• PNF and Movement
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• 제19권2호
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• pp.225-231
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• 2021

Purpose: This study was conducted to investigate the type of physical therapist response work and its intensity, along with the prolonged prevalence of COVID-19, to determine the impact on physical therapists' occupational stress and occupational burnout. Methods: An online survey was conducted with 118 physiotherapists and collected the participants' gender, final educational background, clinical work experience, workplace type, additional workload, and fatigue associated with COVID-19. After excluding one participant who submitted an incomplete questionnaire, 117 respondents were included in the final data. Results: Additional COVID-19-related workloads and response reliability for fatigue, occupational burnout, and occupational stress were shown to have Cronbach's alpha measures of 0.76, 0.89, and 0.87, respectively. Groups who had experienced a new epidemic in the past showed higher fatigue levels (3.06±0.94) than those groups who had no such experience (2.49±0.84; p < 0.05). Correlation analysis of COVID-19 work fatigue and occupational burnout scales showed a positive correlation (r = 0.19; p < 0.05). The regression of occupational burnout and occupational stress showed a regression model of Y = 20.00+0.43X₁ (X₁: job stress; p< 0.05) and an explanatory power of 24.8% with an adj.R² = 0.25. Conclusion: Based on the results, it is suggested that various institutions, such as medical institutions, educational institutions, and physiotherapists' associations, should seek ways to manage and alleviate physiotherapists' stress.

• PNF and Movement
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• 제19권2호
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• pp.269-278
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• 2021

Purpose: This study aimed to investigate effective cueing methods for selective muscle activation of the serratus anterior. Methods: Based on the inclusion criteria, 26 healthy adults, both males and females, were recruited for the measurement of muscle activation of the upper trapezius and serratus anterior muscles while performing basic movements in knee push-up plus (KPP) and dynamic hug (DH) positions using five different cueing methods. An electromyogram was used to measure muscle activation, and both muscle activation and muscle ratio (serratus anterior/upper trapezius) were compared during the basic movements and different cueing methods. The cueing methods were trapezius verbal cueing, trapezius verbal cueing + trapezius tactile cueing, emphasis verbal cueing, serratus anterior tactile cueing, and trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing. Results: The results of the study showed that there was a significant difference in the muscles for the two exercises (p < 0.05). There was also a significant difference between the cueing methods (p < 0.05). The correlative effect between the muscles and cueing methods was also significant (p < 0.05). The muscle ratio in trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing during KPP and DH was higher than in basic movements and other cueing methods. This confirms that trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing is an effective cueing method for selective activation of the serratus anterior during KPP and DH. This study also demonstrated that cueing by a therapist may both increase and decrease selective muscle activation. Conclusion: Through this study, an effective cueing method to selectively activate the serratus anterior may be suggested, and the results of this study may provide basic information regarding future studies and clinical practice.

• PNF and Movement
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• 제19권2호
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• pp.251-260
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• 2021

Purpose: This study aimed to adjust the craniovertebral angle and shoulder alignment through shoulder and abdominal stabilization exercises in adults with a forward head posture. Methods: The study participants were 29 adults with a forward head posture, and they were randomly divided into the following groups: 14 participants in a combined exercise group that used shoulder and abdominal stabilization exercises and 15 participants in a shoulder exercise group that used just shoulder stabilization exercises. The participants performed the stabilization exercises for 30 minutes per day, three times a week for five weeks. Results: There were significant differences in the craniovertebral angle after intervention in the shoulder stabilization exercise group (p < 0.05). There were significant differences in the craniovertebral angle and location of the right root of the spine and both inferior angles before and after intervention in the shoulder and abdominal stabilization exercise group (p < 0.05). There was a significant difference in the location of the right root of the spine and the left inferior angle between the groups at the post-test (p < 0.05), and there was a larger change in the shoulder and abdominal stabilization exercise group. Conclusion: There was a significant difference in the craniovertebral angle and a partially significant difference in shoulder alignment before and after intervention in both groups.

• PNF and Movement
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• 제19권2호
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• pp.261-267
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• 2021

