• 한국전문물리치료학회지
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• 제19권3호
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• pp.61-71
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• 2012

In daily activities, people often perform two or more tasks simultaneously. This is referred to as dual-tasking or multi-tasking. The purpose of this study was to examine the effects of performing dual tasks while using a mobile phone on static and dynamic postural stability. Twenty-four subjects were asked to stand on a force plate and then instructed to perform a balance task only (BT), a balance task while listening to music (BTL), a balance task while talking on the mobile phone (BTT), and a balance task while sending text messages (BTS). We used the BioRescue$^{(R)}$ to measure postural sway and limit of stability for static and dynamic postural stability. Also the star excursion balance test (SEBT) was used to measure dynamic postural stability. A one-way ANOVA with repeated measures was used to compare the effects of the BT, BTL, BTT, and BTS. The Bonferroni's post hoc test was used to determine the differences among four tasks. Carrying out the BTS significantly decreased the limit of stability compared with carrying out the BT, BTL, and BTT (p<.05). In limit of stability, total surface area of BTT was more significantly decreased than that of BT and total surface area of BTS was more decreased than that of BT, BTL and BTT (p<.05). In the SEBT, the BTS displayed significantly smaller reach distance values compared with the BT or BTL (p<.05). These findings suggest that performing the balance task while sending text message on the mobile phone decreases dynamic postural stability, whereas performing the same task while listening to music using the mobile phone does not. Therefore, it requires more attention to maintain dynamic balance while sending text messages.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.72-80
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• 2012

The purpose of the present study was to investigate the effects of familiar exercise and novel exercise on motor function after intracerebral hemorrhage (ICH) in rats. The rats were subjected to a unilateral striatal ICH via collagenase infusion. The rats were randomly divided into the following three groups: the CON (control group; rested one week post-ICH), the FE (familiar exercise group; familiar exercise was performed two weeks after one-week post-ICH period), and NE (novel exercise group; novel exercise was performed two weeks after one-week post-ICH period). We measured neurological behavior using a ladder rung walking test and a beam walking test; we measured the level of nerve growth factor (NGF) using immunohistochemistry and western blot analysis. We performed a one-way ANOVA test to analyze the scores obtained from the neurological behavior tests and the differences of NGF protein levels among the three groups. In the present study, the FE group and the NE group showed significant improvement during the neurological behavior tests and in their expression of NGF protein level, as compared to the CON group. Especially, NE group more increase than FE group in neurological behavior tests, the expression of NGF on motor cortex. In conclusion, these results suggest that, after ICH, familiar exercise and novel exercise enhance motor function and, novel exercise is more effective than familiar exercise.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.91-97
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• 2012

The primary aim of this study was to compare responsiveness of self-report by worker and therapist-scored functional capacity instrument. Self-report and therapist-scored interval-level person measures and item difficulties were compared at admission and discharge. Therapist and worker ratings were collected on 230 clients from 27 rehabilitation sites using the newly developed Occupational Rehabilitation Data Base (ORDB) functional capacity instrument. ORDB comprises several subscales measuring relevant variables of "a return-to-work model" in work-related rehabilitation clinics. The functional capacity scale deals with 10 DOT job factors. The rating scale categories were 1-severely impaired, 2-moderately impaired, 3-mildly impaired, and 4-not impaired. Only data from clients with low back pain (n=98) with complete data (both admission and discharge scores) were used for the present study. Therapists and workers completed the functional capacity instrument at admission and discharge. Rasch analysis [1-parameter item response theory model (IRT)] was applied to calibrate item difficulty and person ability measure of therapist and workers ratings. Effect sizes for therapist and self-report ratings were slightly different, .69 and .30, respectively. Therapist and worker ratings were more consistent at discharge (r=.54) than at admission (r=.32). Workers have a tendency to be more severe in their ratings (show higher item difficulties) than therapists at admission and discharge. Therapists and workers report similar magnitudes of improvement following treatment program. These findings challenge the belief that injured workers may unreliable source for monitoring therapeutic outcomes. Self-report measures have the advantage of conserving therapist time for treatment (versus evaluation). While the therapist and self-report ratings are comparable at discharge, there is less consistency at admission. Comparable therapist-worker ratings may be achieved by controlling for rating severity using IRT methodologies.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.98-104
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• 2012

