• Physical Therapy Korea
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• v.28 no.2
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• pp.108-116
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• 2021

Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint. Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions. Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions. Results: There were significant improvements in the weight-bearing (p = 0.002) and non-weight-bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions. Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.1
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• pp.21-30
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• 2021

Background: This study aimed to investigate the effects of muscle energy technique (MET) and instrument assisted soft tissue mobilization (IASTM) on knee extension ROM, knee extensor/flexor strength and muscle thickness immediately and after 24 hours. Methods: A total of 30 subjects participated in this study. The participants were assigned to either MET (n=15) or IASTM (n=15). 90-90 straight leg raise, knee extensor/flexor muscle strength, muscle thickness test were measured before, immediately after and 24 hours after the intervention. Results: Both groups significantly improved knee extension ROM on immediate (MET 10.7°, IASTM 10.21° increased) and after 24 hours assessment (MET 5.61°, IASTM 5.47° increased)(p<.05). In the MET group, knee extension and flexion muscle strength increased immediately after intervention (p<.05). In the IASTM group, knee extension muscle strength increased and knee flexor muscle strength decreased immediately after intervention (p<.05). Furthermore, both groups showed a pattern of returning to the initial strength after 24 hours. In both groups, no significant difference in muscle thickness immediately and after 24 hours was observed (p>.05). Conclusion: According to the results of the present study, MET and IASTM technique showed lasting effectiveness in flexibility of shortened hamstring immediately after and in 24 hours after the intervention. In both groups, MET increased muscle strength and increased ROM, while IASTM decreased muscle strength and increased ROM, with no change in muscle thickness.

• Physical Therapy Korea
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• v.28 no.1
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• pp.65-71
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• 2021

Background: The hamstring is a muscle that crosses two joints, that is the hip and knee, and its flexibility is an important indicator of physical health in its role in many activities of daily living such as sitting, walking, and running. Limited range of motion (ROM) due to hamstring tightness is strongly related to back pain and malfunction of the hip joint. High-frequency diathermy (HFD) therapy is known to be effective in relaxing the muscle and increasing ROM. Objects: To investigate the effects of HFD on active knee extension ROM and hamstring tone and stiffness in participants with hamstring tightness. Methods: Twenty-four participants with hamstring tightness were recruited, and the operational definition of hamstring tightness in this study was active knee extension ROM of below 160° at 90° hip flexion in the supine position. HFD was applied to the hamstring for 15 minutes using the WINBACK device. All participants were examined before and after the intervention, and the results were analyzed using a paired t-test. The outcome measures included knee extension ROM, the viscoelastic property of the hamstring, and peak torque for passive knee extension. Results: The active knee extension ROM significantly increased from 138.8° ± 9.9° (mean ± standard deviation) to 143.9° ± 10.4° after the intervention (p < 0.05), while viscoelastic property of the hamstring significantly decreased (p < 0.05). Also, the peak torque for knee extension significantly decreased (p < 0.05). Conclusion: Application of HFD for 15 minutes to tight hamstrings immediately improves the active ROM and reduces the tone, stiffness, and elasticity of the muscle. However, further experiments are required to examine the long-term effects of HFD on hamstring tightness including pain reduction, postural improvement around the pelvis and lower extremities, and enhanced functional movement.

• Physical Therapy Korea
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• v.28 no.1
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• pp.59-64
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• 2021

Background: Hip flexor muscles are very important in the hip joint structure as a mover and stabilizer. In addition, isometric hip flexor strength in the supine position needs to be considered with isometric core strength (WICS) to measure a precise strength in a clinical way. Objects: We compared isometric hip flexor strength in the supine position in subjects with and without WICS (between factors) and conditions with and without an external support (within factors). Methods: A total of 34 subjects (16 with WICS, 18 without WICS) participated in this study. We used the double-bent leg-lowering test to divide the subjects in two groups according to the presence of WICS. Isometric hip flexor strength was evaluated in the supine position both with and without an external support condition. The two-way mixed analysis of variance was applied to identify significant differences between groups (with vs. without WICS: between factors) and conditions (with vs. without an external support: within factors). Statistical significance was set at α = 0.05. Results: In subjects with WICS, isometric hip flexor strength was greater with an external support than without it (p = 0.0064). In subjects without WICS, there were no significant differences in isometric hip flexor strength in the presence or absence of an external support (p = 0.075). The isometric hip flexor strength was significantly greater with an external support condition in particular in subjects with WICS. Conclusion: The findings of this study reported that an external support condition in individuals with WICS may contribute to the improvement of isometric hip flexion strength in the supine position. Therefore, isometric core strength should be evaluated to distinguish the weakness between core region and hip flexors.

• Journal of Korean Physical Therapy Science
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• v.29 no.1
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• pp.47-54
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• 2022

Background: Plyometric exercise is an exercise exerting forceful power in a brief period using isotonic activation. It is effective to improve reaction of muscle, agility, endurance and athletics performance. Weight training is an exericse improving muscular strength, endurance and respirating ability applying diversely in frequency and load of exercise Plyometric exercise and Weight training is to facilitate the athletics performance though improving the function of lower limb muscle, there is a difference that Plyometic jump squats is the way to improve agility and Weight training is the way to improve muscular strength. Therefore, it is necessary to know how this difference effects on athletics performance as measuring ankle, ROM, and jumping ability. Design: Randomized controlled trial. Method: This study was conducted with the voluntary participation of 40 university students, who were randomly assigned to jump squat and calf raise groups (n=20 per group). For each subject, we measured the range of motion of the ankle joint before and after exercise, as well as a standing broad jump and vertical jump test performance. We compared the performance indices before and after exercises using paired t-tests, and between groups using independent-samples t-tests. Conclusions: Both jump squat and calf raise exercises improved ankle joint dorsiflexion and plantar flexion, as well as standing broad jump and vertical jump height performance. However, there were no significant differences before versus after exercise, or between exercise types. Although jump squats and calf raises have different purposes, it is thought that, in combination, these exercises improve performance more effectively than either alone, and that such a combined exercise program improves the quality of training in both the general public and athletes in various sports.

