• The Journal of Korean Physical Therapy
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• 제31권1호
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• pp.56-61
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• 2019

Purpose: The spasticity of stroke patients decreases the ankle range of motion and increases the gastrocnemius muscle tone. This study examined the effects of stretching exercise and far infrared irradiation on the ankle function in stroke patients with spasticity. Methods: This study was conducted on 20 stroke patients admitted to Jesaeng General Hospital, who were divided into a study group (stretching exercise with far infrared) and control group (stretching exercise only). The dorsiflexion range of motion was measured using a smartphone and the medial gastrocnemius muscle tone and stiffness were measured using a Myoton pro. Results: With the exception of the non-paretic gastrocnemius muscle tone in the control group, the medial gastrocnemius muscle tone and stiffness decreased significantly in both groups. In both groups, the dorsiflexion range of motion increased significantly. In addition, the experimental group had a significantly higher dorsiflexion range of motion than the control group. On the other hand, there was no significant difference between the two groups in terms of the medial gastrocnemius muscle tone and stiffness. Conclusion: For stroke patients with spasticity, stretching exercises increased the ankle's range of motion and decreased the gastrocnemius muscle tone. The addition of heat therapy further increased the ankle's range of motion. On the other hand, as the sample size was small, future studies should include more subjects.

• 국제물리치료학회지
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• 제12권1호
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• pp.2302-2307
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• 2021

Background: Patients with lumbar spinal stenosis show abnormal changes in muscle activity due to pain and limited range of motion of the lumbar spine. Excessive increased muscle tone and decreased muscle activity patterns threaten the patients' quality of life. However, there have been a few studies showing how to improve muscle performance in patients with lumbar spinal stenosis. Among these, joint mobilization is one way of improving muscle performance through pain relief and increasing the range of motion. Objectives: To investigate the effect of lumbar mobilization by orthopedic manual physical therapy on paravertebral muscle activity and tone in patients with lumbar spinal stenosis. Design: A randomized controlled trial. Methods: In this study, 24 patients with lumbar spinal stenosis were randomized (1:1 ratio) into two groups. The experimental group underwent lumbar posteroanterior mobilization, and the control group underwent conventional physical therapy (conventional transcutaneous electrical nerve stimulation) for 15 minutes each. For outcome measures, Myoton^®PRO was used to evaluate muscle tone when resting of the paravertebral muscle in the pain area. For muscle activity evaluation, the reference voluntary contraction of the paravertebral muscle was evaluated using surface electromyography. Results: Muscle tone and activity were significantly improved after intervention in both the experimental and control groups. In addition, the experimental group showed more significant decrease in muscle tone and activity than the control group. Conclusion: These results suggest that lumbar mobilization improving muscle performance in patients with lumbar spinal stenosis.

• 대한정형도수물리치료학회지
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• 제27권3호
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• pp.69-78
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• 2021

Background: Approximately 30% of people suffer from chronic neck and shoulder pain. Chronic neck and shoulder pain arise due to the exposure to continuous low loading and monotonous work. This is a common musculoskeletal disorder in a society. As physical therapists, we should give appropriate treatment to these people. Methods: A total of 26 patients with chronic neck and shoulder myalgia were randomly allocated into two experimental groups. First, 13 patients received shoulder strength training, while the other 13 patients received cervical mobilization. Outcome measures included bilateral pressure pain threshold by using an algometer at upper trapezius, visual analogue scale (VAS) to express their pain scale, and muscle tension by using myoton pro device pre-intervention and after the final treatment. Results: The VAS and muscle tension in upper trapezius significantly decreased (p<.05) in both groups; however, no differences between two groups were observed (p>.05). The pressure pain threshold in upper trapezius significantly increased (p<.05) in both groups; yet, again, the differences between the groups did not reach statistical significance (p>.05). Conclusion: As methods of treatment, shoulder-specific strength training and cervical mobilization can be appropriate approaches to the treatment of neck and shoulder musculoskeletal disorder.

• Physical Therapy Rehabilitation Science
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• 제11권4호
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• pp.446-453
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• 2022

Objective: The popularization of smartphones can lead to abnormal cervical alignment in university students. The aim of this study was to investigate the relationship among smartphone screen time, cervical alignment, and muscle function in university students. Design: Cross-sectional study. Methods: Seventy-five university students participated in the study. They completed the evaluation of cervical alignment and muscle function, such as handgrip strength, proprioception, and muscle quality (tone, stiffness, and relaxation time). All participants recorded their general characteristics and individual smartphone screen time before the evaluation. They were evaluated craniovertebral angle (CVA) using smartphone application (angle meter 360) for measuring cervical alignment. The muscle function was assessed using a digital hand-held dynamometer, dual inclinometer, and MyotonPRO device. Results: Of all participants, twenty-five university students had forward head posture (CVA<49°, 33.33%). Independent t-test revealed that there were significant differences on smartphone screen time, muscle stiffness, and muscle relaxation between the participants with and without forward head posture (p<0.05). There were significant correlations between the smartphone screen time and the CVA, muscle tone, and muscle relaxation (r=-0.493, 0.250, and -0.500, respectively). Conclusions: The results indicate that the university students with forward head posture had high smartphone screen time and muscle stiffness compared to the students without forward head posture, and smartphone screen time might be associated with cervical alignment and muscle quality.

