Earticle

Purpose: The purpose of this study was to prove the effects of coordinative locomotion training (CLT) on walking speed, walking endurance, and balance for incomplete spinal cord injury patients. Methods: Ten subjects were randomly assigned to the CLT group (n = 5) and the treadmill (TM) group (n = 5). The CLT group performed PNF pattern exercise using the motions of the sprinter and skater for 30 minutes, while the TM group performed using a treadmill for 30 minutes. Both groups performed these therapeutic interventions for five days per week, for a period of four weeks. A 10 meter walking test, Berg Balance Scale (BBS), and 6 meter walking test were used for the assessment of gait speed, balance, and gait endurance. The SPSS Ver. 18.0 statistical program was used for data processing. A Wilcoxon signed rank test was used for the comparison of pre- and post-intervention performance and a Mann-Whitney test was used for comparison between the groups. The significance level for the statistical inspection was set at 0.05. Results: Both groups showed significant improvements in the 10 meter walking test, Berg Balance Scale, and 6 meter walking test (P < 0.05). Conclusion: CLT had an effect on the improvement of walking speed, walking endurance, and the balance of incomplete spinal cord injury patients. Thus, we suggest that CLT is a therapeutic intervention for incomplete spinal cord injury patients.

Purpose: This study used a comparative analysis to propose the effectiveness of using scapular and pelvic patterns of proprioceptive neuromuscular facilitation simultaneously (USPS) on the components of gait in patients with stroke. Methods: Subjects who signed a written consent form to participate in the experiment and attended voluntarily were divided randomly into two groups: the USPS group (12) and the control group (9). The USPS group received pattern training for 30 minutes a day, 3 days per week for 6 weeks. The control group received general physical exercise for the same duration. Gait ability was tested and analyzed before and after the 6 weeks of training with the GAITRite system. Results: The components of gait increased significantly in the USPS group after training (p < 0.05) and did not increase significantly in the control group. Conclusion: According to the results of this study, USPS training improves the components of gait more than general physical exercise. The USPS training method is effective for improving motor functions in patients with stroke, especially for gait rehabilitation.

Purpose: The purpose of this study was both to examine the effects of proprioceptive neuromuscular facilitation (PNF) lower leg taping and treadmill training on the gait and balance abilities of patients with hemiplegia resulting from a stroke and to provide a taping method based on the PNF concept. Methods: Twenty patients with hemiplegia resulting from a stroke were randomly and equally assigned to a control group (n=10), which received treadmill training, and to an experimental group (n=10), which received PNF lower leg taping and treadmill training. The intervention was conducted five times per week for six weeks. In order to measure changes in the gait ability of the subjects, a 10-meter walking test (10MWT) and a 6-minute walking test (6MWT) were conducted, and in order to measure changes in the subjects’ balance ability, a timed up and go test (TUG) was performed. In order to compare differences within each group before and after the intervention, a paired-t test was carried out, and in order to compare differences between the two groups, the analysis of covariance was utilized. All statistical significance levels were set at α=0.05. Results: There were significant differences before and after the intervention within both groups in changes of 10MWT, 6MWT, and TUG (p<0.01). Regarding differences between the two groups, the experimental group underwent more effective changes than the control group in 6MWT and TUG (p<0.05). Conclusion: This study applied PNF lower leg taping and treadmill training to patients with hemiplegia resulting from a stroke, and this resulted in improvement in the subjects’ gait and balance abilities. Taping and treadmill training based on the PNF concept is considered to be usefully applied as one of the programs to improve hemiplegic patients’ gait and balance abilities.

