• 한국전문물리치료학회지
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• 제27권3호
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• Physical Therapy Rehabilitation Science
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• 제8권2호
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• pp.61-66
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• 2019

Objective: The purpose of this study was to investigate the effects of resistance applied in various directions on lower extremity muscle activity and balance during squat exercise performance. Design: Cross-sectional study. Methods: Forty-one adults (19 males and 22 females) agreed to the study purpose and procedures. All subjects randomly performed squat exercises with an intensity of overcoming 10% of body weight resistance pulled forward, backward and general squats with $60^{\circ}$ of knee joint flexion. Electromyography was used to measure muscle activity of the vastus medialis oblique (VMO), rectus femoris (RF), vastus lateralis oblique (VLO), biceps femoris (BF), and semitendinosus (ST) muscles. The Wii Balance Board was used to assess balance during the three-method squat operation. Each operation was measured three times for 10 seconds. Results: There were significant differences in muscle activities of the VMO, RF, VLO, ST and balance ability with the application of three directions of resistance (p<0.05). Post hoc comparisons revealed that squats performed with resistance pulled in the backward direction resulted in higher VMO, RF and VLO activity than with the resistance placed in a pulled forward direction (p<0.05). In the ST, resistance applied in the pulled forward direction showed greater muscle activity compared to the pulled backward direction (p<0.05). With balance, squats performed with resistance pulled in the forward direction showed greater muscle activity than with resistance applied in the pulled backward direction and during general squat performance (p<0.05). Conclusions: In this study, squat exercises performed with resistance applied in the direction of pulling backwards was found to be the most effective in improving quadriceps muscle strength and balance. It is effective to provide resistance that is placed in the forward when it is difficult to perform a general squat due to weakness of the quadriceps.

• The Journal of Korean Physical Therapy
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• 제23권1호
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• pp.21-28
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• 2011

Purpose: The aim of this study was to investigate correlations between the Functional Movement Screen (FMS), pain, and performance ability in professional fencing players. Methods: Fifty-six athletes participated in this study. The pain group included those who had a score on a pain-related Visual Analogue Scale (VAS) of ${\geq}$20 and an Oswestry Disability Index (ODI) score ${\geq}$10). In the non-pain group, these scores were: VAS(<20), ODI(<10). The VAS and ODI were used to measure pain throughout the study. Performance ability included motor function of the lower extremities (as assessed by a Modified Functional Index Questionnaire, MFIQ), dynamic balance (Balance system, BS and Posture med, PM), flexor and extensor muscle strength of the lumbar region was recorded as maximal isometric strength. Results: Among athletes who had pain, 5 of 15(33.33%) showed impaired functional movement. Conversely, only 2 of 41(4.88%) of those who had no pain showed such impairment (FMS ${\leq}$14score). The athletes who had pain and who had an FMS score above 14 (10/56; 17.86%) showed a significantly higher score for extensor muscle strength of the lumbar compared with those with pain and an FMS score below 14 (5/56; 8.93%) were significant correlations between the FMS and pain (r=-0.40 to -0.42, p<0.01), the MFIQ (r=-0.33, p<0.05), dynamic balance (r=-0.27 to -0.40, p<0.05-0.01), muscle strength of the lumbar (r=0.27 to 0.29, p<0.05). Stepwise multiple regression analysis showed that the dynamic balance score (${\beta}{\beta}$=-0.41) had slightly more power in predicting FMS score than pain, motor function of lower extremity, or muscle strength. Conclusion: The FMS was significantly associated with values of pain, motor function of the lower extremities, dynamic balance, and muscle strength of the lumbar. However the FMS appears to lack relevance and reasonable evidence to suggest that it is an acceptable measurement tool for functional movement analysis.

• 대한물리의학회지
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• 제18권3호
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• pp.55-64
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• 2023

PURPOSE: Examine the effects of auditory feedback and functional electrical stimulation on balance, walking ability, and lower extremity function of subacute stroke patients. METHODS: Twenty-seven subjects diagnosed with subacute stroke within six months were randomly divided into three groups: test group 1, which performed walking exercises with auditory feedback and functional electrical stimulation; test group 2, which performed walking exercises only with functional electrical stimulation; control group applied only functional electrical stimulation, with nine subjects each. RESULTS: There were significant pre- to post-intervention differences in BBS in the gait training group with auditory feedback and functional electrical stimulation treatment, and significant pre- to post-intervention differences in BBS, sit-to-stand time, and average step speed in the gait training group with functional electrical stimulation, but no statistically significant differences in between-group comparisons. CONCLUSION: Gait training with auditory feedback and functional electrical stimulation can improve the balance and gait performance in stroke patients. Therefore, in the future, gait training with auditory feedback and functional electrical stimulation therapy may be suggested as a gait rehabilitation training tool for stroke patients.

