KJC Korea
Journal Central

PURPOSE: This study was conducted to analyze the effects of carrying weight on the gait of elderly women using a walking-assistant vehicle (WAV) as the weight increased. METHODS: A total of 30 elderly women living in the local community were included as subjects and instructed to walk 50 m using a WAV loaded with sandbags corresponding to 0%, 5%, 10%, or 15% of their mean weight. The subjects’ gait was analyzed using a gait analyzer to measure stride length, step length, step width, and gait time. RESULTS: Stride and step lengths were longest when carrying 5% of their weight and shortest when carrying 15% of their mean body weight. Step width and gait time were lowest when carrying weights corresponding to 5% and highest for 15% of their mean body weight. When observing gait with a WAV, the gait time was greatly affected by weights, with carrying weight equivalent to 5% of the body weight positively affected the gait with a WAV, whereas carrying weights of >15% resulted in slower gait speed. CONCLUSION: When walking with a WAV, an appropriate carrying weight of approximately 5% of the body weight stabilizes gait, while a weight of 15% leads decreased gait efficiency. Therefore, when using a WAV during outdoor activities, elderly women should add some weight to the WAV; however, the carrying weight should be <15% of the body weight.

PURPOSE: This study was conducted to compare the effects of the Graston-based massage method and microcurrent application on muscle fatigue after causing muscle fatigue of the quadriceps femoris by applying high- intensity exercise. METHODS: Study subjects (56 healthy subjects in their 20s) were randomized into a microcurrent group (MG), Graston group (GG), and control group (CG). To induce fatigue of the quadriceps femoris, the subjects performed squats 100 times without a break within about 5 minutes. Muscle fatigue was measured immediately after performing squats and 15 minutes after intervention. To measure muscle fatigue, surface electromyogram (EMG) was used to obtain and compare the median frequency. Microcurrent or Graston massage was applied to their quadriceps muscles 15 minutes after performing the squats. RESULTS: Muscle fatigue increased significantly in the vastus lateralis before and after intervention in the Graston group (p<.05), while no significant difference was observed in the rectus femoris and vastus medialis (p>.05). There were also no significant differences in the microcurrent group or the control group. CONCLUSION: Both the microcurrent group and Graston group showed a tendency for increasing median frequency values compared to the control group, but there was no significant difference except in the vastus lateralis treated with the Graston technique. Although there was no significant difference, the Graston technique could be utilized to reduce the occurrence of DOMS by preventing muscle fatigue in clinical practice or sports medicine.

PURPOSE: This study was conducted to investigate the correlation between the activity of suprahyoid muscles, infrahyoid muscles and swallowing ability in stroke patients with dysphagia. METHODS: The subjects of this study were 120 patients who were diagnosed with CT or MRI stroke and had swallowing disorder at Daegu Metropolitan General Hospital from August 2014 to February 2017. The suprahyoid and infrahyoid muscle activity was measured in patients with dysphagia and the new videofluoroscopy swallowing studies scale (new VFSS scale) was used for evaluation of swallowing function. Correlation analysis was conducted using the measured data. RESULTS: The activities of suprahyoid muscles were 325.8 (%RVC) on average, while the average infrahyoid muscle activity was 302.65 (%RVC) and the average value of the new VFSS scale was 31.52. The total for oral organs was 3.62 on average and that for pharynx organs was 28.30 on average. The activity of the suprahyoid muscles showed a significant positive correlation with the activity of the infrahyoid muscles, but a significant negative correlation with the total oral phase, total pharyngeal phase and total new VFSS scale (p<.01). The activity of the infrahyoid muscles showed a significant negative correlation with the total oral phase, total pharyngeal phase, and total new VFSS (p<.01). CONCLUSION: Based on the results of this study, it is necessary for researchers to consider the infrahyoid and suprahyoid muscles when conducting swallowing rehabilitation.

PURPOSE: This study was conducted to identify the relationships among stress response inventory, hospital anxiety and depression, muscle tone and stiffness, and hand strength in chronic stroke patients. METHODS: A total of 14 chronic stroke patients voluntarily agreed to this experiment and were included in this study. All measurements were performed in one day and in a room without noise. The tests conducted in this study were as follows: muscle tone and stiffness of the upper trapezius hand grip measurement. Subjects were also asked to complete surveys describing the following: stress response inventory and hospital anxiety and depression scale. RESULTS: There were significant correlations among stress response inventory and hospital anxiety and depression, stress response inventory and hand strength, and hospital anxiety and depression and hand strength (P<.05). There were high positive correlations between stress response inventory and hospital anxiety and depression (r=.979), while there were moderate negative correlations between stress response inventory and hand strength (r=-.415) and between hospital anxiety and depression and hand strength (r=-.420). CONCLUSION: The results of the present study indicate that there is a relationship among stress response inventory, hospital anxiety and depression, and hand strength in patients with chronic stroke.

