Background: Forward head posture (FHP) causes various posture imbalances associated with the head and neck. Myofascial release is an effective treatment method used for relaxing muscles and reducing muscle hyperactivity, but no studies have been conducted on suboccipital and neck muscles related to FHP. Objects: The purpose of this study was to investigate the immediate effect of roller massages on the cranio-cervical flexion (CCF) range of motion (ROM) and CCF strength applied to suboccipital and neck muscles in subject with forward head posture. Methods: Twenty-four FHP subjects (male: 13, female: 11) were recruited for this study. All subjects were recruited with a craniovertebral angle (CVA) of 53 degrees or less and a head tilt angle (HTA) of 20.66 degrees or higher. CCF strength was measured using Pressure biofeedback unit (PBU) in the supine posture and CCF ROM was measured using smartphone-based inclinometer. Roller massage (RM) was applied to suboccipital and neck muscles for 2 minutes and CCF ROM and strength were remeasured. Results: These results of this study showed that CCF ROM was a significant difference in CCF ROM before and after RM (p < 0.05). CCF strength also showed a significant difference before and after RM (p < 0.05). Conclusion: RM method might be recommended to increase the immediate ROM and strength of CCF in subjects with forward head posture.

본 연구는 한국의 종교들이 전 지구적인 전염병의 위험에 대비하여 새로운 유형의 대안 의례를 생산하고 실천하는 현상에 대해서 미셸드 세르토의 전략 과 전술 개념을 차용하여 해석하고 고찰하는 기회를 마련하였다. 세르토의 ‘전략’은 특정한 장소를 중심으로 지배자의 행위가 피지배자들을 통치하는 계산이라면, ‘전술’은 약자가 강자의 지배 영역 안에서 도피하지 않으면서도 주체적인 행위의 공간을 생산하면서 승리하려는 작전의 실천이다. 본래적인 의미의 종교의 의례는 공간의 무한함과 무질서에서 중심을 설정하고 거룩하고 성스러운 내 부의 장소를 구축하는 장소화 전략이다. 본래적인 종교의 의례에 함축되어 있는 권력 관계와 피지배자들에 대한 가시적인 통제를 전략이라고 본다면, 가상공간 속에서 이루어지는 사이버(온라인) 의례는 종교 내부의 위계질서와 인체에 침범 하는 바이러스의 공격을 무력화하는 장소의 공간화를 실천하면서 전술적 성공을 이룬다.

Background: Hip flexor muscles are very important in the hip joint structure as a mover and stabilizer. In addition, isometric hip flexor strength in the supine position needs to be considered with isometric core strength (WICS) to measure a precise strength in a clinical way. Objects: We compared isometric hip flexor strength in the supine position in subjects with and without WICS (between factors) and conditions with and without an external support (within factors). Methods: A total of 34 subjects (16 with WICS, 18 without WICS) participated in this study. We used the double-bent leg-lowering test to divide the subjects in two groups according to the presence of WICS. Isometric hip flexor strength was evaluated in the supine position both with and without an external support condition. The two-way mixed analysis of variance was applied to identify significant differences between groups (with vs. without WICS: between factors) and conditions (with vs. without an external support: within factors). Statistical significance was set at α = 0.05. Results: In subjects with WICS, isometric hip flexor strength was greater with an external support than without it (p = 0.0064). In subjects without WICS, there were no significant differences in isometric hip flexor strength in the presence or absence of an external support (p = 0.075). The isometric hip flexor strength was significantly greater with an external support condition in particular in subjects with WICS. Conclusion: The findings of this study reported that an external support condition in individuals with WICS may contribute to the improvement of isometric hip flexion strength in the supine position. Therefore, isometric core strength should be evaluated to distinguish the weakness between core region and hip flexors.

Background: If there is a difference in leg length, the center of gravity shifts unilaterally toward the short leg, causing loss of balance and secondary postural imbalance, trunk muscle tone changes, gait abnormalities and pelvic imbalance. Objectives: To investigate effects of self exercise program on leg length, balance in adults with leg-length discrepancy. Design: Single blind randomized controlled trial. Methods: Twenty-eight participants were selected and divided into resistance exercise, flexibility exercise, and core exercise. Each exercise was performed for 40 minutes, 3 times a week for 6 weeks. Leg length and balance before and after exercise were measured and analyzed. Results: Following the interventions, resistance exercise group showed significant improvement in balance, but leg length difference did not show significant results. Flexibility exercise group showed significant improvement in leg length difference, but balance did not show significant results. Core exercise group showed significant improvement in leg length difference and balance. There was no significant difference in the comparison between the three groups. Conclusion: This study suggests that customized exercise according to the patient's level is beneficial to the patients.

