Background: Landing from a step or stairs is a basic motor skill but high incidence of lateral ankle sprain has been reported during landing with inverted foot. Objects: This study aimed to investigate the effect of landing height and visual feedback on the kinematics of landing and supporting lower limbs before and after the touch down and the ground reaction force(GRF)s. Methods: Eighteen healthy females were voluntarily participated in landing from the lower (20 cm) and the higher (40 cm) steps with and without visual feedback. To minimize the time to plan the movement, the landing side was randomly announced as a starting signal. Effects of the step height, the visual feedback, or the interaction on the landing duration, the kinematic variables and the GRFs at each landing event point were analyzed. Results: With eyes blindfolded, the knee flexion and ankle dorsiflexion on landing side significantly decreased before and after the touch down. However, there was no significant effect of landing height on the anticipatory kinematics on the landing side. After the touch down, the landings from the higher step increased the knee flexion and ankle dorsiflexion on both landing and supporting sides. From the higher steps, the vertical GRF, anterior GRF, and lateral GRF increased. No interaction between step height and visual feedback was significant. Conclusion: Step height and visual feedback affected the landing limb kinematics independently. Visual feedback affected on the landing side while step height altered the supporting side prior to the touch down. After the touch down, the step height had greater influence on the lower limb kinematics and the GRFs than the visual feedback. Findings of this study can contribute to understanding of the injury mechanisms and preventing the lateral ankle sprain.

Background: Hemiparesis not only affects the affected side but also exerts an impact on the unaffected side. Stroke patients endure muscular weakness attributable to hemiparesis, resulting in asymmetry of muscular strength between the paralyzed and non-paralyzed sides. Objectives: To investigate the correlation between lower limb muscle strength asymmetry and functional factors in patients with stroke. Design: A cross-sectional study. Methods: A total of 58 stroke patients participated in this study. After measuring the muscle strength of both lower limbs using manual muscle testing, the asymmetry was calculated. Functional factors such as berg balance scale (BBS), timed up and go (TUG), 10-metre walk (10MW), and modified barthel index (MBI) were measured. Results: The BBS showed positive correlations with hip, knee, and ankle strength asymmetry (P<.05). The TUG showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The 10MW showed negative correlations with hip, knee, and ankle strength asymmetry (P<.05). The MBI showed positive correlations only with hip strength asymmetry (P<.05). Conclusion: We were found that there is a more pronounced lower limb muscle strength asymmetry in the lower extremity of stroke patients, which is associated with BBS, TUG, and 10MW.

Structural cuticular proteins (CPs) and the liner polysaccharide, chitin, are the primary components of insect cuticle or exoskeleton. A large number of insect CP family proteins are divided into several distinct subfamilies defined by the presence of specific amino acid sequence motifs. One of these subfamilies is composed of Cuticular Protein Analogous to Peritrophins (CPAPs), containing one (CPAP1s) or three (CPAP3s) type-2 chitin-binding domains. In this study, we report a novel function of TcCPAP1-C from Tribolium castaneum in movement of legs. RNAi for TcCPAP1-C at larval stage has no effect on insect molting, growth and development. However, the resulting adults exhibit impaired leg movement, in which internal tendon cuticles are ruptured near the femur-tibia joint. The exoskeletal cuticle, hemiadherens junctions, microtubule array, myotendinous junctions and muscle fibers exhibit normal morphology before the tendon breakage. These results indicate functional specialization of TcCPAP1-C in structural integrity of the internal tendon cuticle, and loss of function of TcCPAP1-C caused breakage of the tendon cuticle, resulting in defective limb movement and locomotion.

