Objective: This study investigated the effects of air stacking training (AST) on pulmonary function, respiratory strength, and peak cough flow (PCF) in persons with cervical spinal cord injury (CSCI). Design: Randomized controlled trial. Methods: A total of 24 persons with CSCI were randomly allocated to the AST group (n=12) or the incentive spirometry training (IST) group (n=12). Patients with CSCI received AST or IST for 15 minutes, with 3 sessions per week for 4 weeks, and all groups performed basic exercises for 15 minutes. In the AST group, after the subject inhaled the maximal amount of air as best as possible, the therapist insufflated additional air into the patient's lung using an oral nasal mask about 2-3 times. In the IST group, patients were allowed to hold for three seconds at the maximum inspiration and then to breathe. The pre and post-tests measured forced vital capacity (FVC), forced expiratory volume one at second (FEV1), maximal expiratory pressure (MEP), maximal inspiratory pressure (MIP) and PCF. Results: Both groups showed significant improvements in FVC, FEV1, MEP, MIP and PCF values after training (p<0.05). The FVC in the post-test and the mean change of FVC, FEV1, MIP were significantly higher in the AST group than the IST group (p<0.05). Conclusions: The findings of this study suggested that AST significantly improved pulmonary function, respiratory strength, and PCF in persons with CSCI. Therefore, AST should be included in respiratory rehabilitation programs to improve coughing ability, pulmonary function and respiratory muscle strength.

Objective: The purpose of this study was to investigate the effects of eccentric contraction training (ECT) and concentric contraction training (CCT) on the muscle thickness (MT), muscle strength (MS) and delayed onset of muscle soreness (DOMS) of the lower extremities in persons with chronic stroke. Design: Randomized controlled trial. Methods: Thirty persons with chronic stroke were randomly assigned to the ECT or the CCT group. The ECT was performed in a specially designed system of eccentric contraction of both legs and, the CCT was performed using a traditional stepper system for concentric contraction of both legs. The training was performed for 30 min/times, 3 times/wk for 6 weeks. Rehabilitation ultrasound imaging was used to measure MT of the vastus medialis/lateralis (VL), and soleus (SOL), a digital muscle tester was used to measure MS, and a visual analog scale was used to assess DOMS. Results: In the ECT group, MT was significantly improved except for SOL resting (p<0.01). In the CCT group, the MT was significantly improved except for VL contraction (p<0.05). The MS was significantly improved in both groups, especially in the ECT group (p<0.01). In the ECT group, muscle soreness was highest in the first week after training but gradually decreased, and in the CCT group, it was highest in the second week of training but gradually decreased (p<0.01). Conclusions: ECT can improve lower limb MT, MS, and DOMS of chronic stroke survivors. Therefore, it is recommended that ECT be used in the rehabilitation of persons with chronic stroke.

Objective: The purpose of this research was to determine the immediate effects of wearing a foot-pressure-based insole (FPBI) on ankle dorsiflexion range of motion (DFROM), postural sway, and muscle activation in healthy individuals with genu varum. Design: Cross-sectional study. Methods: This study was conducted on thirteen adults, with six male and seven females subjects. The mean age was 24.08 years. Foot pressure was measured to apply the FPBI and the weight bearing lunge test was performed with the application of a flat insole (FI) and FPBI. Examination was randomly performed in four conditions to measure both postural sway and muscle activation. All participants applied both the FI and FPBI with four conditions. The four conditions were as follows: 1) Romberg test posture with eyes closed, 2) Romberg test posture with eyes opened, 3) dominant single leg standing with eyes opened, and 4) non-dominant single leg standing with eyes opened. Results: For ankle DFROM between the FI and FPBI, a significant increase was observed in both the dominant and non-dominant leg (p<0.05). For postural sway between the FI and FPBI in the Romberg test posture with eyes closed and dominant single leg standing with eyes opened conditions, a significant decrease was observed (p<0.05). However, the postural sway between FI and FPBI in the Romberg test posture with eyes opened and non-dominant single leg standing with eyes opened, no significant decrease was observed. Also, there were no significant effects on muscle activation between the application of the FI and FPBI. Conclusions: The result showed that FPBI immediately improved ankle DFROM and postural sway. It seems that FPBI may improve genu varum in healthy individuals with genu varum.

Objective: The purpose of this study was to show the temporary effects of performing jumping lunges on a sand surface on static balance and dynamic balance. Design: Randomized controlled trial. Methods: Twenty healthy subjects volunteered in the study and was randomly assigned into either the sand group (n=10) or the control group (n=10). The subjects in the sand group performed jumping lunges on a sand surface and the subjects in the control group performed jumping lunges on a firm surface. The intervention was performed for 3 sets of 8 repetitions by both groups. To measure static balance, the force plate was employed to measure the center of pressure (CoP) area, and the CoP velocity during one-legged standing. Anterior, postero-medial, postero-lateral movements was assessed using the Star Excursion Balance Test (SEBT) to measure dynamic balance. Results: After the intervention, the sand group showed statistically significant improvements on all variables (CoP area, CoP velocity) in static balance (p<0.05). There were statistically significant changes in CoP area and CoP velocities between the two groups (p<0.05). In the sand group, there were significant improvements in the postero-medial and postero-lateral directions (p<0.05) except for anterior direction on dynamic balance. In the control group, there was a significant improvement in the postero-lateral and anterior directions (p<0.05). In comparison of the two groups, there was no statistically significant improvement in all variables. Conclusions: This study demonstrated that performing jumping lunges on a sand surface was effective in improving static and dynamic balance temporarily.

