Purpose: The study sought to determine whether goal achievement, performance, satisfaction, activities of daily living, and gross motor function in children with spastic cerebral palsy are positive affected by goal-oriented functional task training. Methods: In a single case study, two 7-year-old girls diagnosed with spastic cerebral palsy were given functional task training based on individualized goals for 24 60-minute sessions over a period of 6 months. The individualized goals reflected the needs of both children and parents. The Canadian occupational performance measure (COPM) and the goal attainment scale (GAS) were used to measure goal performance and satisfaction before and after intervention. Independence of activities of daily living before and after intervention were assessed using the functional independence measure for children (Wee-FIM). And change of gross motor function were assessed using gross motor function measure (GMFM). Results: Clinically significant changes were observed in COPM and GAS, as well as positive changes in independence of gross motor function and activities of daily living. Conclusion: The findings indicate that goal-oriented functional task training addresses the needs of children with spastic cerebral palsy, which increases treatment satisfaction and has a positive effect on independent activities and participation in daily life.

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: Functional ankle instability (FAI) causes tension in the joints, ligaments, and tendons, and the impact on visual and vestibular organs leads to imbalance. This study compared the effects of a traditional balance training program to virtual reality training to improve FAI. Methods: Twenty-four participants with FAI (CAIT score < 24) were assigned to a virtual reality training group (n = 13) and a traditional balance training group (n = 11). Both groups pursued their respective training program for four weeks. After a ten-minute warm-up, participants completed a 30-minute training session, three times per week. The traditional balance training group underwent static and dynamic training using a balance board and a stability trainer pad while the virtual reality group underwent balance training using a virtual reality program. Biorescue was used to measure changes in the speed and length of center of pressure (COP) for single-leg stance pre- and post-training. Results: The speed and length of COP improved significantly in both groups after training as compared to before (p < 0.05). However, there were no significant differences in these outcomes between the virtual reality training group and the traditional balance training group (p>0.05). Conclusion: The study findings confirm the effectiveness of both virtual reality training and traditional balance training in reducing ankle instability, with no difference in treatment effects.

Purpose: The study investigated the effect of combined balance exercise using visual feedback and balance pads in rehabilitation of chronic stroke patients. Methods: The participants were 30 patients diagnosed with stroke who met the study selection criteria. Participants were randomly divided into 3 groups of 10: a balance pad exercise (BPE) group, a visual feedback exercise (VFE) group, and a combined balance exercise (CBE) group. All three groups engaged in 30 minutes of exercise, 3 times per week, for 6 weeks. Results: Pre-test and post-test results were analyzed using the functional reach test (FRT), the Berg balance scale (BBS), the timed up & go test (TUG), and the Korean version of the activities-specific balance confidence (K-ABC) scale. The study yielded the following results. Pre- and post-program FRT measures showed significant differences between the BPE and CBE groups (p < 0.05). BBS, TUG, and K-ABC scores showed clear differences in all three groups. Secondly, the CBE group and the BPE group a differed significantly on the BBS before and after the 6-week program (p < 0.05). Finally, the CBE group and the VFE group differed significantly on the BBS before and after the 6-week program (p < 0.05). Conclusion: The study results indicate that combined balance exercise improves balance more effectively than the balance pad and visual feedback exercises. This finding should help to improve rehabilitation in the future.

Purpose: The purpose of the study was to assess the effects of proprioceptive neuromuscular facilitation (PNF) training and respiratory muscle endurance training on pulmonary function and activity in chronic stroke patients. Methods: The participants were 25 chronic stroke patients. They were assigned to two groups: a PNF and respiratory muscle training group (experimental group; n = 12) and a conservative training group (control group; n = 13). The experimental group completed 50 minutes (30 minutes of conventional physical therapy, 10 minutes of PNF training, and 10 minutes of respiratory muscle endurance training). The control group also completed 50 minutes (30 minutes of conventional physical therapy and 20 minutes on a full-body workout machine). Pulmonary function and activity were measured before and after the intervention, using Cosmed to analyze pulmonary function and 6MWT as clinical evaluation indicators. Results: Both groups showed significant within-group differences on all tests before and after the intervention; the experimental group showed greater improvement on all tests. Conclusion: The findings confirm that PNF training and respiratory muscle endurance training have a positive effect on pulmonary function and activity index in chronic stroke patients.

