• PNF and Movement
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• v.17 no.2
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• pp.207-214
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• 2019

Purpose: Although multi-directional reaching exercises are commonly used clinically, the effects of specific movement directions on the muscle systems of the lower extremities have not been explored. We therefore investigated lower extremity muscle activity during reaching exercises with different sagittal and horizontal plane movements. Methods: The surface electromyography responses of the bilateral rectus femoris, tibialis anterior, peroneus longus, and gastrocnemius muscles were measured during reaching exercises in three directions in the horizontal plane (neutral, $45^{\circ}$ horizontal shoulder adduction, and $45^{\circ}$ abduction) and three directions in the sagittal plane (neutral, $120^{\circ}$ flexion, and $60^{\circ}$ flexion). A total of 20 healthy, physically active participants completed six sets of reaching exercises. Two-way repeated ANOVA was performed: body side (ipsilateral and contralateral) was set as the intra-subject factor and direction of reach as the inter-subject factor. Results: Reaching at $45^{\circ}$ horizontal shoulder adduction significantly increased the activity of the contralateral rectus femoris and gastrocnemius muscles, while $45^{\circ}$ horizontal shoulder abduction activated the ipsilateral rectus femoris and gastrocnemius muscles. The rectus femoris activity was significantly higher with reaching at a $120^{\circ}$ shoulder flexion compared to the other conditions. The gastrocnemius activity decreased significantly as the shoulder elevation angle increased from $60^{\circ}$ to $120^{\circ}$. Conclusion: Our results suggest that multi-directional reaching stimulates the lower extremity muscles depending on the movement direction. The muscles acting on two different joints responded to the changes in reaching direction, whereas the muscles acting on one joint were not activated with changes in reaching direction.

• PNF and Movement
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• v.17 no.1
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• pp.119-127
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• 2019

Purpose: The purpose of this study is to show the effect of elastic band on balance and functional ability in chronic stroke patients living in community. Methods: The subjects who participated in the study were 9 patients with chronic stroke. One of them gave up during the study, finally 8 patients performed. The intervention was conducted once a week for 10 weeks. In this study functional reach test (FRT), timed up and go test (TUG), Tinetti performance oriented mobility assessment (Tinetti-POMA) were measured for balance. The coordination training of arms and legs using the elastic band was performed in three positions as supine, side lying, sitting. One arm performed flexion-adduction- external rotation with elbow flexion pattern and the opposite side(diagonal) leg was performed flexion-adduction-external rotation with knee flexion pattern, the other arm's pattern was extension-abduction-internal rotation with elbow extension and the opposite side (diagonal) leg was in extension-abduction-internal rotation with knee extension pattern. The training was performed in each position for 15 minutes in per position. The participants had a five minute break after each training. Results: The results are as follows. FRT and Tinetti-POMA showed significant increase statistically in each position. The TUG showed significant decrease statistically in each position. Conclusion: Even though the coordination training with elastic band had performed once a week, it showed positive effects on balance in chronic stroke patients. Therefore, if we can suggest the appropriate frequencies of coordination training of arms and legs using the elastic band, it can be a method to improve daily life and life quality to patients with chronic stroke.

• PNF and Movement
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• v.17 no.1
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• pp.57-68
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• 2019

Purpose: This study is an investigation of the effects of long-term smart phone usage and of stretching on muscle stiffness, concentration, and visual acuity. Methods: Forty healthy young adults voluntarily participated in the study and were measured for muscle stiffness, concentration, and visual acuity before smartphone usage and after 30 minutes, 60 minutes, and 90 minutes of smartphone usage. The participants were randomly allocated to the intervention group (n=20) and the control group (n=20). Five minutes after the stretching exercise and eye exercise intervention, the participants were remeasured. Results: After long-term smartphone usage, increases in muscle stiffness and concentration were statistically significant (p<0.05), whereas decreases in visual acuity were statistically significant (p<0.05). After the stretching exercise and eye exercise intervention, muscle stiffness significantly decreased (p<0.05) and visual acuity significantly increased (p<0.05). Concentration, according to the stretching exercise and eye exercise intervention, showed no significant pre- or post-test difference. Conclusion: The results from this study indicate that long-term smartphone usage effectively improved concentration but increased muscle stiffness and decreased visual acuity. Appropriate stretching and eye movement during long-term smartphones usage should mitigate the effects on muscle stiffness and visual acuity. Furthermore, smartphones should be considered an effective tool for concentration training when coupled with the development of appropriate applications.

