Background: During daily activities, stability is maintained to enhance the function of muscles surrounding the lumbopelvic and hip structures. The core muscles such as the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) responsible for this stability. One effective static exercise for strengthening these muscles is the plank. Objects: This study aimed to compare abdominal electromyographic activation when an unstable support surface was applied to the upper and lower extremities during a standard and a knee plank. Methods: A total of 30 adults (15 males and 15 females) participated in this study. Surface electromyography electrodes were placed on the RA, EO, and IO muscles. Data were collected under six conditions for males, including two plank postures (standard and knee planks) and three unstable surface conditions (a dynamic balance cushion applied to the upper extremities, lower extremities, or no cushion). Female participants performed only the knee plank. A mixed-effects model with a random intercept was used to analyze muscle activation across plank posture and surface position, with statistical significance set at α = 0.05. Results: In males, the standard plank elicited greater muscle activation than the knee plank across all muscles (p < 0.0001). Additionally, applying an unstable support surface to the upper extremities significantly increased muscle activation in both plank postures in EO and IO (p < 0.001). Other muscle, RA, was only affected by the unstable support surface in the standard plank position only. In females, the knee plank with upper limb instability resulted in the highest muscle activation for all muscles. Conclusion: These findings highlight the importance of surface instability in core muscle engagement. However, future studies should further investigate abdominal muscle activation with a more detailed analysis and the inclusion of a control group to enhance comparative validity.

Background: With the increase of seated work, interest in forward head posture (FHP) has grown. Prolonged computer tasks with FHP have been considered a factor that increases the stiffness and tone of the upper trapezius (UT) muscle. Traditionally, many studies have measured the craniovertebral angle (CVA) in standing positions to assess FHP, making it difficult to determine whether the CVA measured in a habitual working posture correlates with the stiffness and tone of the UT muscle in office workers. Objects: This study aimed to investigate the relationship among CVA, UT muscle stiffness, and tone in both habitual working and standing postures among asymptomatic office workers. Methods: Forty asymptomatic office workers participated in the study. CVA was measured in both habitual working and standing postures. Stiffness and tone of the UT muscle were assessed after a 10-minute computer task. Pearson’s correlation coefficient was used to investigate the relationship between CVA and stiffness and tone of the UT muscle. Results: No significant correlations were found between CVA in standing posture and the stiffness and tone of the UT muscle. However, moderate negative correlations were observed between CVA measured in the habitual working posture and both the stiffness (dominant: r = –0.490, non-dominant r = –0.465) and tone (dominant: r = –0.501, non-dominant r = –0.446) of the UT muscle. Conclusion: This study highlights that decreased CVA in habitual working posture is associated with increased stiffness and tone of the UT muscle in asymptomatic office workers. Therefore, measuring CVA in the habitual working posture should be considered when evaluating stiffness and tone of the UT muscle.

Background: Portable, small computers and smartphones are now considered essential tools in modern society and smartphone ownership and usage rates are rising every year. However, excessive smartphone use can have musculoskeletal and postural implications, leading to “smartphone addiction” and related dysfunctions. Objects: This study aimed to investigate the effects of smartphone addiction on scapular position and muscle activity during shoulder abduction in asymptomatic individuals. Methods: A total of 45 participants were classified into high-risk, middle-risk, and low-risk groups based on their smartphone addiction levels. Scapular position was measured using the scapular index, round shoulder posture (RSP), lateral scapular slide test, and scapulohumeral rhythm spine angle. Muscle activity was assessed using electromyography of the upper trapezius (UT), lower trapezius (LT), serratus anterior (SA), and anterior deltoid (AD) muscles during shoulder abduction. Results: Smartphone addiction was significantly associated with altered scapular position and muscle activity. The high-risk group exhibited greater forward head posture and more pronounced RSP. Additionally, the high-risk group had lower SA activation and higher UT, LT, and AD muscle activity, indicating compensatory mechanisms due to altered scapular positioning. Conclusion: These findings suggest that excessive smartphone use contributes to postural deviations and altered muscle activation patterns, which may lead to musculoskeletal dysfunction over time. Clinicians should consider smartphone use when assessing patients with scapular dysfunction, and future studies should explore interventions to mitigate these effects.