Purpose: The study investigated the effect on chronic stroke patients' balance of a weight shift to the affected side using an insole on the less affected side during treadmill walking training. Methods: The subjects were 7 patients who had been diagnosed with stroke 6-24 months prior to the study. In each case, an insole was applied on the patient's less affected side during treadmill walking training. Each training session lasted 30 minutes and was undertaken 5 times per week for 4 weeks. Biorescue equipment that measures shifts in center of pressure was used to assess balance ability as measured by the Korea-Berg balance scale (K-BBS) before and after each training intervention. The Wilcoxon signed-rank test was used to evaluate within-group effects. Results: The results revealed statistically significant before and after differences in area, pressure, length, and mean velocity of the balance test and on K-BBS (p < 0.05). Conclusion: In chronic stroke patients, using an insole to adjust the height of the shoe on the less affected side is an effective means of increasing weight-shifting on the paralyzed side during treadmill gait training.

Purpose: The purpose of the study was to compare the effects of different methods of pelvic control on abdominal muscle activity and lumbopelvic rotation angle during active straight leg raising (ASLR) in patients with chronic back pain. Methods: The study participants were patients with low back pain (n = 30). They were instructed to perform ASLR with pelvic control, ASLR with pelvic belt, and ASLR only. Surface electromyography data were collected from the ipsilateral rectus femoris (IRF), ipsilateral internal oblique (IIO), contralateral external oblique (CEO), and ipsilateral rectus abdominal (IRA) muscles, and lumbopelvic rotation angle was measured using a motion analysis device. Results: Activation of all abdominal muscles was greater in the ASLR with pelvic control group than in the ASLR with pelvic belt and ASLR groups. The lumbopelvic rotation angle was lower in the ASLR with pelvic control group than in the other two groups (p < 0.05). Conclusion: These results suggest that ALSR with pelvic control is an effective means of increasing abdominal muscle activity and reducing unwanted lumbopelvic rotation in patients with chronic low back pain. Controlling the pelvis using the opposite leg is an effective form of ASLR exercise for patients with chronic low back pain.

Purpose: The study investigated pain and falls as psychological factors in Total Knee Replacement patients and examined the relationship between these factors. Methods: Ninety-six total knee replacement patients aged 69.31±7.01 (male: 21, female: 75) participated in the study. Post-surgery pain was assessed on a visual analog scale, and fall risk scores were evaluated on fall fear and fall efficacy scales. Other psychological factors assessed included national anxiety and trail anxiety, fear prevention, Beck depression score, and psychological health measures. The data were analyzed using SPSS version 22.0. Results: A statistically significant correlation was found between pain before surgery and FES fall fear score before surgery (p < 0.05). A statistically significant correlation was found between pain after surgery and PWBS fall fear score after surgery (p < 0.05). A statistically significant correlation was found between state anxiety and PWBS, Trail anxiety (p < 0.05). A statistically significant correlation was also found between trail anxiety and BDI, PWBS (p < 0.05). State anxiety and fear avoidance before surgery were found to affect trail anxiety, and pain before surgery and fall fear score before surgery were found to affect FES. In addition, PWBS was found to affect BDI. Conclusion: The study confirms that increased pain in Total Knee Replacement patients can be a risk factor for falls. In addition, fall fears increase fear avoidance and cause psychological deterioration. This suggests that efforts should be made to reduce pain and to manage psychological factors.

