[Purpose] The purpose of this research was to examine differences in muscle activity between the resting forearm position (RFP) and the straight forearm position (SFP) during upper arm strengthening exercises. [Participants and Methods] In total, 35 healthy college students were randomly sampled (18 males and 17 females). Surface electromyography data were collected from the medial and lateral sides of the biceps and triceps brachii muscles. [Results] The medial muscles showed greater activity during SFP versus RFP, but no difference in overall activation was found between the two positions. [Conclusion] Carrying angle less affected to biceps and triceps brachii muscles activation during upper arm strengthening exercises.

[Purpose] It is difficult for amputees to perform conventional cardiopulmonary exercise testing. Values were determined for two-legged, one-legged, and two-armed exercise testing in healthy adult males (Study 1), for comparison with preliminary measurements of endurance in amputee football players (Study 2). [Participants and Methods] In Study 1, cardiopulmonary exercise testing was performed in healthy adult males. Correlations between oxygen uptake in two-legged and one-legged/two-armed exercise were calculated and a comparison was made between one-legged exercise and two-armed exercise for each measured value. In Study 2, cardiopulmonary exercise testing was performed on male amputee football players using a two-arm-driven ergometer. The measured values obtained for healthy adult males and amputee football players were compared. [Results] In Study 1, peak work rate and peak heart rate values of healthy participants were significantly higher in two-armed exercise than in one-legged exercise. The correlation between peak oxygen uptake values for two-legged and one-legged exercise was decreased. In Study 2, peak work rate of two-armed exercise was significantly higher in amputee football players than in healthy participants. [Conclusion] Study 1 suggested that musculoskeletal factors might have greater significance for one-legged exercise than for two-armed exercise. Study 2 suggested that para-sports, including amputee football, may contribute to physical strength and health maintenance in lower leg amputees.

[Purpose] The purpose of this study was to investigate the effect of changing the plantar flexion resistance of an ankle-foot orthosis on knee joint reaction and knee muscle forces. Furthermore, the influence of an ankle-foot orthosis with an over-plantar flexion resistance function on knee joint reaction force was verified. [Participants and Methods] Ten healthy adult males walked under the following three conditions: (1) no ankle-foot orthosis, and with ankle-foot orthoses with (2) a strong and (3) a weak plantar flexion resistance (ankle-foot orthosis conditions). The knee flexion angle, quadricep muscle force, hamstring muscle force, and knee joint reaction force during the stance phase were measured using a motion analysis system, musculoskeletal model, and ankle-foot orthosis model. [Results] The peak knee joint reaction force, knee flexion angle, and quadricep muscle force in the early stance phase significantly increased in the strong plantar flexion resistance condition in comparison with the “no ankle-foot orthosis” condition. [Conclusion] Increased knee joint reaction force with over-plantar flexion resistance suggests that over-plantar flexion resistance causes various knee problems such as knee pain and knee osteoarthritis.

[Purpose] The purpose of this study was to present control data on writing pressure, the amount of weight on the upper limb, joint angle, and the area of overlap from the sample in graphic tracing tasks, and to extract factors that affect pen-operating skills. [Participants and Methods] The participants included 35 healthy volunteers who performed 1-inch graphic tracing and writing. The measurements were recorded under two conditions as follows: strong and weak writing pressure tasks, and fast and careful writing speed tasks. [Results] In the writing pressure task, increase in pen pressure was accompanied by increase in hand pressure; however, the forearm pressure did not change. In the writing speed task, no significant difference in pressure was observed, except for a slight difference in writing pressure. The degree of variation in pen pressure and areas of overlap were greater in the fast task than in the careful task. Two multiple regression models revealed the contributing factors to pen-operating skills, both showing that the degree of variation in pen pressure was significantly involved. [Conclusion] The multiple regression analysis results showed that pen-operating skills can likely be evaluated, where the degree of variation in writing pressure is an index for deciding the effect of treatment intervention.

[Purpose] This study developed a reciprocal hip exercise using Thera-Band for those with flat lumbar spines and observed changes in standing and movement angles during sit-to-stand. [Participants and Methods] Eleven females participated in this study. The participants performed the reciprocal hip exercise using Thera-Band. [Results] The trunk flexion angle increased significantly after reciprocal hip exercise. The sit-to-stand time after reciprocal hip exercise was significantly faster than that before exercise. [Conclusion] The reciprocal hip exercise would useful for patients with flat back who can then sit and work for long periods.