Background: Chronic low back pain (CLBP) is associated with trunk and lower extremity muscle weakness. Kneeling squat (KS) is a hip-focused exercise commonly used in the activities of daily living. However, research on trunk and lower extremity muscle activity across movement phases (ascending, holding, and descending) during KS remains limited and warrants further investigation. Objects: To determine the muscle activity of transversus abdominis/internal oblique (TrA/IO), erector spinae, gluteus maximus (Gmax), gluteus medius (Gmed), rectus femoris (RF) in the contraction phases of KS in individuals with CLBP. Methods: Surface electromyography data were recorded during KS across the ascending, holding, and descending phases on the side with CLBP. A 60-bit metronome was used to control the exercise speed. Results: The muscle activity of the TrA/IO was significantly higher during the holding phase than during the ascending and descending phases. The Gmax and Gmed were significantly higher during the holding phase than during the descending phase, whereas, RF was significantly higher during the ascending phase than during the holding and descending phases. Conclusion: The holding phase of KS may be recommended as a trunk and lower extremity exercise to increase in TrA/IO, Gmax, and Gmed muscle activity. Additionally, the ascending phase activates RF muscle in individuals with CLBP.

Background: Chronic low back pain (CLBP) is a common health problem among female caregivers. In Korea, 70.4% of caregivers experience LBP after caregiving. The prevalence of LBP was higher in female caregivers of patients who required physical assistance with transfer than in those caring for patients who did not require physical assistance. Lifting movements, such as patient transfer and positioning, are associated with lumbopelvic stability (LPS) and knee muscle strength. However, no studies have investigated the differences in LPS and knee muscle strength between female caregivers with and without CLBP. Objects: This study was conducted to investigate the differences of the LPS, knee extension strength (KES) and knee flexion strength (KFS) between female caregivers with and without CLBP. Methods: Thirty-one female caregivers participated in this study. Participants were divided into two groups: (1) caregivers without CLBP (n = 13) and (2) caregivers with CLBP (n = 18). LPS, KES, and KFS levels were measured. An independent t-test was used to compare the LPS, KES, and KFS between caregivers with and without CLBP. The statistical significance was set at α of 0.05. Results: The LPS and KES scores were significantly lower in caregivers with CLBP than those without. In contrast, the KFS did not differ significantly between the groups. Conclusion: This study observed associations of both LPS and KES with CLBP among female caregivers.

Background: Recent research suggests that the most effective and proactive method for correcting excessive pronation, which contributes to the lowering of the medial longitudinal arch, is to enhance both intrinsic and extrinsic foot muscles simultaneously. Objectives: This study aims to compare the effects of intrinsic and extrinsic foot muscle exercises on medial longitudinal arch height, plantar pressure distribution, and lactate levels in university students with flexible flatfoot. Design: Randomized controlled trial study. Methods: Twenty-two students with flexible flat foot participated in this study and were recruited by N University in Korea. The subjects were randomly divided into Intrinsic foot muscle strengthening group (IFG; n=11) that went through Intrinsic foot muscle strengthening exercise, Extrinsic foot muscle strengthening group (EFG; n=11) that went through extrinsic foot muscle strengthening exercise. SPSS was used for statistical analysis. Results: Both groups showed significant increases in medial arch height and first metatarsal bone pressure, while EFG also had increased pressure at the second to fourth metatarsal bones. No significant differences were found in lactate levels. Conclusion: Both intrinsic and extrinsic foot muscle strengthening exercises can be suggested as effective interventions for improving medial longitudinal arch height and plantar pressure.

