Background: The gluteus maximus (GM) muscle comprise the lumbo-pelvic complex and is an important stabilizing muscle during leg extension. In patients with low back pain (LBP) with weakness of the GM, spine leads to compensatory muscle activities such as instantaneous increase of the erector spinae (ES) muscle activity. Four-point kneeling arm and leg lift (FKALL) is most common types of lumbopelvic and GM muscles strengthening exercise. We assumed that altered hip position during FKALL may increase thoraco-lumbar stabilizer like GM activity more effectively method. Objects: The purpose of this study was investigated that effects of the three exercise postures on the right-sided GM, internal oblique (IO), external oblique (EO), and multifidus (MF) muscle activities and pelvic kinematic during FKALL. Methods: Twenty eight healthy individuals participated in this study. The exercises were performed three conditions of FKALL (pure FKALL, FKALL with 120° hip flexion of the supporting leg, FKALL with 30° hip abduction of the lifted leg). Participants performed FKALL exercises three times each condition, and motion sensor used to measure pelvic tilt and rotation angle. Results: This study demonstrated that no significant change in pelvic angle during hip movement in the FKALL (p > 0.05). However, the MF and GM muscle activities in FKALL with hip flexion and hip abduction is greater than pure FKALL position (p < 0.001). Conclusion: Our finding suggests that change the posture of the hip joint to facilitate GM muscle activation during trunk stabilization exercises such as the FKALL.

Background: Cervical spine mobilization is an effective intervention method to increase cervical range of motion (ROM). However, whether using a sling with cervical spine mobilization can provide a similar positive effect in improving ROM and muscle stiffness as conventional cervical spine mobilization has not yet been proven. Objectives: To investigated the effects of sling with cervical spine lateral mobilization on improving neck ROM and muscle stiffness in healthy subjects. Design: A two-group pre-posttest design. Methods: A total of 20 healthy subjects were allocated to a sling with cervical spine mobilization (SWCM) group (n=10) and a cervical spine mobilization (CM) group (n=10). The mobilization exercise at grade Ⅳ+ amplitude was applied to the left-side and right-side C3-C4 and C4-C5 of each group for three sets. The mobilization exercise was performed for 30 seconds (frequency of two vibrations per second), with a 30-second resting time. The active cervical ROM, muscle tone, and muscle stiffness of the cervical region of each group was measured and compared before and after the intervention. Results: The active cervical ROM of both groups significantly improved after the intervention (p<.05). However, no significant differences in the cervical active ROM, cervical muscle tone, and muscle stiffness were observed between two groups. Conclusion: The application of sling with cervical spine lateral mobilization is an intervention method that can be effectively used to improve the physiological movement of the neck, as well as cervical muscle tone and stiffness.

Background: Robot-assisted gait training (RAGT) is an effective method for walking rehabilitation. Additionally, the body weight support (BWS) system reduces muscle fatigue while walking. However, no previous studies have investigated the effects of RAGT with BWS on isokinetic strength of quadriceps and hamstring muscles. Objects: The purpose of this study was to investigate the effects of torque, work, and power on the quadriceps and hamstring muscles during RAGT, using the BWS of three conditions in healthy subjects. The three different BWS conditions were BWS 50%, BWS 20%, and full weight bearing (FWB). Methods: Eleven healthy subjects (7 males and 4 females) participated in this study. The Walkbot_S was used to cause fatigue of the quadriceps and hamstring muscles and the Biodex Systems 4 Pro was used to measure the isokinetic torque, work, and power of them. After RAGT trials of each of the three conditions, the subjects performed isokinetic concentric knee flexion and extension, five at an angular velocity of 60°/s and fifteen at an angular velocity of 180°/s. One-way repeated analysis of variance was used to determine significant differences in all the variables. The least significant difference test was used for post-hoc analysis. Results: On both sides, there were significant differences in peak torque (PT) of knee extension and flexion between the three BWS conditions at an angular velocity of 60°/s and 180°/s conditions. A post-hoc comparison revealed that the PT in the BWS 50% was significantly greater than in the BWS 20% and the FWB and the PT in the BWS 20% was significantly greater than in the FWB. Conclusion: The results of this study suggest that the lower BWS during RAGT seems to lower the isokinetic torque, work, and power of the quadriceps and hamstring muscles because of the muscle fatigue increase.

