This study was designed to determine the effects of different widths in the base of support (BOS) on trunk and lower extremity muscle activation during upper extremity exercise. Twenty-seven healthy male subjects volunteered for this study. Exercises were performed for a total of 10 trials with a load of 10 repetitions maximum (10 RM) for each of the various widths of BOS (10 cm, 32 cm, 45 cm). The width of a BOS is the distance between each medial malleoli when a subject was in a comfortable standing position. Electromyography was used to determine muscle activation. Surface bipolar electrodes were applied over the tibialis anterior, medial gastrocnemius, biceps femoris, rectus femoris, gluteus maximus, upper rectus abdominis, and elector spinae muscle. Electromyographic (EMG) root mean square (RMS) signal intensity was normalized to 5 seconds of EMG obtained with a maximal voluntary isometric contraction (MVIC). The data were analyzed by atwo-factor analysis of variance (ANOVA) with repeated-measures () and Bonferroni post hoc test. The results were as follows: (1) There were significant differences in the width of the BOS (p=.006). (2) The post hoc test showed significant differences with the BOS between 10 cm and 32 cm, between 10 cm and 45 cm and between 32 cm and 35 cm (p=.008, p=.003, p=.011). (3) There was no interaction with the BOS and muscle. (p=.438) There were no significant differences in the muscle activation (p=.215).

This study is aimed at investigating the influence of different quantitative knowledge of results on the measurement error during lumbar proprioceptive sensation training. Twenty-eight healthy adult men participated and subjects were randomly assigned into four different feedback groups(100% relative frequency with an angle feedback, 50% relative frequency with an angle feedback, 100% relative frequency with a length feedback, 50% relative frequency with a length feedback). An electrogoniometer was used to determine performance error in an angle, and the Schober test with measurement tape was used to determine performance error in a length. Each subject was asked to maintain an upright position with both eyes closed and both upper limbs stabilized on their pelvis. Lumbar vertebrae flexion was maintained at for three seconds. Different verbal knowledge of results was provided in four groups. After lumbar flexion was performed, knowledge of results was offered immediately. The resting period between the sessions per block was five seconds. Training consisted of 6 blocks, 10 sessions per one block, with a resting period of one minute. A resting period of five minutes was provided between 3 blocks and 4 blocks. A retention test was performed between 10 minutes and 24 hours later following the training block without providing knowledge of results. To determine the training effects, a two-way analysis of variance and a one-way analysis of variance were used with SPSS Ver. 10.0. A level of significance was set at .05. A significant block effect was shown for the acquisition phase (p<.05), and a significant feedback effect was shown in the immediate retention phase (p>.05). There was a significant feedback effect in the delayed retention phase (p<.05), and a significant block effect in the first acquisition phase and the last retention phase (p<.05). In conclusion, it is determined that a 50% relative frequency with a length feedback is the most efficient feedback among different feedback types.

In most tissues, apoptosis plays a pivotal role in normal development and in regulation of cell number. Therefore inappropriate apoptosis is revealed in a variety of diseases. This study was carried out to investigate the effects of acupuncture and needle electrode electrical stimulation on the change of caspase-3, 9 and neuronal nitric oxide synthase (nNOS) immunoreactive cells in the sprague dawley rats (SD rat). In immobilized SD rats (n=5), enhanced caspase-3 and caspase-9 expression were detected in the reticular part of substantia nigra, and enhanced nNOS was detected in the dorsolateral periaqueductal gray (DL-PAG) of midbrain and the paraventricular nucleus (PVN) of the hypothalamus using immunohistochemistry. Following the immobilization, acupuncture (n=5) and needle electrode electrical stimulation (n=5, 2 Hz) was applied at Hg (LI4) acupoint of SD rats, respectively. The stress-induced enhancement in the expression of caspase-3, 9 and nNOS were The present results demonstrate that and needle electrode electrical stimulation are effective in the modulation of expression of caspase-3, 9 and nNOS induced by immobilization.

