• Physical Therapy Korea
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• v.27 no.3
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• pp.191-198
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• 2020

Background: Stroke patients experience multiple dysfunctions that include motor and sensory impairments. Therefore, new intervention methods require a gradational approach depending on functional levels of a stroke patient's activity and should include cognition treatment to allow for a patient's active participation in rehabilitation. Objects: This study investigates the effect of integrated revision of electrical sensory stimulation, which stimulates somatosensory and action observation training, which is synchronized cognition intervention method on stroke patients' functions. Methods: Twenty-one stroke patients were randomized into two groups. The two groups underwent twenty minutes of intervention five times a week for three weeks. This study used an electromyogram to evaluate symmetric muscle activation of lower extremities and muscle onset time when performing sit to stand before and after intervention. A weight-bearing ratio was used to evaluate the weight-bearing of the affected side in a sit to standing. To evaluate sit to stand performance ability, this study performed five timed sit to stand tests. Results: The two groups both showed statistically significant improvement in muscle onset time of lower extremity, static balance ability in a standing position, and sit to stand performance after the intervention (p < 0.05). In addition, the action observation and synchronized electrical sensory stimulation group showed significant improvement in symmetric muscle activation of lower extremities and weight-bearing ratio of the affected side (p < 0.05). Conclusion: action observation and synchronized electrical sensory stimulation (AOT with ESS) can have positive effects on a stroke patient's sit to stand performance, and the intervention method that provides integrated AOT with ESS can be used as new nervous system intervention program.

• PNF and Movement
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• v.17 no.2
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• pp.275-282
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• 2019

Purpose: This study aimed to investigate the optimal positions of safety grab bars for effective sit-to-stand (STS) movement by comparing the results of the STS movement while using a safety grab bar installed under two different conditions: the height of the grab bar installation was determined by (1) the Building Act and (2) the principle of proprioceptive neuromuscular facilitation (PNF). Methods: A total of 50 undergraduate students participated in this study, and they were required to perform an STS movement twice under each condition. A baropodometric platform for sitting and a Biorescue (RM Ingenierie, France) were used to collect and analyze changes in the center of pressure (COP) on the left and right sides before and after performing the STS movement. The average completion time for the STS movement was also measured for analysis. Moreover, the participants were asked to express their individual subjective preferences regarding the two positions of the grab bars. Results: The COP changes were significantly smaller when performing the STS movement with the grab bar installed at the height determined by the PNF principle than the Building Act (p<0.01), and the difference in the completion time of the STS movement was not statistically significant between the two conditions. Conclusion: The findings of this study suggest that the principle of PNF can be useful for planning therapeutic exercise as well as for proposing the optimal grab bar position for older adults and those with health-related issues when performing the STS movement. In addition, this may serve as a basic rehabilitation technique for maintaining remaining functions and providing functional efficiency.

• PNF and Movement
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• v.16 no.2
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• pp.295-300
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• 2018

Purpose: This study aimed to determine whether the abdominal muscles, which are the major lumbar stabilizers along with the respiratory muscles, are affected by smoking. We compared abdominal muscle activity between smokers and non-smokers during the sit-to-stand movement. Methods: A total of 28 healthy adult males (14 smokers and 14 non-smokers) in their 20s-30s voluntarily participated in the study. The subjects performed the sit-to-stand movement, and then their abdominal muscle activity was measured. The surface electromyography system was employed to measure the maximal voluntary isometric contraction (MVIC) values of the subjects' rectus abdominis, external oblique abdominal, internal oblique abdominal, and transversus abdominis muscles. Then, the values were quantified into %MVIC. Results: The activity of the rectus abdominis muscle was higher in the smokers than in the non-smokers. Conversely, the activity of the internal oblique abdominal and transversus abdominis muscles, which are deep abdominal muscles, was higher in non-smokers than in smokers, but the difference was not statistically significant. Conclusion: Smoking can inhibit the activity of smokers' deep abdominal muscles and increase the activity of their superficial muscles, thus making it detrimental to their musculoskeletal system.

