[Purpose] The aim of this study was to compare the effects of “McGill stabilization exercises” and “conventional physiotherapy” on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.

[Purpose] The aim of this study was to determine the effect of short-term self-joint mobilization of the upper spine using a Kaltenborn wedge on the pain and cervical dysfunction of patients with neck pain. [Subjects and Methods] Twenty-seven patients with neck pain were divided into two groups; the self-mobilization group (SMG, n=13) and the self-stretching group (SSG, n=14). The SMG performed upper thoracic self-mobilization and the SSG performed self-stretching exercises as a short-term intervention for a week. To assess the degree of neck pain, the visual analog scale (VAS) was utilized, and to measure the joint range of motion at the flexion-extension, it was compared and analyzed by using the goniometer. [Results] Both SMG and SSG show a significant decrease in the visual analog scale and a significant increase in joint range of motion within the group. In the comparison of groups, there was no significant difference, but it indicated effects on improving the range of motion of extension in SMG. [Conclusion] Self-mobilization of the upper spine, using a Kaltenborn wedge, was useful in alleviating pain in and dysfunction of the cervical spine, and in particular, in improving cervical spine extension in this study.

[Purpose] The purpose of the present study was to confirm the relationships between shoulder strength (extensor strength and internal rotator strength) of the abducted position and swimming power during arm-only swimming. [Subjects and Methods] Fourteen healthy male collegiate swimmers participated in the study. Main measures were shoulder strength (strength using torque that was calculated from the upper extremity length and the isometric force of the abducted position) and swimming power. [Results] Internal rotation torque of the dominant side in the abducted external rotated position (r=0.85) was significantly correlated with maximum swimming power. The rate of bilateral difference in extension torque in the maximum abducted position (r=−0.728) was significantly correlated with the swimming velocity-to-swimming power ratio. [Conclusion] The results of this study suggest that internal rotator strength measurement in the abducted external rotated position and extensor strength measurement in the maximum abducted position are valid assessment methods for swimmers.

[Purpose] The purpose of this study was to investigate the effects of regular Taekwondo training on mood state in children from multicultural families. [Subjects and Methods] Twenty-four children participated in the study. Eight children from non-multicultural families were assigned to the non-multicultural family children group. The remaining 16 children from multicultural families were randomly assigned to the multicultural family children (control, n=8) or multicultural family children trained in Taekwondo (Taekwondo training, n=8) group. Mood state was measured using the Profile of Mood States (Tension-Anxiety, Depression-Dejection, Anger-Hostility, Vigor-Activity, Fatigue-Inertia, and Confusion-Bewilderment). [Results] Vigor-Activity scores increased significantly, whereas Tension-Anxiety and Anger-Hostility scores decreased significantly after intervention when compared with the pre-intervention scores in the multicultural family children trained in Taekwondo group. [Conclusion] It is suggested that regular Taekwondo training may be effective in improving the mood states of children from multicultural families living in Korea.

[Purpose] This study clarified differences in players’ contributions to the team’s score in female wheelchair basketball at the 2016 Rio Paralympics by physical capacity classification, and examined the roles required in the team. [Subjects and Methods] This study used stats (record of play contents) for players who played for more than 20 minutes from the official box scores of all 31 games at the 2016 Paralympics. Players were divided into three groups by physical capacity classification: low, middle, and high. The average stats for each group were compared and the covariance structure was analyzed to determine the role of each group during the game. [Results] Comparisons showed that the higher the class, the higher the value of many stats items. Important elements were defensive rebound, steal, and turnover in the low group; and score, offensive rebound, and turnover in the high group. [Conclusion] Players in the high group have more plays related to the ball. Those in the low group should increase the numbers of steals and defensive rebounds and reduce turnover. High group players are required to have scoring ability, acquire offensive rebound, and reduce turnover.

[Purpose] This study was to investigate differences in the level of activity of the external oblique (EO), internal oblique (IO), and multifidus (MF) muscles with deep breathing in three sitting postures. [Subjects and Methods] Sixteen healthy women were recruited. The muscle activity (EO, IO, MF) of all subjects was measured in three sitting postures (slumped, thoracic upright, and lumbo-pelvic upright sitting postures) using surface electromyography. The activity of the same muscles was then remeasured in the three sitting postures during deep breathing. [Results] Deep breathing significantly increased activity in the EO, IO, and MF compared with normal breathing. Comparing postures, the activity of the MF and IO muscles was highest in the lumbo-pelvic upright sitting posture. [Conclusion] An lumbo-pelvic upright sitting posture with deep breathing could increase IO and MF muscle activity, thus improving lumbo-pelvic region stability.

