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The Effectiveness of the Use of Custom-Made Foot Orthotics on Temporal-Spatial Gait Parameters in Children With Spastic Cerebral Palsy

  • Kim, Sung-Gyung;Ryu, Young-Uk
    • Physical Therapy Korea
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    • v.19 no.4
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    • pp.16-23
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    • 2012
  • This study examined the effects of custom-made foot orthotics on the temporal-spatial gait parameters in children with cerebral palsy. Twenty spastic bilateral cerebral palsy (spastic CP) children (11 boys and 9 girls) participated in this study. GAITRite was used to examine the velocity, cadence, step length differential, step length, stride length, stance time, single support time, double support time, base of support, and toe angle while walking with and without foot orthotics. The differences in temporal-spatial parameters were analyzed using paired t-test. The significance level was set at .05. The velocity, cadence, both step lengths, both stride lengths, both bases of support and right toe angle significantly increased when the children with spastic CP with foot orthotics compared to without foot orthotics (p<.05). The step length differential between the two extremities, left stance time and left single support time, significantly decreased with foot orthotics (p<.05). Right stance time, right single support time, both double support times and left toe angle showed little change (p>.05). This study demonstrated that foot orthotics were beneficial for children with spastic CP as a gait assistance tool.

Selecting Common Items for Linking the Oswestry Low Back Pain Questionnaire and a Short Form of Self-Reported Activity Measure for Low Back Pain

  • Choi, Bong-sam
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.61-70
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    • 2015
  • To develop an effective and efficient measurement system for tracking changes of functional status across two measures, it is essential to integrate information and communicate scores across two measures. The lack of communication between two measures leads to score incompatibility. A potential solution would be the development of a crosswalk table between those measures. Prior to creating a crosswalk table, selecting common items between two measures is critical. By using the Oswestry low back pain disability questionnaire (Oswestry) and a short form measuring disability resulting from low back pain, item level statistics as well as differential item functioning (DIF) using the Rasch measurement were investigated. Eighty-two participants with known group validity were recruited. Based on the application of the Rasch measurement model, item difficulties across the two measures were logically and hierarchically ordered. Ceiling effects for both measures were detected, which were not be able to be effectively measured with the two measures. The DIF analysis across the two measures confirmed that five paired items were found to have DIF and five common items were selected for common items. Although five paired items function differently across the Oswestry and the short form, all items of both measures were well targeted study participants. The common items selected by the Rasch measurement model may be effective when creating a crosswalk table between the Oswestry and the short form.

Magnetic Resonance Imaging as a Biomarker for Duchenne Muscular Dystrophy

  • Lim, Woo-taek
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.98-105
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    • 2015
  • Muscular dystrophy is a hereditary musculoskeletal disorder caused by a mutation in the dystrophin gene. Duchenne muscular dystrophy (DMD) is one of the most common, and progresses relatively faster than other muscular dystrophies. It is characterized by progressive myofiber degeneration, muscle weakness and ultimately ambulatory loss. Since it is an X-linked recessive inheritance, DMD is mostly expressed in males and rarely expressed or less severe in females. The most effective measurement tool for DMD is magnetic resonance imaging (MRI), which allows non-invasive examination of longitudinal measurement. It can detect progressive decline of skeletal muscle size by measuring a maximal cross-sectional area of skeletal muscle. Additionally, other techniques in MRI, like $T_2$-weighted imaging, assess muscle damage, including inflammation, by detecting changes in $T_2$ relaxation time. Current MRI techniques even allow quantification of metabolic differences between affected and non-affected muscles in DMD. There is no current cure, but physical therapist can improve their quality of life by maintaining muscle strength and function, especially if treatment (and other forms of medical intervention) begins in the early stages of the disease.

Study of Effects on Taping of Knee Joint for Patellofemoral Compressive Force During Stair Descent in Elderly Women (노인여성의 계단 내려오기 시 무릎 관절 테이핑이 슬개대퇴 압박력에 미치는 영향에 관한 연구)

  • Moon, Gon-sung;Kim, Tack-hoon
    • Physical Therapy Korea
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    • v.22 no.3
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    • pp.12-22
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    • 2015
  • The purpose of this study was to investigate the effect of taping on knee joint for patellofemoral compressive force (PCF) during stair descent for elderly women. Ten healthy elderly women voluntarily participated in this study. A three-dimensional motion analysis system and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the maximum PCF, maximum quadriceps contraction force and maximum knee extension moment (p>.05) but, there was a pattern decreasing all values with the taping during stair descent. There were significant differences for the knee and ankle angle on the event of maximum PCF (p<.05) and there was a pattern decreasing all values with the taping during stair descent. Therefore, taping on the knee would be effective to relieve the pain like patellofemoral pain syndrome in the knee joint.