• 대한물리의학회지
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• 제18권4호
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• pp.77-87
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• 2023

PURPOSE: The purpose of this study was to investigate the changes in the flexibility and elasticity of the muscles when the hamstrings were stretched in one direction and when they were stretched in three directions. METHODS: In this study the subjects were divided into two groups, namely the 'one-direction stretching exercise of the hamstring muscle in the neutral position' group (female: 14 people, male: 14 people) and the 'three-way stretching exercise' group (female: 12 people, male: 14 people) considering the positions of the three hamstring muscles. The elasticity and flexibility of the hamstring muscles were measured before and after the self-extension exercise, and the average value of two measurements was noted. To evaluate the flexibility of the hamstring muscle, a 'sit and reach' test was performed, and muscle elasticity was measured using the MyotonPRO® device. RESULTS: After the stretching exercise, flexibility increased in both groups. In terms of muscle elasticity, the body dynamic strength and resonance frequency of the stretching one-direction stretching group decreased after the stretching exercise. CONCLUSION: To alter the muscle characteristics and increase the flexibility when performing a stretching exercise, selecting and stretching only one muscle with the lowest range of motion yields effective results. The ideal technique to be employed appears to be to stretch the entire hamstring muscle in one direction from the neutral position.

• 한국전문물리치료학회지
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• 제25권2호
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• pp.13-21
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• 2018

Background: After a stroke, the patient may have abnormal muscle tone due to abnormal alignment. Physical therapists have used stretching, neural mobilization other methods to treat patients after stroke. In addition, joint mobilization is also used to stimulation in pathway of cervical segmental region and to normal cervical spine alignment. Objects: The purpose of this study was to determine whether Maitland cervical spine mobilization has an immediate effect on muscle tone and stiffness of upper extremity. Methods: Thirty subjects were divided into a experimental group ($n_1=10$), a placebo group ($n_2=10$), and a control group ($n_3=10$). The Maitland cervical spine mobilization was applied in the supine position. Immediately after the intervention, muscle tone and stiffness of biceps brachii, brachioradialis, deltoid, and pectoralis major were measured using Myoton(R)PRO. In the placebo group, sham mobilization was applied to the fifth and sixth cervical vertebra, and the control group was instructed to control breathing. Results: In the experimental group, significant differences were found in muscle tone and stiffness of biceps brachii and brachioradialis in comparison with the affected side and the non-affected side before the intervention (p<.05), whereas there was no significant difference after the intervention (p>.05). Muscle tone of biceps brachii on the non-affected side and pectoralis major on the affected side was significantly decreased before and after the intervention (p<.05). The placebo and control group showed no changes on the non-affected and affected side, and no significant differences were detected before and after the intervention. All the groups revealed no significant differences in muscle tone and stiffness of upper extremity before and after the intervention. Conclusion: This study suggests that the application of Maitland cervical spine mobilization enhanced muscle tone of upper extremity on the involved side symmetrically, and influenced a decrease in muscle tone.

• The Journal of Korean Physical Therapy
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• 제30권4호
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• pp.135-140
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• 2018

Purpose: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. Methods: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, $MAS{\geq}2$) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. Results: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p<0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 30 Hz (p<0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p<0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p<0.05). Conclusion: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.

• 한국전문물리치료학회지
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• 제27권2호
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• pp.133-139
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• 2020

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before-after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects' GCMs for 10-15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle's architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

• 대한물리의학회지
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• 제14권4호
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• pp.19-27
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• 2019

PURPOSE: This study examined which stretching exercise had the most positive effect on increasing the range of motion (ROM) of the knee joint in healthy people and whether there was a difference between continuous stretching and intermittent stretching. METHODS: This study included 30 healthy university students from OOO University. The subjects were asked to sit on a mat and perform hamstring-stretching exercise during which the ROM and muscle tone were measured with pre and post-tests. Each subject was assigned randomly to a continuous stretching group (stretching without relaxation time group, n=10, G1) or intermittent stretching group (stretching with 10s relaxing time group, n=10, G2; and stretching with 20s relaxing time group, n=10, G3). The participants conducted hamstring stretching exercises with a sit-and-reach box at three different rest times (0s, 10s, and 20s). Subsequently, they underwent passive knee extension (PKE) tests, in which the ROM of the knee joint was measured with a goniometer, and the muscle tone was evaluated using a MyotonPro. RESULTS: Significant differences in muscle tone, stiffness, and ROM were observed between pre-test and post-test in each groups (p<.05). Although the post hoc tests indicated no significant differences in muscle tone and ROM between the continuous stretching group and intermittent stretching group (p>.05), the rate of change of the ROM showed that the intermittent stretching group developed more effective maintenance of the hamstring flexibility. CONCLUSION: No significant differences in the muscle tone of the hamstring and ROM of the knee joint were observed according to the hamstring stretching exercises with three different rest times. On the other hand, the rate of change of the ROM showed that intermittent stretching maintained the hamstring flexibility more effectively.

• 대한물리의학회지
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• 제12권2호
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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.