Background: Research efforts to improve the pulmonary function of children with cerebral palsy (CP) need to focus on their decreased diaphragmatic ability compared to normal children. Real-time ultrasonography is appropriate for demonstrating diaphragmatic mechanisms. Objects: This study aimed to compare diaphragm movement, pulmonary function, and pulmonary strength between normal children and children with CP by using ultrasonography M-mode. The correlation between general characteristics, diaphragm movement, pulmonary function, and pulmonary strength was also studied. Methods: The subjects of this study were 25 normal and 25 CP children between five and 14 years of age. Diaphragm movement was measured using real-time ultrasonography during quiet and deep breathing. Pulmonary function (such as forced expiratory volume in one second; FEV1 and peak expiratory flow; PEF) and pulmonary strength (such as maximum inspiratory pressure; MIP and maximum expiratory pressure; MEP) were measured. A paired t-test and Spearman’s Rho test, with a significance level of .05, were used for statistical analysis. Results: The between-group comparison revealed that normal children had significantly greater diaphragm movement, FEV1, PEF, MIP, and MEP (p<.05) than CP children. The results showed that general characteristics were significantly related to FEV1, PEF, MIP, and MEP (p<.05). Conclusion: In clinical settings, clinicians need to concern decreased diaphragm movement, pulmonary function, and pulmonary strength in CP group compared to normal children.

Background: Recently, there has been an emphasis on the use of interventions with biofeedback information for the maintenance or correction of posture. Objects: This study assessed the change of trunk posture and trunk muscle activation when people exhibiting postural kyphosis performed visual display terminal work with or without a contact feedback device (CFD). Methods: Eighteen right-handed individuals were recruited. Thoracic angle and right thoracic erector spinae (TES) muscle amplitude were analyzed. There were two sessions in these experiments. The control session involved 16 minutes of typing without a CFD, and the CFD session involved 16 minutes of typing with a CFD. The visual analog scale score was analyzed with a paired t-test, and the kinematic and electromyography data were analyzed through two-way repeated analysis of variance. Results: The paired t-tests revealed that subjects had significantly less pain after the CFD sessions than after the control sessions (p<.05). Significant main effects by session and by time were observed in the thoracic kyphosis angle (p<.05). There was a significant session×time interaction for TES amplitude (p<.05), along with significant main effects by session and by time (p<.05). Conclusion: The CFD caused people with postural kyphosis to straighten and to activate their TES continuously, even though they were habituated to bend their bodies forward. Therefore, the CFD was a beneficial treatment tool

Background: The toe-spread-out (TSO) exercise has been introduced as a strengthening exercise for the abductor hallucis muscle in subjects with hallux valgus. Visual biofeedback using ultrasound imaging during exercise, may increase the ability to selectively contract the abductor hallucis muscle, compared with exercise alone. Objects: The aim of this study was to investigate the effects of ultrasound imaging visual feedback during the TSO exercise with respect to its influence on the angle of the first metatarsophalangeal joint (1st MPJ) and the cross-sectional area (CSA) of the abductor hallucis muscle in subjects with hallux valgus. Methods: Twenty-five healthy young subjects with a mean average age of 22.5 years, and a standard deviation of 2.3 years, were recruited for this study. Hallux valgus was defined as an angles greater than 15° angle of 1st MPJ. Goniometric measurement was used to determine the angle of 1st MPJ. In addition, an ultrasound system was used to collect the CSA of the abductor hallucis muscle in each foot. The angle of the 1st MPJ and CSA of the abductor hallucis were measured in three positions; the resting position, during TSO exercise, and during TSO exercise in conjunction with real-time ultrasound imaging feedback. All data analyzed using a repeated analysis of variance with Bonferroni correction in order to compare the dependent variables in all three positions. Statistical level of significance was set up as p<.05. Results: The angle of the 1st MPJ was noted to be significantly reduced and the CSA of the abductor hallucis to be significantly greater during TSO exercise used in conjunction with ultrasound imaging visual feedback, compared to when the values were recorded during TSO exercise alone (p<.05). Conclusion: Based on these findings, it can be concluded that the application of ultrasound imaging visual feedback during TSO exercise is more effective in contracting selectively the abductor hallucis than the use of exercise alone.

For professional drivers, there is a possibility to have musculoskeletal disorders on ankle joint due to repetitive pedaling operation. Therefore, this study have focused to examine ankle active range of motion (AROM), dorsiflexor strength, and pressure pain threshold (PPT) of tibialis anterior muscle (TA) in taxi drivers compared to a age-matched control group. Thirty male taxi drivers with at least 10 years of driving experience and thirty male sedentary workers were evaluated for ankle AROM, dorsiflexor strength, and PPT of TA. Multiple independent t-tests were used to identify significant differences between two groups. For the results, taxi drivers had significantly less AROM in dorsiflexion and greater AROM in external tibial rotation compared to the control group. Also, dorsiflexor strength and PPT of TA in taxi drivers was significantly lower than in the control group. This study indicates that the repetitive ankle movements associated with driving have an effect on ankle AROM, dorsiflexor strength, and PPT of TA and may lead to work-related musculoskeletal disorders on ankle. Professional drivers may need to be educated to prevent a potential musculoskeletal disorders associated with repetitive movement.

