Purpose: The aim of this study was to evaluate the effect of lumbar stabilization exercise on an unstable surface on trunk posture and static standing balance ability in patients with scoliosis. Methods: Subjects included 18 patients who showed symptom of scoliosis. Patients were divided into two experimental groups, one using an unstable surface and one using a fixed surface, and the patients were required to perform a lumbar stabilization exercise a total of 12 times for 60 minutes per session, three times per week for a period of four weeks, with a six-months follow-up period. Results: A significant reduction was observed in the group that performed the lumbar stabilization exercise on an unstable surface (p<0.05). A significant decrease in both the condition of closed eyes or open eyes in the left and right directions was observed in the group that performed the lumbar stabilization exercise on an unstable surface (p<0.05). After six months, results of comparison of the length of both sides of the trunk showed a significantl decrease in the group performing lumbar stabilization exercises on an unstable surface. Conclusion: Lumbar stabilization exercise on an unstable surface improved the trunk posture of patients with scoliosis symmetrically, and static balance ability in a standing posture showed improvement. In the future, lumbar stabilization exercise on an unstable surface may be used as an exercise for posture correction and balance increase for patients with scoliosis.

Purpose: Osteoarthritis occurs in many different joints of the body, causing pain, stiffness, and decreased function. The knee is the most frequently affected joint of the lower limb. The aim of this study was to investigate the differences of biomechanics between independent gait and anterior walker dependent gait of patients with osteoarthritis of the knee. Methods: Lower limb joint kinematics and kinetics were evaluated in 15 patients with knee osteoarthritis when walking independently and when walking with an anterior walker. Participants were evaluated in a gait laboratory, with self-selected gait speed and natural arm swing. Results: When walking with a dependent anterior walker, participants walked significantly faster (p<0.01), using a longer stride length (p<0.01), compared to independent gait. When walking with a dependent anterior walker, participants exhibited significantly greater knee flexion/extension motion (p<0.01) and lower knee flexion moment (p<0.05) compared to independent gait. When walking with a dependent anterior walker, participants showed significantly greater peak ankle motion (p<0.01), ankle dorsiflexion/plantarflexion moments (p<0.01), and ankle power generation (p<0.05) compared to independent gait. Conclusion: These biomechanical properties of gait, observed when participants walked with a dependent anterior walker, may be a compensatory response to impaired knee function to allow sufficient power generation for propulsion. Therefore, rehabilitative strategies for patients with osteoarthritis of the knee are needed in order to improve not only knee function but also hip and ankle function.

Purpose: The purpose of this study was to provide quantitative data regarding development of the chest wall in children with cerebral palsy (CP) according to Gross Motor Function Classification System (GMFCS) levels and age using the radiological image diameter measurement method. Methods: Subjects included 112 children with CP and 110 healthy children, All of the children underwent simple chest x-ray. The diameters of the upper chest ($D_{apex}$) and lower chest ($D_{base}$) were measured on the anteroposterior (AP) view of a chest x-ray, and the $D_{apex}$ to $D_{base}$ ratio was calculated. Chest wall ratios were compared among children with CP at GMFCS levels I ~ III, GMFCS levels IV and V, and healthy children. Results: The results showed significant differences between the upper and lower chest wall diameters of children with CP at GMFCS levels IV and V, and healthy children (F=4.54, p=0.01; F=3.20, p=0.04). Results of comparison between the chest wall ratios of children with CP and healthy children, showed that the upper chest walls of healthy children were significantly larger in children younger than 48 months (p<0.05), and both the upper and lower chest walls of healthy children were significantly larger compared to children with CP in children older than 48 months (p<0.05). Conclusion: Radiographic measurement for examination of chest wall development is relatively simple, and the results yield quantitative data on development of the chest wall for children with CP. In addition, therapeutic interventions may be considered based on the results.

