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2019, Vol.14, No.1

  • 1.

    The Immediate Effect of Interferential Current Therapy on Muscle Tone and Stiffness in Chronic Stroke Patients

    Park Sinjun | Kyun-Hee Cho | Kim,Soon-Hee | 2019, 14(1) | pp.1~5 | number of Cited : 0
    Abstract
    Purpose: In chronic stroke patients, muscle tone and stiffness increase due to ankle spasticity. Electrotherapy may control the spasticity of patients with central nerve system damage via neurophysiological mechanisms. Therefore, this study was conducted to determine the immediate effects of interferential current therapy on gastrocnemius (GCM) muscle. Methods: This study was a one-group pretest-posttest design and 20 stroke patients participated. The experimental group underwent interferential current therapy for GCM for 30 minutes. Muscle tone (MT) and stiffness were assessed using MYOTONEⓇ PRO. After 30 minutes of interferential current therapy, MT and stiffness of the affected side and unaffected side by GCM were measured. Results: After interferential current therapy, the medial GCM MT (Hz) was significantly reduced in stroke patients. There was a significant difference in MT between affected GCM muscles and unaffected side medial GCM muscles before intervention, but there was no significant difference after interferential current therapy. Conclusion: This study demonstrated that interferential current therapy had a positive effect, producing an immediate decrease in the medial GCM muscles tone of stroke patients. However, this study employed a one-group pretest-posttest design. Future studies will show differences in muscle tone compared to a control group or other electrical stimulation treatments.
  • 2.

    Effect of Action Observation by Subject Type on the Balance and the Gait of Stroke Patients

    Jong-Su Lee | Kyoung Kim | Kim, YoungMi | 2019, 14(1) | pp.7~14 | number of Cited : 0
    Abstract
    PURPOSE: This study examined the effects of observing a self-video or a video of another person performing balance and gait training, followed by actual performance of the observed movements on the balance and walking ability of chronic stroke patients. METHODS: Thirty patients, who had experienced a stroke and were admitted to S rehabilitation hospital for treatment, were selected randomly and divided into three groups with 10 patients each: self-action observation (SAO) group, other-action observation (OAO) group, and treadmill walking training (TWT) group. The training program was conducted five times per week for four weeks. The GAITRite system, 10 m walking test, and timed up and go test were performed to measure the subjects’ gait and balance ability. RESULTS: The velocity, cadence, double support, and stride length were increased significantly in the SAO and OAO groups (p<.05) but the T group showed no significantchanges; no significant difference was observed among the groups (p > .05). The 10MWT decreased significantly in the OAO group (p<..05), but there were no significant changes in the SAO and T groups, and no significant difference was observed among the groups (p>.05). The TUG decreased significantly in the SAO and OAO groups (p<.05), but there were no significant changes in the T group, and no significant difference was observed among the groups (p>.05) CONCLUSION: The self or other action observation training helps improve the balance and gait ability.
  • 3.

    Comparison of Effects of Different Myofascial Meridians Methods on Pain and Postural Control of College Students with Forward Head Posture

    Byeong-Hoon Song | Yoon-Hee Choi | Yong-Jun Cha | 2019, 14(1) | pp.15~23 | number of Cited : 0
    Abstract
    PURPOSE: This study was conducted to investigate the effects of the myofascial meridians release technique on pain and postural control of college students with forward head posture and to compare the intervention effects of the Grastone massage and the Rollfing massage. METHODS: Thirty subjects with forward head posture were randomly and equally allocated to experimental group I (myofascial meridians release technique using Grastone massage, n=15) or experimental group II (myofascial meridians release using Rollfing massage, n=15). All subjects underwent 30 minutes of different myofascial meridians release techniques in addition to general physical therapy (hot pack: 15 min, interferential current therapy: 15 min, ultra sound: 5 min) three times a week for a total of 6 weeks. Outcome was measured before and after 4 weeks of intervention. RESULTS: In both groups, the numerical rating scale of pain was significantly decreased after intervention, with experimental group I showing a greater decrease than experimental group II. The neck disability index decreased significantly after intervention in both groups, with experimental group I showing a significantly greater decrease than the controls. The distance of the head forward displacement did not differ significantly between the two groups (p>.05). CONCLUSION: This study suggests that the Grastone method combined with the myofascial meridians release technique is a more effective intervention for improvement of pain and postural control in adults with moderate forward head posture.
  • 4.

