• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.2
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• pp.169-184
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• 1999

The purpose of this study was to identify the effects of breathing biofeedback training on the stress of nursing students in clinical practice. The research design was a nonequivalent control group pretest-posttest design. The subjects of this study were 39 nursing students from the College of Nursing of K University. The study was conducted from July 20 to September 3, 1998. The subjects were assigned to one of two groups : the experimental group (19 students), and the control group (20 students). The breathing biofeedback training was performed 12 times with the experimental group. The level of psychological stress was measured using the State Anxiety Inventory, Profile of Mood State, and Visual Analogue Stress Scale. The level of physiological stress was measured using pulse rate and blood pressure. The data were analyzed using descriptive statistics, $x^2-test$, t-test, and repeated measures of ANOVA. The results of study are as follows : 1) State anxiety scores were not significantly different between the experimental group and the control group after the biofeedback training. 2) Profile of mood state scores were not significantly different between the experimental group and the control group after the biofeedback training. 3) Visual Analogue Stress Scale scores were significantly different between the experimental group and the control group after the biofeedback training(F=11.68, p=0.002). 4) Pulse rates were not significantly different between the experimental group and the control group after the biofeedback training. 5) Systolic blood pressures were significantly different between the experimental group and the control group after the biofeedback training(F=5.44, p=0.025). 6) Diastolic blood pressures were not significantly different between the experimental group and the control group after the biofeedback training. On the basis of the above findings, the following recommendations for further study are made ; 1) Identification of the effects of breathing biofeedback training at times of high stress during clinical practice. 2) Identification fo the effects of stress reduction according to the frequency of the breathing biofeedback training.

• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.59-68
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• 2015

PURPOSE: The purpose of this study was to determine the comparison of visual and auditory biofeedback during sit-to-stand training in patients with stroke. METHODS: Thirty-five subjects with chronic stroke were divided into three groups: a visual feedback group (12 subjects), an auditory feedback group (12 subjects) and a control group (11 subjects). All Groups received neurodevelopmental treatment, and sit-to-stand training for 30minutes three times a week for four weeks. During the sit to stand training, the experimental groups received visual feedback and auditory feedback, whereas the control group performed sit-to-stand training without feedback. Five times sit-to-stand test (FTSST), motion analysis and postural sway during sit-to-stand were used to evaluate sit to stand performance ability. In addition, Berg balance scale (BBS) was performed for evaluation of balance function in participants. RESULTS: All groups showed significant increase on FTSST and BBS between pre- and post-intervention. The BBS scores in visual feedback group was significant increase than control group. The motion analysis and postural sway, more improvement was observed in the visual and auditory feedback groups compared with the control group. The only visual feedback group was a better performance of midline excursion during sit-to-stand than control group. CONCLUSION: These findings suggest that sit-to-stand training using a biofeedback may help to improve sit to stand performance and balance ability of stroke patients.

• Physical Therapy Korea
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• v.17 no.3
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• pp.1-10
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• 2010

The purpose of this study was to measure intra-rater and inter-rater reliability and range of motion for measurement of passive shoulder internal rotation range of motion and to compare anterior glide distance of humeral head in three methods. Fifty healthy subjects and fifty patients with shoulder musculoskeletal pain were recruited for this study. The subjects' passive shoulder internal rotation range of motion was measured by visual estimation, manual stabilization, and pressure biofeedback unit methods. In two trials, measurements were performed on each subject by two examiners. Intraclass correlation coefficient (ICC(3,1)) was used to determine the reliability of each measurement. The intra-rater reliability of the three methods was excellent (ICC=.77~.93) in both groups. The inter-rater reliability of the visual estimation method was poor (ICC=.20, .29), the manual scapular stabilization method was poor and fair (ICC=.09, .50), and the pressure biofeedback unit method was excellent (ICC .86, .75) in the experimental and control groups. In the experimental group, the difference of examined range of motion by each examiner was significant in the visual estimation method and manual scapular stabilization method, but there was an insignificant difference between the groups is the pressure biofeedback unit method. This result suggests that the intra-rater and inter-rater reliability of a pressure biofeedback unit was better than the other methods. The difference in distance of the anterior glide of humeral head was insignificant among all the methods. The pressure biofeedback unit method was the most reliable method, so it is proposed to be a new and reliable method to measure internal rotation range of motion.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Journal of Korean Academy of Medicine & Therapy Science
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• v.10 no.2
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• pp.5-11
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• 2018

