This study investigated the relationships between Work-related musculoskeletal disorders (WMSDs), contributing factors, and the occupational stress of physical therapists. Self-reported questionnaires were given to 180 physical therapists in Gangwon Province. Variables examined included the prevalence of pain sites related to WMSDs; pain intensity; pain pattern; and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Among physical therapists, work-related musculoskeletal pain commonly affected the low back (30.1%), shoulder (29.3%), and wrist (12.2%). The sites of work-related musculoskeletal pain treated medically were the low back (22.8%), shoulder (19.8%), neck (12.7%), and wrist (12.1%). "Repeating the same work constantly" was suggested to be the major cause of the pain. The younger therapists were significantly more likely to feel high job stress due to the physical environment (p<.05), job demand (p<.05), and organizational system (p<.01). Women were more likely to feel greater job stress related to job demand, insufficient job control, the organization system, and job rewards. Men were more likely to feel greater job stress related to job insecurity. Weak positive relationships were observed between work-related musculoskeletal pain and job stress, which is thought to involve the physical environment; job demand; insufficient job control; interpersonal conflict; job insecurity; organizational system; reward system; and occupational culture. Physical therapists appear to be at higher risk of WMSDs because 80.1% of the physical therapists studied experienced work-related musculoskeletal pain. To reduce the risk, we need intervention strategies such as preventive education, ergonomically designed medical equipment, a psychosocial approach to work conditions, improved mechanical conditions related to therapeutic patterns, and an institutional infrastructure with sufficient personnel and scheduling.

The purpose of this study was to assess the level of quality of life and related factors among the elderly in Korea. In particular, we focused on factors affecting the quality of life of the elderly in long term care. We used the third Korean National Health and Nutrition Examination Surveys (KNHANES) from 2005. We sampled a total of 3,571 (10.5%) elderly from the national survey. We compared the mean of quality of life to socioeconomic status, Activities of Daily Living (ADL), health behavior, and disease variables. We used EuroQol-5D among KNHANES to assess the quality of life. In this study, the mean score of the quality of life among the elderly was 2.57. Logistic regression showed that the elderly who were male, with spouses, with health insurance, and with good ADL levels enjoyed higher quality of life scores and odds ratios than those who were female, divorced, uninsured, and with low ADL levels (p<.05). The quality of life of the elderly was affected by socioeconomic, ADL, health behavior and disease variables. To improve long term care and the quality of life among the elderly, we need detailed research to clarify the effects of these factors.

The objective of this study was to investigate the relationship between addiction to online games and carpal tunnel syndrome (CTS) in college students. A total of 377 (205 male and 172 female) college students completed an online game addiction scale, a Symptom Severity Scale (SSS), and a Function Status Scale (FSS) for CTS. It was found that five (1.3%) students were diagnosed with an online game addiction, 74 (19.6%) students were diagnosed with a pre-addiction to online games, and 298 (79.0%) students were diagnosed as being average users. The pre-addiction group had significantly higher scores on the SSS than did the average user group (p<.05). The average user group scored significantly lower than did the online game addiction group (p<.05). Symptoms of wrist pain and hand numbness in the daytime were common in the addiction group. There were statistically significant but poor positive relationships between the online game addiction scale and the SSS (r=.312, p<.01), and between the online game addiction scale and the FSS (r=.149, p<.01). The information about online game addiction and CTS identified in this study could contribute to the prevention of online game addiction and CTS in college students.

The aim of this study was to investigate the effect of abdominal drawing-in maneuver (ADIM) on peak exploratory flow (PEF), forced exploratory volume in 1 second (FEV1), and low back pain during forced expiration. Twenty-two subjects (14 subjects in experimental group, 8 subjects in control group) participated in this study. The stabilizer was used for ADIM training for five consecutive days. Vitalograph PEF/FEV1 DIARY and visual analogue scale (VAS) were used to determine forced expiratory pulmonary function and low back pain, respectively. Independent t-test and analysis of covariance were used for statistical analysis with a significance level of .05. The findings of this study were as follows: 1) There were no significant differences of ADIM effect on PEF and FEV1 between experimental group and control group. 2) There was a significant pain reduction in experimental group with ADIM. 3) PEF and FEV1 increased significantly in the fifth day compared with the first day pre-exercise baseline. Therefore, it is concluded that ADIM was effective in improving PEF and FEV1, and reducing VAS during forced expiration in patients with chronic low back pain.