• The Journal of Korean Physical Therapy
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• 제25권2호
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• pp.88-95
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• 2013

Purpose: The purpose of this study was to conduct an analysis of kinematics of lower extremities and trunk in stance phase of walking according to turning direction. Methods: Ten university students (five male, five female) who were in their 20s (mean age was 20.6 years old) participated in this study. Participants did not have participants did not have any problem with skeletal muscular system. We used the "Qualisys motion capture system" for analysis of trunk and lower extremity movement in stance phase of walking according to turning direction. We collected data while subjects walked a distance of 10 m, and at the 6 m line, subjects were required to turn to the left side and the right leg was positioned in stance phase and the left leg was positioned in swing. For data analysis, the SPSS for Windows ver. 20.0 statistics program was used in performance of one way analysis of variance according to turning direction. Results: Significant difference of trunk and lower extremities was observed for turning direction according to walking cycle (p<0.05). Upper trunk movement showed a greater increase at three dimensions than lower trunk, and in heel off phase, pelvic movement showed a greater increase than lower trunk (p<0.05). In 45 degree and 90 degrees of turning direction, all movements of trunk and lower extremities were significantly different among three events of stance phase (p<0.05). Conclusion: We suggest that three-dimensional movement analysis of trunk and lower extremities during turning movement was very important in order to indicate increasing balance or walking ability for people with impaired movement or walking.

• 대한물리의학회지
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• 제2권1호
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• pp.73-84
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• 2007

Purpose : The purpose of this study was to determine risk factors and methods in balance assessment associated with fall in older adults. Methods : This article describes many of the tools that can be used to evaluate the physical parameters associated with fall risk in older adults. Results : Composite ratings of performance(Tinetti balance assessment, Guralnik test battery, Berg balance scale, modified-physical performance test) measures the score compounding the balance measure to determine fall risk. Static balance instruments are composed of FICSIT-4 that measures the ability of maintaining foot positions and CTSIB that measures postural stability. Dynamic balance instrument is composed of functional reach test. To measure walking velocity and mobility, 8-foot up-and-go test and walking around two cones are used. We can use 1-RM and to measure muscular strength, isokinetic dynamometery, and 30-second chair stand to measure lower extremity muscle strength. Conclusion : The described instruments are easy to use and widespread. To select and use these tool kits carefully is considered to be helpful in identifying those who are most likely to fall. The final part of the article includes a brief discussion of the potential role of exercise training interventions to improve these physical parameters and prevent falls.

• PNF and Movement
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• 제20권1호
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• pp.135-145
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• 2022

Purpose: The purpose of this study was to investigate the association between cognitive and motor inhibition by comparing muscle activity and ground reaction force during unplanned gait termination according to reaction time measured through the stop-signal task. Methods: Sixteen young adults performed a stop-signal task and an unplanned gait termination separately. The subjects were divided into fast and slow groups based on their stop-signal reaction time (SSRT), as measured by the stop-signal task. Electromyography (EMG) and ground reaction force (GRF) were compared between the groups during unplanned gait termination. The data for gait termination were divided into three phases (Phase 1 to 3). The Mann-Whitney U test was used to compare spatiotemporal gait parameters and EMG and GRF data between groups. Results: The slow group had significantly higher activity of the tibialis anterior in Phase 2 and Phase 3 than the fast group (p <0.05). In Phase 1, the fast group had significantly shorter time to peak amplitude (TPA) of the soleus than the slow group (p <0.05). In Phase 2, the TPA of the tibialis anterior was significantly lower in the fast group than the slow group (p <0.05). In Phase 3, there was no significant difference in the GRF between the two groups (p >0.05). There were no significant difference between the two groups in the spatiotemporal gait parameters (p >0.05). Conclusion: Compared to the slow group, the fast group with cognitive inhibition suppressed muscle activity for unplanned gait termination. The association between SSRT and unplanned gait termination shows that a participant's ability to suppress an incipient finger response is relevant to their ability to construct a corrective gait pattern in a choice-demanding environment.

