Earticle

본 연구는 예비 초등교사의 배구 서비스 동작시 영상분석을 통해서 오버핸드 서비스 동작의 운동학적 요인을 비교 연구하여 배구 서비스 동작의 기능향상에 대한 정량적인 정보제공을 목적으로 연구되었다. 연구방법은 3차원 공간 좌표 설정을 위해 배구 서비스 동작을 완전히 촬영하도록 카메라(High Smart Camera, 촬영속도 125 frame/sec, 노출시간1/1000초)를 대상자 측면 45 °각도에 2대 설치하였다. 신체계측점 23점을 디지타이징하고, 이들의 3차원 좌표값을 DLT법에 의해 산출하였다. 서비스 동작은 성공과 실패에 따라 그룹별로 구분하여 3회씩 평균값을 제시하였다. 연구내용으로는 서비스 동작시 소요된 시간요인, 신체각도요인, 신체중심 및 임팩트 위치등 을 분석하였다. 연구대상은 배구수업 교육과정에 참여하는 학생 10명을 선정하였다. 이러한 분석결과는 초등배구 수업에서의 올바른 자세의 교정 및 효과적인 지도방법에 대한 정량적인 정보를 제공할 목적으로 수행되었다. 연구 결과 A그룹에서 첫째, 서비스 동작을 수행하는데 소요된 시간이 적은 결과를 보였다. 정확한 타격이 가능한 배구공 의 체공시간을 갖고, 타격시 빠른 스윙에 의한 결과로 배구공의 속도 향상에 필요한 소요시간에 유지하였다. 둘째, 각도변인에서 A그룹에서 상대적으로 공의 궤적을 효율적으로 수행할 수 있는 손분절과 어깨관절로 이루어지도록 회전반경을 크게하고, 타격시 수직높이를 증가시키는 신체각을 유지하였다. 셋째, 신체중심 및 임팩트 위치요인에 서는 A그룹에서 신체중심 높이가 높고, 중심의 이동변위의 상승폭이 크게, 임팩트시 수직높이가 높게 형성되었다.

This study tried to provide kinematic information and improve service ability of successful motion performance of volley ball service motion through the study of success and failure factors of volleyball service motion in the educational course of physical education department with prospective elementary school teachers. Variables such as time, angle, and position of each group according to the success factors in service motion showed the difference in performing an efficient volleyball service motion, and this information could be a learning factor necessary for successful motion of volleyball service motion. First, in Group A, the time required to perform the service motion was short. This could be a factor necessary to improve the speed of the volleyball. Second, in the angle variable A group showed body angle factor that can perform the ball trajectory efficiently. Third, in the factors of body center and impact position, A group showed higher body center height, bigger center movement displacement and higher vertical height at impact. It also showed the position factor that can perform the service successfully at the displacement of hands and body and the displacement of left and right feet. By supplying the quantitative information such as duration of flight, body joint angle and center position factor shown in the above to the students of education universities, they can improve the technique of volleyball service motion. It is believed that it can provide much information on the ways of teaching elementary school students later.

Background Recent studies have used kinematic chain theory to establish a relationship between the hallux valgus and the lower limb joints and bones. This theory suggests that movement at one joint of a lower extremity may affect all other joints via a chain reaction. Purpose We examined the hip joint range of motion and muscle strength in subjects with asymmetric hallux valgus angles. Study design A cross-sectional study. Methods Fifteen participants with asymmetric hallux valgus angles were recruited. Two exami-ners measured the hallux valgus, intermetatarsal and tibial torsion angles, and the iliotibial band flexibility. The independent t-test was used to compare the differences between the two sides. Results The side with the greater hallux valgus angle also had a larger intermetatarsal angle. The iliotibial band was significantly less flexible on this side. The tibial torsion angles did not differ significantly between the two sides. Conclusions We suggest that the hallux valgus angle is associated with iliotibial band flexibility. Therefore, stretching of the iliotibial band should be considered during rehabilitation of the hallux valgus.