The purposes of this study were to assess and modify the original classification categories of the modified Oswestry Low Back Pain Disability Questionnaire (ODQ) and to determine the unidimensionality of the modified ODQ applying Rasch Analysis. The data were obtained from 108 work-related low back pain patients by physical therapists. Construct validity of the scale using the Rasch model required the structure of the rating scale to be modified from 6 response levels to 4 response levels. Eight items from the modified ODQ fit the Rasch model. The items, "pain intensity" and "social life" showed misfit statistics. In general, the order of item difficulty of the remaining 8 items showed a logical item difficulty hierarchy with the "changing degree of pain" item being the most difficult and the "walk" item being the easiest. The results showed that further study is needed to expand the construct of ODQ including additional higher-level items related to work activities. This study may be useful for establishing a standard method to assess the functionality of low back pain patients.

Multi-sensory systems, including the visual, somatosensory, and vestibular ones, are involved in maintaining standing balance. The organization of these sensory systems is as important as the efficiency of each individual system in maintaining optimal balance. The purpose of the present experiment was to investigate the developmental changes in static standing balance and sensory organization under altered sensory conditions. This study involved 64 children (from 4 to 15 years of age) and 17 young adults. The children were divided into four age groups: 4~6, 7~9, 10~12, and 13~15 years. Static standing balance was assessed with the one-leg standing test under four different sensory conditions: the children stood on a firm surface with (1) eyes open or (2) closed, and they stood on a foam surface with eyes (3) open or (4) closed. In balancing ability, the age groups exhibited significant differences. The function of sensory organization for balance control was poorer for the children than for the young adults. The functional efficiency of the somatosensory system of the children aged 7~9 years was at the young adults' level, and the visual function of the children aged 10~12 years had also reached the young adults' level. However, the functional efficiency of the vestibular system of children was significantly lower than that of the young adults, even at the age of 15 years. This may indicate that sensory organization and standing balance are still developing after the age of 15 years.

The purpose of this study was to examine the effect of the hip internal rotation on knee extensor and hip abductor electromyographic (EMG) activity during stair up and stair down mobility. Eighteen healthy subjects were recruited. All subjects performed stair up and down movements on a step of 30cm height while maintaining the hip in neutral (condition 1) and hip in internal rotation (condition 2). Surface EMG activity was recorded from five muscles (gluteus maximus, vastus lateralis (VL), vastus medialis oblique (VMO), posterior gluteus medius (Gmed), and tensor fascia latae (TFU)) and hip internal rotation angle was measured using a three dimensional motion analysis system The time period for stair up and down was normalized using the MatLab 6.5 program, and EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities according to the hip rotation (neutral or internal rotation) during the entire time period of stair up and down in each phase were compared using a paired t-test. During the entire period of stair up, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). During the entire period of stair down, the EMG activities of VL and TFL in condition 2 were significantly greater than in condition 1 (p<.05). However, the EMG activities of the other muscles were not significantly different between the conditions (p>.05). These results suggest that the stair up and down maintaining hip internal rotation was could be a contributing factor on patellar lateral tracking.

Studies of attentional focus effects, have shown that the performer's attentional focus plays an important role in the performance and learning of motor tasks. We examined the influence of attentional focus on the performance of dual tasks (a postural task and a suprapostural task) and used electromyography (EMG) to examine whether the differences between external and internal focus were also manifest at the neuromuscular level. The subjects (n=40) stood on a balance board (postural task) and held a bar horizontally (suprapostural task). All of the subjects performed under different attentional focus conditions: external (balancer on balance board) or internal (feet) focus on the postural task, and external (balancer on bar) or internal (hand) focus on the suprapostural task. The mean displacement velocity of the bar and the percent reference voluntary contraction (%RVC) of the biceps brachii were reduced when the subjects adopted an external focus on the suprapostural task (p<.05). In addition, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were reduced when the subjects adopted an external focus on the postural task (p<.05). When the subjects adopted an external focus on the suprapostural task, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were also reduced (p<.05). When the subjects' attentional focus was on the postural task, there were no differences in the mean displacement and %RVC of the biceps brachii between attentional focuses. The performance of each task was enhanced when subjects focused on the respective task. The suprapostural task goals had a stronger influence on postural control than vice versa. These results reflect the propensity of the motor system to optimize control processes based on the environmental outcome, or movement effect, that the performer wants to achieve.