PURPOSE: This study was conducted to investigate the effects of Kinesio taping and massage application to the calf muscles on ankle stability. METHODS: The study subjects were 66 healthy adults (male: 32, female: 34) who had no instability in their ankles. Subjects were randomly assigned to a Kinesio taping group or a massage group. The research tool used the Y-balance test to measure instability of the ankle. The distance between the right and left foot was measured from the center in the anterior, posterior-medial, and posterior-lateral directions. Massage was applied to the calf muscles three times over two weeks and Kinesio tape was attached to the calf muscle and tibialis anterior for 10 hours twice during the experimental period. RESULTS: The results showed that application of Kinesio taping resulted in increases in the distance between the feet increased in some directions. After the massage, the distance extended from the anterior and posterior-lateral directions was prolonged, and the ankle stability on the right and left sides was partially improved by massage application. CONCLUSION: Kinesio taping and massage applied to the calf muscles are appropriate interventions for the improvement of ankle stability. Based on the application times of massage, Kinesio taping appears to work more effectively for ankle stability.

PURPOSE: The purpose of this study is to examine the effect of proprioceptive neuromuscular facilitation (PNF) neck flexion exercise and the Shaker exercises on the activity of the suprahyoid muscles in chronic stroke patients with dysphagia and to show what exercise methods are effective for swallowing rehabilitation. METHODS: This study was conducted at F hospital in Daegu from August 2014 to February 2017 with 60 participants who understood the purpose of the study and desired to participate. The 60 participants were randomly divided into an experimental group (PNF neck flexion exercise) (n=30) and a control group (Shaker exercise) (n=30). PNF neck flexion exercise was performed in the experimental group and the Shaker exercise was performed in the control group for 30 minutes, 5 times a week for 6 weeks.The activity of the suprahyoid muscles was measured before and after treatment. RESULTS: Both the experimental group and the control group showed a statistically significant change in the activity of the suprahyoid muscles before and after the treatment. The changes were also statistically significant when compared by group. CONCLUSION: In conclusion, PNF neck flexion exercise should be used in addition to Shaker exercise when rehabilitating a patient with a swallowing disability.

PURPOSE: This study was conducted to determine if the Harrison hip score (HHS), a tool for assessing hip joint function, and the Burg balance scale (BBS), a general balance assessment tool, actually reflect the balance ability of total hip arthroplasty (THA) patients 3 months after surgery. In addition, this study investigated the initial weight distribution strategy for bilateral lower extremity after THA surgery to understand the balance of THA patients. METHODS: Fourteen 3-month THA patients performed static dual standing and sit-to-stand (STS) tasks. Ground reaction forces on each leg were collected to calculate the weight distribution symmetricity (SWD), and the HHS, functional HHS (f-HHS), and BBS were evaluated. Correlation analyses between SWD and the HHS (also f-HHS) and BBS were then applied to the THA patients. RESULTS: The correlations between functional evaluation tools (HHS, f-HHS, BBS) and SWD were weak strength for the static balance task, but moderate for the dynamic STS task. Among the evaluation tools used in the present study, f-HHS was most useful for evaluation of dynamic balance ability. CONCLUSION: The results suggest that use of HHS, f-HHS, and BBS as functional evaluation tools does not provide meaningful information regarding balance ability, but that they are useful for evaluating dynamic balance ability of THA patients. The dynamic balance ability at 3 months after THA seems to be under development.

PURPOSE: The purpose of the present study is to investigate the changes in the cognitive function of elderly dementia patients residing in a residential care facility, following six weeks of brain-computer interface (BCI)-based cognitive training and to determine whether BCI-based cognitive training effectively improves their cognitive functions. METHODS: Thirty subjects diagnosed with dementia were randomly assigned to either the experimental or control group. Pre- and post-test cognitive function assessments were conducted using the mini mental state examination-Korean (MMSE-K) and Korean-dementia rating scale (K-DRS). The experimental group received BCI-based cognitive training, which consisted of games such as flying a ball and exploding a bomb, while the control group participated in music listening activities and National Health Gymnastics. Both groups engaged in a total of 18 sessions (3 times per week for 6 weeks, for 40 minutes per session). RESULTS: After 6 weeks of intervention, the experimental group had significantly increased MMSE-K scores (19.53±1.30 to 22.20±1.15; p<.0011) and total K-DRS scores (87.20±4.16 to 99.33±1.15; p<.0011). In addition, the experimental group showed greater cognitive improvements than the control group. CONCLUSION: The results of this study suggest that BCI-based cognitive training is a positive intervention tool for improving the cognitive function of dementia patients.

