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pISSN : 1975-311X / eISSN : 2287-7215

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2017, Vol.12, No.2

  • 1.

    The Effect of Transfer Modality, Temperature, and Application Time on Gastrocnemius Muscle Activation in Healthy People

    이영신 | Bae Seahyun | 2017, 12(2) | pp.1~8 | number of Cited : 2
    Abstract
    PURPOSE: The purpose of this study was investigate the changes of gastrocnemius (GCM) muscle activity by applying different hot and cold therapeutic modalities. METHODS: A total of 20 healthy subjects were enrolled into the study. We selected transfer modalities that are frequently used in clinical settings: conduction, radiation, and convection. We performed hot pack, ice pack, and infrared therapy for 10, 20, and 30 minutes. After each application, a break was taken between each day. In addition, we performed cryotherapy for 3 min (airflow rate = -6~-20℃). We measured muscle activity changes in the GCM muscle. RESULTS: For the conduction method, muscle activity significantly increased after ice pack therapy for 10 min and 20 min but decreased after hot pack therapy for 10 min and 20 min. For the radiation method, muscle activity significantly decreased after infrared therapy for 10 min and 20 min. For the convection method, muscle activity significantly increased after cryotherapy for 3 min and 10 min. There were no differences in the change of muscle activity in the conduction and radiation transfer method using heat. However, there were differences in the change of muscle activity in the conduction and convection transfer method with cold application. CONCLUSION: For a reduction in muscle activity, regardless of the transfer type, thermal application for 20 min would be effective. For an increase in muscle activity, cold pack application or cryotherapy for 20 min would be effective. This study could contribute toward therapeutic modality application in changing muscle activity.
  • 2.

    The Characteristics of Risk Factors in Korean CAD Patients Comparing to American Counterpart and Its Implications to Prevention of CAD

    KIM, WAN-SOO | 2017, 12(2) | pp.9~20 | number of Cited : 1
    Abstract
    PURPOSE: The purpose of this study is to understand the difference in the risk factors of coronary artery disease (CAD) between Korean and American CAD patients to determine the discriminant factor for each group, as well as to provide useful information to be reflected in the national concern of health. METHODS: Data were collected from 248 Korean and 107 American CAD patients who underwent either percutaneous coronary intervention or coronary artery bypass grafting. By using t-test and X²-test, risk factors were compared between the Koreans and Americans. To elucidate which risk factor was the most discriminant for each group, logistic regression analysis was performed. RESULTS: All risk factors, except diastolic blood pressure, showed a significant difference between the two groups. X²-test showed statistical significance with respect to the smoking rate between the female groups. Moreover, there was a statistically significant difference between the two groups regarding blood total cholesterol (TC) and triglyceride, and between the male groups, here was a statistically significant difference with respect to blood high-density lipoprotein cholesterol (HDL). Diabetes mellitus (DM) was the most discriminant factor for Korean patients while TC/HDL is the most discriminant for the Americans. CONCLUSION: The characteristics of CAD risk factors were determined to be different between Koreans and Americans in this study. TC/HDL was a discriminant factor for Americans while DM was a discriminant factor for Koreans. This result implies that DM should primarily be given attention to prevent CAD in Korean adults.
  • 3.

    Changes in Balance and Gait Following Backward Walking Exercise in Hemiplegic Stroke Patients

    신규현 | Kang, Soon-hee | 2017, 12(2) | pp.21~31 | number of Cited : 2
    Abstract
    PURPOSE: The purpose of this study was to identify whether backward walking exercise was more effective than conventional physical therapy for balance and gait in hemiplegic stroke patients. METHODS: Eighteen patients with chronic stroke were randomly assigned to the experimental (n=9) or control (n=9) group. The experimental and control group performed backward walking exercise and conventional physical therapy, respectively, for 8 weeks. Stability Index (SI) and Weight Distribution Index (WDI) during standing were assessed using the Tetrax Balance System. The Timed Up and Go (TUG) test and Korean version of the Berg Balance Scale (K-BBS) were used to evaluate balance and fall risk. Walking speed, stride length, and step length on the affected side were measured using the 10-Meter Walk and ink foot printing tests. Wilcoxon signed-rank and Mann-Whitney U tests were used for within- and between- group comparisons, respectively. RESULTS: The experimental group showed significantly higher changes in SI (p<.01), WDI (p<.01), TUG (p<.001), and BBS score (p<.001) following intervention compared with the control group. The experimental group also showed significantly greater improvements in walking speed (p<.01), stride length (p<.001), and step length on the affected side (p<.001) after intervention compared with the control group. CONCLUSION: Backward walking exercise is an effective intervention to improve balance and gait in hemiplegic stroke patients.
  • 4.