    Effects of different Diaphragm Breathing Methods on the Diaphragm Thickening Ratio and Pulmonary Function in Young Adults

    Tae-Won Ha | Lee Myungmo | 2019, 14(1) | pp.25~33 | number of Cited : 0
    Abstract
    PURPOSE: This study examined the effective impact of self and resistive and ultrasound-biofeedback diaphragm breathing on the pulmonary function and diaphragm thickening ratio of young adults. METHODS: Thirty normal adults were assigned randomly to three experimental groups (self- diaphragm breathing (n=9), resistive-diaphragm breathing (n=11), ultrasound- biofeedback diaphragm breathing (n=10)). Each group participated for 15 minutes for times with a two minute rest between two sets. The subjects were assessed using the pre- and post- diaphragm thickening ratio and the pulmonary function (forced vital capacity, forced expiratory volume at one second, maximal voluntary ventilation, and respiratory rate) on the thirty subjects. A paired t-test was to determine the difference between before and after the experiment in each group of diaphragm breathing before and after the exercises. One-way ANOVA was used to determine the differences between the groups. RESULTS: The forced vital capacity and maximal voluntary ventilation measurements revealed a significant difference in the resistive-diaphragm breathing group than the other two groups. On the other hand, there was no significant difference between the self-diaphragm breathing and ultrasound-biofeedback breathing groups. CONCLUSION: The resistive-diaphragm breathing group showed greater improvement in the pulmonary function than the other two groups. Therefore, resistive- diaphragm breathing will improve the pulmonary function on normal young adults.
  • 5.

    Effects of a Vestibular Stimulation Training Program on the Gait of Chronic Stroke Patients

    Nam Ki Won | Go, JaeChung | Yong-Pil Yang | 2019, 14(1) | pp.35~41 | number of Cited : 1
    Abstract
    PURPOSE: This study examined the effects of a vestibular stimulation training program on the walking ability of chronic stroke patients over a six month period. METHODS: Forty stroke patients were enrolled in this study. The patients were divided randomly into a control group (n=20) and experimental group (n=20). A general exercise program was applied to Group I and vestibular stimulation training was applied to Group Ⅱ(30 min, three times a week for six weeks). The changes in straight walking ability, curved walking ability, and functional walking ability were measured using a 10 m walking test figure-of- eight-walking test, and dynamic gait index, respectively. The measures before and after the program were compared using a paired t-test for a comparison of each group and an independent t-test for a comparison between groups. RESULTS: The changes in each group were examined according to the measurement period. The Experimental group showed significant functional improvement in all three tests after the vestibular stimulation training program, but the control group did not show significant improvement in any of the tests after the general exercise program. A comparison of the changes between groups revealed the experimental group to show significantly higher improvement than the control group in all tests. CONCLUSION: The vestibular stimulation training program helps improve the gait function of stroke patients. Based on the results of this study, it is expected that various vestibular stimulation training programs will be developed and applied in a range of places.
  • 6.

    Pulmonary Function Index Comparisons Depending on Various Postures of Stroke Patients

    Kyung-Soo Lee | Lee Myungmo | 2019, 14(1) | pp.43~51 | number of Cited : 0
    Abstract
    PURPOSE: To prevent secondary complications from decreased pulmonary functions and promote neurological recovery, identification of respiratory capacity change patterns depending on different postures of stroke patients and investigation of their properties are needed for active rehabilitation. Therefore, this study was conducted to investigate the changes in vital capacity in response to different positions and to implement the results as clinical data. METHODS: A respiratory function test was administered to 52 patients with stroke in the sitting, supine, paretic side lying, and non-paretic side lying positions. Pulmonary function indexes used for comparison were forced vital capacity (FVC), forced expiratory volume at 1 second (FEV1), forced expiratory flow 25–75% (FEF 25–75%), and maximum voluntary ventilation (MVV). One-way repeated ANOVA was used for analysis, and post hoc analysis was conducted using least significant difference (LSD). RESULTS: All pulmonary function indexes were measured in the order of sitting, paretic side lying, supine, and non-paretic side lying positions. Excluding the FEF25-75% and MVV of the supine compared with the paretic side lying position, all other pulmonary function indexes differed significantly (p<.05). CONCLUSION: There are differences in pulmonary function indexes depending on different postures of stroke patients, and the study showed that the non-paretic side lying position yielded the greatest effect on lung ventilation mechanisms. Based on these results, appropriate postures need to be considered during physical therapy interventions for stroke patients.
  • 7.