Background: The characteristics of lateral epicondylitis (LE) are muscle strength weakness and increased common extensor tendon (CET) thickness. Ultrasonography has recently been used to evaluate tendinopathy. Diamond taping (DT) is commonly used to manage patients with LE. However, no previous studies have investigated the effects of DT on CET thickness. Objects: The aim of this study was to investigate the effects of DT applied around the lateral elbow on CET thickness, grip strength, and wrist extension force in healthy subjects. Methods: The subjects were 26 adults (13 male) in their twenties. First, the CET thickness was measured at rest. The CET thickness was measured by using ultrasonography at two points. The subjects were then instructed to perform maximal grip activities or maximal wrist extension activities before and after DT around the lateral elbow. The DT technique was applied using non-elastic tape. While the subjects performed maximal grip activities, the investigator measured the maximum grip strength (MGS) and CET thickness. Likewise, while the subjects performed maximal wrist extension activities, the investigator measured the maximum wrist extension force (MWEF) and CET thickness. Results: The MGS showed a statistically significant improvement after DT taping application in men (p < 0.05). The MWEF showed a statistically significant improvement after DT application in male (p < 0.01) and female (p < 0.05). When performing the activities, the CET thickness increased compared to that at rest. However, CET thickness didn’t show a statistically significant improvement before and after DT. Conclusion: This study shows that DT applied around the lateral elbow is effective in improving MGS and MWEF. However, it does not affect CET thickness.

Background: For performing various movements well, cooperation between the muscles around the scapula and shoulder has been emphasized. Taping has been widely used clinically as a helpful adjunct to other physiotherapy methods for shoulder pathology and dysfunction treatment. Previous studies have evaluated the effect of taping techniques using dynamic tapes on shoulder function and pain. However, no study investigated the electromyographic (EMG) changes in the shoulder muscles. Objects: This study aimed to investigate the effect of the upper limb offload taping technique using a dynamic tape on EMG activities of the upper trapezius (UT), lower trapezius, serratus anterior (SA), and middle deltoid (MD) muscles during scaption plane elevation. Methods: A total of 26 healthy subjects (19.85 ± 6.40 years, male = 20) volunteered to participate in this study. The subjects were instructed to perform scaption elevation with and without dynamic taping on the shoulder. Shoulder elevation strength tests were performed at 100%, 75%, 50%, and 25%, for the maximal isometric contraction force. Results: There were statistically significant interaction effects between the taping application and shoulder scaption elevation force in EMG activities in the UT (p < 0.05) and MD (p < 0.05). EMG activities in the UT showed significant increases in 50%RVC (reference voluntary contraction, p < 0.05) and 25%RVC (p < 0.01). Furthermore, the EMG activity of the SA significantly increased in 50%RVC (p < 0.01) and 25%RVC (p < 0.01) after dynamic taping. For the MD, the EMG activity level significantly decreased in 100%RVC (p < 0.05). Conclusion: These results indicated that upper limb offload dynamic taping application affects the muscle activities of some shoulder muscles depending on different scaption elevation strength levels. Therefore, we suggest that the upper limb offload dynamic taping can be applied to the shoulders when patients need middle deltoid inhibition or upper trapezius facilitation, such as patients with shoulder impingement syndrome.

본 연구의 목적은 무릎 푸시업 플러스 동작 시 슬링과 진동기 적용이 체간 근육의 근활성도 변화에 미치는 영향에 대해 알아보는 것이었다. 본 연구의 대상자는 신체 건강한 20대 남성 10명을 대상으로 실시하였고(연령, 23.00±0.45 세; 신장, 176.60±1.64 cm; 체중, 67.50±1.22 kg; 신체질량지수, 21.65±0.34 kg/m2), 3가지의 기본 무릎 푸시업 플러스 동작, 슬링을 적용한 무릎 푸시업 플러스 동작, 및 진동기를 적용한 무릎 푸시업 플러스 동작을 수행하였으며, 표면전극 부착 부위는 체간 근육의 오른쪽 상부 승모근, 대흉근, 전거근, 복직근, 및 외복사근으로 설정하였다. 본 연구의 결과는 다음과 같다. 승모근, 대흉근, 전거근, 복직근, 및 외복사근의 근활성도는 진동기를 적용한 무릎 푸시업 플러스 동작 시 통계적으 로 가장 높게 나타났다(p<.001). 따라서 본 연구의 결과는 향후 무릎 푸시업 플러스 동작 적용 시 효과적인 체간 근육을 강화시키기 위한 트레이닝 프로그램의 기초자료가 될 것으로 기대된다.

