Background: Scapular dyskinesis may cause not only rotator cuff (RC) tear but also weakness of the upper extremity, studies on scapular dyskinesis that may occur after RC repair is still lacking. Objects: To determine whether scapular dsykinesis was present in patients after arthroscopic RC repair and to investigate the influence of passive scapular stabilization on upper extremity strength. Methods: A total of 30 patients after RC repair participated in this study. To compare the scapula of the arthroscopic RC repair shoulder and the contralateral shoulder, the winged scapula (WS) was measured using a scapulometer and scapular dyskinesis was also classified by type. Fixed instruments for muscle strength measurements were used to measure upper extremity muscle strength differences depending on passive scapular stabilization position or natural scapular position. A chi-square test, an independent t-test and a 2-way mixed measures analysis of variance (ANOVA) was used as statistical analysis. In analyses, p < 0.05 was deemed to be statistically significant. Results: Postoperative shoulder had a significant association with scapular dyskinesis and the WS compared to the contralateral shoulder (F = 0.052, p < 0.01). Postoperative shoulder, muscle strength in the shoulder abduction (p < 0.01), elbow flexion (p < 0.01) and forearm supination (p < 0.05) were significantly greater in the scapular stabilization position than in the scapular natural position. Conclusion: Patients underwent arthroscopic RC repair had a significant association with scapular dyskinesis and muscle strength was improved by a passive scapular stabilization position, therefore scapular stabilization is important in rehabilitation program.

Background: Several factors contribute to shoulder pain, including abnormal neck posture, repeated use of the upper limbs, work involving raising the upper limbs above the head, and the effects of vibration. However, previous study has reported that constant vibration exposure could impact improvement of the stability on joints related with muscle recruitment and activation. For this difference reason, we need to verify for the complex study of relationship with repetitive upper limb movements, poor head posture, and constant vibration exposure. Objects: Our study was made to investigate the influence of vibration exposure on the shoulder muscle activity during forward-head and over-head tasks with isometric shoulder flexion. Methods: In a total of 22 healthy subjects, surface electromyography (EMG) data were collected from shoulder muscles (upper/lower trapezius, serratus anterior, and lumbar erector spinae) on tasks (neutral-head task [NHT], forward-head task [FHT], and over-head task [OHT]) with and without vibration exposure. Results: In all tasks, the EMG data of the upper trapezius and serratus anterior significantly increased with vibration exposure (p < 0.05). Furthermore, the EMG data of the lumbar erector spinae significantly increased with vibration exposure in the NHT and FHT (p < 0.05). Conclusion: We suggest that continuous vibration exposure during the use of hand-held tools in the tasks could be associated with harmful effects in the workplace. Lastly, we clinically need to examine the guidelines regarding the optimal posture and vibration exposure.

Background: Excessive hamstring (HS) activation due to the weakness of the gluteus maximus (GM) causes pain in the hip joint. A single-leg deadlift is a hip extensor exercise, especially GM, that includes functional movements in daily life and complex multi-joint training. In single-leg deadlift, the muscle activity depends on the forward trunk lean angle, and it's necessary to study which muscles are used dominantly depending on the angle. Objects: The purpose of this study was to compare the effect on the muscle activity of the GM and HS during single-leg deadlift according to different forward trunk lean angles and the ratio of the GM vs HS (GM/HS). Methods: Twenty-one healthy female participants were recruited. The muscles activities of the GM, HS and the GM/HS ratio were measured through electromyography during single-leg deadlift according to three condition of forward trunk lean angles (30°, 60°, and 90°). Results: The GM and HS activities significantly differed among three conditions (p < 0.05). GM/HS ratio was significantly higher at 30°and 60° of forward trunk lean compared to 90°. Moreover, the GM activity was significantly higher at 60°of forward trunk lean than at 30° (p < 0.05). Conclusion: The single-leg deadlift at 60°of forward trunk lean is a proper GM muscle strengthening exercise.

Background: A backpack is available equipment for moving some objects. Most studies have found that the appropriate weight limit of backpack for students is between 10% to 15% of their body weight (BW). However, Some students should carry a backpack heavier than 15% of BW. Therefore, It is associated with abnormal shoulder and neck posture on students. Objects: This study tested the effects that various amounts of weight carried by university students in their backpacks had on their cervical posture and electromyography of neck muscle. Methods: The subjects consisted of 12 students (6 male, 6 female) in university. There were three loading conditions tested: no backpack, a backpack that weighed 10% and 15% of the student’s BW. The dependent variables were the craniovertebral angle (tragus to C7) and the neck muscle activities (sternocleidomastoid, upper trapezius). All 12 subjects were asked to walk while wearing a backpack for 5 minutes and were then instructed to rest for 2 minutes. Results: When assessing the craniovertebral angle, the results of this study were significantly decreased in the order of 0%, 10%, and 15%. And then, there were significantly increased electromyography of neck muscles that comparison of the weight of 10% and 15% on 0%. It was found that as the weight of the backpack increased, the craniovertebral angle decreased (p < 0.05) and the muscle activities increased (upper trapezius p = 0.012, sternocleidomastoid p = 0.013). Conclusion: Our study recommended that some students shouldn’t carry on over the 15% backpack of own weight, and also they should distribute backpack load to equal on body for optimal posture.

