Although conservative management of congenital muscular torticollis (CMT) has been well documented, relatively little is known about the response to the treatment. The purposes of this case report were to describe the use of a therapeutic approach based on motor development in physical therapy intervention for an infant with CMT and to report the result of the treatment. The patient was a 20-day-old baby boy with left CMT presenting muscular mass in the left sternocleidomastoid muscle. The angle of the lateral head tilt was 20 degrees. The size of muscular mass was 5.3 mm in ultrasonography. Intervention included ultrasonic therapy, soft tissue massage, passive and active range of motion exercises, motor developmental therapy, and parent instruction. The procedures of motor developmental therapy and changes in the amount of lateral head tilt were documented using photography. The size of the mass was decreased to .3 mm before the 5-month follow-up. The patient also maintained a midline head position in the supine position and a midline head alignment during all functional activities. A therapeutic approach based on motor development is a beneficial method for reducing an asymmetrical head and neck position, and facilitating normal development as a component of physical therapy intervention.

Skeletal muscle injury occurs frequently in sports medicine and is the most general form of injury followed by physical impact. There are growth factors which conduct proliferation, differentiation, and synthesis of myogenic prodromal cells and regulate vascular generation for the continued survival of myocytes. The purpose of the present study was to confirm the effects of electroacupuncture (EA) and electrical stimulation (ES) on muscle recovery processes according to vascular endothelial growth factor (VEGF) expression. Eighteen Sprague-Dawley rats were separated into 2 experimental groups and a controlled group. All animals had suffered from crush damage in the extensor digitorum longus for 30 seconds and were killed 1, 3, and 7 days after injury. 30 Hz and 1 mA impulsion for 15 minutes was applied to the EA experimental groups Zusanli (ST36) and Taichong (LR3) using electroacupuncture and the same stimulation was applied to the ES group using an electrical node. Hematoxyline-Eosin staining and VEGF immunohistochemistry were used to ascertain the resulting muscle recovery. There were few morphological differences between the EA and ES groups, and both groups were observed to have tendencies to decrease atrophy as time passed. In the controlled group, gradually diminishing atrophy could be observed, but their forms were mostly disheveled. There were few differences in VEGF expression between the EA and ES groups, and tendencies to have an increased quantity of VEGF with the lapse of time were observed in both groups. In the controlled group, a little VEGF expression could be observed merely 7 days after injury. In conclusion, EA and ES contributed to muscle recovery processes and could be used for the treatment of muscle injury.

This study aimed to compare movement patterns of shoulder joints between the right and left symmetry in stroke patients and control subjects. This study proposes use of the voluntary response index (VRI) calculated from quantitative analysis of surface electromyographic (sEMG) and motion data recorded during voluntary movement as a feeding task. The VRI is comprised of two numeric values, one derived from the total muscle activity recorded for the voluntary motor task (magnitude), and the other from the sEMG distribution across the recorded muscles with the similarity index (SI). Five stroke patients and five age-matched healthy controls were recruited. Feeding motion was performed using the provided spoon five times with rests taken on a chair in between tasks. EMG data were digitized and analyzed on the basis of the root mean square (RMS) envelope of activity. The average amplitude of responses was calculated. Responsiveness and clinically meaningful levels of discrimination between stroke patients and control for EMG magnitude and SI were determined. The similarity index of the results from two successive examinations of both sides apart for stroke patients and control subjects were .86 and .95 in motion analysis and .84 and .99 in electromyographic analysis. The SI of sEMG data and motion data was significantly correlated in stroke patients. The data suggest that SI is a sensitive program for comparing and analyzing the symmetry of muscle activity and motion in both sides. This analysis method has a clinical value in grading muscular activity and movement impairment after brain injury.

The purpose of this study was to identify the effect of the hip internal rotation on gluteal and erector spinae muscle electromyographic (EMG) activity during treadmill walking. Eleven healthy subjects were recruited. All subjects performed treadmill walking while maintaining the hip in neutral position (condition 1) and in internal rotation (condition 2). Surface EMG activity was recorded from four muscles (gluteus maximus (GM), gluteus medius (GMED), tensor fascia latae (TFL), and erector spinae (ES)) and the hip internal rotation angle was measured using a three dimensional motion analysis system. The gait cycle was determined with two foot switches, and stance phase was normalized as 100% stance phase (SP) for each condition using the MatLab 7.0 program. The normalized EMG activities according to the hip rotation (neutral or internal rotation) were compared using a paired t-test. During the entire SP of treadmill walking, the EMG activities of GM in condition 1 were significantly greater than in condition 2 (p<.05). The EMG activities of TFL and ES in condition 2 were significantly greater than in condition 1 (p<.05). The EMG activities of the GMED in condition 1 were significantly greater than in condition 1 (p>.05) except for 80~100% SP. Further studies need randomized control trials regarding the effect of hip internal rotation on the hip and lumbar spine muscle activity. Kinetic variables during gait or going up and down stairs are also needed.

