Purpose: The purpose of this study was to determine the effects of a modified abdominal draw-in maneuver on trunk stability and functional capacity as well as pain in patients with chronic low back pain. Methods: The study included 3 patients with chronic low back pain who volunteered to participate. The modified abdominal draw-in maneuver included a posterior pelvic tilt, a traditional abdominal draw-in maneuver, and a vibration sensory feedback device. Voluntary abdominal contraction using the vibration sensory feedback device was performed by the subjects for more than 1 hour per day, 5 times per week, for 6 weeks along with common low back pain treatment. Electromyographic signals in the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES) muscles were measured to compare muscle activation. The degree of pain was measured using the visual analogue scale (VAS), and functional capacity was measured using the Korea Oswestry Disability Index (K-ODI). All results were compared to the means before and after intervention. Results: After the intervention, the RA, EO, and IO showed increased muscle activation and the ES showed decreased muscle activation. The visual analogue scale decreased after intervention and the K-ODI decreased after intervention. Conclusion: Modified abdominal draw-in maneuvers in daily life combined with therapeutic exercises may be effective in relieving pain and dysfunctions in chronic low back pain patients.

Purpose: The purpose of this study was to investigate the effects of coordinative locomotor training (CLT) on the foot pressure and balance of patients with scoliosis. Methods: This was a single-case A-B-A study involving two patients with scoliosis. The study was designed to perform repeated measurements as follows: 5 times at baseline (A), 10 times during intervention (B), and 5 times after intervention (A). The study period was 5 weeks, and the CLT program was divided into warm up, CLT program, and cool down stages, at 50 min per stage. For the primary outcome measure, Gait View AFA-50 was used to determine the foot pressure and balance ability. For the secondary outcome measure, the SRS-22 questionnaire was used to assess the quality of life of the patients with scoliosis. Descriptive statistics and visual analysis using graphs were used to compare the rates of change. Results: The results of this study showed that the foot pressure and balance ability of the two subjects improved during the intervention period and remained improved even during the baseline period. However, their quality of life did not change after the intervention. Conclusion: CLT may have a positive effect on foot pressure and balance ability in patients with scoliosis. Also, this body function improvement may have positive effects on the performance of daily activities which employ the upright position.

Purpose: The purpose of this study was to investigate the effects of forward-and-backward shift trunk exercise using a proprioceptive neuromuscular facilitation (PNF) diagonal pattern in a closed kinematic chain exercise on the upper limb function and activity of daily living (ADL) in a stroke patient. Methods: One subject participated in this study. The study used a reversal A-B-A' design, where A and A' were the baseline period (no intervention), and B was the intervention period. The intervention was a forward-and-backward trunk shift exercise, using a PNF diagonal pattern on both a stand-on-hand position and a quadruped position of closed kinematic chain exercises, for 20 min per day for 2 weeks. The range of motion (ROM) of the shoulder joint was measured and a Fugl-Meyer assessment of upper extremity (FMA-UE) and a functional independence measure (FIM) were performed to measure upper limb function and activity of daily living (ADL). Results: ROMs of shoulder joint (flexion, extension, abduction, and external rotation) increased in the intervention phase. The FMA-UE score increased (from 28 to 36) in the intervention phase. The FIM score increased (from 20 to 25) in the intervention phase. These increases were maintained after intervention (Baseline II). Conclusion: These results suggest that forward-and-backward shift trunk exercises using a PNF diagonal pattern in a closed kinematic chain exercise have a positive effect on stroke patients' upper limb function and ADL ability.

Purpose: This study sought to examine the effect of coordinative locomotor training (CLT) program on the balance and gait of stroke patients and to develop effective programs and training methods to improve the functions of such patients. Methods: Subjects included 29 patients with hemiplegia caused by stroke. The subjects were randomly divided into an experimental group (n=14) that participated in CLT program and a control group (n=15) that participated in general exercise therapy. The experimental group underwent CLT program, while the control group underwent general exercise therapy, for 30 minutes, 3 days per week for a 6-week period. timed up and go test (TUG), four square step test (FSST), figure-of-8-walk test (F8WT), and 10m walking test (10MWT) were conducted to evaluate changes in balance and gait. Results: After the intervention, significant differences (p<0.05) were seen in the TUG, FSST, F8WT, and 10MWT in both groups. The experimental group showed more significant improvement than the control group(p<0.05). Conclusion: The results from this study indicate that a CLT program is extremely effective for improving the balance and gait in stroke patients.

