• PNF and Movement
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• v.18 no.3
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• pp.393-401
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• 2020

Purpose: In recent years, there has been increasing interest in using blood flow-restricted exercise (BFRE) or KAATSU training. The KAATSU training method, which partially restricts arterial inflow and fully restricts venous outflow in the working musculature during exercise at reduced exercise intensities, has been proven to result in substantial increases in both muscle hypertrophy and strength. The purpose of this study was to investigate the proper level of pressure for KAATSU training using compound muscle action potential (CMAP) analysis. Methods: Twenty-two healthy adults voluntarily participated in this study. CMAP was conducted by measuring the terminal latency and amplitude using a motor nerve conduction velocity test. For reference-line, supramaximal electrical stimulation was applied to the median nerves of the participants to obtain CMAP for the abductor pollicis brevis. For baseline, the intensity of the electrical stimulation was decreased to a level at which the CMAP amplitude was about a third of the CMAP amplitude obtained by the supramaximal electrical stimulation. The pressure levels for the KAATSU were set as a systolic blood pressure (strong pressure), the median values of systolic and diastolic blood pressure (intermediate pressure), and diastolic blood pressure (weak pressure). In the KAATSU condition, CMAP was performed under the same conditions as baseline after low-intensity thumb abduction exercises were performed at the subjects' own pace for one minute. Results: As the pressure increased, the CMAP amplitude was significantly increased, signifying that more muscle fibers were recruited. Conclusion: This study found that KAATSU training recruited more muscle fibers than low-intensity exercise without the restriction of blood flow.

• PNF and Movement
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• v.18 no.3
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• pp.305-313
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• 2020

Purpose: The aim of this study was to investigate the relationship between a functional evaluation model and the Fugl-Meyer assessment (FMA) scale in evaluating the upper extremities of stroke patients Methods: Thirty-eight stroke patients were evaluated using the FMA and performed reaching and grasping motions using a three-dimensional motion analysis (Qquas 1 series, Qualisys AB, Sweden). The participants sat on a chair with a backrest. The position of the cup was located at a distance of 80% to the front arm length. The markers were attached to the sternum, acromion, elbow lateral epicondyle, ulnar styloid process, three metacarpal heads, and the distal phalanges of the thumb and index finger. The variables of the correlation between the functional evaluation model and the FMA scale were analyzed. Multiple regression (stepwise) was used to investigate the effect of the kinematic variables. Results: A significant negative correlation was found between the movement time (p < 0.05), movement unit (p < 0.05), and trunk displacement values (p < 0.05) in the FMA total scores, while a positive correlation was found between the peak velocity (p < 0.05) and maximum grip aperture values (p < 0.05). As a result of the multiple regression analysis, the most significant factor was the movement unit, followed by the general movement assessment and trunk displacement. The explained FMA total score value was 62%. Conclusion: This study presents a new functional evaluation model for assessing the reaching and grasping ability of stroke patients. The factors of the proposed functional evaluation model showed significant correlations with the FMA scale scores and confirmed that the new functional evaluation model explained the FMA by 67%. This suggests a new functional evaluation model for reaching and grasping stroke patients.

• PNF and Movement
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• v.18 no.3
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• pp.415-424
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• 2020

Purpose: This study aimed to compare changes in abdominal muscle thickness in different standing postures with a handheld load between subjects with and without chronic low back pain (CLBP). Methods: Twenty subjects with CLBP and 20 controls participated in this study. Ultrasound imaging was used to assess the changes in the thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles. Muscle thickness in three different standing postures (standing at rest, standing with loads, standing with lifting loads) was compared with the muscle thickness at rest in the supine position and was expressed as a percentage of change in the thickness of the muscle. Results: While standing with loads, the change in IO muscle thickness in the CLBP patients increased more significantly than in the pain-free controls (p < 0.05). The standing with lifting loads posture showed a significant increase in the change in thickness of the TrA compared with the standing with loads posture (p < 0.05). In addition, the standing with lifting loads posture showed a significant decrease in the change in the thickness of the EO when compared with the standing with loads posture (p < 0.05). Conclusion: The automatic activity of the IO muscle in subjects with CLBP increased more than that of the pain-free controls in the standing with loads posture. These findings suggest that IO muscle function may be altered in those with CLBP while standing with loads. Additionally, TrA the activation level was found to be associated with increased postural demand caused by an elevated center of mass.