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with 90˚ knee flexion, without hip external rotation (b) with 90˚ knee flexion, with hip external rotation (c) with 135˚ knee flexion, without hip external rotation (d) with 135˚ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). While HAM muscle activity was significantly less in 135˚ knee flexion position than in the 90˚ knee flexion position (p<.001). ES muscle activity was significantly less in the 135˚ knee flexion position than in the 90˚ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in 135° of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

Background: Ankle evertor muscles are important for preventing lateral ankle sprain. Since, the evertor muscles cross the ankle and toe joints, the position at which the ankle evertor muscle strength is measured is important. However, no studies have previously investigated the effect of ankle and toe positions on the strength of the ankle evertor muscle. Objects: This study is aimed to determine the effect of various ankle and toe joint positions on the strength of the ankle evertor muscles in healthy subjects. Methods: Eighteen healthy subjects participated in this study. Isometric ankle evertor strength of the dominant leg was determined in each subject in different ankle and toe positions (dorsiflexion (DF) with toe extension (TE), DF with toe flexion (TF), plantar flexion (PF) with TE, and PF with TF). A 2 by 2 repeated analysis of variance (ANOVA) was used to determine the difference in the evertor strength between the ankle positions (PF and DF) and toe positions (TE and TF). Results: The results indicate that there was no significant ankle position by toe position interaction effect (p=.83). However, the ankle evertor strength was significantly increased in the ankle DF position than in the PF position (p<.01), and the ankle evertor strength during eversion with TE was significantly higher than eversion with TF (p<.01). Conclusion: The findings of this study suggest that clinicians should consider the ankle and toe positions when measuring the muscle strength and during performance of selective muscle strengthening exercises of the ankle evertor muscles.

Background: Passive straight leg raising (PSLR) is the common clinical test to measure of hamstring muscle length. Hip flexion angle contributes to change the lumbopelvic rotation during PSLR. Pressure biofeedback unit (PBU) is commonly used to detect lumbopelvic movement during lower limb movements. Thus, there may be the relationship between pressure of PBU and lumbopelvic motion during PSLR. Objects: The objective of this study was to determine the relationship between pressure of PBU and lumbopelvic motion during PSLR. Methods: Thirty two subjects participated in this study. A three-dimensional motion analysis system were used to measure the lumbopelvic angle during PSLR, while recording the pressure of PBU according to angle of PSLR by 10 degree increments. Pearson product moment correlations and linear regression analysis were used to describe the relationship between variables. Results: The results showed that there was a significant relationship between the lumbopelvic and angle of PSLR (Pearson’s r=.83, p<.05), between the pressure of PBU and angle of PSLR (Pearson’s r=.75, p<.05), and between lumbopelvic motion and pressure of PUB (Pearson’s r=.83, p<.05). Linear regression equation using lumbopevic angle as an independent factor was as follows: Pressure of PBU = 47.35 + (2.55 × angle of lumbopelvic motion) (R2=.69, p<.05). Conclusion: Results of the present study indicate that pressure of PBU can be used to indirectly detect the amounts of lumbobevic motion during muscle length test or stretching of hamstring.

The purpose of this study was to investigate the effects of stable and unstable bridging exercises on the EMG activity of abdominal muscles. Twenty healthy women participated in this study and the muscle activities of left-right rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were recorded during 4 bridging exercises (unilateral/ bilateral, stable/unstable). The activity of the right EO muscle was the highest during unilateral exercise in unstable condition, and left EO muscle also produced the same result. The activity of the right IO muscle was the highest during unilateral exercise in an unstable condition, and left IO muscle also produced the same result. The activity of the right RA muscle was the highest during unilateral exercise in a stable condition, and left RA muscle produced the same result. Unstable/unilateral (USUL) represented the highest activity among the 4 exercises. EO/IO muscles represented the highest activity during the USUL exercise, and RA did so during the stable/unilateral exercise. These results suggest that specific posture (USUL) can be administered targeting a specific side of abdominal muscles.

