• Physical Therapy Korea
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• v.20 no.1
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• pp.28-35
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• 2013

The purpose of this study was to determine the effects of warm-up and cool-down exercises on pain and muscle activation of delayed onset muscle soreness after intense exercise. Delayed onset muscle soreness was caused by the eccentric exercise in the elbow flexor muscle of the non-dominant upper limb. Forty-four subjects volunteered to participate in this study and were randomly assigned to one of the following groups: warm-up and cool-down group, only warm-up group, only cool-down group, or control group with no intervention. The level of perceived pain using the visual analogue scale and electromyographic activation change in maximal voluntary isometric contraction were measured 4 times at the following times: 10 min, 24 hr, 48 hr, and 72 hr after the exercise. The results revealed the main effect between the groups and interaction effect between the group and measurement session (p<.05). The warm-up and cool-down group showed most favorable results with respect to reduced perceived pain level and increased muscle strength in most measurement sessions, and the only warm-up group showed significantly more decreased pain level than the control group at 24 hr and 48 hr and more increased muscle activation than the cool-down group at 48 hr (p<.05). However, there were no significant differences in pain level and muscle activation between the only cool-down group and control group at all measurement sessions (p>.05). The findings suggest that the warm-up exercise performed before an intense exercise had beneficial effects on the symptoms of delayed onset muscle soreness, whereas cool-down exercise performed after the intense exercise did not.

• Physical Therapy Korea
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• v.20 no.1
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• pp.36-46
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• 2013

This study examined the effects of a physical therapy program on quality of life (QOL), and neck and shoulder disability in head and neck cancer patients. The program included neck and shoulder range of motion (ROM) exercises, massage, progressive strengthening exercises, and stretching exercises. Sixteen patients who were assigned to an experimental group performed physical therapy for 40 minutes three times a week for eight weeks. Fifteen other patients were assigned to a control group who did not performed the physical therapy program. The European organization for research and treatment of cancer (EORTC QLQ-C30) and head and neck (EORTC QLQ-H&N) instruments, and the Neck Disability Index (NDI) were assessed before and after the rehabilitation program. The 40-minute program consisted of a 10-minute ROM exercise for the neck and shoulder, a 10-minute massage and 15-minute of progressive resistance exercises, followed by a five-minute stretching exercises. Statistically significant differences were noted for changes in global health, physical function in the EORTC QLQ-C30 and cancer related symptoms in the EORTC QLQ-H&N35 (p<.05). The NDI also showed significant differences (p<.05). Physical therapy may therefore benefit the physical aspects and QOL and improve neck and shoulder disability in patients with head and neck cancer.

• Physical Therapy Korea
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• v.20 no.1
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• pp.47-54
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• 2013

The purpose of this study was to compare the immediate effects of upper trapezius muscle stretching in more tensed position (MTP) and less tensed position (LTP) on the change of range of motion (ROM) for neck rotation, and the ROM for conjunct neck motions at end-range of neck rotation toward the painful side in patients with unilateral neck pain. Eighteen patients with unilateral neck pain were recruited for the study's MTP group, and 18 age-, weight- and gender-matched patients with unilateral neck pain were recruited for LTP group. The ROM changes in active neck primary and conjunct motions were measured using a cervical ROM inclinometer in the sitting position. Our results showed that both upper trapezius stretching method in MTP and LTP were significantly effective in increasing the ROM of neck rotation toward painful side in patients with unilateral neck pain. However, a significantly greater increase in the ROM for neck rotation and a further decrease in conjunct neck extension during neck rotation toward the painful side were shown in MTP group, compared to LTP group. The upper trapezius stretching in MTP is useful in increasing the ROM of neck rotation and decreasing the range of conjunct neck extension during neck rotation toward the painful side in patients with unilateral neck pain.

• Physical Therapy Korea
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• v.20 no.1
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• pp.55-63
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• 2013

This study investigated the effects of axillary crutch length on trunk muscle activity and lumbo-pelvic-hip complex movements during crutch gait. Eleven healthy men participated in this study. The participants performed a three-point gait with optimal, shorter, and longer crutch lengths. Weight-bearing (WB) side was determined as the dominant leg side. The electromyography (EMG) activity of the bilateral rectus abdominis (RA) and erector spinae (ES) muscles and lumbo-pelvic-hip complex movements were monitored using a three-dimensional motion system with wireless surface EMG. Differences in the EMG activity of RA and ES muscles and range of motion (ROM) of lumbar spine, pelvis, and hip among conditions were analyzed using one-way repeated-measures analysis of variance, and a Bonferroni correction was conducted. There was less RA muscle activity on the WB side under the optimal crutch length condition compared with shorter and longer crutch length conditions (p<.05). The EMG activity of the RA muscle on the non-WB side and ES muscle on the WB side were significantly decreased under the optimal crutch length condition compared with shorter crutch length condition (p<.05). No significant differences in the EMG activity of the ES muscle on the non-WB side and ROM of lumbo-pelvic-hip complex were found among conditions (p>.05). These findings indicate that the optimal crutch length improves the trunk muscle efficiency during crutch gait.