• PNF and Movement
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• v.17 no.1
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• pp.69-79
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• 2019

Purpose: This study aims to investigate the effects of a group computerization cognitive rehabilitation program on cognitive function in patients with cognitive impairment. Methods: The subjects of this study comprised 34 patients with cognitive impairment (15 males and 19 females) who were randomized into two groups. The experimental group (n = 17) were trained with the group computerization cognitive rehabilitation program, while the control group (n=17) received traditional cognitive therapy. The interventions for both groups were performed for 1 hour per day, once a week for 12 weeks. The cognitive functions of the subjects before and after the experiment were measured using the Korean mini-mental state examination (K-MMSE), global deterioration scale (GDS), clinical dementia rating (CDR), and Lowenstein occupational therapy cognitive assessment (LOTCA). A paired t-test was conducted to examine the intragroup differences before and after the experiment, and ANCOVA was performed to check intergroup differences. Results: The intragroup comparison results showed that the cognitive function of the group that were trained with the group computerization cognitive rehabilitation program improved after the experiment more than for the group that received traditional cognitive therapy. The intergroup comparison results showed significant differences in orientation, visual perception, and visuomotor organization between the two groups. Conclusion: The results of this study confirmed that the group computerization cognitive rehabilitation program was more effective in improving cognitive function than the traditional cognitive therapy in patients with cognitive impairment. Based on the results of this study, the group computerization cognitive rehabilitation program can be used as an effective intervention method for patients with cognitive impairment.

• PNF and Movement
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• v.17 no.1
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• pp.129-136
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• 2019

Purpose: This study is a comparison of spatiotemporal parameters between straight and curved walking in individuals with chronic hemiparetic stroke, investigating whether those patients can adapt their walking according to task demands and environmental changes. Methods: Twenty-eight patients who diagnosed with their first stroke at least six months prior to this study were recruited. They were measured for spatiotemporal parameters in three different walking conditions: straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. This study also measured secondary clinical factors, such as the timed up-and-go test, the trunk impairment scale, and the dynamic gait index. The statistical methods for the three different walking conditions, using the averaged value of each condition, was repeated measures ANOVA. Results: The difference in cadence was statistically significant when comparing straight walking, walking with an inner curve to the more-affected leg, and walking with an inner curve to the less-affected leg. Swing duration (%) was also a statistically significant difference between straight walking and walking with an inner curve to the more-affected leg. However, differences in other spatiotemporal parameters were not statistically significant among the three conditions. Conclusion: The results of this study suggest that stroke survivors could adapt their walking according to straight and curved walking conditions, although cadence and swing duration were different between straight and curved walking groups.

• PNF and Movement
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• v.17 no.1
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• pp.137-144
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• 2019

Purpose: This study examined the effects of the abdominal drawing-in maneuver (ADIM) on muscle activity in the trunk and legs while subjects walk on a ramp. Methods: The subjects were healthy adult males (n=15) and females (n=8) in their twenties. The subjects were asked to maintain the ADIM contraction for 15 minutes using a pressure biofeedback unit. Their muscle activity was then measured while ascending or descending the ramp with or without the ADIM contraction maintained. Activity in the sternocleidomastoid, splenius capitis, rectus abdominis, external oblique abdominal, transversus abdominis, erector spinae, vastus medialis, and vastus lateralis muscles was measured using surface electromyography (TM DTS, Noraxon, USA). A paired t-test was conducted using SPSS 18.0 (IBM) for statistical data processing. Results: Maintaining the ADIM contraction during ascension led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Furthermore, maintaining the ADIM contraction during descent led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, external abdominal oblique, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Conclusion: As a result of this study, it maintains the ADIM and reduces lumbar muscle activity at the waist and increases muscle activity in the legs when walking on a ramp. Therefore, maintaining the ADIM contraction during ramp walking is recommended as training to improve the function of patients' muscular skeleton.

• PNF and Movement
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• v.17 no.1
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• pp.93-101
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• 2019

Purpose: This study aimed to investigate lower extremity muscle activation to the variable weight shift on the affected side of patients with hemiplegia. Methods: Eighteen patients with chronic hemiplegia volunteered to participate in this study. All participants performed three types of weight shift (sideways, forward, and backward) in limits of stability on the affected side. Muscle activation in a paralyzed leg was measured with electromyography on the gluteus medius, tensor fasciae latae, rectus femoris, and biceps femoris; furthermore, the attached area was recommended by SENIAM projects. Each weight shift was performed three times, and then the mean value of the three measurements was analyzed. The data were analyzed by measuring the symmetrically standing position with the reference voluntary contraction (RVC) and was standardized with the percentage of RVC method. Results: No significant difference in lower extremity muscle activation occurred according to the three types of variable weight shift. However, significant differences in lower extremity muscle activation did occur with each weight shift position. In addition, activation increased at the rectus femoris and decreased at the gluteus medius and tensor fasciae latae. Conclusion: Hip abductor muscle strength training and variable weight shifts on the affected side must increase to improve patients'balance and limits of stability.