• 대한물리의학회지
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• 제13권4호
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• pp.139-148
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• 2018

PURPOSE: This study compared the effects of indoor and outdoor environmental changes on the activity of the major lower limb muscles and walking factors in people 40-50 years and those aged older than 70 years. METHODS: Ten middle-aged people in their forties (age:$44.2{\pm}2.7$, BMI:$21.8{\pm}1.8$) and 10 elderly aged more than 70 years (age:$76.4{\pm}5.9$, BMI:$22.2{\pm}1.9$) with a normal walking ability were included. The participants walked 100 m both indoors and outdoors at their own speed. Using a 3D motion analyzer and EMG, the walking speed, angle of the ankle and activity changes of the lower limb muscles were compared. RESULTS: Significant differences in walking speed and peak-plantar flexion angle were observed between the two groups (p<.05). The muscular activity of the gastrocnemius muscle (GCM) was significantly different outdoors in the swing phase between the two groups (p<.05). In the people aged in their forties, the muscular activity of the rectus femoris (RF) was significantly higher outdoors than indoors (p<.05). In the elderly, however, the muscular activity of the RF was lower outdoors than indoors (p<.05). When compared to those in there forties, the muscular activity of the outdoor RF significantly decreased in the elderly group (P<.05). The muscular activity of the biceps femoris (BF) in the elderly decreased significantly outdoors compared to indoors (p<.05). CONCLUSION: For the elderly, increasing the exposure to the new environments or focusing on the performance of repeated movements for gradual speed control and precise movements is required to maintain normal gaits and movements that are less affected by environmental changes.

• The Journal of Korean Physical Therapy
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• 제34권6호
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• pp.298-303
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• 2022

Purpose: The purpose of this study was to figure out how PAP (Post-Activation Potentiation) phenomenon affects short-term performance efficiently. Methods: This study was conducted with 18 Taekwondo athletes and 16 healthy adults. By using isokinetic dynamometer, two different intervention, TDP (Top-down program) and BUP (Bottom-up program), were performed to measure isokinetic parameter; (peak torque: PT, total work: TW, average power: AP, and average torque: AT) of knee extensor for intragroup, intergroup comparison and two-way ANOVA. Results: The Taekwondo athletes group showed statistically significant differences in all isokinetic parameters PT, TW, AP, and AT after TDP (p<0.05). However, in the healthy adult group, the difference in isokinetic parameters according to the exercise sequence was not statistically significant. (p>0.05). PT and TW at TDP were statistically significant (p<0.05) when the rate of change in TDP and BUP was compared and analyzed considering the difference in physical ability between the Taekwondo athlete group and the healthy adult group. However, AP and AT were not statistically significant. Finally, when examining the interaction between the two groups and two exercise sequence according to isokinetic parameters, only TW (p<0.05) showed a statistically significant interaction, while PT (P=0.099), AP (P=0.103), and AT (P=0.096) did not. This study suggests that short-term performance can be improved through the PAP phenomenon when TDP is applied to the Taekwondo group. Conclusion: According to our result, for Taekwondo athletes, if the goal is to improve short-term performance just before the main game, we suggest a training program through TDP.

• PNF and Movement
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• 제17권1호
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• pp.119-127
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• 2019

Purpose: The purpose of this study is to show the effect of elastic band on balance and functional ability in chronic stroke patients living in community. Methods: The subjects who participated in the study were 9 patients with chronic stroke. One of them gave up during the study, finally 8 patients performed. The intervention was conducted once a week for 10 weeks. In this study functional reach test (FRT), timed up and go test (TUG), Tinetti performance oriented mobility assessment (Tinetti-POMA) were measured for balance. The coordination training of arms and legs using the elastic band was performed in three positions as supine, side lying, sitting. One arm performed flexion-adduction- external rotation with elbow flexion pattern and the opposite side(diagonal) leg was performed flexion-adduction-external rotation with knee flexion pattern, the other arm's pattern was extension-abduction-internal rotation with elbow extension and the opposite side (diagonal) leg was in extension-abduction-internal rotation with knee extension pattern. The training was performed in each position for 15 minutes in per position. The participants had a five minute break after each training. Results: The results are as follows. FRT and Tinetti-POMA showed significant increase statistically in each position. The TUG showed significant decrease statistically in each position. Conclusion: Even though the coordination training with elastic band had performed once a week, it showed positive effects on balance in chronic stroke patients. Therefore, if we can suggest the appropriate frequencies of coordination training of arms and legs using the elastic band, it can be a method to improve daily life and life quality to patients with chronic stroke.