Earticle

Purpose: Researchers found that blocks of evidence-based practice (EBP) implementation lacked opportunities for EBP education. The study found that physical therapists had negative views of research as well as their roles in EBP, lacked confidence in EBP, and had limited access to web-based materials. The purpose of this study was to highlight the importance of information research technology for efficient EBP in a clinical environment. Methods: The web-based information research technologies that should be used for sustainable EBP include: the clinical practice guideline (CPG) and PubMed’s My NCBI service. Journal mailing services and other academic information sources should also be used to gather information from RSS feeds. An EBP library or archive must be created. A site that provides EBP-specific information is also needed. Results: We should usually do EBP. Practitioners must learn and use information technologies that will help them improve their EBP skills. Conclusion: Facilitating EBP implementation and building an EBP system require related education as well as a practical work environment and equipment. However, the highest priority is individual efforts and trial. Information technology will complement the lack of time. It is important to use information research technology to overcome real obstacles. Lasting EBP must use a number of web-based information research technologies to overcome the practical challenges encountered in EBP implementation.

Purpose: This study reviewed articles to identify the optimal rhythmic stabilization or stabilizing reversals application method for improving balance. Methods: The Cochrane, EBSCO, eArticle, Embase, DBpia, KISS, Medline, ProQuest, PubMed, SAGE, ScienceDirect, Scopus, Springer, and Wiley databases were used to search articles from 1990 to January 2017. The search terms included: "rhythmic stabilization" and "stabilizing reversals." Only experimental human studies (randomized controlled trials) that compared the effects of varying the optimal application of rhythmic stabilization or stabilizing reversals to improve balance were included in the review. Non-English language (except Korean) and unpublished studies were excluded. Results: During the research, 1,098 articles were initially identified. Of these articles, nine were randomized controlled trials. Of these nine articles, five were in English, and four were in Korean. In addition, three of the trials did not measure the patients’ balance, two did not report the intensity and location of the resistance, and three performed the rhythmic stabilization incorrectly. Only one article met the inclusion and exclusion criteria. The remaining study evaluated the participants’ performance of the alternating trunk flexor and extensor isometric contraction of the scapulae using the optimal resistance for 10 seconds in a sitting position. The participants completed three sets of eight repetitions with rest intervals of 30 seconds between the repetitions and 60 seconds between the sets. Conclusion: Due to the lack of the scientific research on the topic, this review may not provide the evidence needed to support the optimal application of rhythmic stabilization or stabilizing reversals to improve balance. Future research should consider the methodological quality to identify the proper rhythmic standardization and stabilizing reversals application method.

Purpose: This study compares the effects of treadmill gait training accompanied by visual feedback and general treadmill gait training on the gait and balance ability of patients with chronic stroke. Methods: A total of 11 patients with chronic stroke were randomly divided into either the treadmill gait training accompanied by visual feedback group (six patients) or the general treadmill gait training group (five patients). The gait and balance ability of the two groups were measured before and after the interventions using the functional reach test, the Timed Up and Go (TUG) test, Berg’s balance test, and the Biodex balance test. The treadmill gait training accompanied by visual feedback group performed the exercise under the supervision of a therapist after first being provided with a hat and a goal that was devised for the purpose of providing visual feedback information. The interventions were applied to the respective groups for four weeks. For the statistical analysis, we conducted a Mann-Whitney test to compare the results between the two groups. Additionally, the Wilcoxon test was used to compare the results from before and after the intervention in each group. Results: The treadmill gait training accompanied by visual feedback group showed a significant difference in terms of the functional reach test after the intervention when compared to the general treadmill gait training group (p<0.05). Although there was no significant difference, the treadmill gait training accompanied by visual feedback group showed a larger improvement in the TUG test, Berg’s balance test, and the Biodex balance test than the general treadmill gait training group (p>0.05). Conclusion: The results of this study suggest that treadmill gait training accompanied by visual feedback can be used as a beneficial intervention scheme for the recovery of the gait and balance ability of patients with chronic stroke.

Purpose: This study attempts to identify the effects of abdominal strength training using proprioceptive neuromuscular facilitation (PNF) on the balance ability and pain level of patients with chronic lower back pain. Methods: A total of 30 patients with chronic lower back pain were randomly divided into either experimental group Ⅰ (n=10), who received abdominal strength training using PNF, experimental group Ⅱ (n=10), who received abdominal strengthening training, or the control group (n=10), who received conventional physiotherapy. The interventions were applied three times a week for six weeks. We measured Berg’s balance scale (BBS) in order to investigate the change in balance ability, while we measured the visible analogue scale (VAS) to determine the severity of pain. We conducted a paired t-test to compare the within-group change before and after the intervention. For the comparison of the between-group difference, we used a one-way ANOVA test. Tukey’s test was used as a post hoc test. The statistical significance level was set at α=0.05 for all the variables. Results: Experimental group Ⅰ and experimental group Ⅱ showed a significant within-group change in BBS (p<0.01). A statistically significant between-group difference was observed in terms of the change in BBS (p<0.01). According to the results of the post hoc Tukey test, experimental group Ⅰ and experimental group Ⅱ showed a more effective change in BBS than the control group. Experimental group Ⅰ, experimental group Ⅱ, and the control group all showed a significant within-group change in the VAS (p<0.01). There was a statistically significant between-group difference in terms of the change in the VAS (p<0.01). According to the results of the post hoc Tukey test, the change in the VAS was more effective in experimental group Ⅰ than in experimental group Ⅱ and the control group. Conclusion: In this study, the application of abdominal strength training using PNF for subjects who complained of chronic lower back pain proved effective in improving their balance ability and reducing pain. We therefore believe that this training method could be applied as a useful program for patients with chronic lower back pain.

