Earticle

Purpose: This study aims to determine the effect of Jeonbuk tri-pull taping and proprioceptive neuromuscular facilitation (PNF) exercise on the shoulder’s active range of motion, pain, subluxation, upper extremity function, and activities of daily living in patients with stroke. Methods: In this study, Jeonbuk tri-pull taping and PNF exercise were applied to three patients with stroke and subluxation. The tape was removed and new tape applied for two days every Monday, Wednesday, and Friday over six consecutive weeks. PNF exercise was applied five times a week for six weeks. To measure the range of motion, a smart phone clinometer application was used, and the degree of pain was measured using a visual analogue scale (VAS). A jig measuring method was employed to measure the distance of subluxation. The Fugl-Meyer Assessment (FMA) was used to evaluate arm function, and the modified Barthel Index (MBI) was employed to evaluate the activities of daily living. Results: The shoulder’s active range of motion was improved in the patients compared to the range of pre-tests, and the pain and subluxation distance were reduced compared to those of pre-tests. Arm function and activities of daily living were increased compared to those of pre-tests. Conclusion: The study results verified that Jeonbuk tri-pull taping and PNF exercise are useful when applied to patients with subluxation and stroke.

Purpose: The purpose of this study was to investigate the effects of combined training on the physical fitness of male short distance athletes. Methods: Combined training was applied with CLT and isokinetric training three times a week for eight weeks. For CLT, elastic bands were used in the sitting and standing positions to gradually increase sprint and skating movements. Isokinetic training was conducted at 60°/sec and 180°/sec to improve muscle strength and muscle power. Results: After the application of combined training, strength (hand force) improved from 42.25 kg to 47.30 kg. Muscle power for standing long jump improved from 240.00 cm to 248.80 cm, while the sergeant jump improved from 55.00 cm to 58.00 cm. Isokinetic testing showed that muscle strength (60°/sec) improved from 315.65 %BW to 365.79 %BW for the left extensor and from 306.60 %BW to 325.00 %BW for the right extensor. The left flexor improved from 177.23 %BW to 189.47 %BW, but the right flexor decreased slightly from 210.87 %BW to 201.53 %BW. Muscle power (180°/sec) improved from 254.00 %BW to 293.00 %BW for the left extensor and from 256.00 %BW to 272.00 %BW for the right extensor. The left flexor improved from 150.00 %BW to 162.00 %BW and the right flexor from 145.25 %BW to 182.00 %BW. Conclusion: Combined training could be used as a physical training program for male short distance athletes.

Purpose: The aim of our study was to evaluate the therapeutic effects of walking and turning plus treadmill training on the functional balance and walking ability of individuals with Parkinson’s disease (PD). Methods: Twenty-four participants with Stage 1 to 3 (2.13 ± 0.64) PD based on the Hoehn and Yahr scale were randomly allocated to the experimental group (EG) and control group (CG), with 12 participants in each group. The measured outcomes included the motor subscale of the unified Parkinson’s disease rating scale (UPDRS-M), the Berg balance scale (BBS), the Timed Up and Go (TUG) test, the 10-meter walk test (10MWT), and the 6-minute walk test (6MWT). Results: Pre-to-post intervention improvements were noted for all the outcome measures for both groups (p < 0.05). Post intervention, there was a significant improvement in the EG compared to the CG for the following measured outcomes (p < 0.05): UPDRS-M (p = 0.021; 95% CI, 0.081–6.519), BBS (p = 0.042; 95% CI, 1.375–4.541), TUG (p = 0.034; 95% CI, −3.315–−0.143), 10MWT (p = 0.011; 95% CI, −2.032–−0.289), and 6MWT (p = 0.002; 95% CI, 24.39–91.273). Conclusion: Our study suggests that walking and turning plus treadmill training improves balance and walking compared to treadmill training only in patients with PD.

