[Purpose] To estimate the effect of Klapp method on idiopathic scoliosis in school students. [Subjects and Methods] A single-blind randomized clinical trial with 22 students randomly divided into intervention group (n=12) and inactive control group (n=10). Exercise protocol consisted of Klapp method, 20 sessions, three times a week for intervention group, and inactivity for control group. Dorsal muscle strength was measured by dynamometer; body asymmetries and gibbosity angles were measured by biophotogrammetry. Data were obtained by Generalized Estimated Equation, with 5% significance level. Clinical impact for dependent variables was estimated by “d” Cohen. [Results] There was no change in intragroup analysis and intergroup for all postural symmetry variables. However, it was detected intergroup difference in extensor muscle strength and intergroup difference with marginal significance of gibbosity angles. Regarding extensor muscle strength, intervention group produced average improvement of 7.0 kgf compared to control group. Gibbosity angles progressed less in intervention group, with 5.71° average delay compared to control group. [Conclusion] Klapp method was effective for gibbosity stabilization and it improves spine extensor muscle strength.

[Purpose] The mechanical strength of wheelchair and seating products is specified by standards to ensure user safety. However, some individual users are affected by severe spasticity resulting from cerebral palsy that occasionally breaks such devices. Until recently, reports of quantitative measurement of these mechanical overloads have been scarce, and the exact loads applied have been unknown. This study aimed to conduct a sampling survey prior to conducting a future full-scale study. [Subjects and Methods] Using two force plates, we measured the load on the foot support applied by three participants with cerebral palsy. The applied load was measured at a 100 Hz sampling rate, and maximum load and vertical/horizontal component forces were analyzed. [Results] The maximum load applied by participants was approximately 1.34 times their body weight. The vertical force applied on the foot support accounted for 70–80% of the total load. The horizontal force also reached about 35% at its maximum. [Conclusion] Because the horizontal load also reached 1/3 of the total load, it will be advantageous to use a three-axis force plate to measure forces in a future study with more participants.

[Purpose] To investigate the gender-related differences in lower limb alignment, range of joint motion, and history of lower limb sports injuries in Japanese university athletes. [Subjects and Methods] The subjects were 224 Japanese university athletes (154 males and 70 females). The quadriceps angle (Q-angle), arch height index, and ranges of internal and external rotation of the hip joints were measured. History of lower limb sports injury was surveyed using a questionnaire. [Results] Females had a significantly higher Q-angle and hip joint internal rotation angle and a significantly lower arch height index than males. The survey revealed that a significantly higher proportion of females had a history of lower limb sports injuries, and that the proportion of those with a history of foot/ankle injuries was particularly high. [Conclusion] These results suggested that females experience more lower limb sports injuries than males, and that a large proportion of these injuries involve the foot/ankle. Reduced lower limb alignment and increased range of joint motion in females may be risk factors for injury because they lead to increased physical stress being exerted on the lower legs during sporting activities.

[Purpose] To clarify the changes in postural strategy by evaluating leg joint motion and muscle activity before and after continuous exercise against perturbation using the Balance Exercise Assist Robot (BEAR). [Subjects and Methods] Nine healthy subjects (male 7, female 2; mean age 23 ± 1 years) performed a postural perturbation coping exercise only. In the task, the robot leaned and moved automatically. Participants were instructed to maintain their default upright position and they performed the exercise five times in a row (1 minute/trial). Changes in total movement distance, range of motion of each joint (hip, knee, ankle), and mean activity of each muscle for the first and fifth trials were compared. [Results] The total movement distance of BEAR and range of motion in the hip decreased significantly from the first trial to the last trial. No change in muscle activity was observed in the rectus femoris, biceps femoris, tibialis anterior or gastrocnemius. [Conclusion] The results for exercise against perturbation using BEAR in this study suggest that BEAR may be a promising method to improve the ankle strategy for maintaining a standing posture.

[Purpose] Exercise therapy during dialysis is currently being recommended since it is easy for patients to follow and results in high participation rates. In this study, this therapy was performed for elderly patients undergoing maintenance dialysis, and its effects were examined. [Subjects and Methods] Seven elderly patients (age: 70.6 ± 4.4) with chronic renal failure, who were able to perform exercises during maintenance dialysis, received the exercise therapy 2 or 3 times weekly for 3 months. Lower-limb muscle strength as well as the standardized dialysis dose (Kt/V) was measured before and after intervention. The patients were also evaluated using the 30-sec chair stand test (CS-30), the World Health Organization QOL Assessment 26 (WHO-QOL26), and a questionnaire. [Results] The lower-limb muscle strength and circumference, CS-30 score, and Kt/V values improved after intervention, but the difference was not significant. Significant differences were observed only in the WHO-QOL26 score. [Conclusion] The outcome was particularly favorable in terms of the quality of life (QOL). Based on the results from the questionnaire, the higher QOL may be due to the patients’ development of a positive attitude toward these activities. Although there were no significant differences, the values for the other criteria also improved, thereby supporting the effectiveness of exercise therapy to maintain or improve the patients’ motor functions and activity daily living (ADL) ability.

