Objective: The aim of this systematic review was to investigate for effective strategies to improve home exercise program (HEP) adherence in vestibular rehabilitation (VR). Design: Systematic review. Methods: A systematic review was conducted to identify effective strategies used to improve HEP adherence of patients in VR. Six databases, Academic Search Premier, Cochrane Library, CINAHL, PUBMED, PsycINFO, and Web of Science were searched from their inception to December 31, 2015. The keywords used for search were 'home program', 'home intervention', 'compliance', 'adherence', 'vestibular rehabilitation', 'motion sickness', and 'motion sensitivity'. Results: A total of eight studies were selected to be included in the review. There was 95.2% agreement between the two reviewers who reviewed the studies using a quality assessment tool. The overall inter-rater agreement (${\kappa}$=0.73) showed good agreement between the reviewers. Strong evidence was identified for 3 major categories of effective HEP adherence strategies, 1) providing patient with written summary of HEP; 2) asking patient to maintain a record of HEP and symptoms; and 3) providing tele-rehabilitation in form of email and/or telephone support along with in person treatment sessions. Also, based on strong evidence, computerized technology was not found to be superior to other strategies for improving patients' HEP adherence in VR. Conclusions: The effective strategies for improving HEP in VR include written summary of exercise, maintenance of log of HEP and symptoms and tele-rehabilitation along with in person treatment sessions.

Objective: To evaluate the effects of sit-to-stand (STS) imagery group training (IGT) on STS movement and balance performance for chronic hemiparetic stroke. Design: Randomized controlled trial. Methods: A total of 30 people with chronic hemiparetic stroke (15 for STS-IGT group and 15 for control) were recruited in this study. The STS-IGT group participated in a videotape-based STS-IGT for 30 minutes a day, five days a week for six weeks, while the control group watched a documentary on television for the same period. The STS-IGT focused on a five-stage protocol. Specifically, external imagery was used during the four phases of the STS movement from the seat of the chair to standing up. All of the participants also participated in a regular rehabilitation program. STS movement and balance performance were assessed using three clinical measures. Results: After training, time to perform the 5-repetition STS test significantly increased in the STS-IGT group (change value, $4.0{\pm}2.0$ sec) compared with the control group (change value, $0.9{\pm}0.7$ sec) (p<0.05). There was a greater improvement in Berg balance scale scores in the STS-IGT group (change value, $0.2{\pm}4.1$ points) compared with the control group (change value, $0.3{\pm}0.9$ points) (p<0.05). There was a greater improvement in Timed Up and Go scores in the STS-IGT group (change value, $2.6{\pm}1.5$ sec) compared with the control group (change value, $0.9{\pm}1.0$ sec) (p<0.05). Conclusions: STS-IGT can be considered as a useful option for restoration of STS movement and balance performance for individuals with chronic hemiparetic stroke who are unable to fully participate in physical activities.

Objective: The purpose of this study was to compare the activation of trunk and gluteal muscles during bridge exercises with a sling (BS), single-legged bridge exercise with a sling (SBS), single-legged bridge exercise (SB), and general bridge exercise (GB). Design: Cross-sectional study. Methods: Twenty-five healthy participants (19 males and 6 females, aged 27.8 [4.78]) voluntarily participated in this study. In the bridging exercise, each subject lifted their pelvis with their legs and feet in contact with the sling or normal surface. The electrical activities of the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO) muscles during the bridging exercises on the 2 surfaces were measured using surface electromyography. Subjects practiced each of the four bridge condition three times in random order and average values were obtained. Results: On the ipsilateral side, activities of the IO, EO, and ES during SBS was significantly higher than those during BS, SB, and GB (p<0.05). Activities of the IO and EO during SB was significantly higher than those during BS and GB (p<0.05). On the contralateral side, activities of the GM and EO during SB and SBS was significantly higher than that during BS and GB (p<0.05). These results verify the theory that the use of sling and single leg lift increases the activation trunk and gluteal muscles during bridging exercises. Conclusions: The single-legged bridge exercise with a sling can be recommended as an effective method to facilitate trunk and gluteal muscle activities.