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

Background: The characteristics of lateral epicondylitis (LE) are muscle strength weakness and increased common extensor tendon (CET) thickness. Ultrasonography has recently been used to evaluate tendinopathy. Diamond taping (DT) is commonly used to manage patients with LE. However, no previous studies have investigated the effects of DT on CET thickness. Objects: The aim of this study was to investigate the effects of DT applied around the lateral elbow on CET thickness, grip strength, and wrist extension force in healthy subjects. Methods: The subjects were 26 adults (13 male) in their twenties. First, the CET thickness was measured at rest. The CET thickness was measured by using ultrasonography at two points. The subjects were then instructed to perform maximal grip activities or maximal wrist extension activities before and after DT around the lateral elbow. The DT technique was applied using non-elastic tape. While the subjects performed maximal grip activities, the investigator measured the maximum grip strength (MGS) and CET thickness. Likewise, while the subjects performed maximal wrist extension activities, the investigator measured the maximum wrist extension force (MWEF) and CET thickness. Results: The MGS showed a statistically significant improvement after DT taping application in men (p < 0.05). The MWEF showed a statistically significant improvement after DT application in male (p < 0.01) and female (p < 0.05). When performing the activities, the CET thickness increased compared to that at rest. However, CET thickness didn’t show a statistically significant improvement before and after DT. Conclusion: This study shows that DT applied around the lateral elbow is effective in improving MGS and MWEF. However, it does not affect CET thickness.

The purpose of this study was to investigate the comparison of nutrient intake and metabolic syndrome between single person households and non-single person households in elderly subjects. We analyzed data from 2,903 subjects ≥ age 65 who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) 2013~2015. As a result, single-person households had lower income and economic ability, overall nutrient intake was deteriorated, and the proportion of high-carbohydrate intake was high, compared to non-single person households. After adjusting for potential confounders (sex, age, education, household income, economic activity, smoking status, alcohol consumption, walking frequency, health status, depression status, and dietary factors), the singleperson household showed a tendency of 1.22-fold higher ORs of metabolic syndrome and 1.3-fold higher ORs of hypertriglyceridemia than the non-single-person household. We suggest that the single-person household may be associated with increased prevalence of metabolic syndrome and hypertriglyceridemia in the elderly subjects.

Background: The gastrocnemius (GCM) is one of the lower extremity muscles that tend to tighten easily. GCM tightness results in limited ankle dorsi-flexion (DF), especially when the knee joint is fully extended. Joint flexibility is determined by the morphological and physiological characteristics of joints, muscles, tendons, and ligaments. Impaired joint flexibility can be attributed to increased susceptibility to muscle injury. High-frequency diathermy is clinically used to reduce pain and muscle tightness and to improve limited range of motion. Objects: This study aimed to investigate the immediate effects of high-frequency therapy in subjects with GCM tightness. Methods: The study was designed as a one-group before–after trial. The subjects included 28 volunteers with GCM tightness (an active ankle DF angle of less than 12°) without any known neurological and musculoskeletal pathologies in the ankle and calf areas. WINBACK Transfer Electrode Capacitive and Resistive Therapy equipment was used to apply high-frequency therapy to the subjects’ GCMs for 10–15 minutes. The pennation angle and the fascicle length of the GCM were measured using ultrasonography. The flexibility of the ankle joint, peak torque to the passive ankle DF (Biodex), and soft tissue stiffness (MyotonPRO) were also measured. Results: The pennation angle was significantly decreased following the treatment; however, no significant difference in the fascicle length was found (p < 0.05). The flexibility was significantly increased and both the passive peak torque to passive ankle DF and the soft tissue stiffness significantly decreased (p < 0.05). Conclusion: High-frequency therapy is immediately effective for improving the muscle’s architectural properties and functional factors in subjects with GCM tightness. Further longitudinal clinical studies are required to investigate the long-term effects of high-frequency therapy on subjects with GCM tightness from various causes.

Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.

