Forward head posture (FHP) is a musculoskeletal disorder that causes neck pain. Several exercise interventions have been used in South Korea to improve craniovertebral angle (CVA) and relieve neck pain. There has been no domestic literature review study over the past 5 years that has investigated trends and effects of exercise intervention methods for CVA with neck pain. This domestic literature review aimed to evaluate the trends and effects of exercise interventions on CVA and neck pain in persons with FHP. A review of domestic literature published in Korean or English language between 2018 and 2022 was performed. Literature search was conducted on Google Scholar and Korea Citation Index by using the following keywords: “exercise,” “exercise therapy,” “exercise program,” “forward head posture,” and “neck pain.” Ten studies were included in this review. All of the studies showed positive improvements after intervention programs that included exercises. Notably, four of these studies demonstrated significant differences in results between the experimental and control groups. Among the 10 studies, nine measured visual analogue scale or numerical rating scale scores and reported significant reductions in pain following interventions, including exercise programs. Five of these studies showed significant differences in results between the experimental and control groups. Furthermore, six studies that used neck disability index exhibited a significant decrease in symptoms after implementing intervention programs that included exercise, and significant differences in results were found between the experimental and control groups. This domestic literature review provides consistent evidence to support the application of various exercise intervention programs to improve CVA and relieve neck pain from FHP. Further studies are warranted to review the effects of various exercise interventions on FHP reported not only in domestic but also in international literature.

Background: The elderly population is increasing rapidly worldwide. Muscle mass, usual walking speed (UWS), knee extension strength (KES), hand grip strength (HGS), peak expiratory flow (PEF), and depression is used for sarcopenia diagnosis. All four of these factors (KES, HGS, PEF, and depression) correlated with UWS and also to muscle mass. But, many studies have suggested that no correlation exists between muscle mass and UWS. Objects: This study aimed: 1) to investigate whether muscle mass reduction affected UWS, as mediated by KES, HGS, PEF and depression, and 2) to explored whether significant changes in these mediators varied by the body segment in which muscle mass evaluated in elderly female aged 65–80 years. Methods: A total of 100 female aged 65–80 years were surveyed. Muscle mass was measured by body segment (upper and lower segment), and KES, HGS, PEF, depression, and UWS were also assessed. Median analyses were progressed in IBM SPSS software (ver. 23.0, IBM Co.) using a downloaded INDIRECT macro. Results: The direct effect of the KES and PEF were significant, and the indirect effect of KES and PEF were not significant. Thus, KES and PEF served as full mediators of the effect of muscle mass on UWS. Regardless of bodily region, KES and PEF combined with muscle mass were significant mediators of UWS, with similar indirect effect sizes. Conclusion: KES and PEF are the only mediators regardless of body part. Therefore, mediating the KES and PEF may prevent sarcopenia progression in elderly female. Also, sarcopenia can be readily assessed by evaluating either the upper or lower body; it is not necessary to measure total muscle mass.

Background: Office workers experience neck or back pain due to poor posture, such as flexed head and forward head posture, during long-term sedentary work. Posture correction is used to reduce pain caused by poor posture and ensures proper alignment of the body. Several assistive devices have been developed to assist in maintaining an ideal posture; however, there are limitations in practical use due to vast size, unproven long-term effects or inconsistency of maintaining posture alignment. We developed a headphone and necklace posture correction system (HANPCS) for posture correction using an inertial measurement unit (IMU) sensor that provides visual or auditory feedback. Objects: To demonstrate the test-retest reliability and concurrent validity of neck and upper trunk flexion measurements using a HANPCS, compared with a three-dimensional motion analysis system (3DMAS). Methods: Twenty-nine participants were included in this study. The HANPCS was applied to each participant. The angle for each action was measured simultaneously using the HANPCS and 3DMAS. The data were analyzed using the intraclass correlation coefficient (ICC) = [3,3] with 95% confidence intervals (CIs). Results: The angular measurements of the HANPCS for neck and upper trunk flexions showed high intra- (ICC = 0.954–0.971) and inter-day (ICC = 0.865–0.937) values, standard error of measurement (SEM) values (1.05°–2.04°), and minimal detectable change (MDC) values (2.92°–5.65°). Also, the angular measurements between the HANPCS and 3DMAS had excellent ICC values (> 0.90) for all sessions, which indicates high concurrent validity. Conclusion: Our study demonstrates that the HANPCS is as accurate in measuring angle as the gold standard, 3DMAS. Therefore, the HANPCS is reliable and valid because of its angular measurement reliability and validity.