[Purpose] This study aimed to determine the effectiveness and mechanisms of extracorporeal shock wave therapy in the treatment of femoral head osteonecrosis. [Subjects and Methods] Histomorphometric analysis of necrotic femoral head in rabbits treated with shock waves was performed. Bilateral osteonecrosis of femoral heads was induced with methylprednisolone and lipopolysaccharide in eight rabbits. The left limb (study side) received shock waves to the femoral head. The right limb (control side) received no shock waves. Biopsies of the femoral heads were performed at 12 weeks after shock wave therapy. [Results] Necrotic femoral heads treated with shock waves, compared with controls, had higher bone volume per tissue volume, trabecular thickness, trabecular number, osteoblast surface/bone surface, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineralizing apposition rate, and bone formation rate. However, trabecular separation was lower in shock wave-treated femoral heads than in controls. Eroded surface/bone surface and osteoclast surface/bone surface did not differ significantly between groups. [Conclusion] The bone mass of necrotic femoral heads treated with shock waves increases. Extracorporeal shock wave may promote bone repair in necrotic femoral heads through the proliferation and activation of osteoblasts.

[Purpose] The purpose of this study was to clarify the impact of postural changes during tidal breathing on the configuration and motion of chest-wall in order to further breathing motion evaluation. [Subjects and Methods] Chest-wall configuration and motion in the supine, right lateral, and sitting positions were measured using optoelectronic plethysmography in 15 healthy adult men. [Results] The anteroposterior diameters of the chest wall were significantly lower in the supine position for the pulmonary and abdominal rib cages, whereas the mediolateral diameters in the lateral position were lowest for the abdominal rib cage. Regarding chest-wall motion, both craniocaudal and anteroposterior motions of the anterior surface of the pulmonary and abdominal rib cages were significantly greater in the sitting position. Regarding motion of the left lateral abdominal rib cage, lateral motion was greatest in the lateral position. [Conclusion] Chest-wall configuration and motion changed according to posture in healthy men, particularly in the pulmonary and abdominal rib cages.

[Purpose] This study was to compare the shoulder and trunk muscle activity according to the various resistance condition during knee push-up-plus. [Subjects and Methods] Twenty healthy adults participated in this study (9 males and 11 females). The subjects performed dominant-leg-extended knee push-up-plus apply to resistance in the direction of abduction, adduction, extension and the flexion. The surface Electromyography activities of the upper trapezius, serratus anterior, homolateral external oblique and the heterolateral internal oblique were measured. The Electromyography activities of each muscle were compared using a one-way repeated analysis of variance. [Results] The Electromyography activities of serratus anterior and external oblique muscles between the resistance directions were significantly increased extension. The Electromyography activities of heterolateral internal oblique muscle between the resistance directions were significantly increased adduction. [Conclusion] To suggest use of the decision exercise tolerance orientation when muscle strengthening exercises for shoulder and trunk according to variation resistance in lower extremity during Push-up-plus.

[Purpose] The purpose of this study was to examine what changes occur in brain waves when patients with stroke receive mirror therapy intervention. [Subjects and Methods] The subjects of this study were 14 patients with stroke (6 females and 8 males). The subjects were assessed by measuring the alpha and beta waves of the EEG (QEEG-32 system CANS 3000). The mirror therapy intervention was delivered over the course of four weeks (a total of 20 sessions). [Results] Relative alpha power showed statistically significant differences in the F3, F4, O1, and O2 channels in the situation comparison and higher for hand observation than for mirror observation. Relative beta power showed statistically significant differences in the F3, F4, C3, and C4 channels. [Conclusion] This study analyzed activity of the brain in each area when patients with stroke observed movements reflected in a mirror, and future research on diverse tasks and stimuli to heighten activity of the brain should be carried out.

[Purpose] For preventing the patellofemoral pain syndrome, this study aims to suggest a proper squat method, which presents selective muscle activity of Vastus Medialis Oblique and muscle activity ratios of Vastus Medialis Oblique/Vastus Lateralis by applying squat that is a representative weight bearing exercise method in various ways depending on the surface conditions and knee bending angles. [Subjects and Methods] An isometric squat that was accompanied by hip adduction, depending on the surface condition and the knee joint flexion angle, was performed by 24 healthy students. The muscle activity and the ratio of muscle activity were measured. [Results] In a comparison of muscle activity depending on the knee joint flexion angle on a weight-bearing surface, the vastus medialis oblique showed a significant difference at 15° and 60°. Meanwhile, in a comparison of the muscle activity ratio between the vastus medialis oblique and the vastus lateralis depending on the knee joint flexion angle on a weight-bearing surface, significant differences were observed at 15° and 60°. [Conclusion] An efficient squat exercise posture for preventing the patellofemoral pain syndrome is to increase the knee joint bending angle on a stable surface. But it would be efficient for patients with difficulties in bending the knee joint to keep a knee joint bending angle of 15 degrees or less on an unstable surface. It is considered that in future, diverse studies on selective Vastus Medialis Oblique strengthening exercise methods would be needed after applying them to patients with the patellofemoral pain syndrome.