목적 : 본 연구의 목적은 문항반응이론에 기초한 라쉬모형을 적용하여 뇌졸중 외래환자의 일상생활수행 평가도구를 개발하는 것이다. 연구방법 : 연구 대상자는 뇌졸중 외래환자로 169명이었다. 조사방법은 사전연구에서 항목의 중요도로 수집된 23개의 일상생활수행 평가항목으로 구성된 설문지를 사용하였다. 조사자료는 전국 18개 재활기관에서 작업치료사가 평가한 결과를 수집하여 Winsteps 프로그램으로 라쉬분석을 하였다. 결과 : 7개 항목이 부적합한 항목으로 판정되었으며, 16개 항목이 적절한 항목으로 채택되었다. 뇌졸중 외래환자의 일상생활 수행능력은 -6.32~6.23 로짓으로 표시할 수 있으며, 표준화점수로 표시하기 위한 변환식은 "점수=(로짓점수+6.32)/(6.32+6.23)100" 이었다. 일상생활 수행능력을 평가하기위한 항목을 난이도 순서에 따라 배열하였다. 가장 어려운 항목은 보행영역의 '계단 오르내리기' 항목이었으며, 가장 쉬운 항목은 식사하기 영역의 '음료 마시기’항목이었다. 결론 : 라쉬분석을 이용하여 개발된 뇌졸중 외래환자의 일상생활수행 평가도구는 신뢰도와 타당도가 입증된 객관적인 도구이다.

The purpose of this study was to examine inter- and intra-examiner reliability of the sacroiliac joint (SIJ) anatomical landmarks palpation. Two physical therapists and one doctor specializing in rehabilitation examined 22 asymptomatic subjects. They examined anterior superior iliac supine (ASIS), posterior superior iliac supine (PSIS) and iliac crest (IC). For the assessment of intra-examiner reliability, 3 examiners repeated the measurements 3 times over a 2-week interval. Kappa (Kg) yielded intra-examiner reliability that ranged between slight to fair for the ASIS (Kg=.06 to .26; mean Kg=.19), and slight for the PSIS(Kg=-.04 to .18; mean Kg=.07) and slight to fair for the IC (Kg=.06 to .32; mean Kg=.21). Inter-examiner reliability was slight (ASIS Kg=.13; PSIS Kg=.05; IC Kg=.14). These results suggest that the reliability of the assessing SIJ anatomical landmarks using palpation and observation as an indication of SIJ dysfunction still remains questionable. Before this test can be relied upon as an accurate indicator of SIJ dysfunction, it must undergo further research. This further research needs to examine not only reliability, but also validity, sensitivity and specificity.

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in erector spinae, multifidus, rectus abdominis and biceps brachii during perturbation between subjects with and without work-related chronic low back pain (LBP). Twenty-nine subjects, 14 with and 15 without LBP, participated in this study. The muscle responses were measured by surface EMG (electromyography) during perturbation in eye opened and eye closed conditions. The EMG onset times of the erector spinae, multifidus, rectus abdominis and biceps brachii were similar between groups in eye closed condition. But the onset times of the erector spinae, multifidus, rectus abdominis were significantly delayed in subjects with LBP in eye opened condition. The results provide an evidence for impaired feed-forward control of the trunk muscles in subjects with LBP. Further studies are needed to identify whether the impaired feed-forward control of the trunk muscles is the contributing factor to LBP.

The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) is a valid and widely used instrument for the assessment of osteoarthritis patients. In this study, data was obtained from the out-patients with painful osteoarthritis of the knee. One hundred-three out-patients were interviewed by physical therapists. In an exploratory way, a Korean version of the KWOMAC was analyzed for unidimensionality, item separation, and item difficulty using the Winsteps programs. Ninety-five patients with osteoarthritis of the knee over 65 years were analyzed for Rash analysis. In the analysis several functional items poorly fit to the model. These items included "heavy domestic duties" and "standing". In the pain domain, one item ("at night while in bed") did not fit the model. In the stiffness domain one item ("after sitting, lying, or resting later in the day") did not fit the model. Although 4 items from the 3 domains (pain, stiffness, function domain) do not fit well, the KWOMAC domains were confirmed by Rasch analysis. Thus the KWOMAC needs to be further examined before it can be used to properly determine the health status of the elderly with OA.

