[Purpose] The purpose is to analyze the effects of Constraint-induced Movement Therapy in post stroke patients in chronic course. [Subjects and Methods] This is a Quasi-experiment study and the adopted protocol consisted of a three-hour therapy for ten consecutive working days applied to a constraint intact upper limb. Surface Electromyography, Motor Activity Log, Wolf Motor Function Test and Functional Independence Measure were used for evaluating the experiment. [Results] The individuals showed reduction in the degree of spasticity, confirmed by Surface Electromyography. In relation to Motor Activity Log this study showed an increase in amount and in quality of the paretic upper limb movement. The Wolf Motor Function Test showed reduction in the average time to perform the tasks and a functional improvement was identified through the Functional Independence Measure. [Conclusion] Constraint Induced Movement Therapy proved to be a relevant method to improve motor function in chronic hemiparesis post stroke reducing the spasticity, maximizing and improving the use of committed upper limb.

[Purpose] Present study aimed to evaluate the relationship between sleep bruxism and headache in school children. [Subjects and Methods] This study was conducted with 103 children aged 3–6 years. The exclusion criteria were early tooth loss, dental appliance was used, physical or psychological limitations, chronic disease and continuous medication. Sleep bruxism was diagnosed based on an indication by parents of the occurrence of teeth clenching/grinding and incisor/occlusal tooth wear, following the criteria of the American Academy of Sleep Medicine. Sleep quality was evaluated by a questionnarie, detailing the child’s sleep characteristics. [Results] Forty-nine children (47.6%) were diagnosed with sleep bruxism. Those with sleep bruxism were 3.25-fold more likely to present headache. Children whose parents were separated had a significantly greater frequency of sleep bruxism and primary headache. The relative risk of exhibiting primary headache was 13.1 among children with sleep bruxism whose parents were separated. [Conclusion] Children with SB demonstrated a greater risk of having primary headache and those whose parents were separated had a greater chance of having headache. Only sleep bruxism was associated with headache, clenching the teeth during waking hours was not correlated with primary headache.

[Purpose] To verify the effects of individual and group exercise programs on pain, balance, mobility and perceived benefits of rheumatoid arthritis patients (RA) with pain and foot deformities. [Subjects and Methods] Thirty patients with RA pain and foot deformity were allocated into two groups: G1: individual exercise program and G2: group exercise program. The variables analyzed were Numerical Rating Scale (NRS) for pain, Berg Balance Scale (BBS) for balance, Timed Up & Go Test (TUG) and Functional Reach (FR) for mobility, and Foot Health Status Questionnaire (FHSQ-Br) for perceived benefits. Both exercise programs consisted of functional rehabilitation exercises and self-care guidance aimed at reducing pain and improving balance and mobility. Intragroup comparisons of variables between A1 (pre-intervention) and A2 (post-intervention) were performed. [Results] Patients in both groups were similar in A1 (pre-intervention) in all the variables analyzed. Comparison between A1 and A2 for each variable showed improvement for G1 in the NRS, BBS, FR, TUG and in four out of ten domains of FHSQ-Br. G2 showed improvement in the NRS, BBS and eight out of ten domains of FHSQ-Br. [Conclusion] Both individual and group programs revealed benefits for patients with RA, however, group exercise programs showed better perception of benefits.

[Purpose] The purpose of this study is to investigate the effect of the newly designed multi joint ankle-foot orthosis on the gait and dynamic balance of stroke patients having foot drop. [Subjects and Methods] This study was conducted with 15 subjects who were diagnosed with stroke. 10-meter walk test, functional reaching test and timed up and go test were measured after each subjects wore a plastic ankle-foot orthosis and a multi joint ankle-foot orthosis that consists of orthosis joints (having free joint, anterior-stop joint, poster-stop joint, and Klenzak joint functions). In the case of the newly developed multi joint ankle-foot orthosis, the experiments were performed using posterior-stop joint and Klenzak joint. [Results] 10-meter walk test, functional reaching test and timed up and go test showed significant differences in the orthosis using posterior joint-stop function and Klenzak joint function. [Conclusion] The appropriate use of the four functions of the newly designed multi joint ankle-foot orthosis is expected to have a positive effect on improving the gait and balancing ability of stroke patients having foot drop.

[Purpose] The purpose of this study was to analyze the effects of open and closed chain exercise on the muscle strength and muscle activity of the ankle joint. [Subjects and Methods] Twenty women in their 20s were randomly assigned to two groups: the open kinetic-chain group and the closed kinetic-chain group. Each group performed 5 sets 3 times per week for 4 weeks. Exercise intensity was increased once after two weeks. The muscle activity of the tibialis anterior, gastrocnemius, tibialis posterior, and peroneus longus muscles were measured. The collected data were analyzed with two-way repeated measures ANOVA. [Results] In the results for muscle strength, both groups showed significant differences in dorsiflexion and plantar flexion between the pre-test and post-test. In the results for muscle activity, no significant differences were noted for either group. [Conclusion] Open and closed kinetic-chain exercises can help to improve muscle strength.