• PNF and Movement
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• v.17 no.1
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• pp.31-39
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• 2019

Purpose: Cognitive function is a main concern for rehabilitation progression in individuals who have sustained brain damage, even among those whose motor function has returned after brain damage. The purpose of this study was to investigate how cognitive impairment relates to functional independence in postural stability and gait performance in patients with chronic hemiparetic stroke. Methods: This was an observational design in an outpatient rehabilitation hospital. Twenty-eight adults with chronic hemiparetic stroke, receiving a course in an outpatient rehabilitation program, participated in this study. They were divided into two groups (i.e., non-cognitive impairment and cognitive impairment groups) via a cut-off score of 23 or less on a mini-mental state examination. Functional independence was assessed with the timed up-and-go test (TUG), 10-meter walk test (10mWT), five times sit-to-stand test (FTSST), Berg balance scale (BBS), and modified Barthel index (MBI). The independent t-test was used for statistical analysis when comparing the two groups. Results: The cognitive impairment group had less functional independence, balance, and gait performance than those of the non-cognitive impairment group had. The former also showed a statistically significant decrease in their TUG score, FTSST score, BBS score, and MBI score compared to the latter, but not in their 10mWT score (p<0.05). Although the non-cognitive impairment group walked faster than the cognitive impairment group did, that difference was not statistically significant (p>0.05). Conclusion: The results of this study suggest that cognitive impairment relates to functional independence in postural stability and the activities of daily living. In rehabilitation settings, cognitive impairment would be considered a major component in therapeutic rehabilitation to overcome the patients difficult physical problems and to treat for improving functional independence more after stroke.

• PNF and Movement
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• v.17 no.1
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• pp.41-46
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• 2019

Purpose: Continuous use of a smartphone increases the angle of forward bending of the user's cervical vertebrae, causing pain in the shoulders and back, including the thorax, lumbar region, and vertebrae. Although there are many studies on changes in the cervical spine due to smartphone usage, the changes in the shoulders, thoracolumbar spine, and pelvic have rarely been compared. The purpose of this study is to investigate the change in the spinal segments, shoulders, and pelvic when using a smartphone with both hands while in the standing position. Methods: This study was conducted on 35 adults in their twenties. The selection criteria for the subjects were limited to those in a similar age group, thus excluding posture differences according to age, and to those who did not have specific diseases or pain in the spinal and musculoskeletal system for 12 months prior to the study. In this study, we used a 3D spinal diagnostic imaging system (Back Mapper, Frickenhausen) to compare the changing conditions in each vertebral segment before and during smartphone usage with both hands while in the standing position. Posture differences according to smartphone usage were compared using the paired t-test for the motion of each spinal segment. Results: This study showed that the thoracic and lumbar angle increased posteriorly during smartphone usage (p<0.05). In addition, the anterior rotation angle of the shoulder bone significantly increased, but no significant difference occurred in the pelvic region. Conclusion: Based on the results of this study, smartphone usage with both hands while in the standing position showed that the spine, as a whole, forms a kyphotic curve. Therefore, we propose to present a postural guideline for correct smartphone usage, considering the change in each vertebral segment.

• PNF and Movement
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• v.19 no.1
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• pp.87-95
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• 2021

Purpose: The purpose of this study was to determine the effects of talus stability taping during gastrocnemius stretching on ankle passive dorsiflexion, talus posterior glide, and balance in subjects with limited ankle dorsiflexion. Methods: Fifteen subjects (eight males and seven females) with limited ankle dorsiflexion participated in this study. Ankle passive dorsiflexion range of motion (ROM), talus posterior glide, and the lower quarter Y-balance test (YBT-LQ) were measured pre-stretching, after applying gastrocnemius stretching (GS), and after applying gastrocnemius stretching with talus stability taping (GSTST). The two types of stretching were performed at random. Results: Ankle passive dorsiflexion ROM was significantly increased by both types of stretching (p < 0.05), and ROM was significantly more increased post-GSTST than post-GS (p < 0.05). In addition, talus posterior glide was significantly increased post-GSTST than pre-stretching and post-GS (p < 0.05). However, there was no significant difference between post-GS and pre-stretching (p > 0.05). YBT-LQ score was significantly increased post-GSTST than pre-stretching (p < 0.05). Conclusion: Gastrocnemius stretching with talus stability taping is an effective method for subjects with limited ankle dorsiflexion to improve ankle passive dorsiflexion, talus posterior gliding, and balance.