• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.13-19
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• 2011

Purpose:This study was designed to investigate difference in isokinetic muscle strength in the knee extensor muscle and characteristic differences in muscle strength between males and females through the ankle joint angles. Methods: Seventy-four subjects participated in this study. There were two groups: 36 males and 38 females. The mean age of the men was 24.58 years and women was 23.74 years. Subjects were seated on a CON-TREX LP (leg press) lean to back of chair, and there bodies were fixed by straps with the hip joint at an angle of $130^{\circ}$. After randomly fixing the ankle joint at $0^{\circ}$, $20^{\circ}$, and $40^{\circ}$ of plantar flexion (PF) in range of full extension of knee joint. We studied force max average, force max average/kg, power average, and total work through the angle of the ankle joint when the knee joint was extended from $90^{\circ}$ to $180^{\circ}$. Results: In the male group, all maximum measured value showed at the ankle joint $0^{\circ}$, all minimum measured value showed at $40^{\circ}$ PF (p<0.01). In the female group, all maximum measured value showed at the ankle joint $20^{\circ}$ PF, especially the power average increased significantly. All minimum measured value showed $40^{\circ}$ PF (p<0.01). Conclusion: There are differences between males and females in isokinetic muscle strength of the knee extensor through ankle joint angles in healthy adults. Males and Females have different characteristics of muscle strength through the ankle joint angles.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.4
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• pp.85-94
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• 2018

PURPOSE: This study was conducted to determine the effects of therapeutic exercise on range of motion (ROM), the manual muscle test (MMT), functional movement screen (FMS) and radiological evaluation in a youth football player with football-specific anterior pelvic tilt (APT). METHODS: The subject of this case report was a 12-year-old youth football player, who presented with football-specific APT. Therapeutic exercise consisted of hamstring stretch, prone hip extension, abdominal crunch, bridging with isometric hip abduction, plank exercise with posterior tilt and posterior pelvic tilting exercise using a swiss-ball for 40 min/day, twice a week for 8-weeks. ROM, MMT, FMS (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, rotary stability and trunk stability push-up) and radiographs (lumbar lordotic and sacral horizontal angle) were analyzed before and after week 8 of therapeutic exercise. RESULTS: The ROM, MMT, and FMS increased and the lumbar lordotic angle and sacral horizontal angle improved after 8-weeks of therapeutic exercise. CONCLUSION: The results of this case report suggest that therapeutic exercise improves ROM, MMT and radiography associated parameters in youth football players with football-specific APT. These findings have clinical implications for therapeutic exercise in youth football players with football-specific APT.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• Physical Therapy Korea
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• v.26 no.3
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• pp.84-90
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• 2019

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

• Physical Therapy Rehabilitation Science
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• v.8 no.3
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• pp.125-133
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• 2019

Objective: To compare the postural control between non-specific chronic low back pain (NSCLBP) subgroups and healthy people during dynamic balance performance using a modified Star Excursion Balance Test (mSEBT). Design: Cross-sectional study. Methods: Eighteen NSCLBP subjects (9 active extension pattern [AEP], 9 flexion pattern [FP]), and 10 healthy controls were enrolled in this study. All subjects performed mSEBT on their dominant leg on a force plate. Normalized reach distance and balance parameters, including the center of pressure (COP) displacement and velocity, were recorded. Results: There were significant differences in mean reach distances in both posterolateral and posteromedial (PM) reach directions between AEP and healthy subjects (p<0.001) and between FP and healthy subjects (p<0.001). However, there were no significant differences among the three groups in the anterior reach direction. Also, the results showed no significant differences in mean COP variables (velocity and displacement) between pooled NSCLBP and healthy subjects. However, the subjects were reclassified into AEP, FP and healthy groups and the results showed a significant difference in mean COP velocity in the PM direction between AEP and FP subjects (p=0.048), and between AEP and healthy subjects (p=0.024). Conclusions: The findings in this study highlight the heterogeneity of the individuals with NSCLBP and the importance of identifying the homogenous subgroups. Individuals with AEP and FP experience deficits in dynamic postural control compared to healthy controls. In addition, the findings of this study support the concept of the Multidimensional Classification System.

• Journal of Korean Medicine Rehabilitation
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• v.31 no.2
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• pp.99-108
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• 2021

The study reports the clinical case of a patient with lower extremity weakness and gait disturbance treated with Korean medicine treatments including Chuna therapy. The patient suffered lower extremity weakness and gait disturbance with diagnosis of lumbar disk herniation and spinal stenosis. As a treatment, the doctor applied Chuna therapy, herbal medicine, acupuncture, pharmacopuncture, cupping and moxa. The effect of treatment was evaluated by numeral rating scale (NRS), self-walkable distance, functional independence measure (FIM), Oswestry disability index (ODI) and manual muscle test (MMT). NRS decreased from 6 to 4 at the leg. Self-walkable distance increased from 0 m to 10 m, FIM increased 85 to 96 points while ODI decreased 64% to 54%. MMT of hip flex and knee extension improved from grade 3+, grade 3 to grade 4, respectively. Korean medicine treatment can be effective for patients who suffer lower extremity weakness and gait disturbance due to lumbar disk herniation and spinal stenosis. Further clinical studies are required to verify these findings.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.1-8
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• 2018

