• PNF and Movement
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• v.20 no.2
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• pp.167-177
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• 2022

Purpose: Pes planus is a common foot deformity that involves the loss of the medial longitudinal arch. The medial longitudinal arch deformity is usually asymptomatic; however, it can lead to an increased risk of pain and injury. Low-Dye taping is designed to treat plantar heel pain and pes planus. However, low-Dye taping is relatively complex, and a considerable amount of time is required to apply the tape correctly. The purpose of this study was to compare the acute effect of two different types of taping (low-Dye taping and modified Mulligan taping) on arch reformation, plantar pressure, and gait characteristics in participants with asymptomatic flexible pes planus. Methods: Twenty subjects (9 males and 11 females; mean age = 21.95 years) with asymptomatic flexible pes planus voluntarily participated in this study. Arch reformation was evaluated using navicular height measurements. Changes in plantar pressure distribution were measured using BioRecue equipment. Gait parameters were measured using spatiotemporal data collected during consecutive gait cycles using a G-WALK device. One-way analysis of variance was used to compare the three different conditions (i.e., bare foot, low-Dye taping, and modified Mulligan taping) for each variable. Results: Navicular height was significantly increased in subjects who underwent the two types of taping compared to those who experienced the bare foot condition. The plantar pressure was significantly shifted to the posterolateral area after modified Mulligan taping compared with the bare foot condition. There were no significant differences in the gait parameters. Conclusion: The findings of this study indicate that modified Mulligan taping has a similar effect to low-Dye taping, and modified Mulligan taping is a simpler method than low-Dye taping.

• PNF and Movement
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• v.20 no.2
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• pp.263-273
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• 2022

Purpose: Translation and adaptation involve cross-cultural and conceptual aspects; they are not simply based on linguistic equivalence. This study aimed to produce a conceptually equivalent Korean version of the motor activity log (K-MAL) for the upper extremities that can be applied across the Korean population and its cultures. Methods: Following the procedures used in the translation of other cross-cultural evaluation tools, and the five steps of the translation process, the motor activity log (MAL) was translated into Korean (K-MAL). We then examined the content validity of the K-MAL. Twenty-two rehabilitation professionals (11 males and 11 females, mean length of clinical career = 101.54 months) assessed the content validity of the K-MAL. The content validity ratio and content validity index were used to verify the content validity. Results: There were inconsistencies found in three sub-items in the MAL during the forward translation process. These inconsistencies were corrected, and the complete K-MAL was produced. The exact critical values of the content validity ratio and the content validity index of the K-MAL were 0.45-0.95 and 0.77-1.00, respectively. Conclusion: The K-MAL was successfully developed using a systematic methodology, which included translation, adaptation, and evaluation of the content validity. We expect that stroke rehabilitation professionals working in both clinical and research settings will apply the K-MAL when evaluating the amount and quality of use of the upper extremities in post-stroke patients in Korea.

• PNF and Movement
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• v.20 no.2
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• pp.179-187
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• 2022

Purpose: The purpose of this study was to determine the asymmetrical difference between the use of leg muscles on the surgical and non-surgical sides during initial lower extremity ergometer exercise after unilateral knee arthroplasty. Methods: Twelve elderly patients diagnosed with degenerative arthritis of the knee and who underwent unilateral arthroplasty were included in this study. The leg length of each subject was taken into account when setting the application distance of the lower extremity ergometer. The same pedal resistance, strength, and speed were used for all the subjects. The total angle of use of the ergometer (360°) was analyzed by dividing it into an extension section and a flexion section. Using a surface electromyography system, the activities of the muscles of the surgical and non-surgical sides were converted into maximal voluntary isometric contraction (MVIC) and analyzed using the paired t-test. Results: When the activities of the muscles on the surgical and non-surgical sides were compared, it was found that the rectus femoris and biceps femoris had significant differences in the flexion and extension sections (p < .05), and that the tibialis anterior significantly differed in the flexion section (p < .05). There was no significant difference in the extension section of the tibialis anterior muscle, or in the flexion and extension sections of the gastrocnemius (p >.05). Conclusion: The results of this study confirm that the rectus femoris, tibialis anterior, biceps femoris, and gastrocnemius on the surgical side act in an opposite manner to those on the non-surgical side during pedaling in the same section.

