• PNF and Movement
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• v.15 no.2
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• pp.149-157
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• 2017

Purpose: The purpose of this study was to assess the effect of using smartphones for tele-rehabilitation on head position and neck dysfunction in workers with visual display terminal (VDT) syndromes over a four-week period. Methods: Sixteen VDT workers volunteered to participate in stretch exercise and posture education sessions. The subjects were divided into three groups as follows: five subjects in the visit group (VSG), six subjects in the video group (VEG), and five subjects in tele-rehabilitation group (TG). The subjects in all the groups performed the exercises three days per week for four weeks. Cranial rotation angle (CRA), craniovertebral angle (CVA) measurement, and neck disability index (NDI) tests were performed before and four weeks after the intervention. Results: No significant difference in the CRA and CVA variables was found among groups. No significant difference in the CRA variable was found within each group. A significant difference in the CRA variable was found in the VSG after the four-week intervention. No significant difference in NDI was found among the groups. The NDIs among all the groups were significantly decreased after the intervention when compared with the NDIs measured before the intervention. Conclusion: The use of smartphones in the tele-rehabilitation of VDT workers with neck pain was found to be as effective on neck function as the conventional intervention method. The tele-rehabilitation of VDT workers with neck dysfunctions may be presented as an alternative way.

• PNF and Movement
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• v.15 no.3
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• pp.227-236
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• 2017

Purpose: The purpose of this study was to investigate the effects of coordinative locomotor training (CLT) on the foot pressure and balance of patients with scoliosis. Methods: This was a single-case A-B-A study involving two patients with scoliosis. The study was designed to perform repeated measurements as follows: 5 times at baseline (A), 10 times during intervention (B), and 5 times after intervention (A). The study period was 5 weeks, and the CLT program was divided into warm up, CLT program, and cool down stages, at 50 min per stage. For the primary outcome measure, Gait View AFA-50 was used to determine the foot pressure and balance ability. For the secondary outcome measure, the SRS-22 questionnaire was used to assess the quality of life of the patients with scoliosis. Descriptive statistics and visual analysis using graphs were used to compare the rates of change. Results: The results of this study showed that the foot pressure and balance ability of the two subjects improved during the intervention period and remained improved even during the baseline period. However, their quality of life did not change after the intervention. Conclusion: CLT may have a positive effect on foot pressure and balance ability in patients with scoliosis. Also, this body function improvement may have positive effects on the performance of daily activities which employ the upright position.

• PNF and Movement
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• v.18 no.2
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• pp.265-273
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• 2020

Purpose: The purpose of the study was to investigate the effects of HMD (head mounted display)-based virtual reality balance training on static balance in young adults, and whether appropriate balance training can help healthy adults to improve balance ability in daily living. Methods: The study subjects were 14 healthy adults. Subjects received 20 minutes of HMD-based virtual reality balance training 3 times per week for 4 weeks. Static balance was measured before, during, and after training and after one month. Static balance was measured in a total of 8 conditions, and the results were classified as visual (F1), somatosensory (F5-6), vestibular (F2-4), and central nervous system (F7-8). Results: The test results showed no significant difference in pre-training, post-training, and follow-up results under all conditions at Fourier index F1, F5-6, and F7-8 frequencies. For the F2-4 frequency, there was a significant difference before and after training under NC (neutral head position, eyes closed, firm surface) and PC (neutral head position, eyes closed, elastic surface) conditions. The NC condition returned a significant decrease of F2-4 frequency in post-training testing as compared to pre-training, and the PC condition showed a significant decrease of F2-4 frequency between the pre-training and mid-training tests, and between the pre-training and post-training tests. Conclusion: These results indicate that HMD-based balance training can improve balance ability, even in normal adults, and seems especially effective for vestibular function training.

• PNF and Movement
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• v.5 no.2
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• pp.63-71
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• 2007

Objective : Respiratory muscle weakness and decreased chest mobility has been suggested to result from the deconditioning that accompanied activity level in chronic elderly stokes. The benefits of respiratory exercise programmes on exercise capacity and muscle strength in hemiplegia. This study aimed to determine the effects of selective inspiratory and expiratory muscles training and chest mobility exercise on patients with strokes to establish if an improved exercise capacity can be obtained in patients that are not limited in their daily activities. Methods & Intervention : Twelve patients were assigned to the intensive respiratory exercise group participated in a measures design that evaluated the subjects with pre-treatment and post-treatment. Thirteen subjects who were assigned to a control group received training with breathing exercise and resistance exercise of skeletal muscles. The subjects performed spirometry then undertook a 6-week programme of respiratory muscle and chest mobility training. Training for the two groups was carried out 2 times a week for 6 weeks. Measurements and Results : Spirometry(Forced Vital Capacity: FVC and Closed Circuit Spiromety: CCS) and thoracic mobility were measured before and after the 6 weeks. The experimental group improved significantly compared to control group in FVC, $FEV_1$, MVV, IRV and ERV, and upper chest wall expansion(p<0.05). No significant improvement was seen in thoracic mobility or lung function in control group(p>0.05). Conclusion : The major findings in this study were that a intensive 6week exercise programme of resistive breathing and chest mobility in patients with hemiplegia led to an increase in lung capacity. The resistive breathing exercise programme used here resulted in a significant increase in the chest excursion during breathing.

