• Physical Therapy Korea
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• v.29 no.3
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• pp.194-199
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• 2022

Background: Older adults use different ankle muscle activation patterns during difficult static balance conditions. It has been suggested that this is related to a decline in proprioception with age, resulting in reduced postural balance. However, the association between proprioception and ankle muscle activity during quiet standing has not been directly assessed. Objects: This study aimed to investigate the effects of age and sensory condition on ankle muscle activity and the association between ankle proprioception and ankle muscle activity. Methods: We recruited 10 young women and 9 older women. Ankle proprioception was evaluated using joint position sense (JPS) and force sense (FS) divided by dorsiflexion and plantarflexion. The electromyographic activity of the tibialis anterior (TA) and gastrocnemius (GCM) muscles was collected during quiet standing. Results: Older women activated GCM muscle more than young during quiet standing and when performing difficult tasks. Older women had more errors in JPS dorsiflexion and FS plantarflexion than did young. The GCM muscle activity is related to JPS dorsiflexion and FS plantarflexion. Conclusion: Lower proprioception of the GCM with age leads to increased muscle activity, resulting in reduced postural balance. There was no difference in TA proprioception or muscle activity among older women with frequent physical activity.

• Physical Therapy Korea
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• v.23 no.4
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• pp.27-37
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• 2016

Background: In previous studies regarding flexible pes planus, Foot orthosis, special shoes have been used as interventions for correcting malalignment and intrinsic muscles strengthening exercise have been regarded as interventions for foot function and supporting medial longitudinal arch during walking. However, some recent studies reported that strengthening extrinsic muscles as well as intrinsic muscles is more effective and active intervention for flexible pes planus. In particular, the tibialis posterior muscle of foot extrinsic muscles plays essential roles in maintaining the medial longitudinal arch during dynamic weight bearing and balance. In addition this muscle acts longer than other supination muscles during the stance phase in the gait cycle. Objects: This study aimed to investigate the effect of foot intrinsic muscle and tibialis posterior muscle strengthening exercise for plantar pressure and dynamic balance in adults with flexible pes planus. Methods: 16 young flexible pes planus adults (7 males, 9 females) were recruited and were randomized into two groups. The experimental group performed foot intrinsic muscle and tibialis posterior muscle strengthening training, the control group performed only foot intrinsic muscle strengthening training. All groups received strengthening training for 30 minutes five times a week for six weeks. Results: The experimental group had significantly lower plantar pressure of medial heel area than the control group in stand (p<.05). The experimental group had significantly higher dynamic balance ability than control group (p<.05). Conclusion: The results of this study provide evidence to suggest that foot intrinsic muscle and tibialis posterior muscle of extrinsic muscle strengthening exercises may improve plantar pressure distribution and dynamic balance ability in adults with flexible pes planus.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.43-52
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• 2017

PURPOSE: This study aimed to compare the impact of exercise with that of functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS) on muscle tone, calf muscle stiffness, and balance ability in patients with stroke. METHODS: Thirty patients with stroke were randomly divided into an FES group (n=15) and a TENS group (n=15), and a progressive task-oriented exercise was assigned to them. These exercises were performed non-synchronously from December 5, 2016 to January 31, 2017. Patients underwent TENS and simultaneously exercised for 30 minutes daily, 5 times a week for 4 weeks. To determine the effect of the interventions, muscle tone and stiffness of the medial and lateral region of gastrocnemius muscle were measured using the MyotonPRO instrument and balance was assessed using the Berg Balance Scale. RESULTS: Both groups revealed a significant decrease in muscle tone and stiffness of the medial part of gastrocnemius muscle before and after the interventions (p<.05). Berg Balance Scale scores increased significantly (p<.05). However, none of the other parameters were significantly different (p>.05). CONCLUSION: Our results prove that progressive task-oriented exercise along with FES and TENS decreases muscle tone and stiffness of the gastrocnemius muscle in patients with stroke and improves balance. TENS could serve as a complementary replacement for functional electrical stimulation for in-house training, as TENS poses less risk of muscle fatigue and has lesser contraindications than does functional electrical stimulation.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.205-211
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• 2022

Purpose: This study investigated the effects of an intervention that combined the abdominal drawing-in maneuver and frequency-specific neuromuscular electrical stimulation on changes in trunk muscle activity, muscle fatigue, and balance in stroke patients. Methods: Thirty stroke patients were randomly assigned to two groups. Fifteen subjects were assigned to group I which performed the abdominal drawing-in maneuver combined with low-frequency neuromuscular electrical stimulation and the other 15 subjects to group II where the abdominal drawing-in maneuver was combined with high-frequency neuromuscular electrical stimulation. Muscle activity and fatigue were measured using surface electromyography before the intervention. Balance was measured using the Trunk Impairment Scale and re-measured after six weeks of intervention for comparative analysis. Results: Both groups showed a significant increase in muscle activity and balance (p<0.05), and there was no significant difference between the groups (p>0.05). In the changes in muscle fatigue, only the experimental group II showed a significant increase in muscle fatigue (p<0.05). The difference between the groups was statistically significant (p<0.05). Conclusion: It was confirmed that among stroke patients, the combination of the abdominal drawing-in maneuver and low-frequency neuromuscular electrical stimulation was more effective in changing the muscle activity and balance of the trunk by minimizing the occurrence of muscle fatigue compared to the combination of the abdominal drawing-in maneuver and high-frequency stimulation. These results can be used as basic data for clinical trunk stabilization training.