[Purpose] The association between foot injuries and foot alignment, including the transverse arch height (TAH) and asymmetry, was examined in athletes participating in college track events. [Participants and Methods] This study included 55 male athletes participating in a college track and field club. Data including demographic information and the incidence of foot injuries within a year prior to participation in this study were obtained via questionnaires. TAH and the medial longitudinal arch height during 10 and 90% loading, leg-heel alignment, and the heel angle were measured before calculating the asymmetry of each alignment parameter measured. Participants were categorized into an injury or a normal group. Unpaired t-tests were used to perform between-group comparisons for each alignment parameter measured and asymmetry. Additionally, logistic regression analysis was performed to identify factors associated with foot injuries after adjustment for demographic data. [Results] TAH asymmetry during 10 and 90% loading was significantly greater in the injury group. Further logistic regression analysis performed showed that only TAH asymmetry during 90% loading was significantly associated with foot injuries after adjustment for demographic data. [Conclusion] With regard to track events, a greater asymmetry of forefoot TAH in a weight-bearing position was observed to be associated with foot injuries.

[Purpose] This study investigated the effect of respiratory exercise on pulmonary function, balance, and gait in chronic stroke patients. [Participants and Methods] Twenty patients with chronic stroke were randomly assigned to experimental and control groups (n=10 each). The patients in both groups underwent neurodevelopmental treatment. Moreover, the experimental group performed respiratory exercise. Pulmonary function was measured using a pneumatometer. Balance was measured using a Berg Balance Scale and Functional Reach Test. Gait was measured with a 10-m walk test and Timed Up-and-Go Test. [Results] Intragroup comparison showed significant differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test. Intergroup comparison showed that the differences in forced vital capacity, forced expiratory volume in one second, Berg Balance Scale, Functional Reach Test, 10-meter walk test, and Timed Up-and-Go Test for the experimental group were significantly related to those for the control group. [Conclusion] Based on these results it was concluded that respiratory exercise effectively improves the pulmonary function, balance, and gait in patients with chronic stroke.

[Purpose] The gait characteristics, such as short step, decreased arm swing and stooped posture, in Parkinson disease (PD) are well established. Pharmacological and non-pharmacological treatments have been attempted to improve the gait in patients with PD. Among the non-pharmacological approaches to improve gait, spinal orthosis can be applied for patients with spinal deformity. The purpose of our study was to investigate the effect of spinal kypho-orthosis to gait in PD by using a three-dimensional analysis. [Participants and Methods] Twenty-six patients with PD with gait disturbance with forward bend posture >15°. All participants were instructed to walk along a 6-m track and turn 180° and come back to the starting point under three-dimensional motion capture. The participants performed the test again with spinal kypho-orthosis. Gait parameters during examination is compared with and without spinal kypho-orthosis. The degree of forward flexion after kypho-orthosis in patients with PD was compared. [Results] Wearing the spinal kypho-orthosis significantly improved turning performance but did not affect locomotion. The severity of forward bend posture is mildly improved after the application of spinal kypho-orthosis. [Conclusion] Spinal kypho-orthosis has a short-term effect for gait performance, particularly during turning and erect posture. Spinal kypho-orthosis can be potentially used for management of turning deficits in PD.

[Purpose] The objective of this cross sectional study was to investigate the validity of Functional Ambulation Category in evaluating functional balance and identifying the relationship between balance impairment and functional ambulation in individuals with chronic stroke. [Participants and Methods] A total of 31 chronic stroke patients with first ever ischemic middle cerebral artery strokes, with no cognitive deficits were recruited. Participants had a mean age of 54.84 (SD=7.05) years and a time after stroke of 22.74 (SD=27.13) months. Community ambulation was determined by Functional Ambulation Category and functional balance was assessed by Berg Balance Scale. [Results] The mean Berg Balance Scale and the Functional Ambulation Category scores were 47.38 (SD=7.54) and 3.8 (SD=0.79), respectively. Correlation analysis revealed that balance impairment and ambulatory function was significantly positively correlated with each other (r=0.80). [Conclusion] The results shows that the Functional Ambulation Category is a valid tool in evaluating functional balance and suggest that functional balance may be an important goal for rehabilitation to achieve improvement in walking ability in people with chronic stroke.

[Purpose] To describe the nature of multi-joint motor coordination during body rotation while in the standing position. [Participants and Methods] The participants were 22 healthy adults with no visual problems or history of diseases that could compromise their ability to execute body rotation. The position facing forward in an upright standing position was defined as 0°, and targets were placed at the following five points on concentric circles: 30°, 60°, 90°, 120°, and 150°. The participants always turned to the right. A three-dimensional motion analyzer consisting of six infrared cameras was used to measure the spatial coordinates of the infrared reflective markers. [Results] A main effect was found for all body segments. For all the target angles, the start of movement was approximately equal, and the angular change of the craniocervical joint was the largest. A nonlinear relationship was observed between the craniocervical and thoracolumbar joints for all target angles. However, a linear relationship was found between the thoracolumbar and pelvic joints. [Conclusion] The results of this study demonstrate that various regions such as the craniocervical and thoracolumbar junctions and the pelvis coordinate during such move to achieve optimal locomotive patterns.