• PNF and Movement
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• v.18 no.3
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• pp.403-414
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• 2020

Purpose: This study examined how performing chin tuck exercises in supine, sitting, and standing positions affects changes in the muscle activity of the neck and shoulder. Methods: Seventeen men and three women with forward head posture participated in the study. The subjects performed the chin tuck exercise using a pressure biofeedback unit. After determining the ideal order for performing the chin tuck exercise in supine, sitting, and standing positions through randomized controlled trials, muscle activity was measured in the dominant-side sternocleidomastoid, scalenus anterior, upper trapezius, and levator scapulae. Muscle activity was measured three times in each muscle for each position, and the average of the three measurements was used for analysis. Results: In this study, the chin tuck exercise performed in a supine position reduced muscle activity of the sternocleidomastoid, scalenus anterior, upper trapezius, and levator scapulae significantly more than performing the exercise in either sitting or standing positions (p < 0.05). No significant difference in muscle activity was observed when the exercise was performed in a sitting position versus a standing position (p < 0.05). Conclusion: Performing a chin tuck exercise in a supine position is more effective for stabilizing the neck and shoulder than performing it in a sitting or standing position, as it reduces excessive tension and fatigue in the neck and shoulder.

• PNF and Movement
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• v.18 no.3
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• pp.323-331
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• 2020

Purpose: This study was conducted to determine the effects of motion taping on muscle activity and the WOMAC in a rehabilitation exercise program for elderly women with knee joint osteoarthritis. Methods: The subjects were 28 elderly women aged over 65 years with knee joint osteoarthritis. The subjects were divided into two groups: one experimental and one control group. During the study period, a total of 26 patients completed the experiment, with one drop each from the experimental group and control group. The experimental group applied motion taping and conducted a rehabilitation exercise program. The control group experienced a rehabilitation exercise program without motion taping. The rehabilitation exercise program consisted of warm-up exercises, maximum isometric exercises, the range of motion of the joints, and leg stretching exercises. The intervention was conducted three times a week for six weeks. To investigate the effects of the intervention, muscle activity and the WOMAC were measured. The WOMAC is a tool that can be used to evaluate the pain, stiffness, and physical function of osteoarthritis patients; it has 29 items in three areas. Results: The change in muscle activity according to the intervention showed a statistically significant increase in both the experimental group and control group. The WOMAC also showed statistically significant changes in terms of pain, stiffness, and physical function in both the experimental and control groups. The experimental group showed a greater functional improvement than the control group. Conclusion: For older women with osteoarthritis of the knee, a rehabilitation exercise program is a good intervention. When motion-taping is applied, it is considered to be an intervention program that can be expected to have a better effect on knee joint osteoarthritis.

• PNF and Movement
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• v.18 no.3
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• pp.333-341
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• 2020

Purpose: The purpose of this study was to investigate the effect of open and closed kinetic chain exercises with a sling on neck flexor thickness during chin-in movement in office workers with forward head posture. Methods: Thirty-one selected subjects randomly performed chin-in movement in open kinetic chain and closed kinetic chain exercises using a sling. All subjects were measured for their neck flexor thickness using ultrasound measurement equipment during the performance of chin-in movement in open and closed kinetic chain exercised. A paired t-test was used to compare the thickness of the total neck flexor, superficial, and deep neck flexor, respectively, between open and closed kinetic chain exercises with chin-in movement. Results: The thickness of the superficial neck flexor diminished in size more greatly during the chin-in movement with the closed kinetic chain than the open kinetic chain, but this was not a statistically significant difference (p > 0.05). On the other hand, the thickness of the total neck flexor and deep neck flexor had more greatly increased during the chin-in movement with the closed kinetic chain than the open kinetic chain, and this was a statistically significant differences (p < 0.05). Conclusion: This study suggested that chin-in movement with a closed kinetic chain is more effective in activating the deep neck flexor than the open kinetic chain. Thus, we believe that the closed kinetic chain exercise using a sling is an effective intervention to correct the postural alignment of individuals with forward head posture.