• 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.12 no.4
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• pp.209-215
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• 2014

Purpose: This study aims to understand the effect of balance training on ankle muscle activity and static balance in stroke patients. Methods: The subjects were composed of 12 patients who were admitted with chronic stroke in H, K, and R hospitals located in Gangwon-do from August to October 2014. This study conducted balance training on the subjects for 20 min a session, twice a day, five times a week for six weeks. This study measured the surface electromyogram (EMG) of the paretic side's tibialis anterior and medial gastrocnemius for muscle activity. Static balance was measured as a TETRAX stability index. The measurements were conducted before the experiment and six weeks after. The result was statistically analyzed using paired t-test at the significance level of 0.05. Result: Muscle activity of the paretic side's tibialis anterior and medial gastrocnemius did not show a significant difference in the comparison between pre- and post-balancing training. However, the stability index showed a significant difference (p<0.05) between standing with eyes open (NO) and standing on a sponge with eyes open (PO). Conclusion: Although balance training did not affect the muscle activity of chronic stroke patients, it had an effective influence on the stability index. That is, balance training was effective at the functional level, but it did not change the structure level in terms of the ICF evaluation standard. Balance training becomes more effective when it is applied in relation to task.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.348-354
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• 2012

Purpose: This study examined the effects of computerized feedback postural training on the balance and electromyography activity of subjects with stroke. Methods: A total of 30 chronic stroke patients were enrolled in this study. Subjects were divided into an experimental group (n=15) and a control group (n=15). Computerized feedback postural training was used in the experimental group. Both groups received intervention for six weeks, 5 times per 30 minutes period. Data analysis was performed using analysis of covariance for determination of statistical significance. Results: Significant difference in static and dynamic balance was observed in the experimental group, compared with the control group (p=0.05), and a significant difference in muscle activity was observed in the gastrocnemius muscle, quadriceps muscle, and elector spinae muscle. However, the hamstring muscle showed no significant difference. Conclusion: Computerized feedback postural training is more effective in improving the ability of balance and muscle activity than neurological physical therapy.

• Journal of muscle and joint health
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• v.19 no.3
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• pp.263-271
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• 2012

Purpose: The purpose of this study was to examine the effects of line dance program on muscle strength, balance, flexibility, pain, and mood state in post-menopausal women. Methods: A quasi-experimental research design (one group pretest-posttest) was employed. A total of 13 post-menopausal women completed 12-week line dance program(60min/day, 2days/wk) in S city. Descriptive statistics, Wilcoxon signed rank test were used in the data analysis by SPSS 18.0. Results: Muscle strength and balance were higher, and pain level were lower than before the line dance program. However, flexibility and mood state were not significantly changed after the line dance program. Conclusion: Findings of this study indicated that the 12-week line dance program were effective on muscle strength, balance, and pain relief in the post-menopausal women. Future study is needed to explore the effect of the line dance program on flexibility and mood state with the post-menopausal women.

• Journal of Advanced Technology Convergence
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• v.2 no.2
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• pp.31-38
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• 2023

This study compares the correlation between muscle thickness (abdominal, quadriceps muscle) and how the muscle thickness affects the static balance when the static balance is measured in a standing position. The subjects of study were to select 29 subjects to find out what relationship muscle thickness had on the static balance when measuring muscle thickness and static balance. rectus femoris muscle thickness showed a significant correlation in statically balanced weight distribution index. In this study, only healthy men in their twenties were selected, and the results could not be generalized to other age groups. As a limitation of this study, muscle strength and peripheral vision were not measured, so it seems difficult to express the accuracy of the study and generalize the results. In future studies, the number of subjects and muscle strength should be measured to proceed with the study.

• PNF and Movement
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• v.19 no.2
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• pp.153-162
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• 2021

Purpose: The purpose of this study was to investigate the difference in the dynamic balance and leg muscle activity of adults in their 20s with or without shoes. Methods: In this study, seven male and 11 female university students in their 20s were randomized to determine the order of being with or without shoes, and the dominant foot was supported on the central platform of dynamic balance according to the order procedure. Using the opposite foot, the distance of leg stretching in the anterior, posterior medial, and posterior lateral directions and the muscle activity of the supporting leg were measured. Muscle activity measurement sites were attached to the dominant vastus medialis oblique muscle, vastus lateral oblique muscle, tibialis anterior muscle, peroneus longus muscle, and lateral gastrocnemius muscle. Results: As a result of this study, the distance of leg stretching was significantly increased in the anterior, posterior medial, and posterior lateral directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the vastus medial and lateral oblique muscles was significantly increased in all three directions when barefoot rather than when wearing shoes (p < 0.05). The muscle activity of the tibialis anterior was significantly increased in the anterior direction when barefoot (p < 0.05), the peroneus longus muscle was significantly increased when it was barefoot in the posterior medial direction (p < 0.05), and the lateral gastrocnemius muscle activity significantly increased when barefoot in the posterior direction (p < 0.05). Conclusion: The movement of the legs is freed when barefoot as compared to when wearing shoes, and being barefoot can effectively activate muscle activity and improve balance ability.