• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.62-71
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• 2023

Objective: Stroke patients need the training to adjust their posture and maintain balance is necessary to restore movement function, and unstable support training is one of the appropriate training. In this study, a systematic review and meta-analysis were conducted to find out the effects of unstable surface training on balance and gait in stroke patients. Design: Systematic review and meta-analysis Methods: After creating a search expression referring to MeSH and EMTREE, the literature from 1976 to February 2022 was searched in the databases of PubMed, EMBASE, and Cochrane Library CENTRAL. A total of 331 studies were searched from three databases, and 11 studies were finally selected according to the inclusion criteria. Unstable surface training included studies using balance trainer, Whole-body vibration, and sand surfaces. Results: The results were found to be d=2.28 (p=0.02) and the effect size was 0.36 (95% CI: 0.05, 0.67) on the Berg Balance Scale. In the Kinesthetic Ability Trainer static balance, d=2.59 (p=0.01) and the effect size was 1.01 (95% CI: 0.24, 1.78). Timed Up and Go test showed that d=2.18 (p=0.03) and the effect size was 0.38 (95% CI: 0.04, 0.72). At the gait speed, d=0.99 (p=0.32) and the effect size was 0.15 (95% CI: -0.15, 0.45). In the 6-minute walk test, d=0.14 (p=0.89) and the effect size was 0.04 (95% CI: -0.47, 0.55). Conclusions: In this study was found that training was effective in balance if it became unstable in standing posture. Therefore, unstable surface training can be used to improve the balance of stroke patients in clinical practice.

• Journal of Korean Neurosurgical Society
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• v.29 no.1
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• pp.78-86
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• 2000

Objective : Lumbar spinal instability occurs when normal biomechanics support in lumbar vertebrae interrupted. Despite the recent enthusiastic studies, the precise radiological assessment has not been fully established, yet. Therefore, we carefully studied our cases to analyze the radiologic findings in lumbar spinal instability. Patients and Methods : We have put together radiological analysis and assessment based on 38 patients who have been diagnosed and treated for lumbar spinal instabilities from June 1994 to December 1998, Patients who have been diagnosed and treated for trauma were excluded from study. Results : The outcomes are as follows : 1) Lumbar lordotic curve was statistically significant in unstable group by 23.7, compared to the control group ($17.0^{\circ}$). 2) According to the resting x-ray, sagittal plane angulation measured on unstable group was $21.1^{\circ}$, control group $18.0^{\circ}$. Therefore unstable group was noticeably higher(p<0.01). 3) According to the resting x-ray sagittal plane displacement, unstable group had 4.3mm, the comparison had 1.2mm. Therefore measurement from the unstable group were significantly higher(p<0.01). 4) According to stress view, sagittal plane translation was 4.1mm for the unstables and 2.7mm for the comparisons. Therefore unstables were noticeably higher(p<0.01). 5) According to stress view, sagittal plane rotation was $15.1^{\circ}$ at L3-4, $22.0^{\circ}$ at L4-5, $27.9^{\circ}$ at L5S1 for the unstable group and $11.3^{\circ}$, $18.1^{\circ}$, $21.0^{\circ}$ each for the comparison. 6) Facet angle for unstable group, left $29.3^{\circ}-61.5^{\circ}$, right $24.4^{\circ}-63.2^{\circ}$ and the mean for each are $43.1^{\circ}$, $47.2^{\circ}$. The difference between left and right facet angle was $3.5^{\circ}-20.7^{\circ}$ and the mean value $15.3^{\circ}$. Facet angle for the comparisons for the left was $29.3^{\circ}-59.5^{\circ}$, right was in between $25.7^{\circ}-64.5^{\circ}$ range and the each mean are $44.9^{\circ}$ and $47.6^{\circ}$. Also, the difference between left and right facet angle was $4.1^{\circ}-9.3^{\circ}$ and the average was $17.1^{\circ}$. The average and the difference between the left and right angle are found not to have statistic necessity for both unstable and stable measurements(p>0.01). 7) 19 patients were found to have vacuum facet phenomenon among unstable group etc. results were collected. Conclusion : According to above results, we attempted to prepare the application to the patient of radiological analysis and assessment for lumbar spinal instability early checkup.