Objective To assess the relationships between phase angle and muscle mass, strength, and physical function in patients with heart failure. Methods This study used a cross-sectional design. The analysis included 51 patients with heart failure. The Short Physical Performance Battery, one-leg standing time, handgrip strength, phase angle, and skeletal muscle index were measured. To identify explanatory variables of phase angle, hierarchical multiple regression analysis was performed. Results Handgrip strength was found to be an explanatory variable of phase angle independent of age, sex, and body mass index. This model was able to explain 30.4% of the model variance for phase angle. Conclusion In patients with heart failure, improving muscle strength rather than muscle mass or physical function might be more important for improving phase angle. Handgrip strength is an important outcome for improving prognosis in patients with heart failure.

Objective: To investigate the relationship between the torque onset angle (TOA) of the isokinetic test for knee extensors in the paretic side and walking related balance in subacute stroke patients.Methods: We retrospectively reviewed patients with first-ever strokes who have had at least two isokinetic tests within 6 months of onset. 102 patients satisfied the inclusion criteria. The characteristics of walking related balance were measured with the Berg Balance Scale sub-score (sBBS), Timed Up and Go test (TUG), 10-m Walk Test (10MWT) and Functional Independence Measure sub-score (sFIM). The second isokinetic test values of the knee extensor such as peak torque, peak torque to weight ratio, hamstring/quadriceps ratio, TOA, torque stop angle, torque at 30 degrees, and peak torque asymmetry ratio between paretic and non-paretic limb were also taken into account. Pearson’s correlation, simple regression and multiple regression analysis were used to analyze the correlation between TOA and walking related balance.Results: TOA of the knee extensor of the paretic limb showed significant correlations with BBS, sBBS, TUG, 10MWT, and sFIM according to Pearson’s correlation analysis. TOA also had moderate to good correlations with walking related balance parameters in partial correlation analysis. In multiple regression analysis, TOA of the paretic knee extensor was significantly associated with walking related balance parameters.Conclusion: This study demonstrated that TOA of the paretic knee extensor is a predictable parameter of walking related balance. Moreover, we suggest that the ability to recruit muscle quickly is important in walking related balance.

Objective To suggest rotation angles of fluoroscopy that can bypass the carotid sheath according to vertebral levels for cervical transforaminal epidural steroid injection (TFESI). Methods Patients who underwent cervical spine magnetic resonance imaging (MRI) from January 2009 to October 2017 were analyzed. In axial sections of cervical spine MRI, three angles to the vertical line (α, angle not to insult carotid sheath; β, angle for the conventional TFESI; γ, angle not to penetrate carotid artery) were measured. Results Alpha (α) angles tended to increase for upper cervical levels (53.3° in C6-7, 65.2° in C5-6, 75.3° in C4-5, 82.3° in C3-4). Beta (β) angles for conventional TFESI showed a constant value of 45° to 47° (47.5° in C6-7, 47.4° in C5-6, 45.7° in C4-5, 45.0° in C3-4). Gamma (γ) angles increased at higher cervical levels as did α angles (25.2° in C6-7, 33.6° in C5-6, 43.0° in C4-5, 56.2° in C3-4). Conclusion The risk of causing injury by penetrating major vessels in the carotid sheath tends to increase at upper cervical levels. Therefore, prior to cervical TFESI, measuring the angle is necessary to avoid carotid vessels in the axial section of CT or MRI, thus contributing to a safer procedure.

Background Although various foot progression angle (FPA) modifications during gait have been applied to reduce peak knee adduction moment (KAM), few studies have investigated effects of applying toe-in and toe-out walking modifications on three-dimensional (3D) moments of the hip joint. Purpose To determine effects of two different artificial FPA walking trials on peak hip moment in individuals with knee osteoarthritis using a 3D motion analysis system and a force platform equipment. Study design A cross-sectional and repeated-measures study design. Methods Biomechanical data of the KAM and 3D peak hip moments were obtained from 27 participants. A 3D motion analysis system and two force platforms were used to measure KAM and 3D peak hip moments under three different FPA walking conditions: freely normal foot position (FNFP), maximal possible internal rotation foot position, and maximal possible external foot position (MEFP). Two-way repeated measures analysis of variance was used to compare moment data among FPA modification walking conditions and both lower limb sides. Results The second peak KAM (F=5.624, p=0.014) occurring at 75%?100% stance phase during gait was significantly different among FPA gait conditions. The second peak KAM of the MEFP walking trials showed a significant decrease compared to that of the FNFP condition through post-hoc test (p<0.05). All peak moments generated at the hip joint in the stance phase during walking showed no significant differences in FPA modification walking trials (p>0.05). There were no interactive effects between FPA condition and knee sides for any KAM or peak hip moment values (p>0.05). Conclusions MEFP modification walking reduced the second peak KAM compared to the baseline walking and MIFP walking condition. All hip moments were unaffected by applying the three FPA modification conditions during gait. Results of this study suggest that FPA walking trials, which affects peak KAM of the knee joint, does not have a significant effect on the peak hip moment. Therefore, interventions of FPA walking retraining to patients with knee OA should be applied to each patient based on accurate biomechanical evaluation.

