Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group (n1=7) and conventional postural vertical training (CPVT) group (n2=7). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject’s postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured preand post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.

Background: Genu varum is also known as bow leg. It is a deformity wherein there is lateral bowing of the legs at the knee. it does give rise to pain, and persistent bowing can often give rise to discomfort in knees, hips and ankles. Objects: This study investigated the effect of narrow squats on the knee joint during a gait and distance between the knees of person with genu varum. Methods: This study analyzed 23 patient with genu varum that grade Ⅲ, 12 narrow squat group and 11 genenal squat group in motion analysis laboratory. The subjects of experiment took gait before and after intervention, the range of joint motion, moment of knee joint adduction, power, distance of the knees were measured. And in order to make an analysis between groups, an paiered t-test and independent t-test was carried out. For statistical significance testing, it was decided that significance level α be .05. Results: It was shown that the group of narrow squat exercise significantly decreased in distance of knees (p<.05),In moment of adduction of knee joint, it was shown to significantly decrease in two groups (p<.05), was significantly decreased in adduction, abduction, and rotation (p<.05). In relation of peak-knee adduction moment and valgus angle, there was significant decrease in narrow squat group (p<.05). Conclusion: When the above result of study were examined, a narrow squat exercise given to the genu varum patients significantly decreased the distance between the knees, range of knee adduction and abduction, knee adduction moment, knee power. And stability gains through the decrease of excursion of knee medial part be effective for the correction of genu varum deformation.

Background: It is very difficult for hemiplegic patients to effectively perform the sit-to-stand (STS) movements independently because of several factors. Moreover, the analysis of STS motion in hemiplegic patients has been thus far confined to only muscle strength evaluation with little information available on structural and environmental factors of varying chair height and foot conditions. Objects: This study aimed to analyze the change in biomechanical factors (ground reaction force, center of mass displacement, and the angle and moment of joints) of the joints in the lower extremities with varying chair height and foot conditions in hemiplegic patients while they performed the STS movements. Methods: Nine hemiplegic patients voluntarily participated in this study. Their STS movements was analyzed in a total of nine sessions (one set of three consecutive sessions) with varying chair height and foot conditions. The biomechanical factors of the joints in the lower extremities were measured during the movements. Ground reaction force was measured using a force plate; and the other abovementioned parameters were measured using an infra-red camera. Two-way repeated analysis of variance was performed to determine the changes in biomechanical factors in the lower extremities with varying chair height and foot conditions. Results: No interaction was found between chair height and foot conditions (p>.05). All measured variables with varying chair height showed a significant difference (p<.05). Maximum joint flexion angle, maximum joint moment, and the displacement of the center of mass in foot conditions showed a significant difference (p<.05); however the maximum ground reaction force did not show a significant difference (p>.05). Conclusion: The findings suggest that hemiplegic patients can more stably and efficiently perform the STS movement with increased chair height and while they are bare-foot.

The purpose of this study was to investigate the effect of taping on knee joint for patellofemoral compressive force (PCF) during stair descent for elderly women. Ten healthy elderly women voluntarily participated in this study. A three-dimensional motion analysis system and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the maximum PCF, maximum quadriceps contraction force and maximum knee extension moment (p>.05) but, there was a pattern decreasing all values with the taping during stair descent. There were significant differences for the knee and ankle angle on the event of maximum PCF (p<.05) and there was a pattern decreasing all values with the taping during stair descent. Therefore, taping on the knee would be effective to relieve the pain like patellofemoral pain syndrome in the knee joint.

