This study examined the rates of spinal abnormal curvature and the correlation of the Body Mass Index (BMI), Low Back Pain (LBP) and spinal curvature by measuring scoliosis, kyphosis, and lordosis in university students. The study population included 67 male, 92 female university students, making a total of 159, in Wonju City. Spinal curvature was measured by an electrogoniometer in a computerized skeletal analysis system. Lateral curvature of spine of more than 10 degrees was considered as nonspostural scoliosis. The correlation of BMI, LBP and the spinal curvature was analysed by Pearson's correlation coefficient and t-test. The following results were obtained: 1. The overall incidence and rate of scoliosis in cases with a greater than 10 degree curve in males was an incidence of 8 and a rate of 11%. In females the incidence was 36 and the rate 39.2%. 2. The overall incidence and rate of kyphosis of less than 20 degrees in males was a rate of 9 and an incidence of 11.9%. In females, the rate was 5 and the incidence 5.4%. In kyphosis cases of more than 40 degrees, the male rate was 5 and the incidence 7.7%. For female the rate was 13 and the incidence 14.2%. 3. The overall incidence and rate of lordosis with curves of less than 20 degrees was a rate of 6 for males and an incidence of 9.0%. For females, the rate was 5 and the incidence 5.4%. In cases of more than 50 degrees lordosis, the female rate was 2 and the incidence 2.2%. There were no males in this category. 4. There was a negative correlation between kyphosis and BMI. The greater the kyphotic curve, the less the BMI in males (p<0.05). There was no significant BMI difference by gender in either scoliosis or lordosis. There was, however, a significantly decreased sacral angle in the female group with LBP. The results of this study cannot be generalized to the general population because the subjects were all from one university. The measurements were quite reliable because the angles determined by the Metrocom System were highly correlated with radiologic findings. This study shows the need for a regular screening system for spinal curvatures in university health examination procedures.

Noninvasive low intensity ultrasound has been shown to be an effective means of accelerating bone fracture repair in both animal and clinical studies. The effects of ultrasound stimulation on bone repair after fibular osteotomy were assessed in a rabbit fibular fracture model. Bilateral closed fibular fractures were made in skeletally mature male White Japanese rabbits. In this study, 24 subjects were randomly divided into 2 groups: experimental group 1 (n=12), and experimental group 2 (n=12). Experimental group 1 received 0.875 MHz continuous ultrasound and Experimental group 2 was treated with 3 MHz continuous u1trasound. The ultrasound intensity was 50 and treatment time was 10 minutes for every session in both groups. In each rabbit, one fibula served as a control and the other was subjected to ultrasound treatment 5 times per week for 3 weeks. After 3 weeks, rabbits were sacrificed and the ratios of the area between the trabeculae and bone marrow of the fibulae were calculated. At the end of the experimental period, 14 of the 24 rabbits were excluded due to complications from surgery or inadequate fracture status for this study. There was no statistically significant difference in the trabeculae area between experimental leg and control leg in experimental group 1 and experimental group 2 (p>0.05). And there was also no statistic-statistically significant difference between experimental group 1 and experimental group 2 according to ultrasound treatment frequencies, 0.875 MHz and 3 MHz (p>0.05). These data suggest that in Japanese white rabbits, low intensity ultrasound stimulation does not facilitate fracture repair nor is there any difference in fracture repair results between ultrasound frequencies, 0.875 MHz and 3 MHz.

The purposes of this study were to ascertain differences of the sensory system, central processing system, effector system, and balance ability according to general characteristics (sex, fall experience, and age), and to identify the contributions of the sensory, central processing, and effector system to balance ability in 83 healthy elderly subjects. The subjects were elderly (over 60 years) who live in Wonju City. All subjects participated in six tests (position sense test, visual acuity, vestibular stepping test, Mini-Mental Status Exam-Korea, strength of dorsiflexors, and Berg Balance Test). Collected data were analyzed by the independent t-test, one-way ANOVA, and stepwise multiple regression. The results were as follows: 1. The results of the six tests according to sex showed that vestibular function was significantly better in women than in men. But visual acuity, cognitive function, strength of dorsiflexors, and balance ability were significantly better in men than in women (p<0.05). 2. There were no significant differences in position sense, visual acuity, vestibular function, cognitive function, strength of dorsiflexors, and balance ability between fallers and non-fallers (p>0.05). 3. However, the results of the six tests according to age (group A: 60-69 years, group B: 70-79 years, group C: 80-89 years) showed significant differences in five tests. In the Scheff test, position sense, visual acuity, and cognitive function showed significantly different results between in group A and group C: the strength of the dorsiflexors was significantly different between in group A and group B, and balance ability was significantly different between in group A and group C, and between in group B and group C (p<0.05). 4. Cognitive function and position sense were positively associated with balance ability. Their power of explanation regarding balance ability was 38% (p<0.05). These results suggest that cognitive function and position sense play an important role in balance ability. This would seem to suggest that programs for evaluation or improvement of elderly's balance ability in the elderly should consider cognitive function and position sense.

