The purpose of this study was to establish reliability and validity of the Northwick Park Neck Pain Questionnaire (NPQ) translated into Korean for neck pain patients. Sixty-two subjects (35 males, 27 females) with neck pain enrolled in the study. They completed a standardized self-administered questionnaire that included pain intensity, sleeping, sensory at night, duration of symptoms, carrying, reading and watching television, working, social activities, and driving. Reliability was determined by intraclass correlation coefficient (ICC) and Cronbach's alpha by internal consistency. Validity was examined by correlating the NPQ scores to the Visual Analog Scale (VAS) score. Test-retest reliability of the translated versions of the NPQ was good ICC(2,1)=.83 (95%CI=.85~.95). Cronbach's alpha value for NPQ was found to be .87 and this was statistically significant (p<.05). The criterion-related validity coefficients was .75 (p<.01). We concluded that the Korean version NPQ was shown to be a reliable and valid instrument for the assessment of neck pain.

This study examined whether any changes by mental task types on postural control in chronic stroke persons. Sixteen chronic stroke persons (mean age=53.75 yr) and sixteen age-and gender-matched healthy controls (mean age=54.44 yr) took part in this study. Participants randomly performed three different tasks on the stable and unstable surfaces. The no mental task was to stand while holding a 100 g weight in each hand, the arithmetic task (mental task) was to perform a silent 1-backwards counting while standing and holding a 100 g weight in each hand, and the simple task (mental task) was to stand and hold with both hands a tray (200 g) on which a glass filled with water has been placed. Sway path and sway velocity of the center of pressure (COP) were measured to assess standing postural control by task performance using the force platform. According to the results, in stroke group, total sway path and total sway velocity of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable surface (p<.05), and sway path (anteroposterior AP, mediolateral ML) of COP, total and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the unstable surface (p<.05). Especially, sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In healthy control group, sway path (AP, ML, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased during arithmetic and simple task compared to no mental task on the stable and unstable surface (p<.05), and sway path (AP, total) of COP and sway velocity (AP, ML, total) of COP was significantly decreased under the simple task when compared to the arithmetic task on the unstable surface (p<.05). In conclusion, the findings of this study showed that arithmetic and simple task improved standing postural control for chronic stroke patients and the type of arithmetic and simple tasks were critical factor that reduced standing postural sway in dual-task conditions. Future research should determine whether dual-task conditions, including simple task, would be effective as a training program for standing postural control of stroke patients.

The aim of this study was to investigate correlations of the Trunk Control Test (TCT), Postural Assessment Scale for Stroke (PASS-TC), and Trunk Impairment Scale (TIS) and to compare the TCT, PASS-TC, TIS and its subscales in relation to balance, gait and functional performance ability after stroke. Sixty-two stroke patients attending a rehabilitation program participated in the study. Trunk control was measured with the use of TCT, PASS-TC, TIS balance (Berg Balance scale; BSS), gait ability (10 m walk test), functional performance ability (Tuned Up and Go Test TUG) and the mobility part of the Modified Barthel index (MBI), Fugl Meyer-Upper/Lower Extremity (FM-U․L/E). The scatter-plot (correlation coefficient) was composed for the total scores of the TCT, PASS-TC, and TIS. The multiple regression analysis was performed to evaluate the impact of trunk control on balance, gait, and functional performance ability. Twenty eight participants (45.2%) and twenty participants (32.3%) obtained the maximum score on the TCT and PASS-TC respectively; no subject reached the maximum score on the Trunk Impairment Scale. There were significant correlations between the TIS and TCT (r=.38, p<.01), PASS-TC (r=.30, p<.05), TCT and PASS-TC (r=.59, p<.01). Stepwise multiple regression analysis showed that the BBS score (β=.420～.862) had slightly more power in predicting trunk control than the . TIS-dynamic sitting balance, TUG and the MBI-mobility part. This study clearly indicates that trunk control is still impaired in stroke patients. Measures of trunk control were significantly related with values of balance, gait and functional performance ability. The results imply that management of trunk rehabilitation after stroke should be emphasized.