The smart-phone has become a necessity for most people. In this study, we determined that using a smart-phone for 20 minutes can cause increased neck and shoulder muscle activities and fatigue. Seventeen healthy male smart-phone users who attended Yonsei University played a smart-phone game for 20 minutes and changes in their bilateral cervical erector spinae and upper trapezius muscle activities and fatigue were measured. To assess muscle activities and fatigue, we used the following variables: the median frequency, the 50th percentile Amplitude probability distribution function (APDF) value (median load), and the discrepancy in the 90th percentile APDF value and the 10th percentile APDF value (APDF range). A paired t-test was used to compare pre-smart-phone-use status with post-smart-phone-usestatus. The median frequency of the bilateral cervical erector spinae and the upper trapezius decreased significantly after 20 minutes of smart-phone use (p<.05). In addition, the 50th percentile APDF value of the bilateral cervical erector spinae and the right upper trapezius increased significantly (p<.05). The APDF range of the bilateral cervical erector spinae and the upper trapezius also increased significantly (p<.05). However, the 50th percentile APDF range of the left upper trapezius was not significantly different (p>.05). These findings suggest that using smart-phones for 20 minutes can induce muscle fatigue and increased neck and shoulder muscle activities.

The purpose of this study was to investigate the reliability and validity of goniometer measurements of the hallux valgus angle (HVA) compared to radiographic measurements, which are the current standard. Twenty subjects (10 female, 10 male) were recruited for this study (40 feet). The HVA of the subjects was measured using goniometer and radiographic measurement. In three trials, measurements were taken of each subject by two examiners using goniometer and radiographic measurements using radiography in a standing position. The reliability of the measurements was investigated using intraclass correlation coefficients (ICC(3,1)), and the validity was tested using the Pearson product-moment correlation coefficient and an independent t-test. The intra-rater reliability of left and right HVAs were poor (ICC=.409 and .341, respectively). The inter-rater reliability of left and right HVAs were poor and moderate (ICC=.303 and .501, respectively). Left and right HVAs measured using goniometer and radiographic measurements were also poor and moderate (Pearson r=.246 and .544, respectively). These results suggest that goniometer measurements of the HVA are inaccurate and have unacceptable validity compared to radiographic measurements.

Delayed onset muscle soreness (DOMS) is a painful condition that arises from e+M8xercise-induced muscle damage after unaccustomed physical activities. Various therapeutic interventions have been applied to reduce the intensity and duration of DOMS-related symptoms. Recently, pulsed electromagnetic field (PEMF) intervention has been introduced as an alternative noninvasive treatment for DOMS. This randomized, double-blind, placebo-controlled experiment was conducted to examine the effects of PEMF therapy on DOMS in elbow flexors at 24, 48, and 72 hours after the experimental DOMS induction. Thirty healthy volunteers ( yrs, cm, and kg) participated in this study. Each was randomly assigned to a PEMF or placebo group. On the first day, DOMS was induced in the elbow flexors by repeated isokinetic motions at low () and fast () speeds in all subjects. Thereafter, the PEMF group received 15-min daily treatment with a PEMF device. The placebo group received sham treatment of the same duration. Overall, PEMF application was more effective than the sham treatment in reducing the physiological symptoms associated with the DOMS including perceived soreness, median frequency, and electromechanical delay of the surface electromyography. In addition, median frequency and isokinetic peak torque of the PEMF group recovered to the pre-DOMS induction level earlier than the placebo group. In conclusion, this study suggests that PEMF can be applied as a new recovery strategy in reducing DOMS symptoms. Further experiments are required to examine the effect of the PEMF treatment on different types of exercise conditions and to determine the optimal treatment dosage and duration in a real clinical setting.

We evaluated whether group locomotor imagery training-combined knowledge of performance (KP) lead to improvements in gait function in community dwelling individuals with chronic stroke. Ten adults who had suffered a hemiparetic stroke at least 6 months earlier participated in group locomotor imagery training-combined KP for 5 weeks, twice per week, with 2 h intensive training. Dynamic gait index scores increased significantly after the group locomotor imagery training-combined KP. However, times for the timed up-and-go test did not improve significantly after the training. Group locomotor imagery training-combined KP may be a useful option for the relearning of gait performance for community dwelling individuals with chronic hemiparetic stroke.

The purpose of this study was to investigate the kinematic and kinetic changes that may occur in the pelvic and spine regions during cross-legged sitting postures. Experiments were performed on sixteen healthy subjects. Data were collected while the subject sat in 4 different sitting postures for 5 seconds: uncrossed sitting with both feet on the floor (Posture A), sitting while placing his right knee on the left knee (Posture B), sitting by placing right ankle on left knee (Posture C), and sitting by placing right ankle over the left ankle (Posture D). The order of the sitting posture was random. The sagittal plane angles (pelvic tilt, lumbar A-P curve, thoracic A-P curve) and the frontal plane angles (pelvic obliquity, lumber lateral curves, thoracic lateral curves) were obtained using VICON system with 6 cameras and analyzed with Nexus software. The pressure on each buttock was measured using Tekscan. Repeated one-way analysis of variance (ANOVA) was used to compare the angle and pressure across the four postures. The Bonferroni's post hoc test was used to determine the differences between upright trunk sitting and cross-legged postures. In sagittal plane, cross-legged sitting postures showed significantly greater kyphotic curves in lumbar and thoracic spine when compared uncrossed sitting posture. Also, pelvic posterior tilting was greater in cross-legged postures. In frontal plane, only height of the right pelvic was significantly higher in Posture B than in Posture A. Finally, in Posture B, the pressure on the right buttock area was greater than Posture A and, in Posture C, the pressure on the left buttock area was greater than Posture A. However, all dependent variables in both planes did not demonstrate any significant difference among the three cross-legged postures (p>.05). The findings suggest that asymmetric changes in the pelvic and spine region secondary to the prolonged cross-legged sitting postures may cause lower back pain and deformities in the spine structures.