Background: Prolonged use of computers and mobile devices has contributed to postural abnormalities such as Rounded Shoulder Posture (RSP), which is characterized by muscle imbalances that can lead to pain and functional limitations. Correcting these imbalances through targeted stretching and strengthening exercises was expected to help improve postural alignment and muscle function. Objectives: This study aimed to investigate the effects of a six-week integrated exercise program targeting the pectoralis minor (PM), upper trapezius (UT), and lower trapezius (LT) on postural alignment and muscle activation in female adults with RSP. Design: Single-group pre-post test study. Methods: Eighteen female university students (aged 20–22 years) with RSP participated in a six-week intervention consisting of PM stretching, UT stretching, and LT strengthening exercises. RSP severity was assessed using acromion-to-ground distance, PM length was measured with a caliper, and surface electromyography (sEMG) was used to evaluate UT and LT muscle activity. Normality was verified using the Shapiro-Wilk test, and paired t-tests were conducted for statistical analysis (α=0.05). Results: After the intervention, significant improvements were observed in all measured variables. Acromion-to-ground distance decreased (P<0.001), PM length increased (P<0.001), UT activation decreased (P<0.01), and LT activation increased (P<0.01). Conclusion: The six-week integrated exercise program effectively improved postural alignment and muscle activation in women with RSP by addressing muscle shortening, overactivity, and weakness. These findings suggest that combined stretching and strengthening exercises can serve as a practical and effective approach for RSP correction. Future studies with longer durations and diverse populations are recommended to further validate these results and enhance clinical applicability.

Background: When shorter muscles are restored to normal, non-specific low back pain, which is the mechanism that causes pain along with muscle relaxation, disappears. Among the stretching methods, self-stretching is a good exercise method not only for treatment but also for preventive purposes. Objectives: To find out what is the most effective method of self-stretching, which is often used in treatment and preventive arbitration, which can reduce muscle activity and increase spinal flexibility in patients with non-specific back pain. Design: Randomized controlled trials. Methods: Three self-stretching exercise methods for erector spinae are randomly assigned to 13 people each, and three self-stretching exercise methods are performed for each study subject. Surface electromyography using, was performed to measure the erector spinae muscle activity. flexibility was measured through Trunk flexion test in a standing position. Muscle activity and flexibility were measured before and after stretching. Results: The difference in muscle activity and flexibility in the three groups, including cat stretching, seated stretching, and Reclining stretching, all showed statistically significant differences. There was no statistically significant difference in comparison between the three groups of stretch muscle activity. However, a statistically significant difference was shown in the comparison of the variability between the three groups of flexibility. In a post-mortem analysis comparing the amount of change in flexibility, the flexibility of the seated stretching in the chair increased significantly compared to the cat stretching group. Conclusion: It can be confirmed that the stretching method of the erector spinae, cat stretching, seated stretching, and Reclining stretching, all have positive effects on muscle activity and flexibility.

Background: With the increasing demand for healthcare devices, the home healthcare market has been continuously expanding. Objectives: This study examined how a home calf massager affects muscle tone and stiffness in the calf region and the active range of motion (AROM) of the ankle in healthy adults to determine whether the massager is suitable for healthcare use in healthy individuals. Design: A quasi-experimental clinical trial. Methods: The study included 20 healthy men in their 20s, analyzing changes in muscle tone and stiffness in the calf region, AROM of the ankle joint, and differences between the two legs before and after applying the home calf massager. Results: After using the home calf massager, significant reductions in muscle tone and stiffness were observed in the lateral gastrocnemius muscles on both sides, as well as in the stiffness of the medial gastrocnemius muscles on both sides (P<.05). The AROM of the ankle joint significantly increased in all cases of dorsiflexion, plantar flexion, inversion, and eversion (P<.05). Conclusion: The use of a home calf massager in healthy adult males did not impose a physiological burden on muscle tone and stiffness in the calf region and was effective in immediately improving ankle joint mobility.

Background: Rotator cuff tears often cause shoulder pain and functional limitations that may require conservative treatment or surgical intervention. Identifying preoperative differences in muscle strength and function can aid in treatment decisions. Objects: This study aimed to compare the preoperative shoulder muscle strength and functional outcomes between patients undergoing arthroscopic rotator cuff repair and those receiving conservative treatment. Methods: A retrospective review was conducted of 315 patients with rotator cuff tears, including 145 who underwent surgery and 170 who received conservative treatment. Shoulder isokinetic muscle strength (external rotator, internal rotators, abductor, and adductors) and functional scores (American Shoulder and Elbow Surgeons [ASES] and Constant-Murley shoulder scores) were measured. The conservative treatment group was assessed during a hospital visit, whereas the surgery group was tested on the morning of the surgery. An independent t-test was used to evaluate the preoperative shoulder strength and functional scores. Results: The conservative treatment group showed lower deficits in external (11.3 ± 23.9) and internal (11.7 ± 15.5) rotators compared to the surgery group (26.3 ± 33.8 and 17.1 ± 26.1, respectively; p = 0.001). Abductor and adductor deficits (18.2 ± 25.3 and 9.8 ± 16.8) were also lower in the conservative treatment group (30.7 ± 31.6 and 21.9 ± 28.4, respectively; p = 0.036 and p = 0.001). The external per internal rotator ratio (50.9 ± 16.8; p = 0.003) and ASES scores were higher (74.5 ± 14.8; p = 0.047) was higher in the conservative treatment group. Conclusion: The conservative treatment group had lower shoulder strength deficits, better muscle balance, and higher ASES scores than the surgery group, indicating superior functional outcomes. These findings suggest that assessing preoperative muscle strength and function might provide valuable insights into treatment planning for patients with rotator cuff tears.