The purpose of this study was to evaluate the effect of concurrent and reciprocal isometric contraction and angle of ankle joint on fatigue of concentrically contracting contralateral dorsiflexor and plantar flexor. Seventeen able-bodied subjects participated in the study. Concurrent and reciprocal isometric contraction were performed under three different ankle joint angles (dorsiflexion, neutral position, plantar flexion). During concurrent or reciprocal isometric contraction. fatigue of concentrically contracting contralateral tibialis anterior, gastrocnemius, and soleus was investigated and compared. There was no interaction between different ankle joint angles and direction of isometric contraction (p<.05). No significant differences were found among three different ankle joint angles (p<.05). Contralateral muscle fatigability was lower in reciprocal isometric contraction than that in concurrent isometric contraction (p<.05). Therefore, the findings of this study suggest that reciprocal isometric contraction is more beneficial than concurrent isometric contraction inducing less fatigability during contralateral concentric contraction.

정서를 경험하는 동안 자율신경 반응과 외현적 반응, 그리고 얼굴 표정, 몸짓, 자세, 언어 등과 같은 정서적 의사소통을 나타낸다. 안면근육반응은 공포, 놀람, 행복, 혐오, 슬픔, 분노와 같은 감정적인 표현을 측정하는 하나의 수단으로, 특정한 안면근육에 기초를 둔 반응을 식별할 수 있다. 본 연구에서는 아동이 긍정정서와 부정정서를 느낄 때 나타나는 안면근육반응의 변화를 알아보고, 아동이 느끼는 긍정정서와 부정정서의 구분이 가능한지를 알고자 하였다. 시청각 동영상(Audiovisual Film Clips)을 이용하여 긍정정서 (기쁨)와 부정정서를 유발하였고, 47명의 아동이 이들 정서를 느끼는 동안 안면근전도(Facial EMG : 우측 corrugator supercilii와 orbicularis oris)를 측정하였다. 또한 아동이 경험한 정서의 심리반응 결과를 평가하기 위하여 정서평가척도를 사용하였다. 두 정서에 대한 높은 적합성(85%이상)과 효과성(기쁨 3.15, 공포4.4, 5점 만점)을 보였다. 안면근육반응 결과, 두 정서 모두에서 안정상태와 정서 상태간의 유의한 차이가 있었다. 정서에 따른 반응 결과, 긍정정서와 부정정서에 따라 corrugator supercilii와 orbicularis oris 반응의 차이가 나타났다. corrugator supercilii는 긍정정서일 때 부정정서보다 근육의 활동이 더 증가하였다. orbicularis oris는 부정정서일 때 긍정정서보다 근육의 반응이 더 증가하였다.

The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

The purpose of this study was to investigate the correlation and characteristics between electromyographic (EMG) activities of lower leg muscles and the posturographic assessment of static balance control in normal adults. Twenty-four young, healthy adults(12 males, 12 females) participated in the study. Center of pressure (COP) parameters were obtained using force platform as total path distance, total sway area, X mean frequency and Y mean frequency for 20 seconds in the following conditions: (1) comfortable standing with eyes opened or closed, (2) uncomfortable standing (feet together) with eyes opened or closed, (3) virtual moving surround delivered using Head mount display (HMD) with four different moving patterns. The virtual moving patterns consisted of close-far, superior-inferior tilting (pitch), right-left tilting (roll), and horizontal rotation (yaw) movements. Surface electromyographic activites were recorded on the tibialis anterior, peroneus longus, medial and lateral heads of gastrocnemius muscles under each condition. Correlation between the posturographic measures and EMG activities were evaluated. Total path distance and total sway area of COP were significantly increased during uncomfortable standing. EMG activity of tibialis anterior was significantly more during uncomfortable standing and virtual moving surround stimulation than during comfortable standing. Total path distance and sway area of COP during comfortable standing with closed eyes showed significant positive correlation with the EMG activities of the lateral head of gastrocnemius muscle. Total path distances and total sway area of COP during muscle. Total path distances and total sway area of COP during presentation of virtual moving surround also had significant positive correlations with EMG activities of the lateral head of gastrocnemius muscle under close-far movement.

