• Physical Therapy Korea
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• v.26 no.4
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• pp.35-41
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• 2019

Background: Obstacle training affects lower limb muscle activity, balance, reducing the risk of falls, and making gait more stable. Objects: This study aimed to investigate the effects of aquatic and ground obstacle training on balance and muscle activity in patients with chronic stroke. Methods: The study subjects included 30 patients with stroke, who were divided into aquatic ($n_1=15$) and ground ($n_2=15$) groups. Groups underwent obstacle training three times per week, 30 min per session, for six weeks that went as follows: walking over sites with the paralyzed leg, stepping onto and down from a box step, and walking over obstacles with the non-paralyzed leg. Results: The experimental results were obtained by comparing muscle activity. Activity of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius were significantly increased in the aquatic group (p<.05). Activity of the biceps femoris and tibialis anterior were significantly increased in the ground group (p<.05); however, the rectus femoris and gastrocnemius were not significantly different. In the comparison of maximal distance regarding the limits of stability, it was significantly increased on the non-affected side, affected side, and anterior and posterior distance in the aquatic group (p<.05). It was significantly increased in the non-affected side and anterior and posterior distance the ground group (p<.05); however, maximal distance on the affected side distance was not significantly different. Conclusion: Gait training with aquatic and ground obstacles is effective for improving balance and gait ability of patients with stroke. However, it was more effective for the aquatic group than for the ground group.

• Physical Therapy Korea
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• v.16 no.2
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• pp.9-15
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• 2009

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.131-138
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• 2019

PURPOSE: This study examined the effects on muscle activation and ankle instability following sudden ankle inversion of the closed kinetic chain exercise using visual feedback to evaluate chronic ankle instability in adult males. METHODS: In this study, 28 subjects with chronic ankle instability were recruited and randomly divided into a closed kinetic chain exercise using a visual feedback group(n=13) and an open kinetic chain exercise group(n=15). Each group underwent 30 minutes of exercise three times a week for 8 weeks. The electromyographic(EMG) values of the rectus femoris, biceps femoris, tibialis anterior, peroneus longus, peroneus brevis, and lateral gastrocnemius muscles were measured to analyze muscle activity. The Cumberland ankle instability tool(CAIT) was used to measure ankle instability. RESULTS: Both groups showed improvements in tibialis anterior, peroneus longus and CAIT score(p<.05). In the experimental group, there were significant improvements in the rectus femoris, biceps femoris, and lateral gastrocnemius muscle activation(p<.05). CONCLUSION: The results suggest that closed kinetic chain exercise using visual feedback can be a useful treatment method for patients with chronic ankle instability.

• Korean Journal of Applied Biomechanics
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• v.21 no.2
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• pp.207-213
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• 2011

The purpose of this study was to investigate changes in elastic properties of tendon structure of human ankle dorsiflexor following eccentric exercise. Six male subjects(age: $27.3{\pm}2.0$ years, height: $180.3{\pm}1.4$ cm, weight: $82.6{\pm}5.3$ kg) and three female subjects(age: $26.7{\pm}2.9$ years, height: $170.0{\pm}4.2$ cm, weight: $66.6{\pm}1.4$ kg) performed a single bout eccentric exercise consisting of 120 repetitions of maximum eccentric contractions. Prior to and following the eccentric exercise, isometric ankle dorsiflexion strength along with longitudinal ultrasound image of the tibialis anterior(TA) were collected. Muscle strength decreased about 30% after eccentric exercise. From the muscle strength vs. aponeurosis elongation curve, we obtained an index of stiffness. Stiffness of deep aponeurosis of the TA was assessed and found to be decreased from $87.4{\pm}33.56$ N/mm to $73.1{\pm}23.52$ N/mm. The results of this study suggest that decrease in stiffness of the TA aponeurosis following eccentric exercise might have significant implications to functions of the muscle-tendon complex and the involved joint motion and provide better understanding of eccentric exercise in the fields of training and rehabilitation.

• The Journal of Korean Physical Therapy
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• v.23 no.1
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• pp.7-11
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• 2011

Purpose: Driving is essential to maintain independent living status in modern times. Many patients want to know when they can drive again, but it's only possible if they have the ability to control lower extremity muscles. In this study, we compared the effects of velocity on onset time of lower extremity muscles during driving tasks. Methods: Twelve participants (5 male, 7 female) were enrolled. EMGs were used to test the onset time of lower extremity muscles; tibialis anterior, soleus, rectus femoris. To analyze the data, we used two way ANOVA. Results: According to brake pedaling velocity, there was a significant difference in brake response time (p<0.05). Further, when comparing the lower extremity muscles, there was a significant difference in onset time (p<0.05). The order of muscle recruitment was tibialis anterior, rectus femoris, and soleus for achieving maximal velocity, but the order was rectus femoris, tibialis anterior, soleus for achieving submaximal velocity. Conclusion: Brake pedaling velocity has significant effects on onset time of muscle contractions in the lower extremities. We suggested that a future study needs more subjects and more detailed research such as evaluat-ions of visuo-motor coordination and fine motor dexterity.