The purposes of this study were to determine the effect of different degrees of severity of diabetic neuropathy on balance function, and to evaluate dynamic balance and functional performance in diabetes patients. Twenty-four subjects with diabetes mellitus were divided into three groups according to results of sensory nerve conduction study. All subjects were evaluated for dynamic balance which was measured using computerized dynamic posturography, and functional performance which was measured using the Berg balance scale. One-way analysis of variance was used to determine whether there were any statistically differences of dynamic balance function and functional performance among the three groups. The Spearrnan's rank correlation was used to determine statistical significance between dynamic balance and age. The results were as follows: 1. Dynamic balance measured using computerized dynamic posturography was significantly lower in the no response group than in the normal amplitude group (p<0.05). 2. Functional performance tested by the Berg balance scale was not statistically different among the three groups (p>0.05). 3. an inverse relationship was found between dynamic balance measured using computerized dynamic posturography and age (r=-0.68, p<0.05). These results suggest that patients with severe diabetic neuropathy have loss of dynamic balance function. Therefore, patients with severe diabetic neuropathy need to have their balance evaluated and receive appropriate education.

In motor learning, the relative frequency of external feedback is the proportion of external feedback presentations divided by the total number of practice trials. In earlier studies, increasing the percentage of body weight loading on the affected leg of hemiplegic patients, external feedback was continuously produced as the patient attempted to perform a movement. This feedback was produced to enhance the learning effect. However, recent studies in nondisabled populations have suggested that compared with 100% relative frequency conditions, practice with lower relative frequencies is more effective. My study compared the effect of 100% relative frequency conditions with 67% relative frequency conditions to determine what effect they exerted on motor learning for increasing the percentage of body weight loading on the affected lower limbs of patients with hemiplegia. Twenty-four hemiplegic patients were randomly assigned to one of two experimental groups. Each group practiced weight transfer motor learning on a machine. During practice, visual feedback was offered to all subjects. The experiment was carried out with full visual feedback for patients in group one but only 67% visual feedback for patients in group two. The percentage of loading on the affected leg was recorded four times: before learning (baseline value), immediately after learning, 30 minutes after learning, 24 hours after learning. The results were as follows: 1. In the 100% visual feedback group, the percentage of loading on the affected leg increased significantly in all three testing modes over the baseline value. 2. In the 67% visual feedback group, the percentage of loading on the affected leg increased significantly in all three measurements. 3. Immediately after learning, the learning effect was not significantly different between the two groups, but was significantly greater after both the 30 minutes delay and the 24 hours period. These results suggest that the 33% reduction in the provision of visual feedback may enhance the learning effect of increasing the percentage of body weight loading on the affected leg in patients with hemiplegia.

Laser photobiostimulation (LPBS) is one of the recent additions to therapeutic procedures used in chronic pain management. Though widely used, a clear understanding of its mechanism of action was not disclosed. In addition, the energy density that produces maximal benefit has not yet been established. The purposes of this study were to determine the effects of LPBS on pain relief in rat and to determine treatment dosage. Eight, 8-week old female, Sprague-Dawley rats were employed. All subjects were assigned to one of four groups: a sham laser group, a 0.4 laser group, a 2.0 laser group, and a 6.0 laser group. Ga-As laser (904 nm wavelength) of three different energy densities (0.4, 2.0, 6.0 ) was applied on a tail acupuncture point and tail-flick latencies were measured five times pre-and post-treatment as following schedules: 30 minutes, 1 hour. 24 hours. 48 hours, and 7 days later. An increase in pain threshold was demonstrated following LPBS, employing rat tail-flick test. LPBS of 2.0 produced hypoalgesia of rapid onset and short duration (1 hour, 24 hours) while the response to 6.0 was delayed and lasted longer (48 hours, 7 days). LPBS of 0.4 did not produce any hypoalgesia.