• PNF and Movement
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• v.17 no.3
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• pp.379-389
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• 2019

Purpose: This study examined the effects of wheelchair handle directions on the trunk muscle activity of adult males when climbing ramps. It also evaluated the wheelchair attendant's physical discomfort during tasks. Methods: Healthy males aged over 20 years were chosen and the direction of wheelchair handle grip was randomly selected. The grips included a general grip with ulnar deviation, a medial grip with wrist pronation, and a neutral grip with a neutral wrist. The trunk muscle activity was measured using surface electromyography. Furthermore, the physical discomfort of wheelchair attendants was subjectively evaluated using the Borg CR-10 Scale, which rates the perceived exertion. In addition, the SPSS 18.0 program was used perform repeated measure ANOVA to compare muscle activity and subjective discomfort during the interventions. The contrast test was also conducted with a significance level (α) of 0.05. Results: There was significant difference between the general grip and the medial grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). In addition, there was significant difference between the general grip and the neutral grip in the rhomboid major muscle and the lumbar erector spinae muscle (p<0.05). Further, there was significant difference between the general grip and the neutral grip in subjective discomfort (p<0.05). Conclusion: In this study, adult male trunk muscle activity and subjective discomfort were lowest when using the neutral grip while climbing ramps. Accordingly, we suggest that neutral grips will help improve the function of the musculoskeletal system and reduce the subjective discomfort by putting less strain on the trunk muscles and maximizing efficiency with less force.

• The Journal of Korean Physical Therapy
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• v.15 no.1
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• pp.155-170
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• 2003

Lumbar segmental instability is considered to represent a significant sub-group within the chronic low back pain population. This condition has a unique clinical presentation that displays its symptoms and movement dysfunction within the neutral zone of the motion segment. The loosening of the motion segment secondary to injury and associated dysfunction of the local muscle system renders it biomechanically vulnerable in the neutral zone. There in evidence of muscle dysfunction related to the control of the movement system. There is a clear link between reduced proprioceptive input, altered slow motor unit recruitment and the development of chronic pain states. Dysfunction in the global and local muscle systems in presented to support the development of a system of classification of muscle function and development of dysfunction related to musculoskeletal pain. The global muscles control range of movement and alignment, and evidence of dysfunction is presented in terms of imbalance in recruitment and length between the global stability muscles and the global mobility muscles. The local stability muscles demonstrate evidence of failure of aeequate segmental control in terms of allowing excessive uncontrolled translation or specific loss of cross-sectional area at the site of pathology Motor recruitment deficits present as altered timing and patterns of recruitment. The evidence of local and global dysfunction allows the development of an integrated model of movement dysfunction. The clinical diagnosis of this chronic low back pain condition is based on the report of pain and the observation of movement dysfunction within the neutral zone and the associated finding of excessive intervertebral motion at the symptomatic level. Four different clinical patterns are described based on the directional nature of the injury and the manifestation of the patient's symptoms and motor dysfunction. A specific stabilizing exercise intervention based on a motor learning model in proposed and evidence for the efficacy of the approach provided.

• PNF and Movement
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• v.16 no.3
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• pp.405-414
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• 2018

Purpose: The purpose of this study was to examine test-retest reliability and criterion-related validity of a trunk stability robot when measuring the weight-bearing symmetry static sitting and standing in stroke patients. Methods: For 27 stroke patients, weight-bearing symmetry was assessed twice, 7 days apart. The intraclass correlation coefficient (ICC2,1) and minimal detectable change (MDC) were used to examine the level of agreement between test and retest. The criterion-related validity of weight -bearing symmetry was demonstrated by Spearman correlation of modified Barthel index (MBI), the sit to stand test (STS), the timed up & go Test (TUG), and the function in sitting test (FIST). Results: the test-retest agreements were excellent for the weight-bearing symmetry of static sitting (ICC2,1: 0.90) and standing (ICC2,1: 0.89). It all showed that the acceptable MDC for the weight-bearing symmetry of static sitting and standing was 0.11 and 0.16, respectively (highest possible score<20 %), indicating that the measures had a small and acceptable degree of measurement error. The weight-bearing symmetry of static sitting was significantly correlated with the TUG(r=-0.45) and FIST(r=0.46)(p<0.05); the weight-bearing symmetry of static standing was also significantly correlated with MBI (r=0.65), TUG (r=-0.67), FIST (r=0.61)(p<0.01), and STS (r=-0.47)(p<0.05). Conclusion: The weight-bearing symmetry of static sitting and standing assessed by the trunk stability robot showed highly sufficient test-retest agreement and mild-to-moderate validity. It could also be useful for clinicians and researchers to evaluate balance performance and monitor functional change in stroke patients.

