• Physical Therapy Korea
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• v.26 no.3
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• pp.106-114
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• 2019

Background: It is difficult to assess whether community-dwelling frail older adults may remain pre-frail status or improve into a robust state without being directly checked by health care professionals. The health information perceived by older adults is considered to be one of best sources of potential concerns in older adult population. An online measurement system combined with item response theory (IRT) and computer adaptive testing (CAT) methods is likely to become a realistic approach to remotely monitor physical activity status of frail older adults. Objects: This article suggests an approach to provide a precise and efficient means of measuring physical activity levels of community-dwelling frail older adults. Methods: Article reviews were reviewed and summarized. Results: In comparison to the classical test theory (CTT), the IRT method is empirically aimed to focus on the psychometric properties of individual test items in lieu of the test as a whole. These properties allow creating a large item pool that can capture the broad range of physical activity levels. The CAT method administers test items by an algorithm that select items matched to the physical activity levels of the older adults. Conclusion: An online measurement system combined with these two methods would allow adequate physical activity measurement that may be useful to remotely monitor the activity level of community-dwelling frail older adults.

• Physical Therapy Korea
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• v.26 no.4
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• pp.20-28
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• 2019

Background: The wall squat exercise has been recommended for strengthening of the lower extremity muscles with maintaining lumbar lordosis. Although squat has been studied to be related to lower extremity extensor strength, the relationship between wall squat and lower extremity extensor strength unclear. Because squat and wall squat are biomechanically different, study on the relationship is needed. Objects: The purpose of this study was to determine the lower extremity extensor strength associated with wall squat performance. Methods: 74 healthy volunteers were recruited to participate in this study. The volunteers were measured hip and knee extensors strength and then performed wall squat exercise for maximum count. Results: We found significant relationships between wall squat performance and hip extensor strength normalized by body weight, knee extensor strength normalized by body weight and the composite value. In a regression analysis, hip extensor strength normalized by body weight explained 29% of the variation in wall squat performance in males and 35% in females. Conclusion: These results demonstrate that hip extensor strength normalized by body weight is critical to wall squat performance in both sexes.

• Physical Therapy Korea
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• v.28 no.1
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• pp.13-17
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• 2021

A normal range of motion is essential for performing activities of daily living. The capsular pattern is the proportional motion restriction in range of motion during passive exercises due to tightness of the joint capsule. Although the capsular pattern is widely referred to in clinical practice, there is no scientific evidence to support the concept. In this review, the appropriateness of the capsular pattern for evaluation of joint pathology was assessed. In the Textbook of Orthopaedic Medicine written by Cyriax, the capsular pattern did not specify how much reduction in angular motion is considered motion restriction. As the definition proposed initially was unclear, different methods have been used in previous studies investigating capsular pattern. In addition, the capsular pattern described all the major joints of the human body, but only the hip joint, knee joint, and shoulder joint were studied in experimental studies. Sensitivity and specificity were reported in one study and were meaningful in specific pathologies (loss of extension to loss of flexion). There was no consensus on the reliability and validity. In summary, the capsular pattern suggested by Cyriax or Kaltenborn is not supported or applies only to certain conditions. Various components around a joint complement each other and provide stability to the joint. It is recommended that the therapist perform multiple assessments rather than rely on a single assessment when evaluating joints.

• Physical Therapy Korea
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• v.28 no.3
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• pp.177-185
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• 2021

Background: Muscle undergoes change continuously with aging. Sarcopenia, in which muscle mass decrease with aging, is associated with various diseases, the risk of falling, and the deterioration of quality of life. Obesity and sarcopenia also have a synergy effect on the disease of the older adults. Objects: This study examined the risk factors for sarcopenia, sarcopenic obesity, and sarcopenia without obesity and developed prediction models. Methods: This machine-learning study used the 2008-2011 Korea National Health and Nutrition Examination Surveys in the analysis. After data curation, 5,563 older participants were selected, of whom 1,169 had sarcopenia, 538 had sarcopenic obesity, and 631 had sarcopenia without obesity; the remaining 4,394 were normal. Decision tree and random forest models were used to identify risk factors. Results: The risk factors for sarcopenia chosen by both methods were body mass index (BMI) and duration of moderate physical activity; those for sarcopenic obesity were sex, BMI, and duration of moderate physical activity; and those for sarcopenia without obesity were BMI and sex. The areas under the receiver operating characteristic curves of all prediction models exceeded 0.75. BMI could predict sarcopenia-related disease. Conclusion: Risk factors for sarcopenia-related diseases should be identified and programs for sarcopenia-related disease prevention should be developed. Data-mining research using population data should be conducted to enhance the effectiveness of early treatment for people with sarcopenia-related diseases through predictive models.