The purpose of the current study was to determine the intra- and inter-rater reliability of muscle thickness (MT) measurement of the psoas major (PM) using ultrasonography (US) conducted at different inward pressures of approximately .5 ㎏, 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Twelve healthy male subjects were recruited for the study. The thicknesses of both PMs of each subject were measured by two different examiners in a random manner to assess the intra- and inter-rater reliability. The measurement values were analyzed using the intra-class correlation coefficient (ICC) with a 95% confidence interval (CI). ICC (2,1) was used to determine the inter-rater reliability and ICC (3,1) was used to assess the intra-rater reliability of the MT measurement of the PM. The results indicated higher ICC values for intra-rater reliability compared to inter-rater reliability. In addition, the value for intra-rater reliability with .5 ㎏ inward pressure [ICC=.99 (95%CI=.98∼.99)] was higher compared to 1.0 ㎏, 1.5 ㎏, and 2.0 ㎏. Other inward pressures for intra- and inter-rater reliability in current study were also demonstrated to have excellent values (ICC=.94∼.99). These findings showed that maintaining consistent inward pressure is essential for maintaining reliability of the results when the MT of the PM is measured by different examiners in a clinical setting.

The purpose of this study was to investigate the effects of swiss ball exercise and taping therapy on back muscle strength on normal college students. The aim of this study was to find effective method for back muscle strengthening. Subjects of 30 college students divided 3 groups(taping therapy group: 10, swiss ball group: 10, control group: 10). All subjects inquired physical conditions and normal exercise habits for data base. Back muscle strength measured before and after 3 weeks intervention. Taping therapy was displayed stable a growth curve in continuative a growth graph of back muscle strength better than swiss ball exercise, because it was taping therapy by periodic effect. The result of this study known to effective either taping therapy or swiss ball exercise, but both taping therapy and swiss ball exercise were effect to increase in back muscle strength.

The purpose of this study was to investigate the changes of the center of pressure (COP) trajectory in healthy elderly subjects while crossing an obstacle before and after participation in Tai Chi training. Forty healthy elderly subjects participated either in a 12-week intervention of Tai Chi training or in a health education program. The participants were divided into two groups (the experimental group and the control group). Subsequently, the participants were pre- and post-tested on crossing over an obstacle from a quiet stance. Participants in the experimental group received Tai Chi training that emphasized the smooth integration of trunk rotation, a shift in weight bearing from bilateral to unilateral support and coordination and a gradual narrowing of the lower-extremity stance three times weekly. The participants in the control group attended a health education program one hour weekly and heard lectures about general information to promote health. Performance was assessed by recording the changes in the displacement of the COP in the anteroposterior (A-P) and mediolateral (M-L) directions using a force platform. Participants in the Tai Chi group significantly increased the A-P and M-L displacement of the COP after Tai Chi training (p<.05). No significant differences in the A-P and the M-L displacement of the COP between pre-testing and post-testing in the control group were found. This study has shown that participation in Tai Chi exercise increased the magnitude of the A-P and M-L displacement of the COP, thereby improving the ability of healthy elderly participation to generate momentum to initiate gait. These findings support the use of Tai Chi training as an effective fall-prevention program for the elderly.

The purpose of this study was to evaluate inter-rater reliability of the amplitude and first knee extension angles in deep tendon reflex test by using an electrical hammer. Twenty-five healthy adults participated in the study. Compound muscle action potential is elicited by tapping the knee tendon with an electrical hammer in deep tendon reflex tests. The amplitude and knee extension angle were simultaneously measured. The mean value of the amplitude and the knee extension angles through three time trials for each tester, are used for determining the inter-rater and Intra-class Correlation Coefficients (ICCs) reliabilities. According to the results, the ICCs of the amplitude is .280 and that of the knee extension angle is .789. Pearson correlation coefficients of the amplitude of the action potential and the knee extension angles are .685, showing significant statistically moderate correlation. Inter-rater reliability in the amplitude was not significant. More objective and quantitative deep tendon reflex tests should be done to obtain higher reliability in further studies.

The purpose of this study was to determine whether a relationship existed between foot type and the location of plantar callus in healthy subjects. Twenty-five healthy subjects with plantar callus were recruited for this study. Foot deformities were classified according to the operational definitions as 1) a compensated forefoot varus, 2) an uncompensated forefoot varus or forefoot valgus, or 3) a compensated rearfoot varus. The location of plantar callus was divided into two regions. Fourteen of the 19 feet with compensated forefoot varus and six of the 9 feet showed plantar callus at the second, third or fourth metatarsal head. Five of the 6 feet with uncompensated forefoot varus and twenty of the 16 feet with forefoot valgus showed plantar callus at the first or fifth metatarsal head. A significant relationship was found between foot type and location of callus (p<.01). The results support the hypothesis that certain foot types are associated with characteristic patterns of pressure distribution and callus formation. We believe diabetic patients with insensitive feet and with the types of foot deformity should be fit with foot orthoses and footwears that accommodate their respective deformity in a position as near to the subtalar joint as possible with the goal of preventing plantar ulceration.

