Purpose: The prevalent use of mobile devices may contribute to musculoskeletal disorders, such as forward head posture (FHP), among users. The measurement of the craniovertebral angle (CVA) using photographic images is frequently employed in assessing FHP. Although manual CVA measurement using photographic images is reliable in clinical settings, computer programs or mobile applications to support tele-physical therapy are not yet fully developed. Therefore, in the current study, we propose an automatic method for extracting CVA from photographic images of FHP subjects to facilitate tele-physical therapy. Methods: To develop the automatic CVA measuring computer program, photographic images were obtained from 10 FHP participants. The location information obtained from the markers attached to the tragus and the spinous process of the seventh cervical vertebra were used as coordinates. Using these coordinates, straight line 1 was generated by connecting the seventh spinous process of the cervical vertebra and the tragus, while straight line 2 was drawn parallel to the coordinate obtained from the seventh spinous process of the cervical vertebra. The arc tangent function was used to calculate the angle between the two straight lines. The automatic CVA measurement computer program utilizing photographic images was developed using MATLAB (ver. 2016b). Results: The results showed that the automatic CVA measurement computer program demonstrated stable repeatability and high accuracy. Conclusion: The proposed approach was able to automatically estimate the CVA using photographic images. The developed computer program can potentially be used for easier and more reliable clinical assessment of FHP.

Purpose: This study investigated the effects of side walking training combined with squats on the balance and gait ability of stroke patients. The purpose of this study was to provide fundamental data regarding the use of side walking training combined with squats among stroke patients. Methods: Thirty patients with stroke were randomly divided into an experimental group (n=15) that underwent side walking training combined with squats and a control group (n=15) that performed general rehabilitation exercises. Both groups performed their respective exercises for 30 minutes, five times a week for six weeks. Balance was assessed using the functional reach test and timed up and go test, while gait ability was evaluated using the 10-meter walk test. A paired t-test was performed to compare within-group changes before and after the intervention. Differences between the experimental and control groups were analyzed using an independent t-test. For all tests, the level of statistical significance was set at α=0.05. Results: After the exercise, significant within-group improvements in balance and gait ability were observed in both the experimental and control groups (p<0.05). There was also a significant between-group difference in balance and gait ability following the intervention (p<0.05). Conclusion: While general rehabilitation is commonly employed in treating stroke patients and is relatively effective, the application of side walking training combined with squats may offer additional benefits in terms of improving balance and gait ability in these patients.

Purpose: Ankle instability is a common issue in both daily activities and sports, often leading to recurrent injuries. Elastic taping is a non-pharmacological intervention used to improve ankle stability. This study aimed to investigate the immediate effects of elastic taping on ankle stability, center of pressure (COP) movement, and foot pressure distribution. Methods: A single-group pre-posttest design was employed, with 30 participants included in the study. Plantar pressure and COP parameters were measured before and after the application of elastic taping. Taping was administered in three distinct patterns to enhance ankle stability. Results: Immediate effects of elastic taping were evident in COP parameters. Following taping application, there was a significant decrease in COP total displacement, COP area, and COP velocity. However, no significant changes were observed in plantar pressure parameters. Conclusion: The application of elastic taping in this study demonstrated immediate effects on ankle stability and COP parameters, indicating its potential as a viable intervention for improving balance. Further research with larger sample sizes and long-term follow-up is needed to elucidate the sustained effects of elastic taping on ankle stability.

Purpose: The purpose of this study is to compare lower extremity muscle activities and ankle joint angles between different foot strike patterns (forefoot strike, heelfoot strike) during stair ascent walking. Methods: The subjects of this study were 22 males who walked in each foot strike pattern on ascent stairs at a speed of 85 beats/min. During stair walking with the two types of foot strike patterns, the muscle activities of the rectus femoris, tibialis anterior, medial gastrocnemius, hamstring, and gluteus medius were measured. Additionally, ankle joint angles for inversion, eversion, dorsi flexion, and plantar flexion were recorded. Each participant underwent the experiment three times, with the foot strike pattern randomized. Results were averaged according to the foot strike pattern. Results: Significant differences in ankle angles were observed across all phases according to foot strike pattern. Muscle activities in the lower extremities showed significant differences in all phases except the swing 1 phase. Moreover, differences in foot movement trajectory were noted depending on the foot strike pattern. Conclusion: Walking on ascent stairs elicited differences in lower extremity muscle activities and ankle joint angles based on foot strike pattern. These findings can serve as foundational data for selecting a suitable foot strike pattern tailored to individual patient conditions when training patients in walking on ascent stairs.