Purpose: This study was conducted to predict the risks that arise while standing on mediolateral ramps at various ramp angles by identifying the ratio of medial to lateral gastrocnemius muscle activities. Methods: The subjects were 20 healthy adult men. Seven mediolateral ramp angles ($0^{\circ}$, $2^{\circ}$, $5^{\circ}$, $10^{\circ}$, $15^{\circ}$, $20^{\circ}$, and $25^{\circ}$) were applied for the experiment. The ratio of medial to lateral gastrocnemius muscle activities in each condition was measured using electromyography, and the measured data were converted to root mean square values to calculate the activity ratios. Results: The study results showed statistically significant differences in the ratio of mediolateral gastrocnemius muscle activities according to the selected mediolateral ramp angles. The results of a post hoc test confirmed that the multifidus muscles were asymmetrically used on the two sides at mediolateral ramp angles of $5^{\circ}$ or higher. Conclusion: This study found that an asymmetric use of the multifidus muscles began at a mediolateral ramp angle of $5^{\circ}$, and the provision of propulsion using the ankle joints on mediolateral ramps at $5^{\circ}$ or steeper was maneuvered differently from that on flat ground. This suggests that individuals with balance control disorder have the risk of falling due to ankle sprains and unstable balance control. Therefore, patients and elderly people are required to exercise caution when crossing $5^{\circ}$ or steeper ramps.

Purpose: This study aimed to compare muscle activities in the right leg during squatting on an angle-adjustable inclined wooden plate at three different angles. Methods: The subjects were 19 healthy adult men and women. An angle-adjustable inclined wooden plate was used for the experiment, and the subjects performed squatting at three adjusted angles of $0^{\circ}$ ankle angle, $10^{\circ}$ ankle flexion, and $10^{\circ}$ plantar flexion. Squatting was randomly performed without a sequence. The knee angle was set at $45^{\circ}$, and a goniometer was used to measure the angles accurately. Electromyography was employed to measure and compare muscle activity in the right leg in each condition. The measured data were converted to root mean square values to calculate the muscle activities. Results: This study showed no statistically significant difference at a $0^{\circ}$ ankle angle, but a statistically significant difference was found in the vastus medialis at $10^{\circ}$ of ankle flexion. Moreover, statistically significant differences were observed in the vastus medialis and lateralis at $10^{\circ}$ of plantar flexion. Conclusion: This study showed a statistically significant difference in the vastus medialis at $10^{\circ}$ of ankle flexion and statistically significant differences in the vastus medialis and lateralis at $10^{\circ}$ of plantar flexion. Therefore, it may be effective to perform squatting at $10^{\circ}$ of ankle flexion when intending to selectively strengthen the vastus medialis and at $10^{\circ}$ of plantar flexion when intending to strengthen both the vastus medialis and lateralis.

Purpose: The aim of the investigation was to identify the effects of purposeful activities combined with music on upper extremity function, motivation, and mood in acute stroke patients. Methods: For the study, 19 acute stroke inpatients were recruited at a general hospital in Korea. The patients were allocated between an experimental group (n=9) and a control group (n=10). The experimental group performed purposeful activities with their preferred music, and the control group carried out purposeful activities without music. The 2 groups received the treatments 30 min per day, 5 days per week, for 4 weeks. Measurements were taken before and after intervention, including a manual function test (MFT) for measuring upper extremity function, a volitional questionnaire (VQ) for assessing motivation, and the Beck depression inventory (BDI) and Beck anxiety inventory (BAI) for assessing mood. Results: In post-treatment measurement, both groups showed greater MFT, VQ, and BDI scores than in pre-treatment. Significantly greater VQ and BDI changes were represented in the experimental group as compared to the control group. Conclusion: Based on the findings of this study, purposeful activities combined with music have a positive effect on motivation and depression in acute stroke patients.

Purpose: The purpose of this study was to examine the effect of an 8-week competitive exercise program on physical fitness, psychological variables, and video-game playtime in game-addicted adolescents. Methods: All subjects were screened by a game behavior diagnosis scale questionnaire, and a total of 7 game-addicted, male adolescents ($16{\pm}2$ yrs of age) participated in the study. All subjects were informed of the study's purpose, procedures, and risks, and a consent form was obtained from each subject. The 8-week soccer and basketball exercise program included twice-weekly sessions of 120 minutes per session. All data were presented as $mean{\pm}SE$, and the variables were analyzed with a paired t-test. Results: Following the 8-week intervention, cardiovascular endurance and grip strength were significantly increased (approximately 17 and 7%, respectively [p<0.05]). Although there was no statistical significance on flexibility, vertical jump, and zigzag-run, all variables showed an increasing tendency. Anxiety levels changed from a mild anxiety state to a normal state, and depression levels also altered from moderate to a normal state. The video-game playtime was reduced about 20% during weekends and vacation periods. Conclusion: Given these combined results, 8 weeks of regular participation in competitive exercise (soccer/basketball) may contribute to positive effects on physical fitness, psychological variables, and video-game playtime in computer-game addicted adolescents.