[Purpose] To verify differences in independent mobility improvements between people with subacute stroke with knee-ankle-foot orthoses (KAFOs) and those with ankle-foot orthoses (AFOs) from admission to discharge, and to identify the relationship between mobility improvements and their characteristics. [Participants and Methods] This study included 381 hospitalized patients with subacute stroke who required complete mobility assistance at admission and for whom KAFOs (KAFO group) or AFOs (AFO group) were prescribed after admission. The functional independence measure (FIM) score at admission and discharge, FIM gain, age, Brunnstrom stage (BS) of the paretic lower limb at admission, and the period from admission to prescription for lower limb orthoses were investigated. [Results] Repeated-measures two-way analysis of variance revealed a significant group × time interaction in the walk/wheelchair and stair-climbing items of the FIM. Improvements in the scores in the KAFO group were significantly lower than those in the AFO group. Age, BS, FIM at admission, and period from admission to lower limb orthosis prescription significantly correlated with FIM gain in the walk/wheelchair and stair-climbing items. [Conclusion] A more effective intervention using lower limb orthoses with consideration of the influence of age, motor paralysis, and activities of daily living at admission is required to promote the improvements of people with subacute stroke prescribed KAFOs or AFOs.

[Purpose] This study aimed to determine the safety and immediate effect of a single training session with the Hybrid Assistive Limb (CYBERDYNE) on walking ability in patients with cerebral palsy. [Participants and Methods] This study included 20 patients with cerebral palsy (15 males, 5 females, mean age 15.0 ± 6.3 years; 19 with spastic cerebral palsy, 1 with athetoid cerebral palsy; Gross Motor Function Classification System level I: 4, II: 3, III: 9, and IV: 4). Participants completed a single 20-minute gait training session using the Hybrid Assistive Limb. The safety and immediate effect were evaluated. The immediate outcomes were gait speed and mean step length, and cadence before and after training. [Results] Two participants were excluded because they were not tall enough to use the Hybrid Assistive Limb. Eighteen participants performed the training. There were no serious adverse events during the training. Since 14 participants were able to walk on their own, walking evaluations were performed before and after training. Statistically significant improvements were observed in gait speed and mean step length. [Conclusion] Gait training using the Hybrid Assistive Limb is safe for patients with cerebral palsy and can produce immediate effects on walking ability in ambulatory patients with cerebral palsy.

[Purpose] To investigate the effects of core strength training on core stability with and without the Valsalva maneuver. [Participants and Methods] Twenty-four students were randomly assigned to the training and control groups. Students in the training group undertook a 4-week training program that included exercises for the transverse abdominis, multifidus, diaphragm, and pelvic floor muscles, whereas students in the control group performed their usual activities. Participants were required to perform four types of task with and without the Valsalva maneuver. Seated stabilometry was assessed according to the center of pressure (COP). [Results] In the training group, the rectus area in the quiet sitting position with the Valsalva maneuver was enlarged and the length of trajectory during a sudden perturbation task was decreased. No significant changes to the COP were seen in the control group. [Conclusion] Some parameters of core stability improved after participants completed a 4-week core strength training program.

[Purpose] The Kyoto Scale of Psychological Development is an evaluation scale developed in the field of psychology. The initial aim of this study was to determine whether the quotient of the Postural-Motor area in the scale was correlated with the use of orthosis in patients with Down syndrome. The second aim was to examine a correlation among Postural-Motor, Cognitive-Adaptive, and Language-Social areas in the participants. [Participants and Methods] Patients with Down syndrome who had received a developmental examination, the Kyoto Scale of Psychological Development, were retrospectively investigated. The sample included 78 participants. Data on the participants’ calendar ages ranged from 4.1 to 6.0 years, and the mean age was 4.9 at the examination. The investigated parameters were the number of participants who used an orthosis or insole and the mean developmental quotient for the Postural-Motor, Cognitive-Adaptive, and Language-Social areas. [Results] Twenty participants who completed the exam used an orthosis, and 18 of these had an insole as a first orthosis. The mean Postural-Motor quotient was significantly lower in participants who used an orthosis than in those who did not (52.3 ± 14.7). [Conclusion] The mean quotient of the Postural-Motor area was significantly lower in patients with Down syndrome who were prescribed some kind of orthosis than in those who were not. There was a significant correlation among the quotients of the three areas. The use of orthosis was expected to positively influence the Cognitive-Adaptive and Language-Social areas through the future in people with Down syndrome who have some difficulty with posture and movement.