Purpose: This study aimed to investigate changes in gait variables depending on whether a task was performed using a smartphone while walking on a ramp. Methods: The participants of this study were 41 college students attending U University located in Gyeongju City, Gyeongsangbuk-do. In this study, gait variables were measured during ramp gait while using a smartphone to perform a task and during ramp gait without performing such tasks. In other words, four walking conditions were used: 1) walking up a ramp, 2) walking up a ramp while using a smartphone to perform a task, 3) walking down a ramp, and 4) walking down a ramp while using a smart phone to perform a task. Gait variables were measured using a gait analysis tool (Legsys; BioSensics, USA), and stride time, stride length, stride velocity, cadence, and double support were analyzed. The order of measurements was randomized to control for order effects due to repeated measurements. Results: The comparative analysis of gait variables according to the presence or absence of smartphone use during ramp gait showed that there were significant differences in stride time, stride length, and stride velocity during both ramp ascent and ramp descent (p < 0.05). In both ramp ascent and ramp descent, stride time increased when walking using a smartphone, compared to when walking without using a smartphone (p < 0.05). However, in both ramp ascent and ramp descent, stride length and stride velocity were decreased when walking using a smartphone compared to when walking without using a smartphone (p < 0.05). Conclusion: The study results showed that the use of a smartphone during walking can affect safety. Therefore, it is necessary to improve the awareness of risks associated with walking while using a smartphone, and further research needs to be conducted in various environments and with different ramps.

• PNF and Movement
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• 제19권2호
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• pp.279-285
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• 2021

Purpose: This study aimed to develop new digital navicular drop test (ND-NDT) equipment and to determine its validity and reliability. Methods: A total of 24 healthy male and female adults, who fully understood the purpose of the study and gave consent to participate in the study, were selected as participants. The NDT and ND-NDT were conducted in the dominant foot of the participants in a random order. For the NDT, the position of the navicular bone was marked with a pen first; then, the height of the navicular bone from the ground was measured in both sitting and standing positions. For the ND-NDT, after the sticker-type reflection markers were attached to the position of the navicular bone, the height of the navicular bone from the ground was measured in both sitting and standing positions. To assess the validity of the diagnostic tests, the same examiner measured the height of the medial longitudinal arch (MLA) three times in both the sitting and standing positions. To assess the inter-rater reliability of the ND-NDT, three examiners, in a random order, attached the sticker-type reflection markers to the position of the navicular bone and then measured the height of the MLA in both positions. Results: In the sitting position, the Pearson correlation coefficient (r) between the two diagnostic tests was very high (r = 0.97) and statistically significant. In the standing position, the Pearson correlation coefficient (r) between the two tests was 0.95, which was also statistically significant. The ICC_2,1 values in the sitting and standing positions were 0.93 and 0.95, respectively, indicating significantly high inter-rater reliability. Conclusion: The ND-NDT equipment showed very high diagnostic validity, as well as excellent inter-rater reliability, indicating the clinical usefulness of the equipment as a diagnostic system for confirming pes planus.

• PNF and Movement
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• 제20권1호
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• pp.91-101
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• 2022

Purpose: The purpose of this study was to examine the effect of cycle ergometer exercise inducing movement of the affected side on knee joint function after total knee arthroplasty (TKA). Methods: The primary experiment was conducted on 19 members of the cycle ergometer exercise group to measure the muscle activity of the rectus femoris, hamstring, tibialis anterior, and gastrocnemius muscles during cycle ergometer exercise that induced the affected side's movement. In the second experiment, after receiving physiotherapeutic intervention for 30 min, the general bicycle exercise group and cycle ergometer exercise group performed the corresponding exercise for 15 min, 5 times per week, for 2 weeks. The ROM, muscle strength, pain, and balance were then measured and compared between the two groups. Results: In the results of the primary experiment, cycle ergometer exercise inducing movement of the affected side showed a significantly larger increase in the activity of leg muscles (rectusfemoris, hamstring, tibialis anterior, gastrocnemius) on the affected side than the general bicycle exercise (p <0.05). In the second experiment, the cycle ergometer exercise group showed a significantly larger increase in range of movement of affected side knee flexion and muscle strength of affected side knee flexion, knee extension, and plantarflexion than the general bicycle exercise (p <0.05). No significant between-group difference was observed in pain and balance before or after the intervention (p >0.05). Conclusion: Cycle ergometer exercise inducing movement of the affected side increases use of the muscles around the affected side knee joint after TKA more than general bicycle exercise and produces better effects for enhancing muscle strength. The application of cycle ergometer exercise inducing movement of the affected side is expected to reduce the patients' unbalanced use during the early postoperative period and help them to quickly return to normal daily life through rapid muscle strength recovery.

• PNF and Movement
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• 제19권3호
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• pp.361-374
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• 2021