Purpose: The purpose of this study was to assess the effect of using smartphones for tele- rehabilitation on head position and neck dysfunction in workers with visual display terminal (VDT) syndromes over a four-week period. Methods: Sixteen VDT workers volunteered to participate in stretch exercise and posture education sessions. The subjects were divided into three groups as follows: five subjects in the visit group (VSG), six subjects in the video group (VEG), and five subjects in tele-rehabilitation group (TG). The subjects in all the groups performed the exercises three days per week for four weeks. Cranial rotation angle (CRA), craniovertebral angle (CVA) measurement, and neck disability index (NDI) tests were performed before and four weeks after the intervention. Results: No significant difference in the CRA and CVA variables was found among groups. No significant difference in the CRA variable was found within each group. A significant difference in the CRA variable was found in the VSG after the four-week intervention. No significant difference in NDI was found among the groups. The NDIs among all the groups were significantly decreased after the intervention when compared with the NDIs measured before the intervention. Conclusion: The use of smartphones in the tele-rehabilitation of VDT workers with neck pain was found to be as effective on neck function as the conventional intervention method. The tele-rehabilitation of VDT workers with neck dysfunctions may be presented as an alternative way.

Purpose: This study attempts to determine the effects of applying three kinds of breathing exercises for four weeks on the neck muscle activation of subjects with a forward head posture. Methods: A total of 30 adults aged in their twenties (15 men and 15 women) with a forward head posture who voluntarily agreed to participate after listening to the purpose and procedure of this research were chosen as the subjects of this study. The subjects were randomly divided into either the diaphragmatic breathing exercise (DBE) group, the abdominal drawing-in maneuver (ADIM) group, or the abdominal expansion method (AEM) group according to the breathing intervention scheme. Each group included ten subjects. The muscle activity of the sternocleidomastoid, scalenus anterior, and splenius capitis was measured in all the groups prior to the intervention, two weeks after the intervention, and four weeks after the intervention. All the interventions were implemented for 30 minutes a day, three times a week, for a total of four weeks. Results: No significant between-group difference was observed in terms of the change in neck muscle activity according to the four-week intervention scheme. Further, there was no interaction between the intervention period and the intervention scheme in relation to the change in neck muscle activity. Conclusion: The results of this study suggest that abdominal expansion exercise is as effective as other breathing exercise methods for subjects with a forward head posture. We therefore expect that abdominal expansion exercise can be used as a scheme for the prevention of symptoms as well as therapy for patients with a forward head posture.

Purpose: This study investigated the effect of core and abdominal muscle-strengthening exercises on muscle activity in the lower extremity on unexpected perturbation. Methods: Twenty subjects were randomly divided into the core exercise group (n=10) or the abdominal muscles strengthening group (n=10). The two groups performed their exercises during three sessions a week for a total of four weeks. The muscle activity in the lower muscles (rectus femoris, biceps femoris, tibialis anterior, gastrocnemius) was assessed using surface electromyography (EMG) and normalized maximal voluntary isometric contraction (MVIC) before and after the exercises. Results: An increase in the tibialis anterior activity after the core and abdominal muscles strengthening exercises was found after four weeks. A significant difference in the pre- and post-exercise was found. The gastrocnemius muscle activity increased in the core exercise group more than the abdominal muscles strengthening group. However, the difference was not significant. Conclusion: The results of this study suggest that the core and abdominal muscles strengthening exercises increased the tibialis anterior muscle activity. It is expected to help make more balance ability that affect who has abdominal muscles weakness.