• Journal of The Korean Association For Science Education
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• v.36 no.3
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• pp.423-434
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• 2016

The purpose of this study is to investigate preservice earth science teachers' mental models through applications of Coriolis force experiment apparatus. After the root of preconception was examined by face to face interviews based on the questionnaire, five preservice earth science teachers were finally selected for this study. The mental models about concept of Coriolis force was classified into naive mental model, static unstable mental model, dynamic unstable mental model, and scientific mental model through the result of individual interviews and their drawings. According to the mental model analysis about Coriolis' force conception, students C and M showed naive mental model about concept of Coriolis force before experiment. After the experiment, student M's model changed to static unstable mental model. Student C's model improved to dynamic unstable mental model. In adiition, students D and O's model improved from static unstable mental model to dynamic unstable mental model. In the case of student B, the dynamic unstable mental model was maintained after the experiment, however, student B's preconception changed to scientific concept. It turned out that a change occurred from low mental model level to integrated mental model after the application of the developed Coriolis' force experiment apparatus. According to the results, national curriculum is similar to static unstable mental model and the result of developed Coriolis' force experiment apparatus is similar to dynamic unstable mental model. It is suggested that it become the theoretical foundation to develop more comfortable and advanced Coriolis force experiment apparatus by improving the experiment apparatus.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.2
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• pp.71-82
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• 2005

The couple force of the scapular stabilizers for upward rotation that include the upper and lower trapezius, serratus anterior muscles is essential to maintain the stability of shoulder joint. But if there is an imbalance of these muscles, it would occur many problems of shoulder joint. A push-up plus exercise with an unstable support is used in order to increase the muscle activity and stimulate the proprioception of shoulder joint. The purpose of this study was to compare the muscle activity of upper and lower trapezius, serratus anterior muscles and to determine which exercise is more effective when subjects perform push-up plus exercise in the stable support and unstable support. 15 healthy subjects and 15 painful subjects with injury of shoulder joint participated in this study. Surface electromyography data were collected during plus phase of push-up plus exercise. The types of push-up plus exercise were composed of three conditions. Stable type is subjects performed the push-up plus exercise on the fixed support and unstable type 1 is on the sling without shaking and unstable type 2 is on the sling with shaking by tester's manual. The upper and lower trapezius activities of injured group were higher than uninjured group at three measure conditions, but serratus anterior activities were not. The UT/SA ratio of injured group was higher than uninjured group at three measure conditions. The serratus anterior activities were most high at unstable 2 measure in both groups. The UT/SA ratio was most low at unstable 2 measure condition in injured group only. The present result revealed that push-up plus exercise in the unstable support with shaking which took most high serratus anterior activities and most low of UT/SA ratio is optimal cure method that can improve the imbalance of the scapular stabilizer.

• Journal of the Korean Society for Precision Engineering
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• v.22 no.8 s.173
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• pp.192-198
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• 2005

In this paper, we propose a new training system for the improvement of equilibrium sense using unstable platform. The equilibrium sense, which provides orientation with respect to gravity, is important to integrate the vision, somatosensory and vestibular function to maintain the equilibrium sense of the human body. In order to improve the equilibrium sense, we developed the software program such as a block game, pingpong game using Visual C++. These training system for the equilibrium sense consists of unstable platform, computer interface and software program. The unstable platform was a simple structure of elliptical-type which included tilt sensor, wireless RF module and the device of power supply. To evaluate the effect of balance training, we measured and evaluated the parameters as the moving time to the target, duration to maintain cursor in the target of screen and the error between sine curve and acquired data. As a results, the moving time to the target and duration to maintain cursor in the target was improved through the repeating training of equilibrium sense. It was concluded that this system was reliable in the evaluation of equilibrium sense. This system might be applied to clinical use as an effective balance training system.

• PNF and Movement
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• v.15 no.3
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• pp.311-316
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• 2017

Purpose: Flatfeet are one of the risk factors of foot dysfunction and postural imbalance. The purpose of this study was to compare the limitation of stability (LOS) for the center of gravity (COG) between flatfeet and neutral feet on stable and unstable support surfaces. Methods: The study included 26 healthy, adult male participants: 14 with normal feet and 12 with flatfeet. The subjects were asked to incline the trunk maximumly to the left, right, anterior, and posterior directions and were asked to keep their feet on the floor with the knee extension. The subjects had 30 seconds of rest time between the tasks. The LOS (anterior, posterior, left, right) of COG was measured by Balance Trainer (BT4, Hur-labs, Tampere, Finland). An independent t- test was used to compare the LOS of COG between flatfeet and normal feet on stable and unstable support surfaces, respectively. Results: The LOS of the flatfeet group was generally decreased on stable support surfaces as compared to that of neutral feet, but it was not significantly different (p>0.05), while the LOS of the flatfeet group was significantly decreased compared to that of neutral feet on unstable support surfaces (p<0.05). Conclusion: This study suggested that the LOS of individuals with flatfeet may be decreased on unstable support surfaces and the postural balance of the flatfeet group may easily be disturbed on an unstable support surface.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.19 no.1
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• pp.63-68
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• 2013