The purposes of this study were to examine the effect of two different pelvic alignments and the Valsalva maneuver on electromyographic (EMG) activity of the erector spinae during squat lifting and lowering, and to find an efficient method for squat lifting and lowering. Twenty hea1thy men in their twenties lifted and lowered loads using four different methods: 1) anterior pelvic tilt position with the Valsalva maneuver, 2) anterior pelvic tilt position without the Valsalva maneuver, 3) posterior pelvic tilt with the Valsalva maneuver, 4) posterior pelvic tilt without the Valsalva maneuver. The EMG activity of erector spinae was recorded during both lifting and lowering with each method. The EMG activity of each individual was normalized to EMG activity produced by muscle during maximal voluntary contraction. Two-way analysis of variance for repeated measures () was used to analyze the effect of the two factors: 1) pelvic tilt position (anterior pelvic tilt, posterior pelvic tilt), 2) the Valsalva maneuver (with and without). Analysis was performed separately for the lifting and lowering. The results were as follows: 1) EMG activity of erector spinae was greater when the pelvis was tilted anteriorly than when the pelvis was tilted posteriorly during squat lifting and squat lowering. 2) There was no difference between EMG activity of erector spinae with the Valsalva maneuver and EMG activity of erector spinae without the Valsalva maneuver during squat lifting and squat lowering. These results suggest that the greater EMG activity of erector spinae with an anterior pelvic tilt position during squat lifting and squat lowering may ensure optimal muscular support for the spine while handling loads, but the Valsalva maneuver may have less effect on erector spinae.

The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.89 and =0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.82 and =0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

This study analysed national data of manpower supply for physical therapists in Korea. Based on the comparative analysis results of the future demand and supply, as of May 1998, it is estimated that there was already an oversupply of physical therapists in Korea. This oversupply is expected to continue even though there would be an increase in hospital beds, rehabilitation facilities for the elderly, and nursing homes. Thus it would be desirable to cut down the number of students admitted to physical therapy schools each year. Our estimation shows that the Ministry of Health and Welfare must take measures to reduce the supply of physical therapist as soon as possible.

The ability to maintain an upright position during quiet standing is a useful motor skill. The Sensory Organization Test (SOT) is a timed balance test that evaluates somatosensory, visual, and vestibular function for maintenance of upright posture. The Fugl-Meyer Sensorimotor Assessment (FMSA) balance subscale is the functional status assessment that indicates amount of assistance needed during various balance tasks. Functional Independence Measure (FIM) is the functional status assessment tool and FIM can be used clinically as an outcome measure. The purpose of this study was to see if the SOT can be used as a evaluation tool to measure hemiplegic patients' balance ability. Thirty-six patients with hemiplegia participated in this study. SOT scores were significantly correlated with FMSA balance scores and FIM scores(p<0.05). However correlation coefficients were not so high (r=0.60, and r=0.51, respectively). Therefore, further study is needed to verify the SOT's usefulness when physical therapists are evaluating for hemiplegic patients' balance ability.

The purposes of this study were to compare the electromyographic activities from the rectus femoris, vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis during straight leg raising (SLR) and quadriceps setting (QS) exercise and to determine which exercise is more effective to selectively strengthen the vastus medialis. Thirty two healthy subjects <19 men, 13 women) participated in the study. All participants performed SLR and QS exercises while electromyographic activity was recorded from EMG surface electrodes. Statistical analysis demonstrated significantly greater values for the vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis activities during QS exercise than for those during SLR exercise. However, the rectus femoris muscle activity between SLR and QS exercises was not significantly different. The ratios of vastus lateralis to vastus medialis during SLR and QS exercise were not significantly different. These results show that QS exercise is more effective for strengthening the quadriceps muscle on the whole than the SLR exercise. As for selective methods of strengthening vastus medialis specifically, both SLR and QS exercises are useful.

Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was , , respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.

Photochemotherapy(UVA with 8-methoxypsoralen) was given to 30 patients with systemic psoriasis. The results of clearing and long-term(6-month) interval maintenance were reported. Clearing requirements were in general similar to these reported by Melski and Burger. The skin of the 14 patients (46.6%) recovered good skin condition by a once weekly maintenance dose. This result was better than that reported by other authors. 1. During initial treatment period, average number of treatment was 27.3 and average duration treatment was 24.8 weeks. 2. The factors to quit treatment were motion decrease, moving to the remote area, complications, etc. 3. Number of patient who received maintenance treatment was 14. 4. The complications reported from the patients were hyperpigmentation, nausea, headache, pruritis, vomiting, gastritis.

The purpose of this study was to determine which of several crutch-fitting techniques best predicts ideal crutch length. Ideal crutch length is defined as the length of the crutch, including accessories, obtained during stance when the crutch tip is 6 inches (15.2 cm) lateral and 6 inches(15.2 cm) anterior to the fifth toe and the axillary pad is 2.5 inches(6.4 cm) below the axillary fold. Forty four volunteers were measured for crutches using each of the following methods:(1) 77% of actual height, (2) actual height minus 40.6 cm, (3) actual height minus 45.7 cm, (4) olecranon to opposite third finger tip, (5) olecranon to opposite fifth finger tip, (6) 77% of arm span, (7) arm span minus 40.6 cm, (8) anterior axillary fold to heel plus 5.1 cm, (9) anterior axillary fold to heel plus 10.2 cm, (10) ideal crutch length. Of the techniques studied, the two involving anterior axillary fold to heel were found to be good predictors: anterior axillary fold to heel plus 5.1 cm and anterior axillary fold to heel plus 10.2 cm. Finally, two additional length estimates were derived using linear regression analyses. These estimates provided the best overall predictors based on anterior axillary fold to heel and actual height.