본 연구는 상지운동 동안에 복부에 적용된 압력이 요부와 복부의 근피로도에 미치는 영향을 알아보았다. 연구대상자는 성인 남자 5명이었다. 연구대상자가 10 repetitions maximun (RM) 무게의 아령을 이용하여 1분 동안 상지운동을 수행 시 0 mmHg, 저압(30 mmHg), 중압(70 mmHg), 고압(100 mmHg)의 외부 압력이 복부에 적용되었고, 복직근, 외복사근, 내복사근, 척추기립근에서 근전도 자료가 수집되었다. 주파수 분석을

In most of the medical literature that discusses the common problem of movement in patients with cerebral lesions. This critical problem is ascribed to a mechanism involving uninhibited neural activity. The goals of neurological physical therapy are focus on reduce of muscle hypertonicity, facilitates muscle activities, and improve of performance in living environment. A variety of studies suggest that spasticity is a distinct problem and separate from the muscle weakness. It has become increasingly recognized that the major functional deficits following brain damage are largely due to negative features such as muscle weakness and loss of performance rather than spasticity. Adequate recruitment of prime mover, not release was able to carry out the movement tasks well. The strengthening exercise of spastic limbs on changes in muscle properties and performance skill, the repeated motor practice has been identified as crucial for motor recovery. This article support the concept that strengthening is an appropriate intervention to improve the quality of physical function in patients with central nervous system lesions. Further studies and therapeutic approaches should be efforts at improving motor neuron recruitment in agonist rather than reducing activity in antagonists while retraining muscle strengthening.

The purpose of this study was to determine the effect of intramuscular stimulation (IMS) therapy in older persons with musculoskeletal pain. The subjects were 181 older persons (54 males, 127 females) with musculoskeletal pain. Intramuscular stimulation unit with needles (size mm) was applied for the treatment. The analgesic effects were measured by visual analog scale (VAS). Results showed that the post-treatment VAS score was significantly decreased after IMS therapy for fifteen minutes compared to pre-treatment score. In addition, the post-treatment VAS score was significantly decreased in patients with chronic pain (pain duration of one year after onset) compared to the post-treatment VAS score in patients with subacute pain (pain duration less than three months after onset). There was no significant difference in analgesic effects according to gender and age groups. It is determined from this study that IMS therapy can be beneficial for patients with chronic musculoskeletal pain in clinical setting. Further study is needed to identify whether the IMS therapy can change the pain threshold in patients with neurologic pain.

This study was designed to identify the effects of walking conditions (normal walking vs. toe-walking) on electromyographic (EMG) activity of gastrocnemius, tibialis anterior, and soleus muscle. Seven healthy adult males participated in this study. The exclusion criteria were orthopedic or neurologic disease, congenital anomaly or acquired deformity, or pain in low back or lower extremities. The maximal voluntary isometric contraction for each muscle was used for the reference contraction, and EMG activity of each muscle during normal walking and toe-walking was expressed as a percentage of reference contraction. The gait cycle was determined with two foot switches, and gait was normalized as 100% gait cycle for each condition. The maximal values of EMG activity in terminal stance (30~50% of gait cycle) of each condition were compared for data analysis. No significant differences were found in EMG activity of the tibialis anterior and soleus (p>.05), whereas significant decrement was found in EMG activity of gastrocnemius during toe-walking compared to normal walking (p<.05). There is a limitation to generalize the results of this study, because small number of subjects participated for this study and only EMG was used for data collection. The treatment methods should be developed to improve gait efficiency by substituting the weakened muscles secondary to upper motor neuron, or by strengthening the distal muscles in lower extremity.

전시냅스 억제(presynaptic inhibition)와 동시냅스 억제(homosynaptic depression)는 보행 시에 분절반사(segmental reflex)를 조절하는 두 가지 독립적인 기전이다. 근방추 피드백(feedback)은 전시냅스 억제(inhibition)를 통해 보행 시 원심성 근육 수축기에서 적절이 조절될 수 있다. 이러한 전시냅스 억제 작용은 H-reflex의 강도로 나타내질 수 있는데, 원심성 근육 수축기 동안 H-refl

Thirty normal adults were tested to measure the electrical activity of the anterior (AD), middle (MD), and posterior portion (PD) of the deltoid muscle and sternal portion of the pectoralis major muscle (PM) during the performance of four upper extremity PNF diagonal patterns with elbow flexion angle in , , and . The PNF patterns in which these muscles function optimally have been theoretically advanced by Kabat and further described by Knott and Voss. They theorize that the MD should be most active with shoulder flexion, abduction, and external rotation (D2F); the PD with shoulder extension, abduction, and internal rotation (D1E); the AD with shoulder flexion, adduction, and external rotation (D1F); and the PM with shoulder extension, adduction and internal rotation (D2E). The patterns were performed through range of motion, with an isometric contraction performed in the shortened range. When the EMG activity of AD, MD, PD and PM in its optimal patterns was measured, it does not have significant difference among fixed elbow flexion angle , , and (p>.05). In addition, suggestions were made for study of patients who exhibit imbalance of muscle strength and have muscle weakness.

