• 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 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.

• PNF and Movement
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• v.18 no.3
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• pp.415-424
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• 2020

Purpose: This study aimed to compare changes in abdominal muscle thickness in different standing postures with a handheld load between subjects with and without chronic low back pain (CLBP). Methods: Twenty subjects with CLBP and 20 controls participated in this study. Ultrasound imaging was used to assess the changes in the thickness of the transverse abdominis (TrA), internal oblique (IO), and external oblique (EO) muscles. Muscle thickness in three different standing postures (standing at rest, standing with loads, standing with lifting loads) was compared with the muscle thickness at rest in the supine position and was expressed as a percentage of change in the thickness of the muscle. Results: While standing with loads, the change in IO muscle thickness in the CLBP patients increased more significantly than in the pain-free controls (p < 0.05). The standing with lifting loads posture showed a significant increase in the change in thickness of the TrA compared with the standing with loads posture (p < 0.05). In addition, the standing with lifting loads posture showed a significant decrease in the change in the thickness of the EO when compared with the standing with loads posture (p < 0.05). Conclusion: The automatic activity of the IO muscle in subjects with CLBP increased more than that of the pain-free controls in the standing with loads posture. These findings suggest that IO muscle function may be altered in those with CLBP while standing with loads. Additionally, TrA the activation level was found to be associated with increased postural demand caused by an elevated center of mass.

• Physical Therapy Korea
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• v.19 no.1
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• pp.28-36
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• 2012

This study used an unstable platform to change the support surface type and position of both lower limbs in order to determine changes in weight distribution and muscle including the vastus medialis, tibialis anterior, lateral hamstring, and lateral gastrocnemius of both lower limbs were evaluated during knee joint flexing and extending in a semi-squat movement in 32 hemiplegic patients. The support surface conditions applied to the lower limbs were divided into four categories: condition 1 had a stable platform for both lower limbs; condition 2 had an unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side; condition 3 had a stable platform for the non-hemiplegic side and an unstable platform for the hemiplegic side; and condition 4 had an unstable platform for both sides. The normalized EMG activity levels of muscles and weight bearing ratio of both sides in the four surface conditions were compared using repeated measures ANOVA. A significant increase was found in the weight support distribution for the hemiplegic side in flexing and extending sessions in condition 2 compared to the other conditions (p<.05). A statistically significant decrease in significant decrease in asymmetrical weight bearing in flexing and extending sessions was observed for condition 2 compared to the other conditions (p<.05). A similar significant decrease was found in differences in muscular activity for both lower limbs in condition 2 (p<.05). The muscular activity of the hemiplegic side, based on the support surface for each muscle showed a significantly greater increase in condition 2 (p<.05). An unstable platform for the non-hemiplegic side and a stable platform for the hemiplegic side therefore increased symmetry in terms of the weight support distribution rate and muscle activity of lower limbs in hemiplegic patients. The problem of postural control due to asymmetry in hemiplegic patients should be further studied with the aim of developing continuous effects of functional training based on the type and position of the support surfaces and functional improvement.

• Physical Therapy Korea
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• v.16 no.2
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• pp.16-23
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• 2009

The purpose of this study was to investigate the effects postural changes on respiratory muscles and acoustic parameters of the children with spastic cerebral palsy. Nine children with spastic cerebral palsy who required assistance when walking were selected. The ages of the children ranged from 6 to 9 years old. The phonation of the sustained vowel /a/ and the voice qualities of each child such as fundamental frequency($F_0$; Hz), pitch variation (Jitter; %), amplitude variation (Shimmer; %) and noise to harmonic ratio (NHR) were analyzed by Multi-Dimensional Voice Program (MDVP). The muscle activity of three major respiratory muscles: pectoralis major muscle, upper trapezius muscle and rectus abdorminalis muscle, were measured by examining the root mean square (RMS) of the surface EMG to investigate the impact of changes in the adjusted sitting posture of each subject. However, the RMS of pectoralis major muscle showed a significant differences (p<.05). Secondly, there were no significant differences in $F_0$, Jitter and Shimmer between pre and post posture change, but there was a significant difference in NHR (p<.05). The data were collected in each individual; once prior and once after the sitting posture change. The data were analyzed by Wilcoxon signed ranks-test using SPSS version 14.0 for Windows. The findings of this study were as follows; Firstly, the RMS of upper trapezius and rectus abdorminalis muscle were not significant different between pre and post sitting posture changes. From the result, it is concluded that changes in the adjusted sitting posture decreases the abnormal respiratory patterns in the children with spastic cerebral palsy which is characterized by the hyperactivity of the respiratory muscles in breathing. Also, there is increased on the voice qualities in children with spastic cerebral palsy.

• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.1-6
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• 2021

Purpose: This study examined the effects of heel insoles on the static balance and leg muscle activity and posture control strategy during external perturbation. Methods: Thirty healthy young men participated in the study. The subjects underwent two experimental conditions: 1) no heel insole condition (0cm) and 2) wearing heel insole condition (5cm). The static balance was measured using an I-Balance device, which measured the change in the center of gravity (COG). The onset time of muscle activation and muscle activation of the erector spinae (ES), hamstring (HAM), gastrocnemius (GCM) were measured using surface EMG electrodes to determine the change in posture control strategy during external perturbation. Results: The speed and distance of COG were significantly higher in the wearing heel insoles condition than the no heel insole condition (p<0.05). In addition, significant differences in the onset time of the GCM, HAM, and ES muscle activation were observed when there was no heel insole condition during external perturbation (p<0.017). On the other hand, no significant differences in the onset time of muscle activation were observed between GCM and HAM when wearing the heel insole condition during external perturbation (p<0.017). Moreover, muscle activation of the GCM was significantly higher in the wearing heel insoles condition than the no heel insole condition during external perturbation (p<0.05). Conclusion: These findings suggest that heel insoles may have disadvantages, and increased efforts are needed to maintain balance and change the posture control strategy during external perturbation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.2
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• pp.718-724
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• 2012

This study aims to examine effects of vision control balance training applied to stroke patients on their balance. 26 stroke patients, the subjects of this study, were divided into an affected side 1/2 vision control group (9), a non-affected side 1/2 vision control group (9), and a non-vision control group (8). After vision control standing on Posturo-med, all of the three groups received balance training 20 minutes four times per week for 8 weeks watching themselves 1M away from a mirror. To measure their balance abilities, measurements were made on their time of balance maintenance and muscle activity prior to the intervention, four 4 after the intervention, and 8 weeks after the intervention. Vision control balance training applied to stroke patients resulted in increase in their time of balance maintenance and significant improvement in vastus medialis muscle activity (p<0.05). This study result is that vision control balance training is considered an effective exercise method for balance training of stroke patients.

• The Journal of the Convergence on Culture Technology
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• v.6 no.2
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• pp.341-348
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• 2020

This research is to find out which position is more effective on exercise. This study compared paricipants in their twenties on sitting position & standing position doing abdominal breathing of their respiration & abdominal muscle activation for 4 weeks. In sitting position, FEV1 was the biggest after breathing exercise. In standing position, the gap was biggest between the FEV1 & forced expiratory flow before and after the exercise. In standing and supine position, Lt. rectus abdominis before exercise and Rt. rectus abdominis after exercise muscle activities were the biggiest. Both posture exercise of repeated measure of analysis result, before and after the exercise of the rectus abdomonis muscle and external oblique muscle were not difference in both muscle activity(p>.05). Left Musculus obliquus externus abdominis before and after physical exercise, it's showed a meaningful difference(p<0.05). Before and after exercise, saw a meaningful difference the efforts of FEV1/FVC(p<0.05). The left external oblique abdominis muscle showed the most muscle activity in the supine position before/after exercising, the efforts expiratory showed the lowest muscle activity.The results from the repeated measures ANOVA regarding to before/after the volume and muscle activity, it showed significant difference between at the right rectus abdominis muscle(p<.05). This study finally gathered data about the muscle activity according to the position. This could be used to find in what position the abdominal breath exercise is the post effective & a new treatment for the patients who has worsened respiration function.

• International Journal of Safety
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• v.11 no.1
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• pp.22-25
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• 2012

Scoliosis can be biomechanically described as a three dimensional deformity of the spine, with deviations from the physiologic curves in the sagittal and frontal planes, usually combined with intervertebral rotation. Various factors are suspected such as genetic defects, uneven growth of the vertebrae, hormonal effects, abnormal muscular activity, postural problems, or a mix of some of these elements, but its initial cause is known in only 15-20% cases. The screening test for diagnosing scoliosis is called the Adams Forward Bend Test. During the experiment, the subjects were asked to bend over, with arms dangling, until a curve could be observed. The Scoliometer was placed on the back of the subjects and used to measure the difference between the left and right apex of the curve in the thoracic, thoracolumbar and lumbar area. Then, the subjects were asked to perform Maximum Voluntary Contractions (MVCs) using the digital back muscle dynamometer in three different postures: (1) 0o (sagittally symmetric); (2) 30o from the mid-sagittal plane (clockwise); and (3) 30o from the mid-sagittal plane (counterclockwise). In addition to the experimental data, subject-dependent variables including Body Mass Index (BMI), percentage of body fat and muscle mass of left/right arms and legs were employed to reveal the cause of difference among three MVC conditions. All those variables were tested using statistical methods.

• Physical Therapy Korea
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• v.21 no.3
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• pp.11-19
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• 2014

The purpose of this study was to investigate the activity of the transverse abdominal muscle resulting from changed posture by measuring the thickness of the transverse abdominal muscle in a supine posture, a slouched sitting posture, and an erect sitting posture. The subjects of the study were 28 patients with cerebral palsy. All their transverse abdominal muscles at the end of inhalation were measured at supine, slouched sitting (S sitting) and erect sitting (E sitting) postures by using ultrasonography, and then their dynamic sitting balance was measured at S sitting and E sitting postures by using BioRescue. For the statistical analysis, the Kruskal-Wallis test and the Wilcoxon signed-rank test were used to compare the differences among each the postures. The results were as follows. The thickness of the transverse abdominal muscle when comparing the supine posture and the S sitting posture showed no statistically significant difference. But the E sitting posture showed a statistically significant difference as compared with the others. In addition, the dynamic sitting balance in comparing the S sitting and E sitting postures showed a significant difference. In conclusion, the E sitting posture has a more positive effect on postural control and balance than generally taking the S sitting posture, for the sitting posture of a patient with cerebral palsy. It is suggested that patients with cerebral palsy mainly experiencing a sedentary life or being in a wheelchair should be seated in the E sitting posture during their daily life, and it may be necessary to continue to monitor and manage the proper E sitting posture.