• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.9-16
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• 2017

Background: The purpose of this study was to investigate the relationship between the spine and the flat-foot, the stability and the alignment of the posture of the neck to prevent the alignment of the ankle joint operation and the lower back flexibility of the lumbar region according to the type of treatment using active stretching of the triceps, back pain, and to see how they affect weight bearing differences. Methods: The subjects of this study were 24 chronic low back pain patients. They were randomly divided into experimental group and control group. In the experimental group, ankle joint mobilization and active scraping of triceps were performed three times a week for a total of 6 weeks. The control group was performed in the same way without articulation. The range of flexion and extension motion of the lumbar spine and pain degree and difference of weight-bearing were measured before and after the experiment. Results: The model of ankle joint mobilization and calf muscle elongation of flat foot significantly improved the range of flexion and extension motion of the vertebrae (p<.05) and the VAS and distribution of weight-bearing were decreased in both of two groups (p<.05). In other words, the exercise and mobilization help to recover of the balance of the whole musculoskeletal, the vertebrae. Conclusions: The active exercise of the triceps muscle of the lower leg in this study It affects the flexibility of the lumbar spine, the pain and the difference in the weight support of the lower extremities, when we performed ankle joint mobilization for exercise and cramping, pain and the difference in weight support between the two lower limbs.

• Physical Therapy Korea
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• v.26 no.4
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• pp.70-76
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• 2019

Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges'g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges' g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

• Korean Journal of Applied Biomechanics
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• v.31 no.4
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• pp.259-269
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• 2021

Objective: The purpose of this systematic review and meta-analysis was to investigate age-related bimanual coordination functions in older adults. Method: Thirteen studies that compared bimanual coordination functions in older adults with those in healthy young adults qualified for this meta-analysis. We additionally categorized 21 total comparisons from the 13 qualified studies into two types of task-related moderator variables: (1) kinematic versus kinetic movements and (2) symmetry versus asymmetry movements. Results: Random effects model meta-analysis found that older adults revealed significant bimanual coordination impairments as compared with young adults (Hedges's g = -0.771; p < .0001; I² = 74.437%). We additionally confirmed specific bimanual coordination deficits using two moderator variables: 1) kinematic (Hedges's g = -0.884; p < .0001; I² = 0.000%) and kinetic (Hedges's g = -0.666; p = .023; I² = 86.170%). 2) symmetry (Hedges's g = -0.712; p = .001; I² = 74.291%) and asymmetry (Hedges's g = -0.817; p < .0001; I² = 76.322%). The moderator variable analysis indicated older adults indicated bimanual coordination deficits in the upper extremities than healthy young adults while performing kinematic bimanual coordination tasks and asymmetry coordination tasks. Conclusion: These findings suggest that developing motor rehabilitation programs based on asymmetric bimanual movement task for enhancing interlimb coordination functions of older adults may be crucial for increasing their independence in everyday activities. Given that elderly revealed the deficits in lower extremities coordination when older adults perform gait, posture, and balance, future studies should estimate lower limb coordination functions in elderly people.

• Clinics in Orthopedic Surgery
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• v.10 no.4
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• pp.500-507
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• 2018

Background: The sagittal alignment of the spine and pelvis is not only closely related to the overall posture of the body but also to the evaluation and treatment of spine disease. In the last few years, the EOS imaging system, a new low-dose radiation X-ray device, became available for sagittal alignment assessment. However, there has been little research on the reliability of EOS. The purpose of this study was to evaluate the intrarater and interrater reliability of EOS for the sagittal alignment assessment of the spine and pelvis. Methods: Records of 46 patients were selected from the EOS recording system between November 2016 and April 2017. The exclusion criteria were congenital spinal anomaly and deformity, and previous history of spine and pelvis operation. Sagittal parameters of the spine and pelvis were measured by three examiners three times each using both manual and EOS methods. Means comparison t-test, Pearson bivariate correlation analysis, and reliability analysis by intraclass correlation coefficients (ICCs) for intrarater and interrater reliability were performed using R package "irr." Results: We found excellent intrarater and interrater reliability of EOS measurements. For intrarater reliability, the ICC ranged from 0.898 to 0.982. For interrater reliability, the ICC ranged from 0.794 to 0.837. We used a paired t-test to compare the values measured by manual and EOS methods: there was no statistically significant difference between the two methods. Correlation analysis also showed a statistically significant positive correlation. Conclusions: EOS showed excellent reliability for assessment of the sagittal alignment of the spine and pelvis.

• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.122-128
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• 2019

Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.

• PNF and Movement
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• v.12 no.4
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• pp.243-248
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• 2014

Purpose: The transverse abdominis and themultifidus muscle are located in the core. They surround one's trunk and help in body stabilization. Specifically, they control spine articulation to maintain posture and balance. Therefore, weakened deep muscle in the trunk may cause spinal malalignment. This study aims to compare the correlation between the thickness of the transverse abdominis and the multifidus muscle and the spine alignment among college students in their 20s. Methods: This study measured the thickness of the transverse abdominis and the multifidus muscle of 42 healthy college students in their 20s using ultrasonic waves. The thickness of the muscle was measured for the length of the cross-section except for fascia. The thickness of the left and right muscles was measured, and the mean value was calculated. As the thickness of the transverse abdominis can increase because of pressure during exhalation, it was measured at the last moment of exhalation. Spinal alignment was measured by the kyphosis angle, lordosis angle, pelvic tilt, trunk inclination, lateral deviation, trunk imbalance, and surface rotation using Formetric III, which is a three-dimensional imaging equipment. They were measured for three times, and the mean values were calculated. The general characteristics of the subjects were analyzed using descriptive statistics. The correlations between each factor were analyzed using Pearson's correlation analysis. Results: The transverse abdominis showed asignificant correlation with trunk inclination (p<.05). The multifidus muscle showed a significant positive correlation with pelvic tilt and a negative correlation with surface rotation (p<.05). Conclusion: The thickness of transverse abdominis and the multifidus muscle appears to influence spinal alignment. Specifically, the multifidus muscle, which plays an important role on the sagittal plane, influences surface rotation, thus making it an important muscle for scoliosis patients. Therefore, a strengthening training program for the transverse abdominis and the multifidus muscle is necessary according to specific purposes among adults with spinal malalignment.

• The Journal of Korean Physical Therapy
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• v.33 no.3
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• pp.168-177
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• 2021

Purpose: This study applies the ICF to identify the patient's body function, structure, and participation, evaluates the patient's environmental factors and individual factors, and is a high level of movement to return to the society of patients with multiple ligament injury of the knee joint. Methods: Progressive strength training and ROM exercise were performed 30 minutes a day, 5 times a week for 6 weeks. The evaluation was performed by examining the ROM, length, MMT, instability, dynamic balance, pain and depression. Results: The ROM of the knee joint was improved from 110° to 135° after intervention, and the knee flexion length decreased from 69 cm to 45 cm. Knee flexor is Good after intervention from Poor-, and knee extensor is Good+ after intervention from Poor, and the plantar flexor of the ankle joint improved from Poor- before intervention to Good after intervention and dorsi-flexor of the ankle joint improve to Good from Poor. Pain index was moderate before and after the intervention, with a score of 3, 2 after the intervention, and when maintaining the sitting cross-legged, the before intervention score was 7 to 4 after the intervention. Conclusion: The patient's posture of sitting cross-legged was maintained from 30 seconds before intervention to 14 minutes after intervention. These results were able to set the hypothesis design, intervention method and goal that the multifaceted approach of environment and individual factors as well as body function and structure area, activity and participation area using ICF checklists, it is helped the patient to return to daily life.