목적 : 본 연구에서는 SCIM III를 국내에 소개하고 SCIM III의 검사자간 신뢰도와 타당도를 제시하고자 시행되었다. 연구방법 : 척수손상 환자 31명을 대상으로 두 명의 검사자가 SCIM III을 시행하여 검사자간 일치율과 Kappa계수를 통하여 검사자간 신뢰도를 제시하였고, SCIM III과 더불어 FIM평가를 동시에 실시하여 그 상관관계를 제시함으로써 공인타당도를 구하였다. 결과 : 본 연구 결과 SCIM III의 두 검사자간 일치율은 67%이상이었으며, 19개 세부항목 중 16개 항목은 80%이상이었다. 또한 SCIM III에서 Kappa 계수의 범위는 .62～1.00이었다. 첫 번째 검사자와 두 번째 검사자에 의한 SCIM III와 FIM 총점간 상관계수는 각각 .97, .98로 높은 상관관계를 보였다. 결론 : 척수손상환자의 일상생활동작을 평가하기 위한 SCIM III의 검사자간 신뢰도와 공인타당도는 높은 것으로 나타났으며, 추후 검사-재검사 신뢰도, 문항의 난이도와 척도의 적합성을 확립한다면 앞으로 국내에서 SCIM III의 활용이 가능할 것이다.

This study is performed to investigate the difference of the spinal stability system with and without low back pain. There were 9 participants with low back pain and 9 asymptomatic subjects to be recruited, they were measured thoracic and lumbar curvature, trunk muscle activation in upright sitting postures and slump sitting, back muscle endurance, and lumbar proprioception. Spinal curvature and surface electromyography of 4 trunk muscles were measured in an upright sitting postures and slump sitting in 18 subjects. The result of the study was that there were significant differences between the groups in spinal curvature (p<.05), significantly higher external oblique activity and less internal oblique in the low back pain group than the healthy subjects (p<.05), and significantly less proprioception in the low back pain group (p<.05). But there was not a significant difference between the trunk muscle endurance groups. According to the result, the low back pain group had greater thoracic extension and higher global muscle activity in the upright sitting posture and less proprioception. This study was useful to suggest postural training for normal muscle activation, selective muscle strengthening to prevent chronic deterioration, and helpful in making a treatment plan to indicate a synthetic care method that includes increasing proprioception.

Anticipatory postural adjustments is an example of the ability of the central nervous system to predict the consequence of the mechanical effect of movement on posture and helps minimize a forth coming disturbance. The aim of this study was to evaluate the sequence of activation of the trunk muscles during the performance of hip and shoulder movement and to determine the relationship between anticipatory activity and subjects' motor and functional status in subjects with hemiplegia post stroke. Twenty-four poststroke hemiparetic patients enrolled in this study. Electromyographic activity of the lumbar erector spinae, latissimus dorsi, and of the obliquus internus muscles was recorded bilaterally during flexion of both arm and from the rectus abdominis, obliquus externus, and obliquus internus muscles during flexion of both hip. Onset latencies of trunk muscles were partially delayed in the subjects with hemiplegia post stroke (p<.05). With upper limb flexion, the onset of erector spinae muscle and latissimus dorsi muscle activity preceded the onset of deltoid on both side respectively (p<.05). A similar sequence of activation occurred with lower limb flexion. Also the onset of external oblique muscle and rectus abdominis muscle activity preceded the onset of rectus femoris muscle on both side (p<.05). Major impairments in the activity of trunk muscles in hemiparetic subjects were manifested in delayed onset between activation of pertinent muscular pairs. These problems were associated with motor and functional deficits and warrant specific consideration during physical rehabilitation of post stroke hemiparetic patients.

Anticipatory postural adjustments are pre-planned by the central nervous system (CNS) before the activation of agonist muscles in the limbs, and minimize postural sway. Most previous studies on this topic have focused on upper-limb movement, and little research has been conducted on lower-limb movement. The purpose of this study was to investigate the recruitment order of left and right trunk muscles during limb movement. Fifteen healthy subjects (10 male, 5 female) were enrolled. Electro-myographic signals were recorded on the muscles of: (1) deltoid, lumbar erector spinae, latissimus dorsi and internal oblique during shoulder flexion, (2) rectus femoris, rectus abdominis, external oblique and internal oblique during hip flexion. During right upper limb flexion, the onset of left erector spinae muscle and left internal oblique muscle activity preceded the onset of right deltoid by 8.09 ms and 19.83 ms, respectively. But these differences were not significant (p>.05). A similar sequence of activation occurred with lower limb flexion. The onset of left internal oblique muscle activity preceded the onset of right rectus femoris muscle by 28.29 ms (p<.05). The onset of right internal oblique muscle activity preceded the onset of left rectus femoris muscles by 23.24 ms (p<.05). The internal oblique muscle was the first activated during limb movement. Our study established the recruitment order of trunk muscles during limb movement, and explained the postural control strategy of the trunk muscles in healthy people. We expect that this study will be used to evaluate patients with an asymmetric recruitment order of muscle activation due to impaired CNS.