Objective: To investigate long-term changes in femoral anteversion angle (FAA) in children with intoeing gait and to identify factors that affect FAA changes.Methods: We retrospectively analyzed three-dimensional computed tomography data from 2006 to 2022 of children with intoeing gait with ≥3 years of follow-up without active treatment. The study examined the mean changes in FAA, the effects of sex, age, and initial FAA on FAA change, and mean FAAs by age. Changes in FAA severity up to eight years of age were also observed and analyzed by sex.Results: A total of 126 lower limbs of 63 children (30 males, 33 females) with intoeing gait were included, with a mean age of 5.11±1.05 years and a mean follow-up period of 43.59±7.74 months. The initial FAA was 41.42°±8.29° and the follow-up FAA was 33.25°±9.19°, indicating a significant decrease (p<0.001). Significant correlations were observed between age and changes in FAA, as well as between initial FAA and changes in FAA (r=0.248, p=0.005; r=-0.333, p<0.001). At age 8 years, only 22 limbs were classified as having mild FAA severity.Conclusion: During the follow-up period, children with intoeing gait had a significant decreased in FAA. No significant difference in FAA change was found between sex, but younger children and those with greater initial FAA were more likely to have decreased FAA. However, most children retained moderate to severe severity of increased FAA. Further studies are required to validate these findings.

Background The Pilates method has recently been recommended as the best way to improve spinal stability by strengthening the trunk and gluteus maximus (GM) muscles. Purpose In this study, we compared trunk and GM muscle activities and pelvic rotation angles during four traditional Pilates exercises. Study design Cross-sectional study Methods Twenty healthy volunteers were recruited for this study. During the four exercises, the activity of the trunk and GM muscles were measured via electromyography and pelvic rotation was measured using a smart phone-based measurement tool. Results The activities of the transverse abdominis/internal oblique and external oblique muscles were highest during the leg pull front (LPF) compared to the other exercises. GM activity was significantly higher during the LPF compared to the shoulder bridge and swimming (SW), but not during the one leg kick (OLK). Multifidus (MF) activity was significantly higher during SW than during the other exercises. There were no significant differences in MF activity between the SW and OLK exercises. Pelvic rotation angle was significantly reduced during the OLK compared to the LPF (p=0.004). Conclusions We recommend the LPF exercise if the goal is increased trunk and GM muscle activity and the SW exercise if you target for increased MF activity. The OLK exercise is useful for activating the trunk and GM muscles while reducing uncontrolled pelvic movements.