Background: A decrease in physical activity has been observed due to the global pandemic, resulting in the onset and progression of musculoskeletal disorders as chronic diseases. Objectives: This study aimed to assess the difference in the degree of contraction of the lower limb muscles between the existing vertical vibration method and a new cross-vibration method. Design: Randomized controlled trial. Methods: The exercise program using whole-body vibration equipment was conducted for 12 sessions, 25 min per session, three times per week for 4 weeks. Results: The changes over time showed a significant difference in cross-alternating vibrations (P<.05), except for the lateral gastrocnemius and tibialis anterior, with no significant difference in sonic vertical vibration (P>.05). The interaction between time and group was significant for all muscles (P<.05), except for the biceps femoris, with differences between before the program and at 2 and 4 weeks after the program revealed in the post-hoc analysis. Conclusion: Future studies should further evaluate the use of CAV exercise devices as auxiliary equipment in exercise by assessing different groups and variations in intensity.

목적 : 본 연구는 몰입형 가상현실과 비몰입형 가상현실 두 가지 형태의 가상현실 기기를 이용한 중재가 만성 뇌졸중 환자의 상지기능 향상에 미치는 효과를 알아보고자 하였다. 연구방법 : 연구 대상은 뇌졸중 발병 후 6개월 이상인 편마비 환자 3명이었다. 연구설계는 단일대상실험연 구(single-subject research design)인 AB 디자인과 교차 연구설계(alternating design)를 사용하였 다. 중재효과를 측정하기 위한 상지기능 평가는 Box and Block Test와 Fugl-Myer Assessment를 사 용하였고, 연구진행은 기초선 4회, 중재 기간 16회를 포함하여 총 20회기를 진행하였다. 연구결과는 시 각적 그래프와 2SD 구간을 설정하여 분석하였다. 결과 : 연구결과는 비몰입형과 몰입형 가상현실 중재법 모두 기초선과 비교하여 Box and Block Test, Fugl-Myer Assessment 점수가 확연히 증가하였다. 그러나 비몰입형 가상현실 중재와 몰입형 가상현 실 중재 간의 의미있는 차이는 발견할 수 없었다. 결론 : 본 연구는 몰입형 가상현실을 이용한 중재가 비몰입형 가상현실을 이용한 중재와 같이 만성 뇌졸중 대상자의 상지기능 향상에 긍정적인 효과를 줄 수 있다는 것을 확인하였다. 이러한 결과는 만성 뇌졸중 대상자들의 상지기능 향상을 목표로 하는 임상현장에서 가상현실 중재와 연구에 유용한 자료가 될 것이 라 사료된다.

Background: Falls are a common and serious problem in the elderly population. Muscle strength and balance are important factors in the prevention of falls. The Y-balance test (YBT) is used to assess dynamic postural control and shows excellent test-retest reliability. However, no studies have examined the relationship between lower-limb strength and YBT scores in elderly women. Objects: This study aimed to examine the relationship between lower-limb strength and YBT scores in elderly women. Methods: Thirty community-dwelling elderly women participated in the study. Lower-limb strength including hip flexor, hip extensor, hip abductor (HAB), hip adductor (HAD), knee flexor, knee extensor, ankle dorsiflexor, and ankle plantar flexor (PF) muscles was examined using a smart KEMA strength sensor (KOREATECH Inc.), and the YBT was used to assess dynamic balance. Relationship between lower-limb strength and YBT was demonstrated using a Pearson’s correlation coefficient. Results: HAB strength (r = 0.388, p < 0.05), HAD strength (r = 0.362, p < 0.05), and ankle PF strength (r = 0.391, p < 0.05) positively correlated with the YBT-anterior direction distance. Ankle PF strength was positively correlated with the YBT-posteromedial direction distance (r = 0.396, p < 0.05) and composite score (r = 0.376, p < 0.05). Conclusion: The results of this study suggest that HAB, HAD, and ankle PF strengths should be considered for dynamic postural control in elderly women.

Background: The Trunk Stabilization Exercise and Respiratory Muscle Exercise may help address the complex biomechanical and neuromuscular issues that contribute to shoulder joint disorders and can help improve patient outcomes in terms of pain relief, range of motion, and functional ability. Objectives: To investigated the effects of conventional physical therapy, trunk stabilization exercise, and respiratory muscle exercise, on the Range of Motion (ROM), ULF and balance in patients with shoulder joint disorder. Design: A randomized controlled trial. Methods: This study randomly allocated 18 subjects to the control group, 19 to the trunk stabilization exercise group, and 19 to the respiratory muscle exercise group, while all interventions were performed five times a week for four weeks. The result measurement involved the ROM, the upper limb function test (ULT), and balance tests. Results: The respiratory muscles exercise group indicated significant improvement in ROM and balance tests than the trunk stabilization exercise group and control group. Conclusion: The respiratory muscle exercise is a more effective way to improve ROM and balance ability than trunk stabilization exercise for patients with shoulder joint disorder.