본 연구의 목적은 무릎 푸시업 플러스 동작 시 슬링과 진동기 적용이 체간 근육의 근활성도 변화에 미치는 영향에 대해 알아보는 것이었다. 본 연구의 대상자는 신체 건강한 20대 남성 10명을 대상으로 실시하였고(연령, 23.00±0.45 세; 신장, 176.60±1.64 cm; 체중, 67.50±1.22 kg; 신체질량지수, 21.65±0.34 kg/m2), 3가지의 기본 무릎 푸시업 플러스 동작, 슬링을 적용한 무릎 푸시업 플러스 동작, 및 진동기를 적용한 무릎 푸시업 플러스 동작을 수행하였으며, 표면전극 부착 부위는 체간 근육의 오른쪽 상부 승모근, 대흉근, 전거근, 복직근, 및 외복사근으로 설정하였다. 본 연구의 결과는 다음과 같다. 승모근, 대흉근, 전거근, 복직근, 및 외복사근의 근활성도는 진동기를 적용한 무릎 푸시업 플러스 동작 시 통계적으 로 가장 높게 나타났다(p<.001). 따라서 본 연구의 결과는 향후 무릎 푸시업 플러스 동작 적용 시 효과적인 체간 근육을 강화시키기 위한 트레이닝 프로그램의 기초자료가 될 것으로 기대된다.

Background: Flat-footed persons with collapsed medial longitudinal arch lose flexibility after skeletal maturity, resulting in several deformities and soft tissue injuries. Although arch support taping is usually applied in the clinic to support the collapsed arch, research on the use of different types of tape for more efficient arch support in flat-footed persons is lacking. Objects: The purpose of this study was to examine three conditions (barefoot, kinesio tape, and dynamic tape) and compare their effects on static and dynamic balance in persons with asymptomatic flexible flatfoot. Methods: Twenty-two subjects (9 females and 13 males) with asymptomatic flexible flatfoot participated in this study. The subjects performed the Y-balance test to measure the composite reach score. The subjects also performed a 30-second standing test to measure the center of pressure (COP) path length and a walking test to measure anteroposterior and lateral variability using the Zebris FDM system. One-way repeated-measures analysis of variance compared the three conditions applied to the subjects’ feet for each balance variable. Results: The composite reach score significantly increased following the application of dynamic tape compared with barefoot and that of kinesio tape compared with barefoot. There was no significant difference in the COP path length during standing among the three conditions. Anteroposterior and lateral variability during walking significantly with dynamic tape application compared with barefoot. Conclusion: The results of this study suggest that, in persons with asymptomatic flexible flatfoot, application of kinesio tape and dynamic tape may be effective in increasing the composite reach score in Y-balance test, whereas application of dynamic tape may be effective in reducing anteroposterior and lateral variability during walking.

This study examined the difference of dietary intake behavior between groups of adults aged >20 years with or without dyslipidemia, and comparing the various types of dyslipidemia, based on the Seventh (2016) KNHANES. Men showed higher rate for triglyceridemia and LDL-cholesterolemia than women and subjects in the age group 50-59 years exhibited the highest incidence of triglyceridemia, total cholesterolemia and HDL-cholesterolemia. The ratio of obese people was higher in most types of dyslipidemias. The top five foods in each group of cereal & grain, meat, vegetable, and fruit were selected for analysis, based on the food frequency. The dyslipidemia group showed higher intake frequencies for mixed grains, cabbage kimchi and leafy vegetable than the no-dyslipidemia group, and the group with high blood total cholesterol for mixed grains, apple, and cutlassfish-croaker. Group with high blood triglyceride showed higher intake frequencies of rice and mackerel-mackerel pike than the other groups of high blood triglyceride. No food showed significant difference in the frequencies between groups of LDL-cholesterol. Group with high blood HDL-cholesterol showed higher intake frequency of bibim-fried rice, deep fried chicken, stir fried chicken, apple, tangerine, banana and butter-margarine. These results indicate that people with high levels of blood total cholesterol are more concerned with food having health benefits than those with abnormal levels of other blood lipid. More information on dietary benefits need to be provided to patients having high levels of triglyceride, LDL-cholesterol and HDL-cholesterol.