The purpose of this study was to assess the effect of applied insole types to lower extremities muscle fatigue during treadmill exercise. The control group and each different insole type group consisted of ten healthy male subjects. In the control group and each different insole type (soft type; 10 shore, semi-rigid type; 33 shore, rigid type; 50 shore) treadmill exercise was performed in twenty-five minutes. The electromyography (EMG) signals of four muscle (tibialis anterior, gastrocnemius medialis, rectus femoris, biceps femoris) were recording at sampling rate of 1024 Hz during treadmill exercise. The localized muscle fatigue (LMF) can be investigated using power spectral analysis. When did data analysis that excepted initial five minutes. The raw EMG signals was processed using the fast Fourier Transformation (FFT) and the median power frequency value was determined in initial ten second period and in last ten second period. Fatigue index was calculated and collected data were statistically analyzed by SPSS version 10.0 two-way using analysis of variance (ANOVA) with repeated measures () was used to determine the main effect and interaction. Post hoc was performed with least significant difference. A level of significance was .05. Muscles fatigue index were significantly decreased in insole types (p<.05) and not significantly different in muscle (p>.05). Post hoc analysis shows that fatigue index in soft insole type, semi-rigid insole type and rigid insole type were lower than that control group (p=.028, p=.146, p=.095). There were no interaction between insole type and muscles (p>.05). The finding of this study can be used as a fundamental data when insole is applied and insole can be used to decreased of a fatigue during the dynamic exercise.

This simulation study investigated the characteristics of normal gait, crouch gait, crouch/equinus gait, crouch gait, crouch/equinus gait. The knee flexion angles were restricted using a specially designed orthosis. This study was carried out in a motion analysis laboratory of the National Rehabilitation Center. Fifteen healthy male subjects were recruited for the study. The purposes of this study were (1) to compare spatiotemporal parameters, kinematics, and kinetic variables in the sagittal plane among the different gait, (2) to investigate the secondary compensatory strategy, and (3) to suggest biomechanical physical therapy treatment methods. The pattern and magnitude observed in each condition were similar to those of normal gait, except the peak knee extension moment of the unrestricted ankle motion-crouch gait. However, the speed of the crouch gait was half that of a normal gait. The ankle joint moment in the crouch/equinus gait showed the double-bump pattern commonly observed in children with spastic cerebral palsy, and there was no significant difference in gait speed as compared with normal gait. The peak ankle plantar-flexor moment and ankle power generated during the terminal stance in the crouch/equinus conditions were reduced as compared with normal and crouch gaits (p<.05). The crouch/equinus gait at the ankle joint was an effective compensatory mechanism. Since ankle plantarflexion contracture can be exacerbated secondary to the ankle compensatory strategy in the crouch/equinus gait, it is necessary to increase the range of ankle dorsiflexion and the strength of plantarflexion simultaneously to decrease the abnormal biomechanical advantages of the ankle joint.

Slipping during various kinds of movement often leads to potentially dangerous incidents of falling. The purpose of this paper was to review some of the research performed in the field including such topics as rating scales for balance, kinematics and kinetics of slipping, adaptation to slippery conditions, postural and balance control, and protective movement during falling. Controlling slipping and fall injuries requires a multifaceted approach. Environmental conditions (state of floor surface, tidiness, lighting, etc), work task (walking, carrying, pushing, lifting, etc), and human behavior (anticipation of hazards, adaptation to risks, risk taking, etc) must be accounted for in the assessment of slip and fall-related risks. Future directions of research must deal with modeling of basic tribophysical, biomechanical, and postural control process involved in slipping and falling.

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.

In-shoe measurement systems allow the clinician and researcher to examine the pressure parameters within the shoe. The purpose of this study was to investigate the test-retest reliability of plantar pressures using the Parotec system over speeds and plantar regions. Seventeen healthy subjects were recruited for the study. Sampling rate was 100 Hz, and data of six variables (pressure on medial heel, lateral heel, 1st metatarsal head, 5th metatarsal head, and great toe and total impulse) were collected in four different gait speed (1.0 m/sec, 1.5 m/sec, 2.0 m/sec, and comfortable walking speed) in each day. The result indicates fair to excellent reliability between the two day test. Intraclass correlation coefficients (ICCs) ranged from .693 to .979, and range of reliability was similar depending on the speed and plantar region. In most cases, data recorded by the Parotec systems provide good evidence for the reliability.

