[Purpose] The purpose of this investigation was to compare the activities of the abdominal muscles and peak expiratory flow between forced vital capacity and fast expiration exercise. [Subjects and Methods] Fifteen healthy male participated in this study. Peak expiratory flow and electromyographic activities of the rectus abdominis, external oblique, and internal oblique/transversus abdominis muscles were measured during forced vital capacity and fast expiration exercise and then peak amplitude and its appearance time were obtained. [Results] Peak expiratory flow values were significantly higher during fast expiration exercise than during forced vital capacity. The internal oblique/transversus abdominis muscles showed significantly higher peak amplitude during fast expiration exercise than during forced vital capacity. However, there were no significant differences between forced vital capacity and fast expiration exercise in the rectus abdominis and external oblique muscles. There was no difference in the appearance time of the peak amplitude between forced vital capacity and fast expiration exercise in any muscle. [Conclusion] Fast expiration exercise might be beneficial for increasing expiratory speed and neuromuscular activation of the internal oblique/transversus abdominis muscles compared to forced vital capacity. These findings could be considered when recommending a variation of expiratory muscle strength training as part of pulmonary rehabilitation programs.

[Purpose] The purpose of this research was to determine the awareness of the actual conditions of the diagnosis and treatment of scoliosis by focusing on middle-school students in order to provide a basis for active education and treatment of scoliosis. [Subjects and Methods] The survey was conducted among 4,782 students. The students performed Adam’s forward bend test, and some of the students who showed predictive features of scoliosis were further examined for the spine structure with rasterstereography. [Results] The proportion of students with awareness about scoliosis appeared to be 71.47%. Among the students, 50.84% knew the definition of scoliosis and 4.37% were diagnosed as having scoliosis, of whom 46.37% underwent treatment. It was a significant difference between to get a diagnosis and the predictive scoliosis or the scoliosis. [Conclusion] The results showed that the students in the second grade of middle school had high awareness levels, but about 50% of them did not know the definition of scoliosis. More than 50% of them did not receive treatment after diagnosed as having scoliosis. Therefore, active education and school screening for scoliosis should be provided to adolescent students.

[Purpose] The purpose of this study was to evaluate hip flexor and extensor strength due to differences in posture measurement. [Subjects and Methods] Healthy adults (26 males and 24 females) were enrolled. Using a hand-held dynamometer, hip flexor and extensor strengths were measured in various postures and in a basic posture (sitting posture and hip/knee joint flexed 90°) according to the Manual Muscle Testing procedure. While calculating intraclass correlation coefficients by measurement, hip flexor and extensor strengths were compared in males and females for every posture. [Results] Intraclass correlation coefficients were greater than 0.7 in every measurement. There was no significant difference in hip flexor and extensor strengths in both males and females. Furthermore, there was a significant difference in right and left hip flexor strengths and in left hip extensor strength. [Conclusion] Hip flexor and extensor strengths can be simply and easily measured using a hand-held dynamometer.

[Purpose] The purpose of this project was to expose physical therapy students to transformative learning through a community health promotion project for mothers of hearing-challenged children. [Subjects and Methods] The participants were three mothers with their respective hearing-challenged child and twenty physical therapy students. The project consisted of seven sessions supervised throughout by a physical therapy instructor. The students participated in seven sessions, while the mothers were required to attend only two sessions of a health checkup and exercise program. [Results] Through the interaction between the mothers and students, the former felt physically and mentally refreshed, and the latter experienced transformative learning. The mother’s physical status showed that all parameters for health variables were within normal range. However, it was found that mothers had little time for their personal mental or physical well-being because their focus was on planning and executing daily assignments for development of the child’s verbal skills. [Conclusion] This project contributed to the students’ learning experience and provided them with tools for possible future interest and involvement in community activity. The exercise session appeared to stimulate in the mothers an awareness and importance of their own personal and mental well-being.

[Purpose] The purpose of this study was to investigate the differential effects of fixation of the thoracolumbar junction on the activity of the thoracic and lumbar muscle groups with and without the abdominal drawing-in maneuver (ADIM). [Subjects and Methods] The participants were 40 healthy adults. During trunk extension, thoracic and lumbar muscle activities were assessed using surface electromyography when fixing the pelvic and popliteal areas and the thoracolumbar junction, with and without the ADIM. [Results] The activity of the thoracic extensors at the T9 level applying thoracolumbar fixation with ADIM was significantly higher than with only pelvic fixation or pelvic fixation with ADIM during prone trunk extension. However, the activity of the lumbar extensors at the L3 level with pelvic fixation alone, without ADIM, was significantly higher than pelvic fixation with ADIM or additional thoracolumbar fixation with ADIM during prone trunk extension [Conclusion] This study demonstrated that fixation of the thoracolumbar junction with ADIM during trunk extension was more effective at eliciting thoracic extensor and minimising lumbar extensor activity than other conventional fixation methods.

[Purpose] Accurate measurement of unaffected lower extremity muscle strength on the unaffected side is useful in patients with hemiparetic stroke; however, muscle strength measurement results in patients with hemiparetic stroke vary greatly compared with those in healthy individuals. The objective of the present study was to determine the characteristics of patients with hemiparetic stroke who yield highly reliable muscle strength measurements. [Subjects and Methods] The subjects were 55 incipient patients with hemiparetic stroke. Muscle strength was measured twice. Based on the measured changes and on error ranges in repeated measurements in previous studies, the subjects were divided into two groups: subjects whose measurement results were within the acceptable range, and those whose measurement results were not within the acceptable range. Logistic regression analysis was performed with this separation of groups as the dependent variable, and demographic data, physical functioning, and functional independence measure (FIM) as independent variables. [Results] From the analysis results, the FIM cognitive subscore was selected as a criterion for patient selection; the cutoff score was 19. [Conclusion] The results of the present study indicated that muscle strength measurements were highly reliable in patients with hemiparetic stroke with an FIM cognitive subscore of ≥19.