Background: An excessive pronated foot is defined as a flattening or complete loss of the medial longitudinal arch. Excessive foot pronation is considered to have high risk factors of overuse injuries in the lower limb. Various treatments have been investigated in attempts to control excessive pronation. Objects: This meta-analysis identifies the effects of an anti-pronation taping technique using different materials. Methods: The electronic databases used include MEDLINE, the Physiotherapy Evidence Database (PEDro), Science Direct, the Korean Studies Information Service System (KISS), the Research Information Sharing Service (RISS), the Korea National Library, and the Korean Medical Database (studies published up to July 31, 2019). The database search used the following keywords: "foot drop" OR "foot arch" OR "foot pronation" OR "flat foot (pes planus)" AND "taping" OR "support." Eight eligible studies were analyzed to determine the effectiveness of anti-pronation taping in study and control groups. Results: The overall random effect size (Hedges’ g) of the anti-pronation taping technique was 0.147 (95% confidence interval [CI]: -.214 to .509). When the effect (Hedges’ g) was compared by the type of tape material, rigid tape (RT; Lowdye taping) was .213 (95% CI: -.278 to .704) and kinesiotape (KT; arch support taping) was -.014 (95% CI: -.270 to .242). Based on this meta-analysis, it was not possible to identify the extent to which anti-pronation taping was effective in preventing navicular drop, improving balance, or changing foot pressure. Only three of the eight eligible studies applied KT on excessive pronated feet, and the outcome measure areas were different to those of the RT studies. The KT studies used EMG data, overall foot posture index (FPI) scores, and rear foot FPI scores. In contrast, the RT studies measured navicular heights, various foot angles, and foot pressure. Conclusion: This review could not find any conclusive evidence about the effectiveness of any taping method for patients with pronated feet. Future studies are needed to develop the anti-pronation taping technique based on the clinical scientific evidence.

Background: The serratus anterior is one of the most important muscle for maintaining good scapular alignment in the shoulder joint. The pectoralis major and upper trapezius may also compensate for weak serratus anterior muscles. The push-up plus exercise has been identified as the optimal exercise for maximum activation of the serratus anterior. Objects: The purpose of this study was to examine differences in surface electromyography (EMG) activity of upper trapezius, pectoralis major, and serratus anterior muscles during push-up plus exercises on variously angled surfaces in subjects with winged scapula. Methods: Sixteen subjects with winged scapula (male=5, female=11) volunteered for this study. The subjects performed push-up plus exercise on four different tilt angles, namely 0˚, 30˚, 60˚, and 90˚. EMG activities in the serratus anterior, upper trapezius, and pectoralis major muscles during performance of push-up plus exercise were measured in all subjects. Data were processed from repeated measures one-way analysis of variance. Results: There was significant difference in the muscle activity of the serratus anterior on the different surface angles (p＜.05). The results of the post-hoc analysis showed significantly greater serratus anterior muscle activity on a surface at a 0˚ angle than at others tilt angles (p＜.05). There was also significant difference in the ratio of serratus anterior to upper trapezius and serratus anterior to pectoralis major across the four surfaces (p＜.05), and post-hoc analysis showed significantly greater values on the 0˚ surface than on other tilts (p＜.05). Conclusion: This study found that performing push-up plus exercises on a flat surface with 0˚ and 30˚ tilt angle achieves high activation of the serratus anterior muscle for selective strengthening. It can also take into account the sequential application, which is first performed at a 30˚ and at a 0˚ tilt angle for and effective but not excessive muscle activation.

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with 90˚ knee flexion, without hip external rotation (b) with 90˚ knee flexion, with hip external rotation (c) with 135˚ knee flexion, without hip external rotation (d) with 135˚ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). While HAM muscle activity was significantly less in 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). ES muscle activity was significantly less in the 135˚ knee flexion position than in the 90˚ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in 135° of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