The purpose of this study was to investigate whether the standing balance could be influenced by the different foot positions. Seventeen patients with hemiplegia were tested for the static and dynamic balance under the different foot positions. In the balance test, subject stood by bearing weight on one foot, and the other foot was positioned in three different positions (symmetric, anterolateral, and anterior position). This study used the Kinesthetic ability trainer (KAT2000) to measure the standing balance. The results were as follows: 1) There were significant differences in the static standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 2) There were also significant differences in the dynamic standing balance in different foot positions with both weight-bearing on the paretic limb and on the nonparetic limb (p<.05). 3) There was a significant difference when the paretic weight-bearing and the nonparetic weight-bearing were compared (p<.01). 4) when the paretic weight-bearing and the nonparetic weight-bearing were compared, anterior foot position showed a significant difference in the dynamic standing balance (p<.05), but anterolateral foot position did not show a significant difference (p>.05). In this study, the standing balance showed a significant difference according to different foot positions in hemiparetic patients, and standing balance was better when they stood by bearing weight on the nonparetic limb. These results indicate that it is a necessary to consider both weight-bearing limb and foot position not only in the rehabilitation program but also in achieving the stability in the independent life.

The purpose of this study was to investigate the effect of donning of a hard insole in patients with hallux valgus. Fourteen subjects were selected from patient with foot pain at Lee Chang-Heon Foot Clinic from August 4, 2000 to September 15, 2000. The hallux valgus angle and the first-second intermetatarsal angle were radiographically measured before and after donning the hard insole. Based on these two kinds of angles, a mild hallux valgus deformity group was characterized by the hallux valgus angle of less than 20 degrees, and a moderate hallux valgus deformity group was characterized by the hallux valgus angle of 20 to 40 degrees. After three weeks with the hard insole donned, the foot angles of the patients with hallux valgus were measured again. The data were analyzed by Wilcoxon signed ranks test, and the following results were obtained: 1) After the trial, both mild hallux valgus deformity group and moderate hallux valgus deformity group demonstrated that the hallux valgus angles were significantly decreased. 2) After the trial, mild hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was significantly decreased. 3) After the trial, moderate hallux valgus deformity group demonstrated that the first-second intermetatarsal angle was not significantly decreased. The above findings revealed that according to donning hard insole, the hallux valgus angles of mild and moderate hallux valgus deformity groups and the first-second intermetatarsal angle of mild hallux valgus deformity group were significantly decreased. The results of this study have some limitation for generalization due to the limited number of subjects. Further studies are needed to evaluate the effect of hard insole on hallux valgus with more precise laboratory equipments and measurements in patients with hallux valgus.

During therapy sessions, feedback is often provided concurrently by the physical therapist as the patient attempts to perform a movement and after the movement attempt. This feedback is provided to enhance the patient's balance abilities. However, recent studies in nondisabled populations have suggested that frequent feedback may be detrimental to retention or learning of motor skills. This study compared the effects of 100% relative frequency of knowledge of performance (KP) with 66% relative frequency of KP for motor learning on balance retraining in patients with hemiplegia. Twenty patients with hemiplegic were randomly assigned to one of two experimental groups. The acquisition phase consisted of 16 blocks of 5 trials for 2 days (80 total practice trials). The retention phase consisted of 2 blocks of a short-term retention test, one day after the end of the acquisition phase and a long-term retention test, one week after the end of the short-term retention test. In the 100% feedback condition, participants received feedback after every practice trial. A faded KP schedule was used in the 66% condition. No significant differences were found between the two groups during all experimental phases (acquisition and retention phases), (p>.05). However, there were significant decreases in balance index for both groups of acquisition phase (p<.05). These results suggest that 66% relative frequency of KP is not more effective than 100% relative frequency of KP with respect to retention over time when hemiparetic patients attempt to learn balance.

The purpose of this study is to determine whether movement strategies affect functional forward reach distance in a standing position. Forty-seven healthy subjects were selected for this study: 23 men and 24 women, with an average age of 22.3. Functional forward reach distances were measured as hip strategy and squat strategy (included knee and ankle movement strategy) in a standing position, respectively. The mean values of functional forward reach distance in hip strategy, squat strategy were 33.57 cm, 29.48 cm, respectively. There was significantly difference in functional forward reach distance between hip strategy and squat strategy(p<.001). There was no difference of functional forward reach distance between male and female in hip strategy, but there was significant difference in other strategy(p<.05). These results suggest that movement strategies should be considered during functional forward reach test in standing. Further study is required to determine whether movement strategies affect functional reach distance in elderly and disabled groups.