Background: Uncontrolled lumbopelvic movement leads to asymmetric symptoms and causes pain in the lumbar and pelvic regions. So many patients have uncontrolled lumbopelvic movement. Passive support devices are used for unstable lumbopelvic patient. So, we need to understand that influence of passive support on lumbopelvic stability. It is important to examine that using the pelvic belt on abdominal muscle activity, pelvic rotation and pelvic tilt. Objects: This study observed abdominal muscle activity, pelvic rotation and tilt angles were compared during active straight leg raise (ASLR) with and without pelvic compression belt. Methods: Sixteen healthy women were participated in this study. ASRL with and without pelvic compression belt was performed for 5 sec, until their leg touched the target bar that was set 20 ㎝ above the base. Surface electromyography was recorded from rectus abdominis (RA), internal oblique abdominis (IO), and external oblique abdominis (EO) bilaterally. And pelvic rotation and tilt angles were measured by motion capture system. Results: There were significantly less activities of left EO (p=.042), right EO (p=.031), left IO (p=.039), right IO (p=.019), left RA (p=.044), and right RA (p=.042) and a greater right pelvic rotation angle (p=.008) and anterior pelvic tilt angle (p<.001) during ASLR with pelvic compression belt. Conclusion: These results showed that abdominal activity was reduced while the right pelvic rotation angle and anterior pelvic tilt angle were increased during ASLR with a pelvic compression belt. In other words, although pelvic compression belt could support abdominal muscle activity, it would be difficult to control pelvic movement. So pelvic belt would not be useful for controlled ASLR.

Background: Leg length discrepancy (LLD) leads to many musculoskeletal disorders and affects daily activities such as walking. In the majority of the population, mild LLD is a common condition. Nevertheless, it is still controversy among researchers and clinicians on the effects of mild LLD during gait, and available studies have largely overlooked this issue. Objects: The purpose of the present study is to investigate the effects of mild LLD on the gait parameters and trunk acceleration. Methods: A total of 15 female and male participants with no evidence of LLD of >.5 ㎝ participated in the present study. All participants walked under the following two conditions: (1) The non-LLD condition, where the participants walked in shoes of the same heel height; (2) A mild LLD condition induced by wearing a 1.5 ㎝ higher heel on the right shoe. The GAITRite system and tri-axial accelerometer were used to measure gait parameters and trunk acceleration. To compare the variation of each variable, a paired t-test was performed. Results: Compared to the non-LLD condition, step time and swing phase were significantly increased in the mild LLD condition, while stance phase, single support phase, and double support phase significantly decreased in the short limb (p<.05). In the long limb of the mild LLD condition, single support phase significantly increased, while swing phase significantly decreased (p<.05). Furthermore, significant decrease in the gait velocity and cadence in the mild LLD condition were observed (p<.05). In the comparison between both limbs in the mild LLD condition, the step time and swing phase of the short limb significantly increased compared with the long limb, while step length, stance phase, and single support phase of the long limb significantly increased compared with the short limb (p<.05). Additionally, trunk acceleration of all directions (anterior-posterior, medial-lateral, vertical) significantly increased in the mild LLD condition (p<.05). Conclusion: The results of the present study demonstrate that mild LLD causes altered and asymmetrical gait patterns and affects the trunk, resulting in inefficient gait. Therefore, mild LLD should not be overlooked and requires adequate treatment.

