Core stability exercises for patients with hemiplegia have become increasingly important and a variety of exercises have been developed over the years to give the hemiplegic patients more stable postural control. This study examined the therapeutic effects of the core stability exercises on the ability of static and dynamic postural control. Fifteen hemiplegic patients (7 males, 8 females, age ranging from 46 to 76 years) hospitalized in a Daejoen rehabilitation hospital were enrolled in this study. Nine and 6 patients had a cerebral infarction and cerebral hemorrhage, respectively. The subjects participated in a core stability exercise program consisting of a total of 12 sessions 3 times each week over a 4-week period with each exercise lasting approximately 15 minutes. The ability of static and dynamic postural control by Berg Balance Scale (BBS) and Timed Up and Go (TUG), respectively, were measured before and after the core stability exercise. A Wilcoxon signed ranks test was used to compare the effects of the ability of static and dynamic postural control before and after core stability exercise in patients with hemiplegia. The =.05 level of significance was used for the statistical tests. Core stability exercises were effective in improving the ability of static postural control; BBS (p<.05). Core stability exercises were also effective in improving the ability of dynamic postural control; TUG (p<.05). Overall, core stability exercise is believed to be an important therapeutic method in rehabilitation programs for hemiplegic patients.

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 aim of the study was to evaluate the effectiveness of exercise therapy on physical function of patients with anklyosing spondylitis (AS) through the systemic review and meta-analysis. The 54 studies were identified from computerized search of published researches on PubMed, Embase, CINAHL, PEDro, KISS, KERIS database until February, 2008 and review of reference lists. The main search terms were the combination "ankylosing spondylitis", "exercise", "spondyloarthropathy and exercise", "ankylosing spondylitis and physical therapy". The subgroup analysis was performed by the publication year, quality score, type of disease, content of intervention, intervention provider, type of intervention, method of intervention, intervention period and the point of outcome measured. Two reviewers independently selected trials for inclusion, assessed the quality and extracted the data. The result was as follows: The 10 trials were eligible for inclusion criteria, then the systematic review and meta-analysis was assessed on effectiveness of exercise therapy. The meta-analysis of 10 studies based on the random effect model showed that the exercise therapy was beneficial in treating the diseases (effect size .55; 95% confidence interval -.3.75~.61). The findings suggest that the exercise therapy would be appropriate to manage the physical function of AS with evidence based on Meta-analysis. Therefore, the exercise therapy supervised by physical therapist should be recognized as the essential approach to manage the AS and necessarily recommended to improve physical function.

This study examined the vastus medialis oblique (VMO) and the vastus lateralis (VL) onset time differences (OTD) during quadriceps contraction in different hip positions. Twelve healthy subjects were recruited (four men, eight women). Surface EMG activities of the VMO and VL were measured during a quadriceps strengthening exercise in a long sitting condition and in a sitting at a chair with feet hanging condition. For each condition, subjects were tested in two hip positions (neutral and adduction). The OTD between the two muscles was calculated for each condition, by subtracting the onset time of the VL from the VMO. Therefore, the negative value of OTD represent earlier EMG onset of the VMO compared to the VL. The OTD was not significantly different between the hip neutral and the hip adduction position in the long sitting condition (p=.064). However, the OTD was significantly different between the hip neutral position (15.83±109.51 ms) and hip adduction position (-5.58±121.08 ms) during the sitting at a chair with feet hanging condition (p=.047). The negative OTD value in the hip adduction condition during quadriceps strengthening exercises is the result of earlier onset of the VMO than VL. Therefore, quadriceps contraction in the hip adduction position can prevent the risk of patella lateral tracking. We expect that quadriceps strengthening exercise in the hip adduction position will be a safe way to prevent patellofemoral pain syndrome resulting from abnormal patella lateral tracking.

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.

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.

