• Physical Therapy Korea
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• v.7 no.2
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• pp.35-54
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• 2000

The purposes of this study were to assess variation of body sway prior to and after submaximal treadmill exercise; to determine the time course of the effects of a fatiguing performed on a treadmill on body sway; and to compare position sense prior to and after exercise in order to assess any variance in proprioception caused by submaximal treadmill exercise. The subjects were twenty-four healthy men in their twenties. They stood barefoot on the Kinesthetic Ability Training Balance Platform to measure body sway. Control trials were performed with eyes alternately open and closed. In the eyes open condition, they were asked to look at a target placed at eye level 1 m in front them. A total of 10 trials, each lasting 20 seconds, were performed. After this series of trials, position sense was measured. Subjects then exercised on the treadmill until 85% of each person's maximal heart rate was reached. The first series of postural sway measurements began immediately after this exercise. The second identical series of postural sway trials was performed at approximately 10 minutes after exercise. The third series was performed approximately 20 minutes after exercise. This allowed approximately 5 minutes of rest between each experimental series. Position sense was measured at approximately 15 and 25 minutes after exercise. The results were as follows: 1) There was a significant increase in body sway after submaximal treadmill exercise compared to pre-exercise values under both visual conditions (p<.05). 2) After submaximal treadmill exercise, under the eyes open condition, the mean value of body sway was significantly increased after both the first and second series (p<.05). Under the eyes closed condition, the mean value of body sway increased significantly after the first series but decreased significantly after the third series (p<.05). 3) Position sense, measured repeatedly after submaximal treadmill exercise, did not change significantly with respect to pre-exercise values (p>.05). These results suggest that fatigue induced by submaximal treadmill exercise produced an increase in body sway in young healthy subjects with or without visual input, but the increase appeared to be lasting less than 15 minutes. No significant change in position sense suggested that proprioception was unaffected by submaximal treadmill exercise-induced fatigue.

• Journal of Biomedical Engineering Research
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• v.43 no.2
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• pp.81-93
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• 2022

Proprioception training has been considered a secondary method to facilitate postural control ability. This study investigated the effects of two different proprioception training methods - the proprioceptive neuromuscular facilitation (PNF) and visual feedback-based joint position and force reproduction (VF) - on postural control advancements. Sixteen healthy people volunteered for this study, and they randomly grouped two. Each group participated in the PNF and VF training for three weeks. We evaluated each subject's proprioception levels and balance ability before and after the training. We used a clinometer and electromyogram (EMG) for VF training. The joint position reproduction test was also used to evaluate the position and force aspects of the proprioception level. We analyzed the trajectory of the center of pressure (COP) while subjects were standing on the firm floor and balance board with one leg using a pressure mat. The improvement of the position aspect of the proprioception level of the VF group (4.93±4.74°) was larger than that of the PNF group (-0.43±2.08°) significantly (p=0.012). The improvement of the anterior-posterior COP velocity of the PNF group (0.01±0.01 cm/s) was larger than that of VF group(0.002±0.01 cm/s) significantly (p=0.046). Changes of position error in the PNF group (rho=0.762, p=0.028) and tibialis anterior force reproduction error in the VF group showed a significantly strong relationship with balance ability variables. These results showed that different PNF and VF have different effects on improving two aspects of proprioception and their relationship with the balance ability. Therefore, these results might be useful for selecting proprioception or balance rehabilitation considering the clinical and patients' situation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.6
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• pp.498-507
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• 2020

The purpose of this study was to examine the effects of thoracic flexibility exercise on sitting balance, static standing balance, gait parameters, and the fall risk of patients with chronic stroke. The participants were randomized into the control (n=12) and thoracic flexibility exercise groups (n=12). Both groups received standard rehabilitation therapy for 30 minutes per session. The subjects in the experimental group performed additional thoracic flexibility exercises 3 times a week for 6 weeks. The trunk impairment scale, static standing balance, gait speed, cadence, and fall risk were assessed for all the participants before and after the intervention. The thoracic flexibility exercise group showed greater improvement than did the control group on the trunk impairment scale (t=-3.57, p=.002), static standing balance (t=5.37, p<.001), gait speed (t=-3.29, p=.003), cadence (t=-2.77, p=.011), and fall risk (t=6.33, p<.001). Furthermore, the thoracic flexibility exercise group significantly improved all the outcomes compared to the baseline values (P<.05). This study showed that the thoracic flexibility exercise improved the functional ability of patients with chronic stroke.