The aim of this study was to examine the effects of repeated passive movement (RPM) of different velocities on the improvement of knee joint position sense (JPS) in post-stroke patients with hemiplegia, thereby investigate the possibility of clinical application in the initial stage of rehabilitation for patients with post-stroke hemiplegia. Thirteen hemiplegic patients participated in this study. For the subjects' knee JPS tests, a passive angle reproduction test and an active angle reproduction test were performed prior to and after the intervention, which involved 30 repetitions of passive full-range-of-motion flexion and extension exercise of the knee joints at randomized degrees of $0^{\circ}/s$, $45^{\circ}/s$, and $90^{\circ}/s$. Paired t-test analysis was done in order to compare changes in the pre- and post-intervention knee JPS. One-way repeated analysis of variance was used in order to compare changes in JPS after intervention at three different movement velocities. The level of significance was set at .05. The result was that the subjects' post-intervention knee JPS significantly improved after the RPM exercise at a $45^{\circ}/s$ and a $90^{\circ}/s$ relative to the RPM exercise $0^{\circ}/s$ (p<.05). JPS changes with RPM intervention at the rapid velocity of $90^{\circ}/s$ were most increased, suggesting the most effective enhancement in knee JPS is with intervention at the velocity (p<.05). Therefore, RPM intervention at a half or higher velocity improved stroke patients' knee JPS. During the initial stage of rehabilitation for patients with post-stroke hemiplegia, the efficient application of the RPM exercise at a half or higher velocity will be possible.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.105-114
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• 2012

This study was performed to compare the muscle activity of lumbar stabilizers between stoop and semi-squat lifting techniques at different lifting loads. Twenty healthy subjects (9 males, 11 females) were recruited for this study. Muscle activity of external obliques (EO), internal obliques (IO) and lumbar multifidus (LM) muscle was measured by surface electromyography during stoop and semi-squat lifting at different lifting loads (10%, 20%, and 30% of the subject's body weight). A one-way repeated measure ANOVA was applied. The results showed that EMG activity of EO was significantly increased with a load of 30% of body weight compared to 10% and 20% of body weight in both lifting techniques (p<.05). Muscle activity of LM was significantly increased in 20% compared to 10% and 30% compared to 10% of subject's body weight in stoop lifting and the muscle activity of LM was significantly increased in 20% compared to 10%, 30% compared to 20%, and 30% compared to 10% of the subject's body weight in semi-squat lifting (p<.05). However, there was no significant difference in activity of IO according to lifting loads in both lifting techniques. There were no significant differences in muscle activity of EO, IO, and LM between stoop and semi-squat technique (p>.05). Therefore, the results of this study suggested that the EO can contribute to increase the lumbar stability during stoop and semi-squat lifting at 30% of body weight rather than at lower loads, and the LM seems to act as counteractor to imposed loads during stoop and semi-squat lifting with increasing loads.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.124-131
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• 2012

Most conventional instruments measuring disability rely on total score by simply adding individual item responses, which is dependent on the items chosen to represent the underlying construct (test-dependent) and a test statistic, such as coefficient alpha for the estimate of reliability, varying from sample to sample (sample-dependent). By contrast, item response theory (IRT) method focuses on the psychometric properties of the test items instead of the instrument as a whole. By estimating probability that a respondent will select a particular rating for an item, item difficulty and person ability (or disability) can be placed on same linear continuum. These estimates are invariant regardless of the item used (test-free measurement) and the ability of sample applied (sample-free measurement). These advantages of IRT allow the creation of invariantly calibrated large item banks that precisely discriminate the disability levels of individuals. Computer adaptive testing (CAT) method often requiring a testing algorithm promise a means for administering items in a way that is both efficient and precise. This method permits selectively administering items that are closely matched to the ability level of individuals (measurement precision) and measuring the ability without the loss of precision provided by the full item bank (measurement efficiency). These measurement properties can reasonably be achieved using IRT and CAT method. This article aims to investigate comprehensive overview of the existing disability instrument for back pain and to inform physical therapists of an alternative innovative way overcoming the shortcomings of conventional disability instruments. An understanding of IRT and CAT method will equip physical therapist with skills in interpreting the measurement properties of disability instruments developed using the methods.

• 한국전문물리치료학회지
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• 제19권3호
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• pp.20-30
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• 2012

The purpose of this study was to determine the effect of ankle joint mobilization with movement (MWM) on the range of motion (ROM) in the ankle, on the muscle strength of lower extremities, and on spatiotemporal gait parameters in chronic hemiplegic patients. Fifteen subjects with chronic stroke were divided into two groups: an experimental group (8 subjects) and a control group (7 subjects). Both groups attended two or three sessions of physical therapy each week. The experimental group also attended additional MWM training sessions three times a week for five weeks. For both groups, the ROM of the ankle, the muscle strength of the lower extremities, and the spatiotemporal gait parameters in paretic limbs were evaluated before and after the training period. The results showed that the experimental group experienced more significant increases than did the control group in terms of passive (6.10%) and active (21.96%) ROM of the ankle, gait velocity (12.96%), and peak torque, of the knee flexor (81.39%), the knee extensor (24.88%), and the ankle plantar flexor (41.75%)(p<.05). These results suggest that MWM training in patients with chronic stroke may be beneficial in increasing ROM in the ankle, muscle strength in the lower extremities, and gait speed.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.65-71
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• 2016