Objective: The purpose of this study was to investigate whether the intrinsic foot muscle training method can improve the medial longitudinal arch in patients with chronic ankle injury and with pronated feet, as well as to investigate for the most effective exercise method for these patients. Design: Randomized controlled trial. Methods: Thirty men and women with pronated feet had participated in this study and were allocated to either the short foot exercise group (SFEG) or the towel curl exercise group (TCEG) randomly. SFEG and TCEG underwent exercises three times a week for 8 weeks, with three sets per day, totalling up to 5 minutes per day. The navicular drop test (NDT) was used in order to assess for changes in the medial longitudinal arch and the Cumberland ankle instability tool (CAIT) was used to assess for ankle instability of the chronic ankle sprain patients. Results: There was a significant increase in CAIT scores in the SFEG (p<0.05) and a significant difference between groups was presented (p<0.05). The NDT scores were significantly decreased in both groups (p<0.05). In the SFEG, the NDT scores were more decreased than in the TCEG (p<0.05). Conclusions: These results suggest that short foot exercises are more effective in providing intrinsic foot muscle training for patients with pronated feet among chronic ankle sprain patients. Furthermore, short foot exercises may be used to provide ankle stability.

Objective: Generally, it is known that there is a correlation between excessive calcaneus eversion and a patient with low back pain and it also affects pelvic alignment. However, there are not enough studies that show calcaneal eversion having an effect on the alignment of the trunk. Design: Cross-sectional study. Methods: A 3-dimensional motion analysis system was used to assess the lower limbs, pelvic alignment, and trunk alignment with increased unilateral and bilateral calcaneal eversion in twenty-one subjects. All subjects were asked to maintain a static posture for seven seconds on a wedge three times per posture for measurement and analysis purposes. The wedge used in the process was a lateral wedge with a 10-degree tilt to the lateral direction. To unify all of the subjects' foot position, the front and inner side of the wedge were marked. The height of the tilted wedge's inner side and flat wedge were balanced equally in order to be able to maintain the lateral part of the foot to the same height when producing an increased calcaneal eversion. Results: Comparing the changes in trunk and pelvic alignment in accordance to calcaneal eversion for each posture, there was a significant different in the X and Y-axis for each posture, but not in the Z-axis (p<0.05). Thus, it can be confirmed that calcaneal eversion in the sagittal plane and frontal plane may have and effect on the pelvis and the trunk. Conclusions: Postures with increased bilateral and unilateral calcaneal eversion has an effect on pelvic alignment, but does not cause any changes in trunk alignment.

Objective: This study was aimed to compare the thickness and pennation angle of gastrocnemius through ultrasonography during the heel-drop exercise on ankle dorsiflexion angle. Design: Cross-sectional study. Methods: Nineteen normal adults in their 20s had voluntarily participated in this study. All subjects performed the ankle heel-drop exercise with ankle dorsiflexed to $0^{\circ}$, $10^{\circ}$, and $20^{\circ}$: heel-drop exercise with ankle dorsiflexed to $0^{\circ}$ was executed on floor-level, heel-drop exercise with ankle dorsiflexed to $10^{\circ}$ on a wooden-block of 2.3 cm in height, and heel-drop exercise with ankle dorsiflexed to $20^{\circ}$ on a wooden-block of 5.5 cm in height. In each regimen, the subjects completed a session of 100 heel-drop exercises (10 repetitions${\times}$10 sets; with 30 seconds rest following each set; with 24 hours rest following each exercise). Before and immediately after each heel-drop exercise, the thickness and pennation angle of gastrocnemius were measured using an ultrasonography. Results: After the performance of the heel drop exercises with ankle dorsiflexed to $0^{\circ}$, $10^{\circ}$, and $20^{\circ}$, the thickness of the gastrocnemius was significantly higher than pre-exercise (p<0.05), and furthermore heel-drop exercise with ankle dorsiflexed to $10^{\circ}$ was significantly higher than exercise with the ankle dorsiflexed to $0^{\circ}$ (p<0.05). However, as for the pennation angle of the gastrocnemius, there were no significant changes after each heel-drop exercise. Conclusions: This finding suggest that the heel-drop exercise with ankle dorsiflexed to $0^{\circ}$, $10^{\circ}$, and $20^{\circ}$ is effective on the strengthening of the gastrocnemius. Furthermore, the heel-drop exercise with the ankle dorsiflexed to $10^{\circ}$ is more effective than with the ankle dorsiflexed to $0^{\circ}$.