[Purpose] This study was performed to evaluate the long-term histopathological changes in knee-joint components including synovial membrane and joint capsule in a rat model of osteoarthritis (OA) induced by monosodium iodoacetate (MIA). [Subjects and Methods] Fifty male rats were used. OA was induced through intra-articular injection of MIA, and ten rats were randomly allocated to each of five groups induced with OA for 1, 2, 4, 6, or 8 weeks. At the end of each period, the knee components were examined histopathologically. [Results] After 1 and 2 weeks, chondrocytes were weakly stained. After 4 weeks, fibrillation, fissuring, and eburnation were observed, whereas after 6 weeks, chondrocyte clustering and osteophyte formation were detected. In the synovial membrane, the proliferation of spindle-shaped cells and a multilayered structure of the surface cells were observed at 1 and 2 weeks, but the degree of these changes decreased over time. In the joint capsule, a narrowing of the space between collagen fiber bundles was observed at 4–8 weeks. [Conclusion] The long-term histopathological changes of the joint components observed in a rat model of OA induced by MIA were similar to those detected in OA, but differed at specific times and tissues.

[Purpose] Chondrocytes in articular cartilage are aligned as columns from the joint surface. Notably, loss of chondrocyte and abnormalities of differentiation factors give rise to osteoarthritis (OA). However, the relationship between chondrocyte alignment and OA progression remains unclear. This study was performed to investigate temporal alterations in surgically-induced OA rats. [Subjects and Methods] Thirteen-week-old Wistar rats (n=30) underwent destabilized medial meniscus surgery in their right knee and sham surgery in their left knee. Specimens (n=5) were collected at 0, 1, 2, 4 and 8 weeks after surgery. Histological analysis with Osteoarthritis Research Society International (OARSI) scores, cell density ratios, cell alignments and correlation between OARSI scores and cell density/alignment was performed. [Results] OARSI scores were significantly higher at 1, 2, 4 and 8 weeks in the DMM group than in the control. Cell density ratios were decreased significantly in the DMM group at 2, 4 and 8 weeks compared with the control. Chondrocyte alignment was decreased significantly in the DMM group at 4 and 8 weeks. There were negative correlations between OA severity and cell density / cell alignment. [Conclusion] The results suggest a relationship between chondrocyte alignment and cartilage homeostasis, which plays an important role in OA progression.

[Purpose] The aim of this study was to investigate the effects of repeated vibratory stimulation to muscles related to hand functions on dexterity, strength, and sensory function in patients with chronic stroke. [Subjects and Methods] A total of 10 stroke patients with hemiplegia participated in this study. They were divided into two groups: a) Experimental and b) Control, with five randomly selected subjects for each group. The experimental group received vibratory stimulation, while the control group received the traditional physical therapy. Both interventions were performed for 30 minutes each session, three times a week for four weeks. [Results] There was a significant within-group improvement in the box and block test results in both groups for dexterity. Grip strength improved in both groups but the improvement was not statistically significant. [Conclusion] The vibratory stimulation activated the biceps brachii and flexor carpi radialis, which increased dexterity to grasp and lift the box and block from the surface. Therefore, repeated vibratory stimulation to muscles related to hand functions improved hand dexterity equality to the traditional physical therapy in patients with chronic stroke.

[Purpose] This study was conducted to identify the effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia. [Subjects and Methods] A total of 18 stroke patients with dysphagia were enrolled in the study. All participants were randomly assigned to either an experimental group (n=9) or a control group (n=9). All participants performed traditional-swallowing rehabilitation therapy in 30-minute sessions five times a week for four weeks; however, only the experimental group received expiratory muscle strength training. [Results] Both groups showed significant improvements after mediation. When compared with the control group, the functional dysphagia scale, vallecular residue, and penetration-aspiration scale were significantly improved in the experimental group. [Conclusion] Expiratory muscle strength training is an effective intervention for impaired swallowing function in acute strike patients with dysphagia.

[Purpose] The purpose of this study is to examine patient preferences for counseling related to sexuality post-stroke in Korea. [Subjects and Methods] A survey was conducted on 200 stroke patients. Among the 200 submitted questionnaires, 156 responded but 147 cases are available. The questionnaire is composed of 27 questions such as 8 independent variables related to the general characteristics of the patients, 7 dependent variables in conjunction with sexual intercourse and changed muscle tone, 6 questions regarding to changed sexual function, and 6 questions about a changed motor and a sensory function after stroke. To analyze the factors related to a sexual function after a stroke, we used the random forest, boosting algorithm and MANOVA. [Results] The most important variable in variable group 1 is VAR1, and then VAR22, VAR23, VAR26, VAR27, VAR25, VAR21 and VAR 24 respectively. The most important variable in variable group 2 is VAR22, and then VAR26, VAR23, VAR25, VAR1, VAR27, VAR21 and VAR 24. Finally, for variable group 3, VAR1 has the most important percentage, and we have the order as VAR26, VAR23, VAR27, VAR22, VAR25, VAR21 and VAR 24 among the rest of variables. The result of variable importance in boosting algorithm is somehow the same as that of random forest. [Conclusion] As a result of our analysis, we figured out that duration of illness, age, and education level are important factors of sexual functions for Korean Stroke patients.

[Purpose] To investigate the relationship between the lateral tibial rotation angle during knee joint flexion and the medial and lateral hamstring muscle thickness ratio during knee joint extension while resting, doing nothing, in upright standing position. The lateral tibial torsion is an important factor of orthopedic knee joint diseases as well as other weight bearing joint diseases such as osteoarthritis, meniscus syndrome, anterior cruciate ligament rupture, etc. [Subjects and Methods] Thirty healthy young adults participated in this study. The thickness of the medial and lateral hamstrings was measured using ultrasonographic imaging technique during knee extension in a resting position. The angle of tibial rotation was measured with 2D motion analysis during knee flexion in a half kneeling position. Pearson’s correlation coefficient was used to test the relationship. [Results] There is no significant relationship between the angle of lateral tibial rotation and the ratio of hamstring muscle thickness. [Conclusion] These results demonstrate that lateral tibial rotation is not affected by hamstrings during rest in a standing position.