The purpose of this study was to compare the electromyography (EMG) activities of the lumbar extensor muscles during motion of trunk flexion-extension and compare range of motion (ROM) with a 3-dimensional motion analysis system of the lumbar region between subjects with chronic low back pain (CLBP) and healthy subjects during the trunk flexion-extension, trunk rotation and trunk lateral flexion cycle. Thirty CLBP subjects and thirty healthy subjects were included. We measured the root mean square (RMS) value of the lumbar extensor muscles from resting, standing, lumbar flexion and return position. The RMS ratio was normalized from maximal EMG activity of the lumbar extensor muscles during trunk motion. The results of this study showed that the RMS ratio of the lumbar extensor was significantly higher in CLBP subjects than healthy subjects during all of trunk motion (p<.05). The ratio of the highest RMS value during flexion and extension was higher in CLBP subjects than in healthy subjects (p<.05). The ROM of the lumbar region was significantly lower in CLBP subjects than healthy subjects during trunk flexion-extension, trunk rotation and lateral flexion cycle. The relationship between the RMS ratio for full lumbar flexion and the ROM of lumbar flexion was not correlated significantly. CLBP subjects have both decreased ROM of the lumbar region and higher muscle activities of the lumbar extensor muscle than healthy subjects.

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.

The purpose of this study was to examine the effect of the angle of a wedged insole on knee varus torque during walking. Fifteen healthy subjects were recruited. Knee varus torque was measured using three-dimensional motion analysis (Elite). Knee varus torque was normalized to gait cycle (0%: initial contact; 100%: ipsilateral initial contact) and stance phase (0%: initial contact; 100%: ipsilateral toe off). The average peaks of knee varus torque during the stance phase of the gait cycle according to the different insole angles (10 or 15 degrees) were compared using one-way ANOVA with repeated measures. The results showed that in the early stance phase, the average peak knee varus torque increased significantly for both the medial 10 and 15 degree wedged insole conditions and decreased significantly for both the lateral 10 and 15 degree wedged insole conditions as compared with no insole (p<.05). However, there were no significant differences between the 10 and 15 degree wedged insole conditions with either the medial or lateral wedged insole (p>.05). In the late stance phase, the average peak knee varus torque increased significantly for the medial 10 and 15 degree wedged insole conditions (p<.05), but not for the lateral 10 and 15 degree wedged insole conditions as compared with no insole (p>.05). We suggest that these results may be beneficial for manufacturing foot orthotic devices, such as wedged insoles, to control medial and lateral compartment forces in the knee varus-valgus deformity. Further studies of the effects of wedged insole angle on knee varus torque in patients with medial-lateral knee osteoarthritis are needed.

Many factors affect foot and ankle biomechanics during walking, including gait speed and anthropometric characteristics. However, speed has not been taken into account in foot kinematics and kinetics during walking. This study examined the effect of walking speed on foot joint motion and peak plantar pressure during the walking phase. Eighty healthy subjects (40 men, 40 women) were recruited. Maximal dorsiflexion and excursion were measured at the first metatarsophalangeal joints during walking phase at three different cadences (80, 100, and 120 step/min) using a three dimensional motion analysis system (CMS70P). At the same time, peak plantar pressure was investigated using pressure distribution platforms (MatScan system) under the hallux heads of the first, second, and third metatarsal bones and heel. Maximal dorsiflexion and excursion and excursion at the ankle joint decreased significantly with increasing walking speed. Peak plantar pressure increased significantly under the heads of the first of the first, second, and third metatarsal bones, and heel with increasing walking speed: three was no change under the hallux. There were no significant changes in maximal dorsiflexion or excursion at the first metatarsophalangeal joint. The results show that walking speed should be considered when comparing gait parameters. The results also suggest that slow walking speeds may decrease forefoot peak plantar pressure in patients with peripheral neuropathy who have a high risk of skin breakdown under the forefoot.