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP

본 연구의 목적은 체지방률이 높은 직장인 여성을 대상으로 리포사지(Lypossage)를 이용한 복부와 하지 체형 관리가 비만 관리 방법으로 타당한지 알아보고자 진행되었다. 연구 대상자는 총 35명으로 주관적인 비만 체형을 고민하는 사람을 무작위로 배정하였다. 리포사지는 9주동안 주 2회 실시하였으며, 단일 실험군은 리포사지 1Zone인 허리와 둔부, 허벅지 관리 50분을 실시하였다. 검사는 처치 전, 처치 4주 후와 9주 후 시행하였으며, 그룹 내 중재 기간에 따른 전ᆞ중ᆞ후 비교를 통해 종속변수에 미치는 효과를 알아보고자 하였다. 본 연구의 결과는 사전검사(0주), 4주후 검사, 9주 후 검사에 대한 세 기간과 집단의 상호작용으로 체중과 체지방량, 허리둘레, 허벅지 둘레 감소에 유의한 차이가 있었다(p<.05). 이러한 결과를 미루어 볼 때 리포사지는 직장인 여성의 하지 체형 관리에 긍정적인 효과를 보인 것으로 알 수 있었다

본 연구의 목적은 골프 스윙 시 3가지 스탠스에서 클럽헤드 스피드와 볼의 정확성을 유지하기 위한 신체 전략을 하지의 운동학적 변인과 지면반력 변인을 통하여 알아보고자 하였다. 연구의 대상은 공식 핸디캡이 2인 남자골프선수 10명으로 하였다. 모든 대상자들은 스탠스 조건(스퀘어, 오픈, 클로즈드)에 따라 어드레스 자세를 유지한 후 스윙을 수행하였다. 3차원 동작분석 시스템과 지면반력기를 이용하여 각 스탠스에 따라 7번 아이언 풀스윙을 수행한 결과를 산출하였다. 연구결과로 신체중심의 변위, 고관절 각변위, 무릎관절 각변위는 차이가 나타나지 않았다. 발목관절 각변위는 어드레스부터 다운스윙까지 왼쪽에서 오픈 스탠스가 저측굴곡이 크게 수행되었고, 오른쪽에서 클로즈드 스탠스에서 저측굴곡이 크게 수행되었다. 지면반력에서 전후, 수직은 차이가 없었지만, 어드레스부터 테이크백까지 왼발은 오른쪽 방향, 오른발은 왼쪽 방향의 힘이 오픈이 클로즈드 스탠스보다 크게 나타났다. 결론적으로 다양한 스탠스에도 불구하고, 임팩트 시 동일한 자세를 유지하는 것이 클럽헤드 스피드와 볼의 방향에 긍정적으로 작용되는 것으로 판단 된다.

목적 : 본 연구는 상지운동장애를 가진 아동에게 상지재활로봇치료가 기능회복에 미치는 영향에 대하여 문 헌을 고찰하고 그 효과를 메타분석을 통해 알아보고자 한다. 연구방법 : 국외 검색엔진을 이용하여 자료를 수집하였다. 주요 검색용어는 ‘Upper extremity’, ‘Robotic’, ‘Rehabilitation’, ‘Child’ 등이 사용되었다. 2010년 1월부터 2020년 12월까지 게재된 연구 중 선정기준에 적합한 논문 22편을 선정하여 분석하였다. 결과 : 연구의 질적 분석 및 계량적 메타분석, 상지 재활로봇의 종류와 로봇 치료 전·후로 사용된 측정도 구를 분석하였다. 상지운동장애를 가진 아동에게 상지재활로봇치료의 효과는 큰 효과크기로 나타났으며, 통계적으로 유의하였다(p < .05). 결론 : 상지운동장애를 가진 아동에게 상지재활로봇의 치료는 로봇의 종류와 상관없이 기능회복에 효과적 임을 알 수 있었다. 이것은 임상에서 아동에게 상지 재활치료를 위한 치료방법으로 객관적인 근거가 될 수 있을 것이다.