[Purpose] This study examined the effects of extracorporeal shock wave therapy on pain and range of motion in patients with adhesive capsulitis. [Subjects and Methods] Thirty patients with adhesive capsulitis were divided into an experimental group (n=15) that would be treated with extracorporeal shock wave therapy and a control group (n=15) that would be treated only with conservative physical therapy. Both groups were treated three times a week over a four-week period. [Results] An intra-group comparison before and after the treatment showed that both groups experienced a decline in pain and an increase in their range of motion that were statistically significant. An inter-group comparison after the treatment showed that the experimental group had a lower level of pain and a higher range of motion than the control group that were statistically significant. [Conclusion] Extracorporeal shock wave therapy may be an effective intervention for reducing pain and improving the range of motion in patients with adhesive capsulitis.

[Purpose] This study aimed to understand the nutritional status of patients hospitalized for long periods and the risk of physical therapy (PT) for such patients. [Subjects and Methods] Participants were selected from patients who were hospitalized at a designated medical long-term care sanatorium. The participants were divided into 5 groups (A–E) depending on their mode of energy intake and ambulatory ability during PT. The serum albumin level, energy intake, total daily energy expenditure, and total daily energy expenditure per session of PT (EEPT) were evaluated for each group. [Results] Protein-energy malnutrition was observed in 69.6% of the participants. No significant association was identified between the serum albumin level and body mass index. Energy intake was significantly higher in Groups D and E, whose energy intake was via ingestion, than in Groups A and B, whose intake was via tube feeding. EEPT was highest in patients of Group E who had gait independence different from the ability of those in groups A–D. [Conclusion] The actual energy intake is lower with tube feeding than with ingestion. Risk management and energy intake should be revisited in elderly patients who have been hospitalized for long periods and subsequently obtain gait independence.

[Purpose] The fingernails allow for increased sensory perception at the finger pulp, and contribute to the accurate picking up of small objects. The purpose of the present study was to clarify the effect of fingernail length on hand dexterity using subjects’ own fingernails. [Subjects and Methods] The hand sizes and fingernail configurations of 38 young healthy volunteers (eighteen males and twenty females) were measured. The effect of fingernail length (0 and 2 mm) on hand dexterity also was investigated using the simple test for evaluating hand function. [Results] The hand and finger sizes as well as fingernail widths were significantly larger in males than in females. The time taken for each subtest of the simple test for evaluating hand function was generally shorter at a fingernail length of 2 mm than at 0 mm, and it was significantly shorter for a number of subtests. There was little significant difference in the time taken for the subtests between genders. [Conclusion] It was clear that a fingernail length of 2 mm had an advantageous effect on hand dexterity, with little gender difference observed. These findings suggest that the fingernail lengths of the subjects should be standardized when evaluating changes in their hand dexterity with time.

[Purpose] The Robotics Knee Orthosis (RKO) is a knee–ankle–foot orthosis with active robot assisting technology. The purpose of this study is to examine the effects of exercise with the RKO (RKO-exercise) in stroke patients with hemiplegia. [Subjects and Methods] Participants were nine stroke patients with hemiplegia, residing in a convalescent rehabilitation ward. The duration of the RKO-exercise program was 10 days. Participants were evaluated three times prior to intervention, once after intervention, and one month post intervention. Each session consisted of standard-of-care physical therapy for 60 minutes and RKO-exercise for 20 minutes. Dependent variables were 10-meter gait speed, cadence, Berg Balance Scale (BBS) score, stride length, the absolute value of left-right symmetry of the step length, and one-leg support period while walking. Data were analyzed using a one-way repeated measures ANOVA. [Results] Stride length, left-right symmetry of the step length, and one-leg support period while walking changed following the RKO exercise program. 10-meter walking speed, cadence, percentage of one-leg support period (affected side), and BBS changed significantly at one month post treatment time points. [Conclusion] It is expected that RKO-exercise helps recovery process after the stroke. RKO-exercise effectively treats impaired mobility in patient status-post stroke.

[Purpose] The purpose of this study is to evaluate the applicability of the calf circumference as a tool for screening sarcopenia. [Subjects and Methods] One hundred sixteen community-dwelling elderly females were enrolled. Calf circumference of the dominant leg was measured using a plastic measuring tape. Subjects were divided into 3 groups based on body mass index (BMI); subjects with the values for BMI <18.5 kg/m²; those with BMI 18.5 to 25.0; those with BMI ≥25.0 kg/m². Positive predictive value and negative predictive value of sarcopenia were calculated based on the obtained cut off values of calf circumference and the diagnosis of sarcopenia in each group. [Results] Prevalence rate of sarcopenia was 9.4% (n=10). Cut off value of the calf circumference was 32.8 cm (sensitivity: 73.0%, specificity: 80.0%, AUC: 0.792). Each BMI group showed high negative predictive value of sarcopenia based on the calf circumference cut off value of 32.8 cm. [Conclusion] These results suggested that to identify non-sarcopenia by larger calf circumference is more reasonable and useful than to identify sarcopenia due to the smaller calf circumference regardless of BMI.