Purpose: The purpose of this study was to evaluate the effects of a virtual upper extremity training program using the RAPAEL Smart Glove on upper extremity function in stroke survivors with chronic hemiparesis and to focus the training program development using the Smart Glove as a feasibility study. Methods: This study was conducted using a single group and pre-post test research design in the outpatient departments of local rehabilitation units. Ten chronic hemiparetic stroke survivors with a diagnosis of first stroke received therapeutic rehabilitation at the rehabilitation units. All the participants used a virtual reality program with the RAPAEL Smart Glove for 30 minutes per session 3 days a week over 8 weeks. They also received conventional occupational therapy with functional electrical stimulation for 40 minutes per session 3 days a week for 8 weeks as an additional therapy. To analyze the effects of this therapeutic intervention, four clinical measures, including the box-block test (BBT), the Wolf motor function test (WMFT), the trail-making score, the Jebsen Taylor hand function test (JTHFT), and grip strength, were used. Results: Upon completion of the intervention in week 8, all the participants demonstrated significant WMFT, JTT, BBT, grip strength, and trail-making score gains compared to the respective baselines at week 0. Conclusion: This study suggests that virtual upper extremity training using the RAPAEL Smart Glove has a reasonable and beneficial effects on upper extremity function in chronic hemiparetic stroke survivors.

Purpose: Although multi-directional reaching exercises are commonly used clinically, the effects of specific movement directions on the muscle systems of the lower extremities have not been explored. We therefore investigated lower extremity muscle activity during reaching exercises with different sagittal and horizontal plane movements. Methods: The surface electromyography responses of the bilateral rectus femoris, tibialis anterior, peroneus longus, and gastrocnemius muscles were measured during reaching exercises in three directions in the horizontal plane (neutral, 45°horizontal shoulder adduction, and 45°abduction) and three directions in the sagittal plane (neutral, 120° flexion, and 60° flexion). A total of 20 healthy, physically active participants completed six sets of reaching exercises. Two-way repeated ANOVA was performed: body side (ipsilateral and contralateral) was set as the intra-subject factor and direction of reach as the inter-subject factor. Results: Reaching at 45° horizontal shoulder adduction significantly increased the activity of the contralateral rectus femoris and gastrocnemius muscles, while 45° horizontal shoulder abduction activated the ipsilateral rectus femoris and gastrocnemius muscles. The rectus femoris activity was significantly higher with reaching at a 120° shoulder flexion compared to the other conditions. The gastrocnemius activity decreased significantly as the shoulder elevation angle increased from 60° to 120°. Conclusion: Our results suggest that multi-directional reaching stimulates the lower extremity muscles depending on the movement direction. The muscles acting on two different joints responded to the changes in reaching direction, whereas the muscles acting on one joint were not activated with changes in reaching direction.

Purpose: The objective of this study was to investigate whether augmented low-dye taping treatment, which consists of low-dye, reverse-six, and calcaneal-sling taping, is effective in alleviating the collapse of the medial longitudinal arch, which is used for physical balancing during one leg standing. Methods: The subjects comprised 27 students in their 20s whose navicular bone height was lowered by 10 mm or more when evaluated using the navicular drop test. Those with interference factors like deformities, fractures, or traumas were excluded. Frequency-division multiplexing was used to measure one leg standing, and the method to avoir the average each time after 3 times of measurement was applied. Results: Significant differences in the center of pressure (COP) path length, COP average velocity, and forefoot force were observed during left leg standing (p<0.05), but for right leg standing, only changes in forefoot force were noted. Conclusion: Based on the changes to the non-dominant leg in terms of COP path length, COP average velocity, and forefoot force, the immediate effect of augmented low-dye taping, which combines three types of anti-pronation taping, on one leg standing balance in people with flat feet was confirmed.

Purpose: This research was to develop a module for problem-based learning(PBL) and to enhance the problem-solving abilities of physical therapy students in a neurological physical therapy course and to evaluate the effects of the module using quantitative and qualitative data. Methods: The PBL module was applied to 55 third-year physical therapy students who participated in a neurological physical therapy course at S university in Seoul. Anonymous self-report questionnaires and reflection journals were collected, and the data were analyzed. Results: The results of the analysis showed that the academic achievements of the students who participated in the first PBL class improved compared to the academic achievements of the students who had participated in the same class in the previous semester. Second, the students who participated in the PBL class evaluated the PBL as a very effective learning method for developing clinical practical ability. Third, the students of the PBL class showed increased cooperation and communication abilities between team members. Conclusion: The results of this study indicated that, if PBL class case studies and various types of teaching and learning methods appropriate for theoretical and practical fields are continuously studied, then it is expected that teaching models will be developed that can develop flexibility and creativity among preliminary physical therapists in a rapidly changing medical environment.