[Purpose] The purpose of this study was to research asymmetry in infants with congenital muscular torticollis (CMT) according to head rotation. [Subjects and Methods] 70 infants with CMT were divided into grade I, grade II, and grade III according to the asymmetry of cervical rotation. Patients received ultrasound and massage therapy for 30 minutes, in conjunction with passive stretching exercises, 3 times a week. Repeated measurement results from interventions were presented from baseline, 3 months, and 6 months. Asymmetry was evaluated by head tilt (HT) and the torticollis overall assessment (TOA). [Results] The TOA measured at 3 months and 6 months showed a significant difference in inter group scores and an intra group interaction with grade and rating scale was observed. In contrast, HT was significantly different in intra group comparison, but no significant difference in inter and intra group interaction was observed in the angle and grade. [Conclusion] Conservative physical therapy showed lasting effects according to the intervention period over 3 months and 6 months of repeated measurements over time in TOA and HT. Especially, TOA showed significant differences in asymmetric changes according to the cervical rotation.

[Purpose] The purpose of this study was to establish the reliability and validity of the Foot Function Index translated into Korean for use in patients with plantar fasciitis and foot/ankle fracture. [Subjects and Methods] Thirty-six subjects with foot complaints, 14 males and 22 females, participated in the study. Reliability was determined by using the intra-class correlation coefficient and Cronbach’s alpha for internal consistency. Validity was examined by correlating Foot Function Index scores with the Short Form-36 and the Visual Analog Scale scores. [Results] Test-retest reliability was 0.90 for the pain subscale, and 0.94 and 0.91 for the disability and activity limitation subscales, respectively. The criterion-related validity was established by comparison with the Korean version of the Short Form-36 and Visual Analog Scale. [Conclusion] The Korean version of the Foot Function Index was shown to be a reliable and valid instrument for assessing foot complaints.

[Purpose] The purpose of this study was to analyze the change in interface pressure redistribution of three different types of cushions sat on by individuals in their 20s and older than 60 years old. [Subjects and Methods] One hundred and eleven college students and 100 persons than 60 years old were recruited. Sitting pressure redistribution was measured while subjects sat without cushions or on honeycomb, air, and memory foam cushions in that order. Subsequently, the cushion preference was measured. After obtaining all measurements, the mean total pressure and each quadrant’s mean and peak pressure were analyzed. [Results] The mean hip and the peak pressures were low in the group of females aged 60 years or older, and the highest in the group of males in their 20s. The hip pressure ratio was low in the groups of females in their 20s and 60 years or older, whereas the thigh pressure ratio was high in the same groups. The analysis of cushion preference showed that the groups of males (42.0%) and females (40.0%) in their 20s mostly preferred air cushion. The men (55.1%) and women (50.0%) aged 20 years or older selected honeycomb and air cushions as the first and third preferred cushions with a high response rate. [Conclusion] Our results indicate that gender and age should be considered when recommending appropriate pressure redistribution cushions.

[Purpose] Grip strength is used as an indicator of overall body muscular strength. However, most studies on grip strength have been performed in healthy people, and no study has evaluated it in the unaffected side of patients with hemiparetic stroke. The purpose of this study was to determine if grip strength on the unaffected side of patients with hemiparetic stroke correlates with the strength of other ipsilateral musculature. [Subjects and Methods] The maximal strengths of the muscles on the unaffected side of 31 patients with hemiparetic stroke were measured, and correlation coefficients were calculated. [Results] The results revealed significant positive correlations between grip strength on the unaffected side and the strength of the other ipsilateral muscle groups, with relatively high correlations being observed for the upper extremity muscle groups. [Conclusion] This suggests that grip strength on the unaffected side of patients with hemiparetic stroke can be used as a simple way to estimate overall strength on that side.

[Purpose] Our working hypothesis is that underwater treadmill training improves normal people’s gait ability. [Subjects and Methods] Twenty-five healthy subjects with no orthopedic history of lower extremity were recruited. Gait training is performed using an underwater treadmill (HydroTrack^® Underwater Treadmill System, Conray, Inc., Phoenix, AZ, USA), for twenty minutes per session, five sessions a week for four weeks. The water temperature was set at about 33 °C and the depth was fixed to reach between the subjects’ xiphoid process and the navel. [Results] After the intervention, step length, velocity, and cadence increased significantly. [Conclusion] This study conducted underwater treadmill training with normal people, with positive effects on gait ability.

[Purpose] Although there are several studies on the use of elastic tape to influence muscle strength, results are contradictory and controversial. Our previous studies based on the sliding mechanism between superficial fascia and subcutaneous tissue may help the muscle strength. The purpose of this study was to confirm the effects of new taping methods on muscle strength. [Subjects and Methods] Sixteen healthy male participants took part in this study. Tape was applied on the right gluteus maximus and hip extension strength was determined by an isokinetic evaluation (30°/sec, concentric mode, four conditions). Condition 1: Tape was applied from the muscle insertion to origin; Condition 2: Tape was applied from the origin to insertion; Condition 3: Dummy tape with no direction; Condition 4: No tape was applied. [Results] The mean value of conditions 1–4 were 398.2 ± 24.3 Newton (N), 343.7 ± 25.9 N, 363.7 ± 26.4 N, and 371.3 ± 26.3 N, respectively (mean ± SE). The result of condition 1 was significantly greater compared with the other conditions. [Conclusion] This new method corresponded to a tape direction of insertion-rigin may help to increase the muscle strength.

