• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.7 no.2
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• pp.23-39
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• 2001

Dysfunction of the anterior and dorsal muscles of the trunk have been studied in relation to low back pain of many years. Many muscles of the trunk are capable of contributing to the stabilization and protection of the lumbar spine, recent evidence has suggested that transversus abdominis may be critically involved and has been the focus of rehabilitation. The delay in onset of contraction of trunk muscles associated with movement of the upper or lower limb in patients with low back pain indicates a significant deficit in the automatic motor command for control of disturbance to the spine. The function of transversus abdominis has been largely ignored in the evaluation of spinal stabilization and protection. The most essential stabilizing muscles for the lumbar column are the transversus abdominis and the multifidus. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensorimotor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovasc+ular exercises, group exercise, personal exercise at home. Sensorimotor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercises on an unstable surface, thereby achieving optimum stimulation of the sensorimotor apparatus.

• PNF and Movement
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• v.14 no.2
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• pp.75-81
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• 2016

Purpose: This study used a comparative analysis to propose the effectiveness of using scapular and pelvic patterns of proprioceptive neuromuscular facilitation simultaneously (USPS) on the components of gait in patients with stroke. Methods: Subjects who signed a written consent form to participate in the experiment and attended voluntarily were divided randomly into two groups: the USPS group (12) and the control group (9). The USPS group received pattern training for 30 minutes a day, 3 days per week for 6 weeks. The control group received general physical exercise for the same duration. Gait ability was tested and analyzed before and after the 6 weeks of training with the GAITRite system. Results: The components of gait increased significantly in the USPS group after training (p < 0.05) and did not increase significantly in the control group. Conclusion: According to the results of this study, USPS training improves the components of gait more than general physical exercise. The USPS training method is effective for improving motor functions in patients with stroke, especially for gait rehabilitation.

• Journal of Mechanical Science and Technology
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• v.17 no.8
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• pp.1140-1147
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• 2003

We have examined the effect on neck-muscle activation of altering whole body posture. A Rhesus monkey (Macaca mulatta) was trained to produce sinusoidal (0.25 Hz) head tracking movements in the sagittal plane when seated with trunk and head vertical or while standing in the quadrupedal position. Video-fluoroscopic images of cervical vertebral motion, and electromyographic (EMG) responses were recorded simultaneously. Results demonstrated that vertebral motion varied with body posture, occurring synchronously between all joints in the upright position and primarily at skull-$C_1$ when in the quadrupedal position. Muscle EMG activation was significantly greater (P<0.001) in the quadrupedal position than when upright for all muscles except semispinalis cervicis. Peak activation of all the muscles occurred prior to peak head extension in the quadrupedal position, suggesting synchronous activity between muscles. Data suggest that, when upright, muscles were activated in functional groupings defined by their anatomical arrangement. In the quadrupedal position, gravity acting on the horizontally oriented head produced greater activation and a collective response of the muscles.

• Journal of Preventive Medicine and Public Health
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• v.46 no.sup1
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• pp.50-54
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• 2013

Out-of-home mobility is necessary for accessing commodities, making use of neighborhood facilities, and participation in meaningful social, cultural, and physical activities. Mobility also promotes healthy aging as it relates to the basic human need of physical movement. Mobility is typically assessed either with standardized performance-based tests or with self-reports of perceived difficulty in carrying out specific mobility tasks. Mobility declines with increasing age, and the most complex and demanding tasks are affected first. Sometimes people cope with declining functional capacity by making changes in their way or frequency of doing these tasks, thus avoiding facing manifest difficulties. From the physiological point of view, walking is an integrated result of the functioning of the musculoskeletal, cardio-respiratory, sensory and neural systems. Studies have shown that interventions aiming to increase muscle strength will also improve mobility. Physical activity counseling, an educational intervention aiming to increase physical activity, may also prevent mobility decline among older people. Sensory deficits, such as poor vision and hearing may increase the risk of mobility decline. Consequently, rehabilitation of sensory functions may prevent falls and decline in mobility. To promote mobility, it is not enough to target only individuals because environmental barriers to mobility may also accelerate mobility decline among older people. Communities need to promote the accessibility of physical environments while also trying to minimize negative or stereotypic attitudes toward the physical activity of older people.

• The Journal of Korean Physical Therapy
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• v.31 no.5
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• pp.311-316
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• 2019

Purpose: Generally, patients with stroke present with decreased balance and increased spasticity following weakness of the paralyzed muscles. Muscle weakness caused by stroke has two causes. This is caused by a decrease in motor output and an adaptive muscle change, resulting in muscle weakness and muscle paralysis. The purpose of this study was to investigate the effect of strengthening exercise on balance and spasticity in chronic stroke patients and to suggest the basis of clinical treatment. Methods: Twenty subjects were divided into two groups: a lower-extremity strengthening group (experimental group) and a general physical therapy group (control group). The sliding stander equipment was used for the experimental group and a regimen of warm-up exercise, the main exercise routine, and cool-down exercise were used for the muscle strengthening exercise program. Balance and spasticity were measured before and after the training period. Balance ability was measured by the Berg balance scale, the Timed up and Go test and the weight distribution of the paralyzed muscles by the Spacebalance 3D. Spasticity was measured by the Biodex system. Results: After the training periods, the experimental group showed a significant improvement in BBS, weight distribution of the paralyzed muscles, and decreased spasticity when compared to the control group (p<0.05). Conclusion: This study supported the hypothesis that lower-extremity strengthening exercise improves the balance and decreases the spasticity of stroke patients. If it is combined with conventional neurologic physiotherapy, it would be effective rehabilitation for stroke patients.