Purpose: The aim of this study was to evaluate the effect of progressive body weight decrease combined with increasing level of overground walking speed training for patients with chronic stroke. Methods: Eighteen subjects with chronic stroke were composed of the control group (5% body weight support combined with increasing speed training) and the experimental group (progressive body weight decrease with increasing speed training); three sets, three times per week over a period of four weeks. Results: Significant differences in terms of comfortable gait speed (CGS) and the rate of change of CGS were observed between the control and experimental groups (p<0.05). However, no significant difference in the dynamic gait index was observed between the control and experimental groups (p>0.05). A significant difference in the 6 minute walking test (6MWT) was observed for the experimental group, and a significant difference in the rate of change for the 6MWT was observed between the control and experimental groups (p<0.05). Conclusion: The progressive body weight decrease combined with increasing in level of overground walking speed training may be a better and more effective method for community walking and reintegration.

Purpose: This study was conducted in order to evaluate the quantitative effectiveness of region of interest (ROI) setting in MR-DTI analysis with and without fMRI activation results. Methods: Ten right-handed normal volunteers participated in this study. DTI and fMRI datasets for each subject were obtained using a 1.5T MRI system. For neural fiber tracking, ROIs were drawn using two methods: The drawing points were located in the fMRI activation areas or areas randomly selected by users. In this study, the neural fiber tract targeted the corticospinal tract (CST) Quantitative analyses were performed and compared. The pixel numbers passing through the fiber tract in the individual brain volume were counted. The ratios between the ROI pixel numbers and the extracted fiber pixel numbers, and the ratios between the fiber pixel numbers and the whole-brain pixel numbers were also calculated. Results: According to our results, extracted CST fiber tract in which the ROI was drawn with fMRI activation areas showed higher distribution than drawing the ROI by users' hands. In addition, the quantitatively measured values represented higher pixel distribution: The counted average pixel numbers were 4553.8 and 1943.3. The average ratios of the ROI areas were 33.87 and 22.52. The average percentages of the individual whole-brain volume numbers were 2.06 and 0.87. Conclusion: Results of this study appear to indicate that use of this method can allow for more objectives and significant for study of the recovery of neural fiber mechanisms and brain rehabilitation.

Purpose: The purpose of this study was to determine the influence of whole body vibration (WBV) exercise on balance and lower extremity muscle activity according to different intensity of vibration in stroke patients. Methods: Thirty subjects were randomly divided into three groups: experimental group II (n=10), III (n=10), and control group I (n=10). Each subject was exposed to three WBV conditions, as follows: 1. no WBV (group I), 2. 10 Hz (group II), 3. 30 Hz (group III) in semi squat position. The exercise program was conducted for six weeks (five times per week; 16 minutes per day). Subjects were measured on balance (limited of stability: LOS) and lower extremity muscle activity. Results: Significant difference in balance and lower extremity muscle activity was observed in the experimental group (II, III), compared with the control group (I). Results of post-hoc analysis, showed a significant difference in balance (LOS) in on group II and group III compared with group I, but no significant difference in on group II compared with group III, and a significant difference in lower extremity muscle activity in on group II and group III compared with group I, and a significant difference on in group II compared with group III. Conclusion: WBV exercise may be helpful in improvement of balance and lower extremity muscle activity in stroke patients.

Purpose: The purpose of this study is to determine the effect of motor imagery training on residual upper extremity strength and activities of daily living of chronic cervical spinal cord injury patients. Methods: Twelve ASIA A B patients, who had more than a 12-month duration of illness and C5 or 6 motor nerve injury level, were randomly divided into experimental group (n=6) and control group (n=6). Patients in the experimental group performed motor imagery training for five minutes prior to general muscle strengthening training, while those in the control group performed general muscle strengthening training only. The training was performed five times per week, 30 minutes per day, for a period of four weeks. General muscle strengthening training consisted of a progressive resistive exercise for residual upper extremity. Motor imagery training consisted of imagining this task performance. Before and after the training, EMG activity using BTS Pocket Electromyography and Spinal Cord Independent Measure III(SCIM III) were compared and analyzed. Results: The residual upper extremity muscle strengths showed improvement in both groups after training. Comparison of muscle strength improvement between the two groups showed a statistically significant improvement in the experimental group compared to the control group (p<0.05). SCIM III measurements showed significant improvement in the scores for Self-care and Transfer items in the experimental group. Conclusion: Motor imagery training was more effective than general muscle strengthening training in improving the residual upper extremity muscle strength and activities of daily living of patients with chronic cervical spinal cord injury.

