The purpose of this study was to identify the relationship between sitting and standing balance in acute stroke patients and gait outcome, and to determine appropriate test times. The subjects of this study were 20 hemiplegic patients who had been hospitalized in Sangji University Oriental Medical Hospital from August 26, 1997 through November 3, 1997. Twenty patients with cerebral infarcts had sitting and standing balance assessed on the 5th day and 10th day of stroke onset. Gait outcome was assessed 5 weeks later using the MMAS (Modified Motor Assessment Scale) score. The data were analyzed by the Spearman's Rho test and Wilcoxon signed rank test. The results were as follows: 1) Correlation coefficients between sitting balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.89 and =0.83, respectively. All of the sitting balance data significantly correlated with gait outcome (p<0.05). 2) Correlation coefficients between standing balance on the 5th day and 10th day after their stroke and gait outcome 5 weeks after their stroke were =0.82 and =0.87, respectively. All of the standing balance data significant1y correlated with gait outcome (p<0.05). 3) The difference between sitting balance scores on the 5th day and 10th day after stroke onset were statistically significant (p<0.05). But the difference between standing balance scores on the 5th day and 10th day after stroke onset were not statistically significant (p>0.05). In conclusion, sitting and standing balance tests on the 5th day and 10th day after their stroke appear to be predictive of gait outcome. Also, the result of this study can provide reference for appropriate test times as an assessment of sitting and standing balance in stroke patients.

This study analysed national data of manpower supply for physical therapists in Korea. Based on the comparative analysis results of the future demand and supply, as of May 1998, it is estimated that there was already an oversupply of physical therapists in Korea. This oversupply is expected to continue even though there would be an increase in hospital beds, rehabilitation facilities for the elderly, and nursing homes. Thus it would be desirable to cut down the number of students admitted to physical therapy schools each year. Our estimation shows that the Ministry of Health and Welfare must take measures to reduce the supply of physical therapist as soon as possible.

The ability to maintain an upright position during quiet standing is a useful motor skill. The Sensory Organization Test (SOT) is a timed balance test that evaluates somatosensory, visual, and vestibular function for maintenance of upright posture. The Fugl-Meyer Sensorimotor Assessment (FMSA) balance subscale is the functional status assessment that indicates amount of assistance needed during various balance tasks. Functional Independence Measure (FIM) is the functional status assessment tool and FIM can be used clinically as an outcome measure. The purpose of this study was to see if the SOT can be used as a evaluation tool to measure hemiplegic patients' balance ability. Thirty-six patients with hemiplegia participated in this study. SOT scores were significantly correlated with FMSA balance scores and FIM scores(p<0.05). However correlation coefficients were not so high (r=0.60, and r=0.51, respectively). Therefore, further study is needed to verify the SOT's usefulness when physical therapists are evaluating for hemiplegic patients' balance ability.

The purposes of this study were to compare the electromyographic activities from the rectus femoris, vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis during straight leg raising (SLR) and quadriceps setting (QS) exercise and to determine which exercise is more effective to selectively strengthen the vastus medialis. Thirty two healthy subjects <19 men, 13 women) participated in the study. All participants performed SLR and QS exercises while electromyographic activity was recorded from EMG surface electrodes. Statistical analysis demonstrated significantly greater values for the vastus medialis oblique portion, vastus medialis longitudinal portion, and vastus lateralis activities during QS exercise than for those during SLR exercise. However, the rectus femoris muscle activity between SLR and QS exercises was not significantly different. The ratios of vastus lateralis to vastus medialis during SLR and QS exercise were not significantly different. These results show that QS exercise is more effective for strengthening the quadriceps muscle on the whole than the SLR exercise. As for selective methods of strengthening vastus medialis specifically, both SLR and QS exercises are useful.

Two standard methods of cane length measurements were compared to find which methods really achieve the elbow flexion of 20 degrees to 30 degrees Twenty-four patients with hemiplegia who were ambulatory participated in this study. Method I : Length of the cane measured from the floor to the top of the greater trochanter. Method II : Length of the cane measured from the floor to the distal wrist crease with the arm at the side. Using an adjustable cane, each individual was fitted according to the two methods, and elbow angle was measured after each adjustment. The elbow angle according to Method I and Method II was , , respectively. No significant difference was found in the elbow angle or the cane length between the two methods. Of the 24 participants, 5(20.8%) measured according to method I and 3(12.5%) measured according to method II showed the elbow angle between 20 degrees and 30 degrees. These low predictive rates of agreement between ideal cane length and actually achieved elbow angle showed that these two methods which have conventionally been accepted as a standard to measure ideal cane length need to be revised through further research.

