• Journal of Korean Medical Science
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• v.33 no.46
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• pp.289.1-289.10
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• 2018

Background: Cerebral microbleeds (CMBs) are associated with cerebrovascular risk factors and cognitive dysfunction among patients with Parkinson's disease (PD). However, whether CMBs themselves are associated with PD is to be elucidated. Methods: We analyzed the presence of CMBs using 3-Tesla brain magnetic resonance imaging in non-demented patients with PD and in age-, sex-, and hypertension-matched control subjects. PD patients were classified according to their motor subtypes: tremor-dominant, intermediate, and postural instability-gait disturbance (PIGD). Other cerebrovascular risk factors and small vessel disease (SVD) burdens were also evaluated. Results: Two-hundred and five patients with PD and 205 control subjects were included. The prevalence of CMBs was higher in PD patients than in controls (16.1% vs. 8.8%; odds ratio [OR], 2.126; P = 0.019); CMBs in the lobar area showed a significant difference between PD patients and controls (11.7% vs. 5.9%; OR, 2.234; P = 0.032). According to the motor subtype, CMBs in those with PIGD type showed significant difference from controls with respect to the overall brain area (21.1% vs. 8.9%; OR, 2.759; P = 0.010) and lobar area (14.6% vs. 4.9%; OR, 3.336; P = 0.016). Among PD patients, those with CMBs had higher age and more evidence of SVDs than those without CMBs. Conclusion: We found that CMBs are more frequent in PD patients than in controls, especially in those with the PIGD subtype and CMBs on the lobar area. Further study investigating the pathogenetic significance of CMBs is required.

• Physical Therapy Rehabilitation Science
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• v.3 no.1
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• pp.27-32
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• 2014

Objective: The aim of this study was to compare the radial bone strength, sitting balance ability and global self-esteem of wheelchair martial arts practitioners and healthy control participants. Design: Cross-sectional study. Methods: Nine wheelchair martial art practitioners with physical disabilities and 28 able-bodied healthy individuals participated in the study. The bone strength of the distal radius was assessed using the Sunlight Mini-Omni Ultrasound Bone Sonometer; sitting balance was quantified using the modified functional reach test (with reference to a scale marked on the wall); and the self-administered Rosenberg self-esteem (RSE) scale was used to measure the global self-esteem of the participants. The velocity of the ultrasound wave (speed of sound, m/s) traveling through the outer surface of the radial bone was measured and was then converted into a T-score and a Z-score. These ultrasound T-score and Z-score that represent bone strength; the maximum forward reaching distance in sitting (cm) that represents sitting balance; and the RSE total self-esteem score that indicates global self-esteem were used for analysis. Results: The results revealed that there were no statistically significant between-group differences for radial bone-strength, maximum forward reaching distance, or self-esteem outcomes. Conclusions: The wheelchair martial arts practitioners had similar radial bone strength, sitting balance performance and self-esteem to able-bodied healthy persons. Our results imply that wheelchair martial arts might improve bone strength, postural control and self-esteem in adult wheelchair users. This new sport-wheelchair martial arts-might be an exercise option for people with physical disabilities.

• PNF and Movement
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• v.15 no.1
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• pp.77-84
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• 2017

Purpose: This study aimed to investigate the effect of visual feedback training-for gradual weight shift in sit-to-stand training-on the balance and walking abilities of chronic hemiplegia patients. Methods: Twenty patients with chronic hemiplegia volunteered to participate in this study. The experimental group received visual feedback for gradual weight shift in the sit-to-stand training, while the contrast group followed the standard process for the sit-to-stand training. The evaluation of the balance and walking ability was conducted with the functional reach test (FRT), Berg balance scale (BBS), five time sit-to-stand (FTSTS) test, timed up and go (TUG) test, 10 m walk test (10MWT), balancia, activities-specific balance confidence (ABC) scale, and falls efficacy scale (FES). Results: In the results before and after intervention, there was a significant difference in TUG, 10MWT, ABC, and FES in the visual feedback training group (p < 0.05). In the control group, there was a significant difference in the 10MWT and ABC (p < 0.05). Also, in the evaluation of the postural fluctuations, the control group data showed a significant increase in Covar. The visual feedback group showed a significant difference in the W average. Conclusion: The visual feedback training group showed some improvement in terms balance and walking ability and on the ABC scale and FES. Therefore, if the diagonal progressive weight bearing exercise is combined with the various patterns and basic principles of PNF, it may be a more efficient intervention method.