Winged scapular (WS) causes muscle imbalance with abnormal patterns when moving the arm. In particular, the over-activation of the upper trapezius (UT) and decrease in activity of the lower trapezius (LT) and serratus anterior (SA) produce abnormal scapulohumeral rhythm. Therefore, the SA requires special attention in all shoulder rehabilitation programs. In fact, many previous studies have been devoted to the SA muscle strength training needed for WS correction. Objects: The purpose of this study was to investigate the effect of shoulder girdle muscle and ratio according to the angle of shoulder abduction and external weight in supine position. Methods: Twenty three WS patients participated in this experiment. They performed scapular protraction exercise in supine position with the weights of 0 ㎏, 1 ㎏, 1.5 ㎏, and 2 ㎏ at shoulder abduction angles of 0˚, 30˚, 60˚, and 90˚. The angle and weight applications were randomized. Surface electromyography (EMG) was used to collect the EMG data of the SA, pectoralis major (PM), and UT during the exercise. The ratio of PM/SA and UT/SA was confirmed. Two-way repeated analyses of variance were used to determine the statistical significance of SA, PM, and UT and the ratios of PM/SA and UT/SA. Results: There was a significant difference in SA according to angle (p<.05). Significant differences were also identified depending on the angle and weight (p<.05). The angle of abduction at 0˚, 30˚ and weight of 2 ㎏ showed the highest SA activity. However, there was no significant difference between PM and UT (p>.05). There was a significant difference between PM/SA and UT/SA in ratio of muscle activity according to angle (p<.05). Significant differences were found at PM/SA angles of 30˚, 60˚ and 90˚ (p<.05). For UT/SA, significant difference was only observed at 90˚ (p<.05). Conclusion: Based on the results of this study, in order to strengthen the SA, it was found to be most effective to use 1 and 1.5 ㎏ weights with abduction angles of 0˚ and 30˚ at shoulder protraction in supine position.

Background: Forward head posture (FHP) is a postural alignment of the cervical vertebrae that leads to increased gravitational load on cervical segmental motions. The overhead arm lift test assesses the ability to actively dissociate and control low cervical flexion and move the shoulders through overhead flexion. Objects: The purpose of this study was to explore muscle activities in the upper trapezius (UT), serratus anterior (SA), sternocleidomastoid (SCM), and lower trapezius (LT) alongside changes in head position during the overhead arm lift test in individuals with FHP. Methods: Fifteen subjects with forward head posture and fifteen subjects with normal subjcects were enrolled in this study. The patients performed the overhead arm lift test, and muscle activities of the UT, SCM, SA, and LT were measured using surface electromyography and by evaluating changes in head position. Independent t-tests were used to detect significant differences between the two groups and Cohen’s d was calculated to measure the size of the mean difference between the groups. Results: The FHP group demonstrated significantly increased muscle activity of the UT (32.46±7.64), SCM (12.79±4.01), and LT (45.65±10.52) and significantly decreased activity in the SA (26.65±6.15) than the normal group. The change in head position was significantly higher in the FHP group (6.66±2.08) than the normal group. Effect sizes for all parameters assessed were large between the two groups. Conclusion: The subjects with excessive FHP displayed were unable to fix their heads in position during the overhead arm lift test. The overhead arm lift test can thus be used in clinical settings to confirm control of the neck in these subjects.

Background: In previous studies, changes in postural alignment were found when the slope was changed during walking. Downhill walking straightens the trunk by shifting the line of gravity backward. Objects: This study investigated the effect of the downhill treadmill walking exercise (DTWE) on thoracic angle and thoracic erector spinae (TES) activation in subjects with thoracic kyphosis. Methods: A total of 20 subjects with thoracic kyphosis were recruited for this study. All the subjects performed the DTWE for 30 minutes. A surface EMG and 3D motion capture system were used to measure TES activation and thoracic angle before and after the DTWE. Paired t-tests were used to confirm the effect of the DTWE (p<.05). Results: Both the thoracic angle and TES activation had significantly increased after the DTWE compared to the baseline (p<.05). An increase in the thoracic angle indicates a decrease in kyphosis. Conclusion: The DTWE is effective for thoracic kyphosis patients as it decreases their kyphotic posture and increases the TES activation. Future longitudinal studies are required to investigate the long-term effects of the DTWE.

본 연구는 4년제 대학 중국어 전공자들을 위한 국가직무능력표준(NCS) 기반 관광서비스 분야 교과목 개발 모색을 목표로 하였다. 4차 산업혁명에 따른 일자리 변화와 중국과의 관계를 고려할 때, 서비스산업의 성장과 중국어 필요성의 요구는 관광서비스 분야의 교과목 도출로 이어지며 나아가 맞춤형 인재양성의 교육목표에도 부합된다. NCS기반 관광서비스 분야 교과목 개발 첫 단계에서는 관광산업전망 동향과 부산 지역 대학교의 교과목 현황을 분석하였다. 다음으로, NCS 분류에서 관련된 직무와 능력단위를 도출하여 부산 지역적 특성을 고 려한 맞춤형 교과목을 개발하였다. 마지막으로 NCS 능력단위요소에 따른 수행준거 및 지식, 기술, 태도를 바탕으로 각각의 교과목 프로파일을 작성하였다.