Purpose: This study aimed to investigate the factors that increase fall risk in the residential environment and the perceived fall risk among community-dwelling elderly through comparisons between fallers and non-fallers. Methods: The subjects were 95 community-dwelling elderly aged 65 years and over residing in the metropolitan city of Ulsan. A structured questionnaire consisting of items on sociodemographics and health- and fall-related characteristics was used and data were collected from July to August 2015. The data were analyzed with the SPSS/WIN program. Results: Among recent fallers, 38.9% had diagnosed diseases when the fall occurred, 56.87% were fearful of a recurrent fall, and 86.5% stated that they were increasing their carefulness but that had led to a decrease in activity. There were significant differences between elders who had fallen at least once and elders who had no falls in age, health status, depression, the experience of falling, fear of falling, diseases, and medications. Conclusion: The results indicate a need to assess risk factors to identify older adults with a high risk for falling and the need to develop multifactorial intervention programs that consider both environmental and perceived risk factors as well as physical risk factors to reduce and prevent falls among the elderly.

Purpose: The purpose of this study was to examine the effects of proprioceptive neuromuscular facilitation (PNF) wrist taping, after the application of a rhythmic stabilization (RS) technique, on the decrease of pain and the increase of grip strength in physical therapists who complained of wrist pain and to provide basic data on interventions for wrist pain patients. Methods: The subjects were 15 peoples in their 20s who complained of pain with a visual analogue scale (VAS) at five points or higher due to overuse of their wrists. They were randomly assigned to a control group, to which PNF wrist taping was applied after stretching (n=7), or to an experimental group (n=8), to which PNF wrist taping was applied after application of the RS technique of PNF. The experiment was conducted for four weeks, five times per week. VAS was measured in order to measure pain decrease, and grip strength (GS) was measured using a dynamometer. In order to compare within- group differences before and after the intervention, a paired t-test was performed, and in order to compare differences between the two groups, the analysis of covariance (ANCOVA) was used. All statistically significant levels were set at α=0.05. Results: There were significant differences in changes of VAS and GS within each group before and after the intervention (p<0.01), but there was no significant difference between the two groups. Conclusion: This study applied PNF wrist taping after the application of stretching or PNF RS to patients who complained of pain beyond a sense of discomfort; these interventions resulted in a decrease in pain and an increase in the grip strength of the subjects. Taping and therapeutic techniques using PNF are considered to be usefully applied as one of the programs to improve wrist pain patients’ pain and grip strength.

Purpose: The purpose of this study was to compare the intramuscular activation of the scapular stabilizing muscles and the upper trapezius/middle serratus anterior (UT/MSA) ratios during shrug exercise and proprioceptive neuromuscular facilitation (PNF) scapular pattern exercise. Methods: The participants of this study were 13 young adult men who voluntarily consented to participate in this experiment after listening to its purpose and methods. All participants were instructed on maximal voluntary isometric contraction and scapular exercises. The intramuscular activation of the upper trapezius (UT), lower trapezius (LT), middle serratus anterior (MSA), and lower serratus anterior (LSA) muscles while performing scapular exercises in a side-lying position were measured using surface electromyography. To analyze the muscle activation and UT/MSA ratio between the two exercises, a one-way repeated ANOVA was performed. Post-hoc analyses were conducted using Tukey’s multiple comparison and analysis. Hamstring flexibility for each group was measured by a passive straight leg raising test. Results: The shrug exercise showed significantly higher UT activation compared to PNF anterior elevation and posterior elevation scapular patterns. The PNF scapular anterior elevation pattern showed significantly higher serratus anterior activation than the shrug exercise. Additionally, the UT/MSA ratios were significantly lower in the PNF scapular anterior elevation pattern than in the two exercises. Conclusion: Although shrug exercise was effective for strengthening UT, the PNF scapular anterior elevation pattern may be effective for strengthening MSA and improving the UT/MSA ratio.

Purpose: The purpose of this study was to investigate the effects of visual and auditory stimulation on the ability to perform exercise. Methods: One hundred twenty subjects were randomly divided into four groups (Green light and Fast tempo music, GF; Green light and Slow tempo music, GS; Red light and Fast tempo music, RF; and Red light and Slow tempo music, RS). One of either two visual stimuli or one of two auditory stimuli were applied to each group. The experiment was conducted randomly twice in two environments: one had visual and auditory stimuli and one had no stimulation. Muscle strength, grip, endurance, quickness, agility, concentration, and balance were measured to determine the ability to perform exercise. Results: Significant differences were found in the muscle strength of the participants who were exposed to the auditory factor and the interaction of visual and auditory factors. In endurance, significant differences were found in all of the factors: visual, auditory, and the interaction of visual and auditory. In quickness, agility, and balance ability there were significant differences in the visual factor. In concentration, there was a significant difference in the auditory factor. Conclusion: Visual stimuli, auditory stimuli, and their interaction influenced the ability to perform exercise. These facts imply that providing the proper environmental stimulation is important to increase the ability to perform during exercise.