[Purpose] The purpose of this study was to evaluate the effect of physical therapy on elasticity of muscles quantitatively by using sonoelastography equipment in infrared and ultrasound treatment commonly used in hospital physical therapy rooms. [Participants and Methods] We also investigated correlations among various variables such as height, weight, BMI (Body Mass Index), body fat mass, muscle mass, and basal metabolic rate. From July 30th 2017 to August 30th, 2017, muscular elasticity ratio was measured in 10 males in their 20s by comparing muscles of the upper and lower extremities before and after ultrasound and infrared therapy. [Results] Results showed that muscular elasticity was increased 1.55 ± 0.41 folds in forearm muscle region of the upper extremity in ultrasound therapy, which was significantly higher than the increase (1.23 ± 0.10 folds) in infrared therapy. Thus, ultrasound therapy and infrared therapy both would have good result in cardiac treatment for 1-cm away region. In ultrasound therapy and infrared therapy, elasticity increase rates in forearm region of the upper extremity were higher when body fat mass and BMI were increased. [Conclusion] Results of this study could be used as basic data for ultrasound and infrared therapy studies in the future.

[Purpose] The purpose of this study is to investigate the effects of disability awareness educational program of university students in the department of physical therapy on reducing prejudice against people with disabilities and increasing positive attitudes toward people with disabilities. [Participants and Methods] Students who participated in the disability awareness educational program were selected as experiment group and 15 students who did not take program were selected as control group. [Results] First, in the comparisons between the control and experimental group, there was no difference in the overall prejudice on people with disabilities and positive attitudes toward people with disabilities before the disability awareness educational program. However, there was a significant difference in the overall prejudice and positive attitudes between two groups after the disability awareness educational program. Second, in the comparisons between pretest and posttest, there was no significant difference in the overall prejudice on people with disabilities in control group. However, in the comparisons between pretest and posttest, there was a significant difference in the overall prejudice in experimental group. [Conclusion] It is necessary to provide disability awareness educational program for the university students in the department of physical therapy to reduce the overall prejudices against people with disabilities and increase positive toward people with disabilities.

[Purpose] The purpose of this review is to identify which preoperative physiotherapy interventions are applied in patients undergoing Coronary Artery Bypass Graft. [Participants and Methods] A literature review was carried out using the databases EBSCOhost, Pubmed, LILACS, IBECS, Cochrane and PEDro. Taking into consideration the inclusion and exclusion criteria, 14 studies published in 2006–2017 about preoperative physiotherapy to Coronary Artery Bypass Graft in adults were selected. [Results] Preoperative physiotherapy included interventions such as inspiratory muscle training, aerobic exercise, education in breathing exercises and counselling. Most of the studies described a combination of these interventions illustrating benefits for patients as decreasing the risk of developing postoperative pulmonary complications, reducing the length of hospitalization as well as time to extubation, anxiety and depression. [Conclusion] Preoperative Physiotherapy in patients undergoing Coronary Artery Bypass Graft includes different interventions, and their effects have been evaluated mainly through a combination of them. These combined interventions, particularly those with an inspiratory muscle training component reduce postoperative pulmonary complications. More studies are needed to identify their impact for patients.

[Purpose] To present a case series demonstrating the reduction of thoracic hyperkyphosis by the Chiropractic BioPhysics^® multimodal rehabilitation program. [Participants and Methods] Ten randomly selected files and corresponding radiographs were chosen from recent clinic archives of patients who were treated for thoracic hyperkyphosis. All patients were treated by CBP mirror image^® thoracic extension traction and exercises, as well as spinal manipulative therapy. [Results] Results demonstrated an average reduction in hyperkyphosis of 11.3° over an average of 25 treatments, over an average of 9 weeks. Patients also experienced a reduction in pain levels and disability ratings. [Conclusion] Postural hyperkyphosis is a serious progressive deformity that is related to a plethora of symptoms, syndromes, and early death. Thoracic hyperkyphosis may be reduced/corrected by posture-specific, thoracic extension protocols including mirror image extension traction and exercises, as well as spinal manipulation as part of the CBP multi-modal rehabilitation program.