Objective To evaluate femoral anteversion angle (FAA) change in children with intoeing gait depending on age, gender, and initial FAA using three-dimensional computed tomography (3D-CT). Methods The 3D-CT data acquired between 2006 and 2016 were retrospectively reviewed. Children 4 to 10 years of age with symptomatic intoeing gait with follow-up interval of at least 1 year without active treatment were enrolled. Subjects were divided into three groups based on age: group 1 (≥4 and <6 years), group 2 (≥6 and <8 years), and group 3 (≥8 and <10 years). Initial and follow-up FAAs were measured using 3D-CT. Mean changes in FAAs were calculated and compared. Results A total of 200 lower limbs of 100 children (48 males and 52 females, mean age of 6.1±1.6 years) were included. The mean follow-up period was 18.0±5.4 months. Average initial and follow-up FAA in children with intoeing gait was 31.1°±7.8° and 28.9°±8.2°, respectively. The initial FAA of group 1 was largest (33.5°±7.7°). Follow-up FAA of group 1 was significantly reduced to 28.7°±9.2° (p=0.000). FAA changes in groups 1, 2, and 3 were -6.5°±5.8°, -6.4°±5.1°, and -5.3°±4.0°, respectively. These changes of FAA were not significantly (p=0.355) different among the three age groups. However, FAA changes were higher (p=0.012) in females than those in males. In addition, FAA changes showed difference depending on initial FAA. When initial FAA was smaller than 30°, mean FAA change was -5.6°±4.9°. When initial FAA was more than 30°, mean FAA change was -6.8°±5.4° (p=0.019). Conclusion FAA initial in children with intoeing gait was the greatest in age group 1 (4?6 years). This group also showed significant FAA decrease at follow-up. FAA changes were greater when the child was a female, younger, and had greater initial FAA.

Background: Osteoarthritis (OA) is a major public health concern, yet standard radiographic diagnosis faces limitations like radiation exposure, costs, and poor correlation with clinical symptoms. Accessible non-invasive indicators are needed. The popliteal crease obliquity angle (PCOA) has emerged as a promising tool reflecting lower limb alignment, while the Early Osteoarthritis Questionnaire Assessment (EOQA) provides critical subjective symptom data. Despite their individual utility, the relationship between PCOA and EOQA remains insufficiently explored. This study investigates their association to evaluate if PCOA can serve as a reliable, non-invasive surrogate to supplement or replace conventional imaging in OA evaluation. Purpose: To investigate the association between the PCOA and the clinical features of the EOQA in individuals with preclinical knee osteoarthritis. By analyzing this relationship, this study evaluates whether PCOA can serve as a potential non-invasive clinical indicator for early screening and biomechanical assessment in primary care settings. Study design: A comparative study. Methods: This study involved 43 manufacturing workers (86 legs) recruited from a cosmetic production facility. Participants were assigned to the experimental group (n=42 legs) and control group (n=44 legs). The PCOA was measured in a barefoot standing position under two conditions. Mann-Whitney U test to compare PCOA values between groups under two different conditions: shoulder-width apart and feet together. Results: In the shoulder-width stance, the EOQA group exhibited significantly higher PCOA angles compared to the non-EOQA group. Similarly, in the feet-together stance, EOQA-positive limbs showed a significantly greater PCOA. For both positions, the differences were statistically highly significant (p<0.001), confirming a robust association between EOQA status and PCOA. Receiver operating characteristic analysis demonstrated an area under the curve of 0.888, and the optimal cutoff value of PCOA was 7.0deg, yielding a sensitivity of 0.900. Conclusions: This study demonstrates a significant association between the PCOA and the clinical features of the EOQA. Measuring PCOA, especially in a shoulder-width stance, provides a practical, radiation-free screening tool for preclinical knee OA. The high area under the curve and sensitivity indicate the practical utility of integrating objective PCOA with subjective EOQA assessments. This combined approach facilitates early detection and simplifies biomechanical evaluation in primary care and occupational health settings.

Background In clinical settings, a pressure biofeedback unit (PBU) is sometimes used to detect pelvic movement and retrain movement patterns during lower limb movement. Hamstring length influences changes in pelvic movement during passive straight leg raising (PSLR). Purpose To determine the relationship between pelvic motion and biofeedback pressure measured by a PBU during PSLR, and to identify changes in biofeedback pressure after hamstring stretching. Study design Cross-sectional study Methods Twenty participants with short hamstrings were recruited for this study. A three-dimensional motion analysis system and PBU were used to measure pelvic angle and biofeedback pressure during PSLR, respectively. The pelvis angle and biofeedback pressure were measured before and after hamstring stretching, increasing PSLR in 10-degree increments. Results There was a significant relationship between pelvic motion and biofeedback pressure (Pearson’s r=0.76, p<0.05). Linear regression equation using lumbopevic angle as an independent factor was as follows: Pressure of PBU=45.05+(3.35×angle of lumbopelvic motion) (R2=0.57, p<0.05). Biofeedback pressure decreased significantly between PSLR angles of 10?60° after hamstring stretching (p<0.05). The pelvic angle decreased significantly at PSLR angles of 50° and 60° after hamstring stretching (p<0.05). Conclusions Biofeedback pressure measured with a PBU can be used to assess pelvic motion during muscle length tests following hamstring stretching.