Purpose: The purpose of the present study was to investigate the effects of toe wedges on the gait ability of adolescents with spastic diplegic cerebral palsy. Methods: Six adolescents with spastic diplegic cerebral palsy participated in this study. During the participants walked withand without toe wedges, the gait ability was analyzed using the electronic walkway system. Gait parameters, including velocity, cadence, step length, stride length, single support time, and double support time, were collected and analyzed. Results: When the participants walked with toe wedges, there were significant improvements in gait velocity, cadence, and double support time compared to those without toe wedges (p<0.05). However, there were no significant differences in step length, stride length, and single support time. Conclusion: Toe wedges may have a positive effect on the gait ability of adolescents with spastic diplegic cerebral palsy. However, it is necessary to conduct high-quality studies to identify the effects of toe wedges.

Purpose: The purpose of this study was to determine the effects of action observation training on lower limb muscle activity and dynamic balance in chronic stroke patients. Methods: This study evaluated 20 chronic stroke patients who were divided randomly into a control and an experimental group comprising 10 patients each. Both the experimental group and the control group performed the general exercise therapy provided by the hospital, but the experimental group also performed action observation training. Lower limb muscle activity was measured with a surface electromyograph, and dynamic balance was measured with the Timed Up and Go test and the 10-meter walk test. The paired t-test was used to compare the groups before and after the experiment. Furthermore, the independent t-test was used to assess differences in the degree of change between the two groups before and after the experiment. Results: The within-group comparisons for both the experimental group and the control group showed significant differences in muscle activity and dynamic balance (p<0.05). In a comparison between the groups, the differences in the muscle activity and dynamic balance of the experimental group appeared significant compared with those of the control group (p<0.05). Conclusion: The study results indicate that action observation training is effective in improving the muscle activity and dynamic balance of chronic stroke patients.

Purpose: The purpose of this study was to identify the causal relationship between workplace stress and working posture and the development of work-related neck pain in office workers. Methods: The study participants included 62 office workers who had not experienced neck pain in the previous 12 months. A battery of measures to evaluate potential workplace risk factors in an office setting were conducted at baseline, and the 12-month incidence of work-related neck pain was reported via monthly questionnaires. Survival analysis was used to evaluate the longitudinal relationship between the workplace risk factors and the development of work-related neck pain. Results: The incidence of work-related neck pain was 1.91 (95% CI: 1.06–3.45) per 100 person months. The incidence of neck pain was predicted to be less likely to happen when workers had a more upright thorax posture during computer work (hazard ratio, 0.94; 95% CI: 0.89–0.99). However, stress may deteriorate the preventative effects of other risk factors on neck pain and showed a positive relationship with episodes of neck pain (hazard ratio, 1.37; 95% CI: 1.03–1.84). Conclusion: Understanding the psychophysiological effects of neck pain may explain the development of neck pain in office workers. Our interest in prevention plans and treatments should therefore involve a multifactorial pathology of neck pain in the workplace.

Purpose: This article was conducted to determine the immediate effects of unilateral contract-relax (CR) stretching on contralateral knee extension range and to compare both sides of the knee extension range between experimental and control groups. Methods: This study recruited 16 adult males and females with straight leg raising abilities below 90°. The subjects were randomly divided into an experimental group and a control group comprising 8 subjects each. The experimental group performed direct CR stretching on the right hamstring muscles with straight hip extension adduction, and the control group performed indirect CR stretching on the right hamstring muscles with straight hip flexion abduction. Each group performed CR stretching 4 times with 4 repetitions comprising 10 sec of contraction and a 10 sec break between repetitions. Before and after the CR stretching exercises, the subjects’ passive knee extensions were measured at the hip in a 90° flexed position. The subjects’ peak force on the right leg and peak pressure on the left leg during each CR stretching exercise were also measured. Results: After doing CR stretching 4 times, each group showed a significantly increased passive knee extension range on both sides, and there was no difference in the passive knee extension ranges between the groups. The peak force on the right leg was significantly higher in the experimental group than the control group. There was no difference in peak pressure between the groups. Conclusion: After applying unilateral CR stretching, the study subjects experienced a significantly increased passive knee extension range on the contralateral side. For patients who find it difficult to apply stretching techniques to knee joints directly, the use of the proprioceptive neuromuscular facilitation technique of CR stretching may be useful in improving the range of the knee joint on the contralateral side without direct treatment.