Purpose: The purpose of this study was to investigate the characteristics of patients with Chronic Low Back Pain (CLBP) in disability, pain, and cognition, and to compare those characteristics to the ICF concept analyzing the association between World Health Organization Disability Assessment Schedule 2.0: 12 item-interviewer version (WHODAS 2.0) and those of scales i.e. Oswestry Disability Index (ODI), the Short-Form McGill Pain Questionnaire (SFMPQ), and the Fear avoidance & belief questionnaire (FABQ). Methods: A total of 91 patients with CLBP were invited to participate in the study. Physical therapists interviewed all participants using SFMPQ, FABQ, ODI, and WHODAS 2.0 for collection of information on pain, cognition, and functional level data. Subjects scored their disability, pain, and cognition related to LBP using WHODAS 2.0, ODI, SFMPQ, and FABQ. Data analysis was performed using the Spearman correlation coefficient. Results: A positive relationship was observed between WHODAS 2.0 and each scale indicating that lower back specific disability components could be related to the ICF concept in ODI (r=0.77). Pain intensity and pain oriented movement were found to be related to general functioning in patients with CLBP (r=0.52, r=0.55, respectively). Conclusion: It can be suggested that the specific disability scale for LBP, ODI can be related to the ICF concept, WHODAS 2.0, and it may be a useful measure for patients with CLBP.

Purpose: This study was conducted in order to determine whether mechanical horseback-riding training depending on velocity can improve vestibular function and static postural balance on standing in healthy adults. Methods: For evaluation of vestibular function, electrooculography (EOG) of vertical and horizontal was performed for identification of the motion of eyes. For evaluation of static postural balance, COP distance, time spent on the sharpened Romberg test with neck extension (SRNE) were measured. Measurements were performed three times before training, three weeks after training, and six weeks after training. Participants were randomly assigned to three groups: fast velocity-mechanical horse -riding training (FV-MHRT, n=12), moderate velocity-mechanical horse-riding training (MV-MHRT, n=12), and slow velocity-mechanical horse-riding training (SV-MHRT, n=12). Results: According to the result for vertical, horizontal EOG, there was significant interaction in each group in accordance with the experiment time (p<0.05). The FV-MHRT group showed a significant decrease compared with the MV- MHRT, SV-MHRT groups (p<0.05). According to the result for static postural balance, the time spent, COP distance in SRNE showed significant interaction in each group in accordance with the experiment time (p<0.05). The time spent on the SRNE showed a significant increas in FV-MHRT, SV-MHRT (p<0.05). The COP distance of SRNE showed a significant increase in MV-MHRT (p<0.05). Conclusion: The MHRT velocity activated mechanism of vestibular spinal reflex (VSR), vestibular ocular reflex (VOR), also helped to strengthen vestibular function and static postural balance. In addition, it should be applied to different velocity of MHRT according to the specific purpose.