This study investigated the effect of a load of 15% body weight on trunk, pelvis and hip joint coordination and angle variability in subjects with and without chronic low back pain (CLBP) during an anterior load carriage task. Thirty volunteers participated in the study (15 without CLBP, 15 with CLBP). All participants were asked to perform an anterior carriage task with a load of 15% body weight. The outcome measures included the means and standard deviations for measurements of three-dimensional coordination and angle variability of the trunk, pelvis and hip joint. As CLBP patient group .06, control group .70, the correlation coefficient between the groups showed a significant difference only in trunk-pelvic in the sagittal plane (p<.05). Angle variability of CLBP patient group increased significantly in the trunk in frontal plane, the pelvis in all sagittal plane, frontal plane, transverse plane, and the hip in sagittal plane, the hip in frontal plane than angle variability of control group (p<.05). This results mean that the CLBP patient group showed a disconnected coordination pattern in the trunk-pelvis in the sagittal plane, an increased pelvic angle variability in all three planes, and hip angle variability in the sagittal, and frontal planes. The CLBP patient group may have developed a compensatory movement of the pelvis and hip joint arising from the changed stability due to the abnormal coordination patterns of the trunk-pelvic in the sagittal plane. Therefore, CLBP symptoms can potentially worsen in the pelvis and adjacent hip joint in CLBP patients who perform weight-related behaviors in their daily lives. Further research is needed to determine the three-dimensional characteristics of the electromyography and neuromuscular aspects of subjects with CLBP.

The purposes of this study were to develop a new orthosis controlling ankle and knee joint motion during the gait cycle and to identify the effects of the newly designed orthosis on gait kinematics and tempospatial parameters, including coordination of the extremities in stroke patients. Fifteen individuals who had sustained a stroke, onset was 16 months, participated in this study. Before application of the measurement equipment the subjects were accustomed to walking on the ankle-foot orthosis (AFO) or stance control knee with knee flexion assisted-oil damper ankle-foot orthosis (SCKAFO) for 5 minutes. Fifteen patients were investigated for 45 days with a 3-day interval between sessions. Measurements were walking in fifteen stroke with hemiparesis on the 3D motion analysis system. Comparison of AFO and SCKAFO are gait pattern. The difference between the AFO and SCKAFO conditions was significant in the gait velocity, step length of the right affected side, stance time of both legs, step-length asymmetry ratio, single-support-time asymmetry ratio, -thigh angle and -shank angle in the mid swing (p<.001). Using a SCKAFO in stroke patients has shown similar to normal walking speeds can be attained for walking efficiency and is therefore desirable. In this study, the support time of the affected leg with the SCKAFO was longer than with the AFO and the asymmetry ratio of single support time decreased by more than with the AFO. This indicates that the SCKAFO was effective for improving gait symmetry, single-support-time symmetry. This may be due to the decrease of gait asymmetry. Thus, the newly designed SCKAFO may be useful for promoting gait performance by improving the coordination of the extremity and decreasing gait asymmetry in chronic stroke patients.

The purpose of this study was to evaluate the effects of bridging stabilization exercise on balance ability and gait performance in elderly women. The subjects of this study were thirty-one elderly women over 65 years old in HongSung-Gun Senior Citizen Welfare Hall. The subjects were randomly assigned into one of three groups (trunk stabilization exercise on the mat, whole body vibration, and Swiss ball) and participated in each exercise program three times a week for 4 weeks. Each exercise began in the bridging position. The dynamic balance and gait were measured by limit of stability area using force plate, Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). The results were as follows: 1) The limit of stability in three groups increased significantly in anterior-posterior and medial-lateral lean after 4-weeks intervention (p<.05). 2) There were no significant differences in the limit of stability among three groups after 4-weeks intervention (p>.05). 3) The BBS and TUG in three groups increased significantly after 4-weeks intervention (p<.05). 4) There were significant differences among three groups in BBS. Post-hoc test showed that Swiss ball exercise group was significantly higher than the mat and whole body vibration groups. 5) There were no significant differences TUG among three groups after 4-weeks intervention (p>.05). In conclusion, this study suggested that 4 weeks of the bridging stabilization exercises were effective on balance and gait in all three groups. Particularly Swiss ball exercise group showed higher improvement than two other exercise groups (mat, whole body vibration group).