This study was designed to examine, applying Rasch analysis based on item response theory, the questionnaires of the Activities-Specific Balance Confidence (ABC) scale for the elderly. The subjects were 99 institutional older adults and clients of social welfare facilities. The subjects (17 men, 72 women) ranged in age from 65 to 94 years (mean age 76.5 yrs). The Winsteps software was used to assess whether the ABC scale fits the Rasch model, to estimate the score and to refine the rating scale. The results are as follows. Twenty-two subjects were excluded as misfit persons. Four items were found to be misfits and the order of difficulty of the remaining 12 items was rearranged. Their balance confidence is indicated by -.64~1.12 logit, and the transformation formula is score=[(logit score+2.76)/(2.76+3.48)]100. The most difficult item was "Walk outside in icy sidewalks" and the easiest item was "Walk around house." In conclusion, the ABC scale for the elderly has been proven reliable and valid. Therefore, it is expected to be used as an effective examination tool for treatment planning and screening for older adults.

목적 : 문항반응이론에 기초한 Rasch모형을 적용하여 뇌졸중 입원환자의 일상생활수행 평가도구를 개발하는 것이다． 연구방법 : 2002년 8월 5일부터 2005년 4월 20일까지 전국 18개 재활기관에서 뇌졸중 입원환자 308명을 대상으로，작업치료사가 평가한 6개 영역의 23개 항목으로 구성된 설문지 결과를 수집하여 Winsteps 프로그램으로 라쉬분석하였다． 결과 : 3개 항목이 부적합한 항목으로 판정되었으며，남은 20개 항목의 난이도 순서를 배열하였다．뇌졸중 입원환자의 일상생활 수행능력은 -6.77~6.73 로짓으로 표시할 수 있으며，표준화점수로 표시하기 위한 변환식은 "점수 =（로짓점＋6.77)/ (6.77+6.73) 100" 이었다．평가항목의 난이도는 가장 어려운 항목은 보행영역의 ‘계단 오르내리기’ 항목이었으며，가장 쉬운 항목은 식사하기 영역의 ‘음료 마시기’ 항목 이었다． 결론 : 라쉬분석을 이용한 뇌졸중 입원환자의 일상생활수행 항목의 적합도와 난이도에 관한 결과제시로 개발되었으며，신뢰도와 타당도가 입증된 객관적인 평가도구이다．

This study was designed to examine, using Rasch analysis, the rating scale performance of the Korean version of the Berg Balance Scale (BBS). The subjects were 95 elderly people at community dwelling. Subjects (19 men, 76 women) ranged in age from 65 to 91 years. Rasch analysis was then done by means of the Winsteps program to determine the validity and reliability of the Korean version of the BBS evaluation tools for elderly people. The results were as follows: Twenty-one elderly people were excluded for misfit persons. Three items were found to be misfits and the order of item difficulty of the remaining 11 items was arranged. Elderly people BBS ability is indicated by -.94~7.41 logit, and the transformation formula is score=(logit score+.94)/. This transformation formula can be applied to Korean elderly people for balance ability. In the order of difficulty of evaluation items, the most difficult item was "Standing on one foot" and the easiest item was "Standing to Sitting". In conclusion, the Korean version of BBS evaluation tool for the elderly people has been proved valid and will be useful in clinical practice and research in Korea.

Work-related musculoskeletal disorder has been associated with long hours of computer work and prolonged periods of static posture. In clinical settings, postural correction is a common treatment approach for individuals with neck, shoulder, and back pain. This study was designed to identify the effect of Forward Head Posture Correctional Device during computer work. Twelve healthy adults (mean age, 27.4 yrs; mean height, 165.0cm mean weight, 65.8 kg) participated in the study. They had no medical history of neurological or surgical problems with their upper extremity. The subjects were asked to perform Head Forward Posture under the guidance of physical therapists and the measured angles were analyzed using a 3-D motion analysis system. Markers were placed on the C7 spinous process, tragus of the ear and forward head angle was between the line from the tragus to the C7 line and the Y-axis at the C7. The statistical significance of difference between, "without" and "with" correctional device was tested by paired t-test. A level of significance was set at α=.05. In comparison of the computer work between "without" and "with" correctional device, Forward Head Angle was showed significant difference (p<.05). In conclusion, the range of Forward Head Angle was significantly decreased during computer work with the correctional device. Further research is needed to understand the nature of motor control problems in deep muscles in patients with neck, shoulder, and back pain.