The self-report measure is a useful tool for evaluating self-recognized disability and difficulty in daily living activities. Although many studies and clinics used the Neck Pain and Disability Scale (NPDS) for measuring neck pain and functional impairment, there has not been much adaptation of this for use with Korean patients. The purpose of this study was to establish the reliability and validity of NPDS among Korean neck pain patients. Fifty-five subjects (32 males, 23 females) with neck pain enrolled in this study. They completed standardized self-administered questionnaires. The NPDS measures pain intensity; its interference with vocational, emotional, recreational, social, and functional aspects of living; and the presence and extent of associated factors. Reliability was determined by the intraclass correlation coefficient (ICC) and Cronbach's alpha for internal consistency. Validity was examined by correlating the NPDS scores to the Visual Analog Scale (VAS) score. The test-retest reliability of the translated versions of the NPDS was good ICC (2,1)=.86 (95%CI .76~.92). Cronbach's alpha value for NPDS was found to be .93, and this was statistically significant (p<.05). The criterion-related validity coefficient was .79 (p<.Oll. We conclude that the Korean version of NPDS has been shown to be a reliable and valid instrument for the assessment of neck pain. Successful linguistic and cultural translation will admit appropriate cross-cultural comparison for clinical analysis. Therefore, this study can be expected to be used as an adequate evaluation scale for neck pain related studies and treatments.

The purpose of this study was to determine reliability and validity of the Neck Disability Index (NDI) now in use for the first time in neck pain patients of Korea. Fifty subjects (26 males and24 female) with neck pain enrolled in the study. They completed a standardized self-administered questionnaire that include pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping and recreation. Reliability was determined by intra-class correlation coefficient (ICC) and Cronbach's alpha by internal consistency. Validity was examined by correlating the NDI scores to the Visual Analog Scale (VAS) score. The Test-retest reliability of the translated versions of the NDI was good ICC (2,1) = .90 (95%CI .85 .95). Cronbach's alpha value for NDI was found to be .95 and this was statistically significant (p<.05). The criterion-related validity coefficients was .72 (p<.01). We conclude that the Korean version of NDI has shown to be a reliable and valid instrument for the assessment of neck pain.

This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

The purposes of this study were to investigate the median frequency (MDF) between initiation and termination of muscle contraction through surface electromyographic (sEMG) analysis and to propose the basis of clinical treatment for movement problems in early hemiparetic upper limbs. Thirteen patients who had stroke with onset less than 3 months prior to the study and seven control subjects participated in the study. The median frequency in initiation and termination of muscle contraction was recorded from wrist flexor and extensor muscles using the sEMG, with 3 second beeper signals, during maximal isometric wrist flexion and extension. Flexion and extension must be done as quickly and forcefully as possible. The results of the study were as follows: 1. The MDF of the onset and offset sections were significantly lower on the paretic than the nonparetic and control sides. 2. The MDF of the offset section significantly decreased on the paretic and nonparetic sides. Consequently, this study showed that the lowering of the MDF was due to the hemiparetic wrist motor impairment and muscle weakness. These results are also related to Fugl-Meyer motor assessment (FMA) scores in hemiparetic upper limbs. This study also suggests that since muscle weakness of early stroke patients affects the functional decrease of upper limbs, further studies must focus on the treatment to improve muscle agility and muscle fiber recruitment efficiency that can induce the functional recovery correlated to motor control.

Tracking is an experimental paradigm that can be used to study information processing in continuous movements involving accurate, ongoing control of motor performance. The purpose of this study was to identify the effects of knee tracking performance. Six patients with hemiplegia and six age-matched controls participated in the study. The tracking test was administrated. It was composed with regular ranges of to and randomized range .2 to .4 Hz. Using the Mann-Whitney U test, a comparison was made between subjects who had suffered from stroke and subjects who were well coordinated. The Wilcoxon Matched Pairs Signed Ranks Test was used to compare and analyze the paretic and nonparetic sides of the stroke patients. The results of study were as follows: accuracy index of the tracking test was significantly higher on the control side than paretic and nonparetic sides. Accuracy index scores were significantly higher for nonparetic sides with stroke compared with paretic sides with stroke. This study shows tracking is impaired in paretic and nonparetic knee of subjects with stroke.