ABSTRACT Background Lumbopelvic rhythm can be affected by several factors, such as stiffness of the hip joint, hamstring, and ankle, and sciatic nerve tension. Currently, no reports indicating that sciatic nerve tension affects the anterior pelvic tilting angle during forward bending are available. Purpose This study aimed to compare the anterior pelvic tilting angle during forward bending in subjects with and without sciatic nerve tension. Study design Cross-sectional comparative study. Methods Eighty-eight subjects were screened and classified into two groups, namely subjects with (12 subjects) and without (12 subjects) sciatic nerve tension. Sciatic nerve tension was measured by the knee extension angle recorded in the seated position with ankle dorsiflexion using the Smart KEMA motion sensor. The mean±standard deviation of the knee extension angle with ankle dorsiflexion in our study population was 66.8±11.8°. The standard deviation was used to define the group with sciatic nerve tension (<55°) and without sciatic nerve tension (>79°). The Smart KEMA motion sensor was placed on the second spinous process of the sacrum to measure the anterior pelvic tilting angle during forward bending. Results The mean values of the knee extension angle with ankle dorsiflexion were 46.6° and 82.9° for the groups with and without sciatic nerve tension, respectively. The mean values of the anterior pelvic tilting angle measured during the forward bending test were 36.7° and 46.5° in the groups with and without sciatic nerve tension, respectively. There was a statistically significant difference in the anterior pelvic tilting angle between the groups with and without sciatic nerve tension (p<0.05). Conclusions The results of this study suggest that sciatic nerve tension can affect the anterior pelvic tilting angle during forward bending. Further studies are needed to determine whether exercise for decreasing sciatic nerve tension can increase the anterior pelvic tilting angle during forward bending.

Objective To clarify the relationship of the initial radiologic and a biomechanical parameter at first clinical visit, and define the effectiveness of modified insole, following insole fitting in children with flexible flatfoot. Methods Children aged less than 13 years with flexible flatfoot were enrolled. The total number of subjects was 66 (33 boys, 33 girls). The subjects were divided into 5 subgroups, based on age: 1?2, 3?4, 5?6, 7?9, and 10?12 years. The mean time period between the initial & final examination for their resting calcaneal stance position angle (RCSPA) was 24 months. Radiography quantified the deformity by measuring angles, including the talometatarsal angle, the metatarsal angle, and the calcaneal pitch angle. Results From the angles measured on radiographs, only the talometatarsal angle showed a statistically significant correlation to the initial RCSPA (r=-0.578 for right side, r=-0.524 for left side; p<0.01). The mean RCSPA improved in all subgroups of subjects following insole fitting. Moreover, in children younger than 7 years, the improvement in RCSPA from the insole fitting was greater compared to children aged 7 years and older. Conclusion The insole has additionally beneficial effects in all populations younger than 13 years. However, there might exist a hidden effect of normal structural pedal alignment during growth accompanied with bony maturation and developmental process. To date, it is controversial whether the treatment of flexible flatfoot is necessary in the vast majority of cases, or simple observation and advice to parents would suffice.

ABSTRACT Background The infrasternal angle is typically measured using goniometric or photographic methods. Because chest anterior?posterior radiographic images cannot be used to identify the xiphoid process, no study has evaluated the validity of infrasternal angle measurement. Purpose The purpose of this study was to determine reliability and validity of measurement of infrasternal angle by radiographic method. Study design Intra- and inter-tester repeated measures. Methods Infrasternal angles were measured in 25 healthy students using goniometric and radiographic method. To check the xiphoid process in radiographs, the examiner set the marker at the xiphoid process. Radiographs were taken by one X-ray technician for each subject using a radiographic apparatus. Repeated radiographs measurements were made in two test sessions conducted on different days by two testers to assess inter-rater and intra-rater reliability. The reliability of the infrasternal angle measurement was using intraclass correlation coefficients (ICCs: 3,1). The correlation between measurements taken by the radiograph and goniometric methods was calculated to test the validity of the radiographic method. The alpha level was set at 0.05. Results The intra- and inter-rater reliability of infrastenral angle measurements taken by the radiographic method were excellent (ICC=0.991 and 0.993, respectively). Radiographic measurement of the infrasternal angle was highly correlated with goniometric measurement (r= 0.85). Conclusions We suggest that the radiographic method is a highly reliable and valid tool for infrasternal angle measurement.