The purpose of this study was to investigate the effect of high heeled shoes with the total contact insert (TCI) on the frontal plane of the joints for the lower extremity during the gait. Ten healthy females voluntarily participated in this study and the height of the high heeled shoes was 7 cm. A three-dimensional motion analysis system (VICON) and force plates were used to analyze the movements of the joints for the lower extremities. The results were as follows: There were no significant differences for the angle value on the event of the gait cycle in the maximum eversion and inversion of the ankle joint, the varus and valgus of the knee joint, and the adduction and abduction of the hip joint (p>.05). But, there was a significant difference or the range of motion in the ankle joint (p<.05). The value of ankle and knee moment with a TCI was less than the value for no TCI. And there were significant differences for the moment value of the maximum inversion and eversion on the ankle joint and for the maximum varus and valgus on the knee joint (p<.05). Therefore, a TCI would be effective in stabilizing the joints of the lower extremities and increasing the balance of a body to reduce the injure from a fall during the gait.

The purpose of this study was to compare the trunk and lower extremity muscle activity induced by six different conditions floor, intensity 0, 1, 3, 5 of whole body vibration (WBV), and Swiss ball during bridging exercise. Surface electromyography (EMG) was used to measure trunk and lower extremity muscles activity. Ten elderly women were recruited from Hong-sung Senior Citizen Welfare Center. The collected EMG data were normalized using reference contraction (during floor bridging) and expressed as a percentage of reference voluntary contraction (%RVC). To analyze the differences in EMG data, the repeated one-way analysis of variance was used. A Bonferroni's correction was used for multiple comparisons. The study showed that EMG activity of the rectus abdominis, external oblique, internal oblique, erector spinae and rectus abdominis muscles were not significantly different between six different conditions of during bridging exercise (p>.05). However, there were significantly increased EMG activity of the rectus femoris (p=.034) in the WBV intensity 0, 1, 3, and 5 conditions compared with the floor bridging condition. EMG activity of the medial gastrocnemius were significantly increased in the WBV intensity 0, 1, 3, 5 and Swiss ball conditions compared with the floor bridging condition. Future studies are required the dynamic instability condition such as one leg lifting in bridging.

The aim of this study was to investigate the effect of supporting surface instability to trunk and lower extremity muscle activities during bridging exercise combined with core-stabilization exercise. Thirty young healthy adults (15 males and 15 females) voluntarily participated in this study. Each subject was asked to perform bridging exercise combined with core-stabilization exercise on three different supporting surfaces (stable ground surface, the wooden balancing board, and the air cushion). The muscle activities were measured using surface electromyography (EMG) during performing exercise. To test statistical significance, one-way ANOVA with repeated measures was used with the significance level of .05. The findings of this study are summarized as follows. (1) There were significant differences in muscle activities on internal oblique, external oblique, gluteus medius, semitendinosus, biceps femoris, medial gastrocnemius and lateral gastrocnemius during exercise (p<.05). (2) The biceps femoris and lateral gastrocnemius showed significantly higher muscle activity on the wooden balancing board rather than on the ground, and semitendinosus, biceps femoris, medial gastrocnemius and lateral gastrocnemius showed significantly higher muscle activity on the air cushion rather than on the ground (p<.05). Therefore, it is concluded that muscle activities in the trunk and the lower limbs during bridging exercise combined with core-stabilization exercise was affected with instability of supporting surface. Further researches are needed to investigate the long term effect of bridging exercise on muscle activity with patient group.