Purpose: Falls among persons older than 65 years are a significant concern due to their frequency and severity. This study aimed to develop a vest-type embedded artificial intelligence (AI) system capable of detecting and predicting falls in various scenarios. Methods: In this study, we established and developed a vest-type embedded AI system to judge and predict falls in various directions and situations. To train the AI, we collected data using acceleration and gyroscope values from a six-axis sensor attached to the seventh cervical and the second sacral vertebrae of the user, considering accurate motion analysis of the human body. The model was constructed using a neural network-based AI prediction algorithm to anticipate the direction of falls using the collected pedestrian data. Results: We focused on developing a lightweight and efficient fall prediction model for integration into an embedded AI algorithm system, ensuring real-time network optimization. Our results showed that the accuracy of fall occurrence and direction prediction using the trained fall prediction model was 89.0% and 78.8%, respectively. Furthermore, the fall occurrence and direction prediction accuracy of the model quantized for embedded porting was 87.0 % and 75.5 %, respectively. Conclusion: The developed fall detection and prediction system, designed as a vest-type with an embedded AI algorithm, offers the potential to provide real-time feedback to pedestrians in clinical settings and proactively prepare for accidents.

Purpose: The purpose of this study was to investigate the effects of three relaxation techniques, namely, Static Stretching Exercise (SSE), Eccentric Contraction Exercise (ECE), and Suboccipital Muscle Release (SMR) on the flexibility and balance of the lower limb in adults with hamstring shortening. Methods: The participants were 45 adults in their 20s with hamstring shortening. They performed three exercises (i.e., SSE, ECE, and SMR) for two weeks. We measured flexibility, muscle tone and stiffness, proprioception, and balance before and after the intervention, applying each relaxation technique. Data were analyzed using two-way repeated measures analysis of variance (ANOVA). The significance level was set at α=0.05. Results: Flexibility increased in the SSE, ECE, and SMR groups, with the SSE group showing the greatest improvement. Muscle tone and stiffness decreased in all groups, with the ECE group exhibiting the highest reduction. Proprioception increased in the SSE, ECE, and SMR groups, with SSE demonstrating the greatest enhancement. Balance also increased in all groups, with the ECE group showing the most pronounced improvement. Conclusion: Overall, all three relaxation techniques for hamstring shortening resulted in improved flexibility, muscle tone and stiffness, proprioception, and balance of the lower limb in adults with hamstring shortening. The findings of this study underscore the importance of selecting an appropriate technique according to the purpose of treatment and the condition of the patient.

Purpose: The purpose of this study is to compare the effects of proprioceptive neuromuscular facilitation (PNF) stretching, based on ballistic stretching and the contract-relax technique, on hip joint flexibility and muscle tone in adults with shortened rectus femoris muscles. Methods: The study involved 40 adults with shortened rectus femoris muscles, identified using the modified Thomas test. Participants were randomly divided into two groups: PNF stretching, employing the contract-relax technique, and ballistic stretching. Measurements included muscle tension, hip joint range of motion, and muscle characteristics. The rectus femoris muscle shortening effect was confirmed by the modified Thomas test, while the flexibility effect was assessed through hip joint motion range. The muscle tension effect was determined using Myoton-PRO. Results: Both stretching methods resulted in significant improvements in modified Thomas test angles and frequency, with the PNF stretching group showing notably greater changes. However, neither stretching method significantly affected decrement or stiffness measurements. These findings suggest that PNF stretching may be more effective for certain outcomes compared to ballistic stretching. Conclusion: In summary, both stretching methods positively influenced flexibility and muscle tension, with PNF stretching showing a greater impact. These findings highlight the importance of selecting the appropriate stretching technique for achieving functional improvements in muscles, which could serve as valuable indicators for preventing and treating muscle injuries in both sports and daily activities.