Influence of Forward Head Posture on Electromyography Activity of Hyoid Muscles During Mouth Opening

  • Song, Jae-Ik;Kang, Sun-Young;Park, Joo-Hee;Cynn, Heon-Seock;Jeon, Hye-Seon
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.103-109
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    • 2015
  • Although the relationship between temporomandibular disorder and forward head posture (FHP) is controversial, it is generally accepted that altered head posture can affect mandible position and masticatory muscles activity. Because suprahyoid (SH) and infrahyoid (IH) muscles are stretched by increased passive tension in FHP, this study investigated their activity during mouth opening in FHP compared to neutral head posture (NHP). Twenty healthy subjects (10 males and 10 females) participated in this study. Head postures were evaluated with a cervical range of motion instrument. Electromyography (EMG) activity of bilateral SH and IH muscles was measured while an open mouth was maintained at each head posture. Paired t-test was used to identify significant differences in normalized EMG activity between head postures. Statistical significance was set at .01. Results showed the normalized EMG activity of SH and IH muscles were significantly lower in FHP compared to NHP. This finding indicates that FHP affects the EMG activity of hyoid muscles when they are stretched.

Comparative Study on the Effects of Proprioceptive Neuromuscular Facilitation and Elastic Band Exercise on the Physical Function and Blood Lipid Levels of Obese Elderly Women

  • Noh, Hyeon-Jeong;Kim, Seok-Hwan
    • Physical Therapy Korea
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    • v.22 no.1
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    • pp.79-92
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    • 2015
  • The effects of Proprioceptive Neuromuscular Facilitation (PNF) and elastic band exercise on the physical functions and blood lipids of obese elderly women were investigated. The experimental group ($n_1=16$) patients underwent PNF for 12 weeks, and the control group ($n_2=15$) patients performed elastic band exercises. SPSS 21.0 was used to compute the means and standard deviations. After the 12-week PNF, both the experimental and control groups showed statistically significant differences in the physical functions (cardiovascular endurance, strength of the lower extremity, muscular endurance, flexibility, balance, and agility) (p<.05), but the difference in the experimental group was more significant than that in the control group (p<.05). In terms of the changes in the blood lipid levels (total cholesterol, triglycerides, high-density lipoprotein, and low-density lipoprotein), the experimental group showed significant changes (p<.05). In conclusion, PNF was confirmed as more effective than elastic band exercise in improving the physical functions and blood lipid levels of obese elderly women.

Number of Steps and Time to Accomplish Turning During Timed Up and Go Test in Community-Dwelling Elderlies With and Without Idiopathic Parkinson Disease

  • Choi, Bong-sam;Lim, Woo-taek
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.47-54
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    • 2016
  • Background: Losing balance during locomotive actions becomes an increasing threat to both the community-dwelling elderly and elderly with Parkinson disease (PD). Those with PD may be at a high risk of fall due to particular characteristics during the turn. Turning around during locomotive actions may be one of problematic factors causing losing balance. Objects: This study is part of a larger study, which in part aims to identify turning strategies, to compare the strategies in the elderly with and without idiopathic PD aged 51 years and older and to distinguish whether the turning strategies can predict the elderly at risk of falls. Methods: A total of 22 community-dwelling elderlies (10 elderlies with idiopathic PD and 12 healthy elderlies) were investigated for the turning strategies during the timed up and go test. Results: There were some significant differences between the two groups during turning (p<.05). The idiopathic PD group had a tendency of challenging on taking more number of steps, more time to accomplish and staggering more for the turn relative to the control group. Conclusion: Taking more number of steps and more time to turn may be useful for distinguishing the characteristics of PD from that of the healthy elderly in turning strategy.