[Purpose] This study aimed to evaluate the immediate effect of ankle balance taping on balance ability of soccer players with acute ankle sprain. [Subjects and Methods] This study was conducted with 16 subjects who were diagnosed with ankle sprain. A cross-over randomized design was used. Each subject performed three interventions in a random order. Subjects were randomly assigned to an ankle balance taping, placebo taping, and no taping. For dynamic and static balance, ability was measured using BIORescue (RM Ingenierie, Rodes, France). Limit of stability, sway length and sway speed for one minute were measured. [Results] The Limit of Stability, Sway length and Sway speed differed significantly among the three different taping methods. [Conclusion] In this study, we found that ankle balance taping was effective in terms of improving balance ability of soccer players with an ankle sprain.

[Purpose] The aim of this study was to investigate the effect of bilateral upper extremity exercises on trunk performance in patients with stroke. [Subjects and Methods] Twenty in-patients with chronic stroke of at least 6 month’s duration participated in this study. Patients in the experimental and control groups received neurological rehabilitation treatment for stroke. In addition to the neurological rehabilitation treatment, patients in the experimental group received 30 minutes of bilateral upper extremity exercises 3 times weekly for 4 weeks. Outcomes were measured using the Trunk Impairment Scale before and after the 4-week training period. [Results] Significant intragroup differences in all items of Trunk Impairment Scale were observed after intervention. In particular, significant intergroup differences were observed for dynamic sitting balance, trunk coordination, and between total scores of the Trunk Impairment Scale. [Conclusion] The results of this study suggest bilateral upper extremity exercises could be used in addition to trunk exercises to improve trunk performance in patients with stroke.

[Purpose] The aim of this study was to investigate the effect of segmental weight of the prosthesis on hemodynamic responses and energy expenditure in lower extremity amputees. [Subjects and Methods] Thirteen patients with a mean age of 44 ± 15.84 years and with unilateral transtibial, transfemoral and Syme’s amputation were included to the study. The difference between the lightest and the heaviest prosthesis, 250 g used as the weight. All the patients completed the measurements first without weight and then with 250 g weight on the ankle joint. The blood pressure and heart rate of the patients were recorded before and after Six Minute Walk Test (6MWT) and 10 stairs up & down stairs test. Physiological Cost Index was used to calculate the energy expenditure. [Results] Heart rate and energy expenditure increased significantly when without weight and with weight results compared. [Conclusion] We conclude that the segmental weight of the prosthetic limb has a significant effect on the heart rate and energy expenditure but has no effect on the systolic and diastolic blood pressure of lower limb amputees. In order to generalize our results to lower limb amputees, more patients need to be included in future studies.

[Purpose] The Shoulder36 (V 1. 3) is a regional questionnaire in Japan that has not been validated as a functional evaluation of the shoulder via a thorough comparison with other questionnaires (e.g., QuickDASH). The purpose of this study was to test the reliability, validity, and responsiveness of the Shoulder36 (V 1. 3). [Subjects and Methods] A series of 46 patients with upper extremity disorders completed the Shoulder36 (V 1. 3) and the QuickDASH Japanese version (QuickDASH-JSSH). The reliability of the Shoulder36 was assessed for consistency and validity. The correlation coefficients between the Shoulder36 (V 1. 3) and the QuickDASH-JSSH were obtained. [Results] The total of the Cronbach’s alpha coefficients for the Shoulder36 (V 1. 3) was 0.98. The intraclass correlation coefficients for the six domains of the Shoulder36 (V 1. 3) were similarly high, ranging from 0.81 to 0.94. The correlations between the six domains of the Shoulder36 (V 1. 3) and the three domains of the QuickDASH subscales ranged from −0.43 to −0.78. [Conclusion] The Shoulder36 (V 1. 3) was able to evaluate the relationship between activities of daily living and shoulder joint function with the same degree of accuracy but in more detail than QuickDASH-JSSH. Therefore, it should prove to be a valuable asset in physiotherapy plans and have multiple research applications.

[Purpose] This study observed the plantar pressure between flexible flatfoot and normal foot on different walking conditions to find out if flexible flatfoot needs the treatment and how the plantar pressure change while walking upstairs and downstairs. [Subjects and Methods] Fifteen adults with mild flexible flatfoot, fifteen adults with severe flexible flatfoot and fifteen adults with normal foot were examined while walking on a level surface, walking up and down 10 cm and 20 cm stairs. The max force and the arch index were acquired using the RSscan system. The repeated measures ANOVA was performed to analyze the data. [Results] Compared with normal foot, both max force and arch index of severe flatfoot were significantly increased on different walking conditions. When walking down 10 cm and 20 cm stairs, the plantar data of both normal foot and flatfoot were significantly increased. [Conclusion] The plantar pressure of severe flexible flatfoot were significantly larger than that of normal foot on different walking conditions. In addition, the arches of both normal foot and flatfoot were obviously deformed when walking downstairs. It is therefore necessary to be treated for severe flexible flatfoot to prevent further deformation.

[Purpose] The aim of the present study was to investigate effects of skilled reach training with affected forelimb and treadmill exercise on the expression of neurotrophic factor following ischemia-induced brain injury in rats. [Subjects and Methods] Thirty male Sprague-Dawley rats were divided into 3 groups randomly: namely, the control sacrified 2 weeks after surgery, skilled reach training with forepaw contralateral to brain injury for 2 weeks, and treadmill exercise for 2 weeks. Transient focal cerebral ischemia was induced by intraluminal occlusion of the left middle cerebral artery. After that, skilled reach training and treadmill exercise were conducted. Western blot analysis was performed to investigate expressions of neurotrophic factors. [Results] There were significant differences in brain-derived neurotrophic factor and nerve growth factor expression between the control group and the experimental group. There were no significant differences in brain-derived neurotrophic factor and nerve growth factor expression between the skilled reach training group and the treadmill exercise group. [Conclusion] Skilled reach training and treadmill exercise can affect the expression of neurotrophic factors.

