• Journal of International Academy of Physical Therapy Research
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• v.12 no.2
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• pp.2323-2330
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• 2021

Background: Stroke patients have weak trunk muscle strength due to brain injury, so a single type of exercise is advised for restoring functionality. However, even after intervention, the problem still lies and it is suggested that another intervention method should be applied with exercise in order to deal with such problem. Objectives: To Investigate the effect of bridge exercise combined with functional electrical stimulation (FES) on trunk muscle activity and balance in stroke patients. Design: Randomized controlled trial. Methods: From July to August 2020, twenty stroke patients was sampled, ten patients who mediated bridge exercises combined with functional electrical stimulation were assigned to experiment group I, and ten patients who mediated general bridge exercises were assigned to experiment groupII. For the pre-test, using surface EMG were measured paralyzed rectus abdominis, erector spinae, transverse abdominis/internal oblique muscle activity, and using trunk impairment scale were measured balance. In order to find out immediate effect after intervention, post-test was measured immediately same way pre-test. Results: Change in balance didn't show significant difference within and between groups, but muscle activity of trunk was significant difference rectus abdominis and erector spinae within groups I (P<.01), also between groups was significant difference (P<.05). Conclusion: Bridge exercise combined with FES could improve trunk function more effectively than general bridge exercise due to physiological effect of functional electrical stimulation.

• Journal of muscle and joint health
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• v.29 no.1
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• pp.11-17
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• 2022

Purpose: This study aimed to provide objective and basic data for an effective treatment method by examining changes in the mechanical properties of muscles and the degree of tenderness when a combination of stretching exercise and ultrasound therapy is applied to patients with tension headaches. Methods: The participants were classified into two groups based on the intervention received: the therapeutic ultrasound combined with suboccipital stretching (n=15, experimental group) and infrared combined with suboccipital stretching (n=15, control group) groups. The intragroup differences in mechanical muscle properties and modified total tenderness score were compared and analyzed. Results: The comparison and analyses of the changes in muscle tone and stiffness revealed statistically significant intragroup decreases in the upper trapezius and suboccipitalis in the experimental group. Similarly, the comparison and analyses of the changes in muscle stiffness revealed statistically significant intragroup decreases in the upper trapezius in the control group. Conclusion: Therapeutic ultrasound combined with suboccipitalis stretching effectively increased the flexibility of the muscles around the cervical vertebrae and reduced muscle tension and stiffness in tension-type headache patients

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.788-797
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• 2018

Objective To investigate the effect of upper limb rehabilitation combining robot with low-frequency repetitive transcranial magnetic stimulation (rTMS) on unilateral spatial neglect in stroke patients. Methods Patients who had hemispatial neglect after right hemisphere stroke were randomly divided into rTMS only group, robot only group, and combined group. All groups received conventional neglect therapy and additional treatment for each group. rTMS group received rTMS therapy. Robot group received robot therapy, while combined group received both therapies. The effect of therapy was assessed with Motor-Free Visual Perception Test-3 (MVPT-3), line bisection test, star cancellation test, Catherine Bergego Scale (CBS), Mini-Mental State Examination (MMSE), and the Korean version of Modified Barthel Index (K-MBI). These measurements were evaluated before and after treatment. Results For each group, 10 patients were recruited. There were no significant differences in baseline characteristics or initial values among the three groups. Two weeks after the therapy, all groups showed significant improvement in MVPT-3, line bisection test, star cancellation test, CBS, MMSE, and K-MBI. However, changes in measurements showed no significant differences among groups. Conclusion Treatment effect of the combined therapy of robotic therapy and low-frequency rTMS therapy for hemispatial neglect was not statistically different from that of each single treatment. Results of this study did not prove the superiority of any of the three treatments. Further study with large number of patients is needed to evaluate the superiority of these treatments.

• Journal of Korean Physical Therapy Science
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• v.26 no.3
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• pp.1-7
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• 2019

Purpose: The purpose of this study was to investigate the effects of the Otago exercise combined with action observation training on changes of the brain activity of the elderly. Design: Randomized controlled trial. Methods: Thirty elderly women in the experiment were included. Participants were randomly assigned to the Otago combined with action observation training group, the Otago exercise group, and the control group (10 in each group). The Otago combined with action observation training group and the Otago exercise group performed the strength and balance exercises of the Otago exercise program for 50 minutes three times a week for 12 weeks. The Otago combined with action observation training group underwent additional action observation training for the Otago movement for 20 minutes three times a week. No intervention was performed in the control group. PolyG-1 (LAXTHA Inc., Daejeon, Korea) was used to measure the changes in the brain activity following intervention. One-way analysis of variance was used to compare the effects among the groups and a post-hoc test was performed. Results: The relative mu rhythms in the F3, C3, and C4 regions were significantly increased in the Otago combined with action observation training group. Relative beta wave activity in the Fp1, F3, F3, and C3 regions was significantly increased in the Otago combined with action observation training group (p<0.05). Conclusion: The results indicated that the Otago exercise combined with action observation training was effective for promoting the brain activity of the elderly.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.49-56
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• 2015

