Earticle

Purpose: This study aimed to identify the exercise posture that most efficiently activates the scapular upward rotators among three positions. Methods: Participants were divided into three groups based on foot placement: the 100%, 150%, and 200% groups, with each group randomly assigned 30 participants. The 100% position involved placing the feet to support the wall with the forearm in the wall slide position, transitioning from a standing position. As for the exercise method, a wall slide exercise was performed up to 150˚ shoulder joint flexion, and scapular upward rotator muscle activity was measured during the 5 seconds of concentric contraction. Results: Serratus anterior muscle activity was measured at 46.91±5.96 in the 100% group, 66.97±6.40 in the 150% group, and 45.92±6.77 in the 200% group. A statistically significant difference was found between the 150% and 100% groups, as well as between the 150% and 200% groups (p<.05). No significant difference was observed between the 100% and 200% groups (p>.05). Additionally, no significant differences were found in upper or lower trapezius muscle activity across the three positions (p>.05). Conclusion: The highest serratus anterior muscle activity was observed in the 150% group, where the feet were positioned at the middle distance. Thus, performing the wall slide exercise at the 150% position is considered optimal for activating the serratus anterior muscle.

Purpose: This study investigated the effects of game-based dual-task training on gait and cognitive function in patients with stroke. Methods: The study included 20 patients with stroke, randomly assigned to two groups: the experimental and control groups. The experimental group received virtual reality-based dual-task training in addition to conventional physical therapy, while the control group received only conventional physical therapy. An analysis of covariance (ANCOVA) was conducted to compare gait and cognitive function between the groups, revealing significant differences. Results: The experimental group that participated in game-based dual-task training demonstrated significant improvements in gait and cognitive function compared to the control group, which received conventional physical therapy (p<.05). Conclusion: Game-based dual-task training was shown to be an effective intervention for enhancing balance, gait, and cognitive function. These findings suggest that this training can serve as an efficient intervention for patients with other conditions. Future research focusing on gait and cognitive function is warranted to evaluate the effectiveness of this intervention further.

Purpose: This study aimed to explore the effects of incorporating gym ball exercises for fall prevention on lower limb muscle activity and balance in elderly individuals. Methods: Thirty elderly individuals residing in nursing homes were selected as study participants and randomly divided into experimental and control groups. Each group was comprised of 15 individuals. The experimental group performed fall prevention exercises using gym balls, whereas the control group performed only fall prevention exercises. Both groups were conducted for 6 weeks, 3 times a week, with each session lasting 50 minutes. We compared and analyzed the changes in muscle activity and balance within and between the groups. Results: When comparing the changes in lower limb muscle activity between groups before and after intervention, the experimental group showed significantly higher lower limb muscle activity after the intervention compared to the control group, with a statistically significant difference (p<. 001). Similarly, the experimental group showed significantly higher improvements in both static and dynamic balance abilities after the intervention than the control group, with statistically significant differences (p<. 001). Conclusion: The results of this study demonstrated that incorporating Gym ball exercises into fall prevention programs is an effective method for enhancing lower limb muscle activity and balance in elderly individuals, thereby reducing fall risk.

Purpose: The prevalence of obesity is increasing in most countries, and obesity has a significant impact on the overall disease burden. Therefore, efforts are needed to prevent excessive weight gain, especially during adolescence. Methods: This study investigated stress related to body type, subjective body type perception, and the need for weight control among college students. Results: The study results showed that the factors affecting stress were highly correlated with the level of perceived fatness and need for weight control in college students. Conclusion: The students experienced social standards and pressure regarding the need for body shape and weight control, but the degree and methods were different. Therefore, programs and counseling related to body shape recognition and weight control according to individual characteristics are necessary, and administrative and financial support should be provided so that students can form a positive body image.