    The Immediately Effects of Thoracic Mobilization by Segment on Pain and Range of Motion in Chronic Low Back Pain Patients

    심재헌 | 정의철 | 최희양 and 1other persons | 2017, 12(2) | pp.33~42 | number of Cited : 1
    Abstract
    PURPOSE: This study aims to identify the immediate effects of thoracic mobilization according to segment on disabling low-back pain and the range of motion in patients with chronic low-back pain. METHODS: The participants were divided randomly into two groups: a group (N=12) with pain and disability between the 5th and 9th thoracic vertebrae (T5-T9) and a group (N=12) with pain and disability between the 10th and 12th thoracic vertebrae (T10-T12). The same experiment was conducted in both groups: 10 minutes of thoracic mobilization and 10 minutes of functional massage. The visual analogue scale (VAS) and range of motion measurements were applied to the participants in both groups. All participants were measured again immediately after the program was completed. RESULTS: In both groups, the VAS and range of motion measurements showed statistically significant improvement after the experiment (p<.05). No statistically significant difference was revealed between the two groups (p>.05). CONCLUSION: The results of this study confirmed positive and immediate effects of thoracic mobilization of patients with chronic low-back pain. But, no significant difference in the thoracic mobilization by segment between the two groups. Based on these results, thoracic mobilization could help to improve pain control and functional activity in patients with chronic low-back pain.
  • 5.

    Effect of Exercise with Functional Electrical Stimulation and Transcutaneous Electrical Nerve Stimulation on Muscle Tone, Stiffness of Calf Muscle, and Balance Ability in Patients with Stroke

    Park Sinjun | Kyun Hee Cho | 조용훈 | 2017, 12(2) | pp.43~52 | number of Cited : 5
    Abstract
    PURPOSE: This study aimed to compare the impact of exercise with that of functional electrical stimulation (FES) and transcutaneous electrical nerve stimulation (TENS) on muscle tone, calf muscle stiffness, and balance ability in patients with stroke. METHODS: Thirty patients with stroke were randomly divided into an FES group (n=15) and a TENS group (n=15), and a progressive task-oriented exercise was assigned to them. These exercises were performed non-synchronously from December 5, 2016 to January 31, 2017. Patients underwent TENS and simultaneously exercised for 30 minutes daily, 5 times a week for 4 weeks. To determine the effect of the interventions, muscle tone and stiffness of the medial and lateral region of gastrocnemius muscle were measured using the MyotonPRO instrument and balance was assessed using the Berg Balance Scale. RESULTS: Both groups revealed a significant decrease in muscle tone and stiffness of the medial part of gastrocnemius muscle before and after the interventions (p<.05). Berg Balance Scale scores increased significantly (p<.05). However, none of the other parameters were significantly different (p>.05). CONCLUSION: Our results prove that progressive task-oriented exercise along with FES and TENS decreases muscle tone and stiffness of the gastrocnemius muscle in patients with stroke and improves balance. TENS could serve as a complementary replacement for functional electrical stimulation for in-house training, as TENS poses less risk of muscle fatigue and has lesser contraindications than does functional electrical stimulation.
  • 6.

    Gluteus Medius Muscle Activities According to Various Angle of Mediolateral Ramp During Cross Walking and One-leg Standing

    Seon-Chil Kim | Lee Sang-yeol | 2017, 12(2) | pp.53~57 | number of Cited : 4
    Abstract
    PURPOSE: The purpose of study was to clear up the environmental risk factor that can be easily occurred unstability of hip during gait and one leg standing at various ramp angle. METHODS: Twenties healthy males of 69 subjects is participated in this study. Participants was measured activation on gluteus medius muscle during both conditions (walk across the ramp and one leg stand in the transverse direction) of seven different angle. The measured data were analyzed using one-way ANOVA to investigate the effect of muscle activation on the each condition. The statistical analyses were performed using SPSS ver. 18.0 and p-value less than .05 were considered significant for all cases. A post-hoc test was performed by Bonferoni method. RESULTS: The study showed that more muscle activities on gluteus medius is increased by increasing the ramp angle. Post-hoc analysis demonstrated that the peak and mean of muscle activity increased significantly with a ramp angle of 15° and 25° during gait and one-leg stand. CONCLUSION: According to the study results, impaired balance can be easily occurred when cross walk and one-leg stand on a ramp from higher than 15°, and highest risk was angle of 25° or more. As a people with gluteus medius muscle weakness walks a ramp, the ramp angle has a cross relationship with the impaired balance. If people with gluteus medius weakness walk on the more than 10° of ramp angle, they will need a lot of attention for prevent impaired balance.
  • 7.