The purpose of this study was to investigate the trunk and lower extremity muscle activity induced by three different intensity conditions (intensity 1, 3, 5) of whole body vibration (WBV) during bridging exercise. Surface electromyography (EMG) was used to measure trunk and lower extremity muscles activity. Eleven healthy young subjects (6 males, 5 females) were recruited from university students. The collected EMG data were normalized using reference contraction (no vibration during bridging) and expressed as a percentage of reference voluntary contraction. To analyze the differences in EMG data, the repeated one-way analysis of variance was used. A Bonferroni's correction was used for multiple comparisons. The study showed that EMG activity of the rectus abdominis, external oblique, internal oblique, erector spinae and rectus femoris muscles was not significantly different among three intensity conditions of WBV during bridging exercise (p>.05). However, there were significantly increased EMG activity of the medial hamstring muscle (p=.001) and medial gastrocnemius muscle (p=.027) in the intensity 3 condition compared with the intensity 1 condition. This result can be interpreted that vibration was absorbed through the distal muscles, plantar flexor and knee flexor.

The purpose of this study was to suppose basis data the influence of different chair type and pelvic control on quadriceps muscle activity and strength during knee joint extension isometric exercise in hemiplegic patients. This research were investigated in ten healthy adults and tens hemipelgic patients. Surface electromyography (EMG) and Biodex system were used to collect kinematic data and muscle activity, respectively. Independent t-test, paired t-test and one-way repeated ANOVA were used to determine a statistical significance. The results showed as follows: (1) Posterior pelvic angles in healthy group and hemiplegic group were significantly different on isokinetic equipment (p<.05). (2) Different chair type and pelvic control on quadriceps muscle activity and strength were significantly different in hemiplegic patients (p<.05). From the result of this research, posterior pelvic angle control during knee joint extension isometric exercise in hemiplegic patients on isokinetic equipment is necessary to increase quadriceps muscle strength in hemiplegic patients.

In order to prevent upper extremity musculoskeletal disorders, effective keyboard selection is an important consideration. The aim of this study was to compare upper extremity muscle activity according to transverse plane angle changes during vertical keyboard typing. Sixteen healthy men were recruited. All subjects had a similar typing ability (rate of more than 300 keystrokes per minute) and biacromion and forearm-fingertip lengths. Four different types of keyboard (vertical keyboard with a transverse plane angle of 60˚, 90˚, or 120˚, and a standard keyboard) were used with a wrist support. The test order was selected randomly for each subject. Surface electromyography (EMG) was used to measure upper extremity muscle activity during a keyboard typing task. The collected EMG data were normalized using the reference contraction and expressed as a percentage of the reference voluntary contraction (%RVC). In order to analyze the differences in EMG data, a repeated one-way analysis of variance, with a significance level of .05, was used. Bonferroni correction was used for multiple comparisons. There were significant differences in the EMG amplitude of all seven muscles (upper trapezius, middle deltoid, anterior deltoid, extensor carpi radialis, extensor carpi ulnaris, flexor carpi radialis, and flexor carpi ulnaris) assessed during the keyboard typing task. The mean activity of each muscle had a tendency to increase as the transverse plane angle increased. The mean activity recorded during all vertical keyboard typing was lower than that recorded during standard keyboard typing. There was no significant difference in accuracy and error scores; however, there was a significant difference between transverse plane angles of 60˚ and 120˚ with regard to comfort. In conclusion, a vertical keyboard with a transverse plane angle of 60˚ would be effective in reducing muscle activity compared with vertical keyboards with other transverse plane angles.

An abdominal drawing-in maneuver (ADIM) with a pressure biofeedback unit can be used to prevent excessive lumbar lordosis during bridging exercise. Therefore, in this research, the effects of an ADIM on lumbar lordosis and lower extremity muscle activity during bridging exercise were investigated in thirty healthy adults. Surface electromyography (EMG) and VICON system were used to collect kinematic data and muscle activity, respectively. A paired t-test was used to determine a statistical significance. The results showed as follows: (1) When performing bridging exercise with an ADIM, the height of the anterior superior iliac spine and greater trochanter decreased significantly (p<.05). (2) When performing bridging exercise with an ADIM, the trunk extension angle and pelvic angle increased significantly (p<.05). (3) When performing bridging exercise with an ADIM, the EMG signal amplitude increased significantly in the rectus abdominis, internal oblique abdominis, external oblique abdominis, medial hamstring, and lateral hamstring (p<.05). (4) When performing bridging exercise with an ADIM, the EMG signal amplitude decreased significantly in the erector spinae (p<.05). From the result of this research, an ADIM trained with pressure biofeedback unit during bridging exercise is effective to prevent excessive contraction of erector spinae, to limit excessive motion of pelvis from sagittal plane and to increase muscle activity of abdominal muscles and hamstring muscle.