• Physical Therapy Korea
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• v.26 no.2
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• pp.61-68
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• 2019

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen's d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT ($32.46{\pm}7.64$), SCM ($12.79{\pm}4.01$), and LT ($45.65{\pm}10.52$) and significantly decreased activity in the SA ($26.65{\pm}6.15$) than the normal group. The change in head position was significantly higher in the FHP group ($6.66{\pm}2.08$) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

• Physical Therapy Rehabilitation Science
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• v.10 no.1
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• pp.32-39
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• 2021

Objective: The weakness of muscle strength due to stroke affects the posture control and gait in the patients with stroke. Stroke This study examined the effects of the stair climbing training with functional electrical stimulation on muscle strength, dynamic balance, and gait in individuals with chronic stroke. Design: Randomized controlled trial. Methods: Total forty-eight patients were randomly assigned to the 3 groups. Participants randomly divided to stair climbing training with functional electrical stimulation group (SCT+FES group, n=16), stair climbing training group (SCT group, n=16) and control group (n=16). Subjects in the SCT+FES group and SCT group performed stair walking training with and without functional electrical stimulation for 30 minutes, 3 sessions per week for 4 weeks and all subjects received conventional physical therapy for 30 minutes with 5 sessions per week for 4 weeks. Outcome measurements were assessed using the sit-to stand Test for strength, timed up and go test and modified-timed up and go test for dynamic balance, and 10m walk test and GaitRite system for gait. Results: In the SCT+FES group, subjects have been shown the significant increase in lower extremity strength (p<0.05), significantly improve in dynamic balance (p<0.05), and significantly improve in their temporal gait parameter (p<0.05). The SCT+FES group was significantly better than other groups in all parameters (p<0.05). Conclusions: This result suggested that the SCT+FES may be effective strategy to improve muscle strength, dynamic balance, and gait for individuals with chronic stroke.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.4
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• pp.23-34
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• 2022

Purpose : This study examined the effects of pain, neck dysfunction, psychosocial level, headache impact test (HIT), postural alignment, and trapezius muscle tone of the complex exercise program using dynamic taping in patients with tension headache and chronic neck pain with forward head posture. Methods : The design of this is a randomized controlled trial (RCT). Thirty-four patients with chronic neck pain were screened using a randomized assignment program and assigned to experimental group (n=17) and control group (n=17). Both groups underwent a complex exercise program. In addition, the experimental group dynamic taping was applied to the upper trapezius muscle. All interventions were applied three times per week for four weeks. The visual analogue scale (VAS), the neck disability index (NDI), short form-12 health survey questionnaire (SF-12), Headache impact test-6 (HIT-6), Craniovertebral angle (CVA), Cranial rotation angle (CRA), upper trapezius muscle tone were compared to evaluate the effect on intervention. Results : Both groups showed significant differences before and after the intervention in VAS, NDI, SF-12, HIT-6, and CVA, CRA (p<.05). In addition, significant differences in NDI and upper trapezius muscle tone were observed between the experimental group and control group (p<.05). Conclusion : A complex exercise program using dynamic taping for patients with tension headache and chronic neck pain with forward head posture are effective method with clinical significance in improving the function and reducing upper trapezius muscle tone.