Comparison of the Pediatric Balance Scale and Fullerton Advanced Balance Scale for Predicting Falls in Children With Cerebral Palsy

  • Kim, Gyoung-mo
    • Physical Therapy Korea
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    • v.23 no.4
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    • pp.63-70
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    • 2016
  • Background: The Pediatric Balance Scale (PBS) and the Fullerton Advanced Balance (FAB) scale were used to assess balance function in patients with balance problem. These multidimensional clinical balance scales provide information about potential risk factors for falls. Objects: The purpose of this study was to investigate and compare the predictive properties of the PBS and FAB scales relative to fall risk in children with cerebral palsy (CP) using a receiver operating characteristic analysis. Methods: In total, 49 children with CP (boy=21, girl=28) who were diagnosed with level 1 or 2 according to the Gross Motor Function Classification System participated in this study. The PBS and FAB were performed, and verified cut-off score, sensitivity, specificity, and the area of under the curve (AUC). Results: In this study, the PBS scale was as a predictive measure of fall risk, but the FAB was not significant in children with CP. A cut-off score of 45.5 points provided optimal sensitivity of .90 and specificity of .69 on the PBS, and a cut-off score of 21.5 points provided optimal sensitivity of .90 and specificity of .62 on the FAB. Both scales showed moderately accurate of AUC with .79 and .76, respectively. Conclusion: The PBS is a useful screening tool for predicting fall risk in children with cerebral palsy, and those who score 45.5 or lower indicate a high risk for falls and are in need of balance intervention.

A Study of Translation Conformity on Korean Version of a Balance Evaluation Systems Test (한국어판 Balance Evaluation Systems Test의 번역 적합성 연구)

  • Jeon, Yong-jin;Kim, Gyoung-mo
    • Physical Therapy Korea
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    • v.25 no.1
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    • pp.53-61
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    • 2018
  • Background: The process of language translation, adaptation, and cross-cultural validation of tools for use in multiple countries requires the adoption of well-established, comprehensive, and rigorous methodological approaches. Back translation, which is the most recommended method, permits the detection of errors in the translation and the identification of words or phrases that cannot be accurately or literally translated. Objects: The aim of this study was to verify the content validity of a Korean version of a Balance Evaluation Systems test (BESTest) by using a back-translation method. Methods: This research was conducted in six steps: 1) translation of the BESTest into Korean, 2) evaluation of the translation conformity of Korean-translated BESTest, 3) evaluation of the degree of translation comprehension, 4) back translation of Korean BESTest, 5) evaluation of the technical and conceptual equivalence, and 6) completion of the Korean version of BESTest by the translation verification committee. Results: In this study, Korean version of the BESTest achieved a rating of more than 3 (moderate) for translation comprehension, and technical equivalence and conceptual equivalence of back translation were evaluated as 3 (moderate) or more. Conclusion: The Korean version of the BESTest has proven content validity and is an appropriate tool to measure balance function.

Rasch Analysis of the Korean Version of the Fullerton Advanced Balance Scale

  • Jeon, Yong-jin;Kim, Gyoung-mo
    • Physical Therapy Korea
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    • v.24 no.4
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    • pp.20-28
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    • 2017
  • Background: Rasch analysis has the advantage of placing both the items and the person along a single ratio scale and calibrates person ability and item difficulty onto an interval scale by logits. Therefore, Rasch analysis has been recommended as a better method for evaluating functional outcome questionnaires than traditional analyses. Objects: The aim of current study was to investigate item fit, item difficulty, rating scale, and separation index of the Korean version of the Fullerton Advanced Balance (KFAB) scale using Rasch analysis. Methods: In total, 93 patients with stroke (male=58, female=35) participated in this study. To investigate the item fit, difficulty, rating scale, and separation index of the KFAB scale, Rasch analysis was completed by the Winsteps software program. Results: In this study, all items of the KFAB scale were included in the Rasch model. The most difficult item was 'standing with feet together and eyes closed', and the easiest item was 'two-footed jump'. The rating scale was a 4-point scale instead of the original 5-point scale. Person and item separation indices showed high values that can identify a person with a wide range of balance ability. Conclusion: The KFAB scale appears to be a reliable and valid tool to assess balance function in patients with stroke. Furthermore, the scale was found to discriminate among stroke patients of varying balance abilities.