[Purpose] This study aimed to determine the correlation between accelerometer-based and treadmill-based analysis systems for measuring gait parameters during comfortable walking in healthy young adults. [Subjects and Methods] Twenty-three healthy adults participated in this study. Gait parameters were measured with simultaneous use of accelerometer-based and treadmill-based gait analysis systems, while participants walked for 30 s. [Results] There was a highly-significant correlation between the two systems with respect to cadence and velocity. The cadence, speed, and stride measured with the accelerometer system were significantly and highly correlated with the cadence, velocity, and number of steps measured with the treadmill-based system. The gait cycle duration measured with the accelerometer system was significantly and highly correlated with the step time and stride time measured with the treadmill-based gait system. [Conclusion] Gait analysis using an accelerometer system is a valid method for assessment of the effectiveness of therapeutic interventions in a clinical setting.

[Purpose] Instrument Assisted Soft Tissue Mobilization (IASTM) is a form of manual therapy. Despite its growing popularity and an increasing number of patients receiving IASTM each year, there is a lack of high-level evidence to elucidate its therapeutic mechanisms and to support its clinical applications. The purpose of this research project was to determine the effects of IASTM on activities of mechanosensitive neurons in skin. [Subjects and Methods] Twenty-three subjects, 9 females and 14 males, mean age 25.7 (SD 6.4) years old were recruited through a convenience sampling on the university campus. The study design was a quasi-experimental study using single group pretest-posttest design. The activities of mechanosensitive neurons were measured before and after the application of IASTM. [Results] The mean 2-point discrimination was 40.2 (SD 9.4) mm before IASTM and increased to 44.9 (SD 12.0) mm after IASTM. The increase was statistically significant pre and post IASTM. The mean pain threshold was 18.2 (SD 6.6) lb and increased slightly to 18.7 (SD 6.8) lb after IASTM; however, no statistical significance was found pre and post IASTM. [Conclusion] The data indicates that IASTM changes the neural activities in 2-point discrimination but not in pain threshold.

[Purpose] Although lung capacity in the elderly is affected by age, little research has been performed studying decreasing lung capacity in relation to increasing life expectancy. The aim of this study was to examine the effects of increased life span on the lung capacity of women. [Subjects and Methods] The subjects of this study were 55 healthy elderly women over 60 years of age who were living in Busan. Subjects were classified in the following age categories: 60s, 70s and 80s. For the pulmonary function test, a spirometry (Pony FX, COSMED Inc., Italy) was used. The item for measurement of pulmonary function in elderly women was maximum-effort expiratory spirogram (MES). The pulmonary function test was performed 3 times, and its mean value was used for analysis. [Results] Among items of maximum-effort expiratory spirogram, a significant difference according to age was demonstrated in forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, maximum expiratory flow 75%, maximum expiratory flow 50%, and inspiratory capacity. [Conclusion] According to this study, lung capacity decreases remarkably as age increases. In conclusion, a continuous exercise program beginning at an early age is essential to prevent decrease in lung capacity as age progresses.

[Purpose] The aim of this study was to determine a relationship between joint angle and muscular strength. In particular, this research investigated the differences in maximum muscular strength and average muscular strength at the knee-joint posture. [Subjects and Methods] The study subjects comprised eight female students in their 20s attending S University in Busan. None of the subjects had functional disabilities or had experienced damage to the lower extremities in terms of measurement of muscular strength. A BIODEX system III model (Biodex medical system, USA) was used to measure joint angles and muscular strength. The axis of the dynamometer was consistent with the axis of motion, and measurements were made at 25° and 67° to examine differences in maximum muscular strength according to joint angle. [Results] The maximum muscular strength both knee-joint extension value, at 67° and flexion value, at 25° the value was larger. The average muscular strength both knee-joint extension value, at 67° and flexion value, at 25° the value was larger. [Conclusion] The results of this study reveal that muscular strength does not reach maximum at particular range angles, such as the knee-joint resting posture angle or the knee-joint middle range angle. Rather, a stretched muscle is stronger than a contracted muscle. Therefore, it is considered that it will be necessary to study the effects of the joint change ratio on muscular strength on the basis of the maximum stretched muscle.

[Purpose] This study aims to describe a protocol based on neurocognitive therapeutic exercises and determine its feasibility and usefulness for upper extremity functionality when compared with a conventional protocol. [Subjects and Methods] Eight subacute stroke patients were randomly assigned to a conventional (control group) or neurocognitive (experimental group) treatment protocol. Both lasted 30 minutes, 3 times a week for 10 weeks and assessments were blinded. Outcome measures included: Motor Evaluation Scale for Upper Extremity in Stroke Patients, Motricity Index, Revised Nottingham Sensory Assessment and Kinesthetic and Visual Imagery Questionnaire. Descriptive measures and nonparametric statistical tests were used for analysis. [Results] The results indicate a more favorable clinical progression in the neurocognitive group regarding upper extremity functional capacity with achievement of the minimal detectable change. The functionality results are related with improvements on muscle strength and sensory discrimination (tactile and kinesthetic). [Conclusion] Despite not showing significant group differences between pre and post-treatment, the neurocognitive approach could be a safe and useful strategy for recovering upper extremity movement following stroke, especially regarding affected hands, with better and longer lasting results. Although this work shows this protocol’s feasibility with the panel of scales proposed, larger studies are required to demonstrate its effectiveness.