Purpose: The purpose of this study was to describe the effects of neck and trunk stabilization exercise on the onset time of trunk muscle contraction in the elderly. Methods: Elderly subjects were divided into 2 groups: a neck and trunk stabilization exercise group (NTSG) and a control group (CG). The NTSG performed both neck and trunk stabilization exercises and the CG performed gait training on a treadmill, at 30 min per session, 3 times per week, over 8 weeks. Surface electromyography was employed to measure the onset times of trunk muscle contractions in the right anterior deltoid, rectus abdominis, external oblique abdominis, internal oblique abdominis, and erector spinae muscles. Results: The NTSG subjects showed earlier and statistically significant onset of contraction in trunk muscles as compared to the CG. Conclusion: The combination of neck and trunk stabilization exercises may more effectively improve the onset of muscle contractions in the elderly than other types of exercise. The present study's findings may be used as basic data for the development of exercise programs suitable to the elderly, specifically for the design of home exercise programs.

Purpose: This study observed the activity of trunk and lower limb muscles during a modified bridging exercise with various weight loads. Methods: The participants in this study consisted of 15 male adults. The muscle activity of the elector spinae, rectus abdominis, gluteus maximus, gluteus medius, vastus medialis, vastus lateralis, tibialis anterior, and soleus muscles was measured with an EMG-8 system during a modified bridging exercise performed with various weight loads (indicated as percentage of body weight). Differences in muscle activity during the bridging exercise according to the weight load applied were analyzed using a one-way ANOVA, and post hoc analysis was performed using LSD. Statistical significance was accepted at a p-level of 0.05. Results: When the subjects performed the modified bridging exercise with various weight loads, the muscle activity of the gluteus maximus and vastus medialis peaked at a load of 0.5%. The activity of the gluteus medius showed a remarkable difference when the modified bridging exercise was performed at loads of 0% and 0.5%, 0% and 1%. In addition, the activity of the vastus medialis showed a remarkable difference between modified bridging exercises performed at a load of 0% and that performed at a load of 0.5%. Conclusion: The results suggest that performing modified bridging exercises with a load of 0.5% of body weight results in significant differences in the activity of the gluteus medius and vastus medialis muscles. Thus, it is suggested that performing the modified bridging exercise at 0.5% of body weight may selectively strengthen the gluteus medius and vastus medialis muscles.

Purpose: Flatfeet are one of the risk factors of foot dysfunction and postural imbalance. The purpose of this study was to compare the limitation of stability (LOS) for the center of gravity (COG) between flatfeet and neutral feet on stable and unstable support surfaces. Methods: The study included 26 healthy, adult male participants: 14 with normal feet and 12 with flatfeet. The subjects were asked to incline the trunk maximumly to the left, right, anterior, and posterior directions and were asked to keep their feet on the floor with the knee extension. The subjects had 30 seconds of rest time between the tasks. The LOS (anterior, posterior, left, right) of COG was measured by Balance Trainer (BT4, Hur-labs, Tampere, Finland). An independent t- test was used to compare the LOS of COG between flatfeet and normal feet on stable and unstable support surfaces, respectively. Results: The LOS of the flatfeet group was generally decreased on stable support surfaces as compared to that of neutral feet, but it was not significantly different (p>0.05), while the LOS of the flatfeet group was significantly decreased compared to that of neutral feet on unstable support surfaces (p<0.05). Conclusion: This study suggested that the LOS of individuals with flatfeet may be decreased on unstable support surfaces and the postural balance of the flatfeet group may easily be disturbed on an unstable support surface.