[Purpose] This study aimed to assess the known-groups validity of the estimated metabolic equivalents during physical activities using accelerometer, Active Style Pro HJA 350-IT, in people with subacute stroke. [Subjects and Methods] Ten participants with subacute stroke and ten healthy people performed six activities (lying, sitting, standing, sitting with reaching task, standing with reaching task, and walking) and metabolic equivalents were estimated using the accelerometer during each activity. These estimated metabolic equivalents were compared with reported metabolic equivalents through compendiums or previous studies. Additionally, the estimated metabolic equivalents were compared between subacute stroke and healthy control participants. [Results] The estimated metabolic equivalents of both groups during maintaining posture showed significantly lower values in comparison with previous studies. There were no significant differences between the estimated metabolic equivalents during sitting with reaching tasks or standing with reaching tasks when compared with compendium metabolic equivalents across both groups. The estimated metabolic equivalents during walking were inevitable values significantly differed from previous study which conducted with stroke patients with lower gait abilities in both groups. [Conclusion] The estimated metabolic equivalents using accelerometer may be suitable to assess movement activity rather than motionless activity, and accelerometer demonstrated acceptable validity in people with subacute stroke.

[Purpose] The purpose of this study was to clarify the relationships between falls and sections of the Balance Evaluation Systems Test (BESTest) in patients with stroke or those with a history of fracture. [Subjects and Methods] This longitudinal study included 51 self-ambulatory inpatients. Balance was assessed 1 week prior to discharge using the BESTest, and the incidence of falls within 6 months after discharge was investigated. Relationships between falling and balance components were analyzed using the t-test or the Mann-Whitney U test and receiver operating characteristic (ROC) curve analysis. [Results] Five subjects were dropped out before follow-up at 6 months. Falls were reported by 10 of the remaining 46 participants. Scores for two sections (Anticipatory Postural Adjustments and Sensory Orientation) were significantly lower in fallers than in non-fallers with stroke. Four of the six sections (Biomechanical Constraints, Anticipatory Postural Adjustments, Sensory Orientation, and Stability in Gait) showed areas under the ROC curves >0.8 (0.82, 0.83, 0.84, and 0.81, respectively). In patients with a history of fractures, all sections were not significantly different between fallers and non-fallers. [Conclusion] Anticipatory Postural Adjustments and Sensory Orientation sections of the BESTest were related to future occurrence of fall after discharge in self-ambulatory stroke patients.

[Purpose] The general approach for flat foot (FF) treatment in people with Down’s syndrome (DS) is the use of insoles. However, the appropriate timing of the first insole prescription remains unclear. An aim of this present research was to investigate the status of prevalence of FF and orthosis prescription in the DS population. [Subjects and Methods] Two hundred fifteen subjects with DS who were seen at our hospital were retrospectively investigated. Investigated parameters were: prevalence of FF and other foot diseases, ratio and timing of orthopaedic consultation, ratio and timing of orthoses prescription, and mean age at the time of orthosis prescription. [Results] The prevalence of FF was 27.0% (58 subjects), and 50 subjects (23.3%) consulted an orthopaedic surgeon. An orthosis was prescribed for 54 subjects; 88.9% of these orthoses were insoles. Foot and leg orthoses other than insoles were prescribed significantly more frequently for females than males. The mean ages at the time of the first prescription of all types of orthoses and an insole were 7.3 years and 6.4 years, respectively. [Conclusion] The prevalence of FF was low, and the age at which subjects with DS were prescribed an orthosis was relatively high at our institution compared to previous reports. Since physical therapists see patients who could potentially have FF, those with suspected FF should then be referred to an orthopaedic doctor, which would enable the earlier orthosis prescription.

[Purpose] The purpose of this study was to investigate the measurement method and parameters to simply evaluate the condition of the knee that are necessary for preventing locomotive syndrome as advocated by the Japan Orthopedic Association. [Subjects and Methods] The subjects installed acceleration sensors in lateral condyles of the tibia and measured acceleration and load under the conditions of walking on a flat ground and walking using stairs; the difference between the impulse of impact forces (acceleration × load) of the two knees was defined as a simple evaluation parameter. [Results] Simple evaluation parameters were not correlated with age during walking on a flat ground, but during walking using stairs, it was almost flat up to the age of 20–40 years, and after the age of 49 years, based on the quadratic curve approximation (R²=0.99), a correlation of simple evaluation parameters with age could be confirmed. [Conclusion] The simple evaluation parameter during walking using stairs was highly correlated with age, suggesting a contribution to preventing locomotive syndrome by improving reliability. In the future, we plan to improve reliability by increasing the data, and establish it as a simple evaluation parameter that can be used for preventing locomotive syndrome in elderly people and those with KL classification grades 0–1.