Purpose: This study examined the perceived quality of life of families of individuals with developmental disabilities who regularly participate in physical activities. It also explored differences in the quality of family life based on variables such as family relationships, family income, gender, disability type, and age. Methods: A survey was administered to 69 family members of individuals with developmental disabilities who regularly participate in physical activities. The collected data were analyzed using descriptive statistics, independent samples t-test, and one-way analysis of variance. Results: The average overall quality of life for families of individuals with developmental disabilities who participate in continuous physical activities was 3.49. After analyzing each subtype, psychological health was found to be 3.91, the burden for people with developmental disabilities was 2.75, community participation was 3.76, cohesion was 3.83, and openness was 3.49. No statistically significant differences were found in family relationships or family classes, disability type, age, or gender of the individuals with developmental disabilities across the variables. Conclusion: When planning service development and support to improve the quality of life for families of individuals with developmental disabilities, it is necessary to develop systematic programs at the family level rather than providing support based on various variables.

Purpose: Backward walking has shown positive effects on gait recovery in rehabilitation patients. It is increasingly used as an aerobic training method in rehabilitation populations, inducing more sensory and motor stimulation than forward walking. Therefore, the purpose of this study is to investigate the effects of visual stimulation during backward walking. Methods: Twenty-seven healthy adults with a visual acuity of 0.8 or higher participated in the study. To compare the effects of visual stimulation during various walking conditions among healthy individuals, the participants randomly selected cards numbered one to six and walked a distance of 10 meters. Walking ability was measured using Optogait. Results: Statistically significant differences were observed in speed, stride, and percentages of single support and contact phase during backward walking. Within eyes-closed conditions during backward walking, significant differences were found in percentages of single support, terminal stance, and contact phase. Moreover, the percentage of terminal swing significantly differed during backward walking with head turn conditions. Conclusion: Gait parameters such as speed, stride, and percentages of single support and contact phase were higher during backward walking than forward walking. These results indicate that backward walking involves multiple sensory systems and varying conditions.

Purpose: The purpose of this study was to investigate physical activity as a risk factor for neck pain recurrence using the National Health Insurance Data Sharing Service that utilizes a nationwide cohort in South Korea. Methods: Medical records spanning a two-year period were extracted from the National Health Insurance database for 541,937 patients who sought healthcare services for neck pain (ICD 10 codes: M54.2) in 2020 and completed the national health examination survey. Selected variables for analysis included age, gender, health insurance premium decile, regional health vulnerability index, body mass index (BMI), acuity, blood pressure, and types of physical activity. A mixed-effect multivariate logistic regression analysis was conducted to examine the recurrence rate of neck pain and identify risk factors for neck pain recurrence. Results: Among the participants, 124,433 patients (23.0%) experienced a recurrence of neck pain within two years, with higher recurrence rates observed among older individuals and females. Regression analysis revealed that the risk of neck pain recurrence increased with age (OR=1.51), being female (OR= 1.10), being a medical aid recipient (OR=1.51), and having anaerobic (OR=1.04) or vigorous physical activities (OR=1.06). By contrast, an increased health insurance premium decile (OR=0.96) and having moderate physical activity (OR=0.97) were associated with a decreased risk of neck pain recurrence. Conclusion: This study highlights the importance of moderate physical activity as an effective strategy for reducing the recurrence of nonspecific neck pain, underscoring the necessity for personalized physical activity programs for patients.