Objective: The purpose of the present study is to investigate whether intensive ankle training using biofeedback to increase proprioceptive senses and ankle-joint muscle strength effectively improves the balance of normal adults. Method: This study included 20 voluntary participants with normal adults. The subjects were randomly divided into 2 groups: the biofeedback intensive ankle training group (n=10) and the ankle training group (n=10). The biofeedback group used a visual biofeedback program. Subjects of the group that underwent ankle training only tried to keep their bodies balanced as well as possible on an Aero-Step. Both groups performed the exercise equally for three 30-minute sessions weekly for six weeks. The differences between the measurements before and after the experiment were analyzed using Wilcoxon signed-rank tests. Mann-Whitney U tests were used to analyze the differences in variations between the groups. Results: The biofeedback group showed significant differences in the weight distributions A, B, C, D, LEFT, and HEEL and on the weight-distribution index. In contrast, the ankle training group showed significant differences in the weight distributions A, C, and LEFT. A comparison of the differences between the two groups found significant differences between them in the weight distributions A, B, C, D, LEFT, and HEEL. Conclusion: The biofeedback group showed a greater ability to control weight distribution. A longer experimental period involving more subjects would aid in developing exercise programs that are more diverse.

• Physical Therapy Korea
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• v.18 no.1
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• pp.1-8
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• 2011

Push-up plus has been advocated for increasing the activity of the serratus anterior muscle, the most critical scapular stabilizer. However, no previous study has reported the possibility of compensatory motion on the part of the pectoralis major, which could substitute for the action of the serratus anterior during push-up plus. The aim of the current study was to investigate the immediate effect of electromyography (EMG) biofeedback of the pectoralis major muscle on the pectoralis major, upper trapezius, and serratus anterior muscles during push-up plus. Fourteen healthy young subjects voluntarily participated in this study; each subject performed push-up plus from the quadruped position, in two conditions (i.e., with or without visual and auditory biofeedback). Surface EMG was used to measure pectoralis major, serratus anterior, and upper trapezius activity. A paired t-test was used to determine any statistically significant difference between the two conditions. Additionally, effect size was calculated to quantify the magnitude of EMG biofeedback in each muscle. Visual and auditory feedback reduced pectoralis major muscle activity significantly (p=.000) and increased the serratus anterior muscle activity significantly (p=.002), but did not induce a significant difference in upper trapezius muscle activity (p=.881). Thus, it is concluded that the visual and auditory feedback of pectoralis major muscle activity can be used to facilitate serratus anterior muscle activity during push-up plus.

• The Journal of Korean Physical Therapy
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• v.25 no.6
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• pp.411-416
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• 2013

Purpose: The purpose of the present study was to determine the effects of activation of gluteus maximus (Gmax) and abdominal muscle using EMG biofeedback on lumbosacral and tibiocalcaneal angles in standing position. Methods: Fourteen healthy subjects with normal feet participated in the present study. Electromyographic (EMG) biofeedback using visual cue was used to activate the external oblique (EO) and Gmax. The lumbosacral and tibiocalcalcaneal angles were measured by electronic goniometers. All the subjects were instructed to activate the Gmax and EO monitoring increasing amounts of the muscle activities in each muscle. The lumbosacral and tibiocalcaneal angles were collected in three trials during resting and activation of each muscle using EMG biofeedback in standing position. The mean value of three trials was used in the data analysis. A paired-t test was used to compare the lumbosacral and tibiocalcaneal angles between resting and activation of the Gmax and EO using EMG biofeedback. Results: The lumbosacral and tibiocalcaneal angles were significantly less in the resting compared to activation using EMG biofeedback (p<0.05). Conclusion: The activaition of Gmax and abdominal muscles using EMG biofeedback play role to control the pronation of subtalar joint during the weight-bearing.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.111-119
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• 2019