[Purpose] The Gait Exercise Assist Robot (GEAR) is a stationary, one-leg robot for gait training. The purpose of this case study was to evaluate the efficacy of rehabilitation using GEAR training for chronic stroke hemiplegia. [Participant and Methods] The participant was a 66-year-old male stroke survivor with left hemiparesis due to a right putaminal hemorrhage. He could walk slowly under supervision, although his gait had a constant forward trunk lean, with flexed knee, and a lack of hip extension movement on the affected side. Gait training using GEAR and physical therapy were performed for 14 days. Under both training conditions, the physical therapist made the participant conscious of extension movement of the hip joint in the affected-side stance phase. The robotic assistance was adjusted to maximize voluntary movement while observing gait. Physical function and gait ability parameters were evaluated before and after training. [Results] After training, extension motion of the hip joint increased in the affected-side stance phase, and body weight was transferred smoothly onto the affected-side limb, leading to an improvement in gait speed. [Conclusion] Gait training using GEAR and physical therapy may improve gait pattern and speed in patients with chronic stroke hemiplegia.

[Purpose] Physical activity can influence the development of postural control and balance. Therefore, the aim of study was to use posturography assessment to compare balance control on the Romberg test between athletes in two very different sports, taekwondo and tennis. [Participants and Methods] Twenty-nine young athletes participated in the study, 11 forming the taekwondo group and 18 the tennis group. Posturography was performed using the FreeMed system (Sensor Medica). Between-group differences were evaluated using unpaired Student’s t-test. [Results] There was a significance between-group difference in the centre of pressure and the ellipse surface area with no between-group difference in frontal and sagittal plane postural control. [Conclusion] The taekwondo athletes displayed greater stability than tennis athletes, with a smaller ellipse area and a decrease in the amplitude of oscillations of the centre of pressure along the frontal plane, adaptations which likely reflect the demands of the taekwondo. Further studies are needed to support these conclusions.

[Purpose] Primary purpose was to compare running mechanics between healthy runners and runners with chronic exertional compartment syndrome (CECS) including overstride angles, ankle dorsiflexion (DF) angles, and foot strike patterns. The secondary purpose was to analyze the association between the overstride angles and ankle DF angles. [Participants and Methods] Running images of 7 female runners with bilateral CECS patients were captured at a time of the medical examination. Their running images were compared with gender, age, and body mass index matched 31 healthy control runners. [Results] The bilateral CECS female runners have a propensity of running with significantly greater overstride and ankle DF angles than the healthy female runners. There were no foot strike differences between the two cohorts. There were a non-significant, poor relationship between overstride and ankle DF angles in the healthy female runners while a significant, strong association was found between overstride and ankle DF angles in the bilateral CECS female runners. [Conclusion] Compared to healthy female runners, bilateral CECS female runners demonstrated different running mechanics including greater overstride and ankle DF angles. The two variables were strongly associated with each other in bilateral CECS female runners, but not in healthy female runners. This may potentially contribute to the mechanism of CECS development.

[Purpose] This study aimed to investigate the effect of auditory rhythmic cueing on gross motor skills in children with autism. [Participants and Methods] A total of 30 autistic children aged 8–10 years with mild to moderate autistic features participated in this study. They were randomly allocated to either the control group (n=15), which underwent a specially designed physical therapy program, or the study group (n=15), which underwent the same program in addition to gait training with rhythmic auditory stimulation. To provide rhythmic auditory stimulation, combination of a metronome beat set to the child’s cadence and rhythmic cueing from the MIDI Cuebase musical program was used. Both groups received 3 sessions per week for 3 months. The Bruininks-Oseretsky Test of Motor Proficiency 2nd Edition was used to assess gross motor skills at baseline and after 3 months of intervention. [Results] The study found statistically significant improvements in bilateral coordination, balance, running speed and agility, and strength in both groups after treatment. Moreover, there were statistically significant differences between the 2 groups, with the study group showing better improvement in all outcome measures. [Conclusion] Gait training with auditory rhythmic cueing elicited a positive effect on the gross motor skills of children with autism.

[Purpose] To examine muscular demands during self-propelled treadmill walking to provide a potential option for fitness training. [Participants and Methods] Eleven healthy college students were recruited. Participants walked under three conditions: over-ground walking at a self-selected speed, treadmill walking at a self-selected speed, and treadmill walking at a speed comparable to that of over-ground walking. Step lengths and lower extremity muscle activations were recorded while participants walked under the three conditions. [Results] Step lengths were significantly shorter when participants walked on a self-propelled treadmill than when walking over-ground. The spatiotemporal and muscle activations of the gaits varied among the different walking conditions. Muscular demands at the moment of heel-strike were higher around the hip and knee when walking on the self-propelled treadmill than when walking over-ground. [Conclusion] During heel-strike, the lower extremity extensors were activated more on the self-propelled treadmill with an incline, especially at faster speeds, than during over-ground walking. A low-cost, self-propelled treadmill may be a modality for training specific muscles.