• Physical Therapy Korea
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• v.22 no.1
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• pp.30-36
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• 2015

The purpose of this study was to examine the relationships between the ankle dorsiflexion passive range of motion (DF PROM) under a non-weight bearing condition and the normalized reach distance in three directions of the Y-Balance Test (YBT). Sixty-one healthy adults (32 males and 29 females, age: $23.0{\pm}3.0$ years, height: $169.3{\pm}8.9cm$, weight: $61.9{\pm}5.4kg$) participated in this study. The ankle DF PROM was measured using a goniometer. To assess dynamic balance, all subjects performed three trials to determine the maximum lower extremity reach in the anterior, posteromedial, and posterolateral directions of the YBT. The relationship between the ankle DF PROM and both the normalized reach distance in each direction and the composite score of the YBT were analyzed using the Pearson correlation. Only the normalized reach distance in the anterior direction of the YBT was significantly related to the ankle DF PROM measured under a non-weight bearing condition (r=.50, p<.001). Neither the normalized reach distances in the posterior directions nor the composite score of the YBT were significantly correlated with the ankle DF PROM measured under a non-weight bearing condition. These findings suggest that ankle DF PROM does not affect the overall dynamic balance of the lower extremity, with only the anterior dynamic balance affected among the three directions.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.446-452
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• 2012

This study aims to examine the effects of taping of the ankle joint on the static and dynamic balance and gait ability of stroke patients. Twenty-six stroke patients receiving physical therapy at a hospital located in Gyeonggi-do were divided equally into a group that had taping in physical therapy and an ordinary physical therapy group. They exercised for 30 minutes each, 3 times per week for 8 weeks from June to August 2011. Romberg's eye open and eye closed tests, limits of stability(LOS), forward and back test, timed up and go test(TUG) and 10-meter gait velocity test were performed to evaluate static balance, dynamic balance, and gait ability, respectively, prior to and 8 weeks after the intervention. Differences within each group in relation to the lapse of time were compared by a paired t-test. Differences between the two groups were compared by an independent t-test. Regarding comparison of differences within each group, all tests resulted in significant changes in both groups after the intervention (p<.05). Comparison of differences between the two groups showed that taping in the physical therapy group had significantly better test results than the ordinary physical therapy group in all measured items(p<.05). The after effects of ankle taping on stroke patients are more efficient and effective than ordinary physical therapy alone in improving balance and gait ability.

• The Journal of Korean Physical Therapy
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• v.34 no.5
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• pp.218-223
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• 2022

Purpose: This study sought to identify the effects of an insole applied for the flexible flat-foot condition on dynamic balance and ankle muscle activities during the Y-balance test (YBT). Methods: Thirteen flexible flat-footed adults and an equal number of normal-footed adults were enrolled. The dynamic balance of the subjects was measured using the YBT, which is a reach test. While they were reaching forward with their foot, the percentage maximum voluntary isometric contraction (MVIC) of the tibialis anterior, peroneus longus and medial and lateral gastrocnemius were measured and analyzed. The flat-footed group then applied the ready-made insoles and underwent the YBT again. A comparison of the distance and muscle activity was conducted using YBT, not only between the flat-footed and control group, but also between the flat-footed group before and after the application of the insole. Results: Between the groups, the anterior reach distance in the flat-footed group was significantly lower, but there were no significant differences observed in the posteromedial and posterolateral directions. With the insole, the reach distance of the flat-footed group was significantly increased in the anterior and posterolateral direction compared to the control group. With the insole, the lateral gastrocnemius activity significantly decreased compared to trials without the insole in the flat-footed group, but there were no significant differences in the other muscles. Conclusion: The insole for flat-footed subjects can maintain the medial arch of the foot, and it may help enhance functional and mechanical dynamic balance in people with flat feet.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.134-138
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• 2018