• PNF and Movement
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• v.20 no.2
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• pp.147-156
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• 2022

Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

• PNF and Movement
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• v.20 no.2
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• pp.223-233
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• 2022

Purpose: The study aimed to determine the effect of extra thoracic mobilization exercises on shoulder pain and function in patients who had undergone rotator cuff repair. Methods: Following the recording of baseline measurements, 20 subjects who had undergone rotator cuff repair were randomized into two groups: the experimental group (n = 10), which did thoracic mobilization exercises, and the control group (n = 10), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The pain (using the visual analogue scales [VAS]), the flexion and abduction range of motion (ROM), and the shoulder pain and disability index (SPADI) scores of both groups were recorded pre- and post-intervention. Paired t-tests were used to determine whether post-intervention scores were significantly different from pre-intervention scores, and independent t-tests were used to analyze differences in the dependent variables between the two groups. Results: After the two-week intervention, both groups experienced significantly decreased VAS and SPADI scores (p < 0.05) and significantly increased flexion and abduction ROM (p < 0.05). The experimental group that undertook the thoracic mobilization exercises showed greater improvements in pain, flexion and abduction ROM, and the SPADI than the control group (p < 0.05). Conclusion: These results suggest that thoracic mobilization exercises reduce shoulder pain and disability and enhance function in patients who have undergone rotator cuff repair.

• PNF and Movement
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• v.20 no.2
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• pp.203-214
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• 2022

Purpose: We investigated the effects of multimodal vs. stabilization exercises on chronic low back pain. Methods: Study participants were randomly assigned to a multimodal exercise (n = 20) or a stabilization exercise group (n = 20). Participants in the multimodal exercise group performed stabilization, stretching, and endurance exercises, whereas those in the stabilization exercise group performed only stabilization exercises. Participants in both groups performed the exercises for 1 hour thrice a week for 5 weeks. The following outcomes were evaluated: pain intensity (numeric rating scale), disability (the Oswestry Disability Index [ODI] and the Roland-Morris Disability Questionnaire [RMDQ]), pain-induced fear (the Fear of Daily Activities Questionnaire [FDAQ], the Fear-Avoidance Belief Questionnaire [FABQ], and the Tampa scale for kinesiophobia-11 [TSK-11]). Outcome measures were evaluated at baseline and after intervention. Results: Significant post-intervention improvement was observed in pain intensity and the RMDQ and FDAQ scores in both groups (p < 0.01). The post-intervention ODI, FABQ, and TSK-11 scores were improved in the multimodal exercise group (p < 0.01). Additionally, significant differences were observed in pain intensity, as well as in the ODI, FDAQ, and FABQ scores in the multimodal exercise group compared with these findings in the stabilization exercise group (p < 0.01). Conclusion: The multimodal and stabilization exercise programs reduced pain intensity, disability, and pain-induced fear. Compared with stabilization exercises, multimodal exercises more effectively reduced pain intensity, disability, and pain-induced fear. This study highlights that musculoskeletal rehabilitation for people with chronic low back pain should include a multimodal exercise program.

• PNF and Movement
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• v.21 no.2
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• pp.231-241
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• 2023

Purpose: Weakness of the vastus medialis oblique muscle (VMO), or the imbalance between VMO and vastus lateralis muscle (VL) activity, is one of the most important factors in knee joint problems. Rigid taping techniques, such as patellar inhibition taping and VL inhibition taping, are frequently used in clinical practice to treat knee joint problems. The purpose of this study was to compare the acute effect of three different types of taping (patellar inhibition taping (PIT), distal VL inhibition taping (DVLIT), and proximal VL inhibition taping (PVLIT)) on electromyography (EMG) activity of VMO, VL, and VMO:VL ratio during walking. Methods: Thirty-eight normal healthy subjects (38 males; mean age = 31.00 years) voluntarily participated in this study. EMG was applied to investigate muscle activation during walking. Repeated measures of ANOVA and one-way ANOVA compared the three different conditions (PIT, DVLIT, and PVLIT) for each variable. Results: VMO and VL activation were significantly increased after PTIT application, and VMO and VL activation were significantly decreased after DVLIT and PVLIT application. The VMO:VL ratio increased after the three types of taping application, but there were no significant differences among the three types of taping. Conclusion: Based on the results of this study, PTIT is more effective than DVLIT and PVLIT in increasing the muscle activation of the VMO and VL during walking. Also, DVLIT is more effective for increasing the VMO:VL ratio and has beneficial effects on the imbalance between VMO and VL activity.