[Purpose] The purpose of this study was to investigate the linear relationship between the thoracolumbar flexion angle and hip posterior displacement. [Subjects and Methods] This study was performed on 15 subjects. The subjects performed three trials of a lumbar flexion–extension task. To quantify the statistical linear relationship between the thoracolumbar flexion angle and hip posterior displacement, Spearman’s rank correlation coefficient was used. [Results] The thoracolumbar flexion angle was significantly correlated with the degree of hip posterior displacement. [Conclusion] According to the results of this study, movement of the thoracolumbar joint and posterior movement of the pelvis must be considered for accurate analysis of the lumbopelvic rhythm.

[Purpose] This study examines the effects of the flexion-distraction technique and the drop technique on disorders and on Ferguson’s angle in female patients with lumbar intervertebral disc herniation. [Subjects and Methods] Thirty female patients with lumbar intervertebral disc herniation were divided into an experimental group (n=15) treated with flexion-distraction and drop techniques and a control group (n=15) treated with spinal decompression therapy. Both groups were treated three times a week over an eight-week period. [Results] In the comparison of changes within each group after treatment, both groups showed statistically significant decreases in disorders and in Ferguson’s angle. [Conclusion] Flexion-distraction and drop techniques may be an effective intervention to improve disorders and Ferguson’s angle in female patients with lumbar intervertebral disc herniation.

[Purpose] The purpose of this study was to examine the correlation between the quadriceps angle and muscle-activation ratios for the vastus medialis, rectus femoris, and vastus lateralis during various activities. [Subjects and Methods] Seventeen heathy females were recruited. The quadriceps angles were measured with long-arm goniometers. The muscle activity of the vastus medialis, rectus femoris, and vastus lateralis were measured using electromyography under four different activity settings: walking, squatting, step-up, and sit-to-stand. The muscle activation ratios were calculated and their correlations with the quadriceps angles were analyzed. [Results] The activation ratio of the rectus femoris to the vastus medialis (and, although less significant, of the vastus lateralis to the vastus medialis) was positively correlated with the quadriceps angle during the step-up and sit-to-stand. A similar tendency was also seen during squatting. The activation ratio of the vastus lateralis to the rectus femoris was negatively correlated with the quadriceps angle during walking. [Conclusion] The relative muscle activity among the muscles composing the quadriceps was correlated with the quadriceps angle. During activities involving deeper knee flexion like the step-up, sit-to-stand, and squatting, the relative activity of the lateral muscles tended to increase as the quadriceps angle increased. Meanwhile, during walking the activity of the medial muscles seemed to increase with a larger quadriceps angle.

[Purpose] Pelvic floor muscle training is a first-line therapy for female stress urinary incontinence. Previous studies have suggested that the coccyx tip moves ventrally and cranially during pelvic floor muscle contraction. The study aimed to elucidate the influence of adequate pelvic floor muscle contraction on coccyx movement. [Subjects and Methods] Sixty-three females (57 patients with stress urinary incontinence and additional 6 healthy volunteers) were enrolled. Using magnetic resonance imaging, coccyx movement was evaluated during pelvic floor muscle contraction and strain. An adequate contraction was defined as a contraction with good Oxford grading scale [≥3] and without inadequate muscle substitution patterns. [Results] Inadequate muscle substitution patterns were observed in 33 participants (52.4%). No significant difference was observed in the movement of the coccyx tip in the ventrodorsal direction between females with and without inadequate muscle substitution patterns. However, a significant increase in the movement of the coccyx tip in the cranial direction was detected in the group without inadequate muscle substitution patterns. Compared to participants with inadequate pelvic floor muscle contraction, those who had adequate pelvic floor muscle contraction exhibited significantly increased cranial movement of the coccyx. [Conclusion] Adequate pelvic floor muscle contraction can produce cranial movement of the coccyx tip.