The purpose of this study was to produce the regression equation from non-exercise of healthy young adults and to develop a maximal oxygen consumption () regression model. This model was based on heart rate non-exercise predictor variables (rest heart rate, maximal heart rate/rest heart rate), as an extra addition to the general regression which can reflect an individual's inherent or acquired cardiorespiratory fitness. The subjects were 101 healthy young adults aged 19 to 35 years. Exercise testing was measured by using a Balke protocol for treadmill and indirect calorimetry. The prediction equation was analyzed by using stepwise multiple regression procedures. The mean of was (meanSD). The greatest variable correlated to was %fat. The predictor variable used in the non-exercise included %fat, gender, habitual physical activity and . The non-exercise estimation was as follows: ()=55.58-.41(%fat)+.59(physical activity rating)-2.69()-5.36 (male=0, female=1); (R=.85, SEE=3.64, R2=.72: including heart rate variable); ()=48.47-.41(%fat)+.45(physical activity rating)-5.12 (male=0, female=1); (R=.84, SEE=3.74, R2=.70: with the exception of heart rate variable). As an added heart rate variable, there was only a 2% coefficient of determination improved. Therefore, these results demonstrated that heart rate variable correlation with a non-exercise regression model was very low. In conclusion, for healthy young korean adults, those variables that can affect non-exercise estimation turned out to be only % fat, gender, and physical activity. We suggest that further research of predictor variables for non-exercise is necessary for different patient groups who cannot perform maximal exercise or submaximal exercise.

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 (<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 (<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.

Patellofemoral pain syndrome (PFPS) is often attributed to malalignment and maltracking of patella within the patellofemoral joint. Most exercise for PFPS has focused on selectively strengthening the vastus medialis oblique muscle (VMO). This study was designed to identify the effect of medial, lateral wedge and difference of Quadriceps angle (Q-angle) on vastus medialis oblique/vastus lateralis muscle (VL) activity ratios. The subjects were twenty young adult males who had not experienced any knee injury. They were asked to perform isometric contraction exercises in three postures using medial and lateral wedge. The EMG activity of the VL and VMO were recorded in three postures by surface electrodes and normalized by %MVC values derived from seated, isometric knee extensions. The normalized EMG activity levels (%MVC) of the VL and VMO for the three postures of the lower extremities were compared using 2-way repeated measures ANOVA with 1 between-subject factor (group), and 1 within-subject factor (wedge). Results of repeated measures of ANOVA's revealed that the medial wedge isometric contraction exercise produced significantly greater EMG activity of VMO/VL ratios in Group I (Q-angle or less) (p<.05). But, the medial wedge isometric contraction exercise was no significant difference of VMO/VL ratios in Group II (Q-angle or more) (p>.05). These results have important implications for selective VMO muscle strengthening exercises in PFPS patients.

The purpose of this study was to determine whether gender differences existed in knee valgus kinematics in college students when performing a vertical drop landing. The hypothesis of this study was that females would demonstrate greater knee valgus motion. These differences in knee valgus motion may be indicative of decreased dynamic knee joint control in females. This study compared the initial knee valgus angle and maximum knee valgus angle at the instant of impact on vertical drop landings between healthy men and women. In this study, 60 participants (30 males, 30 females) dropped from a height of 43 cm. A digital camera and two-dimensional video motion analysis software were used to analyze the kinematic data. There was significant difference in the mean knee valgus angle at initial contact landing between the two groups (Mean=, SD= in males, Mean=, SD= in females). The range of knee valgus angle on landing (Mean=, SD= in males, Mean=, SD= in females) was differed significantly (p<.05). The maximal angle of knee valgus on landing (Mean=, SD= in males, Mean=, SD= in females) was also differed significantly (p<.05). The females landed with a larger range of knee valgus motion than the males and this might have increased the likelihood of a knee injury. The absence of dynamic knee joint stability may be responsible for increased rates of knee injury in females. No method for accurate and practical screening and identification of athletes at increased risk of ACL injury is currently available to target those individuals that would benefit from neuromuscular training before sports participation.