Purpose: This study was conducted in order to investigate the kinematic gait parameter of lower extremities with different gait conditions (level walking, stair, ramp) in hemiplegic patients. Methods: Ten hemiplegic patients participated in this study and kinematic data were measured using a 3D motion analysis system (LUKOtronic AS202, Lutz-kovacs-Electronics, Innsbruk, Austria). Statistical analysis was performed using one-way repeated measure of ANOVA in order to determine the difference of lower extremity angle at each gait phase with different gait conditions. Results: Affected degree of ankle joint in the heel strike phase showed significant difference between level walking and climbing stairs, and toe off phase showed significant difference between level walking and climbing stairs, ramps, and climbing stairs. Affected degree of knee joint showed no significant difference in all attempts. Affected degree of hip joint in the toe off phase showed significant difference between level walking, ramps and stairs, and climbing ramps. Swing phase showed significant difference between sides for level walking and stairs, climbing ramps. Affected ankle joint of heel strike and toe off, and affected hip joint of toe off and the maximum angle of swing phase in the angle was increased. Unaffected side of the ankle joint, knee joint, and hip joint showed a significant increase in walking phase. Conclusion: These findings indicate that compared with level walking, different results were obtained for joint angle of lower extremity when climbing stairs and ramps. In hemiplegia patient's climbing ramps, stairs, more movement was observed not only for the non-affected side but also the ankle joint of the affected side and hip joint. According to these findings of hemiplegic patients when climbing stairs or ramps, more joint motion was observed not only on the unaffected side but also on the affected side compared with flat walking.

Purpose: The purposes of this study were to evaluate the correlation of clinical tools for assessment of balance and ability of gait, in order to discriminate the phases of sit-to-walk movement of patients with stroke using the motion analysis system, and to investigate the reliability of the phase of sit-to-walk movement according to functional ability of patients with stroke. Methods: Twenty -one patients participated (men 17, women 4) in this study. Sit-to-walk movement of all patients was recorded by the motion analysis system. Berg Balance Scale, Timed Up and Go test, Functional Reach Test, 10 meter Walk Timed Test, and Performance-Oriented Mobility Assessment were used as functional assessment tools. Results: The results of this study showed significant correlation between the phase I, II, IV and total phase duration of sit-to-walk movement and functional assessment tools. In addition, the intraclass correlation coefficient (ICC) showed high reliability in accordance with the functional ability of patients with stroke (Pearson's r 0.93 to 1.00). Conclusion: In conclusion, there is high reliability between measures of the phase of sit-to-walk movement of chronic stroke patients and the clinical assessment tool. Results of this study suggest that measurement of the phase of sit-to-walk movement can be used significantly as an intervention and a clinical tool for patients with stroke.

Purpose: Forward head posture is a typical symptom in people who use computers for long periods of time. Respiration is a complex function involving co-operation of muscular, skeletal, and nervous systems. Abnormal posture can have a negative effect on respiratory function. The purpose of this study was to investigate the relationship between forward head posture and respiratory function in young adults. Methods: Forty-six healthy subjects participated in this study. Craniovertebral angle was measured for assessment of the forward head posture. The respiratory function of all subjects was evaluated by measuring forced vital capacity (FVC), forced expiratory volume at one second (FEV1), forced expiratory volume at one second/forced vital capacity (FEV1/FVC) ratio, and peak expiratory flow (PEF). The baseline of forward head posture was less than 49 degrees. Results: : Significant differences for predicted FVC and FEV1 were observed between the two groups, however, no statistically significant differences in FEV1/FVC ratio and PEF were observed between the two groups. Conclusion: Results of this study demonstrate that forward head posture has a negative effect on respiratory function in young adults.

Purpose: The aimed of this study was to investigate muscle activation related to postural stability according to different frequency of whole body vibration during quiet standing, to identify the most effective training conditions that cause the highest neuromuscular responses, and to evaluate the difference of EMG activation according to the anatomical position of the muscle - proximal or distal from the vibration platform. Methods: Eighteen healthy subjects voluntarily participated in this single-group, repeated-measures study in which EMG data from upper trapezius, rectus abdominalis, external oblique abdominalis, elector spinae, gluteus maximus, rectus femoris, semitendinosus, and gastrocnemius were collected over different frequencies (0-5-10-15-20-25Hz) for each subject during quiet standing. Results: We observed a statistically significant difference in the mean values of %RVC of muscular activation according to different frequencies of whole body vibration during quiet standing in all muscles (p<0.05). Conclusion: Our results indicate that lower frequencies of vibration result in low muscular activation, and higher frequencies elicit high muscular activation. However, the most effective training condition that caused the highest activation was 20 Hz. In addition, the proximally located lower extremity muscles (GCM, RF, ST, GM) showed higher activation than the distally located trunk and neck muscles (ES, EO, RA, UT) together with increasing frequency.