[Purpose] To determine the effects of a 12-week intervention consisting of marching in place and chair rising daily exercise on activities of daily living and functional mobility (ability to quickly rise from a chair and walk) in frail older adults. [Subjects and Methods] Thirty-one participants were divided into exercise (n=18, age=77.6 ± 7.2 years; 11 males, 7 females) and non-exercise (n=13, age=79.6 ± 7.7 years; 7 males, 6 females) groups. The exercise group performed 12 weeks of training, 7 days per week, and 20 minutes per session. The exercise program consisted of low to moderate intensity marching in place and chair rising movements. The speed of movements was gradually increased over time. The Barthel index, mean power during chair stand, and time to complete a 10-m walk were assessed before and after the intervention. [Results] Significant improvements were noted in the exercise group compared to the non-exercise group for the Barthel Index (11.6%), mean power (33%), and 10-M walk (14.6%) with a medium effect size, and relative mean power (power/body mass) (32.9%) with a large effect size. [Conclusion] The progressive marching in place and chair rising exercise intervention appears to be effective in improving activities of daily living and functional mobility among frail older adults.

[Purpose] The aim of this study was to investigate the feasibility of using exergames as a rehabilitation tool by determining the attitudes, awareness, opinions and experiences of physiotherapists, and older people towards exergames. [Subjects and Methods] A cross-sectional study was conducted and two short self-developed questionnaires (for physiotherapists and older people) were distributed in three hospitals in Cork (Ireland) to assess the attitudes towards and familiarity with exergames among physiotherapists and older people. The data were analysed using Microsoft Excel version 2013. [Results] The results show that a lot of older people have seen exergames devices but have not attempted to play them. This may indicate a lack of interest in or information about these devices and how to use them. With regard to the second group, physiotherapists underestimate older people’s knowledge about exergames. [Conclusion] Older people were not very familiar with exergames but they were willing to try them. In addition, despite physiotherapists being familiar with exergames, they see them as an additional tool that will not replace or change any traditional exercise methods.

[Purpose] The survey aimed to clarify the factors that affect physiotherapists’ job satisfaction. [Subjects and Methods] To examine factors affecting physical therapists’ job satisfaction using a cross-sectional study with a questionnaire survey. Subjects were 193 first-year physical therapists who participated in a newcomer orientation at Hiroshima Prefectural Physical Therapy Association. The questionnaire comprised items concerning physical therapists’ satisfaction with their work, motives for becoming physical therapists, education in school, internships, the workplace, and comfort in the workplace. [Results] Subjects were divided into two groups according to their satisfaction with their occupation. The “high satisfaction” group included 157 subjects, and the group “low satisfaction” group included 36 subjects. Using logistic regression analysis, items concerning comfort in the workplace, motives for becoming physical therapists, and learning in school were analysed. [Conclusion] Factors affecting physical therapists’ job satisfaction were primarily influenced by previous experience and working conditions.

[Purpose] The purpose of this study is to evaluate differences in trunk muscle activity after 4 weeks of trunk stabilization exercises performed under expiration and inspiration conditions. [Subjects and Methods] Thirty subjects were assigned randomly to an expiration group (n=15) or an inspiration group (n=15). The outcomes measured were magnitude of muscle activation (rectus abdominis, multifidus, internal oblique and external oblique) in the bridge position and performance on a trunk muscle endurance test. Paired t-tests were used to assess the statistical significance of the effects of the trunk stabilization exercise program within each group. [Results] Comparison of the electromyography activity of the trunk muscles revealed a significant increase in internal oblique activation in the inspiration group, and a significant increase in multifidus activation in the expiration group. Assessment of the endurance of the trunk muscles revealed a significant increase in both groups. [Conclusion] Our results showed that expiration during trunk stabilization exercises increased the activity of the multifidus muscle, while inspiration enhanced the activity of the internal oblique muscle. Different types of respiration seem to differentially affect trunk muscles during trunk stabilization exercises.

[Purpose] The objective of this study was to determine the effect of pulsed high intensity laser therapy on delayed caesarean section healing in diabetic women. [Subjects and Methods] This study was conducted on forty diabetic women with delayed caesarean wound healing, ranging in age from 28 to 38 years. They were randomly assigned into two groups; the group I (n=20) received pulsed high intensity laser therapy for 6-weeks, 3 times per week plus standard medical treatment for treatment of diabetes and caesarean wound patients, the group II (n=20) received sham laser treatment for 6 weeks, 3 times per week plus standard medical treatment for treatment of diabetes and caesarean wound patients. The wound size and appearance in all participants were measured by the tracing method and pressure sore status tool before and after the 6-week treatment. [Results] Pulsed high intensity laser therapy produced a significant difference in wound size and appearance in comparison to the sham laser treatment in diabetic women with delayed caesarean wound healing. [Conclusion] Pulsed high intensity laser therapy is effective in the treatment of delayed caesarean section healing in diabetic women.