목적 : 본 연구의 목적은 인지활동을 병행한 운동훈련이 치매노인의 균형수행능력에 미치는 영향을 알아보는 것이다. 연구방법 : 본 연구에서는 인지활동 중재로 회상활동과 미술활동을 사용하였다. 연구대상자는 60명의 치매환자이다. 회상활동과 운동치료를 병행한 집단(N=20), 미술활동과 운동치료를 병행한 집단(N=20) 그리고 운동치료만 실시한 집단(N=20)으로 총 3개의 집단으로 나누었다. 연구는 2008년 9월 22일부터 3개월간 이루어졌고 평가도구로는 한국판간이정신상태검사(Mini-Mental Status Exam-Korean: MMSE-K)와 버그균형척도(Berg Balance Scale: BBS)이 사용되었다. 결과 : 본 연구의 결과는 다음과 같다. 3개월 후 MMSE-K와 BBS 총점은 실험 전 후 유의한 증가가 있었다(p<.05). 그리고 인지활동이 적용된 두 집단은 운동치료만 실시한 집단보다 균형수행능력의 유의한 증가가 있었다. 또한 운동치료만 실시한 집단도 인지능력의 향상이 있었다. 회상활동과 운동치료를 병행한 집단의 MMSE-K와 BBS점수는 다른 집단들에 비해 가장 높은 증가를 보여주었다. 결론 : 이 결과를 통해 인지활동을 병행한 운동치료는 균형능력이 감소된 치매노인환자의 균형수행능력을 증진시키기 위해 사용될 수 있다.

This study was designed to investigate the effects of treadmill exercise of low-intensity and moderate- intensity on the functional recovery and histological change in spinal cord injury (SCI) rats. SCI was induced by the spinal cord impactor dropped after laminectomy. Experimental groups were divided into the Group I (normal control), Group II (non-treatment after SCI induction), Group III (low-intensity treadmill exercise after SCI induction), Group IV (moderate-intensity treadmill exercise after SCI induction). After operation, rats were tested at modified Tarlov scale at 2 days with divided into 4 groups, and motor behavior test (BBB locomotor rating scale, Grid walk test) was examined at 3, 7, 14, and 21 days. For the observation of damage change and size of the organized surface in spinal cord, histopathological studies were performed at 21 days by H & E, and BDNF(brain-derived neutrophic factor) & Trk-b immunohistochemistry studies were performed at 1, 3, 7, 14, 21 days. According to the results, treadmill exercise can play a role in facilitating recovery of locomotion following spinal cord injury. Specially, moderate-intensity treadmill exercise after SCI induction was most improvement in functional recovery and histological change.

The purposes of this study were to compare abductor hallucis (AbdH) muscle activity during toe curl exercise according to position of interphalangeal joint (IPJ). Fifteen healthy subjects with neutral foot were recruit for this study. All subjects performed toe curl exercise with towel while maintaining the IPJ in flexion (condition 1) and extension (condition 2). Toe curl exercise with towel was perform three trials for five second periods in each condition. Surface electromyography (EMG) activities were recorded from three muscles (AbdH, tibialis anterior, peroneous longus) in each condition. EMG activity was normalized to the value of maximal voluntary isometric contraction (%MVIC). The EMG activities acoording to position of IPJ were compared using a paired t-test. This study showed that the EMG activity of AbdH during toe curl exercise with IPJ extension significantly increased compared to those during toe curl exercise with IPJ flexion (p<.05). However, the EMG activity of tibialis anterior and peroneus longus were not significantly different between the conditions (p>.05). These results suggest that toe curl exercise with towel must be performed with extension of IPJ in order to strengthen intrinsic muscle in subjects with overuse injuries related to excessive pronation.

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.