The purpose of this study was to compare the effectiveness of modified vertical roll sling and conventional Bobath roll sling in reducing hemiplegic shoulder subluxation. Radiography of anterior oblique radiographic view' were taken, before and immediately after wearing each sling in 13 hemiplegic patients. The vertical distance. horizontal distance. and joint distance were measured. Analysis of radiographically measured distances showed that both modified vertical roll sling and Bobath roll sling decreased vertical, horizontal. and joint distances. Reduction in vertical and joint distances were significantly greater in modified vertical roll sling compared to Bobath roll sling. while horizontal distance showed no significant difference between the two slings. Therefore it can be concluded that modified vertical roll sling is an effective orthosis in reducing hemiplegic shoulder subluxation.

Studies of attentional focus effects, have shown that the performer's attentional focus plays an important role in the performance and learning of motor tasks. We examined the influence of attentional focus on the performance of dual tasks (a postural task and a suprapostural task) and used electromyography (EMG) to examine whether the differences between external and internal focus were also manifest at the neuromuscular level. The subjects (n=40) stood on a balance board (postural task) and held a bar horizontally (suprapostural task). All of the subjects performed under different attentional focus conditions: external (balancer on balance board) or internal (feet) focus on the postural task, and external (balancer on bar) or internal (hand) focus on the suprapostural task. The mean displacement velocity of the bar and the percent reference voluntary contraction (%RVC) of the biceps brachii were reduced when the subjects adopted an external focus on the suprapostural task (p<.05). In addition, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were reduced when the subjects adopted an external focus on the postural task (p<.05). When the subjects adopted an external focus on the suprapostural task, the mean displacement velocity of the balance board and %RVC of the tibialis anterior were also reduced (p<.05). When the subjects' attentional focus was on the postural task, there were no differences in the mean displacement and %RVC of the biceps brachii between attentional focuses. The performance of each task was enhanced when subjects focused on the respective task. The suprapostural task goals had a stronger influence on postural control than vice versa. These results reflect the propensity of the motor system to optimize control processes based on the environmental outcome, or movement effect, that the performer wants to achieve.

This study investigated gait characteristics, kinematics, and kinetics in the lower extremities between two different shoe conditions (high heeled shoes (7 cm), and high heeled shoes with a total contact insert (TCI)) after lower extremity muscle fatigue. Although TCI shave been applied in high heeled shoes to increase comfort and to decrease foot pressure, no study has attempted to identify the effects of TCI in fatigue conditions. The purpose of this study was to determine the effects of walking in high heeled shoes with TCI after lower extremity muscle fatigue was induced. This study was carried out in a motion analysis laboratory at Hanseo University. A volunteer sample of 14 healthy female subjects participated. All in fatigue conditions, the subjects were divided into two groups. The muscle fatigue was induced by 40 voluntary dorsi- and plantar-flexion exercises and 40 heel-rise exercises of the dominant foot. Surface electromyography was used to confirm the localized muscle fatigue using power spectral analysis of three muscles (tibialis anterior, gastrocnemius medialis and lateralis). The results were as follows: (1) In muscle fatigue conditions, the use of TCI decreased the peak flexion angle of the hip joint significantly in the early stance phase (p<.05) and increased the peak hip flexion moment in the terminal stance phase (p<.05). (2) In muscle fatigue conditions, the application of TCI also increased peak hip power generation in the early stance phase and peak hip power absorption in the terminal stance phase (p<.05). (3) In muscle fatigue conditions, the use of TCI reduced the impact force significantly and increased the secondary peak vertical GRF. These findings suggest that the TCI may provide beneficial effects when muscle fatigue occurs for a high heeled shoe gait. Future research employing the patient population and various types of TCI materials are required to clarify the effects of TCI.