[Purpose] The purpose of this study was to investigate the effects of tongue stretching exercise on the tongue length of healthy adults. [Subjects and Methods] This study recruited 6 healthy adults. They were treated for 4 weeks with tongue stretching. The change in tongue length during tongue protrusion before and after intervention was measured using a ruler. [Results] All 6 participants showed increased tongue length (minimum 20 mm to maximum 40 mm). [Conclusion] This study confirms that tongue stretching is a useful method to increase tongue length.

[Purpose] To investigate the effect of motor imagery training and electromyogram-triggered neuromuscular electrical stimulation (MIT-EMG NMES) on the lower extremity function of stroke patients. [Subjects and Methods] This study recruited eight patients with hemiplegia due to stroke. All patients received MIT-EMG NMES for 20 min daily, 5 days per week for 4 weeks. Lower extremity function were assessed using the timed up-and-go (TUG) and 10-meter walk (10MW) tests. [Results] The results of TUG test decreased significantly from 20.5 ± 4.5 to 14.0 ± 3.5 s, while those of 10 MW test showed a significant decrease from 21.3 ± 4.5 to 15.5 ± 3.2 m. [Conclusion] This study suggests that MIT-EMG NMES is a new rehabilitation therapy for lower extremity recovery in hemiplegic stroke patients.

[Purpose] This study was aimed to determine the relative and absolute reliability of Korean version tools of the Berg Balance Scale (BBS), the Timed Up and Go (TUG), the Four-Meter Walking Test (4MWT) and the Groningen Meander Walking Test (GMWT) in patients with dementia. [Subjects and Methods] A total of 53 patients with dementia were tested on TUG, BBS, 4MWT and GMWT with a prospective cohort methodological design. Intra-class Correlation Coefficients (ICCs) to assess relative reliability and the standard error of measurement (SEM), minimal detectable change (MDC₉₅) and its percentage (MDC_%) to analyze the absolute reliability were calculated. [Results] Inter-rater reliability (ICC_(2,3)) of TUG, BBS and GMWT was 0.99 and that of 4MWT was 0.82. Inter-rater reliability was high for TUG, BBS and GMWT, with low SEM, MDC₉₅, and MDC_%. Inter-rater reliability was low for 4MWT, with high SEM, MDC₉₅, and MDC_%. Test-retest (ICC_(2,3)) of TUG, BBS and GMWT was 0.96–0.99 and Test-retest (ICC_(2,3)) of 4MWT was 0.85. The test-retest was high for TUG, BBS and GMWT, with low SEM, MDC₉₅, and MDC_%, but it was low for 4MWT, with high SEM, MDC₉₅, and MDC_%. [Conclusion] The relative reliability was high for all the assessment tools. The absolute reliability has a reasonable level of stability except the 4MWT.

[Purpose] The strategy of trunk lean gait to reduce external knee adduction moment (KAM) may affect multi-segmental synergy control of center of mass (COM) displacement. Uncontrolled manifold (UCM) analysis is an evaluation index to understand motor variability. The purpose of this study was to investigate how motor variability is affected by using UCM analysis on adjustment of the trunk lean angle. [Subjects and Methods] Fifteen healthy young adults walked at their preferred speed under two conditions: normal and trunk lean gait. UCM analysis was performed with respect to the COM displacement during the stance phase. The KAM data were analyzed at the points of the first KAM peak during the stance phase. [Results] The KAM during trunk lean gait was smaller than during normal gait. Despite a greater segmental configuration variance with respect to mediolateral COM displacement during trunk lean gait, the synergy index was not significantly different between the two conditions. The synergy index with respect to vertical COM displacement during trunk lean gait was smaller than that during normal gait. [Conclusion] These results suggest that trunk lean gait is effective in reducing KAM; however, it may decrease multi-segmental movement coordination of COM control in the vertical direction.

[Purpose] This study compared the activity of the quadriceps femoris muscle according to the angle of ankle abduction during a lunge exercise. [Subjects and Methods] Fifteen male healthy volunteers participated in the study. All participants performed the lunge exercise with different angles of ankle abduction (0°, 20°, 40°, 60°). The activity of the rectus femoris (RF), vastus lateralis (VL) and vastus medialis oblique (VMO) muscles were recorded for the four angles by using a surface electromyography system. [Results] There were significant differences between the rectus femoris (RF), vastus lateralis (VL) and vastus medialis oblique (VMO) with every angle of the ankle joint. The most significantly increased muscle activity was evident in the vastus medialis oblique (VMO) when the ankle abduction was 60°. [Conclusion] These findings suggest that as the ankle abduction angle increases during the lunge exercise, the muscle activity of the quadriceps femoris muscle increases and this could be helpful in the selective muscle strengthening of the vastus medialis oblique muscle (VMO) with the ankle in the 60° abduction position.

