Earticle

Purpose: The aim of this study was to investigate the effects of trapezius and serratus anterior strengthening exercise on the shoulder pain and muscle activation of patients with spinal cord injury and functional shoulder impingement syndrome. Methods: The study consisted of 10 patients with spinal cord injury who were hospitalized in Rehabilitation Hospital U, Uijeongbu, South Korea. The exercise was implemented three times a week for 10 weeks. In each session, the subjects performed one of a total of five types of exercise at mid-level intensity. The shoulder pain and disability index (SPADI) was used to evaluate the patients before and after the intervention. The muscle activation of the upper trapezius, middle trapezius, lower trapezius, and anterior serratus muscle was assessed by surface electromyography (EMG) at the beginning of the experiment and 10 weeks later. Wilcoxon’s singed-rank test was conducted to determine differences in the pain index and muscle activation before and after the exercise. The level of statistical significance was set at α=0.05. Results: SPADI scores significantly decreased after the exercise (p<0.05). In comparisons of muscle activation, there was a significant improvement in the upper trapezius at 60° shoulder joint flexion (p<0.05). There was no significant improvement at 90° shoulder joint flexion. The middle trapezius showed a significant improvement at 120° shoulder joint flexion (p<0.05). Conclusion: Trapezius and serratus anterior strengthening exercise reduced pain in spinal cord injury patients with functional shoulder impingement syndrome. The decreased muscle activation of upper trapezius and increased muscle activation of the anterior serratus muscle at 60° shoulder joint flexion point to positive effects of the exercise on supraduction of the scapula.

Purpose: This study investigated the effects of virtual reality-based task training (VRBTT) using a smart glove on upper extremity function and activity of daily living in stroke patients. Methods: Twenty-nine patients with chronic stroke disease were randomly allocated to two groups: the VRBTT group (n=14) and the control group (n=15). All patients received 30 minutes of standard occupational therapy, 5 times a week, for 8 weeks. The VRBTT group performed an additional 30 minutes of virtual reality-based rehabilitation training, 5 times a week, for 8 weeks. Results: Both groups showed significant improvements in upper extremity function, yielding an increase in FMA and K-WMFT (p<0.05). There was a more significant increase in the VRBTT group before and after interventions (p<0.05). There was no significant difference in MAS for the control group (p>0.05); however, there was a significant increase for the VRBTT group (p<0.05). In the activities of daily living, there was a significant difference in the values for K-MBI (p<0.05). In addition, both groups showed a significant increase for K-MBI and K-RNLI (p<0.05). Conclusion: This study showed that VRBTT using smart gloves can have a more positive effect on upper extremity function and activities of daily living in stroke patients than conventional intervention methods. A variety of virtual reality-based contents and glove-shaped wearable devices will help stroke patients in rehabilitation clinics recover and return to society.

Purpose: The purpose of this study was to investigate the effects of neck stabilization exercise with PNF for neck alignment, neck disability index, and sitting balance in adults with forward-head posture. Methods: Forty participants were randomly assigned to two groups. Patients in the neck stabilization exercise group (NSG, n = 20) and the proprioceptive neuromuscular facilitation neck pattern exercise group (PNFG, n = 20) were studied 30 minutes a day three times a week for four weeks. Outcomes were measured using cranial vertical angle (CVA), the Korean version of the neck disability index (KNDI), anterior limit of stability (ALOS), and posterior limit of stability (PLOS) before and after the intervention period. Results: There were significant effects in the CVA and the KNDI of both groups pre- and post-intervention. There were significant effects in ALOS and PLOS in the PNFG pre- and post-intervention compared with the NSG. Conclusion: The results of this study suggest that PNF with neck exercise could be beneficial to the static balance of adults with forward-head posture.