• Physical Therapy Korea
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• v.20 no.2
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• pp.38-45
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• 2013

This study was conducted in order to examine whether abdominal draw-in maneuver (ADIM) with isometric shoulder flexion, extension, adduction, and abduction selectively contracted deep abdominal muscles. This study's subjects were 13 males 17 females. In order to evaluate the comparison of effects of ADIM and ADIM with isometric shoulder flexion, extension, adduction and abduction, measurements were made on transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) using a real-time ultrasonic diagnostic imaging system. Each position was repetitively measured three times with a real-time ultrasonic diagnostic imaging system and their mean values were used for analysis. The ADIM with isometric shoulder flexion, extension, adduction and abduction significantly increased the thickness of TrA relative to the ADIM only (p<.05). The ADIM with isometric shoulder abduction significantly increased the thickness of IO compared to the ADIM only (p<.05). The ADIM with isometric shoulder extension and abduction significantly decreased the thickness of EO compared to the ADIM only and the ADIM with isometric shoulder extension significantly decreased the thickness of EO relative to the ADIM with isometric shoulder adduction (p<.05). ADIM with isometric shoulder abduction is an effective method to selectively strengthen deep abdominal muscles and therefore may be employed as an intervention for trunk stabilization.

• Physical Therapy Korea
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• v.20 no.2
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• pp.28-37
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• 2013

This study examined differences in the activity of upper limb muscles according to how an ultrasound head is gripped. Twenty-two adult males were participated in the study. Each participant was asked to apply ultrasound treatment on to a lump of pork meat by two different ultrasound head grip patterns: spherical and cylindrical grips. Muscle activity was measured in the extensor carpi radialis longus (ECRL), flexor carpi ulnaris (FCU), and pronator teres (PT), triceps brachii (TB), middle deltoid (MD), and upper trapezius (UT) muscles. There were no significant differences in the EMG signals of any muscle according to the ultrasound head grip pattern (p>.05). There were significant differences in the EMG signal of each type of muscle (p<.05). The EMG signal of UT was the lowest and that of TB was lower than ECRL and FCU. There were interactions between ECRL and FCU, between ECRL and PT, between FCU and ECRL, and between FCU and MD. The EMG signal of ECRL using the cylindrical head was low and that of FCU with the cylindrical head was high, while the opposite was the case with the spherical head ($p_{adj}$ <.05/15). The results of this study indicate that the wrist muscles worked actively when the participants applied ultrasound therapy using both spherical and cylindrical heads. A spherical head might induce imbalanced muscle activity among the wrist muscles, leading to deviation of the wrist joint. Therefore, the cylindrical head is recommended for ultrasound therapy because it produced a constant, repeated force.

• Physical Therapy Korea
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• v.20 no.2
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• pp.20-27
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• 2013

The purpose of this study was to compare the slouched and upright sitting positions on lumbar joint reposition error (LJRE). Twenty subjects without low back pain were recruited for this study and, using a random number table, were randomly assigned to two groups; the upright sitting position group (UP group) and the slouched sitting position group (SP group). UP group was first asked to sit in an upright position and the SP group to sit in a slouched position as an intervention, and then the LJRE of both groups was measured at the neutral sitting position (lumbar flexion $0^{\circ}$). The measurement of the LJRE was repeated after one day. The sitting positions were performed for five minutes each and the LJRE was measured using an electronic goniometer. An independent t-test was used to compare the LJRE of both groups after each sitting position and after one day. The results of this study showed that the LJRE after an intervention in the UP group was lower than in the SP group (p<.05) and the LJRE after one day in the UP group was lower than in the SP group (p<.05). The findings of this study indicate that the upright sitting position can be applied to decrease LJRE, compared with the slouched sitting position. These findings also support that the upright sitting position reduces the potential for proprioceptive loss.