Objective: The purpose of this study was to analyze and compare vertical ground reaction forces during sit to stand (STS) and gait between female elderly and young individuals using the Wii Balance Board (WBB). Design: Cross-sectional study. Methods: Fifty-one female elderly people (age: $75.18{\pm}4.60years$), and 13 young people (age: $29.85{\pm}3.69years$) performed the five times STS test and gait respectively on the WBB. We analyzed time (s), vertical peak (%), integral summation (Int_SUM, %), and counter variables (%) in STS and 1st peak (body weight, BW%), 2nd peak (BW%), peak minimum (BW%), time (second), center of pressure (COP) path length (mm), and Int_SUM (BW%) in gait. The independent t-test was used to assess for differences in STS, gait ability, and general characteristics between the female elderly group and young adults group. With the first and last trials excluded, the mean value was obtained from the middle three of the five trials. Results: During STS, Int_SUM and time of young adults were significantly less than of the female elderly subjects. There were no significant differences in peak and counter variables. In gait, all variables (1st peak, 2nd peak, min, time, COP_path, and Int_SUM) showed significant differences between groups (p<0.05). This study demonstrated that the validity of vertical ground reaction forces occurring during STS and gait was significant in female elderly and young adults. Conclusions: Based on the measurement of vertical ground reaction forces in STS and gait using the WBB, it is possible to clinically improve the quality of geriatric physical therapy. Further studies are necessary to examine concurrent validity of elderly patients who have undergone total hip or knee replacement.

Objective: Deep neck flexor muscle endurance (DNFET) is important to cervical pain patients. However, there is no normative data of the DNFET hold time of Korean university students. The purpose of this study was to provide normative data and the reliability of the DNFET times of Korean university students and to compare the DNFET hold times between male and female subjects. Design: Cross-sectional study. Methods: The participants included 39 male and 39 female students with no cervical pain. Each DNFET was measured while the subjects kept their chin tucked in while in a supine (hook-lying) position and with the head lifted 2.5 cm off the bed. The DNFET was conducted on each subject twice and the mean values were obtained. After each measurement, the participants rested for 5 minutes. Inter-rater reliability was measured by intraclass correlation coefficient (ICC) by three separate evaluators. Results: The inter-rater reliability was good, showing an ICC (2,3) value = 0.785 (95% confidence interval, 0.370-0.942). The DNFET time scores for men and women were $25.14{\pm}9.96$ seconds and $15.23{\pm}6.10$ seconds, respectively, in which the time scores of the men were significantly longer compared to women (p<0.05). Conclusions: Asymptomatic men displayed higher DNFET scores than women. This study can help clinicians test cervical function of patients and set an interventional goal. These findings serve as a basis that insists Korean women to increase their amount of physical activity.

Objective: The purpose of this study was to investigate the effects of 5 different personalities on job stress in physical therapists. Design: Descriptive cross-sectional study. Methods: Structured self-report questionnaires consisted of demographic items, 5 types of personalities, and occupational stress. A questionnaire was distributed to 420 physical therapists working in Seoul and Incheon who had voluntarily agreed to participate in the study after the purpose of the study was explained. Of the 420 questionnaires, 405 questionnaires were collected and showed a recovery rate of 96.4%, of which 28 cases were excluded, leaving a total of 377 questionnaires being used for analyses. Pearson correlation analysis was performed to investigate the correlation of job stress and five personalities types. In addition, multiple regression analysis was performed to investigate the effect of general and occupational characteristics of physical therapist on job stress and the effect of personality type on occupational stress. All statistical significance levels were set at p<0.05. Results: The highest number of subjects, which were the physical therapists, showed the tendency to have a sincere personality, followed by affinity, openness, extroversion, and neuroticism. Physical therapists reported to be the most stressed in the order of professional role conflict, overload of work, work relation with a physician and supervisor, interpersonal relationship with patient and caregiver. The higher the level of affinity and sincerity, the lower the amount of stress received by the therapist from the interpersonal relationships between the patient and caregivers. On the other hand, the greater the level of openness and sincerity, the lower the stress levels related to professional role conflict. Conclusions: This study showed that the personality type and job stress of physiotherapists had a statistically significant effect. It is very important for physiotherapists to find their own way of coping with stress, which is satisfactory and appropriate for their job, because it is related not only to individual problems but also to the quality of patient care and medical services. Therefore, it is necessary to continue conducting research on how to relieve the stress levels of physical therapists according to their personality characteristics.

Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.