Purpose: This study examined the effect of proprioceptive neuromuscular facilitation (PNF) rehabilitation exercise on postoperative range of motion (ROM), pain, and function of breast cancer patients. The purpose of this study was to provide fundamental data regarding the use of PNF rehabilitation exercise for patients with breast cancer. Methods: Fourteen patients who underwent surgery due to breast cancer were randomly divided into an experimental group (n=7) that performed PNF rehabilitation exercise and a control group (n=7) that performed general rehabilitation exercise. Both groups performed the respective exercises for 30 minutes, five times a week for 4 weeks. For the measurement of ROM, the range of shoulder abduction was measured using a clinometer smartphone application. The shoulder pain and disability index (SPADI) was used to measure the level of pain and functional activity. A paired t-test was conducted to compare within-group changes before and after the PNF rehabilitation exercise. Differences between the experimental group and control group were analyzed by an independent t-test. For all tests, the level of statistical significance was set at α=0.05. Results: After the exercise, there was a significant within-group change in the ROM and SPADI in both the experimental group and control group (p<0.01). There was also a significant between-group difference in the ROM and SPADI after the intervention (p<0.05). Conclusion: Rehabilitation exercise is generally applied as a treatment for patients with breast cancer after surgery and is relatively effective. The application of PNF rehabilitation exercise may be useful in such patients, considering its effects on ROM improvement, pain reduction, and functional enhancement.

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: The purpose of the study was to investigate the effects of visual feedback exercise (VFE), sandal exercise (SE), and thera-band exercise (TE) on people with functional ankle instability. Methods: The 45 study participants were divided into three groups of 15. In the VFE group, participants performed short-foot exercises using visual feedback; the SE group performed sandal exercises, and the TE group performed thera-band exercises. Over a period of 8 consecutive weeks, the experimental groups exercised for 15 minutes per session, four times per week. Balance was measured using the Biodex Balance System for dynamic balance ability (overall balance index [OBI], mediolateral balance index [MBI], and anterioposterior balance index [ABI]). Vibration threshold sense (VTS) was assessed using a vibratory sensory analyzer. Ankle muscular strength was measured using the Biodex 4 Pro. The main outcome measures were assessed at baseline and after 8 weeks of training. Results: Significant improvements in dynamic balance were noted in all three groups (p < 0.05). Significant improvements in VTS and muscular strength were also noted in the VFE and TE groups but not in the SE group (p < 0.05). Conclusion: Appropriate environmental and situational mediation may be of great clinical significance for patients suffering from chronic ankle instability. It is hoped that the findings will inform a program for prevention of ankle instability.

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: This study examined the effect of calf muscle fatigue on postural sway according to foot posture (a pes cavus, a normal foot, and a pes planus). Methods: The subjects of this study were 12, 11, and 9 students of U University with a pes cavus, a normal foot, and a pes planus, respectively, according to a Navicular Drop Test. Postural sway was measured with a balance instrument (BioRescue, RM Ingenierie, France) while the subjects stood static on two legs as well as during one-leg standing using the dominant leg in two conditions (with the eyes open and with the eyes closed for 30 seconds). Muscle fatigue was then induced in the calf muscle of the dominant leg, and both muscle fatigue and postural sway were measured using an EMG. To compare the degree of postural sway between the three groups after muscle fatigue was induced, the change values were calculated. The results were analyzed using a Kruskal–Wallis test, and a post-hoc test was conducted using the Bonferroni correction. Results: Significant inter-group differences were detected for postural sway during two-leg standing with the eyes closed and during one-leg standing with the eyes open and with the eyes closed (p<0.05). The post-hoc test showed significant differences between the pes cavus and normal foot groups and between the pes planus and normal foot groups for all three variables (p<0.05). However, no significant difference was detected between the pes cavus and pes planus groups (p>0.05). Conclusion: The results of this study show that the pes cavus and pes planus cause more fatigue and postural sway than a normal foot. Therefore, attention should be paid to changes in balance caused by muscle fatigue.

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.

Purpose: This study investigated the effect of plantar-flexor muscle fatigue on the force sense and joint reposition sense of ankle joints in the healthy adults. Methods: Fifteen healthy subjects (male: 9, female: 6) participated in this study. A digital dynamometer was used to measure the force sense error while a wireless motion capture device was used to measure the joint reposition sense error. To induce plantar-flexor muscle fatigue for a dominant lower extremity, the subjects were asked to perform plantar flexion until exhaustion while barefoot. The differences in force sense error and joint reposition sense error for the ankle joint were measured immediately. The Wilcoxon test was used to compare these values before and after inducing plantar-flexor muscle fatigue. Results: The force sense error and joint reposition sense error of ankle joints after inducing plantar-flexor muscle fatigue increased significantly compared to the values before inducing muscle fatigue. Conclusion: This study suggests that plantar-flexor muscle fatigue could degrade the force sense and joint reposition sense in ankle joints. In addition, it could deteriorate ankle proprioception.