Photochemotherapy(UVA with 8-methoxypsoralen) was given to 30 patients with systemic psoriasis. The results of clearing and long-term(6-month) interval maintenance were reported. Clearing requirements were in general similar to these reported by Melski and Burger. The skin of the 14 patients (46.6%) recovered good skin condition by a once weekly maintenance dose. This result was better than that reported by other authors. 1. During initial treatment period, average number of treatment was 27.3 and average duration treatment was 24.8 weeks. 2. The factors to quit treatment were motion decrease, moving to the remote area, complications, etc. 3. Number of patient who received maintenance treatment was 14. 4. The complications reported from the patients were hyperpigmentation, nausea, headache, pruritis, vomiting, gastritis.

The purpose of this study was to determine which of several crutch-fitting techniques best predicts ideal crutch length. Ideal crutch length is defined as the length of the crutch, including accessories, obtained during stance when the crutch tip is 6 inches (15.2 cm) lateral and 6 inches(15.2 cm) anterior to the fifth toe and the axillary pad is 2.5 inches(6.4 cm) below the axillary fold. Forty four volunteers were measured for crutches using each of the following methods:(1) 77% of actual height, (2) actual height minus 40.6 cm, (3) actual height minus 45.7 cm, (4) olecranon to opposite third finger tip, (5) olecranon to opposite fifth finger tip, (6) 77% of arm span, (7) arm span minus 40.6 cm, (8) anterior axillary fold to heel plus 5.1 cm, (9) anterior axillary fold to heel plus 10.2 cm, (10) ideal crutch length. Of the techniques studied, the two involving anterior axillary fold to heel were found to be good predictors: anterior axillary fold to heel plus 5.1 cm and anterior axillary fold to heel plus 10.2 cm. Finally, two additional length estimates were derived using linear regression analyses. These estimates provided the best overall predictors based on anterior axillary fold to heel and actual height.

High Voltage Pulsed Current Stimulation(HVPCS) and Microcurrent Electrical Neuromuscular Stimulation(MENS) have been used to promote the healing of decubitus ulcer and surgical wounds. The benefits of HVPCS and MENS are thought to include an inhibitive effect on bacterial growth. The purpose of this study was to compare the inhibitive effect of two different electrical stimulation techniques growth in vitro. Using agarose-based media, the two bacterial species Staphylococcus aureus, Esherichia coli - which are commonly isolated from open wounds were incubated in an incubator for 24 hours following exposure to HVPCS(400 V, 120 pps, ) and MENS(, 0.3 Hz). We then measured the zone of inhibition around each electrode. Both HVPCS and MENS produced an inhibitive effect on bacterial growth in this vitro study. However MENS was more effective than HVPCS.

The purpose of this study was to determine a more effective method for shoulder pain reduction. Forty-five normal subjects were randomly assigned to one of 3 groups a control group, an acupuncture-like transcutaneous electrical nerve stimulation(ALTENS) group, and a silver spike point(SSP) group. Each person in the ALTENS and SSP groups was measured for pressure pain threshold before and after a 20 minute treatment. The control group was also checked for pressure pain threshold before and after a 20 minute period but no "treatment" was given. The major findings were as follows ; 1)The ALTENS and SSP groups showed significant differences before and after treatment but the control group showed no significant difference. 2)When the three groups were compared, the only significant difference was between the SSP group and the control group. As mentioned above, it may be concluded that both ALTENS and SSP therapy were effective in reducing shoulder pain when measured directly after treatment. However, SSP did not show any superior effect. Further study should be done to determine the effective the maintained pain reduction with post-treatment time lapse.

The purpose of this study was to assess the concurrent validity and reliability of goniometric measurement of joint motion. Subjects were 40 healthy university students. Measurements were performed by 4 inexperienced physical therapy students. Four different instruments were used and three readings were taken with each instrument in random order making a total of 12 readings for flexion of the right elbow of each subject. Goniometers used were 1. universal 2. fluid-based goniometer/inclinometer 3. digital LCD goniometer 4. electronic goniometer/torsiometer. The results were as follows: Concurrent validity was highest (r= .94) with the universal and digital LCD tools. Interrater reliability (Pearson Product Moment Correlation) was good for each tool. Interrater reliability calculated by ICC(2,1) was highest (.96) with the tensiometer and lowest (.78) with the digital LCD goniometer. Intrarater reliability calculated by ICC was excellent () for all instruments. These results show that concurrent validity, intrarater and interrater reliability are very good in the used of all four types of goniometers/inclinometer/tensiometer, even with inexperienced raters. These results confirm the almost universal reliance on hand held goniometers for joint measurement by physical therapists as being a reliable practice. Further research should be done clinically with actual patients.