Observations of line of sight (LOS) Doppler velocity and non-thermal line width in the o-limb solar corona are often used for investigating the Alfven wave signatures in the corona. In this study, we compare LOS Doppler velocities and non-thermal line widths obtained simultaneously from two dierent instruments, Coronal Multichannel Polarimeter (CoMP) and Hinode/EUV Imaging Spectrometer (EIS), on various o-limb coronal regions: aring and quiescent active regions, equatorial quiet region, and polar prominence and plume regions observed in 2012{2014. CoMP provides the polarization at the Fe xiii 10747 A coronal forbidden lines which allows their spectral line intensity, LOS Doppler velocity, and line width to be measured with a low spectral resolution of 1.2 A in 2-D o limb corona between 1.05 and 1.40 RSun, while Hinode/EIS gives us the EUV spectral information with a high spectral resolution (0.025 A) in a limited eld of view raster scan. In order to compare them, we make pseudo raster scan CoMP maps using information of each EIS scan slit time and position. We compare the CoMP and EIS spectroscopic maps by visual inspection, and examine their pixel to pixel correlations and percentages of pixel numbers satisfying the condition that the dierences between CoMP and EIS spectroscopic quantities are within the EIS measurement accuracy: 3 kms􀀀1 for LOS Doppler velocity and 9 kms􀀀1 for non-thermal width. The main results are summarized as follows. By comparing CoMP and EIS Doppler velocity distributions, we nd that they are consistent with each other overall in the active regions and equatorial quiet region (0.25  CC  0.7), while they are partially similar to each other in the overlying loops of prominences and near the bottom of the polar plume (0.02  CC  0.18). CoMP Doppler velocities are consistent with the EIS ones within the EIS measurement accuracy in most regions ( 87% of pixels) except for the polar region (45% of pixels). We nd that CoMP and EIS non-thermal width distributions are similar overall in the active regions (0.06  CC  0.61), while they seem to be dierent in the others (􀀀0:1  CC  0.00). CoMP non-thermal widths are similar to EIS ones within the EIS measurement accuracy in a quiescent active region (79% of pixels), while they do not match in the other regions ( 61% of pixels); the CoMP observations tend to underestimate the widths by about 20% to 40% compared to the EIS ones. Our results demonstrate that CoMP observations can provide reliable 2-D LOS Doppler velocity distributions on active regions and might provide their non-thermal width distributions.

목적 : 본 연구는 뇌졸중 환자의 상지기능과 일상생활동작 향상을 위해 적용된 과제 지향적 접근 연구들을 체계적 고찰과 메타분석으로 연구결과들을 비교 분석하였다. 이 결과들을 통해 앞으로의 과제 지향적 접근의 방향을 제시하고자 하였다. 연구방법 : 분석 자료는 2000년 1월부터 2018년 8월까지 MEDLINE, CINAHL, Pubmed 데이터베이스를 사용하여 선정기준에 적합한 17편의 무작위 실험 연구를 수집하였다. 선정된 연구들은 질적 평가(Pedro score)와 Patient, Intervention, Comparison, Outcome(PICO)를 사용하여 체계적으로 정리하였다. 그 후 각 연구들의 중재 형식을 참고하여 평균, 표준편차, 표본수를 사용하여 메타분석을 실시하였다. 결과 : 선정된 17편의 연구는 Pedro score 5점 이상의 연구로 다양한 과제 지향적 접근을 통하여 상지기 능과 일상생활동작을 증진시키고자 하였다. 과제 지향적 접근의 중재 형식은 횟수 강도 등을 통제하는 반복강화형, 기계적 장치나 보조기 등을 사용하는 조합형, 환자별 특성 및 목표 등을 참고한 환자맞춤형 의 3가지로 분류하였다. 과제 지향적 접근이 상지기능에 미치는 영향은 큰 효과크기를 보였으며, 중재 형식에 따른 분석에서는 환자맞춤형은 큰 효과크기, 조합형과 반복강화형은 중간 효과크기를 보였다. 과제 지향적 접근의 일상생활활동에 대한 영향은 중간 효과크기를 나타내었다. 결론 : 환자의 기능 향상을 위한 과제 지향적 접근은 일관되고 정형화된 과제 보다 다양한 자극과 환자 중심의 목표, 환경, 피드백을 활용하여 과제의 다양성을 강화할수록 보다 높은 치료적 효과를 기대할 수 있다.