Purpose: This study investigated the effect of the augmented reality (AR)-based knee joint short period exercise program and used a motion analyzer with a 3D camera to determine the range of motion and dynamic balance and further investigate the effects of therapeutic exercise on patients. Methods: This study used AR-based motion analysis and a Y-balance test to measure the range of motion (ROM) of each joint: the hip joint and the knee joint. After the measurements, an exercise program was applied to the subjects, using the knee motion program function, and the muscles of the quadriceps femoris and the hamstring were stretched or strengthened. Results: Our results showed knee joint extension at the dominant hip joint flexion position. While there was no significant difference (p>.05) at this position, there were significant differences in the non-dominant hips, unbalanced knee joint flexion, and superior knee joint flexion (p<.05). The Y-balance test using the non-dominant leg supported by the dominant legs showed that the absolute reach was $69.70{\pm}7.06cm$ before the exercise, and the absolute reach after the exercise was $77.56{\pm}6.09cm$ (p<.05). Conclusions: There was a significant difference when the movement of the lower limbs supported the superior limbs, and a significant difference was found in the ROM when the non-dominant side supported the dominant side. Therefore, the AR-based exercise program improves the balance of the human body and the range of motion of the joints, and research that aims to improve patients abilities should continue.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.33-44
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• 2018

Purpose: The primary purpose of this study was to investigate the effects of cervical stabilization exercise (CSE) on hamstring flexibility in patients with neck pain. A secondary purpose of this study was to investigate the effects of cervical range of motion (CROM) and craniovertebral angle (CVA). Methods: This study was a single-blind, randomized, comparative trial. Twenty patients were allocated into either the cranio-cervical flexion exercise (CCFE) group or the CSE group. Before and after the intervention, we measured straight leg raise (SLR), popliteal angle (PA), CROM, and CVA in the sitting and standing positions. Fisher's exact test, the Mann-Whitney test, and Wilcoxon's signed-rank test were used to analyze our data. Results: Both groups showed significant improvements in the value of SLR, PA, cervical extension, cervical rotation, and CVA in the standing position (both, p<.05) after intervention. However, only the CSE group showed significant improvements in cervical right lateral flexion (z=-2.209; p<.01) and cervical left lateral flexion (z=-2.537; p<.05) after intervention. The CSF group showed more significant improvements in SLR, PA, both cervical lateral flexions, and both cervical rotations than the CCFE group. Conclusions: The results of this study will guide future research in identifying the effectiveness of CSE. In conclusion, it can be inferred that CSE has a positive effect on SLR, PA, CROM, and CVA in the standing position in patients with chronic neck pain.

• PNF and Movement
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• v.20 no.1
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• pp.91-101
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• 2022

Purpose: The purpose of this study was to examine the effect of cycle ergometer exercise inducing movement of the affected side on knee joint function after total knee arthroplasty (TKA). Methods: The primary experiment was conducted on 19 members of the cycle ergometer exercise group to measure the muscle activity of the rectus femoris, hamstring, tibialis anterior, and gastrocnemius muscles during cycle ergometer exercise that induced the affected side's movement. In the second experiment, after receiving physiotherapeutic intervention for 30 min, the general bicycle exercise group and cycle ergometer exercise group performed the corresponding exercise for 15 min, 5 times per week, for 2 weeks. The ROM, muscle strength, pain, and balance were then measured and compared between the two groups. Results: In the results of the primary experiment, cycle ergometer exercise inducing movement of the affected side showed a significantly larger increase in the activity of leg muscles (rectusfemoris, hamstring, tibialis anterior, gastrocnemius) on the affected side than the general bicycle exercise (p <0.05). In the second experiment, the cycle ergometer exercise group showed a significantly larger increase in range of movement of affected side knee flexion and muscle strength of affected side knee flexion, knee extension, and plantarflexion than the general bicycle exercise (p <0.05). No significant between-group difference was observed in pain and balance before or after the intervention (p >0.05). Conclusion: Cycle ergometer exercise inducing movement of the affected side increases use of the muscles around the affected side knee joint after TKA more than general bicycle exercise and produces better effects for enhancing muscle strength. The application of cycle ergometer exercise inducing movement of the affected side is expected to reduce the patients' unbalanced use during the early postoperative period and help them to quickly return to normal daily life through rapid muscle strength recovery.

• PNF and Movement
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• v.21 no.1
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• pp.63-74
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• 2023

Purpose: This study aims to compare hamstring flexibility and pressure pain threshold (PPT) after an intervention with proprioceptive neuromuscular facilitation contract-relax (PNF CR) technique, myofascial release (MFR), and a massage gun (MG), as well as to verify the effectiveness of the MG. Methods: This study recruited 36 participants (22 males and 14 females) with shortening of less than 70 degrees upon a straight leg raise (SLR) test, and they were randomly assigned to one of the PNF, MG, and MFR groups, each of which underwent its own protocol for 30 minutes. Flexibility of the hamstring was measured after the intervention using the active and passive knee extension (AKE and PKE) test, the sit and reach test, and PPT. Results: The AKE and PKE angles significantly decreased, as well as significantly increased in flexibility when each of the PNF, MFR, and MG interventions was performed (p<0.05). In addition, there was no significant difference among groups. However, according to the Cohen's D effect size, the MG demonstrated the largest effect size in AKE (d = 1.41) and PNF demonstrated the largest effect size in PKE (d = 1.66) and flexibility (d = 0.63). Conclusion: All interventions used in our study are effective in increasing hamstring flexibility. Based on the Cohen's D effect size, an MG is beneficial to increase the AKE, whereas PNF CR technique is recommended for increasing PKE and flexibility.