[Purpose] The purpose of this study was to examine the hypoglycemic effect of a postprandial exercise program using brief stair climbing-descending exercise in people with type 2 diabetes. [Subjects and Methods] Seven males with uncomplicated type 2 diabetes (age 68.0 ± 3.7 years) performed two sets of stair climbing-descending exercise 60 and 120 min after each meal for the first 2 weeks but not for the following 2 weeks. Each set of exercise comprised 3-min of continuous repetition of climbing briskly to the second floor followed by slow waking down to the first floor in their home. A rest period of 1–2 min was allowed between each set. [Results] Serum 1,5-anhydroglucitol level was significantly higher by 11.5% at the end of the 2-week exercise period than at the baseline. By contrast, the 1,5-anhydroglucitol level at the end of the following 2-week period did not differ from the baseline value. Fasting blood glucose level and insulin resistance index at the end of the exercise period did not differ from the baseline value. [Conclusion] Repeated 3-min bouts of stair climbing-descending exercise after a meal may be a promising method for improving postprandial glycemic control in people with type 2 diabetes.

[Purpose] This study used an alternative approach compared with previous studies by investigating the effect of minimizing arm swing while walking on the trunk and gluteal muscles. [Subjects and Methods] The subjects of this study included 13 adult males. [Results] The latissimus dorsi muscle activities during walking with a minimized arm swing were significantly decreased compared with those during walking with a full arm swing. The gluteus medius muscle activities during walking with a minimized arm swing were significantly increased compared with those during walking with a full arm swing. [Conclusion] Therefore, walking with minimized arm swing would be an effective exercise for selective strengthening of the gluteus medius muscle.

[Purpose] The purpose of this study was to investigate the effect of restricted spinal motion on kinematic changes in the lower extremities using a rigid thoracolumbosacral orthosis. [Subjects and Methods] Forty healthy males in their 20s were selected as the sample, which was randomly and evenly divided into two groups: (1) the WT group (with a thoracolumbosacral orthosis) and (2) the WOT group (without a thoracolumbosacral orthosis). The spinal orthosis used in this study was a thoracolumbosacral orthosis called a plastic body jacket. [Results] The sagittal plane; in the level ground walking measurements, significance differences were found at the H2 (Hip maximum flexion/extension in midstance phase) and K2 (Knee maximum flexion/extension in midstance phase) between the WT group and the WOT group. [Conclusion] It can be concluded that a spinal orthosis is useful in stabilizing the lower extremities during stair gaiting, and that appropriate application of the orthosis plays a supporting role in the activities of daily life and therapeutic intervention.

[Purpose] The present study investigated effects of diaphragm breathing exercise and feedback breathing exercise on respiratory function. [Subjects and Methods] Thirty-one subjects were randomly assigned to two groups; the feedback breathing exercise group and the maneuver-diaphragm exercise group. The feedback breathing exercise group was asked to breathe with feedback breathing device, and the maneuver-diaphragm exercise group was asked to perform diaphragm respiration. Respiratory function was evaluated when a subject sat on a chair comfortably. [Results] There was a significant difference in the functional vital capacity and slow vital capacity before and after all breathing exercises. There was a significant between-group difference in functional vital capacity. However, no between-group difference was found in slow vital capacity. [Conclusion] Diaphragm breathing exercise and feedback breathing exercise can affect respiratory function.

[Purpose] The aims of this study was to investigate mean velocity and angle of shoulder joint, activation of tibialis anterior and gastrocnemius according to both eyes, dominant eye and non-dominant eye condition during reaching task in normal adults. [Subjects and Methods] Our research recruited 24 participants (male 11, female 13) in Silla University. Participants were performed reaching out movement by conditions of both eye, dominants eye, non-dominants eye. The target was placed at 45 degree diagonal direction and distance far away 130% of their arm length. Kinetic analysis of the upper extremities was investigated by QUALISYS 3-dimensional motion analysis system. Muscle activation were measured by EMG during reaching tasks. The collected data were statistically processed using the SPSS for win version 20.0. [Results] There was a significant difference of shoulder joint velocity of flexion, abduction and internal rotation according to visual field condition during reaching tasks. There was no significant difference of shoulder joint angle and muscle activation according to visual field conditions during reaching tasks. [Conclusion] In conclusion, visual field has an influence on shoulder joint velocity. Therefore, the visual field may be to play an important role in reach performance.