The objective of this study was to identify the effects of weight-transfer training on the weight bearing distribution and gait patterns of hemiplegic patients through visual and auditory feedback using a limb load monitor. The subjects of this study were 18 hemiplegic patients who had been hospitalized or were visited out-patient department of the Rehabilitation Hospital, College of Medicine, Yonsei University, from January 5, 1995 through March 15, 1995. Pre-and post-training changes in gait patterns were measured using ink foot prints as well as by recording weight bearing distribution using a limb load monitor. The data were analyzed by the repeated measure one-way ANOVA and paired t-test. The finding were as follows: 1. Prior to the training, 18 subjects bore more weight on the sound leg(61.6 %) than on the affected leg(38.4 %). 2. Posterior to the training, the average percentage of weight bearing on the affected leg increased significantly from 38.4 % prior to training; to 46.0 % immediately after training; 45.7 % after a 30 second delay; and 45.3 % after a 60 second 3. The difference in gait patterns between pre- and post- training was statistically significant, with an increase in gait velocity to 3.65 cm/sec post-training; an increase in stride length to 5.37 cm on the affected side; 4.77 cm on the sound side; and a narrowing of the base of support to 1.19 cm. In conclusion, hemiplegic weight-transfer training using visual and auditory feedback with a limb load monitor was found to be enhancing symmetrical standing posture, and simultaneously improve gait patterns.

The purpose of this study was to examine the inter-rater reliability of the Korean translation of the GMFM(Gross Motor Function Measure). Three licensed physical therapists with varying amounts(2 - 6 years) of clinical experience served as raters. Thirty patients with cerebral palsy were subjects for this study. Subjects were 22 boys and 8 girls, aged 1 to 8 years. Reliability of each dimension and each total score of the GMGM were analyzed using ICCs(intraclass correlation coefficients). The reliability of each dimension score ranged from .76 to .98, with the walking, running, and jumping dimension having higher reliability values. The reliability of the total dimension score was .94. We conclude that the GMFM has inter-rater reliability for assessing gross motor function in patients with cerebral palsy.

Our purpose of this study was to determine the most effective cool-down exercise. The recovery times of dynamic strength after isometric and isotonic cool-down exercise were measured immediately post cool-down exercise, 30 seconds later and 60 seconds later in 30 normal, healthy men from 19 to 29 years, using dumbells(Model, Iron). The recovery time of dynamic strength had a significant positive correlation with isotonic and isometric cool-down exercise using the Chi-square method (p<0.01). Sources of significant differences were determined by the Wilcoxon signed-ranks test (p<0.01). The isometric cool-down exercise significantly shortened the recovery time of dynamic strength. We suggest that the isometric cool-down exercise may be more effective than isotonic cool-down exercise in shortening the recovery time of dynamic strength.

Thirty healthy adults aged 20 to 29 with no history of musculoskeletal or neurogenic disorder volunteered for this study. The contract-relax with agonist contration(CRAC) was applied to the right hamstring muscles with the subject in the supine position. Each hamstring group was stretched on three sucessive days with several repetitions of the technique lasting 1min, 3min, and 5min. respectively. Hamstring extensibility at the knee(ROM) was measured before and after stretching using on electronic digital inclinometer(EDI). The results, namely the increase in ROM, were analysed using one-way repeated ANOVA at p<0.05. The differences were not significant. Possible factors influencing the results are excessive sensitibility of the measuring instrument, the psychological and physical status of the subjects, and the level of muscle fatigue. The mean increases in ROM were 3.0 at 1min., 2.6 at 3min, and 2.1 at 5min. Inclusion of a control group would have further defined the effects of the stretching technique.

This study was performed to determine the inter-rater reliability of manual tests of elbow, knee flexor, and ankle dorsiflexor muscle spasticity graded on the Modified Ashworth Scale. Two raters each independently graded the spasticity of 32 patients with intracranial lesions after moving the paretic limb passively through the available range of motion. The patients were asked to simultaneously squeeze therapeutic putty with their non-paretic hand for reinforcement. The ratings were compared by the Wilcoxon matched pairs signed-rank test and by the Kendall's coefficient of rank(tau) correlation. There was singificant correlation between two raters for spasticity at the elbow, knee flexor, and ankle dorsiflexor. The correlations of the two raters ranged from .6746 to .9308. The highest correlation was for the elbow with reinforcement and the lowest was for the knee without reinforcement. Poorer correlation was evident in the knee joint. The positive results of this study encourage the continued use of manual tests of muscle spasticity, using the Modified Ashworth Scale.