[Purpose] To investigate the effect of night splints on the standing motor function and ankle dorsiflexion angles of patients with Duchenne muscular dystrophy (DMD). [Subjects and Methods] Nine boys (age <11 years) with DMD were divided into the sufficiently-wearing group and the insufficiently-wearing group, according to how often they wore their splint for one year. We evaluated the changes between the pre-implementation and the one-year-after assessments of both the sufficiently-wearing group and the insufficiently-wearing group for the ankle dorsiflexion angle, North Star Ambulatory Assessment, 10-m running time, and time to stand from the floor. [Results] Only the left dorsiflexion angle of the ankle showed significantly difference for the sufficiently-wearing group. For other indicators, there were tendency toward improvement and maintenance in the sufficiently-wearing group. [Conclusion] The standing motor function improved significantly in some patients in the sufficiently-wearing group, suggesting that wearing night splints may promote the improvement and/or maintain of standing motor function in patients with DMD.

[Purpose] This study aimed to assess whether robotic rehabilitation can improve upper limb function, activities of daily living performance, and kinematic performance of chronic stroke survivors. [Subjects and Methods] Participants were 21 chronic stroke survivors (19 men; 60.8 years; Mini-Mental State Examination score: 28; onset duration: 10.2 years). Training exercises were performed with a Whole Arm Manipulator and a 120-inch projective display to provide visual and auditory feedback. Once the training began, red and grey balls appeared on the projective display, and participants performed reaching movements, in the assist-as-needed mode, toward 6 directional targets in a 3-dimensional space. All participants received training for 40 minutes per day, thrice per week, for 6 weeks. Main outcome measures were upper limb function (Fugl-Meyer Assessment, Action Research Arm Test, and Box and Blocks Test scores), activities of daily living performance (Modified Barthel Index), and kinematic performance (movement velocity) in 6 directions. [Results] After 6 weeks, significant improvement was observed in upper limb function, activities of daily living performance, and kinematic performance. [Conclusion] This study demonstrated the positive effects of robotic rehabilitation on upper limb function, activities of daily living performance, and kinematic performance in chronic stroke survivors.

[Purpose] The purpose of this study was to compare effect in a group of stretching and a group of muscle strengthening exercise for patients with forward scapular posture. [Subjects and Methods] This study was performed in 20 subjects who defined to the forward shoulder posture. The subjects were divided into a group of pectoralis muscles stretching and a group of muscle strength exercise for scapular retraction. [Results] The forward shoulder posture of the group of the scapular retraction exercise was significantly decreased when compared to that of the group of the pectoralis muscles stretching. [Conclusion] It is expected that therapeutic effect can be improved and the period can be shortened when strength exercise for forward shoulder posture is applied as a therapeutic intervention.

[Purpose] The purpose of this study is to find the best body spots on the chest and abdomen wall to obtain the correlated indicators to the vital capacity. [Subjects and Methods] Thirty healthy male staff of the center served as the participants were advised to conduct a breathing movement using spirometer and a wearable strain sensor (WSS) respectively, which was the measured at four spots on chest and abdomen wall from maximal end of inspiration to maximal end of expiration. The Pearson’s correlation analysis was conducted to find the correlation of the data obtained respectively by the WSS and spirometer. [Results] The correlation of the mobility data at the four body spots to the vital capacity data were calculated for each level by means of Pearson’s correlation coefficient, which showed that the values at each body spot were positive significant correlations and the highest value was at the 10th rib. [Conclusion] There was a correlation between the mobility data of the chest and abdomen obtained by the WSS and the vital capacity data obtained by the spirometer, for which, the 10th rib is the best body spot to detect the positive significant correlation.

[Purpose] This study aimed to conduct experiments to examine the effects of wrist eccentric control exercise or shoulder stabilization exercises after a basic direct treatment of the elbow in the treatment of tennis elbow patients in terms of pain and grip strength. [Subjects and Methods] The subjects were divided into two groups: one group conducted wrist eccentric control exercise and was comprised of 5 male and 4 female subjects, and the other group received shoulder stabilization exercise and was comprised of 5 male and 4 female subjects. [Results] In the intragroup comparison, both groups showed a significant decrease in pain level and a significant increase in the measurement of the tenderness thresholds of the upper trapezius muscle, lateral epicondyle, and grip strength. In the intergroup comparison, the shoulder stabilization exercise group showed a significantly greater increase in the measurement of the tenderness thresholds of the upper trapezius muscle and grip strength, and the differences were not significant in the pain level and tenderness threshold of the lateral epicondyle. [Conclusion] Wrist eccentric control exercise and shoulder stabilization exercises can be useful as intervention methods for relief from pain due to lateral epicondylitis and for the improvement of functions impaired by tennis elbow.