[Purpose] This study developed a pelvic wedge and belt and investigated their effects on the selective activation of medial and lateral hamstring muscles during knee flexion. [Subjects and Methods] Nine adults were enrolled. The participants performed exercises without and with the pelvic wedge and belt, and the electromyographic activities of the medial and lateral hamstring muscles were recorded. [Results] The activity of the medial hamstring was increased significantly when using the pelvic wedge and belt, while the activity of the lateral hamstring did not differ significantly. [Conclusion] The pelvic wedge and belt provide a self-locked position during knee flexion in the prone position. Prone knee flexion in this position is an effective self-exercise for balanced strengthening of the medial hamstring.

[Purpose] The aim of this study was to investigate the change in tibial rotation during walking among young adults after neuromuscular joint facilitation therapy. [Subjects and Methods] The subjects were twelve healthy young people (6 males, 6 females). A neuromuscular joint facilitation intervention and nonintervention were performed. The interventions were performed one after the other, separated by a 1-week interval. The order of the interventions was completely randomized. The rotation of the tibia during walking was evaluated before and after treatment. [Results] The neuromuscular joint facilitation group demonstrated increased lateral rotation of the tibia in the overall gait cycle and stance phase, and decreased medial rotation of the tibia in the overall gait cycle, stance phase, and swing phase after the neuromuscular joint facilitation intervention. In the control group, there were no significant differences. [Conclusion] These results suggest neuromuscular joint facilitation intervention has an immediate effect on the rotational function of the knee.

[Purpose] The purpose of this study was to determine the relationships of changes in pain and gait after ischemia reperfusion was induced by tourniquet in rats. [Subjects and Methods] The subjects were six ten-week-old male Wistar rats. Ischemia was induced in the left lower limbs of the experimental rats at a pressure of 300 mmHg for 90 minutes. Pain behavior evaluations were measured using the von Frey test in all the rats’ hind limbs. A consistently increasing plantar stimulus was applied until the rats exhibited an escape behavior. For the evaluation of gait, a two-dimensional motion analysis system was used to measure the distance from the calcaneus to the floor (DCF) and toe extension angle (TEA) during gait. The evaluations were performed in the normal state, 3 hours after ischemia-reperfusion, and daily until 7 days after ischemia-reperfusion. [Results] Compared with the normal state, the means of the pain threshold showed a significant decrease until 4 days after ischemia. In addition, both TEA and DCF continued to show a significant decrease at 7 days after ischemia as compared with the normal state. [Conclusion] This study revealed that hyperalgesia occurs after ischemia-reperfusion, and recovery of hyperalgesia occurred earlier than gait dysfunction recovery.

[Purpose] The purpose of this study was to determine whether two-handed task training is effective on motor learning of injured cerebral cortex activation and upper extremity function recovery after stroke. [Subjects and Methods] Two hemiplegic subjects participated in this study: one patient was affected on the dominant side of the body and the other was affected on the non-dominant side of the body, and both scored in the range of 58–66 in the Fugl-Meyer assessment. The excitability of the corticospinal tract and Manual Function Test were examined. [Results] The excitability of the corticospinal tract and the Manual Function Test showed significant differences in the activation of both sides of the cerebral cortex and in the variation in learning effect of upper extremity motor function recovery in patients with hemiplegic non-dominant hand (left). [Conclusion] The results suggested that two-handed task training had a different influence on dominant hand (right) and non-dominant hand (left) motor recovery.

[Purpose] The Purpose of this study was to investigate the effects of spiral taping on proprioception in functional ankle instability. [Subjects and Methods] Thirty-five participants in this study had discomfort in only one ankle and Cumberland ankle instability score of ≤23. ST was applied to the unstable ankle, and proprioception was measured baseline and 30 min later. Proprioception was measured using the active joint angle reproduction test. [Results] Plantar flexions of 10° (ES, 0.303) and 20° (ES, 1.369) and inversion 20° (ES, 0.998) showed a significant improvement. [Conclusion] Spiral taping improved on proprioception. Therefore, spiral taping may be an effective method for functional ankle instability.

[Purpose] The purpose of this study was to compare kinematic data regarding the head, trunk, and pelvis strategies used by individuals with hemiplegia when crossing over obstacles of different heights. [Subjects and Methods] Nine adults with hemiplegia from stroke (7 males and 2 females) participated in this study. A motion analysis system with six infrared cameras was used to measure the kinematic data of the head, trunk, and pelvis while the subjects crossed over obstacles of different heights. Repeated measures ANOVA analysis was performed to compare the resulting kinematic data. [Results] An increase in the magnitude of the kinematic data of the head, trunk, and pelvis of the hemiparetic stroke patients was observed when the height of the obstacles, which they crossed over, increased. [Conclusion] This study described the kinematic strategies, with regard to the head, trunk, and pelvis, used by hemiplegic patients crossing over obstacles of different heights. The results indicate that these kinematic strategies primarily change when the obstacle height was 20% of the height of the subjects.