• PNF and Movement
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• v.3 no.1
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• pp.17-26
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• 2005

Objectives : The purpose of this study is to identify influence that PNF method have an effect in function restoration of the impaired patients of central nervous system. Methods : The data were collected by 15 adult stroke patients. The treatment was based on proprioceptive neuromuscular facilitation techniques. Temporal and spatial parameters of gait were analysed for using the computerized GAITRite system. Results : In the comparison of functional ambulation profile(FAP) before and after experiment, the FAP was significantly increased in the PNF method. The gait velocity, cadence and single support time asymmetry ratio was significantly increased in the PNF method. The Motor Assessment Scale was significantly increased in the PNF method. Conclusions : Based on these results, it is concluded that the forced PNF method for 6 weeks can be improve the temporal-spatial gait parameters including FAP in hemiplegic patients. Therefore, the forced PNF method is useful to improve the function restoration in hemiplegic patients. Further study should be done to analyze the effects of intervention duration of treatment, optimal time to apply the treatment in more long peried.

• Physical Therapy Korea
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• v.28 no.4
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• pp.273-279
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• 2021

Background: Lunge exercises are lower extremity rehabilitation and strengthening exercises for patients and athletes. Most studies have shown the effectiveness of the forward and backward lunge exercises for treating patellofemoral pain and anterior cruciate ligament injuries (by increasing lower extremity muscle activity) and improving kinematics. Objects: However, it is not known how the two different lunge movements affect trunk muscle activities in healthy individuals. The purpose of this study was to investigate the electromyographic activity of the rectus abdominis and erector spinae muscles during forward and backward lunge exercises in healthy participants. Methods: Twelve healthy participants were recruited. Electromyographic activity of the rectus abdominis and erector spinae was recorded using surface electrodes during forward and backward lunges, and subsequently normalized to the respective reference voluntary isometric contractions of each muscle. Results: Activity of the erector spinae was significantly higher than that of the rectus abdominis during all stages of the backward lunge (p < 0.05). The activity of the erector spinae was significantly greater during the backward than forward lunge at all stages (p < 0.05). Conclusion: Backward lunging is better able to enhance trunk motor control and activate the erector spinae muscles.

• Journal of Korean Physical Therapy Science
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• v.28 no.2
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• pp.1-9
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• 2021

Background: The requirements for postural and motor control in backward walking training (BWT) may improve balance and walking speed in patients with acute stroke. The aim of this study was to analyze the effect of BWT on balance, balance confidence, and fall efficacy in this population. Design: Randomized controlled pilot trial. Methods: This study included 14 subjects with acute stroke (onset of illness less than one month). They were randomly allocated to a BWT (n=7) or forward walking training (n=7) group and observed five times in a week for a period of two weeks. Measurements were taken before and after the experiment using the Berg balance scale (BBS), Activities-specific balance confidence scale (ABC), and Fall efficacy scale (FES). Results: The BBS, ABC and FES scores obtained in both groups after the experiment were significantly higher than those before the experiment (p<0.05). In addition, the BBS, ABC, and FES scores in the experimental group were significantly higher than those in the control group (p<0.05). Conclusion: These findings indicate that BWT improved balance and balance confidence and decreased the risks of fall in patients with acute stroke. Further study is needed to better understand the effects of backward walking in acute stroke patients.

• Journal of Korean Neurosurgical Society
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• v.64 no.2
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• pp.143-150
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• 2021

Spinal dysraphism often causes neurological impairment from direct involvement of lesions or from cord tethering. The conus medullaris and lumbosacral roots are most vulnerable. Surgical intervention such as untethering surgery is indicated to minimize or prevent further neurological deficits. Because untethering surgery itself imposes risk of neural injury, intraoperative neurophysiological monitoring (IONM) is indicated to help surgeons to be guided during surgery and to improve functional outcome. Monitoring of electromyography (EMG), motor evoked potential, and bulbocavernosus reflex (BCR) is essential modalities in IONM for untethering. Sensory evoked potential can be also employed to further interpretation. In specific, free-running EMG and triggered EMG is of most utility to identify lumbosacral roots within the field of surgery and filum terminale or non-functioning cord can be also confirmed by absence of responses at higher intensity of stimulation. The sacral nervous system should be vigilantly monitored as pathophysiology of tethered cord syndrome affects the sacral function most and earliest. BCR monitoring can be readily applicable for sacral monitoring and has been shown to be useful for prediction of postoperative sacral dysfunction. Further research is guaranteed because current IONM methodology in spinal dysraphism is still deficient of quantitative and objective evaluation and fails to directly measure the sacral autonomic nervous system.

• PNF and Movement
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• v.12 no.3
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• pp.189-199
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• 2014

Purpose: The objective of this case report is to examine the impact of physical therapy using the proprioceptive neuromuscular facilitation (PNF) concept for a patient with shoulder impingement syndrome. Methods: The patient is a 35-year-old female who has felt pain in the right shoulder for one month. The physical examination evaluated sensory integration, pain, joint integration and mobility, posture, reflex integration, range of motion, muscular strength, analysis of movement, and shoulder function. Comprehensive physical therapy was given to the patient, including stretching, mobilization, strengthening, posture correction, coordination improvement, daily activities, and sports exercises. The therapy was given 5 times a week for the first 5 weeks, then 3 times a week for the next 5 weeks. In all, the intervention lasted for 10 weeks. Results: The patient's senses, posture, and muscular strength all improved to a normal level. The degree of pain fell from 3/10 to 0/10 for activities taking place below shoulder height, and from 8/10 to 1/10 for activities above the head. Additionally, joint integration, motility, range of motion, and movements also improved. The disabilities of the arm, shoulder and hand (DASH) for functional evaluation improved from 27.5 to 10.3. Conclusion: Physical therapy using the PNF concept is effective in improving the body structure, function, activity, and participation of patients with motor disorders of the shoulder impingement syndrome.