Purpose: The study investigated the effects of extracorporeal shock wave therapy with myofascial release techniques (ESWT+MFR) on pain, movement, and function in patients with myofascial pain syndrome. Methods: Forty participants with upper trapezius trigger points were recruited and randomly allocated to two groups: an experimental group (n = 20) and a control group (n = 20). The experimental group performed the ESWT+MFR, and the control group performed only myofascial release techniques. Each group was treated for 15 minutes, twice a week for four weeks. Pain was assessed using a visual analogue scale and a pressure pain threshold measure. Movement was assessed by cervical range of motion, and cervical and shoulder function were assessed on the Constant-Murley Scale and the Neck Disability Index before and after treatment. Results: The results indicate statistically significant improvements in the two groups on all parameters after intervention as compared to baseline (p < 0.05). As compared to the control group, the experimental group showed statistically significant improvements on the visual analogue scale and pressure pain threshold, cervical range of motion (except rotation), and on the Neck Disability Index (p < 0.05). Conclusion: The ESWT+MFR is more effective than myofascial release techniques for pain, movement, and function in patients with myofascial pain syndrome and would be clinically useful for physical therapists treating myofascial pain syndrome.

Purpose: The purpose of this study was to investigate the effect of proprioceptive neuromuscular facilitation (PNF) lower extremity pattern on the dominant leg on muscle activity of the lower extremity supported by the ground. Methods: The subjects were 20 healthy males living in Busan. All subjects performed four direction PNF lower extremity patterns, and data were collected by surface electromyography from the gluteus medius (GM), tensor fascia latae (TFL), vastus medialis oblique (VMO), vastus lateralis oblique (VLO), and semitendinosus (STD) muscles of the opposite lower extremity during PNF lower extremity pattern. The PNF lower extremity pattern applied to the dominant leg was (1) flexion/adduction/external rotation with knee flexion; (2) extension/abduction/internal rotation with knee extension; (3) flexion/abduction/internal rotation with knee flexion; and (4) extension/adduction/external rotation with knee extension pattern, repeated 3 times per pattern and using the average value of the collected results. Collected muscle activity values were analyzed by one-way ANOVA, and post-hoc Tukey testing was performed to check between-group differences. The statistical significance level was set at α = 0.05. Results: GM and TFL flexion/abduction/internal rotation pattern with knee flexion was significantly higher than other patterns. VMO and VLO extension/adduction/external rotation pattern with knee extension was significantly higher than other patterns. STD flexion/adduction/external rotation pattern with knee flexion was significantly higher than other patterns. Conclusion: The study confirms differences in lower extremity muscle activity for the PNF lower extremity pattern, indicating that selective muscle contraction induction is possible using a pattern appropriate to the purpose of treatment.

Purpose: The purpose of the study was to investigate the effects of HMD (head mounted display)-based virtual reality balance training on static balance in young adults, and whether appropriate balance training can help healthy adults to improve balance ability in daily living. Methods: The study subjects were 14 healthy adults. Subjects received 20 minutes of HMD-based virtual reality balance training 3 times per week for 4 weeks. Static balance was measured before, during, and after training and after one month. Static balance was measured in a total of 8 conditions, and the results were classified as visual (F1), somatosensory (F5-6), vestibular (F2-4), and central nervous system (F7-8). Results: The test results showed no significant difference in pre-training, post-training, and follow-up results under all conditions at Fourier index F1, F5-6, and F7-8 frequencies. For the F2-4 frequency, there was a significant difference before and after training under NC (neutral head position, eyes closed, firm surface) and PC (neutral head position, eyes closed, elastic surface) conditions. The NC condition returned a significant decrease of F2-4 frequency in post-training testing as compared to pre-training, and the PC condition showed a significant decrease of F2-4 frequency between the pre-training and mid-training tests, and between the pre-training and post-training tests. Conclusion: These results indicate that HMD-based balance training can improve balance ability, even in normal adults, and seems especially effective for vestibular function training.

