The purpose of this study was to assess the test-retest reliability of heart rate (HR) and velocity measurements during peak effort and free treadmill walking tests in older patients with gait-impaired chronic hemiparetic stroke and control group. Twenty-two adults (13 men, 9 women; mean age, 73.7±5.2 yrs) with chronic hemiparetic stroke are the experimental group. Nineteen elderly people (5 men, 14 women; mean age, 72.3±3.5 yrs) were recruited as control group. Patients had mild to moderate chronic hemiparetic gait deficits, making handrail support necessary during treadmill walking. Free and peak effort treadmill walking tests were measured and then repeated at least two days later. Reliability was calculated from HR and walking velocity during free and peak effort treadmill walking test. Among the people who had strokes, HR [ICC(2,1)=.85, r=.86] and velocity [ICC(2,1)=.93, r=.93] were good parameters during free testing. Maximal testing generated good results for HR [ICC(2,1)=.81, r=.82] and velocity [ICC(2,1)=.96, r=.96] with the chronic hemiparetic stroke. In elderly people, HR [ICC(2,1)=.59, r=.62] and velocity [ICC(2,1)=.77, r=.76] were moderately reliable during free testing. Maximal testing produced moderate parameters for HR [ICC(2,1)=.74, r=.74] and velocity [ICC(2,1)=.66, r=.66] in the elderly. This study provides that free and maximal treadmill testing produce highly reliable HR and velocity measurements in adults with chronic hemiplegia using minimal handrail support.

The purpose of this study was to investigate the effect of balance training with upper extremity exercise on the improvement of balance performance in people who have had a stroke. Eighteen candidates who have all experienced a stroke, were living in Dong-Gu, Ulsan and were participating in a community based rehabilitation program, have been included in this study. The program was conducted three times weekly, 1 hour per session, for 7 consecutive weeks. Subjects were tested with 7 m and 100 m Timed Gait Test (sec), Timed Get Up and Go Test (sec), Functional Reach Test (cm) and 5 items of Berg's Balance Test at pre-training and post-training. Total balance index and balance ratios were measured by K.A.T. 3000. The balance training program performed by sitting on a chair and gymnastic ball and standing on stable and unstable surfaces during upper extremity exercises such as Proprioceptive Neuromuscular Facilitation (PNF) upper extremity pattern, picking a ball up from floor, throwing and catching it. After seven weekends of balance training, subjects showed a significant difference in balance test results. The exceptions were three items of Berg's Balance Test (p<.05). Balance index score and affected and unaffected side balance ratio had a larger improvement than pre-training (p<.05). The result of this study showed that intervention of this balance training program could improve the balance performance in people who have had a stroke.

The purpose of this study was to investigate the effects of serratus anterior strengthening exercises on scapular position and Visual Analog Scale (VAS) pain measurements taken at the resting position in young adults with adducted scapular. The exercise program included stretching of the scapular retractor and strengthening of the serratus anterior muscle. We measured the distance from the midline of the thorax to the vertebral border of the scapular with a tape line (Superior Kibler), and the distance from the 7th cervical spinous process to the acromial angle with 3-dimension motion analysis system, to compare the resting scapular position before and after exercise. Fifteen subjects with adducted scapular were recruited to compare the resting scapular position and VAS. The distance from 7th cervical spine process to acromial angle of the scapular and VAS decreased significantly (p<.01) after exercise, while the distance from the midline of the thorax to vertebral border of the scapular increased (p<.05). The conclusion is that the serratus anterior exercise program altered the resting scapular position and decreased VAS.