Purpose: The purpose of this study was to compare muscle activities in the frontal plane and scapular plane of the middle fiber and lower fiber of the trapezius muscle at different shoulder abduction angles. Methods: Twenty male and female students in their 20s participated in this study. Each subject maintained shoulder abduction at 75˚, 90˚, 125˚, and 160˚ in a standing position and repeated motions three times each in the frontal plane and the scapular plane. While maintaining the motions for 10 seconds in each posture, surface electromyography (EMG) was used to measure muscle activity of the middle fiber and lower fiber of the trapezius muscle. The collected EMG data were normalized using maximal voluntary isometric contraction (MVIC). Differences in muscle activity of the middle fiber and lower fiber of the trapezius muscles according to the angles at each plane were statistically processed using repeated measured analysis of variance, and an independent t-test was used to examine the differences between the two planes at each angle. Results: Muscle activity of the middle and lower trapezius during shoulder abduction in the frontal plane and scapular plane significantly increased as the angles increased (p<.05). However, muscle activity of the middle trapezius was significantly lower in the scapular plane than in the frontal plane for all shoulder abduction angles (p<.05). Conclusion: The results of this study suggest that during shoulder abduction, angles should be different according to the goals, and for training during an acute phase or early phase for functional recovery, it is more efficient to perform the training in the scapular plane than in the frontal plane.

Purpose: This study examined whether a single application of a lumbar flexion muscle energy technique (MET) could significantly influence pain, functional status, and range of motion in chronic back pain patients with restricted active trunk flexion. Methods: Twenty volunteers were randomly assigned to either a control group or an experimental group. Ten subjects in the control group received no treatment. Ten subjects in the experimental group received five sessions with the muscle energy technique, five times per week for two weeks. Outcomes were measured before and after two weeks of treatment in both groups. Pain intensity was assessed using a visual analogue scale (VAS). Range of motion was measured using the sit-and-reach test (SRT). Functional disability levels were assessed using the Korean version of the Oswestry Disability Index (KODI). Results: The experimental group showed a significant difference in VAS, KODI, and SRT between pre- and post-treatment (p < .05), while the control group showed no significant changes. The changes in VAS, ODI, and SRT were statistically significant between the groups pre- and post-treatment (p < .05). Conclusion: This muscle energy technique is clinically effective for chronic low back pain patients.

Purpose: The purpose of this study was to investigate the effects of using proprioceptive neuromuscular facilitation (PNF) exercise in the progressive sitting position on the dynamic balance ability of a patient with a cerebellar injury. Methods: The subject had ataxia due to cerebellar injury. The subject participated in a PNF bilateral scapular pattern exercise with stabilizing reversal technique during a progressive sitting position session as well as baseline for 20 minutes a day for 4 weeks. In the first session, PNF exercises were performed at a height of 40 cm for 10 minutes, and in the second session they were performed at 50 cm for 10 minutes from a lower center of gravity (COG) to a higher COG sitting position. We used the Berg Balance Scale (BBS), Five-Times-Sit-to-Stand Test (FTSST), and the Timed Up and Go Test (TUGT) to measure the subject’s dynamic balance ability every two days through the entire session. Results: After participating in the program, the subject’s dynamic balance ability improved compared to the first baseline, as measured by BBS (2 points increased), FTSST (5.3 sec decreased), and TUGT (2 sec decreased). The increase was also maintained in the second baseline session. Conclusion: PNF exercise using bilateral scapula patterns with a stabilizing reversal technique helps to enhance the dynamic balance ability of a cerebellar injury patient.