[Purpose] This study aimed to investigate the effects of training involving compelled weight shift on the paretic lower limb on gait parameters and plantar pressure distribution in patients with stroke. [Subjects and Methods] Forty-five stroke patients participated in the study and were randomly divided into: group with a 5-mm lift on the non-paretic side for constrained weight shift training (5: constrained weight shift training) (n=15); group with a 10-mm lift on the non-paretic side for constrained weight shift training (10: constrained weight shift training) (n=15); or the control group (n=15). Both, the 5 constrained weight shift training and 10 constrained weight shift training groups underwent constrained weight shift training 5 times per week for 4 weeks, whereas the control group performed ergometer exercises for lower limb muscle strengthening. [Results] The 10 constrained weight shift training group showed a significant increase in the contact surface and impulse of the hindfoot compared to the control group, and the step length and walking speed were significantly longer and faster. [Conclusion] We found that constrained weight shift training on the paretic lower limb is an effective treatment method for improving normal gait pattern in stroke patients.

[Purpose] The purpose of this study was to evaluate the changes in gait patterns and clinical outcomes of patients with chronic ankle instability (CAI) following treatment with a home-based non-invasive biomechanical device. [Subjects and Methods] Thirty-three patients with CAI were compared with 43 healthy controls. Patients underwent a spatiotemporal gait assessment before and three months following treatment. Clinical evaluation was recorded with SF-36 Health Survey and the Foot and Ankle Outcome Score (FAOS). [Results] Significant baseline differences were found between groups. Patients with CAI showed a statistically significant improvement in velocity, cadence, symptomatic limb step length and single limb support over time. Significant improvements in SF-36 PCS and FAOS outcome scores were found in patients with CAI. [Conclusion] Patients with CAI have baseline spatiotemporal gait abnormalities as compared with healthy controls. However, clinical and gait metrics improvement can be expected after 12 weeks of perturbation training using a non-invasive biomechanical device.

[Purpose] The aim of this double-blind, randomized and placebo-controlled study is to investigate the effects of Transcutaneous Electrical Nerve Stimulation for reducing the side effects of Chemotherapy-induced Peripheral Neuropathy in cancer patients undergoing chemotherapy with oxaloplatin or paclitaxel. [Subjects and Methods] Twenty-four patients were randomly allocated into two groups: active or placebo stimulation. All patients were assessed for pain, numbness/tingiling, frequency of symptoms, and quality of life. The transcutaneous Electrical Nerve Stimulation device was applied daily with modulating frequencies ranging between 7 Hz and 65 Hz in distal limb regions during three cycles of chemotherapy (45 days). The other stimulation parameters were: pulse duration of 200 μsec, intensity at the highest tolerable level, and increases in intensity when it diminished. [Results] The data showed no difference between active or placebo groups in terms of pain, numbness/tingling, frequency of symptoms or impact on daily life activities. [Conclusion] These results suggest that Transcutaneous Electrical Nerve Stimulation applied in the frequency variation mode was not proven to be effective to improve the symptoms of Chemotherapy-induced Peripheral Neuropathy during chemotherapy cycles. There was no worsening of symptoms in subsequent cycles of the onset of symptoms of the disease.

[Purpose] The aim of this study was to examine the effects of horse-riding simulator exercise on gait ability and muscle strength, muscle activation in elderly with knee osteoarthritis. [Subjects and Methods] Thirty elderly patients with knee osteoarthritis were recruited, a horse-riding simulator group consisted of fifteen subjects and they performed exercise three times a week for eight weeks. And each exercise was performed, horse riding simulator exercise for 15 minutes and knee strengthening exercise for 15 minutes. Knee strengthening exercise group consisted of fifteen subjects and performed knee strengthening exercise for 30 minutes. [Results] The horse-riding simulator group showed significant differences after the intervention in timed 10-meter walk test (10MWT), muscle strength, muscle activation. [Conclusion] The results of this study indicate that horse-riding simulator exercise is effective on knee osteoarthritis. Therefore, horse-riding simulator exercise can be used for gait training for knee osteoarthritis.

[Purpose] Postural assessment and correction is a common approach in patient management to decrease symptoms and improve function for patients. The purpose of this study was to determine the effects of high-power posing on muscle strength and pain threshold. [Subjects and Methods] Thirty-one subjects, 16 females and 15 males, mean age 28.9 (SD 10.8) years old, were recruited through a convenience sampling on the university campus. The research design was a randomized controlled trial. In the experimental group, the subjects were instructed to stand in a high-power posture. In the control group, the subjects were instructed to stand in a low-power posture. Grip strength and pain threshold measurements were conducted before and after the postural intervention. [Results] The grip strength changed by −3.4 (−3.7, 0.3) % and 1.7 (−3.6, 5.3) % for the experimental and control groups, respectively. The pain threshold changed by 0.6 (−9.9, 10.4) % and 15.1 (−9.3, 24.4) % for the experimental and control groups, respectively. However, both changes were not significant as all the 95% CIs included 0. [Conclusions] The data did not show significant benefits of high-power posing in increasing grip strength and pain threshold compared to low-power posing.

[Purpose] The purpose of this study is to assess the influence of tool holding on brain activities during motor imagery in two tasks: imagining the movement of writing the alphabet while holding a pen and without holding the pen. [Subjects and Methods] Eleven healthy right-handed adults performed two tasks, holding a pen and not holding the pen during imagining the movement of writing the alphabet using a pen. Regions of targets were Brodmann areas 6 which were a motor-related region, 44/45 and 39/40 which taken on the role of forming the body schema. Change of the oxygenation state of hemoglobin associated with brain activity were acquired using a near-infrared spectroscopy. [Results] When using their dominant right hands, task-related increases in oxy-Hb were prominent in Brodmann areas 44/45 and 39/40 when imagining writing while actually holding the pen than when not. When using the non-dominant left hands, there were no significant differences between the two conditions in the same areas. [Conclusion] These results suggest that the tool held can be incorporated into the body schema in the motor imagery of an automated tool use task. Therefore, tool holding during motor imagery might be more effectively influence during rehabilitation.