    Effects of Artificial Leg Length Discrepancies on the Dynamic Joint Angles of the Hip, Knee, and Ankle During Gait

    Kim Yong-wook | Seung-Yeon Jo | Yeoung-In Byeon and 4other persons | 2019, 14(1) | pp.53~61 | number of Cited : 0
    Abstract
    PURPOSE: This study examined the dynamic range of motion (ROM) of the hip, knee, and ankle joint when wearing different shoe sole lifts, as well as the limb asymmetry of the range according to the leg length discrepancy (LLD) during normal speed walking. METHODS: The participants were 40 healthy adults. A motion analysis system was used to collect kinematic ROM data. The participants had 40 markers attached to their lower extremities and were asked to walk on a 6 m walkway, under three different shoe lift conditions (without an insole, 1 cm insole, and 2 cm insole). Visual3D professional software was used to coordinate kinematic ROM data. RESULTS: Most of the ROM variables of the short limbs were similar under each insole lift condition (p>.05). In contrast, when wearing a shoe with a 2 cm insole lift, the long limbs showed significant increases in flexion and extension of the knee joint as well as; plantarflexion, dorsiflexion, pronation, eversion, and inversion of the ankle joint (p<.05). Of the shoes with the insole lifts, significant differences in all ROM variables were observed between the left and right knees, except for the knee internal rotation (p<.05). CONCLUSION: As the insole lift was increased, more ROM differences were observed between the left and right limbs, and the asymmetry of the bilateral lower limbs increased. Therefore, appropriate interventions for LLD are needed because an artificial mild LLD of less than 2.0 cm could lead to a range of musculoskeletal problems of the lower extremities, such as knee and ankle osteoarthritis.
  • 8.

    Effect of Cardiopulmonary Physiotherapy on Patients With Percutaneous Coronary Intervention - Systematic Review and Meta-Analysis

    Na-yoon Kang | Park Beom Seok | Minhee Kim | 2019, 14(1) | pp.63~73 | number of Cited : 1
    Abstract
    PURPOSE: This study examined the effects of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients with coronary artery disease who underwent percutaneous coronary intervention (PCI). METHODS: Electronic bibliographic databases of a regional information sharing system (RISS) and PubMed were searched to identify studies with randomized and non-randomized controlled trials. As the final outcome, 320 publications were identified and 18 studies met the inclusion and exclusion criteria. All studies were assessed for the quality of study using Cochrane’s risk of bias. RESULTS: Sixteen studies met the inclusion criteria, in which meta-analysis had been conducted to examine the effectiveness of cardiopulmonary physiotherapy on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI. Meta-analysis based on a random effect model showed that the cardiopulmonary physiotherapy was beneficial in improving the cardiopulmonary function, metabolism, inflammatory markers, and quality of life. In particular, there was a significant effect on the peak oxygen uptake (effect size 5.30%; 95% confidence interval 3.62~6.97). Cardiopulmonary physiotherapy for a during period of 6 weeks or more was effective in significantly improving the cardiopulmonary function and metabolism function in a subgroup analysis, but cardiopulmonary physiotherapy for less than 6 weeks was not effective. CONCLUSION: Cardiopulmonary physiotherapy has positive effects on the cardiopulmonary function, metabolism, inflammatory markers, and quality of life in patients undergoing PCI.
  • 9.

    Impact of a Fall-Prevention Exercise Program on Balance, Gait, Lower Limb Strength, and Psychosocial Characteristics in Older Adults with Dementia

    Gi-young Choi | Suhn-yeop Kim | 2019, 14(1) | pp.75~89 | number of Cited : 1
    Abstract
    PURPOSE: This study measured the impact of a 12-week fall-prevention exercise program on balance, ambulatory ability, lower limb strength, and psychosocial characteristics in older adults diagnosed with dementia. METHODS: The participants comprised 31 older adults (9 men, 22 women) diagnosed with Alzheimer’s or vascular dementia at a long-term care hospital located in Gunsan City. A fall-prevention exercise program was provided to the experimental group, while the control group was only provided with instruction and materials related to the fall-prevention exercise program. The participants were evaluated before the intervention, 6 weeks after the intervention, and 12 weeks after the intervention on static and dynamic balance abilities (using Timed Up and Go test: TUG, Tinetti-balance scale, one-leg standing test: OLS), gait (Tinetti-balance scale, 6-minute walk test: 6MWT), lower limb strength (sit to stand test; STS), and psychosocial characteristics (Short Form 36 Health Survey-Korean version, Korean Mini-Mental State Exam). RESULTS: An independent samples t-test and repeated measures analysis of variance were used for the statistical analysis. There were statistically significant improvements after the intervention (p<.05) in dynamic balance abilities (TUG and OLS using the left foot), gait (6MWT), and lower limb strength (STS) for the experimental group, but not for the control group. No difference was seen in psychosocial characteristics. CONCLUSION: Older adults with dementia who participated in the fall-prevention exercise program showed significant improvements in their static and dynamic balance abilities, lower limb strength, and ambulatory ability after the intervention.
  • 10.