This study examined the effects of hold-relax with agonist contraction (HR-AC) on the symptoms of delayed onset muscle soreness (DOMS) induced by intensive eccentric exercise of the non-dominant biceps brachii. Ten men (mean age=26.7 yrs, mean height=172.1 cm, mean weight=66.2 kg) and ten women (mean age=27.4 yrs, mean height=165.9 cm, mean weight=60.7 kg) who had not participated in a regular exercise program for the upper extremities in the previous six months were randomly assigned to one of two experimental groups: the HR-AC group, or the control group. We measured joint range of motion (ROM), maximal voluntary isometric contraction (MVIC), and muscle soreness before eccentric exercise, and 24, 48, and 72 hours after eccentric exercise. The subjects in the HR-AC group received the HR-AC technique in the non-dominant biceps brachii. The HR-AC technique was applied 24 and 48 hours after eccentric exercise. There was no significant difference between the HR-AC and the control group. However, the HR-AC group, compared to the control group, had a significant difference between the time points of the various parameters. Increased ROM (p<.05), decreased muscle soreness (p<.05), and reduced MVIC (p<.05) were found in the HR-AC group after 72 hours. Decreased ROM (p<.05) and MVIC (p<.05), and increased muscle soreness (p<.05) were observed in the control group. These findings suggest that the HR-AC technique effectively reduces muscle soreness and increases ROM 72 hours after eccentric exercise.

Reductions in strength and range of motion in older persons have been associated with decreased functional mobility and risk of falls. The purpose of this research was to investigate the effect of intensive dynamic balance exercise (DBE) during 8 weeks on onset time of medial gastrocnemius and tibialis anterior muscle contraction after perturbation in older women. Thirty subjects were randomly assigned into DBE group or control group. The DBE group participated in 50 minutes 3 days a week for 8 weeks. Surface electromyography (EMG) activity was recorded from the medial gastrocnemius and tibialis anterior muscles of left side. Outcome data were collected both groups at the pre-exercise and post-exercise. Independent t-test and paired t-test were used to determine the statistical difference. Results showed that the passive range of motion and functional reach test were significantly increased in the DBE group than the control group at the post-exercise (p<.05). The onset time of both muscles and discrepancy of onset time significantly reduced in the DBE group than the control group at the post-exercise (p<.05). The onset time of both muscles were significantly reduced in the post-exercise than the pre-exercise in the DBE group (p<.05). The discrepancy of onset time in the DBE group was significantly reduced in the post-exercise than the pre-exercise (p<.05). These findings suggest that intensive dynamic balance exercise for the eight weeks was effective in improving the postural control with older persons.

This study was designed to examine the effects of electroacupuncture and treadmill exercise on the improvement of muscle atrophy and Brain-Derived Neurotrophic Factor (BDNF) expression in an ischemic stroke model induced by middle cerebral artery occlusion. This study selected 120 Sprangue-Dawley rats, divided them into six groups, and assigned 5 rats to each group. Experiments were conducted for 1, 3 days and 1, 8 weeks, respectively. In each group, changes in weight of muscle and relative muscle of tibialis anterior muscle, histologic observations, and BDNF expression were observed and analyzed. For the changes in muscle weight of unaffected and affected sides of tibialis anterior, muscle atrophy was expressed in an affected side 3 days after ischemic stroke was induced. There was a statistically significant difference in Group VI 1 and 8 weeks after ischemic stroke was induced, compared to Group II (p<.05). For the changes in relative muscle weight of unaffected and affected sides of tibial anterior muscle, there was significant decrease in each group 3 days after ischemic stroke was induced, compared to Group I, while there was a statistically significant increase in Group VI 1 week after ischemic stroke was induced, compared to Group II (p<.05). For neurologic exercise behavior test, Group VI generally had the highest score, compared to other groups. The results of the behavior test suggests that 8 weeks after ischemic stroke was induced, Group VI improved in degeneration and inflammation of muscle fiber and decreased in destruction of nerve cells and cerebral infarction, thus indicating a similar state of muscle fiber and brain tissue in Group I. In immunohistochemical observations, Group 1 week showed increase in BDNF. Based on these results, electroacupuncture and treadmill exercise may improve muscle atrophy and change in BDNF expression of ischemic stroke rats and contribute to the improvement of exercise function.