Purpose: Balance and walking ability are important elements of functional independence for people with stroke and are major goals in rehabilitation. These abilities require trunk performance, but most chronic stroke patients reach a plateau in their rehabilitation. Therefore, the purpose of this study was to investigate the effects of a self-training trunk program to improve balance and walking ability in people with stroke, and to suggest such a self-training program for integrated rehabilitation of people with stroke. Methods: The study recruited 7 people with stroke. The subjects performed trunk training for 30 min per day, 6 days per week, for 3 weeks. Participants were measured on the Trunk Impairment Scale (TIS), the Berg Balance Scale (BBS), the Korean Activities-specific Balance Confidence (K-ABC) scale, the Falls Efficacy Scale (FES), the Functional Gait Assessment (FGA), the 6 Minute Walk Test (6MWT) and a gait analysis to measure the training effects. Statistical analysis used the Wilcoxon signed-rank test as a non-parametric statistical test. Results: TIS was not significantly different after the self-training trunk program, but BBS (p>0.05), K-ABC, and FES were significantly improved after the training program (p<0.05). Furthermore, the 6MWT, stride/height %, and one-leg stance were significantly improved after the training program (p<0.05), but cadence, stance, and swing duration were not significantly different after the training (p>0.05). Conclusion: These results suggest that a self-training trunk program should be integrated into stroke rehabilitation to improve balance and walking ability, and further research is needed to develop the program to be more effective for chronic stroke patients.

Purpose: This study was to explore the effects of trunk exercise using PNF combined with treadmill training on balance and walking ability in patients with Parkinson's disease. Methods: This study included 16 patients with Parkinson's disease. Participants were randomly assigned to 2 groups: an experimental group (n=8) and a control group (n=8). All participants underwent treadmill training for 30 minutes. In addition, the experimental group (trunk exercise using PNF) and control group (conventional training) participated in a 30-minute exercise program. Both groups performed the training 5 times per week for 4 weeks. Disease severity (determined using the unified Parkinson's disease rating scale motor subscale, UPDRS-3), balance (determined using the Berg balance scale, BBS), walking speed (determined using the 10-meter walking test, 10MWT), and walking endurance (determined using the 6-minute walking test, 6MWT) were measured at baseline and after 4 weeks. Results: Pre- to post-intervention improvement was noted on all outcome measures for both groups (p<0.05). Post-intervention, there was a significant improvement in the experimental group as compared to the control group for the following measured outcomes (p<0.05): UPDRS-3 (p=0.03; 95% CI, -5.52 to -0.24), BBS (p=0.04; 95% CI, 0.59 to 6.45), 10MWT (p=0.01; 95% CI, -2.19 to -0.42), and 6MWT (p=0.04; 95% CI, 1.81 to 96.72) Conclusion: The results of this study revealed that trunk exercise using PNF plus treadmill training improves balance and walking ability as compared to conventional training plus treadmill training in patients with Parkinson's disease.

Purpose: This study aimed to suggest effective lunge exercise methods for various purposes by comparing differences in the muscle activity of thigh and plantar pressure according to changes in base of support during lunge exercises. Methods: The subjects were 20 college students who agreed to participate in the experiment. They performed three types of lunges-a basic lunge (BL), wide lunge (WL), and narrow lunge (NL). In a static position during each lunge, the muscle activity of the thigh and plantar pressure were measured. Each movement was maintained for 7 seconds, and the muscle activity for the 3 seconds in the middle was measured and analyzed. The plantar pressure was divided into six areas for analysis. The subjects randomly performed the lunges to prevent the influence of an experimental sequence. Each movement was performed three times, and the mean value of the three measurements was analyzed. Results: The analysis of muscle activities in the thigh during the three lunge movements showed statistically significantly higher muscle activity of biceps femoris in WL and NL than BL. Moreover, the analysis of plantar force showed statistically significant differences between BL and WL and WL and NL on the medial-forefoot and medial-midfoot, as well as between BL and WL and BL and NL on the lateral-midfoot. The analysis of plantar contact pressure exhibited statistically significant differences between BL and NL and WL and NL on the medial-forefoot, as well as a statistically significant difference between WL and NL on the medial-midfoot and lateral-hindfoot. Conclusion: This study suggests that changing the base of support during lunges can be useful to suit the purposes of various rehabilitation programs.

Purpose: This study aimed to measure static balance of low back pain patients while one-leg standing in abdominal compression belts. Methods: The study included 40 adult males and females at J university, divided into a low back pain patient group and a normal group through the Oswestry disability questionnaire (ODQ). The subjects were instructed to hold a one-leg standing posture for 15 seconds on a balance measurement plate while wearing an abdominal compression belt. Shifting distance (0.1 cm), mean velocity (cm/s), pressure, and contact area were analyzed using BioRescue (BioRescue, RMINGEIEIRIE, Rodez, France). The average value was used to measure the result 3 times for each condition. Results: Both normal and low back pain groups significantly decreased in the speed of sway while wearing the abdominal compression belt. Furthermore, the pressure of the center of motion significantly decreased in the low back pain groups while wearing abdominal compression belt. However, there were no significant differences in the speed of sway or the pressure of center of motion between groups after wearing the abdominal pressure belt. Conclusion: These results suggest that abdominal compression belts are one option for improving balance temporarily. However, balance after wearing abdominal compression vests depends on onset of back pain, age, and symptoms of pain in the groups with low back pain. Further research is needed to investigate muscle activity, dynamic balance, and the effect of the period of wearing abdominal compression belts in the variety of low back pain patients.