The purpose of this study is to determine the effects of exercise training on the strength and balance ability of the elderly. The results of this study are: 1) After 8 weeks exercise training, knee muscle strength showed a significant increment. 2) After exercise training, forward functional reach and balance index of KAT 2000 showed a significant increment. Results indicate that strengthening exercise can result in improved muscle strength and balance in the elderly. Further studies are required to show long-term effects of exercise training on the elderly.

본 증례연구는 복합손상을 가진 척수손상환자의 재활치료과정을 소개하여 유사한 사례의 치료에 도움이 되고자 하는 것이다. 증례연구의 대상자인 26세의 남자환자는 흉수 4번 완전손상과 사고 당시 전기화상에 의한 좌측하박 절단과 우측손의 정중신경이 마비되었다. 치료초기에는 일상생활동작 검사에서 MBI (Modified Barthel Index) 점수가 22점으로 독립적으로 가능한 것은 거의 없었고, 기능적으로도 모든 도움이 필요한 상태였으나 재활치료결과 독립적

본 연구의 목적은 장애물 높이에 따른 상지 팔운동 제한이 스텝안정화(stabilization step)에 영향을 주는지 알아보기 위하여 실시하였다. 연구대상자는 대학생 남자 14명, 여자 16명으로 총 30명이였으며, 평균 연령은 21.5세이었다. 스텝 안정화는 FASTEX(functional activity System for testing and exercise, Cybex Division of Lumex, Inc., USA)를 이용하여 측정하였다.

The purpose of this case study was to introduce functional electrical stimulation(FES) for paraplegic patients. FES provides the ability to rise from sitting to standing, maintenance of a standing position, and the ability to walk with a reciprocal gait. Six channels of electrical stimulation are sufficient for synthesis of a simple reciprocal gait pattern in these patients. During the double-stance phase, knee extensor muscles of both knees are stimulated, providing sufficient support for the body. Only one knee extensor muscle group is excited during the single-stance phase. The swing phase of the contralateral lower extremity is accomplished by eliciting the synergic flexor muscle response through electrical stimulation of afferent nerves. The transition from the double-stance phase to the swing phase is controlled by two hand switches used by the therapist or built into the handles of the walking frame for using by the patient. A twenty-five years old male was with a T9/T9 spinal cord injury due to a traffic accident and admitted to Yonsei Rehabilitation Hospital for comprehensive treatment. After 30 days of training using the Parastep(R) he was able to stand for 10 minutes. After 43 days, he was able to walk and at discharged he could walk for 100 meters.

This paper reviews physiological changes in the nervous system of patients with hemiparesis that may contribute to muscle weakness. The discussion includes the important role that alterations in the physiology of motor units, notably changes in firing rates and muscle fiber atrophy, play in the manifestation of muscle weakeness. This role is compared with the lesser role that spasticity of the antagonist muscle group appears to play in determining the weakness of agonist muscles. The contribution of other factors that result in mechanical restraint of the agonist by the antagonist is discussed relative to muscle weakness in patients with hemiparesis. More studies on patients with hemiparesis are required to assess what role muscle strength training should play in rehabiliting patients after a stroke.

The objective of this study was to identify the immediate effects of the short leg brace on the weight bearing distribution and gait patterns of hemiplegic patients. The subjects of this study were 18 hemiplegic patients who had been hospitalized or visited out-patient department of Rehabilitation Hospital, Yonsei University College of Medicine, from January 5, 1996 through March 23, 1996. PLS(Posterior Leaf Spring) on and off changes in gait patterns were measured using ink foot print as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the correlation and paired t-test. The findings were as follows: 1. Eighteen subjects were more weighted on the affected leg when PLS was put off(42.74%) than on(40.08%). 2. The defference in gait patterns between PLS on and off was statistically significant, with an increase in step length by 1.7cm on the involved side; a decrease in foot angle by 4.41 degree on the involved side; and a narrowing of base of support by 1.46cm when PLS were off. In conclusion, this study showed that PLS did not affect the weight bearing distribution and gait patterns of hemiplegic patients. Since, the evaluation method used in this study has limitations in regard to temporal distance gait values. Further studies are required to numerous experiments for subject and extensive study.