[Purpose] To determine age-related differences in the subjective vertical in the frontal plane in healthy adults. [Subjects and Methods] The subjects were 26 healthy adults. For the subjective visual vertical (SVV), subjects were presented with a visual indicator in front of them that was rotated. For the subjective postural vertical-eyes open (SPV-EO) and subjective postural vertical (SPV), subjects sat in a seating device that was tilted right or left. The subjects gave a signal when they perceived true verticality. Each task was performed eight times. The items examined were the mean (tilt direction) and standard deviation (variability) of the eight trials, then the mean of four trials that started from the right or left side position. These items were compared between the young (age: 22–30 years [range]) and elderly (age: 60–74 years) groups. [Results] As for variability, the elderly group demonstrated significantly higher values of SPV-EO and SPV. As for the starting point effect, the elderly group demonstrated greater bias toward the starting direction than did the young group in SPV-EO and SPV in frontal plane. [Conclusion] The postural vertical was shown to change with age. Consideration of age-related changes and the starting point effect was indicated to be important.

[Purpose] This study was to find out an inspiratory muscle training (IMT) program therapeutic effects on stroke patients’ functional ability. [Subjects and Methods] Twenty stroke patients were assigned to one of two groups: inspiratory muscle training (n=10), and control (n=10), randomization. The inspiratory muscle training participants undertook an exercise program for 30 minute per times, 5 times a week for 6 weeks. The investigator measured the patients’ trunk impairment scale (TIS) and 6 minute walking test (6MW) for functional ability before and after IMT. [Results] The TIS appeared some significant differences in both groups before and after the training. The 6MW test showed some significant differences in the inspiratory muscle training group, but didn’t show any significant difference in the control group. And the differences in both groups after depending the inspiratory muscle training were significantly found in the tests of TIS and 6MW test [Conclusion] The results showed that the inspiratory muscle training in stroke patients are correlated with the trunk stability and locomotion ability, suggesting that physical therapist must take into consideration the inspiratory muscle training, as well as functional training to improve physical function in stroke patients.

[Purpose] The purpose of this study was to investigate the effect of silver gymnastic exercises on aging-related hormones in elderly women living alone. [Subjects and Methods] The study group consisted of 20 elderly women living alone who performed the silver gymnastic exercises for 12 weeks. Blood samples were obtained for measurement of aging-related hormones (human growth hormone [HGH] and estrogen). [Results] HGH and estrogen levels increased significantly after the exercise program as compared to before the program. [Conclusion] The silver gymnastic exercises helped to induce positive changes in aging-related hormone levels in elderly women living alone. These positive effects on aging-related hormones might help to slow down aging in elderly women living alone.

[Purpose] The main purpose of this study was to identify the impact of rib cage joint mobilization and chest wall stretch on respiratory muscle tone and stiffness and chest expansion in stroke patients and to compare the effects of both interventions. [Subjects and Methods] Subjects were randomly assigned to a rib cage joint mobilization group (n=15) or a chest wall stretch group (n=15). Respiratory muscle tone and stiffness were measured using a myotonometer, and the chest expansion was gauged using a measuring tape. [Results] A significant difference was found on comparing the respiratory muscle tone and stiffness on the affected and sound side before intervention. Although both groups showed an increase in respiratory muscle tone and stiffness after intervention, no significant difference was found. A significant increase in chest expansion was observed; however, no significant difference was observed in the variations between the groups. [Conclusion] This study suggests that rib cage joint mobilization and chest wall stretch exercises can be used to increase chest expansion potential and respiratory muscle tone in patients with chronic stroke.

[Purpose] The purpose of this study was to investigate the effects of the menstrual cycle on the static balance of healthy young women. [Subjects and Methods] Eighteen healthy young subjects (mean age 19.1 years; weight 57.5 kg; height 159.9 cm) participated in this study. The Good Balance system was used to measure the postural sway speed and velocity moment of subjects in the static standing posture. Subjects were measured for static balance between 1 and 3 days after menstruation and 13 days after menstruation. [Results] The velocity moment of postural sway was significantly higher at 13 days after menstruation. [Conclusion] Our results indicate that the menstrual cycle affects the static balance of healthy subjects. During the menstrual cycle, intensity for balance exercises in females should be carefully controlled for injury prevention.

[Purpose] This study investigated the effect of a combined method incorporating the Mendelsohn maneuver and effortful swallowing on aspiration in patients with dysphagia after stroke. [Subjects and Methods] Three patients with dysphagia were recruited. All patients were treated with a combined method consisting of the Mendelsohn maneuver and effortful swallowing. The intervention period was total 20 sessions. Evaluation was based on videofluoroscopic swallowing study and the degree of aspiration was assessed using penetration-aspiration scale. [Results] Before and after intervention, all participants showed a decrease in aspiration with liquid type and semisolid type food. [Conclusion] This study confirms that the combined method of the Mendelsohn maneuver and effortful swallowing has a positive effect on aspiration in patients with dysphagia after stroke.