PURPOSE: This study was conducted to investigate the effects of vibration frequency and amplitude on scapular winging during the knee push-up plus exercise. METHODS: A total of 26 female subjects with scapular winging were evaluated while performing the knee push-up plus exercise with no vibration, low-frequency/low-amplitude (5 Hz/3 mm) vibration, low-frequency/high-amplitude (5 Hz/9 mm) vibration, high-frequency/low-amplitude (15 Hz/3 mm) vibration, and high-frequency/high-amplitude (15 Hz/9 mm) vibration. The surface EMG of the serratus anterior (SA) muscle was compared between the vibration frequency and amplitude. The EMG amplitude was normalized using the maximal voluntary isometric contraction (MVIC). The statistical significance of the results was evaluated using one-way ANOVA. RESULTS: The SA muscle EMG values increased at low-frequency/low-amplitude vibration and at low-frequency/ high-amplitude vibration compared to no vibration. Furthermore, the same values increased at high-frequency/ low-amplitude vibration and high-frequency/high-amplitude vibration compared to no vibration. In general, a higher vibration frequency and amplitude was associated with higher EMG values of the SA muscle, with particularly greater increases observed during high-frequency/high-amplitude vibration. There was also a significant difference between each condition with a high-frequency/high-amplitude vibration (p<.05). CONCLUSION: This study suggests that there were remarkable clinical effect of the knee push-up plus exercise with vibration, which enhanced the SA muscle activation in persons with scapular winging. Furthermore, applying a higher vibration frequency and amplitude more effectively increased for increasing SA muscle activation.

PURPOSE: This study was conducted to determine the effects of whole-body tilt exercise with visual feedback on trunk control, strength, and balance in patients with acute stroke. METHODS: The study included 18 patients with acute stroke who were randomly allocated to a Whole Body Tilt Exercise Group (WBTEG, N=9) and a General Trunk Exercise Group (GTEG, N=9). The WBTEG conducted whole-body tilt exercises with visual feedback, and the GTEG performed general trunk exercises. Both groups performed the exercises five times a week for 4 weeks. Outcomes were assessed using the trunk impairment scale (TIS), the trunk flexor and extensor strength test, the static balance test, and the Brunel Balance Assessment. RESULTS: After 4 weeks of intervention, both groups showed significantly improved TIS scores, muscle strength, and balance components (p<.05 in both groups). However, the improvement in TIS, muscle strength, and static balance in the WBTEG was significantly better than that in the GTEG (p<.05). CONCLUSION: Although both groups in this study showed post-intervention improvement, patients from the WBTEG who received visual feedback demonstrated more improvement. These findings indicate that whole-body tilt exercise with visual feedback may be effective at improving trunk control, trunk muscle strength, and balance in patients with acute stroke. Further studies are needed to gain a better understanding of the effectiveness of whole-body tilt exercise in patients with acute stroke.

PURPOSE: This study was conducted to determine the effects of therapeutic exercise on range of motion (ROM), the manual muscle test (MMT), functional movement screen (FMS) and radiological evaluation in a youth football player with football-specific anterior pelvic tilt (APT). METHODS: The subject of this case report was a 12-year-old youth football player, who presented with football-specific APT. Therapeutic exercise consisted of hamstring stretch, prone hip extension, abdominal crunch, bridging with isometric hip abduction, plank exercise with posterior tilt and posterior pelvic tilting exercise using a swiss-ball for 40 min/day, twice a week for 8-weeks. ROM, MMT, FMS (deep squat, hurdle step, inline lunge, shoulder mobility, active straight-leg raise, rotary stability and trunk stability push-up) and radiographs (lumbar lordotic and sacral horizontal angle) were analyzed before and after week 8 of therapeutic exercise. RESULTS: The ROM, MMT, and FMS increased and the lumbar lordotic angle and sacral horizontal angle improved after 8-weeks of therapeutic exercise. CONCLUSION: The results of this case report suggest that therapeutic exercise improves ROM, MMT and radiography associated parameters in youth football players with football- specific APT. These findings have clinical implications for therapeutic exercise in youth football players with football- specific APT.