• PNF and Movement
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• v.17 no.1
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• pp.137-144
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• 2019

Purpose: This study examined the effects of the abdominal drawing-in maneuver (ADIM) on muscle activity in the trunk and legs while subjects walk on a ramp. Methods: The subjects were healthy adult males (n=15) and females (n=8) in their twenties. The subjects were asked to maintain the ADIM contraction for 15 minutes using a pressure biofeedback unit. Their muscle activity was then measured while ascending or descending the ramp with or without the ADIM contraction maintained. Activity in the sternocleidomastoid, splenius capitis, rectus abdominis, external oblique abdominal, transversus abdominis, erector spinae, vastus medialis, and vastus lateralis muscles was measured using surface electromyography (TM DTS, Noraxon, USA). A paired t-test was conducted using SPSS 18.0 (IBM) for statistical data processing. Results: Maintaining the ADIM contraction during ascension led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Furthermore, maintaining the ADIM contraction during descent led to a significant increase (p<0.05) in muscle activity for the rectus abdominis, external abdominal oblique, transversus abdominis, vastus medialis, and vastus lateralis, but a significant decrease (p<0.05) in muscle activity for the erector spinae, when compared to the same activity without the ADIM maintained. Conclusion: As a result of this study, it maintains the ADIM and reduces lumbar muscle activity at the waist and increases muscle activity in the legs when walking on a ramp. Therefore, maintaining the ADIM contraction during ramp walking is recommended as training to improve the function of patients' muscular skeleton.

• PNF and Movement
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• v.10 no.3
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• pp.7-18
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• 2012

Purpose : This study was to compare the difference Trunk Control Test(TCT), Postural Assessment Scale for Stroke(PASS-TC), and Trunk Impairment Scale(TIS) and its subscales in relation to the difference MBI(Modified Barthel Index), BBS(Berg Balance Scale), and to establish the association between MBI, BBS, Fugl Meyer-motor function(FM-M), and to predict MBI-subscales from the variables. Methods : 58 stroke patients, attending a rehabilitation programme, participated in the study. Trunk control was measured with the use of the TCT, PASS-TC, TIS, and the performance of Activities daily living was obtained by MBI, and dynamic balance ability(by BBS). Trunk control scores from the difference MBI, BBS were compared using the 1-way ANOVA(Mann Whitney U test) and the data were analyzed using Pearson product correlation. Multiple stepwise regression analyses were performed to identify prognostic factors for ADL subscale. Results : Trunk control scores showed significant differences between MBI(F=2.139~13.737, p<.05~.001), BBS(t=3.491~7.705, p<.01~.001). It was significantly related with value of the MBI(r=.25~.50), BBS(r=.38~.68), FMM( r=.31~.48). Stepwise linear regression analysis showed an additional, significant contribution of the TCT, in addition to the PASS-TC, dynamic sitting balance subscale of the TIS for measures of MBI subscales. Conclusion : Measures of trunk control were significantly related with values of MBI, BBS score, so the management of trunk rehabilitation after stroke should be emphasized. The use of both quantitative and qualitative scales was shown to be a good measuring instrument for the classification of the general performance of the stroke patients. Further study about trunk control is needed using a longitudinal study design.

• PNF and Movement
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• v.10 no.1
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• pp.9-17
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• 2012

Purpose : This study's purpose is consideration about change of the hand grip strength according to different posture and shoulder flexion angle. The shoulder joint permits the greatest mobility and carries out the important function of stabilization for hand use. Hand grip activity is important to evaluate while assessing loads of shoulder in hand mobilities. Methods : Thirty(15 male, 15 female) college students with unknown shoulder dysfunction participated subject in five different positions of elbow extension with sitting and standing posture, different positions is followed : (1) shoulder $0^{\circ}$ flexion (2) shoulder $45^{\circ}$ flexion (3) shoulder $90^{\circ}$ flexion (4) shoulder $135^{\circ}$ flexion (5) shoulder $180^{\circ}$ flexion. Results : On the average, in the hand grip strength, the standing posture is higher than sitting posture. Sitting posture showed a most high level at the man's $0^{\circ}$ and woman's $135^{\circ}$. And standing posture showed a most high level at the man's $135^{\circ}$ and woman's $90^{\circ}$. Conclusion : The paired t-test was used to determine the different in grip strength between sitting and standing posture by shoulder angle change. There was no significant difference between the five position by sitting and standing posture. In man, correlation analysis revealed significant connection for all five position by sitting and standing posture. And in woman, correlation analysis revealed connection for all five position by sitting and standing posture.