[Purpose] The aim of this study was to investigate the effect of combined respiratory muscle training on expiratory muscle activity in stroke patients. [Subjects and Methods] Twenty-five stroke patients were assigned to either the intervention group (n=12) or the control group (n=13). Both groups participated in a conventional stroke rehabilitation program, while the intervention group also received respiratory muscle training for 20 to 30 minutes a day, 3 times a week, for 8 weeks. Surface electromyographic data were collected from the rectus abdominis, internal oblique, and external oblique on the paretic side. Pulmonary function (forced vital capacity) and cough capacity (peak expiratory flow) also were measured. [Results] Both groups showed a significant increase in muscle activity after the intervention. However, the intervention group also showed significant increases in forced vital capacity and peak expiratory flow. Comparison of the 2 groups revealed that the intervention group had greater improvements in pulmonary function, cough capacity, and muscle activity. [Conclusion] The results of this study suggest that combined respiratory muscle training has positive effects on both respiratory function and expiratory muscle activity in stroke patients.

[Purpose] This study aimed to investigate the effect of neuromuscular electrical stimulation (NMES) on lip strength and closure function of patients with dysphagia after stroke. [Subjects and Methods] Eight patients with dysphagia were recruited. NMES was applied to the orbicularis oris muscle. All the participants received NMES for 30 min/d, 5 d/wk, for 4 weeks. Lip strength was measured using the Iowa Oral Performance Instrument. To assess lip closure, the lip closure subitem of the videofluoroscopic dysphagia scale was used. [Results] Lip strength showed significant improvement and lip closure function showed a significant decrease. [Conclusion] This study demonstrates that NMES is useful for improving lip strength and closure function.

[Purpose] The purpose of this study was to investigate factors influencing the period from surgery to discharge in patients with femoral trochanteric fractures. [Subjects and Methods] Sixty patients with femoral trochanteric fractures were investigated retrospectively. Based on the mean period from surgery to discharge (85.6 ± 26.6 days), the patients were divided into two groups: an under-85-day group (range, 29–78 days) and an over-85-day group (87–128 days). Age, gender, fracture type, presence of lesser trochanteric displacement, discharge destination, and walking ability were investigated. The relationship between these factors and the period from surgery to discharge was analyzed with logistic regression analysis. [Results] Age and lesser trochanteric displacement were significantly higher in the over-85-day group, and walking ability before fracture and at discharge were significantly lower in the over-85-day group. Logistic regression analysis showed that lesser trochanteric displacement and age were predictors of the length from surgery to discharge. Lesser trochanteric displacement were observed in 87.5% of these. Immediate displacement after surgery occurred in 57.8% of lesser trochanteric fractures, while 26.3% displaced 1 to 3 weeks after surgery. [Conclusion] This study revealed that lesser trochanteric displacement, higher age, and lower walking ability before fracture and at discharge were associated with longer hospitalizations in patients with femoral trochanteric fractures. Lesser trochanteric displacement were observed in 87.5% of lesser trochanteric fractures. These displacements occurred within 3 weeks after surgery in 84.1% of cases.

[Purpose] This study compares the orientation sense of sighted and visually impaired participants to provide basic research on the audiospatial cognitive ability of visually impaired athletes. [Subjects and Methods] Subjects included nine blind athletes and seven sighted subjects wearing eyeshades during static and dynamic tasks. In the static spatial cognitive task, a coin was dropped towards the right, center, or left of the subject, and the task consisted of identifying the location of the coin. In the dynamic spatial cognitive task, performed with the participant walking, an auditory stimulus was provided. In both spatial cognitive tasks, the independent variables consisted of the “blind athlete” and “sight” groups, as well as three directions; a one-way analysis of variance was performed with the mean error angle as a dependent variable using IBM SPSS Statistics. [Results] The error angles found in the rightward and leftward directions during the static task showed no significant differences, but in the dynamic task, the sight group showed a markedly greater error in the left side, indicating a right-and-left asymmetry in spatial cognition. [Conclusion] Our results suggest a highly developed skill of instantly determining the spatial orientation of auditory information in dynamic situations in blind athletes.

[Purpose] To determine the validity of knee extension muscle strength measurements using belt-stabilized hand-held dynamometry with and without body stabilization compared with the gold standard isokinetic dynamometry in healthy adults. [Subjects and Methods] Twenty-nine healthy adults (mean age, 21.3 years) were included. Study parameters involved right side measurements of maximal isometric knee extension strength obtained using belt-stabilized hand-held dynamometry with and without body stabilization and the gold standard. Measurements were performed in all subjects. [Results] A moderate correlation and fixed bias were found between measurements obtained using belt-stabilized hand-held dynamometry with body stabilization and the gold standard. No significant correlation and proportional bias were found between measurements obtained using belt-stabilized hand-held dynamometry without body stabilization and the gold standard. The strength identified using belt-stabilized hand-held dynamometry with body stabilization may not be commensurate with the maximum strength individuals can generate; however, it reflects such strength. In contrast, the strength identified using belt-stabilized hand-held dynamometry without body stabilization does not reflect the maximum strength. Therefore, a chair should be used to stabilize the body when performing measurements of maximal isometric knee extension strength using belt-stabilized hand-held dynamometry in healthy adults. [Conclusion] Belt-stabilized hand-held dynamometry with body stabilization is more convenient than the gold standard in clinical settings.