Background: Posterior capsule tightness (PCT), commonly seen in overhead athletes, is a soft tissue adaptation that is also noted in non-throwers. PCT is associated with scapular and humeral kinematic alterations, significant restriction of shoulder internal rotation (IR) range of motion (ROM), and significant scapular anterior tilting. Sleeper and cross-body stretches (CBS) are suggested for PCT and IR deficits, and have been modified since introduction. A novel modified sleeper stretch (NMSS) was designed in this study to prevent the risk of anterior translation of the humeral head. Though the effects of posterior shoulder stretching exercise have been widely studies, to the best of our knowledge, no previous studies have investigated the effectiveness of posterior shoulder exercises in decreasing scapular anterior tilting. Objects: To compare the immediate effects of two posterior shoulder stretching exercises (NMSS and CBS) on scapular anterior tilting and shoulder IR ROM. Methods: Thirty-two subjects with anteriorly tilted scapula and IR deficits [mean age: 24.3 ± 2.5 years; 15 males and 17 females] participated in this study. Subjects were randomly assigned to either the NMSS or CBS groups. Scapular anterior tilting (at rest and at shoulder 60° active IR) and shoulder IR ROM were measured before and immediately after intervention. Results: Scapular anterior tilting significantly decreased, while the shoulder IR ROM significantly increased in both groups. However, there was no significant group-by-time interaction effect or significant difference between the groups. Conclusion: Both stretching exercises were effective in restoring shoulder IR ROM and decreasing scapular anterior tilting.

Background: Older adults use different ankle muscle activation patterns during difficult static balance conditions. It has been suggested that this is related to a decline in proprioception with age, resulting in reduced postural balance. However, the association between proprioception and ankle muscle activity during quiet standing has not been directly assessed. Objects: This study aimed to investigate the effects of age and sensory condition on ankle muscle activity and the association between ankle proprioception and ankle muscle activity. Methods: We recruited 10 young women and 9 older women. Ankle proprioception was evaluated using joint position sense (JPS) and force sense (FS) divided by dorsiflexion and plantarflexion. The electromyographic activity of the tibialis anterior (TA) and gastrocnemius (GCM) muscles was collected during quiet standing. Results: Older women activated GCM muscle more than young during quiet standing and when performing difficult tasks. Older women had more errors in JPS dorsiflexion and FS plantarflexion than did young. The GCM muscle activity is related to JPS dorsiflexion and FS plantarflexion. Conclusion: Lower proprioception of the GCM with age leads to increased muscle activity, resulting in reduced postural balance. There was no difference in TA proprioception or muscle activity among older women with frequent physical activity.

Background: The application of Kinesio tape (KT) has become an alternative treatment for the reduction of edema owing to its distinct characteristics that mimic skin behavior. Although many studies have found that KT application has a positive effect on edema related to breast cancer and rehabilitation following mandibular third molar surgery, there is little evidence to support the use of KT for musculoskeletal injuries. Objects: The purpose of this study was to review the literature related to KT application for reducing edema caused by musculoskeletal disorders. Methods: A literature search (July 2022) was performed on PubMed for articles published between January 2012 and June 2022. The following keywords were used: “Kinesio taping,” “Kinesio tape,” “swelling,” and “edema,” with different combinations and derivations. Only articles available in English were included in this study. Results: Among 68 identified studies, seven met our search strategy and criteria and were included in the literature review. Five of these studies investigated musculoskeletal disorders of the knee joint; two of them reported that KT application had a positive effect on edema measured using perimetry following total knee replacement and anterior cruciate ligament reconstruction. However, the KT application did not improve swelling in patients with acute lateral ankle sprains. Pediatric patients with acute proximal phalangeal joint sprain experienced a more significant improvement in the reduction of swelling than the group using a splint. Conclusion: This literature review found discrepant evidence to support using KT for edema control in musculoskeletal disorders. Further research is needed to determine the effectiveness of KT for controlling edema following musculoskeletal injuries.

Background: During postural control, older adults are more dependent on proprioception than are young adults. Ankle proprioception, which plays an important role in maintaining postural balance, decreases with age. Published studies are insufficient to establish a significant age difference in postural sway resulting from the known age-related decrease in ankle proprioception and do not examine various detailed test conditions. Objects: The present study aimed to compare ankle proprioception between older and younger groups along dimensions of position vs. force proprioception and dorsiflexion vs. plantarflexion. The present study also aimed to compare postural sway between young and older women during quiet standing under two sensory conditions. Methods: We recruited seven young women aged 21–24 and seven older women aged 60–63. Ankle proprioception was assessed as the accuracy of the joint position sense (JPS) and the force sense (FS). Postural sway was assessed using center-of-pressure measurements recorded during quiet standing under two sensory positions: eyes open and eyes closed with head tilted back. Results: Older women had lower JPS in dorsiflexion and lower FS in plantarflexion than did younger women. We found no significant age differences in JPS in plantarflexion or in FS in dorsiflexion. We observed a main effect of group on postural sway in two sway parameters out of three. We observed significant differences in JPS with dorsiflexion, and in FS with plantarflexion. Conclusion: Proprioception for ankle plantar flexor decreased more significantly with aging than did that for ankle dorsiflexor, accounting for the impaired postural balance observed in older women.