Purpose: This study aimed to investigate the effects of eccentric training applied to the calf muscles on muscle tone, muscle strength, and gait variables in patients with chronic stroke. Methods: Twenty-two participants were divided into experimental (n=12; eccentric training) and control (n=10; static stretching and stretching board) groups. The participants completed 30-minute physical therapy sessions five times a week for three weeks. Calf muscle tone, muscle strength, and gait variables were measured using MyotonPRO, a hand-held dynamometer, and Optogait, respectively, before and after each intervention. Results: Two-way analysis of variance (ANOVA) indicated a significant interaction effect between measurement points and groups in frequency, stiffness, and decrement of the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05). Paired t-tests showed that the experimental group exhibited significantly decreased frequency and stiffness scores for the lateral gastrocnemius, medial gastrocnemius, and soleus muscles (p<.05), as well as significantly increased decrement and muscle strength scores, gait speed, step length, and stride length (p<.05). Conclusion: The application of eccentric training to the calf effectively reduced muscle tone, increased muscle strength, and improved the gait speed, step length, and stride length of patients with chronic stroke.

Purpose: The aim of this study was to investigate and compare the risk factors focusing on the neck and lower back between general workers (GW) and mild intellectual disability workers (MIDW) in the automobile manufacturing industry. Methods: A total of 32 participants were required for this study design to achieve 80% power, 0.9 effect size, and an alpha level of 0.05. Each group consisted of 16 subjects, including GW and MIDW. Pain levels in the neck and lower back were measured for all participants using the visual analog scale (VAS). A dual digital inclinometer was used to measure the range of motion (ROM) in the neck and lower back three times, and the average was used for analysis. The independent t-test was used to compare between the wo groups. Cohen's d effect analysis was employed to determine the effect size. The significant level was set at 0.05. Results: In the MIDW, neck pain was significantly higher, and left cervical flexion was significantly decreased compared with the GW. There was no significant difference in lower back pain between the MIDW and GW. However, both lumbar flexion and extension, as well as lateral flexion, were significantly reduced in the MIDW compared with the GW. Conclusion: This study reveals that MIDW working in the automobile manufacturing industry have a greater risk of neck pain, limitation in left cervical flexion, and overall restriction in the ROM of the lower back compared with GW.

Purpose: This study aimed to investigate the effects of gradually increasing treadmill inclination on the electroencephalogram (EEG) of stroke patients during gait training. Methods: Three stroke patients who were diagnosed with stroke within six months and capable of walking on a treadmill were selected as subjects. EEG electrodes were attached at Fp1, Fp2, F3, F4, C3, C4, P3, and P4 positions of the cerebral hemispheres using the International 10-20 system. The intervention involved walking for 2 minutes each at 0 degrees, 15 degrees, and 30 degrees inclination on the treadmill while focusing on a target point located in front during the treadmill gait training. The EEG (Smartingmobi, Serbia) generated when the treadmill gradient gradually increased was measured. In addition, relative alpha and relative beta waves were visualized through the Brain mapping program in the TeleScan program to assess the changes in each brain region for the activity of the EEG. Results: The relative alpha wave value decreased as treadmill inclination increased, while the relative beta wave value increased. Conclusion: Gradually increasing the inclination during treadmill gait training appears to be a crucial parameter for increasing the brain activity levels of stroke patients.

Purpose: The present study investigated how variations in diagonal exercises affect shoulder muscle activity, examining changes in neuromuscular activation during scapular and shoulder diagonal patterns of exercises. Furthermore, we explored whether the exercise phase affects muscle activation. Methods: Sixteen asymptomatic male participants were recruited. Four diagonal pattern exercises (scapular anterior elevation, posterior elevation, flexion-adduction-external rotation, flexion, abduction-external rotation), and two exercise phases (concentric and eccentric) were administered. Surface electromyography data were collected. Results: Upper trapezius activity was significantly higher during the concentric phase of scapular posterior elevation exercises compared with the others (p<0.05). The serratus anterior, anterior deltoid, and infraspinatus activities were significantly higher during shoulder diagonal pattern exercises compared with the scapular diagonal pattern exercises (p<0.05). Except for the lower trapezius, muscular activities during the concentric phase were significantly greater compared with the eccentric phase (p<0.05). Conclusion: The current study suggests that the diagonal pattern of exercise may contribute to selective strengthening of the shoulder complex muscles and that the form of exercise should be tailored to the subject. It also suggests that diagonal exercises with concentric contractions tend to be more beneficial than eccentric contractions for overall muscle recruitment, but the effects vary for specific diagonal patterns.