    Muscle Activity of the Trunk Muscle According to Change of the Leg Width and Arm Posture during Sit to Stand

    Min-Wook Jae | Lee, Han-Suk | 2019, 14(1) | pp.91~99 | number of Cited : 1
    Abstract
    PURPOSE: This study was conducted to evaluate the activity of trunk muscles according to width of the foot and posture of the arm during sit to stand (STS). METHODS: Thirty subjects were recruited and examined for variation in muscle activity of the erector spine, gluteus maximus, gluteus medius and external oblique during different STS conditions; namely, the cross arm basic sit to stand (CBSTS), overhead basic sit to stand (OBSTS), cross arm wide sit to stand (CWSTS), and overhead wide sit to stand (OWSTS). Repeated measures ANOVA (Analysis of Variance) was used for analysis. RESULTS: Erector spinae muscle activity showed a significant increase in the OBSTS condition (p<.05) and external oblique muscle activity showed a significant increase in the OWSTS condition ((p<.05). There was no significant difference in the activity of the gluteus maximus and gluteus medius under any conditions (p>.05). CONCLUSION: During evaluation of the performance of the STS, the CWSTS condition will be useful to decrease the muscle activity of the erector spinae and the OWSTS condition will be useful to increase the muscle activity of the external oblique. The results of this study can be used as an index to find a suitable exercise method for subjects who have back pain or to strengthen the abdomen.
  • 11.

    Effect of Virtual Reality Inspiratory Muscle Training on Diaphragm Movement and Respiratory Function in Female Patients with Thoracic Restriction

    Myung-Soo Jang | Sung-Dae Choung | JaeHun Shim and 1other persons | 2019, 14(1) | pp.101~110 | number of Cited : 1
    Abstract
    PURPOSE: This study was conducted to analyze the effects of virtual reality inspiratory muscle training and conventional inspiratory muscle training on diaphragm movement and pulmonary function in patients with thoracic restriction. METHODS: This study measured diaphragm movement, forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and thoracic mobility (upper, middle, and lower trunk) under two different conditions. Forty young women between 19 and 24 years of age who had no history of orthopedic symptoms for the last 6 months were divided into experimental and control groups. The experimental group performed virtual reality inspiratory muscle training and diaphragm breathing, and the control group performed conventional inspiratory muscle training and diaphragm breathing. RESULTS: The control group showed a significant increase in all dependent variables except for lower trunk mobility and PEF. The experimental group showed a significant increase in all dependent variables except for lower trunk mobility. Particularly, the experimental group showed significant increases in diaphragm movement (p<.05), FVC (p<.05), FEV1 (p<.05), and PEF (p<.05) relative to the control group. CONCLUSION: We recommend inspiratory muscle training with a virtual reality program over conventional training to improve diaphragm movement and pulmonary function in patients with thoracic restriction.
  • 12.

    Effects of Biofeedback Training with Shaker Exercise on the Suprahyoid muscle Activity of Stroke with Swallowing Disorder

    Shin Yoon A | Hyuk-Cheol Kwon | KIM HWAN | 2019, 14(1) | pp.111~119 | number of Cited : 0
    Abstract
    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.
  • 13.