• PNF and Movement
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• v.21 no.2
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• pp.243-253
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• 2023

Purpose: This study aimed to investigate the effects of an abdominal drawing-in maneuver (ADIM) with a light load while sitting on transverse abdominis contraction in subjects with and without low back pain. Methods: In this study, 20 participants with chronic low back pain and 20 controls participated. Ultrasonography was used to assess the thickness of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA) muscles. Muscle thickness was measured at rest and during ADIM in three different sitting postures: (1) just sitting, (2) sitting loaded position (holding a 1 or 2 kg dumbbell in each hand), and (3) sitting loaded shoulder flexion position (holding a 1 or 2 kg dumbbell in each hand). Results: The contraction ratio (CR) and preferential activation ratio (PAR) of the TrA during ADIM had no significant interactional effect between the group and the sitting postures. However, the CR and PRA of the TrA during the ADIM showed significant differences among the three different sitting postures. The CR of the TrA during the ADIM in the sitting loaded shoulder flexion position was significantly increased compared to that in the sitting position (p<0.05). Moreover, the PRA of the TrA muscle during ADIM in sitting loaded and sitting loaded shoulder flexion positions was significantly higher than that in the sitting position (p<0.05). Conclusion: The findings suggest that ADIM in the sitting-loaded shoulder flexion position should be implemented to facilitate TrA activity.

• PNF and Movement
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• v.21 no.2
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• pp.255-263
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• 2023

Purpose: This study aims to investigate the immediate effects of electromyography (EMG) biofeedback training of the gluteus medius on dynamic balance during single leg squats in healthy individuals. Methods: The sample size in this study was estimated using the G-power program at an effect size of 0.4, a significance level (α) of 0.05, and a testing power of 0.90. In addition, as a result of considering the 10% dropout rate, this study recruited 21 healthy individuals (8 males and 13 females). All subjects measured the Y-balance test-lower quarter (YBT-LQ) and limits of stability (LOS) before and after a single leg squat (SLS) and SLS with EMG biofeedback training of the gluteus medius (SLSEB). They were trained for 10 minutes for each exercise, and two dynamic balance tests were performed three times. Results: There was a significant difference in the YBT-LQ score between the two exercises (p < 0.05). In the YBT-LQ score, there was a significant difference before and after SLS and SLSEB (p < 0.05). SLSEB showed a significantly higher YBT-LQ score than SLS (p < 0.05). There was a significant difference in LOM between the two exercises (p < 0.05). However, there was no significant difference between the two exercises. Conclusion: A single-leg squat with EMG biofeedback exercises is an effective method to improve dynamic balance, such as the YBT-LQ.

• PNF and Movement
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• v.21 no.2
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• pp.185-192
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• 2023

Purpose: This study aimed to confirm the effectiveness of the diaphragm stretching technique as a treatment method for low back pain by evaluating maximum inspiratory pressure, maximum expiratory pressure, and changes in back mobility in patients with low back pain. Methods: Thirty-four patients with low back pain were randomly divided into two groups: an experimental group and a control group. The diaphragm stretching technique was conducted in the experimental group, and the placebo intervention was conducted in the control group. The diaphragm stretching technique was conducted once, maintaining tension for 7 min. The placebo intervention was conducted in the same position as the diaphragm stretching technique, but with only light contact maintained without pressure. Maximum inspiratory pressure, maximum expiratory pressure, and back mobility were measured before and after the intervention, and the changes were compared and analyzed. A paired sample t-test was used to compare measurements within the group before and after the intervention. An independent t-test was used to compare the experimental and control groups. Statistical significance (α) was set at 0.05. Results: In the experimental group, maximum inspiratory pressure, maximum expiratory pressure, and back mobility increased significantly after the intervention (p < 0.05). However, there was no significant difference in the changes in all areas of the control (p > 0.05). As a result of comparative analysis of changes before and after the intervention, there were significant differences in maximum inspiratory pressure, maximum expiratory pressure, and back mobility only in the experimental group (p < 0.05). Conclusion: The diaphragm stretching technique improved maximum inspiratory pressure, maximum expiratory pressure, and back mobility compared to the placebo intervention. Therefore, the diaphragm stretching technique can be recommended as a physical therapy intervention to improve pain in patients with LBP.