Background: To prevent or reduce the risk of strain injury, various approaches, including stretching techniques are currently being used. The effect of proprioceptive neuromuscular facilitation (PNF) and static stretching on flexibility has been demonstrated; however, it is not clear which one is superior. Objects: This study aimed to evaluate the differences between the effects of PNF and static stretching performed at various intensities on muscle flexibility. Methods: The maximum voluntary isometric contraction (MVIC) of the hamstrings using the PNF stretching technique was performed in the P100 group, while 70% of the MVIC was performed in the P70 group. The MVIC value obtained during the PNF stretching in both groups was used as a reference for setting the intensity of static stretching. Static stretching was performed at 130% (S130), 100% (S100), and 70% of the MVIC (S70). The active knee extension (AKE) values, defined as the knee flexion angle were measured before stretching (baseline), immediately after stretching (post), and at 3 minutes, 6 minutes, and 15 minutes. Results: PNF stretching produce a greater improvement in flexibility compared with static stretching. Specifically, the ΔAKE was significantly higher in the S100 and S70 groups than in the P100 group at Post. In the comparison of ΔAKE over time in each group, the ΔAKE at Post showed a significant decrease compared to the value at Baseline in the S130 group; however, no significant difference was observed at 6 minutes while a significant increase was noted at 15 minutes. Conclusion: This study found that PNF stretching is more effective than static stretching with respect to increasing and maintaining the flexibility of muscles. In addition, the increase in flexibility at maximal intensity was similar to that observed at submaximal intensity during both PNF and static stretching.

Background: Stretch-oriented home exercise programs are often used as treatments for patients with adhesive capsulitis; however, there is lack of research on home exercise programs to strengthen rotator cuffs. Objects: The aim of this study is to investigate the effect of home exercise programs for rotator cuff strengthening on pain, range of motion (ROM), disability level, and quality of life in patients with adhesive capsulitis. Methods: Twenty-two patients with adhesive capsulitis volunteered to participate in this study. The subjects were randomly divided into an experimental group (n = 11) and control group (n = 11). For the experimental group, manual therapy and home exercise programs for rotator cuff strengthening were applied for 6 weeks; for the control group, only manual therapy was applied for 6 weeks. Shoulder pain (quadruple visual analogue scale, QVAS), ROM, disability (shoulder pain and disability index-Korean version, SPADI), and quality of life (world health organization quality of life scale-Korean version, WHOQOL-BREF) were evaluated at baseline, after 3 weeks, and after 6 weeks of intervention. The changes in the measurement variables were analyzed by using repeated measure analysis of variance. Results: Significant differences were observed between the experimental group and control group in the QVAS; SPADI-pain scores; SPADI-disability scores; SPADI-total scores; flexion, abduction, internal and external rotation ROM of the glenohumeral joint; and WHOQOLBREF total, overall, physical health, and psychological scores. All groups displayed statistically significant improvements as observed in the QVAS, SPADI, flexion, abduction, external and internal rotation ROM of the glenohumeral joint, and WHOQOL-BREF. Conclusion: Home exercise programs for rotator cuff strengthening had a positive impact on shoulder pain, shoulder ROM, disability level, and quality of life in patients with adhesive capsulitis. Therefore, we propose the use of home exercise programs for rotator cuff strengthening in the exercise rehabilitation of patients with adhesive capsulitis.

Background: As technology has progressed, various robot-assisted devices have been developed to reduce therapists’ labor and assist in therapy. However, due to their many limitations, it is more practical to use traditional mechanical devices. The grahamizer is one such traditional mechanical device used clinically to rehabilitate the upper extremities. No study has yet established the efficacy of the grahamizer in individuals with stroke. Objects: This study investigated the immediate change in arm reaching after the use of a grahamizer. Methods: Twenty-two stroke survivors participated in this study (11 males and 11 females). The reaching of the more-affected arm was measured three times using the three-dimentional electromagnetic motion tracking system “trakSTAR”. After the first measurement, the subjects performed 500 rotatory arm exercises using the grahamizer. To assess the grahamizer’s effect, the subjects were remeasured in the same way. Results: There were significant increases in the reaching distance (p < 0.05) and movement smoothness (p < 0.05) of the more-affected arm after using the grahamizer. Conclusion: Our study confirms that using the grahamizer is beneficial in the rehabilitation for improving movement of the more-affected arm in stroke survivors.