The purpose of this study was to investigate the effect of submerged relaxation therapy for the spasticity on the affected side in three subjects with post-stroke hemiparesis. A single-subject alternating design with multiple baselines across individuals was employed in this study. Each subject alternately participated in a range of motion exercises on the mat and in the pool, and relaxation exercises in the pool. The muscle tone of the affected side was measured using the tone assessment scale (TAS). Measurements were made immediately and one hour following the intervention. The findings showed a therapeutic effect of submerged relaxation exercise on reducing spasticity for all subjects. The effect of submerged relaxation exercise on decreasing muscle tone was maintained for one hour measurements after the submerged relaxation exercise, although the mean TAS score assessed one hour after intervention was higher than that assessed immediately. The results of this study suggest that submerged relaxation exercise has a positive effect on decreasing spasticity on the affected side in persons suffering from post-stroke hemiparesis. Future research on submerged relaxation exercise should focus on objective evaluation and functional the aspects relevant to activities of daily living.

Ischemic stroke results from a transient or permanent reduction in cerebral blood flow that is restricted to the territory of a major brain artery. Thus, this study was performed to examine (1) the effects of swimming exercise on the improvement of muscle atrophy, and (2) exercise and HSP 70 expression in an ischemic stroke model induced by middle cerebral artery occlusion. The results of this study were as follows: One week after ischemic stroke was induced, changes appeared in the muscle weight of the gastrocnemius muscle due to muscle atrophy in the affected side. Group II showed statistically significant difference from group III eight weeks after ischemic stroke was induced. (p<.05). One week and eight weeks after ischemic stroke was induced there was significant decrease in the relative muscle weight of the gastrocnemius muscle in each group except Group IV, while there was statistically significant increase in group II eight weeks after ischemic stroke was induced, compared to group III (p<.05). For neurologic exercise behavior tests, Group II generally had the highest score, compared to other groups. In immunohistochemical observations, Group II showed a decrease in HSP 70. The above results suggest that swimming exercise improved muscle atrophy, changed the HSP 70 expression of ischemic stroke in rats, and contributed to the improvement of exercise function.

This study investigated therapeutic effects of pelvic tilt exercise (PTE) on weight bearing and body sway during sit-to-stand (STS) on 18 hemiplegic patients who had visited the Hanyang University Seoul Hospital and Injae University Sanggyebek Hospital physiotherapy rooms. The study compared the patients with 18 normal adults. The subjects were sampled out from those who could get up independently, maintain a standing posture more than 10 seconds, understand the movements of this study and have no difficulty in performing the tasks. By executing STS in a natural way with habitual movements before and after PTE, the weight bearing was measured by using Mediance II. In order to compare the difference of weight distribution, weight bearing and body sway on affected and nonaffected sides during STS before and after PTE, the Wilcoxon Signed Ranks Test was used. The statistical significance level was based on p<.05. The results revealed that the difference of weight distribution in the hemiplegic group was significantly decreased (p<.05), whereas there was no significant difference in the healthy group (p>.05). Weight bearing loaded on the affected side was 42.53±7.65% and 44.20±6.32%, respectively, in the hemiplegic group during STS before and after PTE. Weight bearing during STS after PTE is increased significantly, as compared with weight bearing before PTE (p<.05). Body sway in the hemiplegic group was significantly decreased (p<.05). As mentioned, PTE proved to be effective for improvement in weight bearing on the affected side during STS of hemiplegic patients.

The limited walking ability after a stroke restricts a patient's independent mobility at home and in the community. It also brings about significant social handicaps. Therefore, it is necessary to improve walking ability in community-dwelling persons with stroke. The purpose of this study was to evaluate the effectiveness of gait training and muscle strengthening exercise of lower extremities in persons with chronic stroke. Nineteen community-dwelling individuals with stroke participated in this program. The exercise program lasted for seven weeks, with a 1-hour program twice per week, and it consisted of balance training, gait training, and strengthening of lower extremities. The outcome of the program was assessed by the gait speed, Wisconsin Gait Scale (WGS), Berg Balance Scale (BBS), and Stroke Impact Scale (SIS). Significant effects were found for the WGS, BBS, and mobility and hand function domain of the SIS (p<.05). It was found that short-term gait training exercise could improve quality of gait, balance, and mobility. Therefore, a more effective exercise program is required for community-based persons with stroke.