Purpose: This study examined the muscle activity of the internal oblique (IO), tensor fascia latae (TFL), gluteus medius (Gmed), gluteus maximus (Gmax), and the pelvic rotation angle during clam exercise (CE) following the deadbug exercise in males with weak abdominal muscles (WAM) and healthy males. Methods: Twelve adult males with WAM and 12 healthy adult males participated in the experiment. Before performing the deadbug exercise, muscle activity of the IO, TFL, Gmed, and Gmax, as well as the pelvic rotation angle in the horizontal plane, were measured during the CE. Both groups then performed the deadbug exercise for 10 minutes, after which the same measurements were repeated. Results: Within the TFL, muscle activity, and pelvic rotation angle in the horizontal plane significantly decreased, while IO and Gmed activity significantly increased (p<.05). When comparing changes before and after the intervention, the WAM group showed significantly greater changes in IO, TFL, and Gmed muscle activity, as well as pelvic rotation angle, compared to the healthy group (p<.05). Conclusion: These findings suggest that performing the CE after the deadbug exercise in adult males with WAM enhances IO and Gmed activity, reduces excessive TFL activity, and minimizes pelvic compensatory movement, creating an effective environment for performing the CE.

Purpose: Urban and rural populations exhibit distinct health outcomes influenced by demographic and environmental factors, with low back pain (LBP) and stress significantly affecting overall health. Regional differences further complicate these impacts. Although mud therapy and hydrotherapy are known to alleviate musculoskeletal pain, limited research exists on combining marine therapy with indoor rehabilitation exercises to address LBP and stress. Methods: The study included 31 patients with LBP aged ≥50 years living in Seoul and Wando, Jeollanam-do. A 3-day short-term indoor marine therapy program was conducted, consisting of 20 minutes of mud application and heat therapy, 15 minutes of deep tissue massage, and 60 minutes of indoor aquatic exercise. Pain, disability, stress, sleep quality, and quality of life were measured pre- and post-intervention. Results: Pain significantly decreased in both groups (p<0.05), with a notable improvement in the LBP disability index in the rural group (p<0.05). Both groups showed significant improvements in stress resistance, stress index, and fatigue levels (p<0.05). Sleep quality improved significantly only in the urban group (p<0.05), and overall quality of life improved in both groups. Conclusion: A short-term indoor marine therapy program effectively alleviates LBP and stress in both urban and rural residents. Fatigue significantly improved in urban residents, while LBP and stress showed marked reductions in rural residents. These findings suggest the need for region-specific marine therapy programs to maximize therapeutic outcomes.

Purpose: This study compared the effect of visual feedback on scapular stabilization muscle activity and shoulder alignment in adults with round shoulder posture after performing an overhead squat exercise. Methods: Participants were selected based on the distance (p≤2.5 cm) from the ground to the acromion in the supine position. Participants were randomly divided into an overhead squat exercise group with visual feedback (15 participants) and an overhead squat exercise group without visual feedback (15 participants). The exercises were performed three times weekly for 6 weeks. Results: When comparing the serratus anterior and lower trapezius between groups, the overhead squat exercise group with visual feedback showed significantly higher muscle activity at 120° shoulder flexion. Regarding shoulder alignment, both groups demonstrated improved alignment after 6 weeks of exercise. Conclusion: These findings suggest that overhead squat exercise with visual feedback effectively enhances muscle activity and shoulder alignment in participants with round shoulder posture.

Purpose: An adult male with stage 2 varus knee was provided a squat exercise combining visual feedback using mirror and ball exercises to examine changes in the Q-angle and the muscle activity of the medial and lateral muscles. This study aimed to determine effective methods for correcting alignment and achieving normal alignment of the lower extremities. Method: A total of 30 participants were included in this study through random sampling. Participants were randomly assigned to the experimental (the visual feedback squat exercise group using a ball, 15 participants) and control (\the visual feedback squat exercise group without a ball, 15 participants) groups. The exercise intervention comprised four exercises designed based on prior research, performed over 3 weeks. Muscle activity and lower extremity alignment measurement equipment were used as measurement tools. Statistical analysis included the paired samples t-test for within-group comparisons and the independent samples t-test for between-group comparisons. Result: The experimental group showed significant improvements in Q-angle and muscle activity of the medial and lateral muscles compared to the control group (p <.05). Conclusion: These findings suggest that the visual feedback squat exercise using a ball is more effective than visual feedback squat exercises alone.