Background: Light touch cue is a sensory input that could potentially help in the control of posture. The immediate stimulatory effect of light touch cues using a cane during gait is associated with postural stability. This strategy can help post-stroke individuals regain their ability to perform the sit-to-stand (STS) transfer safely. Objects: The effects of light grip on postural control during the STS transfer in post-stroke subjects were investigated. Methods: Eleven participants (6 men, 5 women) with hemiplegia due to stroke were recruited in the study. The subjects with hemiparesis performed STS transfer in three randomly assigned conditions (1) without a cane (2) light grip with a cane (3) strong grip with a cane. Results: The difference in weight-bearing distribution between the left and right feet, when the subjects were instructed to stand up, was 52.73±2.13% without a cane, 42.75±3.26% with a strong grip, and 43.00±2.55% with a light grip (p<.05). The rate of rise in force indicates the peak power provided by subjects during their STS transfers. The rate of rise in force was statistically significantly lower without a cane than that with a light grip or a strong grip (p<.05). The subjects’ centers of pressure sway on the mediolateral side during STS transfers statistically significantly declined with a light grip or a strong grip when compared to those without a cane (p<.05). Conclusion: When the subjects with hemiparesis used a cane during STS transfers, their duration, center of pressure sway, and difference in weight-bearing distribution were all reduced. The subjects also exhibited similar results during STS transfers with a cane gripped lightly. This result may provide guidelines for the use of assistive devices when patients with hemiparesis practice STS transfers in clinical settings.

The purpose of this study was to investigate the variations in gait parameters in terms of the type of arm sling used in hemiplegic patients. Ten patients with hemiplegia and ten healthy adults participated in this study and walked at self-selected speeds on a GAITRite-instrumented carpet. The activities of the opposite shoulder girdle muscle including the latissimus dorsi, anterior deltoid, and posterior deltoid were simultaneously recorded using surface EMG during gait. They were randomly assigned a condition: without an arm sling, a single strap arm sling, a Harris hemi arm sling, a Rolyan humeral cuff arm sling, and a Bobath roll arm sling. The following gait variables were analyzed: the temporo-spatial parameters of velocity, step length, stride length, swing phase, stance phase, single support, step time and toe in/toe out. The statistical analysis was one-way ANOVA with repeated measures to compare the variation of each variable. In comparison of parameters in each trial in the hemiplegia group, the non-affected side stride length, single support, and toe in/toe out resulted in statistically significantly changes (p<.05). But without an arm sling group did not show any gait parameter differences with arm slings. This study found that several arm slings varied gait patterns in patients with hemiplegia and in healthy adults. In the EMG analysis, the Rolyan humeral cuff arm sling and the Bobath roll arm sling were higher muscle activity for the latissimus dorsi muscle than did the single strap ann sling. Further study should examine the problems that appeared in patients who worn arm slings by focusing on a larger number of subjects and by studying the variety of responses in more detail using an assessment tool that measures variation.

Grip strength is an objective indicator for evaluating the functional movement of upper extremities. Therapists have been using it for a long time as an excellent barometer for evaluating the therapy process, therapeutic effects and prognosis of patients with injuries in upper extremities. This study investigated the effects of extensor pattern position and elastic taping of non-dominant hand on the grip strength of dominant hand among general adults. The subjects of this study were 23 males and 7 females from physical therapy departments of 3 Universities located in Busan who agreed to participate in the experiment and the resultant data were analyzed using SPSS version 12.0. The results of the study were as follows. First, there was a significant difference between the grip strength of dominant hand when the non-dominant hand was at the neutral position and that when the non-dominant hand was at the extensor pattern position and both hands were at the maximum strength simultaneously (Bonferroni-corrected p<.001). Second, there was a significant difference between the grip strength of dominant hand when the non-dominant hand was at the neutral position and that when the elastic taping of non-dominant hand was applied (Bonferroni-corrected p<.001). Third, there was no significant difference between the grip strength of dominant hand when the non-dominant hand was at the extensor pattern position and both hands were at the maximum strength simultaneously and that when the elastic taping of non-dominant hand was applied. The irradiation effects through the extensor pattern position of non-dominant hand and application of the elastic taping to non-dominant hand showed significant results in improving the maximum grip strength of dominant hand. This finding could be suggested as the probability for the indirect treatment of the upper extremities of hemiplegia and orthopedic patients due to the long-term fixing of upper extremities.

The objective of this study was to compare the differences on the activity and power of the wrist flexors and extensors in subjects before the use of a wrist extension splint, after nighttime wearing of the splint, and after daytime wearing of the splint. Ten healthy male and ten healthy female students (mean: 22.4±1.2 years old) volunteered to wear custom-made wrist splints either during the night or during the day, The hand force of the wrist flexor and extensor, and grip force were measured by PowerTrack II and Dynatron, respectively. At the same time, the activities of the wrist flexor and extensor were recorded by' surface electromyography. The maximal hand force and motor unit recruitment of the flexor carpi ulnatis (FCU) increased significantly (p<.05) when tile subjects wore the wrist splints during the daytime, but the maximal hand power of the FCU decreased with nighttime use of the splints. The maximal hand power and motor unit recruitment of the extensor carpi radialis (ECR) and the ECR/FCU ratio decreased both during nighttime and daytime use. The decrement of the ECR/FCU ratio was significant (p<.05). Wearing a wrist extension splint during nighttime led to the maintenance of a lengthened position of the wrist flexor, resulting in the wrist flexor becoming weak. Wearing a wrist extension splint during the day induced the wrist flexors to be greater. In healthy people, the imbalance between the wrist flexors and extensors may be caused by the use of a wrist extension splint. This study indicates that therapists have to consider whether a splint will be effective, as well as the wearing time, when prescribing splints to people with problems of the musculoskeletal system.