Objective: The aim of this research was to investigate the effects of functional electrical stimulation (FES) applied to the gluteus medius (Gm) and tibialis anterior (TA) during stair climbing in persons with stroke compared to FES applied to the TA only during stair climbing, and during stair climbing without FES in persons with stroke. Design: Cross-sectional study. Methods: Twenty subjects with stroke participated in this study. Subjects were included if: 1) they were diagnosed as stroke at least 6 months before; 2) had Mini Mental State Examination- Korean score of 24 or higher; 3) were able to climb a flight of 10 stairs independently (with or without walking aid). The patients walked 10 stairs 3 times with FES applied to the Gm and TA, only TA, or no FES. There was a 1-minute rest period between each bout. The assessments were made using the Timed Up & Down Test and the Wii Balance Board. Results: Stair climbing with FES applied to the Gm and TA was significantly faster than stair climbing with FES applied to the TA only and without FES (p<0.05). Stair climbing with FES applied to the Gm and TA exhibited significantly greater sway velocity than stair climbing without FES (p<0.05). However, maximal sway distances were not significantly different between groups. Conclusions: Stair climbing with FES applied to the Gm and TA can be an important component of a rehabilitation program for improving stair climbing ability in persons with stroke.

• The Journal of Korean Physical Therapy
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• v.24 no.5
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• pp.334-339
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• 2012

Purpose: This study was conducted in order to compare the ability to control postural sway during perturbation when stroke patients received postural sway induced by head rotation. Methods: This study included 15 stroke patients and 15 healthy adults. Each group was measured by 3D motion analysis for determination of the angle of the neck in static position and by balance performance monitor for estimation of swaying angle in both neutral posture and head rotation position. These results were then analyzed in order to compare the healthy control group and the stroke patients group. Results: In both static posture ($60.7{\pm}4.81$) and dynamic posture ($51.46{\pm}6.87$, $70.8{\pm}6.55$), significant decreases were observed in the angle of head rotation of the patient group, compared to the healthy group (p<0.05), and significant decreases were observed in the sway angle of the patient group when in the neutral position ($3.62{\pm}7$, $24{\pm}0.60$) and head rotation ($3.04{\pm}0.80$, $51.46{\pm}6.87$), compared to the healthy group (p<0.05). Conclusion: According to these findings, patients with stroke tend to restrict the ROM of head rotation and swaying angle in dynamic posture and maintain their posture instability using limitation of head movement relative to the trunk and sway angle of area which is larger than that of affected side in unaffected side.

• Journal of Biomedical Engineering Research
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• v.28 no.3
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• pp.410-416
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• 2007

This paper presents quantitative analysis of a training system based on an unstable platform and a visual interactive system for improving sense of equilibrium. The training system consists of an unstable platform, a force plate, a safety harness, a monitoring device, and a personal-computer. To confirm the effects of the training system, fifteen young volunteers and five elderly volunteers went through a series of balance training using the system. During the training, we measured relevant parameters such as the time a subject maintain his or her center of pressure on a target, the time a subject moves his or her center of pressure to the target, and the mean absolute deviation of the trace before and after training with this system and training programs to evaluate the effects of the training. The results showed that the training system can successfully assess the gradual improvement of the postural control capability of the subject in the system and showed a possibility of improving balance of the subject. Moreover, the significant improvement in the postural capability of the elderly subject suggests that elderly subjects can benefit more from the training using the system for the improvement of sense of equilibrium.

• Journal of Biomedical Engineering Research
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• v.28 no.5
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• pp.590-600
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• 2007

We performed experimental studies on the muscle activities in the lower limbs for the different movement patterns on an unstable platform. A training system for postural control using an unstable platform that we previously developed was applied for the experiments. This unstable platform provides 360 degrees of movement allowing for training of posture in various directions and provides simultaneous excitations to visual sensory, somatic sensation and vestibular organs. Compare with the stable platform, keeping body balance on the unstable platform requests more effective sensation from vision, vestibular sense and somatic sense. Especially, the somatosensory inputs from the muscle proprioceptors and muscle force are crucial. To study the muscle activities for the different movement patterns and find the best training method for improving the ability of postural control through training and improving the lower extremity muscular strength, fifteen young healthy participants went through trainings and experiments. The participants were instructed to move the center of pressure following the appointed movement pattern while standing on the unstable platform. The electromyographies of the muscles in the lower limbs were recorded and analyzed in the time and the frequency domain. Our experimental results showed the significant differences in muscle activities for the different movement patterns. Especially, the spectral energy of electromyography signals in muscle for the movement pattern in anterior-posterior direction was significantly higher than those occurred in the other patterns. The muscles in the lower leg, especially tibialis anterior and gastrocnemius were more activated compared to the others for controlling the balance of body on the unstable platform. The experimental results suggest that, through the choice of different movement pattern, the training for lower extremity strength could be performed on specific muscles in different intensity. And, the ability of postural control could be improved by the training for lower extremity strength.