Purpose: This study aimed to investigate the effects of eye gaze direction during rotation on the thickness of the cervical deep flexor muscles. Methods: Thirteen healthy adults in their twenties were recruited for this study. They were instructed to rotate their necks by 45 °under three conditions: maintaining a forward gaze, moving their gaze along with the head, and closing their eyes. Ultrasonography was performed to measure the thickness of the deep neck flexors during these movements. Data from each condition were analyzed using one-way repeated measures analysis of variance (ANOVA), with post hoc comparisons were performed using the Bonferroni correction. The statistical significance level was set at p < 0.05 or less. Results: There was a statistically significant difference in the thickness of the deep neck flexor muscles when participants maintaining a forward gaze during neck rotation (p < .05). However, when maintaining a 45-degree gaze during neck rotation, there was no statistically significant difference (p < .05). Similarly, there was no statistically significant difference in muscle thickness when participants closed their eyes during neck rotation (p < .05). Conclusion: The results of this study demonstrate that maintaining a forward gaze during neck rotation increases the thickness of the deep neck flexor muscles. These findings indicate that maintaining a forward gaze during neck rotation could serve as an effective exercise for enhancing neck stability during movement.

Purpose: This study compared the muscle activity of the infraspinatus, posterior deltoid, serratus anterior, and the infraspinatus/posterior deltoid muscle activity ratio under three conditions (manual resistance, 4 kg dumbbell, 1 kg dumbbell) during shoulder lateral rotation exercises. Methods: Fifteen healthy adult males performed shoulder lateral rotation exercises under three conditions in random order. Statistical analysis was conducted using repeated measures analysis of variance, with the significance level set at ≤0.05/3 using the Bonferroni correction method. Results: Muscle activity of the infraspinatus and serratus anterior was significantly higher in the manual resistance condition compared to the other two conditions (p<.05). Posterior deltoid muscle activity was significantly higher in the 4 kg dumbbell condition compared to the other two conditions (p<.05). The infraspinatus/posterior deltoid muscle activity ratio was significantly higher in the manual resistance and 1 kg dumbbell conditions than in the 4 kg dumbbell condition (p<.05). Conclusion: Manual resistance during shoulder lateral rotation exercises selectively strengthens the infraspinatus and increases serratus anterior muscle activity, contributing to dynamic stabilization of the shoulder.

Purpose: This study aimed to compare differences in muscle stiffness at rest and in lumbar extension position between the superficial multifidus (SM) and deep multifidus (DM) muscles in patients with low back pain (LBP) and asymptomatic individuals. Methods: Six patients with LBP and seven asymptomatic individuals were recruited. The stiffnesses of the SM and DM were measured using shear wave elastography (SWE) with the participants lying prone. Results: At rest, DM showed higher muscle stiffness than SM in both groups (15.08 ± 3.01 and 16.77 ± 3.75 kPa, p < 0.001). Individuals with LBP showed a lower contraction ratio of SM than the asymptomatic group (LBP; 1.48 ± 0.36, asymptomatic; 2.81 ± 0.89 kPa, p < 0.001). Conclusion: These results suggest that changes in multifidus muscle elasticity at the lumbar extension position are important data for effective extension exercises in patients with LBP.

Purpose: This study aimed to compare and analyze imbalances in dynamic balance ability, systemic muscle strength, and body alignment in female field hockey players. Methods: Fourteen female field hockey players were registered in the Players Association, and their upper and lower limb dynamic balance ability, whole-body muscle strength (measured across five types), and body alignment (front and side) were assessed. Results: The imbalance difference in the hockey player group was significant in the composite score of the Upper Quater Y-balance Test(p=0.047), and the Upper Body(p=0.001) and Lower Body(p=0.001) whole-body muscle strength. The difference in imbalance between the groups was significant in shoulder (p=0.013) and Pelvic tilt(p=0.044), Poserolateral of the Lower Quater Y-Balance Test, Pull(p=0.045) of systemic muscle strength, and trunk rotation(p=0.030). Conclusion: Similar to athletes in other unilateral sports, field hockey players demonstrated body imbalances likely attributable to the sport's repetitive unilateral movements, as well as trunk flexion, and rotation. Regular assessments of imbalances before and after the season as well as following training programs, are recommended to promote balanced growth and improve performance in domestic field hockey players.