This study aimed to evaluate the effect of a weekly circuit-group exercise program on functional performance, flexibility of the trunk and lower extremities, and balance in individuals with chronic stroke who are living in a community. Thirteen community-living individuals (eleven males and two females) with chronic stroke participated in this study. The group exercise program was set up as a weekly circuit application with four stations aiming to strengthen the muscles, increase endurance, improve flexibility, and enhance functional capacity. The average duration of a session was an hour, and the sessions were conducted once a week for six months for a total of 24 sessions. Assessments for functional performance, flexibility of the trunk and lower extremities and balance were conducted four times: before treatment, after one month of treatment, after four months of treatment, and after six months of treatment. There were significant improvements in functional performance and flexibility of the trunk and lower extremities in the given time frame. No significant improvement was observed in balance ability. The findings suggest that a weekly circuit-group exercise program has some benefits in terms of managing the physical symptoms of individuals with mobility problems after stroke. Therefore, this program can be adapted and employed as a community-based rehabilitation program for such patients. Further studies with various community-based treatments will be conducted to validate these findings.

The range of motion (ROM) of ankle dorsiflexion in older women was associated with gait abnormalities and the risk of falls. The purpose of this study was to investigate the effect of self-stretching exercise on the flexibility of the plantar flexors of the ankle and the characteristics of gait in healthy elderly women. Fifteen participants were assigned randomly into an exercise (n=8) or control (n=7) group. The exercise group attended a self-stretching program approximately 30 minutes for 3 days per week for 4 weeks. The active ankle dorsiflexion ROM and gait measurements were taken prior to beginning the stretching program and 1 day after the last stretching day. Results showed that the active ankle dorsiflexion ROM was significantly increased in the exercise group than in the control group after the stretching program (p<.05). However, gait parameters, including gait speed, cadence, and stride length were not significantly different between the two groups (p>.05). The results suggest that a 4-week self-stretching program is capable of provoking a significant increase in ankle dorsiflexion ROM in elderly, community-dwelling women. Additional research is needed to investigate the effect of gait-specific exercise combined with stretching exercise on gait ability.

UN해양법협약에 따르면 연안국을 자국의 법령을 위반했다고 믿을 만한 충분한 이유가 있는 경우 외국선박을 공해상에까지 추적하여 나포할 수 있는 추적권을 행사할 수 있다. 추적권은 공해상의 선박에 대해서는 기국이 관할권을 갖는다는 기국주의 원칙에 대한 중요한 예외의 하나이다. 본 논문은 국제관습법에 의해 형성되었고, UN해양법협약에 의해 인정되고 있는 해상에서의 추적권 행사시 무력사용의 한계에 관하여 사이가호 및 불심선 사건을 중심으로 고찰하였다. 추적권 행사시 가능한 한 무력의 사용은 회피되어야 할 것이며, 무력의 사용을 회피할 수 없다면 그 상황에서 합리적이고 필요한 정도를 초과해서는 안 될 것이다.

This study compared the effect of therapeutic exercise with conservative treatment in women with chronic neck pain. Subjects were allocated to control, neck isometric exercise, and cervical stabilization exercise groups consisting of 29, 32, and 31 patients, respectively. The conservative treatment for the control group consisted of hot packs, ultrasound, interferential current therapy, and intermittent cervical traction. The neck isometric exercise group performed a neck isometric exercise and the cervical stabilization exercise group performed a cervical stabilization exercise. To compare the three groups, the levels of perceived pain, neck disability, and psychological depression were assessed on admission, at discharge, and one month after discharge. On admission and at discharge, the pain and neck disability scores did not differ significantly among the groups. However, one month after discharge, both the neck isometric and cervical stabilization exercise groups had significantly improved perceived pain levels as compared to control (p<.05). The improvement in the degree of neck disability was most significant in the cervical stabilization exercise group (p<.05). On comparing the changes in the variables at the three assessments for each group, there was a significant difference between the control and cervical stabilization exercise groups (p<.05). The findings indicate that therapeutic exercises, especially cervical stabilization exercises, are more effective for improving pain and neck disability than conservative treatment.