[Purpose] Severe calcaneus misalignment is correlated with low back pain, and affects pelvic alignment. However, little has been published with regard to the influence of pronation and supination on trunk alignment. Therefore, the present study aimed to investigate the influence of calcaneal inversion on pelvic and trunk alignment. [Subjects and Methods] A 3-dimensional motion analysis system was used to assess pelvic and trunk alignment in 10 healthy male subjects with unilateral and bilateral calcaneus inversion. [Results] Medial and anterior tilting of the pelvis, and posterior tilting and lateral rotation of the trunk were observed. [Conclusion] Calcaneal inversion induces changes in the alignment of the pelvis and trunk. These changes may induce lumbar lordosis and body misalignment, leading to back pain.

[Purpose] The purpose of this study was to develop a proposal for an effective interventional option for therapeutic stimulation sites by comparing the pain-relieving effect of transcutaneous electrical nerve stimulation (TENS) applied to the same dermatome level of the contralateral sites of the dorsal wrist joint with the pain or the neck, or both sites simultaneously. [Subjects and Methods] A control was first established by triggering pain in the left dorsal wrist joints of adult females by using heat stimulation. Three interventions were then performed, comprising the TENS to the contralateral wrist joint (CW) and to the neck (N) at the same dermatome level as the site of pain, and the TENS to both CW and N simultaneously (CWN). Levels of pain and cerebral blood flow were also measured. [Results] The pain levels of three interventions were found to be significantly decreased compared with the control; however, no significant differences in the levels of pain were seen between any combinations of three interventions. Furthermore, no significant differences were seen between any interventions in terms of cerebral blood flow. [Conclusion] The results suggest that in order for TENS to be effective, it is necessary to make effective use of the dermatome.

[Purpose] The purpose of this study was to investigate the relationships among perceived service encounter quality, service value, patient satisfaction, and behavioral intention in physical therapy patients. [Subjects and Methods] This study surveyed 335 patients who received physical therapy treatment at five medical institutions in Jeonju-si, Republic of Korea. This study conducted path analysis on the collected data using Smart PLS 2.0 M3. [Results] The analysis of this study showed that service encounter quality had significantly positive relationship with service value, patient satisfaction, and behavioral intention. Service value had significantly positive relationship with patient satisfaction and behavioral intention. Patient satisfaction had significantly positive relationship with behavioral intention. [Conclusion] Improving the perceived quality of service encounters for physical therapy patients increases service value and patient satisfaction, and positively influences behavioral intention.

[Purpose] The purpose of this study was to examine changes in fatigue and physical function with age for groups of patients with gastrointestinal cancer in the perioperative period. [Subjects and Methods] The study involved 52 patients with gastrointestinal cancer (28 males and 24 females, aged 62.4 ± 12.0 years). The subjects were divided into two groups: those 65 or over (the so-called elderly group,) and those 64 or under (the so-called young group). The six minute walk distance (6MWD), Cancer Fatigue Scale (CFS), and serum albumin (ALB) were evaluated on three occasions: before surgery, after surgery and after discharge. This study considered change in physical function and fatigue, differences between the two groups and correlations between age and each evaluation on the three occasions. [Results] The 6MWD was the main difference between the elderly and young groups, with the former having significantly reduced 6MWD values as compared to the latter after surgery. Age was positively correlated with 6MWD and ALB after surgery and after discharge. Moreover, age was negatively correlated with CFS after surgery and after discharge. [Conclusion] It is suggested that elderly patients are more likely to experience a decline in exercise tolerance and an increase in fatigue.

[Purpose] This study investigated the factors affecting fear of falling in patients with femoral proximal fracture. [Subjects and Methods] The participants were 26 patients with femoral proximal fracture (3 males and 23 females, average age: 80.2 ± 7.9 years). Fall self-efficacy, motor functions, and pain intensity were measured 4 weeks post-surgery, and the participants were divided into three groups based on their scores on the Falls Efficacy Scale. [Results] The group with low fall self-efficacy was significantly older and experienced stronger pain than the group with high fall self-efficacy did. In a multivariate analysis, age and pain intensity were extracted as factors influencing fall self-efficacy. [Conclusion] For patients with femoral proximal fracture, in addition to age, pain was identified as a correlated factor to fear of falling.