Delayed onset muscle soreness (DOMS) is a common problem that can interfere with rehabilitation as well as activities of daily living. The purpose of this study was to determine the effects of both transcutaneous electrical nerve stimulation (TENS) and microcurrent electrical neuromuscular stimulation (MENS) on DOMS, Twenty-seven untrained and male volunteer subjects were randomly assigned to one of three treatment groups: 1) a group that received TENS (7 Hz), 2) MENS (60 , .3 pps) or 3) a control group that received no treatment. Subjects performed repeated eccentric exercise of the non-dominant forearm flexor muscle with submaximal intensity by the simply designed eccentric exercise devices. Treatments were applied after 24 hours and 48 hours. Subjects attended on two consecutive days for treatment and measurement of elbow flexion, extension, resting angle (universal goniometer), and pain (visual analogue scale: VAS) on a daily basis. Measurements were taken after treatment. Analysis of results were as follows; 1) There were no significant differences between TENS and MENS by one-way repeated ANOVA, 2) The t-test for pain, resting, flexion and extension angle revealed significant differences within TENS group, 3) The t-test for resting angle revealed significant differences within MENS group.

Despite research to treat delayed onset muscle soreness (DOMS), no effective treatment has been reported. The purpose of this study is to investigate the effect of a hold-relax technique and cryotherapy on DOMS. Thirty-three subjects were randomly assigned to one of three treatment groups: control, hold-relax technique, or hold-relax technique and cryotherapy. DOMS was induced in the non-dominant biceps muscle through repeated eccentric contractions. Resting elbow joint position, flexion and extension (universal goniometer), pain (Visual Analogue Scale; VAS), and WBC count (blood analysis) were measured one hour before DOMS was induced and 24, 48, and 72 hours after DOMS was induced. The data were analyzed by repeated measure of two-way ANOVA. The results of this study were summarized as follows: 1) While analysis showed no significant differences between groups in relation to a resting elbow joint position, there were significant differences over time, especially at 24, 48 hours after DOMS was induced compared with resting elbow joint position before DOMS was induced. 2) While analysis showed no significant differences between groups in relation to range of flexion, there were significant differences between range of flexion before DOMS was induced and range of flexion 72 hours after DOMS was induced. 3) There were no significant differences between groups or over time in relation to range of extension. 4) While analysis showed no significant differences between groups in relation to VAS, there were significant differences over time in different hours. 5) There were no significant differences between groups or over time in relation to WBC count. 6) There were no interactions between groups or over time in all variables. This results suggested that hold-relax technique and cryotherapy were not effective to reduce DOMS.

This study was conducted to identify the effects of high-heel shoes on EMG activities of rectus femoris and biceps femoris in 28 healthy women. Subjects were composed of experimental group (wearing high-heel shoes) and control group (wearing low-heel shoes). Two groups participated in three conditions standing (bare foot wearing athletic shoes and 7.5 cm height shoes). In high-heel shoes condition, EMG activities of rectus femoris of control group were significantly lower than that of biceps femoris of experimental group, but EMG activities of both muscles of experimental group did not should significant difference. In bare foot standing condition, EMG activities of rectus femoris of experimental group were significantly lower than that of biceps femoris but EMG activities of both muscles of control group had no significant difference. These results showed that hamstring lengthening effects was produced when wearing high-heel shoes because the external knee extension moment was increased. In the short term, high-heel shoes effect on the increase of the biceps femoris activities by spindle reflex, but in the long term, the normal amplitude of the same muscle activities by Golgi tendon organ reflex.

The purpose of this study was to assess the fatigue in lumbar and abdominal muscles in patients with chronic low back pain compared with normal subjects using spectral analysis with mean power frequency and median power frequency. The experimental group consisted of twenty subjects who had experienced chronic low back pain for over one year after the onset day. A control group consisted of twenty normal subjects with no history of low back pain. All subjects stood in an apparatus to perform sustained contraction in the lumbar and abdominal muscles for 30 seconds with 60% maximal voluntary isometric contraction (MVIC). The resulting electromyographic (EMG) recorded time serial data were transformed into frequency serial data by Fast Fourier Transformation (FFT). The results were as follows: 1) lumbar muscles measured, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group group (p<0.05). In measured two abdominal muscles (inferior rectus abdominis, obliquus externus abdominis) except superior rectus abdominis, the frequency change ratio of both median power frequency and mean power frequency was significantly greater for experimental group compared with control group (p<0.05). 2) In all three (longissimus thoracis, iliocostalis lumborum, multifidus) lumbar muscles measured, the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). In the two (inferior rectus abdominis, obliquus externus abdominis) abdominal muscles measured (superior rectus abdominis not included), the initial frequency value of both median power frequency and mean power frequency was significantly lower for the experimental group compared with the control group (p<0.05). These results suggest that in patients with chronic low back pain there is a trend for more fatigue to occur in both lumbar and abdominal muscles than in the normal control group. This would seem to suggest that in treatment programs for patients with chronic low back pain, improvement of endurance in all trunk muscles should be considered.