Purpose: This study aimed to investigate the optimal positions of safety grab bars for effective sit-to-stand (STS) movement by comparing the results of the STS movement while using a safety grab bar installed under two different conditions: the height of the grab bar installation was determined by (1) the Building Act and (2) the principle of proprioceptive neuromuscular facilitation (PNF). Methods: A total of 50 undergraduate students participated in this study, and they were required to perform an STS movement twice under each condition. A baropodometric platform for sitting and a Biorescue (RM Ingenierie, France) were used to collect and analyze changes in the center of pressure (COP) on the left and right sides before and after performing the STS movement. The average completion time for the STS movement was also measured for analysis. Moreover, the participants were asked to express their individual subjective preferences regarding the two positions of the grab bars. Results: The COP changes were significantly smaller when performing the STS movement with the grab bar installed at the height determined by the PNF principle than the Building Act (p<0.01), and the difference in the completion time of the STS movement was not statistically significant between the two conditions. Conclusion: The findings of this study suggest that the principle of PNF can be useful for planning therapeutic exercise as well as for proposing the optimal grab bar position for older adults and those with health-related issues when performing the STS movement. In addition, this may serve as a basic rehabilitation technique for maintaining remaining functions and providing functional efficiency.

Purpose: The purpose of this study was to investigate the effects of trunk stability training on static balance and game records among archers. Methods: The subjects comprised 24 voluntary archers in middle and high school (aged 14–19 years). All the subjects received trunk stability training for an hour per day 3 days a week for 4 weeks. The Tetrax balance system was used to measure the stability index of the subjects’ static balance. The subjects’ game records were scored using a single FITA round system. All the subjects were measured before the intervention, 2 weeks into the intervention, and 4 weeks after the intervention, with a follow-up measurement 2 weeks later. Results: The results of this study showed that the stability index was significantly different across all the measuring positions after the intervention (p<0.05). Furthermore, the results of the measurements of the standing position with eyes open and closed were significantly different before the intervention compared to 4 weeks after the intervention (p<0.05). The archery position with the head turned to the left and eyes closed was also significantly different pre-intervention compared to 2 weeks after the start of the intervention (p<0.05). Additionally, the archery records were significantly different after the intervention (p<0.05), as well as before the intervention and 4 weeks after the intervention (p<0.05). Conclusion: Trunk stability training can improve static balance in archers. It may also be helpful in improving athletic performance and maintaining the life of the athlete. Accordingly, trunk stability training may prevent and resolve injuries through careful management when playing one-side sports.

Purpose: The purpose of this study was to investigate the effects of plank exercises involving the contraction of the adductor muscle of the hip joint on core muscle thickness and to propose an effective plank exercise method. Methods: A total of 30 healthy young adults (17 males, 13 females) voluntarily participated in the study. The subjects were randomized to the prone plank exercise with hip adductor contraction (n=10), the prone plank exercise (n=10), and the supine plank exercise (n=10) groups. Muscle thickness measurements were taken prior to starting the exercise program and after completing the program at the end of a 4-week period. The muscle thickness of the rectus abdominis (RA), multifidus (MF), external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) muscles were measured using ultrasonography. Each group performed the stipulated plank exercise five times a week as follows: 5 sets of 20 seconds during the first week, 5 sets of 30 seconds in the second week, 5 sets of 40 seconds in the third week, and 5 sets of 40 seconds in the last week. Results: The three different types of plank exercises all showed significantly increased thickness of the RA, MF, EO, IO, and TrA (P<0.05). Furthermore, changes in the thickness of both the MF and TrA were statistically more significant in the groups that did the prone plank exercise with the hip adductor contraction and the supine plank exercise than in the prone plank exercise group (P<0.05). Conclusion: The study results suggest that the prone plank exercise with hip adductor contraction is a more effective method for overall activation of the RA, MF, EO, IO, and TrA than the prone plank exercise and the supine plank exercise.

Purpose: This study aimed to investigate the correlation between abdominal muscle strength and measures of respiratory function in stroke patients. Methods: The study participants comprised 17 (male: 12, female: 5) stroke patients hospitalized at W rehabilitation hospital in Busan, South Korea. Abdominal muscle strength was assessed using a digital manual dynamometer for 5 seconds contacting the sternal notch of the participants to bend the trunk. Respiratory function (forced vital capacity, forced expiratory volume in one second, forced expiratory volume in one second/forced vital capacity, and peak expiratory flow) was assessed using a spirometer. The collected data were analyzed using Pearson’s correlation analysis, and the significance level was set 0.05. Results: A statistically significant correlation was found between abdominal muscle strength and forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. However, abdominal muscle strength and forced expiratory volume in one second/forced vital capacity were not significantly correlated. Conclusion: This study demonstrated that there is a relationship between abdominal muscle strength and respiratory function. Exercise programs to strengthen the abdominal muscles are therefore necessary to improve respiratory function in stroke patients.