The purpose of this study was to determine the therapeutic effect of slope changes of the treadmill with body weight-supported training on gait characteristics in patients with hemiplegia. The volunteered subjects were divided into 3 groups based upon slope changes: control group (0° incline), 7° group (7° incline), 12° group (12° incline), They were trained the body weight-supported treadmill training (BWSTT) for 8 weeks. All subjects were supported up to 40% of their body weight on the treadmill training and the support was gradually decreased to 0~10% as the subjects were adapted to the training. There were significant improvements of walking velocity, step length of the affected side, the asymmetry ratio of step length in 7° group (57.80 cm/s, 67.25 cm, .14), 12° group (71.00 cm/s, 71.00 cm, .11) than control group (40.62 cm/s, 55.00 cm, .74) (p<.05): there were no differences between group 7° and 12° group in the all outcomes (p>.05). Both 7° group and 12° group scored higher than the control group in those outcomes and finally the effects of slopes changes of the treadmill were effective on gait characteristics of patients. But it s till remains undetermined what degree on the treadmill might be better to train the hemipareric patients. Therefore, more studies are required to look into minutely the changes of slopes of the treadmill influencing on gait characteristics.

The objective of this study was to discover the effects of the short-term home visiting physical therapy program involving patients with some chronic brain disorders at Gimhae City, Kyongnam. Recovery of activities of daily living (ADL) is a very important factor of rehabilitative procedures, and Functional Independence Measure (FIM) is a useful standard of evaluation for it. The FIM is widely used in brain disorder research because it measures real functional activities of daily living. We applied the physical therapy exercise program twice per week (10~15 times repeatedly); a warm-up and cool down exercise performed every ten minutes by active & active-assistive ROM and stretching exercises. Main exercises were composed of getting up & laying down in bed, standing training, walking exercise in the room, and window or wall sliding exercise using affected upper limbs for a total duration of 30 minutes. We collected the data from 20 patients with chronic brain disorders at his/her home and analyzed by means of SPSS/PC+ program (Ver. 10.0). After the six week long physical therapy exercise program, the average was 56.10±22.59 point compared with initial 50.55±19.12 point by FIM, improved functional ADL ability about 5.55 point, and these changed scores were statistically significant (p=.000). We also studied another factor regarding patient's satisfaction. The majority of subjects (10 people) rated the program with the maximum score of ten points (50.0%), and three people rated it a seven point program (15.0%), the other two subjects gave a rating of nine and eight points (10.0%). Because the program was effective at improving the physical ADL ability and satisfaction of each subject, we suggest continual development and implementation of a home visiting physical therapy program. Further study should involve a longer period of observation with a larger population that is involved in an individually designed home physical therapy program.

The objective of this study was to discern the effects of a balance training program on the performance of lower extremities in order to improve strength (muscle power, flexibility, walking power), balance control and walking ability in the elderly. The subjects selected were aged 65 years and over, with no known relevant medical history that may disturb their balance, and have also been visiting the Gimhae Senior Welfare Center. The variable group consisted of 30 subjects, of whom were people who had been participating in balance training programs (One Leg Standing; OLS, Functional Reach; FR, Timed Get Up and Go; TUG) as an intervention for 8 weeks 3 times per a week. They were examined in order to identify their balance control before and after. The control group consisted of thirty subjects who preferred to exercise without any intervention relating to balance training program. The subjects were measured before and after balance training in order to determine the effectiveness of exercise and the effectiveness of exercise combined with the aid of a Balance Performance Monitor. 1. Mean time on OLS test with left and right sided extremities in the experimental group was 35.44 sec, 42.10 sec longer than control group respectively. In FR tests applied to the left and right side, mean reaching distance was increased up to 5.56 cm, 6.73 cm in experimental group respectively. Mean time on TUG test from a chair in experimental group was decreased to 2.33 sec. 2. Mean value of decline in the level balance control, both left and right side, decreased to 2.24% as examined by the Balance Performance Monitor. Mean scores for sway level after balance training decrease to .98% and for balance control both anterior and posterior directions decreased to mean 1.07% and 1.44%, respectively.