[Purpose] The purpose of this study was to clarify the correlation between the range of spinal mobility on the sagittal plane and the dynamic balance ability of elderly people living in communities. [Subjects and Methods] The persons studied were 31 healthy elderly people living in the community (16 females and 15 males). The range of mobility of the participants’ spines in the sagittal plane was measured by using a spinal mouse^®. Balance ability was evaluated by using Functional reach (FR), Timed up and go (TUG), and Maximum walking speed (MWS). [Results] A significant positive correlation between the flexion range of the lumbar vertebrae and the FR distance was identified, and a significant negative correlation between the extension range of the thoracic vertebrae and the time required for TUG was also identified. In addition, a significant positive correlation between the extension range of the entire spine and MWS, was identified. [Conclusion] The result of this study have clarified that mobility of the spine in the sagittal plane is associated with dynamic balance ability, which is related to falling.

[Purpose] Hormone replacement therapy has been reported to be effective for alleviating menopausal symptoms, its side effects have been a concern. Therefore, it is necessary to investigate methods that could alleviate menopausal symptoms but with fewer side effects. Few previous reports have investigated the effects of simplified, viable manual lymph drainage, particularly the effects of one-time therapy on physiologically active substances and other variables. Effects of one-time simplified lymph drainage performed at salon A were investigated in females with any type of menopausal symptoms, such as edema or a sense of fatigue. [Subjects and Methods] Before and after lymph drainage, saliva was collected to detect substances that would reveal immune function. Questionnaire surveys were also conducted before and after therapy. [Results] Cortisol and dehydroepiandrosterone levels were significantly reduced after therapy compared with those before therapy. The questionnaire survey showed a significant decrease in the visual analog scale. Also apparent were positive opinions, such as “I feel better” and “My legs feel lighter.” [Conclusion] These results demonstrated the stress reduction effect of one-time simplified lymph drainage, which decreased cortisol and dehydroepiandrosterone levels. This therapy was also shown to produce positive mental and physical effects.

[Purpose] To investigate the effects of pre-induced muscle damage vibration stimulation on the pressure-pain threshold and muscle-fatigue-related metabolites of exercise-induced muscle damage. [Subjects and Methods] Thirty healthy, adult male subjects were randomly assigned to the pre-induced muscle damage vibration stimulation group, post-induced muscle damage vibration stimulation group, or control group (n=10 per group). To investigate the effects of pre-induced muscle damage vibration stimulation, changes in the pressure-pain threshold (lb), creatine kinase level (U/L), and lactate dehydrogenase level (U/L) were measured and analyzed at baseline and at 24 hours, 48 hours, and 72 hours after exercise. [Results] The pressure-pain thresholds and concentrations of creatine kinase and lactate dehydrogenase varied significantly in each group and during each measurement period. There were interactions between the measurement periods and groups, and results of the post-hoc test showed that the pre-induced muscle damage vibration stimulation group had the highest efficacy among the groups. [Conclusion] Pre-induced muscle damage vibration stimulation is more effective than post-induced muscle damage vibration stimulation for preventing muscle damage.

[Purpose] The purpose of this study was to compare the balance and gait functions of children with Down syndrome and typically developing children according to age. [Subjects and Methods] The subjects were 16 children with Down syndrome and 20 children with typical development. The one leg standing test, Romberg’s test (open eyes/closed eyes), sharpened Romberg’s (open eyes/closed eyes), functional reaching test and GAITRite were used for this study in order to measure the children’s balance and gait function. [Results] The results of this study showed that static-dynamic balance ability, spatio-temporal gait parameters and quality of life were statistically and significantly different in Down syndrome children compared to typically developing children. [Conclusion] These results suggest that the balance and gait ability of typically developing children improves during growth, whereas those of children with Down syndrome remain low despite independent gait. Therefore, constant therapeutic intervention for balance and gait function is necessary after independent gait development in Down syndrome children.

[Purpose] The purpose of this study was to compare the interface pressure redistribution when sitting after applying three different types of cushions and on a firm surface in individuals in their 20s and those older than 60 years old. [Subjects and Methods] Healthy 100 elderly (60 years and older) subjects and 111 college students participated in this study. Interface pressure redistribution while sitting on a firm surface or honeycomb, air, and memory foam cushions, examined in that order. [Results] For all groups, significant differences were found in the total pressure mean among sitting states. When the hip and thigh interface pressure among sitting states were compared within each group, significant differences were found in the mean right hip pressure, mean left hip pressure, peak right hip pressure, peak left hip pressure, right hip pressure ratio, and left hip pressure ratio. [Conclusion] Our data indicated that the type of cushion should be considered and fit for individuals when recommending appropriate interface pressure redistribution cushions.

[Purpose] Fluidity in the sit-to-walk task has been quantitatively measured with three-dimensional motion analysis system. The purpose of this study was to determine the validity of an accelerometer-based method for estimating fluidity in community-dwelling elderly individuals. [Subjects and Methods] Seventeen community-dwelling elderly females performed a sit-to-walk task. The motion was recorded by an accelerometer, a three-dimensional motion analysis system and a foot pressure sensor simultaneously. The timings of events determined from the acceleration waveform were compared to the timings determined from the three-dimensional motion analysis data (task onset, maximum trunk inclination) or foot pressure sensor data (first heel strike). Regression analysis was used to estimate the fluidity index from the duration between events. [Results] The characteristics of the acceleration waveform were similar to those previously reported in younger adults. Comparisons of event timings from accelerometer and motion analysis system data indicated no systematic bias. Regression analysis showed that the duration from maximum trunk inclination to the first heel strike was the best predictor of fluidity index. [Conclusion] An accelerometer-based method using the duration between characteristic events may be used to precisely and conveniently assess fluidity in a sit-to-walk task in a community setting.