PURPOSE: The present study was conducted to investigate the effects of functional electrical stimulation gait training with rhythmic auditory stimulation on balance and gait ability in stroke patients. METHODS: In this blinded randomized controlled study, 26 stroke patients were assigned to either experimental group (n=13) consisting of 30 min of gait training 5 days per week for 4 weeks while performing functional electrical stimulation gait training with rhythmic auditory simulation, or a control group (n=13) performing the same gait training program, also consisting of 30 minutes 5 days a week and lasting for 4 weeks, but without functional electrical stimulation and rhythmic auditory stimulation. At baseline and after the 4 week intervention, balance was measured using the timed up and go test (TUG). Gait velocity was measured using the 10-meter walk test (10 MWT) and gait ability was assessed using the functional gait assessment (FGA). RESULTS: After the intervention, the experimental group showed statistically significant differences in gait velocity and ability (10 MWT, FGA) (p<.05). Between-group differences were statistically significant in gait velocity and ability (10 MWT, FGA) (p<.05). CONCLUSION: The findings suggest that functional electrical stimulation gait training with a rhythmic auditory stimulation gait training program may help improve gait ability in stroke patients.

PURPOSE: Strengthening training is effective at improving the function of stroke patients. This study was conducted to compare the effects of exercise intensity on walking, balancing ability, and blood glucose in stroke patients with type 2 diabetes mellitus and to suggest more effective exercise intensity for stroke patients. METHODS: Twenty-two patients with type 2 diabetes mellitus were divided into an experimental group (n=11) and a control group (n=11). In the experimental group, a 40-70% strength of 1RM exercise program was applied for 40 minutes a day, three times a week for 4 weeks. The control group received a 50% intensity of 1RM for the same number and duration of interventions as the experimental group. RESULTS: Both the experimental group and the control group showed significant improvement in the gait function, balance ability, and blood glucose level after the intervention compared to before the intervention. In the FGA (functional gait assessment), the experimental group showed a 52.4% greater increase than the control group, and the fasting blood glucose level was 16.7% greater in the experimental group than the control group. CONCLUSION: The strengthening exercise program, which gradually increases exercise intensity, seems to be effective at improving the function of stroke patients with type 2 diabetes.

PURPOSE: This study was conducted to identify a more effective intervention in sling and resistance exercise for chronic low back pain patients. METHODS: Seventy (70) subjects were randomly divided into the sling group (SG) and resistance exercise group (REG). Muscular activity of the internal oblique (IO), external oblique (EO), rectus abdominis (RA), and pelvic rotation angle during active straight leg raise (ASLR), a pressure pain threshold (PPT) and a visual analog scale (VAS) were measured. Sling and resistance exercises were conducted for 12 weeks. Intermediate measurements were taken after 8 weeks and final measurements were taken after 12 weeks. RESULTS: Both groups showed significantly decreased RA muscle activity and significantly increased IO muscle activity (p<.05). Additionally, EO muscle activity was significantly decreased in the REG, but significantly increased in the SG (p<.05), while the pelvic rotation angle and VAS were significantly decreased in the SG (p<.05). The pressure pain threshold was significantly increased in both groups (p<.05). CONCLUSION: Based on the results of this study, a 12-week intervention seems to be effective at improving back pain in both groups. However, a lower VAS was seen in the sling group after 8 weeks of intervention. Therefore, it is recommended that the sling be applied first when establishing a chronic back pain treatment program to shorten the treatment period and reduce the pain period.

PURPOSE: This study was conducted to investigate the influence of hip abduction angle on the muscle activity of the Gluteus Maximus (GM), Biceps Femoris (BF) and Tensor Fascia Lata (TFL) during Knee Flexed Prone Hip Extension exercise. METHODS: The subjects of this study were 42 healthy individuals. All participant consented to participate in this study. Subjects performed exercise, using the Knee Flexed Prone Hip Extension exercise in three hip abduction position 0°, 15° and 30°. Subjects rested two minutes, between changing hip abduction position. Data were analyzed using a Noraxon MR-XP 1.08 Master Edition EMG to determine average amplitude, for each angle and muscle. All data were processed by Multivariate analysis of variance (MANOVA). There were a total of three groups. the GM muscle, BF muscle, TFL muscle. RESULTS: GM muscle activity was greatest in the 30° hip abduction position (p<.05), followed by 0°. Between 0° and 30° has significant difference in muscle activity. However, the BF and TFL amplitude were greatest at 0° hip abduction position followed by 30°. Moreover, the TFL differed significantly between 0° and 30°, but, BF did not (p<.05). CONCLUSION: Hip abduction at 30° was found to be the most appropriate position for GM muscle activity.