Purpose: The purpose of this study was to examine the effects of performing a dual task on gait velocity, temporospatial variables, and symmetry in subjects with subacute stroke. Methods: The study included 14 independent community ambulators with gait velocity of 0.8m/s. The Korean mini-mental state examination, the Berg balance scale, the Trunk impairment scale, and the Fugl-Meyer assessment scale were used to recruit homogeneous subjects. Subjects performed a single task (10m ambulation at a comfortable speed) and a dual task (10m ambulation at a comfortable speed while carrying a water-filled glass). Gait variables were examined with the OptoGait system. Results: The findings of this study were as follows: 1) Gait velocity decreased significantly in the dual-task condition as compared to the single task condition. 2) There were no significant differences between the paretic and non-paretic stances. 3) Paretic swing decreased significantly in the dual-task condition as compared to the single task condition. 4) The non-paretic, double-limb support phase increased significantly in the dual-task condition as compared to the single- task condition. 5) There was no significant difference in temporal symmetry. 6) Non-paretic step length decreased significantly in the dual-task condition as compared to the single-task condition. 7) There was no significant difference in spatial symmetry. Conclusion: Performing dual tasks decreases gait velocity, paretic swing phase, and non-paretic step length, while it increases non-paretic double limb support. In addition, although there is no difference in temporospatial symmetry, there is high inter-subject variability in temporospatial symmetry. Thus, dual tasks should be selected in accordance with the functional level of the hemiplegic patient, and inter-subject variability of the individual should be considered when dual tasks are considered for gait-training of hemiplegic patients.

Purpose: The purpose of this study was to investigate of the effects of the mode of delivery on pelvic floor muscle function by examining bladder base movement and urinary incontinence. Methods: This study was conducted on 100 females who had delivered in the previous 3-8 months. There were 2 groups: 56 vaginal deliveries and 44 cesarean section deliveries. Prior to the study, a survey was conducted on the subjects' general status, delivery mode, urinary incontinence, and physical activity. The groups could not be blinded due to scar tissue from the operations. The function of the pelvic floor muscle was observed with the bladder base movement using transabdominal ultrasound during pelvic floor contraction. To objectify and measure the subjective symptoms of subjects suffering from urinary incontinence, an incontinence quality of life (I-QoL) test was administered. Statistical analysis of the data was performed using SPSS version 20.0. An independent t-test was used to assess the statistical significance of pelvic floor muscle function between the 2 groups after delivery. Results: The movement of the bladder base in the pelvic floor muscle function was decreased in the vaginal delivery group, but the difference was not significant. Urinary incontinence was significantly increased in the vaginal delivery group. Conclusion: The function of the pelvic floor muscles was better in the cesarean section group and the incidence of urinary incontinence was relatively low in this group. Therefore, vaginal delivery requires more efforts to restore the function of the pelvic floor muscles than cesarean delivery.

Purpose: Although some studies indicate that the Sorensen test may not be used to examine back muscles such as the erector spinae, alternatives to the back-extension test are rarely suggested. Therefore, the purpose of the present study was to investigate an effective way to stimulate the erector spinae muscles by adding a component of trunk rotation and lateral bending to general back extensions. Methods: A total of 18 healthy, physically active participants performed simple trunk extension, extension with trunk rotation, and extension with lateral bending. Surface electromyography responses of the latissimus dorsi, thoracic, and lumbar levels of the erector spinae; the gluteus maximus; and the biceps femoris muscles were investigated during these 3 conditions of modified back extension tests. Results: The simple trunk extension exercise caused significant increases in activity of the gluteus maximus and biceps femoris muscles as compared to the extension with rotation and lateral bending exercises. The extension with trunk rotation exercise showed significantly greater activation in the thoracic and lumbar levels of the erector spinae and in the latissimus dorsi as compared to the other exercises. The index measuring subjective difficulty was significantly lower in the simple trunk extension exercise as compared to the extension with trunk rotation and extension with lateral bending exercises. Conclusion: The present study suggests that extension with trunk rotation has the advantage of stimulating the para-spinal muscles, while simple trunk extension may not be adequate to selectively simulate the para-spinal muscles but may be appropriate for examining global trunk extensors.