• PNF and Movement
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• v.18 no.3
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• pp.365-373
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• 2020

Purpose: The COVID-19 pandemic has changed how healthcare is delivered worldwide and has affected the environment of the healthcare. Physical therapy in traditional healthcare systems can be difficult in unusual circumstances, such as the COVID-19 pandemic. Tele-physical therapy, defined as "the delivery of the physical therapy at a distance using electronic information and telecommunication technologies," will be a solution for this healthcare crisis. Thus, in this study, we proposed a mobile application for tele-physical therapy. Methods: This study used the Chrome Browser version 83.0.4 based on the Windows 10 64Bit operating system to use the App Inventor. To operate the mobile application, we used the Samsung Galaxy Note 9. The design of the mobile application was based on the review of a system used in the physical therapy department. Results: The graphical user interface (GUI) of the mobile application was displayed on three screens: selecting a painful joint (1st screen of the GUI); selecting a painful movement of the joint (2nd screen of the GUI); a self-manual therapy method and movie (3rd screen of the GUI). The proposed mobile application showed the stable repeatability of the self-manual therapy movie. Conclusion: The results of this study demonstrated that the proposed mobile application using the App Inventor for android will be able to create easy to use and reliable tele-physical therapy.

• PNF and Movement
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• v.19 no.2
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• pp.195-203
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• 2021

Purpose: Neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders, although this has not yet been established in the intensity of nerve tension application. This study aimed to investigate the acute effects of neural stretching intensity on nerve excitability using the latency and amplitude of nerve conduction velocity test (NCV) analysis. Methods: Thirty young, healthy male and female subjects (mean age = 21.30 years) voluntarily participated in this study. Nerve excitability was assessed using the median sensory NCV test. The latency and amplitude of the NCV test were measured under four different conditions: reference phase (supra-maximal stimulus, without neural stretching), baseline phase (2/3 of the supra-maximal stimulus, without neural stretching), weak stretch phase (2/3 of the supra-maximal stimulus, with weak neural stretching), and strong stretch phase (2/3 of the supra-maximal stimulus, with strong neural stretching). Results: The NCV latency was significantly delayed after one minute of neural stretching at the baseline, weak phase, and strong phase in comparison with the reference phase. The NCV latency was significantly delayed by increasing the strength of neural stretching. Furthermore, the NCV amplitude was significantly increased at the weak and strong phases, which were under neural stretching, in comparison with the baseline phase. The NCV amplitude was significantly increased by increasing the strength of the neural stretching. Conclusion: Transient neural stretching as a neurodynamic test can increase the sensitivity of the nerve without negatively affecting the nervous system. However, based on the results of this study, strong neural stretching in the neurodynamic test may delay the transmission of nerve impulses and hypersensitivity.

• 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.

• PNF and Movement
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• v.19 no.2
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• pp.183-193
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• 2021

Purpose: The purpose of this research was to investigate the effects of performing Pilates exercises for eight weeks on the isokinetic trunk strength and balance of female middle school students with lumbago. Methods: Twenty-four female students who met the test requirements were recruited and randomly divided into a control group (CG, n = 16) and a Pilates exercise group (Pilates group; PG, n = 8). The PG performed a Pilates program, which consisted of lumbar muscle strengthening exercises, for 60 minutes three times a week for eight weeks. Data analysis was conducted by two-way repeated ANOVA, and a Bonferroni test was carried out when significant differences appeared. The alpha level was set at 0.05. Results: Following the experimental treatment, the PG showed an increased trunk flexion peak torque of 17% and 13% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased about 31% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Following the experimental treatment, the PG showed an increased trunk extensor peak torque of approximately 29% and 21% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased approximately 27% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Both the CG and the PG showed a 20% and 50% decrease in pain index after the experimental treatment, respectively. After the experimental treatment, the PG had about 50% lower pain than the CG. The average error rate of static balance in the PG reduced by 19% from 3.28±0.45 to 2.65±0.36, confirming a significant improvement. Conclusion: Regular Pilates exercise for eight weeks improved the isokinetic trunk muscle strength of female middle school students with lumbago and relieved their pain. Pilates was also shown to be effective in improving balance.