Background: Although many of those who drive for a living are exposed to repetitive and awkward posture and whole body vibration which cause them cumulative trauma disorder, therapeutic studies related to the problems from the transport unit are still somewhat inadequate. The purpose of this case report is to identify the effect of combined exercise program on patients suffering chronic neck pain caused by long hour of intra-city bus driving. Method: A total of 4 subjects are selected as patients, all of whom have more than 10 years of experience in intra-city bus transportation services. These people have suffered from neck pain for years. We ran the combined exercise program 3 times a week for 4 weeks and respectively evaluated the results after the 2nd and 4th week. We implemented conventional physiotherapy for 40 minutes, another 40 minutes of combined exercise program, and then educated the patients to enable themselves to do active stretching program as a home program. The combined exercise program contained 3 different stages. 1st stage: active stretching program, 2nd stage combined stabilization exercise and strengthening exercise, 3rd stage: proprioceptive exercise Result: After 4 weeks of intervention, there was enhance in the range of motion. $12^{\circ}$ increase in flexion, $10^{\circ}$ in extension, $6^{\circ}$ in lateral flexion respectively, and $10^{\circ}$ in rotation on average. VAS(visual analgue scale) decreased by 33% on average, NDI(neck diability index) by 28% and fatigability by 23%. Conclusion: There were improved results in the range of motion, NDI, VAS, and in fatigability after applying combined exercise program to intra-city bus drivers exposed to whole body vibration and cumulative trauma disorder.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.2
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• pp.53-61
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• 2019

PURPOSE: Forward head posture (FHP) is a head-on-trunk malalignment that results in musculoskeletal dysfunction and neck pain. To improve forward head posture, both the craniocervical flexion exercise (CCFE) and the visual guide (VG) technique have been used. This study compared the immediate effects of CCFE and VG combined with CCFE on craniovertebral angle (CVA), as well as on the activity of the sternocleidomastoid (SCM) and anterior scalene (AS) muscles during CCFE in subjects with FHP. METHODS: In total, 16 subjects (nine males, seven females) with FHP were recruited using the G-power software. Each subject conducted CCFE and CCFE combined with VG in random order. The CVA was recorded using a digital camera and the ImageJ image analysis software. The EMG data of SCM and AS were measured by surface electromyography. A paired T-test was used to assess differences between the effects of the CCFE and VG combined with CCFE interventions in the same group. RESULTS: The CVA was significantly greater for CCFE combined with the VG than for CCFE alone (p<.05). The activity of the SCM and AS muscles was also significantly greater when the VG was combined with CCFE than during CCFE alone across all craniocervical flexion exercise phases (p<.05). CONCLUSION: Use of the VG technique combined with CCFE improved FHP in subjects with FHP compared to CCFE alone.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.49-57
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• 2023

Background: This study aims to investigate the effect of lower limb strengthening training combined with electro muscle stimulation on the quadriceps femoris muscle activity of soccer players. Methods: Thirty university soccer players were selected as study subjects and divided into a lower limb strengthening training group combined with EMS (Group I) and a general lower limb strengthening training group (Group II), and 15 subjects were randomly assigned. After receiving general soccer training, subjects in this study additionally mediated lower limb strengthening training combined with EMS and general lower limb strengthening training for 26 minutes, 3 times a week for 8 weeks. Quadriceps femoris muscle activity was analyzed before mediation. Vastus medialis, vastus lateralis, and rectus femoris were measured with maximum isometric contraction in the manual muscle test position in order to analyze leg muscle activity. The same items as above were re-measured and a between-group analysis was conducted after 8 weeks of mediation. Results: As a result of comparative analysis of lower extremity muscle activity between groups, the lower limb strengthening training group combined with EMS showed a statistically significant difference in lower extremity muscle activity compared to the general lower limb strengthening training group. Conclusion: As a result, it was found that lower limb strengthening training combined with EMS was more effective in improving quadriceps femoris muscle activity. Based on this study, we are going to provide basic data on the possibility of using EMS in the field of sports rehabilitation for soccer players.