The purpose of this study was to determine the consequence of resistance strengthening exercise on the hip flexor and extensor performed to improve functional mobility in stroke patients more than six months post stroke. Seventeen patients were randomized into two groups. Both groups received conventional physical therapy for six weeks. In addition, the experimental group performed eccentric resistance strengthening exercise in the hip flexor and extensor using an isokinetic dynamometer. The hip flexor and extensor strength, stair up and down mobility, timed get up and go (TUG), 10 m gait velocity, and functional reach were repeatedly measured at baseline, three weeks, and six weeks after treatment. The results were as follows: 1. The experimental group improved more remarkably in the hip flexor and extensor strength, stair up and down mobility, and the 10 m gait velocity after three weeks and six weeks of treatment (p<.05), 2. The control group improved significantly in the hip flexor and extensor strength, and 10 m gait velocity after three weeks of treatment (p<.05), 3. At each three and six week point, the experimental group made greater gains in hip flexor and extensor strength, stair up and down mobility, and 10 m gait velocity than the control group (p<.05). In conclusion, it is desirable to perform resistance strengthening exercises combined with conventional physical therapy to improve functional mobility in chronic stroke patients.

Muscle weakness in the hemiplegia following stroke is an important factor which determines the quality of life in the future. Therefore, muscle strengthening exercise is essential for functional recovery in hemiplegic patients. Even though the popular conception is that muscle strengthening exercise causes spasticity and associated reaction that hemiplegia patients don't want, and that it disturbs functional recovery, recently there have been many new reports against that opinion. Therefore, the effects of strengthening exercise programs on functional recovery in hemiplegic patients are still controversial. The purpose of this study was to determine the effects of strengthening exercise programs for the knee joint using isokinetic exercise on the associated reaction of the upper extremities. Comparing the muscle activities of biceps brachii and triceps brachii during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise, we examined the increase and decrease of associated reaction. Twenty stroke inpatients participated in this study. Surface electromyography was used to get muscle activity data from biceps brachii and triceps brachii. The major findings of this study were as follows: 1. The flexor and extensor peak torque were significantly higher on the sound side than the affected side (p<.05). 2. Before and after strengthening exercise, there was no significant difference in muscle activities (surface electromyographic root mean square values) between the sound and affected side. 3. Muscle activities were examined during, before, and immediately after 2 and 5 minute intervals of isokinetic exercise. There were significant differences in muscle activities between, before and during the exercises, during exercise and 5 minutes after exercise in the biceps brachii (p<.05), and during exercise and 5 minutes after exercise in the triceps brachii (p<.05). In conclusion, there was no relation between strengthening exercise and associated reaction in the upper extremities. Rather, muscle activities after exercise had a tendency to decrease relative to before the exercise. Thus, it is considered that intensive strengthening exercise contributes to improvement of functional recovery without increase in associated reaction in hemiparetic patients.

The term thoracic outlet syndrome (TOS) is used to describe patients with compressed subclavian arteries, veins, and brachial plexuses in the region of the thoracic outlet. The objective of this study was to evaluate a scalenus stretching exercise that aims to restore normal function to patients with TOS. This study consisted of 60 patients with symptoms of TOS, and divided the patients into 3 groups: one that received manual therapy, one that practiced self stretching, and a control group. Each group consisted of 20 patients. This study assessed the efficacy of scalenus stretching exercise by examining the resting pain, tenderness, spherical grip power, and pinch grip power of patients. The data were analyzed using one-way ANOVA, Scheffe post hoc test, and independent t-test. The results showed that resting pain was statistically significant within the manual therapy and self stretching groups (p<.05), and that the resting pain of the manual therapy group was more statistically significant than that of the self stretching group (p<.05). Tenderness, spherical grip power, and pinch grip were statistically significant within the manual therapy and self stretching groups (p<.05), but there was no statistically significant difference between the two groups (p>.05). Finally I could see that there were no statistical differences between manual therapy and self stretching to improve the symptoms of the patients with TOS. These results imply that self stretching by patients is as important as manual therapy by a physical therapist.