• Journal of Biomedical Engineering Research
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• v.34 no.4
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• pp.197-203
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• 2013

The purpose of this study was to analyze the asymmetry of the reaction forces on lower limbs between dominant and nondominant sides during sit-to-stand movement in normal subjects. Fourteen normal subjects ($22.6{\pm}2.3yrs$, all men) participated in this study. To measure the reaction forces during sit-to-stand movement, two force plates were mounted on the ground and one dual top force plate was mounted on a chair. Five events(movement onset, max thigh reaction force, transition, max hip angle, seat off) were determined from the reaction force and joint angle trajectories. For each of thigh, foot, and total reaction forces, two-way ANOVA was performed with the events and sides as factors. Also investigated was the leg asymmetry expressed as the ratio of the reaction forces of dominant and nondominant sides. The significance of asymmetry was investigated and two-way ANOVA was performed with the events and body parts(foot, thigh and total) as factors. Thigh reaction force and total reaction force showed interaction of events and leg sides(p < 0.01). Post-hoc comparisons showed they were different between sides at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Asymmetry was also significant at the latter stage(transition, max hip angle, and seat off events) (p < 0.01). Interaction of events and body parts on asymmetry was significant(p < 0.01) and asymmetry was greater in thigh reaction forces than total and foot reaction forces at the events of the latter stage(p < 0.01). The results suggest that asymmetry exist in normal subject and should be fully considered when investigating sit-to-stand strategy of patients.

• Physical Therapy Korea
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• v.10 no.2
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• pp.11-22
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• 2003

The purpose of this study was to analyze the effects of three different pelvic tilts on a sit-to-stand (STS) and to suggest a new assessment approach based on biomechanical analysis. The three difrent pelvic tilts were: (1) comfortable pelvic tilt sit-to-stand (CPT STS), (2) posterior pelvic tilt sit-to-stand (PPT STS) and (3) anterior pelvic tilt sit-to-stand (APT STS). To determine the onset time of muscle contraction surface electrodes were applied to the rectus femoris muscle (RF), vastus lateralis muscle (VL), biceps femoris muscle (BF), tibialis anterior muscle (TA), gastrocnemius muscle (GCM), and soleus muscle (SOL). The ICC was used for functional linkage analysis. The findings of this study were as follows. First, significant differences were found in kinematic variables and in muscle activation pattern among the three activities. Second, the results of functional integrated analysis revealed that recruited muscle activation patterns changed when the thigh-off was viewed as a reference point. Third, there were independent functional units between the thigh-off and the VL and between the thigh-off and the RF in the functional linkage analysis. The VL and RF acted as prime mover muscles, and more postural adjustment muscle recruitment was required as the demand of postural muscle control increased (PPT STS, APT STS, and CPT STS in order). In conclusion, the findings of this study suggest the following evaluative and therapeutic approach for STS activity. APT STS can be introduced for movement efficiency and functional advantage when abnormal STS is treated. However, excessive APT would change the muscle activation patterns of BF and SOL and require additional postural muscle control to cause abnormal control patterns.

• PNF and Movement
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• v.21 no.2
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• pp.223-229
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• 2023

Purpose: Assessing physical strength and muscle mass is crucial, but many methods rely on specialized equipment, which can be challenging. In situations where a quick and straightforward test is needed, the sit-to-stand test (STST) proves useful. Although several studies have investigated STST and muscle mass separately, the actual correlation between these two factors has not been extensively researched. Hence, the objective was to comprehensively investigate the correlations between the different tests. Methods: The study participants consisted of 20 healthy young men in their 20s. In this study, measurements were taken for muscle mass, the five-times sit-to-stand test, the 30-second sit-to-stand test, and the 1-minute sit-to-stand test. The results of each test were analyzed using Pearson's correlation analysis. Results: Although no significant correlation was found between muscle mass and STST, interestingly, significant correlations were observed among the different types of STST. Conclusion: The STST is a rapid and straightforward test used to assess lower limb strength and balance ability in individuals. However, there is a dearth of research on STST conducted in domestic settings. Based on the findings of this study, further research is necessary to establish age- and gender-specific reference values for STST. This will allow its broader application, encompassing not only older adults and patients but also healthy individuals.

• 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.