Background: The body schema, which is constantly updated using somatosensory information, enables accurate movement. Since pain is reported as a possible source to alter the body schema, the left right judgement test (LRJT) has been widely used in the pain rehabilitation. However, there was a lack of consistency in the effect of the pain on the LRJT results, and for the effect of the LRJT as a part of intervention programs for pain patients. The deeper understand of the LRJT is necessary for better reproducibility, and to expand the therapeutic applications of the LRJT in the pain and musculoskeletal rehabilitation. Objects: This literature review aimed to understand the LRJT and to study the potential of the LRJT for therapeutic applications. Methods: The PubMed database was searched for studies relevant to LRJT. To establish the query set, the term was regarded from various perspectives. Results: The selected studies were classified into three categories: LRJT development, factors influencing LRJT, and therapeutic applications. Conclusion: Left right judgement test is the evaluation tool for the integrity of body schema as well as a tool for implicit motor imagery. Pain, proprioception, and other factors influence the performance of the LRJT.

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

Background: Postural control deficit is a major characteristic in patients with chronic ankle instability (CAI). Elastic ankle tapings are commonly used to facilitate postural control in patients with CAI as well as prevent relapse of a lateral ankle sprain. However, equivocal evidence exists concerning the effect of elastic ankle taping on postural control. Objects: This study aimed to evaluate the effects of elastic ankle tapings using kinesio taping (KT) and dynamic taping (DT) on static and dynamic postural control in patients with CAI. Methods: Fifteen subjects with CAI were participated in this study. The participants performed tests under three conditions (barefoot, KT, and DT). Static postural control was evaluated using the one-leg standing test (OLST) and dynamic postural control using the modified Star Excursion Balance Test (mSEBT). One-way repeated-measures analysis of variance was used to compare center of pressure (CoP) data and normalized mSEBT reach distances among the three conditions (with α = 0.05). Results: The CoP parameters (path length, ellipse area, and mean velocity) of the OLST significantly decreased on applying KT and DT compared with those when barefoot. The normalized reach distances in the anteromedial (AM), medial (M), and posteromedial (PM) directions of the mSEBT significantly increased with DT compared to that in the control condition. Further, the higher reach distances with KT compared with those in the control condition were obtained in the M and PM directions of the mSEBT. No significant differences were identified in any of the OLST and SEBT parameters between the two different taping applications. Conclusion: KT and DT improved static postural control during the OLST compared with the control condition. Moreover, these tapes improved dynamic postural control during the mSEBT compared to the control. Therefore, elastic ankle tapings are useful prophylactic devices for the prevention and treatment of ankle sprain in people with CAI.

Background: Muscle undergoes change continuously with aging. Sarcopenia, in which muscle mass decrease with aging, is associated with various diseases, the risk of falling, and the deterioration of quality of life. Obesity and sarcopenia also have a synergy effect on the disease of the older adults. Objects: This study examined the risk factors for sarcopenia, sarcopenic obesity, and sarcopenia without obesity and developed prediction models. Methods: This machine-learning study used the 2008–2011 Korea National Health and Nutrition Examination Surveys in the analysis. After data curation, 5,563 older participants were selected, of whom 1,169 had sarcopenia, 538 had sarcopenic obesity, and 631 had sarcopenia without obesity; the remaining 4,394 were normal. Decision tree and random forest models were used to identify risk factors. Results: The risk factors for sarcopenia chosen by both methods were body mass index (BMI) and duration of moderate physical activity; those for sarcopenic obesity were sex, BMI, and duration of moderate physical activity; and those for sarcopenia without obesity were BMI and sex. The areas under the receiver operating characteristic curves of all prediction models exceeded 0.75. BMI could predict sarcopenia-related disease. Conclusion: Risk factors for sarcopenia-related diseases should be identified and programs for sarcopenia-related disease prevention should be developed. Data-mining research using population data should be conducted to enhance the effectiveness of early treatment for people with sarcopenia-related diseases through predictive models.