[Purpose] The purpose of this research is to investigate the effect of the method of bridge exercise on the change of rectus abdominis muscle and the muscle activity of paraspinal muscles while doing treadmill walking with high heels. [Subjects and Methods] The subjects of this research are healthy female students consisting of 10 persons performing bridge exercises in a supine group, 10 persons performing bridge exercises in a prone group, and 10 persons in a control group while in S university in Busan. Bridge exercise in supine position is performed in hook lying position. Bridge exercise in prone position is plank exercise in prostrate position. To measure the strength of rectus abdominis muscle, maintaining times of the posture was used. To measure the muscle activity of paraspinal muscles, EMG (4D-MT & EMD-11, Relive, Korea) was used. [Results] The strength of rectus abdominis muscle of both bridge exercises in the supine group and bridge exercises in the prone group increases significantly after exercise. The muscle activity of paraspinal muscle such as thoracic parts and lumbar parts in bridge exercises in the prone group decreases statistically while walking on a treadmill with high heels. Muscle activity of thoracic parts paraspinal muscle and bridge exercises in the supine group decreased significantly. [Conclusion] According to this study, we noticed that bridge exercise in a prone position is desirable for women who prefer wearing high heels as a back pain prevention exercise method.

[Purpose] The purpose of this study was to investigate the effects of taekwondo training on cognitive function and academic self-efficacy in children. [Subjects and Methods] Thirty-five children participated in the study. Seventeen children were randomly selected to undergo taekwondo training for 16 weeks (5 times per week). As controls, 18 children received no training. Cognitive function and academic self-efficacy were measured using the Stroop Color and Word Test (Word, Color, and Color-Word) and academic self-efficacy scale (Self-confidence, Self-regulatory Efficacy, and Task Difficulty Preference), respectively. [Results] In the taekwondo group, the Color-Word and Self-confidence scores increased significantly after intervention as compared to those before intervention. [Conclusion] It is suggested that regular taekwondo training may be effective for enhancing cognitive function and academic self-efficacy in growing children.

[Purpose] The present study aimed to investigate the discriminative validity of the short-form activities-specific balance confidence scale (ABC scale) in predicting falls, and its validity. [Subjects and Methods] 43 stroke survivors were identified as a group with a history of multiple falls (faller group) and a group without or with a history of one falls (non-faller group). The balance confidence was examined using the ABC scale and the short-form ABC scale. Functional abilities were examined with Fugl-Meyer assessment, sit-to-stand test, and Berg balance scale. [Results] The area under the curve of the ABC scale and the short-form ABC scale in predicting fall was>0.77. This result indicates that both examination tools have discriminative validity in predicting falls. Although both tools showed an identical predictable specificity of 72% in the non-faller and faller groups, the short-form ABC scale exhibited a predictable sensitivity of 86% in the faller group, which is higher than that of the ABC scale (71%). [Conclusion] Results of this study showed that the short-form ABC scale is an efficient clinical tool to evaluate and predict the balance confidence of stroke survivors.

[Purpose] The ratio of step length to cadence (walk ratio) is invariant over a wide range of speeds. However, no studies have investigated details of the change in the walk ratio at slow speeds. It is necessary to explore how walking behavior changes at a low speed to understand the slow walking observed in various conditions such as aging and pathological conditions. In this study, changes in the walk ratio at slow speeds were investigated, and a lower boundary was estimated at which the walk ratio constancy is broken. [Subjects and Methods] Twenty-one healthy adults were instructed to walk along a flat, straight walkway at five different speeds (fast, preferred, slightly slow, slow, and very slow). The walk ratio was calculated from the step length and cadence. [Results] As the walking speed decreased, the walk ratio and variance began to increase abruptly. The initial break in the walk ratio constancy was at approximately 62 m/min. In addition, the boundary of cadence was approximately 98 m/steps/min. [Conclusions] The study successfully determined a lower boundary at which the walk ratio constancy was broken, suggesting that different control strategies are used when walking at less than the gait speed at which constancy is broken in healthy adults. The finding provides valuable information for understanding slow walking observed in individuals with various pathological conditions.

[Purpose] The purpose of the present study was to examine the intrarater reliability and intrarater reliability of lateral scapular slide tests among young females. [Subjects and Methods] A total of 60 female students in U University in Gyeongsangbuk-do, South Korea participated in this study. Lateral scapular slide tests (LSST) were conducted to identify interrater & intrarater reliability. In the LSSTs, the distance from the inferior angle of the scapula to thoracic vertebral spinous process T8 was measured in three positions (shoulder joint 0°, 45°, and 90° abduction) using tape measures. [Results] Intrarater reliability is shown to be moderate with scores not lower than 0.7 in left positions 1 and 3 and is shown to be excellent with scores not lower than 0.9 in the remaining positions. Interrater reliability is shown to be excellent with scores not lower than 0.9 in all three left and right positions. [Conclusion] LSST is sufficiently high to be accepted as an objective tool in the results of general previous studies. In addition, it can be considered useful at clinics because the measuring tool and method are simple.

[Purpose] This study aims to investigate the effects of exercise using an ergometer with swaying saddle on chronic lower back pain. [Subjects and Methods] Thirty-three normal adults (university students) with chronic lower back pain were randomly recruited. The flexibility and strength of muscles were measured before and after an 8-week intervention. Belly-bike, an ergometer with a swaying saddle, was used. The duration of intervention was 30 minutes a day, 3 times a week. To measure the level of pain, visual analogue scale (VAS) and Korean Oswestry Disability Index were used. In addition, flexibility tests such as straight leg raising and forward reaching test in the long sitting posture were used to confirm back muscle shortness. Activations of the erector spinae muscle, gluteus medius muscle, rectus femoris muscle, and vastus lateralis muscle were also measured by electromyography before and after the intervention. Electromyography of muscles around the pelvis was performed and functional tests were conducted. [Results] The flexibility and strength of the muscles significantly increased post-intervention. Functional test scores for the forward reaching test and straight leg raising test significantly improved in the Belly-bike group. [Conclusion] The results show that exercise using the Belly-bike could be effective in reducing lower back pain.