The purpose of this study was to find the difference in muscle firing rate between each muscle according to the knee angle with the quadriceps femoris which is a representative action muscle of the lower extremity. Seven normal healthy subjects were recruited. The median frequency (MDF) of muscle contraction was recorded from vastus lateralis, vastus medialis, and rectus femoris muscles using the surface EMG, in 5 seconds, during maximal isometric knee extension. The data were analyzed by the two-way repeated ANOVA. The results of the study were as follows: 1) median frequency of muscle contraction was significantly higher at the vastus lateralis, vastus medialis, and rectus femoris in descending order. 2) median frequency of muscle contraction was significantly higher at the , , and in descending order. Consequently, muscle recruitment at the knee decreases the EMG activity of the lengthened muscle. This study suggests that the change in EMG activity at different muscle lengths resulted in affecting the muscle firing rate during the knee extension.

본 연구는 초기 편마비 환자의 손목에서 표면근전도 분석을 통해 근수축 개시 및 종료의 특성들을 알아보고, 임상적인 치료방법의 기초를 제안하고자 실시하였다. 연구대상자는 원주기독병원에 뇌졸중으로 입원한 환자 중 발병 후 3개월 미만인 13명과 원주시에 거주하는 대조군 7명이었다. 근수축 개시 및 종료의 지연은 표면근전도를 이용하여 손목굽힘근과 손목펴짐근에서 손목관절의 굽힘과 폄동작 시 3초의 근전도 신호음에 따라 가장 빠르고 강하게 최대 등척성 수축과 이

We processed meta-analysis to test if the effects of laser therapy and mobilization techniques are evidence-based practice for treating tennis elbow. By researching and collecting the results of previous studies on tennis elbow, we inquired into the difference in the effects of each treatment methods on pain, grip strength, and ROM. A total of 10 international and domestic articles on the treatments of tennis elbow were selected for this study, including 7 articles on the effect of laser therapy and 3 on mobilization techniques. According to the qualitative meta-analysis, all 7 of the articles on laser therapy and 1 of the mobilization technique were double-blinded and randomized the subjects, and all of the 10 studies were designed in a high quality research, using statistics. The results of the studies on laser therapy showed in terms of statistical significance: 4 out of 7 did not decrease pain after therapy, and 3 out of 5 did not increase grip strength after therapy. In the studies on the effects of mobilization technique, both the 2 studies significantly increased grip strength after therapy. For other studies which measured ROM and tension, the mobilization therapy increased ROM significantly, and decreased tension significantly. The results of our study are shown in a diverse form in terms of the effects of different therapy techniques. This is related to the accuracy of the measurement tools for assessments and diagnoses. Further qualitative studies on the evidence-based practice and researches on tennis elbow are needed.

The purpose of this study was to compare the relative accuracy of a range of computer-based analysis with respect to EMG onset determined visually by an experienced examiner. Ten healthy students (6 male, 4 female) were recruited and three times randomly selected trials of isometric contraction of wrist flexion and extension were evaluated using four technique. These methods were compared which varied in terms of EMG processing, threshold value and the number of samples for which the mean must exceed the defined threshold, and beyond 7% of maximum amplitude. To identify determination of onset time, ICCs(Intraclass Correlation Coefficients) was used and inter-rater arid intra-rater reliability ranged good in visually derived onset values. The results of this study present that in wrist flexion and extension, the reliability of the inter and intra-examiner muscle contraction onset times through visual analysis showed beyond .971 with ICCs. The reliability of the muscle contraction onset time decision through visual reading, tested with computer analysis, showed a relationship of all the selected analysis methods with ICCs .859 and .871. The objective computer-based analysis comparing with visual reading at the same time is the effective and qualitative data analysis method, considering the specificity of each study method.

The purpose of this study was to establish reliability of the Tone Assessment Scale (TAS) translated into Korean in patients with stroke. The TAS consists of resting posture, response to passive movement, and associated reaction to active effort. Fifteen patients (14 males, 1 female) were examined by two raters. Surface electromyography (EMG) data at elbow flexor muscle and joint excursion were collected from 6 patients. To identify the correlation between muscle activity and angular changes of elbow muscle, Pearson product moment correlation was used. The inter-rater and intra-rater reliability of the TAS ranged from very good to good (K/Kw=.61~1.00 for intra-rater and K/Kw=.73~1.00 for intra-rater comparisons) in the sections of resting posture and associated reaction. However, in the section of response to passive movement, the reliability coefficients ranged from very good to fair (Kw=.29~1.00). In the 11th item, correlation between EMG ratio of elbow flexor and angular changes of elbow joint showed statistically strong positive relationship (r=.94, p<.05). These results indicate that the TAS is selectively reliable in the sections of resting posture and associated reaction.