    The Effect of Postural Control Training on Balance and Walking Ability in Patients with Chronic Stroke

    Dae-Hyouk Bang | 조혁신 | 2017, 12(2) | pp.59~66 | number of Cited : 3
    Abstract
    PURPOSE: The purpose of this study was to determine the effects of postural control training on balance and walking ability in chronic stroke patients. METHODS: Eighteen chronic stroke patients were allocated equally and randomly to an experimental group (n=9) or a control group (n=9). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received a postural control training for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held five times per week for three weeks. Balance was assessed using Berg balance scale (BBS) and walking ability (gait speed, cadence, step length, and double limb support) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant betweengroup difference on measured outcomes (p<.05). The experimental group exhibited greater improvement in the gait speed (p=.01; 95% CI .08-.16), cadence (p=.04; 95% CI .34-4.79), step length (p=.02; 95% CI 1.50-5.17), double limb support period (p=.04; 95% CI -2.18 to -.14), and BBS (p=.01; 95% CI 1.04-6.74) compared to the control group. CONCLUSION: The findings of this study suggest that postural control training may be beneficial for improving balance and walking ability of patients with chronic stroke.
  • 8.

    The Relationship between Sensory Processing Abilities and Gross and Fine Motor Capabilities of Children with Cerebral Palsy

    Park Myoung Ok | 2017, 12(2) | pp.67~74 | number of Cited : 1
    Abstract
    PURPOSE: The purpose of this study was to investigate the difference and relationship between sensory processing abilities, gross motor and fine motor capabilities in children with cerebral palsy. METHODS: 104 children with cerebral palsy participated in the study. Sensory processing abilities of the subjects were measured by Short Sensory Profile (SSP). Gross and fine motor abilities were each measured using the Gross Motor Function Classification System (GMFCS) and Manual Ability Classification System (MACS), respectively. RESULTS: There were significant correlations between SSP level and GMFCS (R=.72, p<.00) or MACS (R=.77, p<.00) levels. Significant differences were showed each gross motor (p=.01) and fine motor level (p=.00) among sensory processing level of children. In addition, sub-items of sensory processing as Tactile sensitivity, Movement sensitivity, Auditory filtering and Low energy/Weak were significantly were showed significant correlations gross motor and fine motor level (p=.01). Also, multiple regression result was showed that as MACS level and GMFCS level were higher, the SSP total score was higher all of participants (adjusted R2=.62). CONCLUSION: Sensory processing abilities of children with cerebral palsy were related with gross motor and fine motor capabilities. Also gross motor and fine motor capabilities are as higher, the sensory processing skill was well of cerebral palsy.
  • 9.

    The Effect of Arm Training in Standing Position on Balance and Walking Ability in Patients with Chronic Stroke

    Dae-Hyouk Bang | 조혁신 | 2017, 12(2) | pp.75~82 | number of Cited : 3
    Abstract
    PURPOSE: The purpose of this study was to determine the effects of arm training in standing position on balance and walking ability in chronic stroke patients. METHODS: Sixteen chronic stroke patients were allocated equally and randomly to an experimental group (n=8) or a control group (n=8). All participants received 60 minutes of comprehensive rehabilitation treatment, the experimental group additionally received an arm training in standing position for 30 minutes, while the control group additionally performed a treadmill training for 30 minutes. These 30-minute training sessions were held three times per week for six weeks. Upper extremity function was assessed using Fugle-Meyer motor assessment function upper extremity (FMA-UE), balance was assessed using Berg balance scale (BBS), and walking ability (gait speed, cadence, step length, and double limb support period) was assessed using the GAITRite system. RESULTS: Improvement on all outcome measures was identified from pre-to-post intervention for both groups (p<.05). Post-intervention, there was a significant betweengroup difference on BBS, gait speed, cadence, step length, and double limp support period (p<.05). The experimental group exhibited greater improvement in the BBS (p=.01; z=-2.48), gait speed (p=.01; z=-3.26), cadence (p=.02; z=-2.31), step length (p=.01; z=-3.36), and double limb support period (p=.03; z=-2.84) compared to the control group. CONCLUSION: The findings of this study suggest that arm training in standing position may be beneficial for improving balance and walking ability of patients with chronic stroke.
  • 10.