Purpose: The study aimed to investigate the effects of neural mobilization with joint mobilization on dysfunction, pain, and range of motion in cervical radiculopathy patients. Methods: Forty-seven cervical radiculopathy patients were recruited for the study. The subjects were randomly allocated to three groups. Group A (n=16) received a neural mobilization with joint mobilization, Group B (n=15) received a neural mobilization (NM), Group C (n=16) received a joint mobilization (JM). All groups had five sets for a day, three days a week, for four weeks. All subjects were evaluated before and after intervention by their neck disability index (NDI), numeric pain rating scale (NPRS), and range of motion (ROM). Results: The results were as follows: First, the NDI was significantly decreased in all groups (p<0.05). Group A had more significantly decreased NDI than Group B and C (p<0.05). Secondly, the NPRS was significantly decreased in all groups (p<0.05). Group A had more significantly decreased cervical NPRS than Group B (p<0.05). Groups A and B were more effective at decreasing upper extremity NPRS than Group C (p<0.05). Thirdly, the ROM was significantly increased in all the groups (p<0.05). Group A had more significantly improved cervical rotation ROM than Group B (p<0.05). Significant short-term effects of the NM with JM on dysfunction, pain, and range of motion in cervical radiculopathy patients were recorded in this study. Conclusion: These findings gave some indications that it may be feasible to include NM with JM in interventions with cervical radiculopathy patients.

• PNF and Movement
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• 제20권2호
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• pp.295-306
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• 2022

Purpose: This study aimed to investigate the effect of robot-assisted gait training on the active ranges of motion, gait abilities, and biomechanical characteristics of gait in patients who underwent lower extremity surgery, and to verify the effectiveness and clinical usefulness of robot-assisted gait training. Methods: This study was conducted on 14 subjects who underwent lower extremity surgery. The subjects participated in robot-assisted gait training for 2 weeks. The active ranges of motion of the lower extremities were evaluated, and gait abilities were assessed using 10-m and 2-min walk tests. An STT Systems Inertial Measurement Unit was used to collect data on biomechanical characteristics during gait. Spatiotemporal parameters were used to measure cadence, step length, and velocity, and kinematic parameters were used to measure hip and knee joint movement during gait. Results: Significant improvements in the active ranges of motion of the hip and knee joints (flexion, extension, abduction, and adduction) and in the 10-m and 2-min walk test results were observed after robot-assisted gait training (p < 0.05). In addition, biomechanical characteristics of gait, spatiotemporal factors (cadence, step length, and velocity), and kinematic factors (gait hip flexion-extension, internal rotation-external rotation angle, and knee joint flexion-extension) were also significantly improved (p < 0.05). Conclusion: The results of this study are of clinical importance as they demonstrate that robot-assisted gait training can be used as an effective intervention method for patients who have undergone lower extremity surgery. Furthermore, the findings of this study are clinically meaningful as they expand the scope of robot-assisted gait training, which is currently mainly applied to patients with central nervous system conditions.

• PNF and Movement
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• 제19권3호
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• pp.375-382
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• 2021

Purpose: The objectives of the present study were to investigate the disadvantages of tire pressure asymmetry of a wheelchair tire and recommend the criterion for appropriate tire pressure without generating negative changes in the musculoskeletal system in asymptomatic participants. Methods: Fourteen asymptomatic participants were asked to sit in pressure-controlled wheelchairs and perform desk work for 20 minutes in each tire condition. The asymmetry of the tire conditions was set as 0% difference, 25% difference, and 50% difference from the recommended pressure. The pelvic alignment and muscular recruitment represented as a flexion-relaxation ratio (FRR) were measured at pre-test, and after each condition of desk work. The displacement of the center of pressure (COP) was measured during the desk work. Results: The tire air pressure condition significantly affected the FRR and COP (P < 0.05). Both sides of the FRR values were significantly higher under the symmetrical tire conditions (0% difference) and pre-test, compared with the asymmetrical tire condition of 50% difference (P < 0.05). The mediolateral COP displacement of the asymmetrical tire conditions (25% and 50% difference) was significantly higher than that of the symmetrical tire conditions (0%) (P < 0.05). Conclusion: Asymmetrical tire conditions could cause changes in the muscle recruitment pattern of the erector spine and mediolateral COP displacement. Tire pressure asymmetry higher than 50% could be a risk factor for prevalence of back pain, so this level of asymmetry in tire pressures should be cautioned against for wheelchair users.

• PNF and Movement
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• 제19권3호
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• pp.303-310
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• 2021

Purpose: The purpose of the present study was to investigate the effects of the contact-relax (CR) intervention on pelvic alignment in subjects with habitual poor posture. Methods: Fifteen subjects who have habitual poor posture participated in this study. The subjects received an intervention inducing pelvic posterior depression with the elevated pelvic side. Pre- and post-intervention, and two weeks after intervention, the pelvic alignment was measured with a palpation meter (PALM) and a three-dimensional diagnostic imaging system. Results: Measuring with PALM, the pelvic height and anterior tilt angle were significantly decreased immediately after and were still decreased two weeks after intervention, compared to the pre-measurement (p<0.05). Three-dimensional pelvic alignment was also significantly different between measurement points, while the pelvic position (pelvic lateral tilt) was significantly decreased after intervention (p<0.05). Conclusion: By applying the intervention generating CR on an elevated pelvis, frontal pelvic alignment can be improved.