Background Active prone hip extension is an exercise commonly used in physical therapy for patients with hip or trunk dysfunction. Insufficient trunk muscle activation or gluteus maximus (GM) activity leads to lumbopelvic rotation during active prone hip extension. However, there is still a lack of research on whether GM strength or GM strength asymmetry causes pelvic rotation. Purpose The current study aimed to investigate the relation of GM weakness to pelvic rotation during active prone hip extension in healthy individuals, specifically by examining the correlation between GM strength and pelvic rotation angle, as well as between GM strength asymmetry and difference in the pelvic rotation angles on the left and right sides. Study design Cross-sectional study Methods This analysis included 35 healthy male participants. Bilateral GM strength was measured using the Smart KEMA tension sensor. The pelvic rotation angle on the right and left legs was measured with a smart phone-based measurement tool during prone hip extension. The significance of the correlations between GM strength and pelvic rotation angle and between GM strength asymmetry and difference in pelvic rotation angles during prone hip extension was assessed using Pearson correlation coefficients. Results There was a very large significant negative correlation between GM strength and pelvic rotation angle (r=?0.807) and a very large significant positive correlation between GM strength asymmetry and difference in pelvic rotation angles (r=0.825) during prone hip extension. Conclusions GM strength and GM strength asymmetry influence pelvic rotation during hip extension movement.

Objective To assess the intra-rater and inter-rater reliability for measuring femoral anteversion angle (FAA) by a radiographic method using three-dimensional computed tomography reconstruction (3D-CT).Methods The study included 82 children who presented with intoeing gait. 3D-CT data taken between 2006 and 2014 were retrospectively reviewed. FAA was measured by 3D-CT. FAA is defined as the angle between the long axis of the femur neck and condylar axis of the distal femur. FAA measurement was performed twice at both lower extremities by each rater. The intra-rater and inter-rater reliability were calculated by intraclass correlation coefficient (ICC). Results One hundred and sixty-four lower limbs of 82 children (31 boys and 51 girls, 6.3±3.2 years old) were included. The ICCs of intra-rater measurement for the angle of femoral neck axis (NA) were 0.89 for rater A and 0.96 for rater B, and those of condylar axis (CA) were 0.99 for rater A and 0.99 for rater B, respectively. The ICC of inter-rater measurement for the angle of NA was 0.89 and that of CA was 0.92. By each rater, the ICCs of the intra-rater measurement for FAA were 0.97 for rater A and 0.95 for rater B, respectively and the ICC of the inter-rater measurement for FAA was 0.89. Conclusion The 3D-CT measures for FAA are reliable within individual raters and between different raters. The 3D-CT measures of FAA can be a useful method for accurate diagnosis and follow-up of femoral anteversion.

Background Active straight leg raise (ASLR) has been used to assess the functional ability to transfer loads through the pelvis and different motor control strategies of transversus abdominis. The pelvic floor muscles are also an important part of the local muscle system. Purpose To investigate the relationships among pelvic floor muscle contraction (PFMC), abdominal muscle activity, and the pelvic transverse rotation angle during voluntary PFMC in healthy, continent women. Study design Cross-sectional study Methods 16 continent women were instructed to perform ASLR with and without PFMC. PFMC was confirmed by transabdominal ultrasound. Surface electromyography data were collected from the muscle activities of the transversus abdominis/internal oblique (TrA/IO), external oblique (EO), and multifidus, and the pelvic rotation angle was measured using a smartphone-based measurement tool. The results were analyzed using the paired t-test (α=0.05). Results PFMC led to an increased both TrA/IO (p<0.01) and decreased contralateral EO muscle activation (p<0.01), together with a greater decrease in pelvic rotation angle (p<0.001), during ASLR. Conclusions The ASLR with PFMC method may be effective for individuals with pelvic floor dysfunction, which cause unwanted pelvic rotation and decreased TrA/IO muscle activity.