The aim of this study was to assess the effectiveness of group therapeutic exercise programs on the cognitive function, Activities of Daily Living (ADL), and balance-performing ability in older adults. Fifteen community-dwelling subjects (mean age 73.7 yrs, standard deviation 2.4) participated in this study. An 8-week group therapeutic exercise program, including strengthening and balance training, breathing and gait exercise, and recreation, consisted of activities related to daily living. The Mini-Mental State Examination-Korean (MMSE-K), Modified Barthel Index (MBI), Berg Balance Scale (BBS), Functional Reaching Test (FRT), and Timed Up & Go (TUG) test were measured during pre-exercise and post-exercise points. The results of this study were as follows: 1. After eight weeks, the MMSE-K and MBI total score was more significantly increased for post-exercise tests than pre-exercise tests (respectively, p<.05, p<.01). 2. Of the MBI contents, personal hygiene, dressing, ambulation, and chair/bed transfers scores were significant increased for post-exercise tests. 3. Post exercise BBS, FRT, and TUG scores were higher than the pre-exercise scores. The difference was statistically significant (respectively, p<.05, p<.05, p<.01). These findings suggest that group therapeutic exercise can be used to improve the cognitive function, ADL, and balance-performing ability in elderly persons.

본 연구의 목적은 21%농도의 산소와 비교하여 30%의 고농도 산소 흡입이 사이클 등속 운동 중에 심박동률(heart rate)과 혈중 산소 포화도(SPO2)에 미치는 영향을 분석하는 것이다. 21%와 30% 농도의 산소를 각각 8liter/min의 양으로 일정하게 공급할 수 있는 산소 공급 장치를 이용하였다. 신체 건강한 10명의 남자 대학생(25.2±2.2세)이 21%와 30%의 두 종류의 산소 농도를 대상으로 각각 두 번의 실험에 참여하였다. 실험은 안정(2분), 20±1km/h의 사이클 등속 운동(10분), 회복(6분)의 세 구간(총 18분)으로 구성되어 있고, 21%또는 30%의 산소는 등속 운동과 회복 구간에만 공급되었다. 21%에 비해 30%산소를 흡입했을 때 사이클 등속 운동과 회복 기간 중에 심박동률은 감소하였고, 혈중 산소 포화도는 .차이가 없었다. 21%와 30% 두 그룹 사이에 동일한 운동부하가 주어졌기 때문에 혈중 산소 포화도는 차이가 없는 것으로 판단되고, 30%의 고농도 산소 흡입으로 동일운동 부하에 필요한 산소 요구량이 원활히 공급되고 있기 때문에 심박동률은 감소한 것으로 판단된다.

Osteoporosis is the most prevalent metabolic bone disease and is characterized by diminished bone strength predisposing to an increased risk of fracture. Thus, this study was performed (1) to examine the effect of aquatic exercise on osteoporosis caused by an ovariectomy in the rats, and (2) to elucidate involvement of histopathologic findings in mediating these actions. The results of this study were as follows: 1. Body weight of the subjects increased after the experiment. There was a statistically significant difference (p<.05) between Group I (sham operated) and Group II (control group). 2. In respect to the length, circumference and weight of the femur, there was no statistically significant difference between the control group and the other groups (p>.05). 3. With the osteocalcin level used as one of the bone formation indexes the bone mineral density increased in every group in comparison with the control group, and in particular, there was a statistically significant difference between Group III and Group IV. The above results suggest that aquatic exercise treatment is effective in the prevention and treatment of osteoporosis.