PURPOSE: The aim of this study was to determine how biofeedback training with Shaker exercise effects the activation of the cervical myocardial muscle in stroke with swallowing disorder. METHODS: From June 2018 to September 2018, 30 patients who were hospitalized at C hospital and K hospital in Daegu, and K hospital in Gumi were surveyed to meet the criteria for selection. The participants were classified into three groups, and Shaker exercise was applied three times a day, five times a week, for four weeks; visuoauditory biofeedback group (VABG), visual biofeedback group (VBG), and self-exercises group (SG). In addition, the suprahyoid muscle activity was performed three times (before intervention, after intervention, and after two weeks). RESULTS: The pre and post-test comparisons, revealed a significant difference between the three groups (p<.01); VABG had the highest suprahyoid muscle activity. The post-test and follow-up test produced similar results in, the three groups (p>.05). The mean comparison showed the smallest difference in VABG, indicating that muscle persistence was the best. CONCLUSION: Shaker exercise has an effect on suprahyoid muscle activation. Biofeedback training, which provides an input of multi-sensory information in swallowing disorder treatment is recommended because it has the greatest effect when combined with visuoauditory biofeedback.

• Archives of Plastic Surgery
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• v.38 no.6
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• pp.867-870
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• 2011

Purpose: The authors would like to introduce two patients who presented with velopharyngeal inadequacy. We emphasize the importance of nasaopharyngeal endoscopy in evaluating the velopharyngeal function and the usefulness of biofeedback trial therapy. Methods: Two patients visited our clinic due to velopharyngeal inadequacy. Both of the patients showed hypernasality, nasal emission and compensatory articulation such as glottal stop. During oral examination and nasopharyngeal endoscopy both showed no evidence of structural deformities. One inconsistently showed a small gap during articulation. The other showed a rather large gap during compensatory articulation. Both received a simultaneous biofeedback trial therapy using the nasopharyngeal endoscope. Results: Both patients were successfully diagnosed and treated at once using biofeedback trial therapy with nasopharyngeal endoscopy. By giving direct visual feedback to the patient, they were both able to achieve complete velopharyngeal closure during production of 2~3 nonsence syllables and hypernasality was not detected in both of them. Conclusion: The authors were able to help patients with velopharyngeal inadequacy to have velopharyngeal closure through biofeedback trial therapy. The accurate evaluation of velopharyngeal function and the possibility of closure prevented unnecessary operations.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.1
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• pp.27-36
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• 2019

Purpose : The purpose of this study figures out how the biofeedback exercise combined with a Shaker exercise and a jaw-opening exercise affects the suprahyoid muscle activation of stroke with a swallowing disorder. Methods : The study period was from June, 2018 to September, 2018, to 45 patients who were suitable for selection criteria. Participants were divided into three groups: a visuoauditory biofeedback group (VABG), and a visual biofeedback group (VBG), and a self-exercise group (SG). The three groups were divided into the Shaker exercise and the jaw-opening exercise, and the biofeedback training by themselves. Three groups performed an intervention three times a day, five times a week, and four weeks long. Also, suprahyoid muscle activity was measured with a pre-test, a post-test and a follow-up test. Results : To know the suprahyoid muscle activity after the intervention, there were statistically significant differences between the pre-test and the post-intervention (p< .01). All three groups showed the improvement with the mean comparing followed by VABG, VBG and SG. Comparing between the post- test and the follow-up test, all three groups showed the reduction of suprahyoid muscle activity with the mean comparing, followed VABG, VBG and SG. Conclusion : It found that it was more effective when providing a double-sensory biofeedback than when training with a single-sensory biofeedback. Therefore, it is necessary to provide a multi-sensory input when applying the biofeedback in rehabilitation of the swallowing disorder.