Background: Thoracic spine self-mobilization exercise is commonly used to manage patients with neck pain. However, no previous studies have investigated the effects of thoracic spine self-mobilization exercise alone in patients with chronic neck pain. Objects: The purpose of this study was to investigate the effects of thoracic self-mobilization using a tool on cervical range of motion (ROM), disability level, upper body posture, pain and fear-avoidance beliefs questionnaire (FABQ) in patients with chronic neck pain. Methods: The subjects were 49 patients (21 males, 28 females) with chronic neck pain. The subjects were randomly divided into an experimental group (EG, n = 23) and control group (CG, n = 26). For the EG, thoracic self-mobilization was applied. We placed a tool (made with 2 tennis balls) under 3 different vertebral levels (T1-4, T5-8, T9-12) of the thoracic spine and the subjects performed crunches, which included thoracic flexion and extension in supine position. Five times × 3 sets for each levels, twice a week, for 4 weeks. Cervical pain, disability, upper body posture, FABQ results, and ROM were evaluated at baseline, after 4 weeks of intervention, and at 8 weeks of follow-up. Assessments included the quadruple visual analogue scale (QVAS); Northwick Park neck pain questionnaire (NPQ); craniovertebral angles (CVA), forward shoulder angle (FSA) and kyphosis angle (KA) measurements for upper body posture; FABQ and cervical ROM testing. Results: The EG showed a statistically significant improvement after intervention in the QVAS (–51.16%); NPQ (–53.46%); flexion (20.95%), extension (25.32%), left rotation (14.04%), and right rotation (25.32%) in the ROM of the cervical joint; KA (–7.14%); CVA (9.82%); and FSA (–4.12%). Conclusion: These results suggest that, for patients with chronic neck pain, thoracic selfmobilization exercise using a tool (tennis balls) is effective to improve neck pain, disability level, the ROM, and upper body posture.

The effect of intercritical annealing temperature on the microstructure and mechanical properties of Fe-9Mn-0.2C- 3Al-0.5Si medium manganese steels containing Cu and Ni is investigated in this study. Six kinds of medium manganese steels are fabricated by varying the chemical composition and intercritical annealing temperature. Hardness and tensile tests are performed to examine the correlation of microstructure and mechanical properties for the intercritical annealed medium manganese steels containing Cu and Ni. The microstructures of all the steels are composed mostly of lath ferrite, reverted austenite and cementite, regardless of annealing temperature. The room-temperature tensile test results show that the yield and tensile strengths decrease with increasing intercritical annealing temperature due to higher volume fraction and larger thickness of reverted austenite. On the other hand, total and uniform elongations, and strain hardening exponent increase due to higher dislocation density because transformation-induced plasticity is promoted with increasing annealing temperature by reduction in reverted austenite stability.

Sand casting 3D printing uses a binder jetting method to produce a mold having complicated shape by spraying a binder on sand coated with activator. Appropriate heat treatment process in sand mold fabrication can increase the degree of polymerization to improve flexural strength. However, long heat treatment of over 24 hours decreases flexural strength and reliability due to chemical bond decomposition through thermal degradation. The main role of the activator is to control the reaction rate between the polymer chains. As a result, when the activator composition is increased from 0.15 wt% to 0.25 wt%, the flexural strength is increased by 218 N/cm2. However, excess activator (0.40 wt%) has been shown to decrease reliability without increasing flexural strength. The main role of the binder is to control the flexural strength of the specimen. As the binder composition is increased from 2.00 wt% to 4.00 wt%, the flexural strength increases to about 255 N/cm2, indicating the maximum flexural strength increase. Finally, the reliability of the flexural strength of the fabricated specimens is evaluated by a Weibull plot. Weibull modulus calculations are used to evaluate the flexural strength reliability of the specimens, and maximum reliability value of 11.7 is obtained at 0.20 wt% activator composition. Therefore, it is confirmed that this composition has maximum flexural strength reliability.

In this study, the effects of Sm addition (0, 0.05, 0.2, 0.5 wt%) on the microstructure, hardness, and electrical and thermal conductivity of Al-11Si-1.5Cu aluminum alloy were investigated. As a result of Sm addition, increment in the amount of α-Al and refinement of primary Si from 70 to 10 μm were observed due to eutectic temperature depression. On the other hand, Sm was less effective at refining eutectic Si because of insufficient addition. The phase analysis results indicated that Sm-rich intermetallic phases such as Al-Fe-Mg-Si and Al-Si-Cu formed and led to decrements in the amount of primary Si and eutectic Si. These microstructure changes affected not only the hardness but also the electrical and thermal conductivity. When 0.5 wt% Sm was added to the alloy, hardness increased from 84.4 to 91.3 Hv, and electric conductivity increased from 15.14 to 16.97 MS/m. Thermal conductivity greatly increased from 133 to 157 W/m·K.