The purpose of this study was to assess the influence of two shoe size conditions on foot pressure, ground reaction force (GRF), and lower extremity muscle fatigue. Seven healthy men participated. They randomly performed walking and running in two different conditions: proper shoe size and 10 mm greater than proper shoe size. Peak foot pressure, and vertical, anterior and mediolateral force components were recorded with the Parotec system and Kisler force platform. To assess fatigue, the participants performed treadmill running for twenty-five minutes twice, each time wearing a different shoe size. Surface electromyography was used to confirm localized muscle fatigue using power spectral analysis of four muscles (tibialis anterior, gastrocnemius medialis, rectus femoris, and biceps femoris). The results were as follows: 1) In walking conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 1, 2, 14, and 18 (p<.05). 2) In running conditions, there was a significantly higher peak pressure in the 10 mm greater than proper shoe size insole sensor 5, 14, and 15 (p<.05). 3) In walking conditions, there was a significantly higher first maximal vertical GRF in the 10 mm greater than proper shoe size (p<.05). 4) In running conditions, no GRF components were significantly different between each shoe size condition (p>.05). 5) Muscle fatigue indexes of the tibialis anterior and rectus femoris were significantly increased in the 10 mm greater than proper shoe size condition. These results indicate that wearing shoes that are too large could further exacerbate the problems of increased foot pressure, vertical GRF, and muscle fatigue.

The purpose of this study was to assess the influence of spine orthosis and sit-to-stand motor strategies on ground reaction force (GRF) and lower extremity muscle activity. Twenty healthy adult men participated, and subjects randomly performed sit-to-stand motions in three different conditions: Momentum-transfer strategy (MTS); MTS with spine orthosis; and zero-momentum strategy (ZMS) with spine orthosis. GRF data, onset time, and muscle activity were determined and compared using force plate and electromyography. Data were statistically analyzed by the SPSS version 13.0. One-way repeated analysis of variance (ANOVA) was used to determine the statistical significance, and least significant difference was used as a post hoc test. The level of significance was .05. The results of this study were as follows: 1. Peak GRF and relative time to peak GRF were not significantly different in the three different conditions (p>.05). 2. Onset time of four muscles, tibialis anterior, gastrocnemius, biceps femoris and rectus femoris, in the three different conditions were significantly different (p<.05). 3. The tibialis anterior and rectus femoris muscle activity before hip-off and tibialis anterior, gastrocnemius, and rectus fermoris muscle activity after hip-off were significantly different in the three different conditions (p<.05).

The purpose of this study was to investigate the effects of hip extension velocity (7.5 degree/second, 30 degree/second) on the relative onset time of the gluteus maximus in relation to the hamstring during hip extension in prone position. Thirteen healthy male subjects (mean age=22.6 years [SD=1.8], mean weight=73.4 kg [SD=10.3], mean height=176.1 cm [SD=6.3]) voluntarily participated in this study. Electromyographic data was collected on the gluteus maximus and hamstring to determine onset time. Statistical analyses were performed with the paired t-test. The results showed that the onset time of the hamstring was significantly faster than that of the gluteus maximus in both fast and slow hip extension velocity. The gluteus maximus began contraction .079 seconds later following the contraction of the hamstring. The onset time of the hamstring was significantly faster in fast hip extension velocity compared with slow hip extension velocity. In conclusion, it was determined that the onset time of the gluteus maximus was faster with fast hip extension velocity compared with slow hip extension velocity. There was a statistically significant difference between the onset times of the gluteus maximus and hamstring in relation to the two velocities (p<.05). Further study is needed to examine whether the velocity of hip extension can influence the onset time in a similar fashion in patients with low back pain.