• Physical Therapy Korea
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• v.29 no.3
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• pp.200-207
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• 2022

Background: The oxygen uptake efficiency slope (OUES) is the most important index for accurately measuring cardiopulmonary function in patients with acute ischemic heart disease. However, the relationship between the OUES variables and important cardiopulmonary function parameters remain unelucidated for patients with acute ischemic heart disease, which accounts for the largest proportion of heart disease. Objects: The present cross sectional clinical study aimed to determine the multiple relationships among the cardiopulmonary function variables mentioned above in adults with acute ischemic heart disease. Methods: A convenience sample of 110 adult inpatients with ischemic heart disease (age: 57.4 ± 11.3 y; 95 males, 15 females) was enrolled at the hospital cardiac rehabilitation center. The correlation between the important cardiopulmonary function indicators including peak oxygen uptake (VO₂ peak), minute ventilation (VE)/carbon dioxide production (VCO₂) slope, heart rate recovery (HRR), and ejection fraction (EF) and OUES was confirmed. Results: This study showed that OUES was highly correlated with VO₂ peak, VE/VCO₂ slope, and HRR parameters. Conclusion: The OUES can be used as an accurate indicator for cardiopulmonary function. There are other factors that influence aerobic capacity besides EF, so there is no correlation with EF. Effective cardiopulmonary rehabilitation programs can be designed based on OUES during submaximal exercise in patients with acute ischemic heart disease.

• Physical Therapy Korea
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• v.29 no.3
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• pp.235-240
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• 2022

Background: A spinal extension and intensive rehabilitation program reduced the symptoms and pain of kyphosis, and improved function. Objects: This study aimed to demonstrate the effect of a spine extension device on the degree of thoracic kyphosis and extension angles, confirm reduction of the kyphosis angle and an increase in flexibility. Methods: Thirteen adults were enrolled in the experiment, using the spine extension device, which was set to passively extend the spine. The angle between the spinous process of the first thoracic vertebra and the spinous process of the twelfth thoracic vertebra was measured by dual inclinometer before and after using the spine extension device. Results: In the static posture, the thoracic kyphosis decreased after using the spine extension device in the thoracic extension posture, and there was a significant difference (p < 0.05); thoracic extension angle increased with statistical significance (p < 0.05). Conclusion: In this study, the thoracic kyphosis angle and thoracic extension angle of the subjects before and after using spine extension device was compared and analyzed, which proved that the spine extension device can effectively improve the mobility of spinal extension.

• Physical Therapy Korea
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• v.29 no.3
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• pp.194-199
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• 2022

Background: Older adults use different ankle muscle activation patterns during difficult static balance conditions. It has been suggested that this is related to a decline in proprioception with age, resulting in reduced postural balance. However, the association between proprioception and ankle muscle activity during quiet standing has not been directly assessed. Objects: This study aimed to investigate the effects of age and sensory condition on ankle muscle activity and the association between ankle proprioception and ankle muscle activity. Methods: We recruited 10 young women and 9 older women. Ankle proprioception was evaluated using joint position sense (JPS) and force sense (FS) divided by dorsiflexion and plantarflexion. The electromyographic activity of the tibialis anterior (TA) and gastrocnemius (GCM) muscles was collected during quiet standing. Results: Older women activated GCM muscle more than young during quiet standing and when performing difficult tasks. Older women had more errors in JPS dorsiflexion and FS plantarflexion than did young. The GCM muscle activity is related to JPS dorsiflexion and FS plantarflexion. Conclusion: Lower proprioception of the GCM with age leads to increased muscle activity, resulting in reduced postural balance. There was no difference in TA proprioception or muscle activity among older women with frequent physical activity.