[Purpose] While primary motor cortex activation has been implicated as a key factor in the arthrogenic muscle inhibition after knee joint injury, no viable rehabilitation protocol has been developed to accommodate this factor. In this study, transcranial magnetic stimulation was applied as a means of dissipating arthrogenic muscle inhibition by introducing temporary motor cortex excitation prior to the rehabilitation. [Subjects and Methods] Twenty-four subjects who have underwent the surgery due to knee injury were recruited, and randomly assigned to the control or the simulation groups. The levels of electromyography signals during the maximum voluntary contraction of the quadriceps muscle before, during, and after training designed for the quadriceps strength rehabilitation were measured. [Results] When compared to controls, subjects who received the transcranial magnetic stimulations showed significantly increased levels of voluntary muscle contraction after the training. Moreover, the beneficial effect of the stimulation increased as the rehabilitation progressed. [Conclusion] Transcranial magnetic stimulation itself does not directly improve the symptoms related to knee injuries. However, the use of this technique can provide a time window for effective intervention by dissipating the unwanted effect of the arthrogenic muscle inhibition during rehabilitation.

[Purpose] To clarify the features associated with decrements in compound muscle action potentials (CMAP) during slow-rate repetitive nerve stimulation (RNS) of muscles involved in amyotrophic lateral sclerosis (ALS) in mainland China. [Subjects and Methods] A retrospective study of decremental responses to slow-rate RNS was performed to compare patients with ALS to those with myasthenia gravis (MG). [Results] A significant decrement (>5%) was observed in at least one muscle in 54% of ALS patients. The trapezius muscle was the most commonly affected (67%). In the ALS group, the CMAP amplitude evoked by the first stimulus was negatively correlated with the CMAP decrement in ulnar but not accessory nerves. Additionally, a positive decrement was associated with disease progression but not gender, age at onset, disease duration, region of onset, ALSFRS-R scores, or ALS diagnostic subgroup in ALS. Furthermore, the incidence of positive decrements and the decremental percentages were significantly higher in myasthenia gravis (MG) than in ALS. [Conclusions] The lower CMAP amplitude by the first RNS stimulus was more likely to induce a positive decrement in the ulnar nerve in ALS patients. The positive decremental responses to RNS observed in ALS indicate the faster progress of the disease, which is helpful for evaluating prognoses.

[Purpose] To determine the effects of a combined physical activity, arts and crafts, and recreational program on the activities of daily living (ADL), cognitive function, and depression in the elderly. [Subjects and Methods] Twenty-eight elderly persons aged 65 years or older who live in P City, South Korea participated in a program combining arts and crafts and physical and recreational activities, twice weekly for eight weeks (a total of 16 sessions). The subjects’ ADL, cognitive function, and depression were measured before and after the program using the following assessment instruments: the FIM, MMSE-K, and BDI, respectively. [Results] The results showed that, after the program intervention, ADL were remarkably improved for both men and women, cognitive function increased considerably, and depression levels significantly decreased, especially for elderly women. [Conclusion] The results of the present study indicate that a program combining physical and recreational activities, as well as arts and crafts, had positive effects on the health of the elderly and provide evidence for managing their health.

[Purpose] To examine if the SPPB is higher with healthy subjects than outpatients, which was higher than inpatients and if the SPPB can be validated assessment tool for strength tests and lower extremity morphological evaluation in cardiovascular disease patients. [Subjects and Methods] Twenty-four middle aged and older adults with cardiovascular disease were recruited from inpatient and outpatient facilities and assigned to separate experimental groups. Twelve age-matched healthy volunteers were assigned to a control group. SPPB test was used to assess balance and functional motilities. The test outcomes were compared with level of care (inpatient vs. outpatient), physical characteristics, strength and lower extremity morphology. [Results] Total SPPB scores, strength tests (knee extensor muscle strength), and lower extremity morphological evaluation (muscle thickness of anterior and posterior mid-thigh and posterior lower-leg) were greater in healthy subjects and outpatients groups compared with inpatients. To predict total Short Physical Performance Battery scores, the predicted knee extension and anterior mid-thigh muscle thickness were calculated. [Conclusion] The SPPB is an effective tool as the strength tests and lower extremity morphological evaluation for middle-aged and older adult cardiovascular disease patients. Notably, high knee extensor muscle strength and quadriceps femoris muscle thickness are positively associated with high SPPB scores.

[Purpose] The purpose of this study was to examine the reliability of ultrasound measurements by analyzing the relative reliability and absolute reliability when measuring soft tissue thickness around the shoulder joint. [Subjects and Methods] Eleven healthy young adults (22 shoulders) participated in this study. Thickness of the supraspinatus tendon, subacromial bursa, and biceps tendon was measured on both shoulders. This protocol was performed twice in the same day. The relative reliability of ultrasound measurement was evaluated using the intraclass correlation coefficient for determining the degree of consistency and agreement between two measures. The absolute reliability of the ultrasound measurement was evaluated using the standard error of measurement, minimum detectable change, and Bland-Altman analysis. [Results] Ultrasound measurements exhibited high relative reliability: intraclass correlation coefficients for the supraspinatus tendon, subacromial bursa, and biceps tendon thickness were demonstrated to be 0.91, 0.82, and 0.90, respectively. Bland-Altman analyses revealed no significant systematic bias between the repeated measurements for the supraspinatus tendon, subacromial bursa, and biceps tendon thickness. [Conclusion] These findings suggest that ultrasound measurement for the supraspinatus tendon, subacromial bursa, and biceps tendon thickness exhibited good relative reliability and no systematic errors were detected regarding their absolute reliability.