• PNF and Movement
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• v.21 no.1
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• pp.75-86
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• 2023

Purpose: This study aims to determine the effect of proprioceptive neuromuscular facilitation (PNF) pectoralis minor stretching and lower trapezius strengthening exercise on posture change, shoulder range of motion (ROM), and pain in rotator cuff repair patients with a rounded shoulder posture (RSP). Methods: Following baseline measurements, the subjects (n = 25) with rotator cuff repair were randomized into two groups: the PNF group (n = 13), which engaged in PNF pectoralis minor stretching and lower trapezius strengthening exercise, and the control group (n = 12), which received traditional physical therapy. Each group participated in the intervention five times per week for two weeks. The RSP values for the postural changes, flexion and abduction ROM, and visual analogue scales (VASs) of both groups were recorded at both pre- and post-intervention. In addition, before and after the intervention, a paired t-test was conducted to compare the within-group changes and an independent t-test to compare the between-group differences. Results: After the two-week intervention, both groups experienced significantly decreased RSP and VAS values (p < 0.05) and a significantly increased ROM (p < 0.05). Meanwhile, the PNF group showed greater improvements in RSP, ROM, and VAS than the control group (p < 0.05). Conclusion: These results suggest that PNF pectoralis minor stretching and lower trapezius strengthening exercise reduce posture and shoulder pain and enhance ROM in rotator cuff repair patients with RSP.

• Journal of the Korea Society of Computer and Information
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• v.28 no.5
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• pp.95-102
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• 2023

The purpose of this study was to the effects of the Sling Neurac stabilization exercise(SNSE) on pain, cervical lordosis angle(CLA), and cervical gravity line(CGL) in young adults with a forward head posture. The subjects of the study were selected as SNSEG(n=10) and control group(n=10), they were conducted for 70 minutes three times a week for 8 weeks. Study results showed that pain(p<.001), CGLe(p<.01) were significantly decreased and CLA(p<.001) were also significantly increased in the SNSEG. In conclusion, SNSE is effective in improving the proprioceptive sense of the LM group and activating the muscle. Co-activation with the GM group was found to be effective in improving the CLA and CGL. Therefore, reactivation of the deep neck flexors and suboccipital muscles is an important factor in pain control and postural alignment, and is suggested as an effective intervention method to improve forward head posture.

• Physical Therapy Korea
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• v.27 no.3
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• pp.178-184
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• 2020

Background: Stroke patients have reduced trunk control compared to normal people. The ability to control the trunk of a stroke patient is important for gait and balance. However, there is still a lack of research methods for the characteristics of stroke control in stroke patients. Objects: The aim of this research was to determine whether trunk position sense has any relation with balance and gait. Methods: This study assessed trunk performance by measuring position sense. Trunk position sense was assessed using the David back concept to determine trunk repositioning error in 20 stroke patients and 20 healthy subjects. Four trunk movements (flexion, extension, lateral flexion, rotation) were tested for repositioning error and the measurement was carried out 6 times per move; these parameters were used to compare the mean values obtained. Subjects with stroke were also evaluated with clinical measures of balance and gait. Results: There were significant differences in trunk repositioning error between the stroke group and the control group in flexion, lateral flexion to the affected side, lateral flexion to the unaffected side, rotation to the affected side, and rotation to the unaffected side. Mean flexion error: post-stroke: 7.95 ± 6.76 degrees, control: 3.32 ± 2.27; mean lateral flexion error to the affected side: 6.13 ± 3.79, to the unaffected side: 5.32 ± 3.15, control: 3.57 ± 1.92; mean rotation error to the affected side: 8.25 ± 3.09, to the unaffected side: 9.24 ± 3.94, control: 5.41 ± 1.82. There was an only significant negative correlation between the repositioning error of lateral flexion and the Berg balance scale score to the affected side (-0.483) and to the unaffected side (-0.497). A strong correlation between balance and gait was found. Conclusion: The results of this study indicate that stroke patients exhibit greater trunk repositioning error than age-matched controls on all planes of movement except for extension. And lateral flexion has correlation with balance and gait.