목적 : 본 연구의 목적은 편마비 아동에게 수중에서 시행하는 대칭운동이 상지기능에 미치는 영향을 알아보는데 있다. 연구방법 : 연구의 대상자는 뇌병변으로 인한 좌측편마비 진단을 받은 8세 아동이었다. 본 연구는 개별사례 실험 연구방법 중 반전연구(ABA)를 사용하였으며, 각각 8회기의 기초선 과정, 치료기간, 그리고 치료 후 관찰기간 동안 상지기능을 평가하였다. 상지기능의 평가는 Bruininks-Oseretsky 운동기능 발달검사 소항목인 동전 옮기기와 Grooved 페그보드 검사를 통하여 이루어졌다. 또한 팔뻗기 과제에 대한 동작분석은 치료기간 전과 후에 각각 측정되었다. 대상자는 치료선 과정과 치료 후 관찰기간에는 일반적인 물리치료 및 작업치료를 받았으며, 치료기간에는 이에 더하여 40분간의 수중 대칭운동을 추가로 시행하였다. 결과 : 동전 옮기기와 페그보드 검사로 평가된 상지기능은 기초선과정보다 치료기간 동안에 향상되었으며, 이는 치료 후 관찰기간에도 지속적으로 유지되었다. 팔뻗기 과제에 대한 동작분석 결과 치료기간 후에 과제 완료시 체간의 굴곡 보상이 감소되었으며 견관절의 굴곡과 주관절의 신전이 움직임이 증가되었다. 또한 견관절과 주관절의 움직임 형태가 안정적으로 변하였다. 결론 : 수중 대칭운동은 편마비 아동의 상지 기능 및 움직임의 향상에 긍정적인 영향을 미칠 수 있다. 향후에는 많은 대상자들을 포함하고 장기간 시행된 연구가 계속적으로 이어져야 할 것이다.

The aim of the study was to evaluate the effect of a disease-specific exercise (DSE) on temporomandibular joint (TMJ) function and neck mobility in TMJ dysfunction associated with ankylosing spondylitis (AS). Ten AS patients (seven males and three females) with TMJ dysfunction were recruited for this study. The DSE included exercises to correct head and neck posture and to improve the flexibility of the neck and TMJs. The patients attended treatment three times a week for 4 weeks, averaging 1 hour each session. Assessments were performed pretreatment, posttreatment, and 6 weeks after the completion of treatment. General physical status was assessed by four clinical measures (tragus-to-wall distance, modified Schober test, lumbar side flexion, and intermalleolar distance), the Bath ankylosing spondylitis function index (BASFI), and the Bath ankylosing spondylitis disease activity index. The main outcome measures included TMJ function (craniomandibular index (CMI)), and neck mobility (flexion, extension, rotation, and lateral rotation). None of the measures of general physical status, with the exception of BASFI, were significant1y different between the pretreatment, posttreatment, and 6-week follow-up (p>.05). However, CMI and all neck movements, except for extension, significant1y improved after the treatment (p<.05). These improvements were maintained during the follow-up period. The DSE used in the present study seems to be a clinical1y useful method for managing patients with symptoms from the stomatognathic system in AS. Further studies with more subjects and longer treatment times, including the follow-up period, will be conducted to validate these findings.

The purpose of this study was to assess the effect of a group self exercise program in improving the quality of life regarding depression and the activities of daily living (ADL) of chronic stroke survivors, as well as the motor functions such as the 3 meter round walk, upper extremity function, and static balance. The subjects were 12 post-stroke ambulatory community center participants. All subjects participated in one 90 minute session per week for 7 weeks and received a home exercise program in every session. They had to record and submit an exercise check list. Quality of life was measured with the Beck depression inventory and the 8-Item Short-Form (SF-8). Motor functions were measured with the manual function test (MF'T), the kinesthetic ability trainer (KAT 3000), and the modified Barthel index. The level of depression decreased somewhat, but there were no significant differences after intervention. However, quality of life related health (SF-8) improved significant1y. There were significant improvements in the time for the 3 meter round walk, the functions of the affected upper extremities, and static balance and ADL (p<.05). The findings of this study suggest that a group self exercise program can improve quality of life related health and motor functions in stroke survivors.