[Purpose] The purpose of the present review is to discuss recent published articles in the understanding of efficacy of interventional exercise on autistic Fragile X syndrome (FXS) with special emphasis on its significance in clinical application in patients. [Methods] This review article was identified scientifically and/or clinically relevant articles from PubMed that directly/indirectly met the inclusion criteria. [Results] Mutation of fragile X mental retardation 1 (fmr1) gene on the X chromosome is related with loss of fragile X mental retardation protein (FMRP) that affecting physiological and behavioral abnormalities. Autistic FXS individuals exhibit disturbed sleep and altered circadian behavior. Although the underlying molecular mechanisms are not been fully explored, interventional exercise in autistic FXS has been clinically used for the treatment of physiological and behavioral abnormalities as well as psychiatric disorder in autistic FXS. [Conclusion] This review describes beneficial efficacy of interventional exercise and its controversy in patients with autistic FXS. This review also provides interventional strategies for clinicians and scientists that the way of neurophysiological approaches according to the level of physical and behavioral abnormalities.

[Purpose] To report an adolescent male basketball player with nonhealing stress fractures of the foot and discuss the probable factors. [Subject and Methods] A 13-year-old basketball player presented with right foot pain. He had been playing basketball for three years and practicing 5 days/week. He denied any increase in daily training intensity. Magnetic resonance imaging confirmed stress fractures of the cuboid and cuneiform, with mild edema of the soft tissues between the tarsal bones and tenosynovitis of the flexor hallucis and flexor digitorum longi. The foot was immobilized for 4 weeks, with progressive weight bearing introduced at the fifth week. At the 6th week, while still restricted to partial weight bearing, he reported diffuse severe pain. The entire foot was painful with palpation, and new imaging showed stress fractures of the talus, cuboid, cuneiform, and proximal first metatarsal bones, and tenosynovitis of the flexor hallucis longus and flexor digitorum longus tendons with progression of the soft tissue edema around the tarsal bones. Acute phase reactants were elevated; vitamin K level was low. [Results] He started participating in games again at the 6th month post-injury. [Conclusion] Management of patients with stress fractures includes immobilization, physical therapy, and biomechanical arrangements. If the expected healing does not occur, a deficiency of vitamin K might be considered as a factor. Questioning on dietary habits of the patient and encouraging adequate intake of the deficient nutrient might assist in the healing process.

[Purpose] This study report a case of a patient with hemiparetic stroke who showed significantly reduced foot pain when ankle spasticity was reduced using nerve and motor point blocks with 20% ethyl alcohol. [Subject and Methods] A 58-year-old woman with left hemiparesis following intracranial hemorrhage five years previously presented with pain in the left fifth metatarsal head for two years (numeric rating scale[NRS]: 8). Erythema and edema were observed on the lateral aspect of the head of the fifth metatarsal bone. She was diagnosed with a Tailor’s bunion. Spasticity was observed in the left ankle plantar flexor and ankle supinator (Modified Ashworth Scale: 1+). Using 20% ethyl alcohol, a block in the medial and lateral motor branches to the gastrocnemius muscle of the left tibial nerve and the motor point of the left posterior tibialis muscle was performed. [Results] After the alcohol block, spasticity had almost disappeared and foot pain was significantly reduced (NRS: 1). Results from the foot pressure measurement system test showed foot contact pressure was highly distributed to the lateral forefoot pre-block. After the block, the distribution of foot contract pressure was similar to normal distribution. [Conclusion] Clinicians should consider the possibility that spasticity can contribute to foot pain.

[Purpose] The purpose of this case series was to examination the effects of trunk and neck stabilization exercise on the static, dynamic trunk balance abilities of children with cerebral palsy. [Subjects and Methods] The study included 11 school aged children diagnosed with paraplegia due to a premature birth. Each child engaged in exercise treatments twice per week for eight weeks; each treatment lasted for 45 minutes. After conducting a preliminary assessment, exercise treatments were designed based on each child’s level of functioning. Another assessment was conducted after the eight weeks of treatment. [Results] The Trunk Control Measurement Scale evaluation showed that the exercise treatments had a significant effect on static sitting balance, selective movement control, dynamic reaching, and total Trunk Control Measurement Scale scores. [Conclusion] The results indicate that neck and trunk stabilization exercises that require children’s active participation are helpful for improving static and dynamic balance ability among children diagnosed with cerebral palsy.

[Purpose] This study aimed to investigate the effects of multisensory dynamic balance training on muscles thickness such as rectus femoris, anterior tibialis, medial gastrocnemius, lateral gastrocnemius in children with spastic diplegic cerebral palsy by using ultrasonography. [Subjects and Methods] Fifteen children diagnosed with spastic diplegic cerebral palsy were divided randomly into the balance training group and control group. The experimental group only received a multisensory dynamic balance training, while the control group performed general physiotherapy focused balance and muscle strengthening exercise based Neurodevelopmental treatment. Both groups had a therapy session for 30 minutes per day, three times a week for six weeks. The ultrasonographic muscle thickness were obtained in order to compare and analyze muscle thickness before and after in each group. [Result] The experimental group had significant increases in muscle thickness in the rectus femoris, tibialis anterior, medial gastrocnemius and lateral gastrocnemius muscles. The control group had significant increases in muscle thickness in the tibialis anterior. The test results of the rectus femoris, medial gastrocnemius and lateral gastrocnemius muscle thickness values between the groups showed significant differences. [Conclusion] In conclusion, a multisensory dynamic balance training can be recommended as a treatment method for patients with spastic diplegic cerebral palsy.

[Purpose] The purpose of this study is to investigate the effect of hippotherapy exercise on the thickness of deep abdominal muscles and daily activities of children with intellectual disabilities. [Subjects and Methods] Seven children with intellectual disabilities were treated with hippotherapy for 30 minutes twice a week for 6 weeks. The thickness of deep abdominal muscles and Functional Independence Measure (FIM) of the subjects were measured by ultrasonography before and after the experiment. [Results] There was no significant change in the thickness of the External Oblique and Internal Oblique muscles, but there was a statistically significant change in Transverse Adbominis thickness and FIM score after treatment compared to before treatment. [Conclusion] Hippotherapy exercise has a positive effect on the improvement of Transverse Abdominis (TrA) and activity of daily livings of children with intellectual disabilities.