Purpose: This study was conducted to determine the structural change in knees caused by quadriceps angle and the muscle activity in lower limbs. Indirect intervention was provided by using taping for stability in the ankle joints, which affected patellofemoral pain. Methods: The subjects in this study were 20 patients with patellofemoral pain who visited OOO Hospital in Busan. The visual analogue scale measured the dynamic quadriceps angle and the degree of pain felt by the patients while walking down stairs, which was a known factor of patellofemoral pain. In addition, muscle activities in the rectus femoris, vastus lateralis, vastus medialis, tibialis anterior, peroneus longus, and biceps femoris, which affect the knees and ankles, were measured using surface electromyography. The muscle activities were converted into %RVC for this study. The data obtained in this study were analyzed with the Wilcoxon signed-rank test using the SPSS Ver. 25.0 statistical program. The significance level α was 0.05. Results: The study results showed that the pain and dynamic quadriceps angle were significantly reduced statistically when applying the calcaneus fixation taping (p<0.05). Muscle activity in the lower limbs was significantly decreased in the vastus medialis, vastus lateralis, and tibialis anterior (p<0.05). Conclusion: The summary of the study results verified that the calcaneus fixation taping reduced the pain and dynamic quadriceps angle by providing stability in the ankle joints. It also produced efficient movement due to the difference in lower-limb muscle activity.

Purpose: This study aimed to investigate the effects of the crocodile breathing exercise on the muscle activity of the erector spinae muscle in patients with low back pain. Methods: The study subjects included 36 patients with low back pain. The patients were divided equally into the experimental group (EG) and the control group (CG). The EG performed the crocodile breathing exercise, and the CG performed a chest expansion breathing exercise. The intervention was conducted for 10 minutes each day for a total of eight weeks. Measurements of muscle activity were conducted using an MP150 system. An electrode was attached 2 cm to the side of the spinous process at the L4-L5 level. The muscle activity value used was %MVIC, and the statistical significance was 0.05. The paired t-test was the statistical method used to determine the pre- and post-average value of each breathing exercise, while the independent t-test was used to assess the delta value of muscle activity in the pre-post test. Results: Inspiration muscle activity showed a significant increase in both the EG and the CG, while expiration muscle activity decreased significantly in both groups. The delta value of muscle activity showed a significant difference in inspiration (p<0.05), but for expiration, there was no significant difference in muscle activity (p>0.05). Conclusion: This study suggests that crocodile breathing is a good method for improving muscle activity in patients with low back pain.

Purpose: Ultrasound imaging is commonly used to measure the pennation angle of human skeletal muscles in vivo. However, manual assessment of the pennation angle using ultrasound images is subjective and time-consuming and requires a high level of examiner skill. The architectural analysis of human skeletal muscles is thus challenging. Automated approaches using image processing techniques are therefore required to estimate the pennation angle in ultrasound images. The purpose of this study was thus to assess the intra-tester and inter-tester reliability and validity of the pennation angle using an automatic measurement program. Methods: Twenty-two healthy young adults (mean age = 22.55 years) with no medical history of neurological or musculoskeletal disorders voluntarily participated in this study. Ultrasound imaging was used to measure the pennation angle of the gastrocnemius muscle at rest. One examiner acquired images from all the participants. The intra-tester and inter-tester reliability were evaluated using the intraclass correlation coefficient (ICC) to estimate reliability. Validity was measured using Pearson’s correlation coefficient. Results: The intra-rater reliability was excellent for the automatic pennation angle measuring program and the manual pennation angle assessment method (ICC>0.95). The inter-rater reliability was also excellent for both methods (ICC>0.93). All the correlation coefficients for the automatic pennation angle measuring program and the manual pennation angle assessment method were 0.79, which indicated a significantly positive correlation (p<0.05). Conclusion: Pennation angle measurement using the automatic pennation angle measuring program showed acceptable reliability and validity. This study therefore demonstrated that the automatic measuring program was able to automatically measure the pennation angle of skeletal muscles using ultrasound images, and thus made it easy to investigate skeletal muscle architecture.