[Purpose] The purpose of this study was to investigate the effects of new sedation management methods and cooperation between nurses and physical therapists on the duration of mechanical ventilation and hospitalization. [Subjects and Methods] Patients who had been treated at the study hospital 2 years before and after the implementation of the new methods were analyzed retrospectively and classified into a “control group” and an “intervention group”, respectively. Both groups were analyzed and subsequently compared regarding the effects of the new sedation and cooperative rehabilitation. [Results] A total of 70 patients met the inclusion criteria and were divided evenly into the two groups. No significant differences were found between the groups in age, APACHE II score, or duration of stay in hospital. On the other hand, significant decreases were seen in the duration of sedation and intubation, mechanical ventilation, and stay in the emergency ward, as well as time until standing. In addition, after intervention, three patients undergoing ventilator treatment were able to be ambulated. [Conclusion] These results suggest that the new sedation and cooperative rehabilitation methods for critically ill patients were effective in the early stage of treatment and shortened the duration of stay in the ward.

[Purpose] This study aimed to examine the effects of a combined intervention consisting of massage therapy and transcutaneous electrical nerve stimulation on gastrocnemius muscle fatigue, assessing whether the intervention improved muscle tone, stiffness, and muscle contraction. [Subjects and Methods] The subjects were 20 healthy males in their 20s who were equally divided into a transcutaneous electrical nerve stimulation group and a combined therapy group that received a combination of massage therapy and transcutaneous electrical nerve stimulation. Muscle fatigue was triggered on the gastrocnemius muscle, and the effects of intervention method on muscle tone, stiffness, and muscle contraction were examined over time. [Results] Lateral and medial gastrocnemius muscle tone and stiffness significantly increased and gastrocnemius muscle contraction significantly decreased in each group immediately after fatigue was triggered on the gastrocnemius muscle. There was no difference in the effects of the two intervention methods over time. [Conclusion] This study verified that a combined therapy of massage therapy and transcutaneous electrical nerve stimulation was able to be used effectively in improving muscle tone, stiffness, muscle contraction, thereby reducing gastrocnemius muscle fatigue.

[Purpose] The purpose of the present study was to examine cognitive function in middle-aged and older adults regularly engaging in synchronized swimming-exercise. [Subjects and Methods] Twenty-three female synchronized swimmers ranging in age from 49 to 85 years were recruited for the present study. The duration of synchronized swimming experience ranged from 1 to 39 years. The control group consisted of 36 age- and gender-matched community-dwelling middle-aged and older adults (age range: 49 to 77 years). Cognitive function was evaluated using the Japanese version of the Montreal Cognitive Assessment (MoCA-J) and compared between the synchronized swimmers and control participants. [Results] No significant differences in mean total MoCA-J scores were observed between the synchronized swimmers and control participants (23.2 ± 3.1 and 22.2 ± 3.6, respectively). Twenty-nine subjects in the control group and 17 in the synchronized swimming group scored below 26 on the MoCA-J, indicative of mild cognitive impairment. Significant differences in delayed recall—but not in visuospatial/executive function, naming, attention, language, abstraction, or orientation—were also observed between the two groups. [Conclusion] The results of the present study suggest that synchronized swimming has beneficial effects on cognitive function, particularly with regard to recent memory.

[Purpose] The objective of this study was to clarify the effects of increased number of steps on body composition, physical functions, vascular functions, health-related quality of life (HR-QOL) and self-efficacy in elderly people. [Subjects and Methods] The subjects were 47 elderly persons who resided in Port Island in the Chuo Ward of Kobe City in Hyogo Prefecture, Japan. After the calculation of the mean preintervention physical activity (PA), the subjects were instructed to increase their PA to a target baseline + 1,300 steps/day. Body composition, physical functions, vascular functions, HR-QOL, and self-efficacy were measured at baseline, after 3 and 6 months. These items were compared between a group that increased their PA and a group that did not. [Results] After 6 months, 26.1% of the subjects achieved the PA target. No significant improvements were observed in body composition, physical functions, vascular functions, or self-efficacy for either group after 3 and 6 months. However, the HR-QOL improved significantly after 6 months in the achievement group. [Conclusion] Although the intervention to increase PA did not produce significant improvements after 6 months in body composition, physical functions, vascular functions, or self-efficacy, the HR-QOL improved significantly during this relatively short period.