[Purpose] This study was conducted to examine the effects of task-specific movement patterns during resistance exercise program, which are applied to children with cerebral palsy, on respiratory functions and thickness of abdominal muscles. [Participants and Methods] This study was conducted with randomized double-blinded controlled research was pursued since it is a clinical trial with minors with disabilities as the participants. Seventeen children with cerebral palsy were randomly allocated to both experimental group and placebo group by means of simple randomized sampling. The experimental group wore weighted vest to which loaded-resistance was applied by means of sand bag while the placebo group wore weighted vest without loaded-resistance. Task-specific movement patterns during resistance exercise were performed for 40 minutes 2 times a week over a period of 12 weeks for the participants in both groups. Differences in respiratory functions and thickness of abdominal muscles measured prior to and after 12 weeks of the experiment were compared. [Results] All the measurement values for the respiratory functions and abdominal muscle thickness displayed statistically significant changes between those prior to and after the exercise in both of the experimental group and the placebo group. There were statistically significant differences in the changes prior to and following the exercise between the two groups. [Conclusion] Therefore, task-specific movement patterns in anatomical plane, diagonal patterns and combined forms during resistance exercise program on for children with cerebral palsy can be considered as an efficient intervention method in improving respiratory capacity.

[Purpose] Although the abdominal draw-in maneuver improves delayed onset of transverse abdomen in patients with low back pain, it is difficult to perform. We investigated whether the maneuver with tape measure-based feedback was more effective in facilitating isolated transverse abdominal muscle contractions than that without feedback in healthy participants. [Participants and Methods] Twenty healthy males performed the maneuver without feedback (control condition) and then with feedback using a tape measure (tape measure condition) in the crook lying, sitting, and standing positions. A B-mode ultrasonography imaging system was used to determine lateral abdominal muscle thicknesses, the percent changes from before the maneuver were calculated for each condition, and the main effects and interactions for each tested muscle were determined. [Results] The percent change in the thickness of the transverse abdominal muscle was significantly greater under the tape measure condition than under the control condition. The percent change in internal oblique thickness during the maneuver was significantly greater in the standing position than in the crook lying or sitting positions. Significant condition-by-position interactions were not observed for any of the examined muscles. [Conclusion] The abdominal draw-in maneuver with tape measure-based feedback may be more effective at facilitating isolated transverse abdominal contractions in all the positions than that without feedback.

[Purpose] A new method for measuring dynamic balance was developed. The aim of this study was to describe the use of a novel “unstable board” to evaluate the balance ability of community-dwelling elderly individuals. [Participants and Methods] The following balance outcomes were evaluated in 59 community-dwelling elderly people: anteroposterior and mediolateral stability indexes on the unstable board, Mini-Balance Evaluation Systems Test score, the Functional Reach Test score, Timed Up-and-Go time, and the Figure-8 Walk Test time. [Results] With respect to the relationship between the stability indexes and functional balance scales, the anteroposterior stability index significantly correlated with the anticipatory postural adjustment component (r=−0.422), stability in the gait component (r=−0.274), and total score of the Mini-Balance Evaluation Systems Test (r=−0.316); timed up-and-go time (r=0.320); and figure-8 walk test time (r=0.340). No correlation was found between the mediolateral stability index and the functional balance scale scores. [Conclusion] The anteroposterior stability index correlated with the declines in postural adjustments and performance in the dynamic balance assessments. Therefore, the anteroposterior stability index, evaluated on an unstable board, could provide an efficient tool for predicting changes in dynamic balance capacity, which could not be identified using the most commonly used balance assessment tools.

[Purpose] The purpose of this research was to examine the effectiveness of modified constraint-induced movement therapy (mCIMT) on the upper extremity function and occupational performance of stroke patients. [Participants and Methods] An experimental study was carried out on two groups of 7 participants selected by a specific criterion. The experimental group received the mCIMT as well as the conventional rehabilitation therapy (CRT) for 5 days per week over a 2 week period. The control group received only the CRT. Outcome measures included the Manual Function Test (MFT), Motor Activity Log (MAL), and Canadian Occupational Performance Measure (COPM). [Results] Average amount of changes in the MAL and COPM is different in statistical analysis between the mCIMT and the CRT groups before and after the intervention. The mCIMT group showed significant improvements on MFT, MAL, and COPM before and after the intervention. [Conclusion] We suggest that the mCIMT improves the upper extremity function and occupational performance of stroke patients better than the CRT alone.