• Physical Therapy Korea
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• v.30 no.1
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• pp.78-85
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• 2023

Background: Despite fall prevention strategies suggested by researchers, falls are still a major health concern in older adults. Understanding factors that differentiate successful versus unsuccessful balance recovery may help improve the prevention strategies. Objects: The purpose of this review was to identify biomechanical factors that differentiate successful versus unsuccessful balance recovery in the event of a fall. Methods: The literature was searched through Google Scholar and PubMed. The following keywords were used: 'falls,' 'protective response,' 'protective strategy,' 'automated postural response,' 'slips,' 'trips,' 'stepping strategy,' 'muscle activity,' 'balance recovery,' 'successful balance recovery,' and 'failed balance recovery.' Results: A total of 64 articles were found and reviewed. Most of studies included in this review suggested that kinematics during a fall was important to recover balance successfully. To be successful, appropriate movements were required, which governed by several things depending on the direction and characteristics of the fall. Studies also suggested that lower limb muscle activity and joint moments were important for successful balance recovery. Other factors associated with successful balance recovery included fall direction, age, appropriate protective strategy, overall health, comorbidity, gait speed, sex and anticipation of the fall. Conclusion: This review discusses biomechanical factors related to successful versus unsuccessful balance recovery to help understand falls. Our review should help guide future research, or improve prevention strategies in the area of fall and injuries in older adults.

• Physical Therapy Korea
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• v.30 no.1
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• pp.1-7
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• 2023

Background: Like many other countries, falls and related injuries in older adults are great concerns in South Korea. In particular, falls are common in medical institutions, often causing the increase of the length of hospitalization. Objects: The purpose of this review was to help understand and address falls in hospitalized individuals in South Korea. Methods: The review was conducted on literature published in Korean from 2010 to 2022, searched in the Korea Citation Index and PubMed. Keywords used for the search were as follows: falls, fall risk, fall risk assessment, hospital, inpatient, intervention, Korea, and prevention. Results: A total of 54 articles were found and reviewed. The most common place of fall accidents was the inpatient room, where there were many cases of falls while walking. Loss of balance was the most common cause of falls, and many falls occurred in patients admitted to the internal medicine. Furthermore, a risk of falling increased with the type of medications taken. In terms of tools to assess patients' fall risk, the Morse Fall Scale (MFS) was commonly used. Patient-specific fall prevention activities were common to address falls, and they decreased the frequency of falls and the fear of falling. Factors influencing the effectiveness of the fall prevention activities included attitudes toward falls, education, environmental factors, patient safety culture, and self-efficacy in preventing falls. Conclusion: Our results should help understand and address falls and injuries in medical institutions.

• Physical Therapy Korea
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• v.30 no.1
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• pp.8-14
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• 2023

Background: Excessive hamstring (HS) activation due to the weakness of the gluteus maximus (GM) causes pain in the hip joint. A single-leg deadlift is a hip extensor exercise, especially GM, that includes functional movements in daily life and complex multi-joint training. In single-leg deadlift, the muscle activity depends on the forward trunk lean angle, and it's necessary to study which muscles are used dominantly depending on the angle. Objects: The purpose of this study was to compare the effect on the muscle activity of the GM and HS during single-leg deadlift according to different forward trunk lean angles and the ratio of the GM vs HS (GM/HS). Methods: Twenty-one healthy female participants were recruited. The muscles activities of the GM, HS and the GM/HS ratio were measured through electromyography during single-leg deadlift according to three condition of forward trunk lean angles (30°, 60°, and 90°). Results: The GM and HS activities significantly differed among three conditions (p < 0.05). GM/HS ratio was significantly higher at 30° and 60° of forward trunk lean compared to 90°. Moreover, the GM activity was significantly higher at 60° of forward trunk lean than at 30° (p < 0.05). Conclusion: The single-leg deadlift at 60° of forward trunk lean is a proper GM muscle strengthening exercise.