Background: The purpose of this study is to examine the effects of unstable bridge exercise on the posture of female university students. Methods: The subjects of this study were 30 female university students who were equally and randomly allocated to a unstable bridge exercise group, an experimental group, and a stable bridge exercise group, a control group. Both did so for 30 minutes three times per week over a six-week period. Using BackMapper, their trunk inclination (TIN), trunk imbalance (TIM), pelvic position (PPO), pelvic torsion (PTO), pelvic rotation (PRO), and the position of their scapulae (PSA) were evaluated. Results: The unstable bridge exercise group obtained significant results in TIN, TIM, PPO, PTO and PSA, while the stable bridge exercise group obtained significant results in TIN, PPO. Conclusion: unstable bridge exercise may be applied as a method to correct the posture of average adults.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.133-137
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• 1999

Purpose: There are so many different methods with the their own advantages and disadvantages for acute AC dislocation and distal unstable clavicle fracture. We evaluated the usefulness of temporary Bosworth's coracoclavicular fixations using the cannulated screw and reviewed our clinical results. Materials and Methods: We evaluated 34 cases of temporary coracoclavicular fixations with cannulated screw and washer for acute AC dislocation(25cases in the Type V, Ⅲ) and distal unstable clavicle fracture(9cases in the Type ⅡB, Ⅱ+Ⅲ). All cases were fixed by the same techniques, guided cannulated screw under C-arm after the repair of the CC ligament within 1 week. Bases on the regular check, screws were removed at the 6-12 weeks under local anesthesia. The final clinical and radiological results(average 14 months follow-up) were rated with the UCLA scale. Results : All shoulders were gained nearly full ROM passively at the 3-4 weeks. The overall satisfactory resuIts(excellent or good) were achieved 88%(22/25) in the acute AC dislocation and all in the distal unstable clavicle fracture. There were no definite complications except three initial fixations loosening. Conclusion: Temporary Bosworth's coracoclavicular fixation using the cannulated screw with guided pin was simple precedure and provided enough initial stability for acute AC dislocation and distal unstable clavicle fracture.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.2
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• pp.93-104
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• 2013

Purpose : The purpose of this study is balanced exercise program according to the supporting surface any affect women's ability to balance high heels. Methods : This study subjects were normal 20 females in their twenties. They were divided into stable supporting surface(n=10), unstable supporting surface(n=10), and they exercised three times a week for 5 weeks. In order to compare the difference of balance, the subjects were measured before and after training. Balance was examined using the balance master 7.0 version systems. Results : 1. There was significant difference values between pre-exercise and post-exercise of unstable surface group on the FORM-EO and FORM EC of MCTSIB and all of Unilateral Stance variables. 2. There was significant difference values between pre-exercise and post-exercise of stable surface group on the mean EPE, mean MXE, and mean DCL of LOS. 3. There was significant difference values between pre-exercise and post-exercise of unstable surface group of the rhythmic weight shift. 4. There was significant difference value in the slow directional control of rhythmic weight shift between groups after exercise. Conclusion : Training on stable supporting surface group and unstable supporting surface group improve balance.

• PNF and Movement
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• v.16 no.1
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• pp.125-132
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• 2018

Purpose: The aim of this study was to investigate the isolated activation ratio of the quadriceps femoris muscle on different support surfaces during squat exercise. Methods: Twenty participants (10 males and 10 females) voluntarily agreed to participate in the research after receiving an explanation about the purpose and process of the study. Each participant performed squat exercises on three different support surfaces (a flat surface, a form roller, and an unstable surface). Muscle activities of the rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) were measured by electromyography. The isolated activation ratio of the quadriceps femoris muscle was calculated using the %isolation formula. Results: For the squat exercise, the %isolation value of the VM was significantly higher on the unstable surface than on the flat surface and form roller. In contrast, the %isolation values for the RF for the squat exercise were significantly higher on the flat surface and form roller than on the unstable surface. There was no significant differences in the %isolation values of the VL on the three different surfaces. Conclusion: The findings indicate that squat exercise on different surfaces results in differential activation of the quadriceps femoris muscle, which suggests that squat exercise on a multi-directional unstable surface could increase the isolated activation ratio of the VM.