[Purpose] This study aimed to review the meaning and potential of interview data for life story depiction. [Participants and Methods] The participants were three mothers who appeared to have positively accepted their daily lives while raising children with severe disabilities. Semi-structured interviews of these mothers were performed. By reference to Trajectory Equifinality Model, noteworthy experiences were extracted for individual cases from the complete records of the interviews. [Results] After the narration of their life stories, the mothers reached the following points: “Strange sense of satisfaction with living with this child,” “Both the child and I are happy,” and “The presence of this child allowed us to save our marriage.” [Conclusion] When one talks about oneself, the past is arranged in a form that explains the present, omitting or ignoring past experiences that are not related to the present. In other words, the present condition is not the point that the mothers has reached through the narration of their life stories, but the life story has been created to explain the present condition. This means that the life story will continue to change with each new context. This is the conclusion of this study with regard to the meaning and potential of interview data.

[Purpose] The current study aimed to investigate the center of pressure, as an indicator of postural sway, to determine any differences between women with clinical lumbar instability and asymptomatic low back pain. [Participants and Methods] Thirty healthy and fifteen clinical lumbar instability participants were measured for their postural sway in the anterior-posterior and medial-lateral directions. The women were tested for postural sway on a force plate in quiet standing and eyes closed. Center of pressure path length and mean velocity in the anterior-posterior and medial-lateral directions and total area of excursion were measured and analyzed for 30 seconds. [Results] Clinical lumbar instability participants showed a significantly increase when compared with healthy participants, in path length and mean velocity in both directions and total area of excursion. [Conclusion] The findings suggest that chronic low back pain patients with clinical lumbar instability have increased postural sway when vision is deprived. The clinical significance of this has not yet been determined but may provide an opportunity for therapy directed at improving balance control in this patient group.

[Purpose] This study aimed to investigate the effects of McKenzie exercise, Kinesio taping, and myofascial release (MFR) on forward head posture (FHP). [Participants and Methods] Twenty-eight individuals with an FHP were enrolled. Participants were randomly assigned to one of three groups: Group A, Group B and Group C. Group A underwent McKenzie exercise and MFR. Group B underwent McKenzie exercise and Kinesio taping. Group C underwent McKenzie exercise, MFR, and Kinesio taping. Interventions for all three groups were provided three times per week for four weeks. The acromion and tragus of ear (A-T length), craniovertebral angle (CVA), Cranial rotation angle (CRA), and neck disability index (NDI) were measured. [Results] The A-T length significantly differed after intervention in all three groups. CVA only significantly differed after intervention in group C. All three groups showed an increase in CRA after intervention; however, these increases were not statistically significant. [Conclusion] Considering these results, these three types of exercise may be recommended as effective exercises to improve posture in adults with FHP.

[Purpose] To investigate changes in hamstring flexibility in relation to intensity of proprioceptive neuromuscular facilitation stretching and changes in pain over time, and examine the correlations between pain level and target intensity or flexibility gain. [Participants and Methods] Sixty-one healthy adults were randomly divided into 4 groups (100% [P100], 70% [P70], 40% [P40], and 10% [P10] of maximum voluntary isometric contraction) according to intensity of hold-relax stretching. Hamstring flexibility was measured with the active knee extension test, and pain was measured using the visual analogue scale. [Results] Concerning hamstring flexibility, P100 showed significant differences from P40 and P10, and P70 was significantly different from P10. At post-stretch, P100 significantly differed from P70, P40, and P10 in visual analogue scale. At 1 day, P100 significantly differed from P40 and P10. Although there was a significant correlation between post-stretch pain level and stretching intensity, there was no significant correlation between pain level and flexibility improvement. [Conclusion] Repetitive high-intensity stretching may cause heavy burden on muscle tissues, and pain caused by high-intensity stretching can hinder muscle performance. Moderate stretching intensity is recommended and considered conducive to maintaining the effects of stretching while ensuring its safety.

[Purpose] The purpose of this study was to investigate electromyographic activity of the quadriceps muscle in different positions of hip rotation (while standing on the toes) in healthy females. [Participants and Methods] The study was conducted on 35 healthy females. Electromyographic activity of the rectus femoris, vastus medialis oblique, and vastus lateralis muscles were recorded with the hip in a neutral position as well as different angles of internal and external rotation (15, 30, and 45 degrees (°)) while the participants were standing on their toes. [Results] There was a significant difference of 15° in external rotation, a neutral position, 15° of internal rotation, and at the end of an internal rotation position. Paired comparison between muscle activity using Bonferroni showed that vastus lateralis activity in 15° of external rotation, a neutral position, 15° of internal rotation, and at the end of a position of internal rotation was more than that of rectus femoris muscle. [Conclusion] The present study showed that average vastus lateralis activity was the highest in all positions. However, the positions studied in the current study did not lead to an increase in muscle activity of the vastus medialis oblique as a medial dynamic stabilizer compared to vastus lateralis.