[Purpose] The aim was to investigate the effects of university students’ smoking and aerobic exercise on metabolic syndrome risk factors. [Subjects and Methods] Twenty-three male students were randomly assigned to the following groups: exercise smoker (n=6), non-exercise smoker (n=6), exercise non-smoker (n=6), and non-exercise non-smoker (n=5). A basketball exercise program was conducted three times per week (70 minutes per session) for 8 weeks with exercise intensity set at 50–80% of heart rate reserve. After 8 weeks, the variables of risk factors for metabolic syndrome were obtained. [Results] Systolic blood pressure and diastolic blood pressure were significantly decreased in the exercise non-smoker group and significantly increased in the non-exercise smoker group. Waist circumference was significantly reduced in both exercise groups regardless of smoking and significantly increased in the non-exercise smoker group. Triglyceride, high-density lipoprotein-cholesterol, and fasting plasma glucose showed no differences between the groups. [Conclusion] Obesity and smoking management should be conducted together for students as well as for those with metabolic syndrome risk factors. It is recommended that more students participate in such programs, and exercise programs should be further developed and diversified to prevent metabolic syndrome and cardiovascular diseases.

[Purpose] The objective of the study was to examine the effects of visual cue and cognitive motor tasks on quiet standing posture center of pressure (COP) and the weight loads to the paretic and non-paretic legs in chronic stroke patients. [Subjects and Methods] Twenty chronic stroke patients were included in the study. COP total distance, sway velocity, and the weight loads to the paretic and non-paretic legs of the participants were measured while they performed a visual cue task, cognitive motor task, and dual task. The parameters were compared using a repeated three-way analysis of variance. [Results] When the visual cue was provided, the COP total distance and sway velocity were significantly reduced compared with when no visual cue was given. When the cognitive motor task was performed, the COP total distance and sway velocity decreased significantly compared to when the task was not performed. [Conclusion] These findings suggest that visual cue and cognitive motor tasks could be used as parts of a rehabilitative training program to improve the control of standing in chronic stroke patients. In addition, visual cues can be used as an intervention to train the paretic leg of stroke patients.

[Purpose] The purpose of this study was to identify the relationship between physical fitness level and academic achievement in middle school students. [Subjects and Methods] A total of 236 students aged 13–15 from three middle schools in D city, South Korea, were selected using a random sampling method. Academic achievement was measured by students’ 2014 fall-semester final exam scores and the level of physical fitness was determined according to the PAPS (Physical Activity Promotion System) score administrated by the Korean Ministry of Education. A Pearson correlation test with SPSS 20.0 was employed. [Results] The Pearson correlation test revealed a significant correlation between physical fitness and academic achievement. Specifically, students with higher levels of physical fitness tend to have higher academic performance. In addition, final exam scores of core subjects (e.g., English, mathematics, and science) were significantly related to the PAPS score. [Conclusion] Results of this study can be used to develop more effective physical education curricula. In addition, the data can also be applied to recreation and sport programs for other populations (e.g., children and adult) as well as existing national physical fitness data in various countries.

[Purpose] Exercise effects on executive functioning depend on exercise mode. We tested the effects of three acute exercises in the sitting position—stepping, stretching, and finger movement—on older adults’ executive functioning in comparison to a resting state (i.e., control condition). [Subjects and Methods] Participants were 26 healthy older adults (mean age, 71.8 ± 4.7 years). All participants performed the three sitting exercises for 10 minutes; resting for an equal amount of time was used as a control condition. These four conditions were presented in random order. The color-word matching Stroop task was used to evaluate executive function before and after the sitting exercises and control condition. [Results] All three sitting exercises significantly reduced Stroop interference scores, while the control condition did not. There was a significant difference between the finger movement exercise and the control condition in pre-to-post-intervention changes in Stroop interference scores. [Conclusion] The acute finger movement exercise was especially beneficial for executive function as evaluated by the color-word matching Stroop task.