• PNF and Movement
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• v.20 no.2
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• pp.179-187
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• 2022

Purpose: The purpose of this study was to determine the asymmetrical difference between the use of leg muscles on the surgical and non-surgical sides during initial lower extremity ergometer exercise after unilateral knee arthroplasty. Methods: Twelve elderly patients diagnosed with degenerative arthritis of the knee and who underwent unilateral arthroplasty were included in this study. The leg length of each subject was taken into account when setting the application distance of the lower extremity ergometer. The same pedal resistance, strength, and speed were used for all the subjects. The total angle of use of the ergometer (360°) was analyzed by dividing it into an extension section and a flexion section. Using a surface electromyography system, the activities of the muscles of the surgical and non-surgical sides were converted into maximal voluntary isometric contraction (MVIC) and analyzed using the paired t-test. Results: When the activities of the muscles on the surgical and non-surgical sides were compared, it was found that the rectus femoris and biceps femoris had significant differences in the flexion and extension sections (p < .05), and that the tibialis anterior significantly differed in the flexion section (p < .05). There was no significant difference in the extension section of the tibialis anterior muscle, or in the flexion and extension sections of the gastrocnemius (p >.05). Conclusion: The results of this study confirm that the rectus femoris, tibialis anterior, biceps femoris, and gastrocnemius on the surgical side act in an opposite manner to those on the non-surgical side during pedaling in the same section.

• The Journal of Korean Physical Therapy
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• v.35 no.1
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• pp.24-30
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• 2023

Purpose: The purpose of this study was to investigate the effectiveness of the elastic compression stockings and Kinesio taping on muscle activity and mechanical properties in healthy women during the heel raise exercise that causes muscle fatigue. Methods: Participants were divided into the elastic compression stockings group (ESG, n=8), Kinesio taping group (KTG, n=8), and control group (CG, n=8). All participants performed the heel raise exercise to cause muscle fatigue. Muscle activity, stiffness, and the muscle tone of the gastrocnemius and tibialis anterior were measured before and after the heel raise exercise. Results: In the gastrocnemius, muscle activity was significantly increased after the heel raise exercise in both the ESG and KTG (p<0.05). There was a significant difference in the change in the gastrocnemius muscle activity between the groups (p<0.05). Post hoc analysis showed that the ESG exhibited a significantly greater change in gastrocnemius muscle activity than the CG (p<0.05). The muscle stiffness of the gastrocnemius was significantly decreased after the heel raise exercise in the ESG (p<0.05). The muscle tone of the gastrocnemius was significantly increased after the heel raise exercise in the control group (p<0.05). There were no significant differences in the change in the gastrocnemius stiffness and muscle tone between the groups (p>0.05). In the tibialis anterior, there were no significant differences in muscle activity, stiffness, and muscle tone between and within the groups (p>0.05). Conclusion: Our findings suggest that the use of elastic compression stockings and Kinesio taping during the heel raise exercise are beneficial and delay muscle fatigue in the gastrocnemius.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.562-565
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• 2013

The fact that flip-flops, one of many different types of unstable shoes, are light and relatively easy to put on, accounts for their popularity among people. But because flip-flops rely heavily on the support of a single thong between your first and second toes, they impose a huge amount of pressure onto lower leg. Thus in the following experiment we tried to examine the different effects of flip-flops and running shoes in terms of their effect on muscle activity and fatigue of tibialis anterior and gastrocnemius during walking. In order to measure an electromyogram we used Free EMG system. 10 men and 10 women in running shoes ran on treadmills for 15 minutes at 4.8km/h, 2 days later the same experiment was carried out, but this time, in flip-flops. p value turned out to be greater than .05 and thus there was no considerable difference between the effects of flip-flops and running shoes on muscle activity and fatigue during walking. Therefore we conclude that despite the fact that flip-flops are considered unstable, their effects on muscle activity and fatigue of tibialis anterior and gastrocnemius are negligible.

• Journal of the Korea Society of Computer and Information
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• v.26 no.5
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• pp.55-60
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• 2021

This study aims to investigate the effects of 4 weeks visual biofeedback training on the knee joint angle and muscle activities of lower extremity. The participants in this study were 15 volunteers with hyperextended knee. To improve the hyperextended knee, visual biofeedback training was used during 4 weeks. The training is an exercise to maintain the balance between the anterior weight bearing and posterior weight bearing of the plantar foot. The knee joint angle significantly increased and the muscle activity of tibialis anterior was significantly decreased after visual biofeedback training. It was confirmed that visual biofeedback training of correcting hyperextended knee through the information on the plantar pressure distribution has a therapeutic effect.

• The Journal of Korean Physical Therapy
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• v.35 no.5
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• pp.145-150
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• 2023

Purpose: This study examined the effects of ankle control training using neuromuscular electrical stimulation (NMES), leg muscle activation, and balance in stroke patients. Methods: Thirty-one stroke patients diagnosed with cerebral infarction and cerebral hemorrhage were selected for the study. The experimental group underwent ankle control training using NMES, while the control group applied NMES to the paretic tibialis anterior muscle for 30 minutes per session, five times a week for four weeks. The muscle activity changes were measured using surface electromyography, and balance parameters were evaluated using a functional reach test (FRT). Results: The intra-group comparison of the concentric muscle activity revealed improvements in the experimental group, including paretic tibialis anterior (TA) muscle (p<0.05), medial gastrocnemius muscle (MG) (p<0.01), and lateral gastrocnemius muscle (LG) (p<0.05), as well as MG (p<0.05), LG (p<0.05), soleus muscle (p<0.05) of the non-paretic side, and soleus muscle symmetry index (p<0.05). The intra-group comparison of the eccentric muscle activity showed improvements in the experimental group, including MG (p<0.01) and LG (p<0.01) of the paretic side, as well as MG (p<0.01), LG (p<0.01) of the non-paretic side, and LG symmetry index (p<0.01). The intra-group comparison of the functional reach test revealed significant differences in the test results in the experimental and control groups (p<0.05). Conclusion: Ankle control training using NMES had a positive effect on the changes in muscle activation and improved balance in patients with stroke.