Community-based group exercise programs for people with chronic stroke are relatively uncommon in Korea. In addition, it is currently not known whether a community-based group exercise program is effective or not. The purpose of this study was to evaluate an 8 week community-based functional exercise program for its effects on balance performance and occupational performance in persons with chronic stroke. Twenty-five community-dwelling individuals with stroke participated in this program. Outcome of the program was assessed by the Berg Balance Scale and the Canadian Occupational Performance Measure (COPM). The functional exercise program lasted for eight weeks, with a 1-hour program twice per week and it consisted of mobility, stability, balance, functional strength, and gait training. The subjects were trained by one physical therapist but were under one-to-one supervision from students. The data of sixteen individuals who scored more than 24 on the Mini-Mental State Examination (MMSE) were analyzed. There was a significant effect both in terms of the COPM Performance Score & the Satisfaction Score (p=.002) and with the Berg Balance Score (p=.001). It was found that a short-term community-based exercise program could improve both performance of activities and balance. Further, all subjects reported that they were satisfied with this program.

Eccentric muscle contraction is more effective than concentric and iosmetric muscle contraction in increasing muscle strength. Also, eccentric or concentric-eccentric training has greater effective in neural activation and muscle hypertrophy than concentric training. In some study, eccentric exercises have been shown to reduce pain and improve function on Achilles tendinopathy. The purpose of this study was to evaluate the effect of eccentric isokinetic exercise in a patient with dislocation of the tarsometatarsal joint by traffic accident. After eccentric isokinetic training, peak torque, average work, and average power were increased. Also, the patient was fully weightbearing with a pain free normal gait thus making good recovery.

The purpose of this study was to produce the regression equation from non-exercise of healthy young adults and to develop a maximal oxygen consumption () regression model. This model was based on heart rate non-exercise predictor variables (rest heart rate, maximal heart rate/rest heart rate), as an extra addition to the general regression which can reflect an individual's inherent or acquired cardiorespiratory fitness. The subjects were 101 healthy young adults aged 19 to 35 years. Exercise testing was measured by using a Balke protocol for treadmill and indirect calorimetry. The prediction equation was analyzed by using stepwise multiple regression procedures. The mean of was (meanSD). The greatest variable correlated to was %fat. The predictor variable used in the non-exercise included %fat, gender, habitual physical activity and . The non-exercise estimation was as follows: ()=55.58-.41(%fat)+.59(physical activity rating)-2.69()-5.36 (male=0, female=1); (R=.85, SEE=3.64, R2=.72: including heart rate variable); ()=48.47-.41(%fat)+.45(physical activity rating)-5.12 (male=0, female=1); (R=.84, SEE=3.74, R2=.70: with the exception of heart rate variable). As an added heart rate variable, there was only a 2% coefficient of determination improved. Therefore, these results demonstrated that heart rate variable correlation with a non-exercise regression model was very low. In conclusion, for healthy young korean adults, those variables that can affect non-exercise estimation turned out to be only % fat, gender, and physical activity. We suggest that further research of predictor variables for non-exercise is necessary for different patient groups who cannot perform maximal exercise or submaximal exercise.

This study was designed to identify the effect of various decline boards and postures of lower extremities on surface electromyographic (EMG) activity of knee muscles during isometric single-leg decline squat exercises. The subjects were twenty young male adults who had not experienced any knee injury and their Q-angles were within a normal range. They were asked to perform single-leg decline squat exercises in five various conditions. The EMG activities of the gluteus maximus (GM), vastus lateralis (VL), vastus medialis (VMO), tibialis anterior (TA), and gastrocnemius (GCM) muscles were recorded in five various single-leg decline squat exercises by surface electrodes and normalized by maximal voluntary isometric contraction (MVIC) values. The normalized EMG activity levels were compared using one-way ANOVA with repeated measures. The results of this study were as follows: 1) Exercises 2 and 4 produced significantly greater EMG activity of VMO than did exercise 1 (<.05/10), 2) The VMO/VL ratio of EMG activity of exercise 4 was the highest, producing a significantly greater ratio than exercise 1 (<.05/10). These results show that single-leg lateral oblique decline squat exercise is the best exercise for selective strengthening of VMO, and the posture of the contralateral leg does also affect strengthening of VMO, but we'll need to research patellofemoral joint compression for clinical application of single-leg lateral oblique decline squat exercises.