• The Journal of Korean Physical Therapy
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• v.33 no.6
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• pp.278-285
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• 2021

Purpose: This study investigated the effects of open kinetic chain (OKC) exercise for the gastrocnemius (GCM) and tibialis anterior (TA) muscles on static and dynamic balance and muscle strength. Methods: We recruited 21 healthy participants, dividing them into 3 groups (GCM, TA, and non-exercise). Each group contains 7 participants. Two exercise groups (GCM and TA) performed OKC exercise with elastic bands twice per week for 4 weeks, while non-exercise group did nothing. We obtained the data for static and dynamic balance and muscle strength before and after the intervention. We used the Kruskal-Wallis test to compare and analyze the pre-post-intervention differences among the groups. Results: For static balance, the stability index of the TA group was the lowest for the dynamic platform (p<0.05). The dynamic balance of the TA group increased for the anterior and posteromedial directions (p<0.05). The peak torque increased in the TA group for dorsiflexion (D/F) movement and in the GCM group for plantar flexion movement compared with the other groups, except for the left direction during D/F (p<0.05). Conclusion: OKC exercises with elastic bands were effective for selectively increasing muscle strength. It is clinically thought that strength training for TA muscles will be effective among the muscles of the ankle.

• Journal of Biomedical Engineering Research
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• v.43 no.5
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• pp.361-368
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• 2022

The purpose of this study was to develop a hand rehabilitation training system for hemiplegic patients. We also tried to find out five hand postures (WF: Wrist Flexion, WE: Wrist Extension, BG: Ball Grip, HG: Hook Grip, RE: Rest) in real-time using multi-channel EMG-based deep learning. We performed a pre-processing method that converts to Spider Chart image data for the classification of hand movement from five test subjects (total 1,500 data sets) using Convolution Neural Networks (CNN) deep learning with an 8-channel armband. As a result of this study, the recognition accuracy was 92% for WF, 94% for WE, 76% for BG, 82% for HG, and 88% for RE. Also, ten physical therapists participated for the usability evaluation. The questionnaire consisted of 7 items of acceptance, interest, and satisfaction, and the mean and standard deviation were calculated by dividing each into a 5-point scale. As a result, high scores were obtained in immersion and interest in game (4.6±0.43), convenience of the device (4.9±0.30), and satisfaction after treatment (4.1±0.48). On the other hand, Conformity of intention for treatment (3.90±0.49) was relatively low. This is thought to be because the game play may be difficult depending on the degree of spasticity of the hemiplegic patient, and compensation may occur in patient with weakened target muscles. Therefore, it is necessary to develop a rehabilitation program suitable for the degree of disability of the patient.

• Journal of the Korean Burn Society
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• v.23 no.2
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• pp.31-36
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• 2020

Purpose: Scar contracture influence the outcome of burn patients significantly. This study aims to investigate the feasibility of robot-assisted training for the lower extremity rehabilitation of burn patients. Methods: This pilot study was conducted on 7 burn patients for 8 weeks between January 2019 and November 2019. Two of 7 patients withdrew from this study because one had skin abrasion on the legs which thigh fastening devices were applied on and the other was not participate in the assessment at 4 weeks after training. Final 5 patients received gait training with SUBAR^® and numeric rating scale (NRS), 6-minutes walking test, and range of motion in flexion and extension of knee and ankle joint were evaluated before training, 4 weeks and 12 weeks after training. Results: The subjects had a mean age of 51.8±98 years, mean total burn surface area of 30.8±13.7%, mean duration from injury to 1^st assessment of 102.8±39.3 days. Anyone of 5 patients did not have musculoskeletal or cardiovascular side effects such as increased or decreased blood pressure or dizziness. The significant improvement in NRS, gait speed, and range of motion in knee extension and ankle plantarflexion after robotic training (all P<0.05). Conclusion: Robot-assisted training could be feasible for the rehabilitation of burn patients and it could improve muscle strength and range of motion in lower extremities, and gait function.

• Physical Therapy Korea
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• v.30 no.1
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• pp.15-22
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• 2023

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study's findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

• Physical Therapy Rehabilitation Science
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• v.11 no.4
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• pp.414-420
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• 2022

Objective: In this study, the test-retest reliability and validity were presented to evaluate the usability of isokinetic rehabilitation equipment for the knee joint. Design: Cross-sectional design, reliability & validity study. Methods: Thirty healthy adults participated in the study. A CSMI dynamometer was used as a standardized measuring device to present the validity of the equipment. It was measured based on the dominant leg. The average peak torque value was selected as the measurement variable. After the measurement, a questionnaire was conducted on safety, satisfaction, and performance through the usability evaluation questionnaire. Results: The knee joint isokinetic rehabilitation equipment showed high reliability with Intraclass Correlations Coefficients (ICC) =0.883~0.956. In order to check the validity of the equipment, the 95% confidence interval of the mean difference limit was confirmed by the Bland & Altman plot. As a result, all three angular velocities showed a smaller confidence interval in the flexion than in extension. There were less than 10 plots that were not included in 2 Standard Deviation (SD) between all measurements. As a result of the usability evaluation questionnaire, the average of the safety domain(4.9±0.4), satisfaction domain(4.1±0.8), performance domain(4.3±0.8). Conclusions: If the product is improved by supplementing the items identified in the usability evaluation process, it is judged that it can be used as a useful device in various knee joint rehabilitation fields.