    The Relationship between Pain and Quality of Life in Stroke Patients

    Kwon,Mi-Ji | 2017, 12(2) | pp.83~90 | number of Cited : 1
    Abstract
    PURPOSE: Central post-stroke pain (CPSP), a chronic pain condition of stroke patients, can impair activities of daily living and worsen the quality of life (QOL), thereby negatively influencing the rehabilitation process. However, CPSP remains an underestimated complication of stroke. This study aimed to describe the prevalence and types of new-onset chronic pain and to identify the relation between pain and QOL in stroke patients. METHODS: All patients hospitalized because of a diagnosis of stroke were included. Questionnaire was used. Pain intensity was measured using Numerical rating scale (NRS), and pain characteristics were assessed using DN4. QOL was measured using SF-36. Descriptive statistics were used to analyze the characteristics and pain data, and chi-square test was used to compare QOL categorical data between the nociceptive and neurological pain groups. RESULTS: CPSP development was reported by 34% of the post-stroke pain patients. Perceived QOL was low in both groups, especially with respect to the physical functioning, bodily pain, physical-role functioning, emotional-role functioning, and mental health domains. However, no significant difference was observed in QOL between the nociceptive and neurological pain groups (p<.05). CONCLUSION: Our results indicated that CPSP is a common and disabling complication that is difficult to treat, often decreases QOL, and may negatively affect rehabilitation treatment.
  • 11.

    The Effect of Trunk Strengthening Exercise using Oscillation on Trunk Muscle Thickness and Balance

    Cho Woon Su | Lim Jae Heon | Park Chi Bok | 2017, 12(2) | pp.91~101 | number of Cited : 9
    Abstract
    PURPOSE: The aim of this study was to verify the effect of trunk strengthening exercise using oscillation by comparing trunk muscle thickness, as well as balance of healthy adults during exercises performed with an oscillatory device and non-oscillatory device. METHODS: Twenty-two participants were randomly assigned to one of two groups: the trunk strengthening exercise using oscillation (TSEO) group (n=11) or the trunk strengthening exercise using non-oscillation (TSEN) group (n=11). Subjects in all groups performed the exercises three days per week for 6 weeks. All subjects performed four types of exercises: pull over, seated twist, power push, and diagonal power plank. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), and multifidus (MT) were measured with an ultrasonography. The balance ability were evaluated using the Romberg test with eyes open, eyes closed, one-leg standing test (OLST), and limits of stability (LOS). All tests were performed before the intervention, as well as after 6 weeks and 8 weeks of exercises. RESULTS: There was a significant difference of RA, IO, TrA, and MT according to the main effect of the time (p<.05). There was a significant difference of IO and LOS according to interaction effect between the time and group (p<.05). CONCLUSION: As intended, the cyclic forces induced by the oscillating device did increase trunk muscle thickness. However, the effect was limited and significant only for the IO muscle. Combining trunk strengthening exercise with oscillation appears to be more effective in improving dynamic balance.
  • 12.

    The Effects of Pelvic Movements-based Training on Trunk Stability and Balance during Sitting in Children with Spastic Cerebral Palsy

    서혜정 | 2017, 12(2) | pp.103~111 | number of Cited : 1
    Abstract
    PURPOSE: This study was aimed to investigate the effects of pelvic movements-based training on trunk stability and balance during sitting in children with spastic cerebral palsy. METHODS: Ten children with spastic cerebral palsy were matched to an intervention (n=5) or control group (n=5). The intervention consisted of two weeks of pelvic movementsbased training, five times a week. All participants were evaluated before, during, and after pelvic movements-based training using a trunk impairment scale (TIS) for trunk stability and a modified functional reaching test for balance during sitting. The collected data were analyzed using Repeated Measures ANOVA and the Mann-Whitney U test. RESULTS: The results of this study were as follows: 1) Significant increases in the TIS score (only dynamic balance) and forward reaching were observed in the experimental group, compared with the control group, after training (P<.05). 2) There were statistically significant time-factor increases within and between the subject' effects, in the TIS score (dynamic balance and total), dominant side, nondominant side, and forward reaching (P<.05). CONCLUSION: In conclusion, this study showed that for children with spastic cerebral palsy, pelvic movementsbased training improves trunk stability and balance during sitting. Further studies will be required to determine the long-term effects of pelvic movements-based training.
  • 13.

