, the aim of this study was to identify the kinematic differences of the primary and secondary joints and to identify mechanism differences that alter the gait performance of stroke survivors. [Subjects and Methods] Five healthy subjects and five stroke survivors were recruited. All the subjects were instructed to walk at a self-selected speed. The joint kinematics and gait parameters were calculated. [Results] For the stroke survivors, the range of motion of the primary-joint motions were significantly reduced, and the secondary-joint motions were significantly increased. Additionally, for the healthy subjects, the primary joint kinematics were the main factors ensuring gait performance, whereas for the stoke survivors, the secondary-joint motions were the main factors. [Conclusion] The results indicate that while increasing the range of motion of primary-joint movements is the main target to achieve, there is a strong need to constrain and support pelvic motions in order to improve the outcome of gait rehabilitation.