Small fishing vessels are manufactured using FRP. Various studies have been conducted to increase the strength of the composite material by mixing alumina powder with resin. Tensile tests and flexural strength tests are conducted to examine the effect of alumina powder on the strength of GFRP. In the current study, resin/alumina composites at different alumina contents (i.e., 0, 1, 5, and 10 vol%) have been prepared. The physical and mechanical properties of the prepared composites have been investigated. From the results, the tensile strength of the specimen with alumina powder mixed in at 10% shows the highest value of 155.66 MPa. The tensile strength of the specimen mixed with alumina powder increases with the amount of alumina powder impregnated. In the flexural strength test, the flexural strength of neat resin without alumina powder has a highest value of 257.7 MPa. The flexural modulus of ALMix-5 has a highest value of 12.06 GPa. Barcol hardness of ALMix- 10 has a highest value of 51. We show that alumina powder leads to decreasing cracks on the surface and decreasing length area of delamination.

Carbon supports for dispersed platinum (Pt) electrocatalysts in direct methanol fuel cells (DMFCs) are being continuously developed to improve electrochemical performance and catalyst stability. However, carbon supports still require solutions to reduce costs and improve catalyst efficiency. In this study, we prepare well-dispersed Pt electrocatalysts by introducing titanium dioxide (TiO2) into biomass based nitrogen-doped carbon supports. In order to obtain optimized electrochemical performance, different amounts of TiO2 component are controlled by three types (Pt/TNC-2 wt%, Pt/TNC-4 wt%, and Pt/TNC-6 wt%). Especially, the anodic current density of Pt/TNC-4 wt% is 707.0 mA g−1 pt, which is about 1.65 times higher than that of commercial Pt/C (429.1 mA g−1 pt); Pt/TNC-4wt% also exhibits excellent catalytic stability, with a retention rate of 91 %. This novel support provides electrochemical performance improvement including several advantages of improved anodic current density and catalyst stability due to the well-dispersed Pt nanoparticles on the support by the introduction of TiO2 component and nitrogen doping in carbon. Therefore, Pt/TNC-4 wt% may be electrocatalyst a promising catalyst as an anode for high-performance DMFCs.

Effect of heat treatment on microstructure and mechanical properties of an Fe-6.5Mn-0.08C medium-manganese steel is investigated in this study. Three kinds of medium-manganese steel specimens are fabricated by varying heat treatments of intermediate quenching (IQ), step quenching (SQ), and intercritical annealing (IA). Hardness and tensile tests are performed to examine the correlation of microstructure and mechanical properties for the Fe-6.5Mn-0.08C medium-manganese steel specimens. The IQ and SQ specimens have microstructures of martensite matrix with ferrite, whereas IA specimen exhibits microstructure of acicular ferrite matrix with martensite. The tensile test results show that the SQ specimen with martensite matrix has the highest yield strength and the lowest elongation. On the other hand, the SQ specimen has the highest hardness due to the relatively lower reduction of carbon content in martensite during intercritical annealing. According to the fractography of tensile tested specimens, the SQ specimen exhibits a dimple and quasi-cleavage fracture appearance while the IQ and IA specimens have fully ductile fracture appearance with fine-sized dimples caused by microvoid coalescence at ferrite and martensite interface.

Doping or incorporation with exotic elements are two manners to regulate the optoelectronic properties of transparent conducting (TCO) cadmium oxide (CdO). Nevertheless, the method of doping host CdO by CdTe semiconductor is of high importance. The structural, optical, and electrical properties of CdTe-doped CdO films are studied for the sake of promoting their conducting parameters (CPs), including their conductivity, carrier concentration, and carrier mobility, along with transparency in the NIR spectral region; these are then compared with the influence of doping the host CdO by pure Te ions. X-ray fluorescence (XRF), X-ray diffraction (XRD), optical absorption spectroscopy, and electrical measurements are used to characterise the deposited films prepared by thermal evaporation. Numerous results are presented and discussed in this work; among these results, the optical properties are studied through a merging of concurrent BGN (redshift) and BGW (blue shift) effects as a consequence of doping processes. The impact of hydrogenation on the characterisations of the prepared films is investigated; it has no qualitative effect on the crystalline structure. However, it is found that TCO-CPs are improved by the process of CdTe doping followed by hydrogenation. The utmost TCO-CP improvements are found with host CdO film including ~ 1 %Te, in which the resistivity decreases by ~ 750 %, carrier concentration increases by 355 %, and mobility increases by ~ 90% due to the increase of Ncarr. The improvement of TCO-CPs by hydrogenation is attributed to the creation of O-vacancies because of H2 molecule dissociation in the presence of Te ions. These results reflect the potential of using semiconductor CdTe -doped CdO thin films in TCO applications. Nevertheless, improvements of the host CdO CPs with CdTe dopant are of a lesser degree compared with the case of doping the host CdO with pure Te ions.