Background: Hallux valgus (HV) is a common foot deformity in which the great toe deviates laterally and the first metatarsal deviates medially, leading to pain, discomfort, and reduced mobility. HV severity is typically assessed using the hallux valgus angle (HVA) and intermetatarsal angle (IMA). Objects: This study aimed to explore how changes in skeletal, muscular, and functional variables correlate with HV severity and to provide evidence for more integrated treatment approaches. Methods: Sixty volunteers with mild to moderate bilateral HV (HVA 15–40 degrees) participated. The measurements included HVA and IMA via radiography, abductor hallucis muscle (AbdH) cross-sectional area (CSA) and tone using ultrasound and Myoton PRO, range of motion (ROM) of the ankle and great toe metatarsophalangeal (MTP) joint with a goniometer, and plantar pressure during gait with a Zebris FDM system. Pearson’s correlation coefficient was used for the statistical analysis. Results: An Increased HVA was associated with a higher IMA (r = 0.858, p < 0.05). The HVA was inversely related to the AbdH CSA (r = –0.337, p < 0.05) and muscle tone (r = –0.889, p < 0.01). With increasing HVA, dorsiflexion ROM of the ankle (r = –0.307, p < 0.01) and both flexion (r = –0.197, p < 0.05) and extension (r=-0.182, p<0.05) ROM of the great toe MTP joint decreased. Conversely, ankle plantar flexion ROM increased with the HVA (r = 0.312, p < 0.01). Additionally, plantar pressure increased in the second metatarsal areas (r = 0.457, p < 0.05) a with higher HVA. Conclusion: This study demonstrates significant correlations between HV severity and various biomechanical factors, highlighting the need for comprehensive treatment strategies. While stretching the adductor hallucis muscle and strengthening the AbdH have been widely recognized interventions for HV, our findings provide evidence that ROM exercises for the ankle and the MTP joint of the great toe are also critical components of a physical therapy program for managing HV. Longitudinal studies are required to assess the effectiveness of these approaches.

Chrysanthemum coronarium L (CC)., a leafy vegetable, has various biological properties, including anti-oxidative, antiinflammatory, antiproliferative, and anti-osteoporosis effects. However, the vascular protective effects of CC remain poorly understood. In this study, we identified the vascular protective effect of CC against ferroptosis in aortic thoracic smooth muscle A7r5 cells. The vascular protective effects of CC against erastin (Era)-induced A7r5 cells were assessed by estimating cell viability, glutathione (GSH) levels, lipid peroxidation, mitochondrial morphological change, and using western blot analysis. The CC treatment effectively ameliorated Era-induced ferroptotic cytotoxicity, including cellular death. The treatment also suppressed mitochondrial morphological change in the Era-induced A7r5 cells. CC significantly regulated Era-induced abnormal mechanisms related to GSH, lipid peroxidation, cysteine/glutamate antiporter SLC7A11 (xCT), and glutathione peroxidase 4 (GPX4) protein expression in A7r5 cells. In conclusion, these findings indicate that CC shows potential as a functional food supplement, nutraceutical, or medicinal food, with protective effects with respect to vascular health by regulating ferroptosis.