[Purpose] To create a regression formula in order to estimate 1RM for knee extensors, based on the maximal isometric muscle strength measured using a hand-held dynamometer and data regarding the body composition. [Subjects and Methods] Measurement was performed in 21 healthy males in their twenties to thirties. Single regression analysis was performed, with measurement values representing 1RM and the maximal isometric muscle strength as dependent and independent variables, respectively. Furthermore, multiple regression analysis was performed, with data regarding the body composition incorporated as another independent variable, in addition to the maximal isometric muscle strength. [Results] Through single regression analysis with the maximal isometric muscle strength as an independent variable, the following regression formula was created: 1RM (kg)=0.714 + 0.783 × maximal isometric muscle strength (kgf). On multiple regression analysis, only the total muscle mass was extracted. [Conclusion] A highly accurate regression formula to estimate 1RM was created based on both the maximal isometric muscle strength and body composition. Using a hand-held dynamometer and body composition analyzer, it was possible to measure these items in a short time, and obtain clinically useful results.

[Purpose] The purpose of the present study was to examine the immediate effects of simultaneous application of proprioceptive neuromuscular facilitation (PNF) and elastic taping (T), and the removal of the elastic tape, on the gait parameters of stroke patients. [Subjects and Methods] Twenty stroke patients were divided into a proprioceptive neuromuscular facilitation group (PNFG, n=7), a taping group (TG, n=6), and a proprioceptive neuromuscular facilitation with taping group (PNFTG, n=7). Relevant interventions were applied for 30 minutes, the tape was removed, and gait parameters were evaluated. [Results] Only the intervention of the PNFTG yielded significant differences in patient cadence, speed, and stride length. [Conclusion] The simultaneous application of PNF and taping for 30 minutes has carryover effects that can improve stroke patients’ gait ability, even after the removal of the tape.

[Purpose] The purpose of this study was to examine the effect of biofeedback postural control training using whole body vibration in acute stroke patients on balance and gait ability. [Subjects and Methods] Thirty stroke patients participated in this study and were divided into a group of 10, a group for biofeedback postural control training combined with a whole body vibration, one for biofeedback postural control training combined with an aero-step, and one for biofeedback postural control training. Biorescue was used to measure the limits of stability, balance ability, and Lukotronic was used to measure step length, gait ability. [Results] In the comparison of balance ability and gait ability between the groups for before and after intervention, Group I showed a significant difference in balance ability and gait ability compared to Groups II and III. [Conclusion] This study showed that biofeedback postural control training using whole body vibration is effective for improving balance ability and gait ability in stroke patients.

[Purpose] The purpose of this study was to investigate the trunk position perception in the anteroposterior direction in young participants sitting without their feet touching the floor to avoid the influence of the hamstrings tension and the feet pressure on the perception. [Subjects and Methods] Fourteen healthy volunteers were seated on a chair fitted with an original manual goniometer. There were 7 reference positions set at 5° increments, from −15° to 15°, and reproductions of each position were conducted 5 times. Trunk position perception was evaluated by the absolute error between the reproduced trunk angle and the reference position angle. [Results] The results revealed a significant effect of reference position on the absolute error. The absolute error at the −5° reference position was significantly larger than at the −15° and 15° positions, and the absolute error at the 0° position was significantly larger than at the −15°, 10°, and 15° positions. [Conclusion] These results suggest that the perception of extreme forward- and backward-leaning trunk positions while sitting without the feet touching the floor would be higher than in a neutral sitting position. The relationship between the stability of the posture and the perception may be involved in the sitting position.

[Purpose] The purpose of this study was to investigate the effects of taping and proprioceptive neuromuscular facilitation in stroke patients. [Subjects and Methods] Thirty patients who were diagnosed with hemiparalysis due to stroke were selected as subjects of study. Experiment group 1 patients had Kinesio taping applied before applying the PNF, while experiment group 2 patients had McConell taping applied before applying the PNF. The control group had only the PNF applied. The dartfish program was used to evaluate the stance phase of stroke patients. [Results] Experiment group 1 and experiment group 2 showed a significantly longer stance phase duration of the affected side than the control group in week 6. [Conclusion] Application of Kinesio taping has a more positive effect on the stance phase duration than McConell taping in the patients with stroke.

[Purpose] This study aimed to compare the amount of physical activity in a minimally invasive cardiac surgery (MICS) group with that in a conventional surgery (median sternotomy) group. [Subjects and Methods] Between November 2010 and December 2011, 39 consecutive patients who underwent elective surgery for valvular disease were prospectively enrolled. The amount of physical activity before and after surgery was measured in 22 cases. The daily in-hospital physical activity level was measured continuously using a triaxial accelerometer. The results were compared in terms of change in the amount of physical activity pre- and postoperatively. [Results] There was no significant difference between the two groups in the amount of physical activity before surgery. However, the amount of physical activity after surgery was significantly higher in the MICS group compared with the conventional surgery group. The number of steps after surgery was significantly increased in the MICS group, and the rate of change in the amount of physical activity was significantly higher in the MICS group than that in the conventional surgery group. [Conclusion] The MICS approach is associated with improvement in postoperative physical activity over median sternotomy.