Background: Flexible flat foot is that the medial longitudinal arch collapses in weight bearing and returns normal arch when weight is removed and the weight bearing shifts toward medial part of the foot, which can cause pathological problems in the alignment of the lower extremities and the entire body. Objective: To compare the foot pressure for adults with flexible flat foot. Design: Quasi-Experimental Study Methods: 24 participants with flexible flat foot were recruited and were randomly divided into Visual feedback Short Foot Exercise (VSFE) group and Short Foot Exercise (SFE) group. To compare changes of foot pressure about pre and post intervention, the contact pressure measurement was conducted. Results: In the VSFE, significant differences were observed for the foot pressure of the 1st toe, 1st, 3rd and 4-5th metatarsal, midfoot, medial and lateral heel (p<.05). The foot pressure of the 3rd and 4-5th metatarsal, midfoot showed significant differences in the SFE (p<.05). The contact pressure of the 1st toe, 3rd metatarsal showed significant differences between the groups. Conclusions: Visual feedback short foot exercise can be useful for moving the pressure from medial to lateral part, and can prevent possible pathological problems.

Background: Physical therapy has been widely studied in various fields, however, the academic trends and characteristics has not been systematically analyzed. Semantic network analysis is used as an approach for this study. Objective: To explore academic trends and knowledge system in the physiotherapy research in the Journal of International Academy Physical Therapy (J of IAPTR) Study design : Literature review Method: Semantic network analysis was conducted using the titles of 272 articles published in the Journal of IAPTR from 2010 to 2019. Results: Frequency analysis revealed following most frequently used key words; Stroke (27 times), Balance (21 times), Elder (13 times), Forward head posture (FHP, 11 times), Muscle activity (9 times). The relationship between the presented keywords is divided into six subgroups (FHP and pain, walk and quality, elder and balance, stroke and apoptosis, muscle strength and function) according to their correlation and frequency to be used together. Conclusion: The study is considered to be of help to researchers who want to identify research trends in physiotherapy.

Background: Neurodynamic mobilization is divided into slider mobilization and tensioner mobilization. However, movement direction in neurodynamic mobilization has been overlooked in neurodynamic exercise program. Objective: To examine the effect of movement direction in neurodynamic mobilization on upper limb mobility and pain. Design: Quasi-experimental study Methods: Twenty-two adults positive for neurodynamic test for the median nerve were recruited for participation in this study. Twenty-two subjects were allocated to the applied neurodynamic mobilization at limited side group (ANTLS, n=7), the applied neurodynamic mobilization at contralateral limited side group (ANTCLS, n=7), and the applied neurodynamic mobilization at bilateral side group (ANTBS, n=8). Before the intervention upper limb limited was measured neurodynamic test for the median nerve, pain was measured using visual analogue scale (VAS), movement direction in neurodynamic mobilization was applied to each group, and then re-measured using neurodynamic test for the median nerve and VAS. Differences the Intra-groups before and between the intergroups after intervention were analyzed. Results: In the ANTLS and ANTBS groups, a statistically significant increase in ROM and decrease in VAS score in the population before and after intervention were indicated. Statistically significant differences in VAS and ROM from before to after intervention were found among the ANTLS, ANTCLS, and ANTBS groups. Conclusions: The results of the present study indicate that movement direction in neurodynamic mobilization must be considered within the limits of its selected range of the neurodynamic exercise program.