• Physical Therapy Korea
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• v.20 no.2
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• pp.11-19
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• 2013

Delayed onset muscle soreness (DOMS) is a painful condition that arises from exercise-induced muscle damage after unaccustomed physical activities. Various therapeutic interventions have been applied to reduce the intensity and duration of DOMS-related symptoms. Recently, pulsed electromagnetic field (PEMF) intervention has been introduced as an alternative noninvasive treatment for DOMS. This randomized, double-blind, placebo-controlled experiment was conducted to examine the effects of PEMF therapy on DOMS in elbow flexors at 24, 48, and 72 hours after the experimental DOMS induction. Thirty healthy volunteers ($23{\pm}2.4$ yrs, $175{\pm}5.7$ cm, and $74{\pm}7.8$ kg) participated in this study. Each was randomly assigned to a PEMF or placebo group. On the first day, DOMS was induced in the elbow flexors by repeated isokinetic motions at low ($60^{\circ}/s$) and fast ($120^{\circ}/s$) speeds in all subjects. Thereafter, the PEMF group received 15-min daily treatment with a PEMF device. The placebo group received sham treatment of the same duration. Overall, PEMF application was more effective than the sham treatment in reducing the physiological symptoms associated with the DOMS including perceived soreness, median frequency, and electromechanical delay of the surface electromyography. In addition, median frequency and isokinetic peak torque of the PEMF group recovered to the pre-DOMS induction level earlier than the placebo group. In conclusion, this study suggests that PEMF can be applied as a new recovery strategy in reducing DOMS symptoms. Further experiments are required to examine the effect of the PEMF treatment on different types of exercise conditions and to determine the optimal treatment dosage and duration in a real clinical setting.

• Physical Therapy Korea
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• v.20 no.2
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• pp.1-10
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• 2013

The purpose of this study was to determine the effect of the changes that occur in the leg muscle activity of unstable surface with different levels of air pressures. Three groups of college students have been placed randomly on unstable surfaces with different air pressures at group 1.0 psi ($n_1$=36), group 1.4 psi ($n_2$=40), and group 1.8 psi ($n_3$=40). Using surface electromyography, the recruitment of the tibialis anterior, peroneus longus, and the gastrocnemius was measured. Maximal voluntary isometric contraction was measured at the different air pressures based on the manual muscle test, then normalizing the value to %maximal voluntary isometric contraction (%MVIC). The tibialis anterior muscle activity was significant change from the unstable surface with difference levels of air pressures between group 1.0 psi and 1.8 psi and between group 1.4 psi and 1.8 psi. peroneus longus muscle activity was significant changes in muscle activity occurred between 1.0 psi and 1.4 psi group and between 1.0 psi and 1.8 psi group. Gastrocnemius muscle activity was significant change in muscle activity occurred between 1.0 psi and 1.4 psi group and between 1.0 psi and 1.8 psi group. In conclusion it identify that 1.0 psi group is most effective on muscle activity than the other groups. These suggest that the rehabilitation or strengthening of patients with ankle injuries, balance exercise with low air pressure like 1.0 psi can be more effective.

• Physical Therapy Korea
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• v.20 no.2
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• pp.60-68
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• 2013

The purpose of this study was to assess the intra-rater test-retest reliability of tibial external rotation angle measurement using a smartphone-based photographic goniometer, DrGoniometer (DrG) compared to a three-dimensional motion analysis system (Vicon). The current study showed an interchangeable method using DrG to measure the tibial external rotation angle in standing knee flexion at $90^{\circ}$. Twelve healthy subjects participated in this study. A rest session was conducted 30 minutes later for within-day reliability and five days later for between-day intra-rater test-retest reliability. To assess the validity of the measurement using DrG, we used a three dimensional motion analysis system as a gold standard to measure the angle of tibial external rotation. Intra-class correlation coefficient (ICC) and the standard error of measurement (SEM) values were used to determine the within- and between- day intra-rater test-retest reliability of using DrG and a three dimensional motion analysis system. To assess validity, Pearson correlation coefficients were used for two measurement techniques. The measurement for tibial external rotation had high intra-rater test-retest reliability of within-day (ICC=.88) and between-day (ICC=.83) reliability using DrG and of within-day (ICC=.93) and between-day (ICC=.77) reliability using a three-dimentional motion analysis system. Tibial external rotation angle measurement using DrG was highly correlated with those of the three-dimensional motion analysis system (r=.86). These results represented that the tibial external rotation angle measurement using DrG showed acceptable reliability and validity compared with the use of three-dimensional motion analysis system.