• PNF and Movement
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• v.15 no.1
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• pp.85-96
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• 2017

Purpose: Peripheral neuropathy accompanied by sensory disturbance, such as limb paralysis and hemiplegia, is mainly caused by acute disseminated encephalomyelitis (ADEM). This case study aimed to determine the effect of ankle strengthening exercises that use proprioceptive neuromuscular facilitation (PNF) on the gait, balance, ankle-control ability, and sit-to-stand ability on a patient with ADEM. Methods: A 10-year-old male with quadriplegia and ankle-control impairment participated in this 4-week training intervention. The patient, diagnosed with ADEM, was treated with ankle strengthening exercises that used PNF. Results: The patient demonstrated improvements in balance, ankle-control ability, sit-to-stand ability, and gait performance. Outcome measures (manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5 time sit-to-stand test, and 10 m walk test) were taken before and after the training program. Conclusion: The results of this case suggest that an ankle strengthening exercise that uses PNF can improve the gait, balance, ankle-control ability, and sit-to-stand ability in patients with ADEM. In ADEM, the initial treatment is important, and the use of ankle strengthening exercises with PNF could lead to meaningful results. However, there is limited research due to an insufficient number of cases. In the future, more patients will need to be studied.

• PNF and Movement
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• v.9 no.4
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• pp.41-48
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• 2011

Purpose : The purpose of this study was to assess the tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity of tibialis anterior, soleus, gluteus maximus, transverse abdominis according to pronated foot and supinated foot. Methods : Group of pronation and supination were taped using augmented low-day method to make pronated and supinated foot the three case were assessed by agnostic radiology for investigating foot structure. Results : 1) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in one step. 2) When supinated foot & pronated foot, soleus & transverse abdominis muscle activity was decreased in one step. 3) When supinated foot & pronated foot, tibialis anterior & gluteus maximus muscle activity was augmented in squat. 4) When supinated foot & pronated foot, soleus muscle activity was decreased in squat. 5) When pronated foot, transverse abdominis muscle activity was decreased in squat. 6) When supinated foot, transverse abdominis muscle activity was augmented in squat. 7) When pronated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was augmented in sit to stand. 8) When supinated foot, transverse abdominis & gluteus maximus & tibialis anterior muscle activity was decreased in sit to stand. 9) When supinated foot & pronated foot, soleus muscle activity was decreased in sit to stand. Conclusion : 1) Pronated foot & supinated foot effects on soleus, gluteus maximus, transverse abdominis muscle activity in one step. 2) Pronated foot & supinated foot effects on tibialis anterior, gluteus maximus, transverse abdominis muscle activity in squat. 3) Pronated foot & supinated foot effects on soleus, transverse abdominis muscle activity in sit to stand. Therefore we suggest the deformity of the foot effects on tibialis anterior, soleus, gluteus maximus, transverse abdominis muscle activity.

• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.1-5
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• 2011

Purpose: The purpose of this study was to investigate changes in muscle activation associated with foot position during a sit-to-stand exercise among normally healthy elderly subjects. Methods: Eight subjects (male=3; female=5; mean age=$70.13{\pm}{\pm}2.53$years) were recruited.The activation of six muscles (neck extensor; lumbar extensor; hamstring; rectus femoris; gastrocnemius; tibialis anterior) was measured by surface EMG (TeleMyo 2400T G2, Noraxon Inc., USA) during a sit-to-stand protocol under three different foot positions (ankle dorsiflexion of 0, 15, or 30 degrees). Results: Muscle activation of the neck extensor and hamstring was decreased according to the change in foot position (p<0.05), but activation of the rectus femoris was increased (p<0.05). Muscle activation of the neck extensor was significantly different between 0 and 15 degrees (p<0.05). Muscle activation of the hamstring was significantly different between 0 and 15 degrees and between 0 and 30 degrees (p<0.05). Muscle activation of the rectus femoris was significantly different between 0 and 30 degrees and between 15 and 30 degrees (p<0.05). However, activation of lumbar extensor, gastrocnemius and tibialis anterior muscles did not significantly differ between foot positions. Conclusion: These findings suggest that muscle activation during a sit-to-stand movement differs depending on foot position. We believe that these differences should be considered when educating the elderly regarding proper body movements.