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

Background: The prevalence of neck pain and neck dysfunction is high in general population. However, there is little literature on the relationship and factors affecting neck pain and neck dysfunction. Objective: To investigate the correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction, and sleep quality in adults with chronic neck pain, and factors affecting neck pain and neck dysfunction. Design: Cross-sectional study Methods : The sample included 114 subjects, who had complained of chronic neck pain for more 12 weeks. We conducted a Pearson’s correlation between neck and shoulder pain, headaches, neck and shoulder dysfunction and sleep quality and a regression analysis of the related variables, thereby analyzing factors affecting neck pain and neck dysfunction. Results : In the present study, in adults with chronic neck pain, neck pain was positively correlated with the Neck Disability Index (NDI), Shoulder Pain and Disability Index (SPADI)-Pain score, and SPADI-Total score (p<.05). The NDI was positively correlated with neck pain, SPADI-Pain score, and SPADI-Total score, as well as with Pittsburgh Sleep Qulity Index(PSQI-K) (p<.05). Among the factors affecting neck pain, shoulder disability as assessed by the SPADI was a significantly associated with neck pain, while shoulder pain and shoulder disability determined by the SPADI were identified as significant variables among the factors affecting neck disability. Conclusion : These results indicated that as neck pain worsened , shoulder pain and neck and shoulder dysfunction also increased, which suggested that shoulder disability affected neck pain. In addition, as the neck dysfunction increased, neck pain and shoulder pain and shoulder dysfunction increased, and sleep quality deteriorated, which suggested that shoulder pain and shoulder disability affected neck disability.

Background: Foot drop is a common symptom after stroke and causes walking disorders. Therefore, its proper treatment is important for improving the walking ability of patients with foot drop. Objective: This study aimed to investigate the effects of electrostimulation during walking on the walking ability of patients with foot drop after stroke. Design: Quasi-experial study. Methods: The study enrolled 18 patients with foot drop after stroke. All subjects were assigned to the experimental or control group. The experimental group underwent electric stimulation during walking, while the control group used ankle foot orthoses. Both groups received treatment 20 minutes a day 5 times a week for 4 weeks. Outcome measures were assessed for walking and balance ability using the 10-m walking test (10MWT), 6-min walking test (6MWT), and Timed Up and Go test (TUG) Results: After the intervention, both groups showed significant improvements in 6MWT and TUG results. However, the experimental group showed significantly better improvement on all tests than the control group. Conclusion: The foot drop stimulator effectively improved the walking and balance ability of patients with foot drop after stroke.

Background: Tension-type headaches, which make up the highest proportion of headaches, are prone to develop into chronic tension-type headaches (CTTH). The characteristic of CTTH in patients is that the active myofascial trigger point (ATrP) which causes pain in the muscles of the back of the head is increased, compared to the normal headache and moves the head position forward. Objective: The aim of this study was to investigate the effects of myofascial release (MFR) and posture correction in effectively improving neck function and sleep quality in the symptoms of CTTH patients. Design: Observer-blind study Methods: To reduce ATrP, MFR was applied and exercise was also applied to correct posture. The subjects of this study were 48 individuals randomly divided into three groups; The MFR group using the MFR technique; The MFR with exercise group subject to both the MFR technique and forward head position correction exercises (MFREx), and the control group. MFR and MFREx groups were given the relevant interventions twice a week for four consecutive weeks, and went through the number ATrPs, range of motion (ROM) of neck, Neck Disability Index (NDI) and the Pittsburgh Sleep Quality Index (PSQI) before and after the intervention. A physical therapist, who was fully familiar with the measuring methods of the equipment, was the measurer and not aware of the target's condition was blinded to take measurements only before and after intervention. Results: There was a significant improvement in the ATrP, Neck ROM, NDI and PSQI in the group of patients to whom the MFR technique and MFREx were applied. MFREx was more effective in increasing neck mobility. Conclusions: According to this study, the application of MFR is effective in improving neck movement and sleep quality in chronic tension headache patients.

Background: Because of the lack of accurate values for applied forces in manual therapy, manual therapists relies on the magnitude of the individual’s perception during applying the force. However, excessive loading maneuvers carry risks for patients. Objective: To establish the relationship between the maximal force applied to swine skin with the specific region, sex, and baseline parameters of the subject. Design: Ex-vivo Study and laboratory Experimental research Methods: 3.5 kg of Korean pork sirloin that is a piece of swine was handled and it was set 3 dimensions; #A; #B; #C. Forty-seven participants who has no experience in physical therapy randomly carried out the experiment, indicated to push each place of the pressure spots with same posture and process under supervision from the instructor who has over 15 years of manual therapy, and we measured the pressure force in each time. Results: The biggest pressure force was recorded in spot #A, and #B was represented after #C. Pressure on #A showed certain statistic relation with height (r=.317, p<.05) and weight (r=.434, p<.01); pressure on #B showed certain relation which has statistical meaning with only height (r=.401, p<.01); pressure on #C emerged to have statistic relationship with height (r=.308, p< .05)and weight (r=.428, p<.01). The age aspect revealed relation with pressure on #A, #B and #C, but that was not statistically significant. Conclusions: It can be inferred that there is the most loss of pressure in the area where cartilage is like an island in the middle.