[Purpose] The purpose of this study was to examine the toe function of elderly people and the association with the dynamic balance ability for the developing effective fall-prevention measures. [Subjects and Methods] Seventy-eight participants in a community health service were included in this cross-sectional study. The Timed Up and Go Test and Four Square Step Test were used to test dynamic balance ability. The toe functions related to dynamic balance ability were toe flexion strength, presence or absence of restricted range of motion of the hallux, presence or absence of hallux pain, and hallux valgus angle. [Results] Factors related to the Timed Up and Go Test results were toe flexion strength, age, and presence or absence of hallux pain. Their standard partial regression coefficients were −0.400, 0.277, and −0.218, respectively. Factors related to the Four Square Step Test results were toe flexion strength and age. Their standard partial regression coefficients were −0.334 and 0.277, respectively. [Conclusion] Toe functions appear to have little impact on dynamic balance ability in elderly people who have mild toe dysfunction. Approaches that address not only the toes, but trunk functions, and other leg joints should be investigated for improving the dynamic balance ability.

[Purpose] The purpose of this case study was to identify the effects of independent and intensive therapeutic exercise using Proprioceptive neuromuscular facilitation on the size of calcium deposits, pain self-awareness, and shoulder joint function in a patient with calcific tendonitis. [Subject and Methods] The subject was a 42-year-old female patient with calcific tendonitis and acute pain who had difficulty with active movement and problems with general function. The independent and intensive Proprioceptive neuromuscular facilitation exercise was applied for 40 min twice a day five times a week for two weeks for a total of 20 times. An X-ray, the visual analog scale, a simple shoulder test, the Constant-Murley Scale, and passive range of motion was used to evaluate the patient’s change. [Results] The size of the calcium deposit, the visual analog scale score, and the simple shoulder test score decreased. The Constant-Murley Scale score and the passive range of motion were increased. [Conclusion] The results of this study suggested that intensive and independent therapeutic short-term exercise without any other exercise reduced pain and produced positive effects in shoulder function in a patient with the calcific tendonitis, which could confirm the importance of therapeutic exercise in the treatment of calcific tendonitis.

[Purpose] The purpose of this study was to examine the effects of interactive metronome training on the postural stability and upper extremity function of an individual with Parkinson’s disease. [Subject and Methods] The participant of this case study was a 75-year-old female with Parkinson’s disease diagnosed 7 years prior. This study was a single-subject research with an A-B-A design. She received IM training during the treatment phase (B phase) for 40 minutes per session. She was assessed pretest and posttest using the Berg balance scale and Wolf motor function test, and at baseline and the treatment phase using the measured box-and-block test and a Tetrax system. [Results] After training, the patient’s static and dynamic balance, functional activity, and performance time of the upper extremity improved. Interactive metronome therapy improved the manual dexterity of both hands. Interactive metronome therapy also improved the limit of stability of the Parkinson’s disease. [Conclusion] Though a case study, the results of this study suggest that IM therapy is effective at restoring the postural stability and upper extremity function of patients with Parkinson’s disease.

[Purpose] The purpose of this study was to investigate the effects of Tai Chi on waist circumference and blood pressure in the elderly. The present study used a nonequivalent control group pretest-posttest design. [Subjects and Methods] Sixty-eight elderly individuals residing in J city were divided into 2 groups: 34 in the experimental group, who received Tai Chi training for 6 weeks, and 34 in the control group, who did not receive Tai Chi training. Simplified Yang style 24-form Tai Chi was used as the intervention, which was conducted for 60 minutes per session, 5 sessions per week, for a total of 6 weeks. In each session, subjects in the experimental group conducted 10 minutes of warm-up exercises, 45 minutes of Tai Chi, and 5 minutes of cool-down exercises. Waist circumference and blood pressure were measured before and after the 6-week intervention. [Results] Waist circumference and blood pressure decreased significantly after the 6-week intervention in the experimental group compared with the control group. [Conclusion] Tai Chi can be used as an effective intervention to improve waist circumference and blood pressure in the elderly.

[Purpose] Training using an arm weight-bearing device combined with upper-limb reaching apparatus to facilitate motor paralysis recovery, named the “Reaching Robot”, as well as Repetitive Facilitation Exercise were applied to a patient with severe impairment of the shoulder and elbow due to incomplete spinal cord injury and the effects were examined. [Subjects and Methods] A 66-year-old man with incomplete spinal cord injury participated in an upper extremity rehabilitation program involving a Reaching Robot. The program was comprised of active motor suspension, continuous low amplitude neuromuscular electrical stimulation and functional vibratory stimulation, as well as Repetitive Facilitation Exercise combined with continuous low amplitude neuromuscular electrical stimulation. This protocol used a crossover design following an A₁-B₁-A₂-B₂. “A” consisted of 2 weeks of Repetitive Facilitation Exercise, and “B” consisted of 2 weeks of Reaching Robot training. [Results] Improvements were observed after all sessions. Active range of motion for shoulder flexion improved after 2 weeks of Reaching Robot sessions only. There were no adverse events. [Conclusion] Reaching Robot training for severe paretic upper-extremity after incomplete spinal cord injury was a safe and effective treatment. Reaching Robot training may be useful for rehabilitation of paretic upper-extremity after incomplete spinal cord injury.