[Purpose] This systematics review was undertaken to synthesize what is known regarding pelvifemoral rhythm, that is, the coordinated flexion of the thigh and posterior tilting of the pelvis during hip flexion (HF). [Methods] Three databases were searched. [Results] Nine relevant articles were identified via independent database searches and a hand search by the authors. The articles were consistent in showing that pelvifemoral rhythm underlies the HF motion under conditions as varied as passive unilateral flexion while supine and active bilateral flexion while hanging from a bar. Posterior pelvic tilting, which begins early during HF, contributes between 13.1% to 37.5% of total HF. Pelvic tilting and HF excursions are highly correlated (r=0.89 to 1.00). [Conclusions] Pelvifemoral rhythm is present to varying degrees during hip flexion under diverse conditions.

[Purpose] This case series presents the unique application of the non-commutative property of finite rotation angles under addition to the CBP^® mirror image^® treatment protocol for adult lumbar and thoraco-lumbar scoliosis. [Subjects and Methods] Five adult patients having lumbar/thoraco-lumbar scoliosis and back pain, and having at least two prominent thoracic postural abnormalities according to Harrison’s rotations and translations of thoracic postures were included. After initial assessment, mirror-image stress x-rays were taken. For each patient, one stress film was taken using the order of mirror image movements with the largest displacement followed by the second largest (primary + secondary) and one stress film was taken in the opposite order (secondary + primary). The consecutive ordered movements that resulted in the largest reduction of curvature were chosen as the order-specific series of movements all exercises and postural traction were to be performed for each patient. Spinal manipulation was also performed. [Results] All patients had a reduction of curvature concomitant with a reduction in pain levels. [Conclusion] This unique treatment approach offers a patient-specific, targeted structural rehabilitative procedure to stress the spine towards a more straightened configuration. Adult lumbar and thoraco-lumbar curves can be reduced and improved by these non-invasive CBP methods.

[Purpose] To present the outcome of a patient, having sciatica and MRI-verified disc herniation/sequestration who underwent Chiropractic BioPhysics^® (CBP^®) protocol designed to improve the lumbar lordosis. [Subject and Methods] A 56-year-old male suffered from chronic low back pain and recent sciatica due to lumbar disc herniation despite being under continuous care from three previous chiropractors. Radiographic analysis revealed a lumbar hypolordosis and MRI confirmed disc herniation and sequestration at L4–L5. Generalized decreased lumbar range of motion and multiple positive orthopedic and neurologic tests were present. [Results] After 26 treatments of CBP lumbar extension traction over 9-weeks a total reduction of the disc herniation and sequestration occurred with concomitant improvement in neurologic symptoms. Continuing maintenance treatments, an 8 year follow-up shows no relapse of condition and patient remained in good health. [Conclusion] A patient with lumbar disc herniation/sequestration was successfully treated with CBP technique procedures including lumbar extension traction that achieved a significant healing of herniation and significant reduction in symptoms not obtained following traditional chiropractic procedures alone. The quick reduction in lumbar disc herniation would appear to be related to a segmental disc unloading force produced during extension traction procedures for increasing the lumbar curvature.

[Purpose] To present the increase in thoracic kyphosis in a patient suffering from exertional dyspnea, reduced lung capacity, and spinal pains related to straight back syndrome (SBS). [Subject and Methods] A 33-year-old male patient was put on a CBP^® corrective care program involving mirror image^® traction procedures designed to increase the thoracic kyphosis. [Results] This patient had a 10° improvement in thoracic kyphosis in 16-weeks that was maintained 7-months later. There was a simultaneous reduction of pain, resolved exertional dyspnea, and a greater than 2 liter increase in lung capacity. [Conclusion] This case illustrates that nonsurgical improvement in thoracic kyphosis in a patient with SBS is possible and that this may positively influence lung capacity, health and function.

[Purpose] To present a case demonstrating the reduction of progressive thoracolumbar scoliosis by incorporating Chiropractic BioPhysics^® (CBP^®) technique’s mirror image^® exercises, traction and blocking procedures based on the ‘non-commutative properties of finite rotation angles under addition’ engineering law. [Subject and Methods] A 15-year-old female presented with a right thoracolumbar scoliosis having a Cobb angle from T5–L3 of 27° and suffering from headaches and lower back pains. Her curve had progressed over the last two years despite being under traditional chiropractic care. [Results] The patient was treated using CBP structural rehabilitation protocols incorporating mirror image traction, home blocking, corrective exercises and spinal manipulation. The patient was treated 24 times (including 45 home self-treatment blocking sessions) over the course of 15-weeks. Her thoracolumbar curve reduced from 27° to 8° and her headache and low back pain disability improved significantly. [Conclusion] CBP mirror image exercises and traction are consistent with other successful non-surgical approaches and show promise in treating adolescent idiopathic scoliosis.