Objective: The purpose of this study was to investigate effects of hand grip strength on the muscle activation of shoulder joint in breast cancer patients. Design: Cross-sectional study. Methods: Ten breast cancer patients who agreed to active participation were included. These patients were operated with either conservative surgery or segmental mastectomy, and then were treated with radiation therapy and chemotherapy. The activity of the upper trapezius, lower trapezius, supraspinatus and serratus anterior muscle were measured using surface electrodes during 4 hand gripping tasks (lowered their arms in standing position, 0%, 30%, and 50% of maximum voluntary contraction) in the scapular abduction plane. Results: The results were analyzed using a one-way repeated measures ANOVA. There was a significant difference in the lower trapezius and supraspinatus muscles according to grip strength, lower trapezius and supraspinatus muscles showed significantly difference according to grip strength (p<0.05). The result of the muscle activation according to hand strength (0%, 30%, and 50%) it showed a significant difference between the upper trapezius and supraspinatus in 0% grip strength (p<0.05). In addition, it did not show a significant difference between muscles in 30%, 50% hand strength. Conclusions: This study showed an increase in shoulder muscle activation with increasing hand grip strength with the upper trapezius muscle being more activated than other muscles in 0% grip strength. The finding of this study suggests usefulness for development of preventative measures and rehabilitation strategies for increasing shoulder motor function in patients with breast cancer.

Objective: The purpose of this study was to measure the change in pain threshold of levator scapular muscle, carniovertebral angle, and head position angle when applying a head-weight device on healthy adult. Design: Cross-sectional study. Methods: This study was conducted with 21 healthy adult male and female who voluntarily agreed to participate in this study after being informed of the purpose and method of this study. After measuring the cervical angle and pain threshold of levator scapular muscle, subject was instructed to walk for 5 minutes on a treadmill at a speed of less than 5 km/h while wearing after wearing head-weight device of 0.5 kg. Then, cervical spine angle and pain threshold of levator scapula muscle were re-measured. Measurement of cervical spine angle was conducted with photo by using the Bluebeam Revu software and the pain pressure thresholds (PPTs) were measured using an electronic algometer over potential trigger points on the body. Results: The results cervical angle showed a significant change, from $49.62^{\circ}$ to $52.10^{\circ}$ (p<0.05). PPT showed a significant change, from 30.71 to 36.89 (p<0.05). Conclusions: These findings suggest that applying head-weight device has a positive influence on increasing cervical angle and reducing pain when applied as a therapeutic intervention method of forward head posture.

Objective: This study was conducted to investigate the effects of resistant exercise on the gait performance of a patient with systemic lupus erythematosus (SLE) patient. Design: A case study. Methods: A 30-year-old male adult who had been diagnosed with systemic lupus erythmatosus (SLE) in April 2013, right middle cerebral artery infarction, and with left hemiplegia agreed to participate in this case study. Patient was unable to walk due to being affected with adynamia. Due to developing necrotizing vasculitis on the left lower extremity, patient underwent a myotomy on the left thigh. The patient was trained with a progressive resistant exercise program for 8 weeks. An intensity of 15 RM was used for the resistant exercises and the resistance level was increased progressively in order to improve the muscle power of the patient. Methods used to increase resistance included changing positions, providing mechanical resistance instead of manual resistance, transitioning from open kinetic chain to closed kinetic chain exercises, and changing the colors of the theraband to those with increase level of resistance. Outcome measures included the 5-repetition sit-to- stand test (5RSST), Timed Up & Go (TUG), and 10-meter walk test (10MWT). In addition, the GAITRite was used to assess the spatio-temporal gait variables, including gait speed, cadence, stride length of the left side, and double limb support pre and post-intervention. Results: The patient was able to perform sit-to- stand after two weeks of performing the resistant exercises. The patient was able to walk after 4 weeks, and the patient's overall gait performance had improved after 8 weeks. All of the variables had improved after each week. Conclusions: The results of this case study may be used to enhance future efforts to objectively evaluate resistant exercises during gait performance in persons affected by SLE.