High Voltage Pulsed Current Stimulation(HVPCS) and Microcurrent Electrical Neuromuscular Stimulation(MENS) have been used to promote the healing of decubitus ulcer and surgical wounds. The benefits of HVPCS and MENS are thought to include an inhibitive effect on bacterial growth. The purpose of this study was to compare the inhibitive effect of two different electrical stimulation techniques growth in vitro. Using agarose-based media, the two bacterial species Staphylococcus aureus, Esherichia coli - which are commonly isolated from open wounds were incubated in an incubator for 24 hours following exposure to HVPCS(400 V, 120 pps, ) and MENS(, 0.3 Hz). We then measured the zone of inhibition around each electrode. Both HVPCS and MENS produced an inhibitive effect on bacterial growth in this vitro study. However MENS was more effective than HVPCS.

The purpose of this study was to determine a more effective method for shoulder pain reduction. Forty-five normal subjects were randomly assigned to one of 3 groups a control group, an acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) group, and a silver spike point(SSP) group. Each person in the ALTENS and SSP groups was measured for pressure pain threshold before and after a 20 minute treatment. The control group was also checked for pressure pain threshold before and after a 20 minute period but no "treatment" was given. The major findings were as follows ; 1)The ALTENS and SSP groups showed significant differences before and after treatment but the control group showed no significant difference. 2)When the three groups were compared, the only significant difference was between the SSP group and the control group. As mentioned above, it may be concluded that both ALTENS and SSP therapy were effective in reducing shoulder pain when measured directly after treatment. However, SSP did not show any superior effect. Further study should be done to determine the effective the maintained pain reduction with post-treatment time lapse.

The purpose of this study was to assess the concurrent validity and reliability of goniometric measurement of joint motion. Subjects were 40 healthy university students. Measurements were performed by 4 inexperienced physical therapy students. Four different instruments were used and three readings were taken with each instrument in random order making a total of 12 readings for flexion of the right elbow of each subject. Goniometers used were 1. universal 2. fluid-based goniometer/inclinometer 3. digital LCD goniometer 4. electronic goniometer/torsiometer. The results were as follows: Concurrent validity was highest (r= .94) with the universal and digital LCD tools. Interrater reliability (Pearson Product Moment Correlation) was good for each tool. Interrater reliability calculated by ICC(2,1) was highest (.96) with the tensiometer and lowest (.78) with the digital LCD goniometer. Intrarater reliability calculated by ICC was excellent () for all instruments. These results show that concurrent validity, intrarater and interrater reliability are very good in the used of all four types of goniometers/inclinometer/tensiometer, even with inexperienced raters. These results confirm the almost universal reliance on hand held goniometers for joint measurement by physical therapists as being a reliable practice. Further research should be done clinically with actual patients.

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

The purpose of this study was to examine the inter-rater reliability of the Korean translation of the GMFM(Gross Motor Function Measure). Three licensed physical therapists with varying amounts(2 - 6 years) of clinical experience served as raters. Thirty patients with cerebral palsy were subjects for this study. Subjects were 22 boys and 8 girls, aged 1 to 8 years. Reliability of each dimension and each total score of the GMGM were analyzed using ICCs(intraclass correlation coefficients). The reliability of each dimension score ranged from .76 to .98, with the walking, running, and jumping dimension having higher reliability values. The reliability of the total dimension score was .94. We conclude that the GMFM has inter-rater reliability for assessing gross motor function in patients with cerebral palsy.

Our purpose of this study was to determine the most effective cool-down exercise. The recovery times of dynamic strength after isometric and isotonic cool-down exercise were measured immediately post cool-down exercise, 30 seconds later and 60 seconds later in 30 normal, healthy men from 19 to 29 years, using dumbells(Model, Iron). The recovery time of dynamic strength had a significant positive correlation with isotonic and isometric cool-down exercise using the Chi-square method (p<0.01). Sources of significant differences were determined by the Wilcoxon signed-ranks test (p<0.01). The isometric cool-down exercise significantly shortened the recovery time of dynamic strength. We suggest that the isometric cool-down exercise may be more effective than isotonic cool-down exercise in shortening the recovery time of dynamic strength.