Background: The effect of mobilization on lumbar back pain has been fully described in several clinical aspects, but evidence for muscle strength would be still less clear. Objective: To assess the effect of lumbar mobilization on lower limb strength in healthy individuals. Methods and Analysis: Healthy people aged 18-65 will be included regardless of race or sex. Original peer-reviewed primary reporting randomized controlled trials (RCTs) will be included. Electronic databases, such as MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Web of Science, Pedro, CINAHL, ClinicalTrials.gov will be searched from inception until July 30. Only studies published in English will be included in this review. Two reviewers will complete the screening for eligibility independently, and the other two reviewers will also complete the risks of data extraction and bias assessment independently. Lower Limb strength will be assessed as primary outcome, and particular intervention or participant characteristics will be assessed as the secondary outcomes. Meta-analysis will be conducted using Review Manager 5.3.3, and evidence level will be assessed using the method for Grading of Recommendations Assessment, Development and Evaluation. Outcomes will be presented as the weighted mean difference or standardized mean difference with 95% CI. If I2 ≤ 50%, P>.1, the fixed effect model will be used, otherwise, random-effects model will be used. Ethics and dissemination: This review might not be necessary ethical approval because it does not require individual patient’s data; these findings will be published in conference presentations or peer-reviewed journal articles. PROSPERO registration number: CRD42020150144.

Background: Spinal Mobilization is one of the manual therapy technique that clinicians have used to treat pain, however, there is still a lack of research on changes in strength in healthy people. Objectives: To investigate the effect of posterior-anterior lumbar mobilization on lower limb strength in healthy individuals. Design: Two-group pretest-posttest design. Methods: In this study, 23 healthy subjects aged 20 years were assigned to 12 lumbar mobilization group (LMG) and 12 sham group (SG) to perform intervention and measurement through pre- and post-design. Intervention was performed in LMG with grade III~IV on L3-5 of the lumbar spine, and lumbar mobilization was performed for each segment. After intervention, knee flexion and extension strength were measured. To measure the main effect on muscle strength, a comparative analysis was conducted using paired t-test and independent t-test. Results: In LMG, knee flexor and extensor strength were increased significantly at 60°/s (P<.05). In addition, the extensors of LMG and SG were significantly different only at 60°/s, and the flexors were significantly different between groups at both 60°/s and 180°/s (P<.05). Conclusion: In healthy individuals, lumbar mobilization results in improvement of strength of knee flexor and extensor, and additional experiments on the effect of mobilization on the lumbar spine on functional changes in the lower limbs will be needed.