Background: Abdominal hollowing (AH) and abdominal bracing (AB) are well-known stabilization maneuvers used in rehabilitation and training programs. However, few studies have examined how these two techniques affected the lumbopelvic stability during leg movements. Purpose: This study aims to compare pelvic rotation angles during leg movements with AH or AB maneuver. Study design: Comparative, repeated-measures design Methods: This study included 20 male healthy participants. After attaching motion sensor, we asked the participants to perform the two leg movements, straight leg raise (SLR), and bent knee fallout, in three conditions, including abdominal resting (AR), AH, and AB maneuvers, and collected and compared the pelvic rotation angles during each condition. Results: The difference between the three conditions for pelvic rotation angles of both leg movements was significant (p<0.05). When performing SLR or bent knee fallout with AB maneuver, the pelvic rotation angle decreased more significantly than that in performing movements with AR or AH maneuver (p<0.05). When performing SLR or bent knee fallout with AH maneuver, the pelvic rotation angle decreased more significantly than that in performing movements with AR maneuver (p<0.05). Conclusions: This study indicated that the AB maneuver is more effective in SLR, and bent knee fallout with lumbopelvic stabilization exercise than the AH maneuver.

Objective: Although the effects of head lift exercise (HLE) in the reclining position have been reported, there is insufficient clinical evidence of the effects. This study compared the effects of HLE in the 0° supine position and 45° reclining position on the swallowing function and the compliance of patients with dysphagia after stroke after both exercises. Methods: This was a randomized, assessor-blinded clinical trial. Thirty-five patients with stroke and dysphagia were assigned randomly to HLE in the 0° supine group (n=18) or HLE in the 45° reclining group (n=17). Patients in both groups performed HLE five days a week for four weeks and received the same conventional dysphagia therapy. The videofluoroscopic dysphagia scale (VDS) was used to evaluate the swallowing function. The dropout rate and subjective feedback related to compliance with the two exercises were monitored. Results: No significant differences in the baseline characteristics were observed between the two groups. Patients in both groups showed significant improvement in the oral and pharyngeal phases of VDS (P＜0.05). After the intervention, no significant differences were observed between the groups (P＞0.05). Dropout rates of 22% and 6% owing to neck discomfort or fatigue were observed in the HLE in 0° supine group and the HLE in 45° reclining group, respectively. Conclusion: HLE in the 45° reclining position has a similar effect on the swallowing function in patients with dysphagia after stroke to that of HLE in the 0° supine position and is associated with better exercise compliance.

Objective To determine the diagnostic accuracy and reliability of the Harris imprint index (HII), Chippaux-Smirak index (CSI), and Staheli index (SI) compared with the talar-first metatarsal angle.Methods Data was collected at the orthotic and prosthetic clinic, Thammasat University Hospital from January 1, 2016 to August 31, 2020. The three footprints were measured by the rehabilitation physician and the orthotist. The talar-first metatarsal angle was measured by the foot and ankle orthopaedist.Results The data from 198 patients with 274 feet was analyzed. The diagnostic accuracy of the footprint triad showed that CSI was the most accurate in pes planus prediction, followed by HII and SI (area under the receiver operating characteristic curve [AUROC]=0.73, 0.68, 0.68, respectively). In pes cavus, HII was the most accurate, followed by SI and CSI (AUROC=0.71, 0.61, 0.60, respectively). For pes planus, the intra-observer reliability by Cohen’s Kappa was 0.92 for HII, 0.97 for CSI, and 0.93 for SI, the inter-observer reliability 0.82, 0.85, and 0.70, respectively. For pes cavus, the intra-observer reliability was 0.89 for HII, 0.95 for CSI, and 0.79 for SI, inter-observer reliability of 0.76, 0.77, and 0.66, respectively.Conclusion The accuracy of HII, CSI, and SI was fair in screening of pes planus and pes cavus. The intra- and inter-observer reliability were in the moderate to almost perfect range by Cohen’s Kappa.