[Purpose] This case presents the reduction of both forward head posture and thoracic hyperkyphosis in a young male with chronic back pain and headaches by a comprehensive posture rehabilitation program as a part of Chiropractic BioPhysics^® methods. [Participant and Methods] A 32 year old male presented with constant pain and headaches for seven years since he was involved in a work related injury. He had seen five different MDs, undergone multiple imaging tests, and received multiple prescriptions, thirteen steroid injections and was recommended for a spine surgery that he had denied. He was on long-term disability. Upon comprehensive posture and spine assessment, the patient had exaggerated forward head translation and thoracic hyperkyphosis. The patient was treated 36 times over 13-weeks with cervical and thoracic extension exercises, traction, and manipulation. [Results] After treatment the patient reported dramatic improvement in symptoms as indicated on valid disability questionnaires and substantial improvements in posture. [Conclusion] Posture-related pain and disability is not often addressed in allopathic medicine but substantial posture improvements are achievable in short time periods as this case illustrates. Poor postures in young patients should be corrected to avoid long-term consequences. Radiography as used in spinal rehabilitation is safe and reliable.

[Purpose] The purpose of this study was to investigate the effect of manual therapy with functional electrical stimulation (FES) on scoliosis curve and quality of life in children with cerebral palsy (CP). [Participants and Methods] Two children with CP performed 30 minutes of manual therapy and 30 minutes of FES three times a week for 3 months. The Cobb’s angle and Pediatric Quality of Life Inventory (PedsQL) score were assessed before and after the intervention. [Results] The Cobb’s angle and PedsQL score were improved after intervention. [Conclusion] Our results indicate that manual therapy with FES was effective for improving scoliosis curve and quality of life.

[Purpose] Describe the effect of a Physical Therapy (PT) program in function improvement and pain reduction in patients over 60 years of age with massive and irreparable Rotator Cuff (RC) tear. [Participants and Methods] Ninety-two patients received a 12 weeks PT program that consisted in manual therapy and a specific exercises program. Before the start and at the end of the treatment, the shoulder function was assessed with Constant-Murley, the upper extremity function with DASH, and the pain during activity with the visual analog scale (VAS). [Results] At the end of the treatment, Constant-Murley exhibited an increment of 24.9 points, DASH showed a decrease of 28.7 points, and the VAS, a decrease of 3.6 cm (p=0.00). [Conclusion] A PT program based on manual therapy and specific exercises in a short term improves the function and reduces the pain during activity in patients with a massive and irreparable RC tear.

[Purpose] To document the non-operative rehabilitation of lumbar lordosis in two cases with chronic low back pain and flexible flat back syndrome. [Participants and Methods] Two young adult males reported suffering from chronic low back pain associated with anterior sagittal balance and severe loss of lumbar lordosis, aka ‘flat back syndrome.’ Lumbar extension traction was applied 3–5 times per week for 16.5–20 weeks. A torsion type lumbar spinal manipulative therapy was provided in the initial 3 weeks for short-term pain relief. [Results] Both patients had dramatic improvement in lumbar lordosis with simultaneous reduction in pain levels. One patient had a 50° lordosis improvement in 100 treatments over 20 weeks; the other had a 26° lordosis improvement in 70 treatments over 16.5 weeks. There were also improvements in sacral base angle, pelvic tilt and sagittal balance. One patient demonstrated stability of health status and further improvements in radiographic measures including lordosis angle nearly 10-months post-treatment. [Conclusion] This is the first successful non-operative correction of flat back syndrome. This approach seems highly effective, is a fraction of the cost of spinal surgery typically used to treat this condition, and offers no health risks including those assumed from radiography necessary for screening and follow-up.

[Purpose] The purpose of this study was to learn about the effects of a home-oriented program based on sensorimotor activities on executive and motor functions in children with ADHD. [Participants and Methods] In this study, a home-based sensorimotor program was conducted for two male children diagnosed with ADHD. The participants performed the program with their parents four times a week, for forty minutes each time, over a 12-week period. The participants’executive functions and gross motor skills were evaluated using the Children’s Color Trails Test (CCTT) and the Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2). [Results] After participating in the home-based sensorimotor program, the participants showed improvements in both their executive and motor functions. [Conclusion] This study confirmed that a home-based sensorimotor program was effective in improving executive and motor functions in children with ADHD. This conclusion suggests the need to develop various exercise programs that can relieve the symptoms of ADHD in children and improve their abilities to adapt at home or school.