Purpose: This study was conducted in order to investigate the awareness of physical therapy and difference between physical therapy and rehabilitation therapy. Methods: A total of 183 subjects who gave consent to participate in the survey at five universities in Gyenggi-do were randomly selected and the survey was conducted from February 2012 to July 2013 by a questionnaire consisting of 13 questions. Frequency analysis for the awareness of the general characteristics of physical therapy, anticipated cost, awareness of difference, and cross tab analysis for correlation with each item were used. Results: Participants recognized the academic ability, and the department for management of physical therapist licensing very well. The kindness and workmanship of physical therapists were average. According to their experience of physical therapy, most participants received a hot pack and electrical therapy at a local clinic and satisfaction with treatment was high. The percentage of students who recognized a difference between physical therapy and rehabilitation therapy was high, however, they misunderstood only electrical therapy for physical therapy and they recognized the exercise method of physical therapy for rehabilitation therapy. No correlation of the awareness of difference was observed between physical therapy and rehabilitation therapy and the awareness of physical therapy, experience, and anticipated cost, except the major of students. Conclusion: We found that people can misunderstand exercise therapy for rehabilitation therapy even though they have good awareness of physical therapy. Therefore, a physical therapist has to find the ways to express their identity while working.

Purpose: Respiratory is an essential vital component for conservation of life in human, which is controlled by respiratory muscles and its related neuromuscular regulation. The purpose of this study is to assess lung capacity and respiratory pressure in healthy children, and to investigate relationship and predictability between respiratory pressure and other related respiratory functions. Methods: A total of 31 healthy children were recruited for this study. Demographic information and respiratory related factors were assessed in terms of body surface area (BSA), chest mobility, lung capacity, and respiratory pressure. Correlation between respiratory pressure and the rested variables was analyzed, and multiple regression using the stepwise method was performed for prediction of respiratory muscle strength, in terms of respiratory pressure as the dependent variable, and demographic and other respiratory variables as the independent variable. Results: According to the results of correlation analysis, respiratory pressure showed significant correlation with age (r=0.62, p<0.01), BSA (r=0.80, p<0.01), FVC (r=0.80, p<0.01), and FEV1 (r=0.70, p<0.01). In results of multiple regression analysis using the backward elimination method, BSA and FVC were included as significant factors of the predictable statistical model. The statistical model showed a significant explanation power of 71.8%. Conclusion: These findings suggest that respiratory pressure could be a valuable measurement tool for evaluation of respiratory function, because of significant relationship with physical characteristics and lung capacity, and that BSA and FVC could be possible predictable factors to explain the degree of respiratory pressure. These findings will provide useful information for clinical assessment and treatment in healthy children as well as those with pulmonary disease.

Purpose: This study was conducted in order to determine the effect of visual and tactile feedback on muscle activity of the gluteus maximus (Gmax) and abdominal muscles and the motion of pelvic rotation during performance of clam exercise (CE). Methods: Thirteen subjects without low back pain were recruited for this study. Each subject was instructed to perform the CE without and with feedback. The subjects were instructed to keep pelvic from rotating backwards by palpating the ASIS and monitoring the pelvic movement by themselves during performance of CE with feedback. The electromyographic (EMG) activities of Gmax and abdominal muscles were collected using surface EMG. Angles of pelvic rotation were measured using a 3-dimensional motion-analysis system. Paired t-tests were used for comparison of EMG activities in each muscle and the angle of pelvic rotation. Results: The EMG activities of all abdominal muscles were not significant between CM without and CM with feedback (p>0.05). The EMG activity of Gmax was significantly greater in CM with feedback compared with CM without feedback (without vs. with feedback; 14.2% vs. 20.7%MVIC) (p<0.05). The angle of pelvic rotation was significantly less in CM with feedback compared with CM without feedback (without vs. with feedback; $15.3^{\circ}$ vs. $10.8^{\circ}$ ) (p<0.05). Conclusion: Therefore, these findings suggest that CM with the visual and tactile feedback is effective in activation of the Gmax and correcting of the uncontrolled lumbopelvic rotation during CE.