    Effects of Cervical Stabilization Exercise Using Pressure Biofeedback on Neck Pain, Forward Head Posture and Acoustic Characteristics of Chronic Neck Pain Patients with Forward Head Posture

    Kim Gi Chul | Pil-Neo HwangBo | 2019, 14(1) | pp.121~129 | number of Cited : 4
    Abstract
    PURPOSE: This study was conducted to measure the effects of cervical stabilization exercises on neck pain, forward head posture, and the acoustic characteristics frequency and amplitude modulation of patients with chronic neck pain caused by forward head posture using pressure biofeedback. METHODS: 20 patients with chronic neck pain and voice disorders presenting at the S Exercise Center in Daegu, Korea, were included in the study. A cervical stabilization exercise program of 50 minutes per session was performed three times a week for eight weeks. Pressure biofeedback was utilized to determine the impact of the exercises on neck pain, forward head posture, and the acoustic characteristics of the patients. The measurements were taken prior to and after the intervention to determine any changes. RESULTS: A significant improvement in neck pain, craniovertebral angle and the acoustic characteristics frequency and amplitude modulation of the patients was demonstrated after the intervention (p<.05). CONCLUSION: Cervical stabilization exercises were demonstrated to have a significantly positive effect on neck pain, forward head posture, and vocalization stability in patients with chronic neck pain in the current study based on measurements taken using a pressure biofeedback system. This indicates that an improvement in forward head posture positively impacts postural stability and vocalization. Future studies investigating a greater range of interventions designed to improve neck pain and acoustical effects in patients with chronic neck pain and forward head posture patients are warranted.
  • 14.

    Effects of Visual Feedback Closed Kinetic Chain Exercise on the Lower Limb Muscles Activity and ankle Instability in Adult men with Chronic Ankle Instability

    Nam Seung Min | Lee, Do-Youn | 2019, 14(1) | pp.131~138 | number of Cited : 2
    Abstract
    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.
  • 15.

    Effects of Treadmill Gait Training with Obstacle-Crossing on Static and Dynamic Balance Ability in Patients with Post Stroke Hemiplegia

    Ji-Eun Lee | Lee Hoseong | 2019, 14(1) | pp.139~150 | number of Cited : 3
    Abstract
    PURPOSE: This study was conducted to determine the effects of treadmill gait training with obstacle-crossing on the static and dynamic balance ability of patients with post stroke hemiplegia. METHODS: Twenty-one patients with post stroke hemiplegia were divided into three groups as: treadmill gait training with obstacle-crossing (TOG, n=7), treadmill gait training without obstacle-crossing (TGG, n=7) and a control (CON, n=7). TOG and TGG performed exercise for 20 minutes, three times a week for 8 weeks. Static balance ability (stability typical, ST; weight distribution index, WDI; fourier harmony index, FHI; and fall index, FI) and dynamic balance ability (berg balance scale, BBS and timed up and go test, TUG) were measured before and after 8 -weeks in each exercise group. Statistical analyses were conducted using two-way ANOVA with repeated measures, a paired t-test, and multiple comparisons according to Tukey’s HSD. RESULTS: FHI and BBS were significantly increased at TOG (p<.01) and TGG (p<.05) after 8-weeks compared to before treadmill gait training with obstacle-crossing. FHI and BBS were significantly increased at TOG compared with CON and TGG (p<.05). CONCLUSION: Treadmill gait training with obstacle- crossing was more effective than that without obstacle- crossing to improve posture control and independent daily life performance of hemiplegia patients.
  • 16.

    Feasibility Test of Smartphone Application for Activity Daily Living by Chronic Stroke Patients

    Chae-won Jung | SONG YO HAN | LEE HYUN MIN | 2019, 14(1) | pp.151~161 | number of Cited : 1
    Abstract
    PURPOSE: To investigate the validity of a smartphone application for post-stroke daily living activity management based on an evaluation by users and experts. METHODS: The study design adhered to the analysis, design, development, implementation, and evaluation ADDIE (Analysis-Design-Development-Implement-Evaluation) model. We downloaded the application onto the smartphones of 33 users and 30 experts, taught them how to use it, and asked them to use the application for four weeks. The users’ daily lives before and after using the application were compared based on the K-MBI (Korean Version of Modified Barthel Index) to evaluate the usability of the application. For the expert group, we investigated the content validity and reliability of the application and evaluated the usability of the application. Data were analyzed using the SPSS 21.0 software. Users’ general characteristics and experts’ evaluation scores were analyzed using descriptive statistics. Content validity was tested using the content validity index (CVI), and reliability was tested with Cronbach's alpha. Users’ K-MBI scores before and after using the application were compared with the paired sample t-test. RESULTS: Users gave an average rating of 2.93 out of 4 for the application for managing the daily lives of stroke patients, while experts gave an average score of 3.14. With regard to the K-MBI scores, only the dressing score improved significantly (p<.005) after using the application, and scores for other categories slightly improved but not to significant levels. CONCLUSION: The results of this study suggest that the STROKECARE application is usable and could help stroke patients manage their daily lives.