목적 : 본 연구는 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련이 뇌졸중 환자의 상지기능, 상지의 근 활성도, 일상생활 활동과 삶의 질에 미치는 효과를 분석하고자 한다. 연구방법 : 선착순 무작위 대조 실험연구 방식으로 연구를 진행하였다. 의료연구협의회 지표(medical research council scale), 한국판 간이정신상태검사(Korean version of Mini-Mental State Examination; MMSE-K)로 대상자를 선별하여 뇌졸중 환자 31명을 무작위로 스마트 글러브를 이용한 가상현실 기반의 상지재활훈련군과 일반적 작업치료군으로 나눈 뒤, 주 5회 하루 30분씩 총 25회기 동안 실험을 진행하였다. 중재 전ᆞ후 비교 분석을 하기 위해서 뇌졸중 상지 기능평가(Manual Function Test; MFT), 표면 근전도 검사(Surface Electromyography; EMG), 한국판 수정된 바델지수(Korean version of Modified Barthel Index; K-MBI), 뇌졸중 영향 척도 3.0(Stroke Impact Scale 3.0; SIS)을 사용하였다. 결과 : 첫째, 실험군과 대조군에서 상지의 기능향상(MFT)이 있었고, 실험군에서 위팔노근의 근 활성도에 유 의한 향상이 있었다. 둘째, 일상생활활동에서는 실험군과 대조군에서 유의한 향상을 보였다. 셋째, 삶의 질 에서는 실험군에서 유의한 향상이 있었다. 결론 : 스마트 글러브를 이용한 가상현실 기반 상지재활훈련은 뇌졸중 환자의 상지기능, 근 활성도, 일상생활 활동과 삶의 질을 향상하는 효과적인 작업치료 방법이다.

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.

보행 시 하이힐 굽 높이에 따른 구간별 차이를 비교하고, 하지관절의 가동범위가 보행 시간에 미치는 영향을 알아보고자 하였다. 20대 여대생 10명이 연구에 참여하였고, 굽 높이에 따라 3차원 보행분석을 통하여 변인을 산출하였다. 통계방법으로 세가지 굽높이에 따른 차이는 일원변량분석을 실시하였고, 보행시간이 하지관절에 미치는 영향은 다중회귀분석을 실시하였다. 연구결과로 보행 시 구간 2는 굽이 높을수록 보행시간이 길게 나타났지만, 구간 3은 굽이 높을수록 보행시간이 짧게 나타났다. 보행시간이 하지 관절 가동범위에 미치는 영향을 분석한 결과 구간 2는 1 cm에서 발목관절, 무릎관절, 5 cm는 발목관절의 가동범위가 클수록 보행시간이 길어졌다. 구간 3은 1 cm에서 고관절 가동범위가 클수록 보행시간이 길어 졌고, 10 cm는 발목관절 가동범위가 작을수록 보행시간이 길어졌다. 따라서 굽 높이 신발의 경우 발목관절의 제어가 중요성이 변인으로 판단된다.

Background: Multifaceted approaches will be needed, such as global synkinesis (GS) achieve functional improvements in the arms of stroke patients from involuntary movements during exercise. Objective: To identify changes in arm GS and muscle activity, functional evaluation and the correlation with variables through action observation training, combined with functional electrical stimulation (FES), thereby verifying the effect on stroke patients. Design: A quasi-experimental study. Methods: The subjects of this study were 20 stroke patients who were divided into two groups: Control group (n=10) and experimental group (n=10). Before the intervention, arm GS and muscle activity were measured using surface electromyography (EMG), and arm function was evaluated using the Fugl– Meyer Assessment (FMA) scale. At the end of the intervention, which lasted 4-wk, arm GS and muscle activity were measured again using the same scale. Results: There was a decrease statistically significant difference in GS during the bending action in experimental group (P<.01). Both groups showed a significant difference increased only in the activity of the anterior deltoid (AD) and biceps brachii (BB) (P<.05). The results of the arm functional assessment revealed a significant difference increase in both groups (P<.05). In the between-group comparison, there was a significant difference decrease in GS during the bending action (P<.05). Only the muscle activity of the AD and BB were significantly increase different (P<.05). There was a significant betweengroup difference increase in the arm functional assessment (P<.05). There was a positive correlation between GS and muscle activity on the FMA in the control group (r=.678, P<.05). In experimental group, GS during the bending arm action exhibited a negative correlation (r=-.749, P<.05), and the muscle activity of the AD and BB showed a positive correlation (r=.701, P<.05). Furthermore, in experimental group, the activity of the extensor carpi radialis increased, and the activity of the flexor carpi radialis decreased, which exhibited a negative correlation (r=-.708, P<.05). Conclusion: These results suggest that brain plasticity could be more efficiently stimulated by combining surface stimulation in the affected arm of stroke patients.