[Purpose] Breathing exercises are frequently prescribed to reduce pulmonary complications after abdominal and thoracic surgery. Appropriate instructions ensuring the integrity of the self-exercise are important. This study compared the effects of two instructions, focusing on non-specific breathing (NB) and diaphragmatic breathing (DB) patterns, respectively, on the ventilatory efficiency and work of breathing. [Subjects and Methods] The participants were healthy men (n=15) and women (n=15). Ventilatory parameters, heart rate, and autonomic nervous system activity were measured during natural and deep breathing phases performed under the two instructions (NB and DB), with the deep breathing phase following the natural breathing phase. [Results] For both men and women, ventilatory efficiency was increased during deep breathing relative to natural breathing, regardless of the instructions. In women, the increment in ventilatory efficiency during deep breathing was greater under NB compared to that under DB. The work of breathing decreased during deep breathing in women under both instructions, but did not change in men under DB. [Conclusion] Under NB instruction, deep breathing elicits similar or greater effects on ventilatory efficiency compared to that under DB instruction.

[Purpose] Many studies have compared over-ground and treadmill walking, but the biomechanical relationship between the two gait modes is unclear. The aim of this study was to analyze differences in pelvic range of motion and lower limb muscles activity during over-ground and treadmill walking in healthy adults. Moreover, we aimed to analyze differences according to gender. [Subjects and Methods] Twenty-three healthy adults (9 men, 14 women) between 25 and 35 years of age walked at the identical speed for 30 seconds each in two difference gait modes. The pelvic range of motion were obtained by using three-axis accelerometer and lower limb muscle activation data were obtained by using wireless surface EMG. [Results] The results showed that pelvic obliquity showed a greater angular range of women than men, and the pelvic rotation decreased more in treadmill walking than over-ground walking. In the muscles activity, vastus lateralis and tibialis anterior increased, and gastrocnemius medialis decreased in treadmill walking than over-ground walking. [Conclusion] We conclude that treadmill walking reduces the range of motion of the pelvic and increases lower limb muscles activity therefore, when using treadmill for the purpose of rehabilitation at the clinic, consider this difference.

[Purpose] This study examined the effects of gum chewing while walking on physical and physiological functions. [Subjects and Methods] This study enrolled 46 male and female participants aged 21–69 years. In the experimental trial, participants walked at natural paces for 15 minutes while chewing two gum pellets after a 1-hour rest period. In the control trial, participants walked at natural paces for 15 minutes after ingesting powder containing the same ingredient, except the gum base, as the chewing gum. Heart rates, walking distances, walking speeds, steps, and energy expenditure were measured. [Results] Heart rates during walking and heart rate changes (i.e., from at rest to during walking) significantly increased during the gum trial compared with the control trial. Walking distance, walking speed, walking heart rate, and heart rate changes in male participants and walking heart rate and heart rate changes in female participants were significantly higher during the gum trial than the control trial. In middle-aged and elderly male participants aged ≥40 years, walking distance, walking speed, steps, and energy expenditure significantly increased during the gum trial than the control trial. [Conclusion] Gum chewing while walking measurably affects physical and physiological functions.

[Purpose] Few studies on the transverse arch (TA) in the forefoot have been conducted. The forefoot is where pains occur most frequently and is related to walking and balance; hence, paying attention to TA is vital. However, the relationship between TA and foot muscles has not been investigated. Therefore, this study aims to investigate muscles related to TA. [Subjects and Methods] Nineteen healthy young males were included. Measurements of their feet, excluding one foot with recent foot pain (n=37), were obtained. The height of TA (TAH) was measured in two ways: during 10% and 90% loading of body weight. The cross-sectional area and thickness of five muscles were measured: flexor digitorum longus, peroneus longus and brevis, flexor hallucis brevis, flexor digitorum brevis (FDB) and abductor hallucis (ABH). All measurements were performed with an ultrasound device. [Results] FDB and ABH were correlated with TAH during 10% and 90% loading after removing the effect of body mass index and age. The greater FDB and ABH, the higher TAH. [Conclusion] As FDB becomes larger, the second, third and fourth metatarsal heads are raised more. Furthermore, the height of the first metatarsal head is lowered by a larger ABH. These mechanisms may increase TAH.