• IMMUNE NETWORK
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• v.9 no.1
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• pp.20-26
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• 2009

We previously reported that $IFN-{\gamma}$ producing T cell responses induced by the combined therapy of DNA vaccine and lamivudine for one year are important for the induction of sustained virological response (SVR). However, $IFN-{\gamma}$ production is not sufficient to predict sustained viremia control in chronic hepatitis B (CHB) carriers treated. Methods: Twelve CHB carriers were intramuscularly immunized 12 times at a 4-week interval with 8mg of HBV DNA vaccine during the standard lamivudine treatment (100mg/daily/1 year). The level of cytokines during and after the combined therapy in plasma of all 12 CHB carriers treated was determined by each ELISA kit. Six out of 12 CHB carriers revisited the clinic, and their HBV DNA levels were examined. Results: The combined therapy increased plasma IL-12 and IL-12/p40 ratio during the treatment (baseline vs. peak level: $41.8{\pm}8.3$ vs. $163.1{\pm}29.2\;pg/ml$; p<0.01 and $0.96{\pm}0.25$ vs. $3.58{\pm}0.86$; p<0.01, respectively), and the peak level of plasma IL-12 and IL-12/p40 ratio was evoked at 6 to 10 months during the combined therapy. In particular, CHB carriers with SVR had two and three-fold higher level of the peak plasma IL-12 and plasma IL-12/p40 ratio than non-virological responders (NVRs), respectively ($218.0{\pm}41.4$ vs. $108.1{\pm}28.6\;pg/ml$; p=0.09 and $5.35{\pm}1.38$ vs. $1.80{\pm}0.29$; p<0.05, respectively), while p40 level was consistent during the combined therapy. In addition, there was no significant temporal correlation between the peak IL-12/p40 ratio and the elevation of serum alanine amino-transferase (ALT) in this study, contrast to $IFN-{\alpha}$ therapy which induced peak IL-12 level following ALT flares. Conclusion: Our results indicate that the combined therapy induces the increase of plasma IL-12 and IL-12/p40 ratio, which are associated with long-term SVR in CHB carriers.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.25 no.2
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• pp.21-29
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• 2019

Background: The purpose of this study is to investigate the effect of the combined exercise program on the static balance ability of the lumbar instability of adults. Methods: The experimental group was divided into two groups and randomly. The experimental group 1 (Exp 1) applied the combined exercise program for the lumbar stabilization exercise and strengthening exercises and the experimental group 2 (Exp 2) applied the combined exercises program for the lumbar stabilization exercises and active stretching exercises. Each experiment group performed exercise program for 4 weeks, 3 times a week, 30 minutes a day. Static balance ability was measured using GOOD BALANCE system. Results: As the comparing results of static balance ability, normal standing eye open was Ant-Post and Med-Lat showed significant differences in Exp 1 (p<.05). One leg left eye open was velocity moment showed significant differences in Exp 1 (p<.05). and one leg right eye open was Med-Lat showed significant differences in Exp 1 (p<.05). Conclusion: These results show that thoracic self mobilization is immediate effective on balance and gait ability. Thus, thoracic self mobilization will help recovery of balance and gait ability in acute stroke patients.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.4
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• pp.93-101
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• 2022

PURPOSE: This study sought to investigate the effects of treadmill gait training combined with a thoracic mobility exercise on gait and balance in patients with stroke. METHODS: In this single-blinded, randomized, controlled, comparative study, a total of 20 patients at a rehabilitation hospital who had suffered a hemiplegic stroke were randomly assigned to the experimental group (treadmill gait training combined with a thoracic mobility exercise, n = 11) or control group (treadmill gait training without the thoracic mobility exercise, n = 9). All the participants underwent comprehensive rehabilitation therapy (5 × /week for 4 weeks). Additionally, the experimental group underwent 20 min of treadmill gait training combined with 10 min of a thoracic mobility exercise (3 × / week for 4 weeks) and the control group underwent the former but not the latter. Gait and balance were measured before and after the 4-week training. RESULTS: Significant improvements were observed in the 10-m walking test (10 MWT), timed up-and-go (TUG) test, center of pressure (COP) velocity, and COP length in the experimental group (p < .05). This group also showed a larger decrease in the 10 MWT and COP velocity than the control group (10 MWT, -3.02 sec vs. -1.68 sec, p < .05; COP velocity, -.07 mm/sec vs. .08 mm/sec, p < .05). CONCLUSION: Treadmill gait training, combined with the thoracic mobility exercise, could be effective in improving the gait and balance of stroke patients. It could also be more effective in improving walking speed and static balance than the treadmill gait training alone.