Background: Augmented somatosensory feedback stimulates the mechanoreceptor to deliver information on bodily position, improving the postural control. The various types of such feedback include ankle-foot orthoses (AFOs) and vibration. The optimal feedback to mitigate postural sway remains unclear, as does the effect of augmented somatosensory feedback on muscle co-contraction. Objects: We compared postural sway and ankle muscle co-contraction without feedback (control) and with either of two forms of somatosensory feedback (AFOs and vibration). Methods: We recruited 15 healthy subjects and tested them under three feedback conditions (control, AFOs, vibration) with two sensory conditions (eyes open, or eyes closed and the head tilted back), in random order. Postural sway was measured using a force platform; the mean sway area of the 95% confidence ellipse (AREA) and the mean velocity of the center-of-pressure displacement (VEL) were assessed. Co-contraction of the tibialis anterior and gastrocnemius muscles was measured using electromyography and converted into a cocontraction index (CI). Results: We found significant main effects of the three feedback states on postural sway (AREA, VEL) and the CI. The two sensory conditions exerted significant main effects on postural sway (AREA and VEL). AFOs reduced postural sway to a level significantly lower than that of the control (p = 0.014, p < 0.001) or that afforded by vibration (p = 0.024, p < 0.001). In terms of CI amelioration, the AFOs condition was significantly better than the control (p = 0.004). Vibration did not significantly improve either postural sway or the CI compared to the control condition. There was no significant interaction effect between the three feedback conditions and the two sensory conditions. Conclusion: Lower-extremity devices such as AFOs enhance somatosensory perception, improving postural control and decreasing the CI during static standing.

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: 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: Numerous studies have used smartphone applications to measure the range of motion in different joints. In addition, studies measuring the active range of motion (AROM) of the craniocervical joint have revealed high reliability. However, the subjects in these studies were all healthy subjects. No study has yet been conducted to measure the inter-rater reliability for the AROM of the craniocervical joint in stroke patients. Objects: The purpose of this study was to investigate the inter-rater reliability of the AROM of the craniocervical joint using a smartphone. Methods: The participants included 21 subjects who had strokes (17 males and 4 females). Two raters evaluated six types of craniocervical AROM, including flexion, extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, rotation to the hemiplegic side, and rotation to the non-hemiplegic side, using a goniometer and a smartphone to investigate inter-rater reliability. The inter-rater reliability was analyzed by intraclass correlation coefficients (ICC). Results: The inter-rater reliability of the smartphone was good for extension, lateral flexion to the hemiplegic side, lateral flexion to the non-hemiplegic side, and rotation to the hemiplegic side [ICC(2,k)=.86∼.88] and excellent for flexion [ICC(2,k)=.95]. The inter-rater reliability for rotation to the non-hemiplegic side was moderate [ICC(2,k)=.72]. Conclusion: These results suggest that the smartphone offers high inter-rater reliability for measurements of the craniocervical AROM in patients with stroke.

Background:Children with cerebral palsy (CP) have impaired postural control, but critically require the control of stability. Consequently, therapeutic interventions for enhancing postural control in children with CP have undergone extensive research. One intervention is sensorimotor training (SMT) using a Flexi-bar, but this has not previously been studied with respect to targeting trunk control in children with CP.Objects:This study was conducted to determine the effect of SMT using a Flexi-bar on postural balance and gait performance in children with CP.Methods:Three children with ambulatory spastic diplegia (SD) participated in the SMT program by using a Flexi-bar for forty minutes per day, three times a week, for six weeks. Outcome variables included the pediatric balance scale (PBS), trunk control movement scale (TCMS), 10 meter walking test (10MWT), and 3-dimensional movement coordination measurement.Results:The SMT provided no statistically significant improvement in PBS, TCMS, 10MWT, or 3-dimensional movement coordination measurement. However, positive changes were observed in individual outcomes, as balance and trunk control movement were improved.Conclusion:SMT using a Flexi-bar may be considered by clinicians as a potential intervention for increasing postural balance and performance in children with SD. Future studies are necessary to confirm the efficacy of Flexi-bar exercise in improving the functional activity of subjects with SD.