[Purpose] The aim of this study was to test the hypothesis that Lee Silverman Voice Treatment-BIG decreases the negative impact of hypokinesia on dual task performance in persons with Parkinson’s disease. [Subjects and Methods] The records of 114 patients with Parkinson’s admitted to outpatient rehabilitation at a suburban hospital were reviewed. Demographics and data for 8 outcome measures were extracted for subjects that completed 14 of 16 sessions of BIG. 93 of these subjects had records of pre and post-test Timed Up and Go, Timed Up and Go Motor, and Timed Up and Go Cognitive scores. Average age was 68.4 years (SD=10.6) and average disease duration was 4.9 years (SD=5.3). [Results] Subjects demonstrated statistically significant improvements for Timed Up and Go (3.3 SD=4.5), Timed Up and Go Motor (4.4 SD=5.8) and Timed Up and Go Cognitive (4.7 SD=5.4). Concurrent motor and cognitive performance remained stable. Dual task cost decreased at a statistically significant level for Timed Up and Go Cognitive (7% SD=31%) but not Motor (4% SD=32%). [Conclusion] These findings suggest that cueing strategies associated with LSVT BIG become internalized and decrease the negative impact of hypokinesia on mobility and cognitive performance while performing two tasks simultaneously in persons with Parkinson’s.

[Purpose] Most of rehabilitation programmes for Anterior Cruciate Ligament (ACL) injury focus on quadriceps-hamstrings activation imbalances and less is known about kinetically linked muscles. This study investigated electromyographic activity of selected trunk, core, and thigh muscles during common rehabilitation exercises for ACL injury. [Subjects and Methods] Twelve active female volunteers participated in this cross-sectional laboratory study. Surface EMG was used to compare activation of eight trunk, hip/core, and lower limb muscles: Erector Spinae (ES), Rectus Abdominis (RA), Gluteus Maximus (GM), Vastus Lateralis (VL), Rectus Femoris (RF), Vastus Medialis (VM), Biceps Femoris (BF), and Semitendinosus (ST) during Forward Lunge, Double Leg Raise, Glute Bridge, Sit-Up, and Squat. [Results] Forward lunge produced significantly higher activation in the VM (61.1 ± 19.4), VL (59.2 ± 12.9), and RF (32.0 ± 2.6). Double leg raise generated highest activity in the RF (26.6 ± 2.8) and RA (43.3 ± 4.4); and Glute Bridge in the GM (44.5 ± 19.0) and BF (22.4 ± 4.3). Sit-up produced the highest activation in the RF (36.6 ± 4.7) followed by RA (18.9 ± 3.8). Squat produced a higher activation in VL (55.0 ± 12.9), VM (51.5 ± 18.2), and ES (40.4 ± 18.3). [Conclusion] This study provide further evidence for developing training programmes for ACL injury prevention and rehabilitation. A combination of exercises to reinstate quadriceps-hamstrings activation balance and enhance core stability is recommended.

[Purpose] The aim of this study was to investigate what outcome measures are reliable in the evaluation of adherence to home exercises among patients with chronic low back pain. [Methods] A systematic review on articles related to adherence to home exercises for patients with chronic low back pain was conducted, and outcome measures and psychometric properties were extracted and evaluated in terms of validity and reliability. [Results] A total of 4,583 articles were identified, and eight articles were finally included after screening. The identified outcome measures were self-reported frequency, duration and intensity of home exercises and Treatment Self-Regulation Questionnaire results. Although the internal consistency and criterion validity of the Treatment Self-Regulation Questionnaire results have been proven in the literature, none of the included articles validated the self-reported frequency, duration, and intensity of the home exercises. [Conclusion] Only the Treatment Self-Regulation Questionnaire results were found to be a reliable measure, and further research to validate self-reported outcome measures is required.

[Purpose] To present a case of the therapeutic reversal of a cervical kyphosis into a lordosis in a patient who presented with neck pain and headaches. [Subject and Methods] A 24-year-old male irritated his neck while dancing. Upon examination it was revealed he had an excessive, 45 mm forward head translation and a 15° cervical kyphosis from C3–C6. The patient was treated with Chiropractic BioPhysics^® methods aimed at restoring the cervical lordosis by mirror image^®, neck extension exercises, cervical extension traction, and spinal manipulative therapy. [Results] After two weeks of treatments the patient reported a complete resolution of neck pain. After 24 treatments over 10-weeks, a lateral radiograph demonstrated the restoration of a cervical lordosis and a complete reduction of forward head translation. [Conclusion] This case demonstrates that a cervical kyphosis may be reversed into a lordosis in as little as 10-weeks by specific care incorporating cervical extension protocols. This case also supports the biomechanical literature that suggests those with cervical kyphosis may be predisposed to spinal injury. We suggest that correcting even asymptomatic patients with obvious cervical spine deformity should be accomplished prior to future injury and/or degenerative changes.