Purpose: This study was designed to measure the level of professional autonomy regarding physical therapists and to determine the association of organizational and occupational characteristics of the profession with its professional autonomy. Methods: We utilized a structured questionnaire survey of physical therapists (280 persons) in Jeju province. Data were collected from June 25 to July 14 in 2012. An additional 173 (63%) of them were used in the final analysis. Using PASW 18.0, descriptive and Hierarchical Linear Model were performed. Results: Regression analysis Result of Factors influencing Physiotherapist Professionalism, refresher training course (t=4.27), formalization (t=3.13), task significance (t=3.39), and autonomy (t=4.17) had a positive effect. Autonomy (${\beta}$=0.33) and formalization (${\beta}$=0.33) exerted the greatest influence. Conclusion: The survey regarding organizational and job characteristics showeds that occupational reeducation, formalization, and self- regulation constitute a positive part of what the professional autonomy is to be upheld. Results of the survey imply that in order to establish professional autonomy for the profession of physical therapist, the organization must make various efforts to beef up the exclusive knowledge and technology, and professional norms of the occupation that are considered essential for specific problem solving.

Purpose: For patients with CNS injury who are restricted in the use of public transportation, car driving means more than simple movements and is essential for their independent lives, such as participation in society and returning to jobs. Therefore, in order to enhance the quality of life of disabled persons, their high perception and necessity of driving rehabilitation are required. The purpose of this study is to determine the perception and necessity of driver rehabilitation in patients with CNS injury. Methods: In order to survey the perception of patients with CNS injury and necessity of driving rehabilitation, questionnaires were distributed to patients with CNS injury. Questionnaires were composed of demographic characteristics, disability related characteristics, and driver's license related characteristics. Results: Our results showed that the number of driving participants with a driver's license for the disabled was significantly higher than that for non- driving participants with a previous general driver's license in the perception of driving rehabilitation. Conclusion: We suggest that driving rehabilitation for patients with CNS injury should be supported in terms of evaluation and treatment.

Purpose: The purpose of study was to investigate effects of dance sports in virtual reality on balance, depression, and activities of daily living (ADL) in stroke patients. Methods: Subjects of the research consisted of 18 stroke patients who were randomly divided into the experimental and control groups, with nine patients each. All subjects underwent 30 minutes of Neurodevelopmental treatment (NDT) and 15 minutes of Functional electrical stimulation (FES) five days per week for a period of six weeks. Subjects in the experimental group performed an extra 30 minutes of dance sports in virtual reality each day. Balance, depression, and ADL of patients before and after the experiment were measured using Berg's balance scale (BBS), Beck depression inventory (BDI), and Modified Barthel index (MBI), respectively. For comparisone of the state before and after the experiment, wilcoxon signed ranks test was applied and for comparison of the difference between the groups, mannn-whitney U test was applied. Results: Results of this study, showed significant difference in balance, depression, and ADL between the experimental and control groups(p<0.05). As a control of the two groups, the experimental group, which performed extra dance sports in virtual reality, showed a significant difference in balance, depression, and ADL(p<0.05). Conclusion: Depending on the result, a dance sport in virtual reality was verified to enhance balance, depression, and ADL in stroke patients. Therefore, from now on, need for effective program development and application using dance sports in virtual reality will arise.