국경 간 인수합병(Cross-border M&A)은 이중 조직 정체성과 다양한 제도적 환경을 관리하는 복잡한 통합 과제를 포함한다. 기존 연구들은 주로 국가 수준의 요인에 초점을 맞췄지만, 특히 자 회사의 경험과 같은 목표 기업의 특성에 대한 연구는 상대적으로 부족했다. 본 연구는 자회사 대 독립 기업, 국내 자회사 대 해외 자회사와 같은 다양한 목표 기업의 특성이 국경을 넘는 M&A에서 인수 기업의 주주 가치에 어떻게 영향을 미치는지 분석한다. 1994년부터 2012년까지의 국경을 넘 는 M&A 거래에 대한 이벤트 연구를 통해, 자회사의 경험이 인수 기업의 주주 가치를 증가시킨다 는 것을 발견했다. 그러나 제도적 거리가 증가할수록 국내 자회사의 경험 가치는 감소하는 경향이 있었다. 이러한 연구 결과는 국경을 넘는 M&A에서 자회사 경험의 중요성을 강조하며, 제도적 거 리가 그 효과를 어떻게 조절하는지를 보여준다. 이는 연구자와 실무자 모두에게 중요한 시사점을 제공한다.

Background: The plank exercise is widely used in rehabilitation to enhance core muscle activation, spinal stability, and reduce the risk of lower back injuries. Objectives: This study investigated the effects of exercise complexity and instability on core muscle activation, with a particular focus on using a sling suspension system during prone bridge exercises. Design: Cross-sectional study. Methods: Twenty healthy adults performed three variations of prone bridge exercises: Both Limb Prone Bridge (BLPB), Single Limb Prone Bridge (SLPB), and Single Limb Prone Bridge with Hip Abduction (SLPBHA). Electromyography (EMG) was used to measure muscle activation in the erector spinae (ES), multifidus (MF), and internal oblique (IO) muscles. Results: Significant increases in ES muscle activation were observed during SLPBHA compared to BLPB and SLPB (P<.05), indicating that exercise complexity and the introduction of instability significantly enhanced ES activation. However, no significant differences were found in MF and IO activation across the exercise variations (P>.05). Conclusion: This study underscores the importance of exercise complexity and instability, particularly SLPBHA, in enhancing ES muscle activation. The findings support the inclusion of these exercises in core stability training programs aimed at improving spinal stability and preventing lower back injuries.

Background: Core muscles provide important dynamic stabilization of the lumbar spine. The twist sit-up can simultaneously stimulate the external oblique (EO), internal oblique (IO), and transverse abdominis (TrA) muscles. Objectives: The purpose of this study is to investigate the impact of knee angles during twist sit-up exercises and determine the most efficient knee angle for performing this exercise. Design: Cross-sectional study. Methods: The study recruited 30 students from S University regardless of gender. The subjects performed a total of 10 twist sit-ups at five different knee angles (0, 40, 65, 90, and 105 degrees), divided between the ipsilateral and contralateral sides. The thickness of abdominal muscles (EO, IO, and TrA), was measured using ultrasonography on rest position and full contraction position for each angle of knee flexion and compared between angles. Results: There were significant differences in the ipsilateral EO, IO, and TrA muscle thickness at different knee flexion angles (P<0.5). There was a significant difference in the thickness of EO between 0 and 105 degrees and between 40 and 105 degrees (P<0.5), a significant difference in the thickness of IO between 0 and 105 degrees (P<0.5), and a significant difference in the thickness of TrA between 0 and 105 degrees, 40 and 90 degrees, and 65 and 90 degrees (P<0.5). Conclusion: In conclusion, the muscles involved in axial rotation i.e., EO and IO, maximally contract at a knee flexion angle of 105 degrees. Therefore, this may be the most optimal angle to perform twist sit-ups.

Background: For instance, forward head posture (FHP), characterized by the forward movement of the head relative to the spine, places significant stress on the neck and upper back muscles, disrupting the biomechanical balance of the body. Objects: The objective of this study was to probe the biomechanical effects of FHP on musculoskeletal health through a relative analysis of 26 adults diagnosed with FHP and 26 healthy controls. Methods: In this study, we evaluated the biomechanical impacts of FHP. Participants adjusted their head positions and underwent muscle strength tests, including electromyography assessments and the Biering-Sørensen test for trunk muscle endurance. Data analysis was conducted using Kinovea (Kinovea) and IBM SPSS software ver. 26.0 (IBM Co.) to compare muscle activities between groups with normal and FHPs. Results: The study shows that individuals with FHP have significantly lower muscle activity, endurance, and spinal extension in the erector spinae compared to those without, highlighting the detrimental effects of FHP on these muscles. Conclusion: This study underscores the impact of FHP on erector spinae function and emphasizes the need for posture correction to enhance musculoskeletal health and guide future research on intervention strategies.