Background: The unilateral prone arm lift (UPAL) is commonly used to exercise the lower trapezius muscle. However, overactivation of the upper trapezius can induce pain during UPAL exercises in subjects with upper trapezius tenderness. Objects: The purpose of this study was to investigate the effects of position of ipsilateral neck rotation (INR) on the inhibition of upper trapezius muscle activity and the facilitation of the lower trapezius muscle when performing UPAL exercises. Methods: In total, 19 subjects with upper trapezius tenderness were recruited for the study. Electromyographic (EMG) activity was measured in the upper, middle, and lower trapezius muscles during UPAL with and without INR position. Wilcoxon signed-rank test was used to compare EMG activity in the trapezius muscles and the muscle ratios. Results: EMG activity in the upper trapezius muscles was decreased significantly in the INR condition compared to without the position with INR during UPAL exercises (p<.05). EMG activity in the middle and lower trapezius was not significantly different between the with and without INR conditions (p>.05). However, the ratio of lower to upper trapezius activation showed a significant increase in the INR condition compared to the without INR condition (p<.05), indicating greater lower trapezius activation relative to the upper trapezius in the INR position than in the without INR position. Conclusions: The EMG results obtained in this study suggest that the position with INR reduced overactivation in the upper trapezius and improved muscle imbalance during lower trapezius exercises in individuals with upper trapezius tenderness.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.46-54
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• 2016

Background: Rasch analysis estimates the probability that a respondent will endorse an item and select a particular rating for that item. It has the advantage of placing both the items and the person along a single ration scale and calibrates person ability and item difficulty onto an interval scale by logits. In addition, Rasch analysis is a useful tool for exploring the validity of questionnaires that have been developed using traditional methods. Therefore, it has been recommended as a method for developing and evaluating functional outcome measures. Objects: The purpose of this study was to investigate the item fit, item difficulty, and rating scale of the Korean version of the Fullerton Advanced Balance Scale (KFAB) using Rasch analysis. Methods: Total 97 subjects (39 males and 58 females) with dwelling elderly adults were participated, but 3 people were excluded for misfit persons. Rasch analysis was then done by means of the Winsteps program to determine the item fit, item difficulty, rating scale, and reliability of the KFAB. Results: In this study, the 'standing with feet together and eyes closed', 'two-footed jump', 'walk with head turns', and 'stand on foam, eyes closed' items shown misfit statistics. The most difficult item was 'stand on one leg', whereas the easiest item was 'turn in full circle'. The rating scale was acceptable with all criteria. Both item and person separation indices and reliability showed acceptable values. This would indicated that each domain covers a useful range of item difficulty that is appropriate for measuring a person with a wide range of functional ability. Conclusion: The KFAB has been proven reliable, valid and an appropriate tool with which to evaluate the balance of the elderly people.

• 한국전문물리치료학회지
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• 제23권1호
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• pp.38-45
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• 2016

Background: Chronic back pain shows a high correlation with lumbar disability, physical disability for daily activities, and psychosocial factors, such as depression. Object: The purpose of this study was to examine the correlation of the level of pain and disability with psychosocial factors, which are potential disturbance variables, in patients with chronic lumbar pain. Method: The sample included 258 patients, who had complained of chronic lumbar pain for more than three months. The Quadruple Visual Analogue Scale was used to measure the level of pain, and a Korean version of Oswestry Disability Index was used to measure the level of disability. Psychosocial factors were measured using the Tampa scale for Kinesiophobia-11, Fear Avoidance Beliefs Questionnaire, and Pain Self-Efficacy Questionnaire. The collected data was analyzed using PASW 18.0, and an independent samples t-test was used to examine frequency, percentage, mean, and standard deviation of sociodemographic characteristics and major variables. Pearson's correlation coefficient was used to investigate the correlation between the level of pain and disability and psychosocial factors. Stepwise multiple regression analysis was done to determine the level of pain and psychosocial factors of functional disorder. The significance level was set at ${\alpha}=.05$. Result: There is a strong correlation between the level of pain and functional disorder and psychosocial factors in patients with chronic lumbar pain. The study also revealed that as the levels of pain and fear avoidance increase, pain self-efficacy decreases. Conclusion: The results suggest that negative perceptions towards pain, limitations of physical movement, and severe fear avoidance directly affect the decrease in pain self-efficacy. Therefore, it is recommended to test pain self-efficacy when measuring the level of pain and disability in patients with chronic low back pain.