Background:Individuals with spinal cord injury (SCI) rely on their upper limbs for body-lifting activity (BLA). While studies have examined the electromyography (EMG) and kinematics of the shoulder joints during BLA, no studies have considered foot position during BLA.Objects:This study compared the effects of different foot positions during BLA on the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion in individuals with SCI.Methods:The study enrolled 13 mens with motor-complete paraplegic SCI, ASIA (American Spinal Injury Association) A or B. All subjects performed BLA with the feet positioned on the wheelchair footrest and on the floor independently. Surface EMG was used to collect data from the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii. The peak plantar pressure was measured using pedar-X and the knee flexion angle with Image J. Borg’s rating perceived exertion scale was used to measure the physical activity intensity level. The paired t-test was used to compare the shoulder muscle activities, peak plantar pressure, knee flexion angle, and rating perceived exertion between the two feet positions during BLA.Results:The activity of the latissimus dorsi, pectoralis major, serratus anterior, and triceps brachii and rating perceived exertion decreased significantly and the peak plantar pressure and knee flexion angle increased significantly when performing BLA with the feet positioned on the wheelchair footrest compared with on the floor (p<.05).Conclusion:These findings suggest that individuals with SCI may perform BLA with the feet positioned on the wheelchair footrest for weight-relief lifting to decrease the shoulder muscle activities and the rating perceived exertion and to increase the peak plantar pressure and the knee flexion angle.

Background: Strengthening the supraspinatus is an important aspect of a rehabilitation program for subacromial impingement and tendinopathy. Many authors recommended empty-can (EC), full-can (FC), and prone full-can (PFC) exercises to strengthen the supraspinatus. However, no ultrasonography study has yet investigated supraspinatus muscle architecture (muscle thickness; MT, pennation angle; PA, fiber bundle length; FBL) in relation to supraspinatus strengthening exercises. Objects: The purpose of this study was to compare the architecture (MT, PA, and FBL) of the supraspinatus muscle during three different types of exercises (EC, FC, and PFC) using diagnostic ultrasound. Methods: Participants performed three different exercises: (A) EC; the arm was maintained at 60° abduction with full internal rotation in the sitting position, (B) FC; the arm was maintained at 60° abduction with full external rotation in the sitting position, and (C) PFC; the arm was maintained at 60° abduction with full external rotation in the prone position. Ultrasonography was used to measure the MT, PA and FBL of the supraspinatus. One-way repeated analysis of variance with Bonferroni’s post-hoc test was used to compare between the three exercises and the initial position of each exercise. Results: Compared with each initial position, the FC exercise showed the greatest mean difference in muscle architecture properties and the PFC exercise showed the least mean difference. Conclusion: The findings suggest that the FC exercise position may have an advantage in increasing the amount of contractile tissue or producing muscle power and the PFC exercise position may be useful in a rehabilitation program because it offers the advantage of maintaining the muscle architecture properties.

Background: Several studies have discussed diverse exercise methods considered to be useful for the selective contraction of the vastus medialis oblique (VMO) muscle for the treatment of patellofemoral pain syndrome. Some studies have reported that exercise methods, including hip adduction, in closed kinetic chain exercises are more effective in terms of the muscle activation of the VMO and the timing of the muscle’s initial contraction. We focused on isometric contraction during a closed kinetic chain exercise with hip adduction. Objects: The purpose of this study was to examine muscle activation in the VMO and the vastus lateralis (VL) and the onset time difference between their initial contractions via closed kinetic chain isometric quadriceps femoris exercises including hip adduction. Methods: In total, 36 healthy subjects adopted two hip positions during isometric contraction of the quadriceps femoris in a closed kinetic chain exercise (hip neutral and hip adduction position). Statistical analyses were conducted using a paired t-test (α=.05). Results: Isometric contraction of the quadriceps femoris in a closed kinetic chain exercise caused a greater increase in VMO muscle activity in the hip adduction position [52.68±22.21 percentage of maximal voluntary isometric contraction (%MVIC)]than the hip neutral position (43.43±19.85 %MVIC). The onset time difference (VL-VMO) decreased more in the hip adduction position (-82.14±34.2 ㎳) than the hip neutral position (73.94±2.94 ㎳). Conclusion: We recommend this exercise as a clinically useful therapeutic method for patients with patellofemoral pain syndrome due to weakening of the VMO muscle and lateral inclination of the patella.

This study examined the effects of trunk stabilization exercise on balance and trunk control in children with spastic diplegia. Four children with ambulatory spastic diplegia participated in the trunk stabilization exercise program using a Both Sides Utilized (BOSU) ball, 30 minutes a day, two times a week for eight weeks. Outcome variables included the pediatric balance scale, trunk control movement scale and multifidus thickness using ultrasound image. After trunk stabilization exercise, there was statistically no significant improvement in pediatric balance scale, trunk control movement scale and multifidus thickness. However, individual outcomes were observed with some positive changes. Balance, trunk control movement, and thickness of multifidus were found to be improved. Trunk stabilization exercise using a BOSU ball could improve trunk control and increase the thickness of multifidus in children with spastic diplegia. Further investigation is needed to evaluate subjects according to type of cerebral palsy and to understand the relationship between postural control and gait.