• The Journal of Korean Academy of Sensory Integration
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• v.20 no.3
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• pp.1-13
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• 2022

Objective : The purpose of this study was to investigate changes in somato-sensory and occupational performance of individually tailored sensory integration interventions for school-age children with somatodyspraxia. Methods : A single subject study with an AB design was conducted the total sessions were 11 sessions, consisting of 3 baseline sessions and 8 intervention sessions. To compare the effects before and after the intervention, the intervention was measured by dividing it into Performance Area (PA) and Performance Factor (PF), and after each intervention session, the Goal Attainment Scale (GAS) was implemented. Results : The children participating in this study showed overall improvement in PA and PF after the intervention, and after each session, it was confirmed that the GAS increased when measuring the target activities (Supine Flexion Posture; SFP, Walking by Arms; WA, Stand on Balance Ball; SBB). Conclusion : This study provided evidence that sensory integration has a positive effect on performing target activities (SFP, WA, SBB) and improving relationships with peers in children with somatodyspraxia.

• Journal of Digital Convergence
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• v.12 no.7
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• pp.411-418
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• 2014

This study, in order to establish the effect of three exercise groups on the static and dynamic balancing abilities and the muscular activity, targeting adult males aged 20-29, assigned 15 men to each aquatic exercise group, trunk stabilization exercise group, and balance exercise group. The study was conducted from June, 2013 to August, 2013, and measured and compared the balancing ability and the muscle activity(tibialis anterior and gastrocnemius muscle) of the participants after performing intervention for 30 minutes a day, 3 days a week, for 6 weeks. As a result, on the comparison between before and after the intervention, there were significant differences in changes of the surface area and the whole path length in all the three groups(p<.05)(p<.01), and also on the dynamic balance, there was a significant difference in change of limited of stability(p<.05)(p<.01). On change of the muscle activity of tibialis anterior, both left and right sides showed statistically significant differences in all the three groups(p<.05)(p<.01), and gastrocnemius muscle showed a statistically significant difference in all the three groups except for the left side of the trunk stabilization exercise group(p<.05)(p<.01). It could be established that aquatic exercise is effective for improvement of the balancing ability and increase of the muscular activity, and we intend to propose specific aquatic exercise program development by conducting a study to determine the objective effect of aquatic exercise on the elderly or patients who have a poor balancing ability.

• Korean Journal of Applied Biomechanics
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• v.17 no.2
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• pp.113-121
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• 2007

The purpose of this study was to determine the effect of three different plates($0^{\circ}$, $10^{\circ$}, $20^{\circ}$)under heels on the lower limb muscles and erector spinae during squat exercise. Ten high school korean traditional wrestling players(age: $18.5{\pm}0.7$, weight: $1972.2{\pm}128.5N$, height: $177.8{\pm}6.0cm$, weight of barbell: $1004.5{\pm}132.4N$) performed squat exercise using three different tilting plates under heels at a cadence of 40beats/sec with 80% one repetition maximum load. Surface electrodes were placed on the participants' left and right erector spinae, and rectus femoris, vastus medialis, vastus lateralis, tibialis anterior, biceps femoris, medial gastrocnemius, and lateral gastrocnemius in the right lower extremity. One S-VHS camcorder(Panasonic AG456, 60fields/s) was placed 10m to the side of the participant. To synchronize the video and EMG data, a synchronization unit was used for this study. Average and Peak IEMG values were determined for each participant. For each variable, a one-way analysis of variance was used to determine whether there were significant differences among three different tilting plates under heels. When a significant difference was found in plates type, post hoc analyses were performed using the Tukey procedure. A confidence level of p<.05 was used to determine statistical significance. As a result of this study, maximum nEMG values of the tibialis anterior in $0^{\circ}$ plates was significantly higher than the corresponding values for the other plates during the knee extension. This increased activation in the tibialis anterior muscle indicates an increase in displacement of center of gravity of body. It is very likely that additional muscle activation are needed to stop the forward and backward movement. The results also showed that muscular activities of quadriceps femoris and erector spinae were decreased with increasing angle of plates. This suggests that increasing angle of plate may help to sustain the balance and posture of squat exercise. It is considered that very few significant differences were found among three different plates($0^{\circ}$, $10^{\circ}$, $20^{\circ}$) since elite players with much experience in squat exercise, were chosen as a participant of this study. In order to obtain meaningful results regarding the tilting angle of heel plates in squat exercise, kinetic and 3D kinematic analysis will be needed in the future study.