Purpose: This study compared and analyzed the effect of the proprioceptive neuromuscular facilitation (PNF) arm extension pattern and leg flexion pattern on the contralateral lower extremity muscles when the patterns were applied to the same subject. Methods: In the study, 35 healthy men and women who understood the PNF patterns were selected as participants. The participants completed the PNF arm extension-abduction-internal rotation pattern and leg flexion- adduction-external rotation with knee flexion pattern in the supine position. While the patients’ completed each pattern, the contralateral leg muscle activity was measured to examine the irradiation effect. The maximum isometric contraction time of the muscles to be measured was kept for 5 seconds, and the mean value was obtained by repeating the pattern three times. Results: When the leg flexion-adduction-external rotation with knee flexion pattern was completed, the muscle activity in the vastus lateralis, vastus medialis, biceps femoris, tibialis anterior, and gastrocnemius of the contralateral lower extremity was significantly greater than that found in the PNF arm extension-abduction-internal rotation pattern. Conclusion: The PNF leg flexion pattern showed greater muscle activity on the contralateral lower extremity than the arm extension pattern. Thus, the PNF leg extension pattern is more effective in the activation of the muscles associated with weight-bearing activity.

Purpose: The purpose of this study was to prove the effects of the PNF patterns combined with whole-body vibration (PWBV) training on muscle strength, balance, walking speed, and endurance in stroke patients. Methods: Sixteen subjects were randomly assigned to the PWBV group (n=8) and the whole-body vibration (WBV) group (n=8). The PWBV group performed PNF pattern exercises using sprinter combined with WBV, while the WBV group performed using squatting for 30 minutes. Both groups performed therapeutic interventions five days per week over a period of four weeks. The manual muscle test, timed up and go test (TUG), 10-meter walk test (10MWT), and six-minute walk test (6MWT) were used to assess the muscle strength, balance, and gait of the participants. The SPSS Ver. 19.0 statistical program was used for data processing. Statistical analysis included a pared t-test to compare the pre- and post-intervention, and an independent t-test was used to compare groups. The significance level was set as 0.05. Results: The PWBV group and WBV group showed significant improvements in the TUG, 10MWT, and 6MWT (P <0.05). Significant differences between the PWBV and WBV groups were found (P <0.05). Conclusion: The PWBV improved muscle strength, balance, gait speed, and endurance in stroke patients. Thus, PWBV may be suggested as a therapeutic intervention in patients with stroke hemiplegia.

Purpose: This study attempts to identify the effects of stretching and core exercise using proprioceptive neuromuscular facilitation (PNF) on the pain and functional disability index of patients with chronic lower back pain. Methods: A total of 20 patients with chronic lower back pain were randomly divided into either the experimental group (n=10), who received PNF stretching and core exercise, or the control group (n=10), who received conventional physiotherapy. Both interventions were applied three times a week for six weeks. The visible analogue scale (VAS) was measured in order to determine the level of pain, while the Oswestry Disability Index (ODI) was used to measure the change in the functional disability index. We conducted a paired t-test to compare the within-group change before and after the intervention. To compare the between-group difference, we used an independent t-test. The statistical significance level was set at α=0.05 for all the variables. Results: The experimental group showed a significant within-group change in both the VAS and the ODI (p<0.01). The control group also showed a significant change (p<0.01). A significant difference was observed between the experimental group and the control group with regard to the change in both the VAS and the ODI after the interventions (p<0.01). Conclusion: In this study, the application of stretching and core exercise using PNF for subjects who complain of chronic lower back pain proved effective in reducing both pain and functional disability. We therefore expect that this intervention can be applied in the future as a useful program for patients with chronic lower back pain.

Purpose: The purpose of this study is to determine the effects of visual biofeedback training on the recovery of balance function in stroke patients. Methods: A total of 30 patients with stroke were chosen as the subjects of this study. The subjects were randomly divided into either the visual biofeedback balance training group (experimental group; n=15) or the general balance training group (control group; n=15). The visual biofeedback balance training and general balance training were implemented for 30 minutes a day, three times a week, for a total of four weeks. The subjects’ balance ability was measured before and after the interventions. Results: The shift length and surface area of the center of the body decreased in both the experimental group and the control group, with the difference being statistically significant. The shift length and surface area of the center of the body both decreased more in the experimental group than in the control group, and there was a statistically significant between-group difference. Conclusion: The experimental group showed a greater improvement in terms of the balance ability of patients with stroke than the control group. Therefore, we believe that visual biofeedback balance training can be effectively applied for the improvement of balance ability in patients with stroke.

Purpose: The purpose of this study was to compare the status of the dementia prevention programs, dementia support centers, and elderly welfare centers in major metropolitan cities to acquire data for future program development and dissemination and the specialization of dementia prevention personnel. Methods: Data were gathered through internet surveys and telephone questionnaires from 15 special demented elderly care centers and elderly welfare centers registered in five metropolitan cities from June 27 to Oct 25, 2016. Results: Dementia care programs were available at 15 centers. Seoul City was running the most diverse dementia programs, and all five cities were spending a significant amount of time on the cognitive therapy program within several dementia programs. In addition, many social workers hosted the program and the frequency of social welfare work was three times a week. Conclusion: To increase the dementia prevention policies’ efficiency, an understanding of dementia has already been established. Experts who can provide client-centered, problem-solving programs will play the role of physical therapists and occupational therapists. However, more research is needed.