    Effect of Physical Therapy Based Tailored Exercise Program on Pain, Accident incidence Rates, and Lost Days of Work in Manufacturing Worker: Single Subject Design

    lee kwan woo | Kim, Won-ho | 2017, 12(2) | pp.113~120 | number of Cited : 5
    Abstract
    PURPOSE: The purpose of this study was to investigate the effect of a physical therapy-based tailored exercise program on pain, accident incidence rates, the number of work days lost, and economical loss cost for workers in an automobile parts manufacturing company. METHODS: A total of 530 workers with musculoskeletal symptoms were given a physical therapy-based tailored exercise program twice a week, for one hour a day. This exercise program consisted of movement pattern correction, muscle stretching and strengthening, and postural correction exercises, according to principles of movement impairment syndromes and medical training therapy. From 2011 to 2016, the lost days of work, accident incidence rates, and loss cost were examined. The pain measured by VAS (visual analogue scale) and the number of workers participating in the exercise program from 2014 to 2016 were also measured. The single subjects A-B design was applied and analyzed. RESULTS: After applying the exercise program, pain decreased and the number of workers participating in the program increased. Accident incidence rates, number of work days lost, and economical loss cost decreased. There was a significant correlation between the number of workers who received exercise therapy by year and accident incidence rates, lost days of work, and economical loss cost (p<.05). CONCLUSION: It is necessary to expand the physical therapy-based tailored exercise program to prevent musculoskeletal disorders because it has a positive effect on both workers and employers.
  • 14.

    Effects of Exercise Training and Chiropractic on Grip Strength and Cervical Muscle Strength of Subjects with Forward Head Posture and Turtle Neck

    Yonghwan Kim | KHIL, JAE HO | 2017, 12(2) | pp.121~127 | number of Cited : 3
    Abstract
    PURPOSE: Forward head posture and turtle neck are common musculoskeletal disorders of the cervical vertebrae. The purpose of this study was to investigate the effects of combined exercise training and chiropractic on the grip strength and cervical muscle strength of subjects with forward head posture and turtle neck. METHODS: The subjects were divided into two groups: forward head posture (n=9) and turtle neck (n=9). Both groups performed combined exercise training and chiropractic. The subjects were instructed about the exercise training once a week. This training was performed for 30 minutes every day for 8 weeks, and the chiropractic was performed for 15 minutes once a week. The cervical muscle strength and grip strength were measured. Two-way repeated measured ANOVA was performed for statistical analysis. RESULTS: In changes to the left grip strength, the main effect over time was significant, but the interaction effect and the main effect in the groups were not significant. In changes to the right grip strength, no difference was found to be statistically significant. In changes to the cervical muscle strength, no difference was found to be statistically significant. CONCLUSION: The increases of grips strengths and cervical muscle strength in forward head posture group were greater than turtle neck group but there were not found to be statistically significant.
  • 15.

    Assessment of Gait as a Diagnostic Tool for Patients with Dementia

    Lee, Han-Suk | Sun-Wook Park | 2017, 12(2) | pp.129~136 | number of Cited : 6
    Abstract
    PURPOSE: The purpose of this study was to compare the gait of elderly patients with and without dementia to investigate the possibility of an ambulation assessment test as a diagnostic tool for dementia. METHODS: A total of 96 subjects were included with 60 participants without dementia (control group) and 36 patients with dementia (dementia group). To compare the walking ability of the two groups, a 4-m walking test (4MWT) and Groningen Meander Walking Test (GMWT) were conducted. The GMWT is graded by amount of time in seconds and by number of oversteps outside the track. Mann-Whitney U test was used to compare the gait between the groups and the area under the curve (AUC) with Received Operating Characteristic (ROC) curve was analyzed. Statistical significance was considered at a p<.05, with a 95% confidence interval. RESULTS: There were statistically significant differences (p<.05) between the dementia group and the control group for the 4MWT, GMWTSEC, and GMWTSTEP scores. The AUC was .95 for 4MWT, .92 for GMWTSEC, and .96 for GMWTSTEP with the 95% confidence interval. The cut-off values of the ROC curve were 1.03m/s for 4MWT, 10.8 second for GMWTSEC, and 3.75 steps for GMSTEP. CONCLUSION: In our study, we investigated the utility of ambulatory assessment tools to predict dementia. The results of this study suggest that the 4MWT and the GMWT used in this study are appropriate assessment tools for dementia prediction.