Purpose: The purpose of this study is to understand and analyze the current status of dementia management and rehabilitation services in Busan, South Korea, in response to the rapid increase of people with dementia due to the aging of the population. Methods: To investigate the current status of dementia rehabilitation in Busan, a survey was disseminated to dementia safety centers and day- and night-care centers in 16 districts/counties in Busan. Of the 209 day- and night-care centers, 23 institutes were registered in the National Health Insurance Service and received the highest grade (Grade A) in the institute evaluation that was implemented in each district. A telephone interview was conducted, and survey questions were related to the existence of an ongoing dementia rehabilitation program, program presenter, number of participants, progress method, program time, program duration, program contents, and participation path. Results: Dementia safety centers were implementing dementia prevention program, cognitive enhancing program, dementia program, self-help meeting and education program for family of dementia patient. The majority of the presenters of all four dementia-related programs were occupational therapists. The highest number of participants in the dementia prevention program was 15, and the highest number of participants in the cognitive enhancing program, dementia program, self-help meeting and education program for family of dementia patient was 10. All institutes' programs delivered group therapy. As for the time and frequency of the program, most dementia program included three-hour sessions five times a week. Most dementia prevention program, cognitive enhancing program, self-help meeting and education program for family of dementia patient included 60-minute sessions once a week. The most frequently observed program duration for the dementia prevention program and cognitive enhancing program was six months, and the most frequently observed duration for the dementia program was three months. Lastly, study participants most often reported that self-help meeting and education program for family of dementia patient lasted for two months. Among day- and night-care centers in Busan, programs related to cognition were implemented in 18 institutes, and the majority of the program presenters were social workers. Conclusion: In response to the rapidly growing number of dementia patients due to the aging of the population, this study examined the current status of dementia rehabilitation in Busan. The study results underscore the need to develop systems that consider the circumstances in Busan and continuously and systematically support dementia programs.

Purpose: The study aims were to develop a wearable inertial sensor-based gait analysis device that uses machine learning algorithms, and to validate this novel device using temporal gait parameters. Methods: Thirty-four healthy young participants (22 male, 12 female, aged 25.76 years) with no musculoskeletal disorders were asked to walk at three different speeds. As they walked, data were simultaneously collected by a motion capture system and inertial measurement units (Reseed®). The data were sent to a machine learning algorithm adapted to the wearable inertial sensor-based gait analysis device. The validity of the newly developed instrument was assessed by comparing it to data from the motion capture system. Results: At normal speeds, intra-class correlation coefficients (ICC) for the temporal gait parameters were excellent (ICC [2, 1], 0.99~0.99), and coefficient of variation (CV) error values were insignificant for all gait parameters (0.31~1.08%). At slow speeds, ICCs for the temporal gait parameters were excellent (ICC [2, 1], 0.98~0.99), and CV error values were very small for all gait parameters (0.33~1.24%). At the fastest speeds, ICCs for temporal gait parameters were excellent (ICC [2, 1], 0.86~0.99) but less impressive than for the other speeds. CV error values were small for all gait parameters (0.17~5.58%). Conclusion: These results confirm that both the wearable inertial sensor-based gait analysis device and the machine learning algorithms have strong concurrent validity for temporal variables. On that basis, this novel wearable device is likely to prove useful for establishing temporal gait parameters while assessing gait.

Purpose: The purpose of this study was to examine the effects of inhalation and exhalation exercise combined with upper extremity proprioceptive neuromuscular facilitation pattern on two spirometry values: forced volume vital (FVC) and peak expiratory flow (PEF). Methods: Thirty-two healthy adults were divided into two groups: 1) a combined group, which performed upper extremity D2 flexion pattern (shoulder flexed/abducted/external rotated, forearm supinated, wrist radial deviated, and finger extended) during exhalation and D2 extension pattern (shoulder extended/adducted/internal rotated, forearm pronated, wrist ulnar deviated, and finger flexed) during inhalation; and 2) reverse combined group, which performed the D2 flexion pattern during inhalation and the D2 extension pattern during exhalation. The inverse application of upper extremity movements during inhalation and exhalation induced selective resistance or assistance on respiration. FVC and PEF were measured at two time points, before and after four weeks. Results: In both groups, the pre-post intervention comparison showed significant increases in FVC and PEF (p < .05). In the between-groups comparison, the reverse combined group showed a significantly higher PEF than the combined group at four weeks post intervention (p < 0.05). Conclusion: The combined respiration exercise with reverse PNF upper extremity patterns using selective resistance showed an effective increase in PEF in healthy adults. Clinicians and researchers might consider using selective resistance as a widely applicable and cost-effective option for respiratory rehabilitation planning.