Purpose: This study aimed to verify the effectiveness of virtual reality (VR) exercise programs and evaluate their practical applicability through systematic research on Ring Fit Adventure, a VR-based fitness game that includes various exercises such as aerobic and muscle strengthening activities. The subjects were randomly divided into two groups, with 15 individuals assigned to each group; due to dropouts, 11 people were ultimately assigned to each group. The experimental group performed three types of exercises using a Ring-Fit Adventure program. Methods: This study measured forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and dynamic balance ability improvement by conducting Parachute, Balance Walk, Hurray GET, Coin Run, Disc Hit, and Twist Bat, which are exercise programs of Ring Fit Adventure. Measurements were taken using BioRescue and MicroQuark systems. Results: The Coin Run exercise significantly improved stability limits in balance ability, specifically in right, and forward, and backward directions. It also significantly increased the average value of FEV1, indicating enhanced breathing ability. The Parachute exercise resulted in an increase in average stability limits for balance ability and improvements in FVC and FEV1, although these changes were not statisticallysignificant. Conclusion: VR exercise programs are effective for improving balance ability and breathing capacity. Ring-Fit Adventure exercise programs such as Coin Run, Disc Hit, and Twist Bat demonstrated greater improvements in balance ability, making them suitable choices for enhancing stability and balance in VR fitness programs.

Purpose: This study aimed to investigate the effects of lumbar stability exercises combined with electrical muscle stimulation (EMS) on the characteristics of lumbar muscles in patients with chronic lumbar pain. Method: The study included 30 patients with chronic low back pain who were divided into the EMS combined lumbar stability exercise group (GroupⅠ) and the General lumbar stability exercise group (Group Ⅱ). The subjects were randomly assigned to each group of 15. The subjects in this study received general conservative physical therapy, and each group received EMS-combined lumbar stability exercises and general lumbar stability exercises. Sessions lasted 27 minutes, 3 times a week for 8 weeks. Before the intervention, lumbar muscle activity and the mechanical properties of the muscles were analyzed. Eight weeks after the intervention, the above items were re-measured identically, and a between-group analysis was conducted. Results: As a result of comparing the lumbar muscle activity between the groups, Group I showed statistically significant differences in lumbar muscle activity and muscle stiffness and tone compared to Group II. Conclusion: These results demonstrate that lumbar stability exercises combined with EMS have a more positive effect on lumbar muscle activity and mechanical properties. This study provides foundational data supporting the potential use of EMS in musculoskeletal rehabilitation.

Purpose: Chemonucleolysis is a pioneering technique in spinal surgery that introduces the concept of percutaneous nucleus removal as a minimally invasive spinal intervention. Methods: The procedure involves the injection of nucleus-dissolving agents such as chymopapain through a cannula to induce decompression of the intervertebral disc. Results: Although this method offers advantages in terms of convenience and cost-effectiveness, it presents a major limitation: the inability to control the diffusion range of the injected drug within the nucleus, posing a risk of widespread nuclear degeneration. To address this issue, a technique utilizing a Pluronic-based nanoparticle drug delivery system to restrict the diffusion of chymopapain. Since 2018, Japanese medical practice has replaced chymopapain with condoiase for chemonucleolysis. Although condoliase is a safe drug; it lacks diffusion control technology, leaving concerns regarding potential nuclear degeneration unresolved. Conclusion: This study investigated the technical principles of chemonucleolysis and the mechanisms of controlled drug diffusion delivery systems in chymopapain-based procedures. It also critically evaluated whether the adoption of condoliase in recent chemonucleolysis practices in Japan aligns with the ideals of minimally invasive interventions. Additionally, the feasibility of developing innovative delivery systems and procedures that ensure both efficacy and safety in disc decompression is explored, outlining future directions for chemonucleolysis advancements.