PURPOSE: This study was conducted to compare the muscle activity of the proximal muscles of the lower limb according to the distance between the front and rear foot during lunge and to determine the most effective foot position for activation of the proximal muscle in the limb. METHODS: A total of 49 young adults were enrolled in this study. All subjects performed lunge by positioning the big toe of the back foot and the heel of the front foot at intervals of 40%, 60%, and 80% of the subject's own leg length. Muscle activity of the vastus medialis oblique, rectus femoris (RF), vastus lateralis oblique (VLO), gluteus medius, biceps femoris, and semitendinosus (ST) was then measured during three intervals of lunge operation. Each operation was measured three times for 10 seconds each, after which the average value was calculated and analyzed. RESULTS: There were significant differences in muscle activities of RF, VLO, and ST among the three intervals of the foot (p<.05). Post hoc, comparisons revealed lunge at 40% intervals resulted in higher RF and VLO activity than at 60% and 80% intervals (p<.05). In the semitendinosus muscle, 80% leg length intervals showed higher muscle activity than 40% (p<.05). CONCLUSION: Strengthening of the proximal muscles of the lower extremities during lunge exercise is considered to be most effective when placing the fore- and rear foot at intervals corresponding to 40% of the leg length.

PURPOSE: This study compared the effects of indoor and outdoor environmental changes on the activity of the major lower limb muscles and walking factors in people 40-50 years and those aged older than 70 years. METHODS: Ten middle-aged people in their forties (age:44.2±2.7, BMI:21.8±1.8) and 10 elderly aged more than 70 years (age:76.4±5.9, BMI:22.2±1.9) with a normal walking ability were included. The participants walked 100 m both indoors and outdoors at their own speed. Using a 3D motion analyzer and EMG, the walking speed, angle of the ankle and activity changes of the lower limb muscles were compared. RESULTS: Significant differences in walking speed and peak-plantar flexion angle were observed between the two groups (p<.05). The muscular activity of the gastrocnemius muscle (GCM) was significantly different outdoors in the swing phase between the two groups (p<.05). In the people aged in their forties, the muscular activity of the rectus femoris (RF) was significantly higher outdoors than indoors (p<.05). In the elderly, however, the muscular activity of the RF was lower outdoors than indoors (p<.05). When compared to those in there forties, the muscular activity of the outdoor RF significantly decreased in the elderly group (P<.05). The muscular activity of the biceps femoris (BF) in the elderly decreased significantly outdoors compared to indoors (p<.05). CONCLUSION: For the elderly, increasing the exposure to the new environments or focusing on the performance of repeated movements for gradual speed control and precise movements is required to maintain normal gaits and movements that are less affected by environmental changes.

PURPOSE: The aim of this study was to investigate the effect of scapular dynamic taping on pain, disability, upper body posture, and range of motion (ROM) in the postoperative shoulder. METHODS: Twenty-two patients who underwent acromioplasty and rotator cuff repair surgery volunteered for this study. The subjects were randomly divided into an experimental group (EG, n=11) and a control group (CG, n=11). For the EG, exercise therapy, manual therapy, and scapular dynamic taping were applied for 6 weeks; for the CG, only exercise therapy and manual therapy were applied for 6 weeks. Shoulder pain, disability, upper body posture, and ROM were evaluated at baseline, after 3 weeks of intervention, and after 6 weeks of intervention. Assessment tools included quadruple visual analog scale (QVAS) for level of pain; shoulder pain and disability index (SPADI) for functional disability level; forward head angle (FHA), forward shoulder angle (FSA), and pectoralis minor index (PMI) for upper body posture; and ROM testing. RESULTS: Significant differences were observed between the EG and CG in SPADI total scores; internal rotation and external rotation ROM of the glenohumeral joint ; FSA ; and PMI. All groups showed statistically significant improvement in QVAS; SPADI; flexion; abduction; external rotation and internal rotation ROM of the glenohumeral joint; FSA; and PMI. CONCLUSION: These results suggest that, for patients who have undergone acromioplasty and rotator cuff repair surgery, the addition of scapular dynamic taping during therapy is effective for improvement of shoulder disability level, ROM, and upper body posture.