Background: Scapular dyskinesis (SD) is closely related to imbalance of the rotator cuff (RC) muscles. However, previous studies have only focused on isometric strength. To our knowledge, there has been no study examining potential differences in concentric and eccentric strength and functional strength ratio (FSR) of the RC muscles based on functional parameters related to throwing in with or without SD. Objects: This study aimed to determine whether there was a difference in the RC muscle strength and FSR between the dominant shoulder with SD and the non-dominant shoulder without SD in adolescent baseball players. Methods: Forty adolescent baseball players participated and classified types of SD based on movement patterns using the SD test by two examiners. The isokinetic concentric and eccentric peak torque of the internal rotation (IR) and external rotation (ER) were measured and quantified as peak torque to body weight (PT/BW). Also, the FSR was obtained by calculating the strength ratios of eccentric IR to concentric ER (IRecc/ERcon) and eccentric ER to concentric IR (ERecc/IRcon), respectively. Results: There was a significant decrease in the IR and ER PT/BW in the dominant shoulder with SD compared to the non-dominant shoulder without SD (p < 0.05), regardless of contraction types. However, no significant difference was observed in the FSR in both IRecc/ERcon and ERecc/IRcon ratios. Conclusion: The findings indicate that the isokinetic concentric and eccentric PT/BW of the IR and ER muscles were significantly lower in the dominant shoulder with SD than in the nonthrowing shoulder without SD. Therefore, when establishing a strategy for addressing RC muscle weakness in adolescent baseball players with SD, it is essential to consider an approach that accounts for scapular kinematic recovery.

Background: Weakness of gluteus medius (Gmed) is related with musculoskeletal disorders. Individuals who experience weakness in the Gmed may activate the tensor fasciae latae (TFL) as a compensatory mechanism. Application of isometric hip extension (IHE) with Thera-band may affect the activities of the Gmed, gluteus maximus (Gmax), and TFL, and the activity ratio of Gmed/TFL during side-lying hip abduction (SHA). Objects: To determine the influences of IHE during SHA on Gmed, Gmax, and TFL activities in participants with Gmed weakness. Methods: Three types of SHA exercises were performed: 1) traditional SHA in the frontal plane (SHA-T), 2) SHA with IHE applying Thera-band in the frontal plane (SHA-IHE), 3) and SHA with isometric hip flexion (IHF) applying Thera-band in the frontal plane (SHA-IHF). Results: SHA-IHE significantly showed higher Gmed and Gmax activities than SHA-T and SHA-IHF. SHA-IHF significantly showed higher activity of TFL than SHA-T or SHA-IHE. The activity ratio of Gmed/TFL was significantly higher in the SHA-IHE, SHA-T, and SHA-IHF, in that order. Conclusion: The SHA-IHE resulted in higher activities of Gmed, Gmax and a higher muscle ratio of Gmed/TFL.

Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mortise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and extension [KE]). Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to investigate differences in muscle activation and strength. Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) position than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position. Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.

Background: Child care center teachers are exposed to musculoskeletal injuries caused by repetitive movements at low heights due to the nature of their jobs. Self-myofascial release (SMFR) improves flexibility, pain, and functional performance. Pectoralis minor self-stretching (PMSS) improves muscle flexibility and postural alignment. PMSS has been commonly used to correct a rounded shoulder posture (RSP). Objectives: To examine the shoulder height, muscle tone, muscle stiffness, and muscle elasticity for women child care center teachers with RSP. Design: Randomized study. Methods: The participants were 20 women child care center teachers with RSP. They were randomly assigned two groups: SMFR group (n=10) and PMSS group (n=10). They performed each exercise for 20 min, 3 times a week for 4 weeks. They measured shoulder height, muscle tone, stiffness, and elasticity of upper trapezius before and after exercise. Results: In the shoulder height, there was no significant difference between two groups. There were significant decreases within both groups. In the muscle tone, stiffness, and elasticity, there was no significant difference between two groups and within two groups. Conclusion: SMFR using a hard massage ball and PMSS have a positive effect on posture correction for child care center teacher with RSP.