• The Journal of Korean Physical Therapy
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• v.20 no.3
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• pp.9-18
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• 2008

Purpose: We determined the effect of global synkinesis(GS) on gait ability, muscle contraction, and central neuron action potentials in post-stroke hemiplegic subjects. Methods: Thirty hemiplegia patients were evaluated for walking ability, muscle contraction, central neuron action potential, and comparing differences between the H-GS(high-global synkinesis) group and L-GS(low-global synkinesis) group. To obtain the GS level, surface electromyography(EMG) data were digitized and processed to root mean square(RMS). Walking ability was tested with a modified motor assessment scale(MMAS), a 10 m walking test, timed up and go(TUG) test, and a Fugl-Meyer assessment(FMA). Muscle contraction ability was measured as maximal isometric contraction(MIC) peak, MIC slope, and MIC ramp up using mechanomyography(MMG). Central neuron action potential was measured as the H/Mmax ratio or V/Mmax ratio using EMG. The data were analyzed with t-tests to determine the statistical significance. Results: MMAS(p<0.01), 10 m walking velocity(p<0.01), TUG(p<0.01), FMA-HKA(Hip, Knee, Ankle)(p<0.05), FMA-coordination(p<0.05), MIC peak (p<0.05), MIC slope(p<0.01), and MIC ramp up(p<0.05) were significantly different between H-GS and L-GS, as was the V/Mmax ratio(p<0.05), but H/Mmax was not. Conclusion: Lower GS levels indicated better walking ability and motor function. Therefore, intervention programs should consider GS levels in gait training of chronic hemiplegia.

• Journal of Institute of Control, Robotics and Systems
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• v.21 no.6
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• pp.538-546
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• 2015

This paper describes an intelligent ankle assistive robot which provides assistive power to reduce ankle torque based on an analysis of ankle motion and muscle patterns during walking on level and sloped floors. The developed robot can assist ankle muscle power by driving an electric geared motor at the exact timing through the use of an accelerometer that detects gait phase and period, and a potentiometer to measure floor slope angle. A simple muscle assistive link mechanism is proposed to convert the motor torque into the foot assistive force. In particular, this mechanism doesn't restrain the wearer's ankle joint; hence, there is no danger of injury if the motor malfunctions. During walking, the link mechanism pushes down the top of the foot to assist the ankle torque, and it can also lift the foot by inversely driving the linkage, so this robot is useful for foot drop patients. The developed robot and control algorithm are experimentally verified through walking experiments and EMG (Electromyography) measurements.

• The Journal of Advanced Prosthodontics
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• v.4 no.2
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• pp.61-71
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• 2012

PURPOSE. To compare the changes in the occlusal vertical dimension, activity of masseter muscles and biting force after insertion of immediate denture constructed with conventional, tooth-supported and Implant-supported immediate mandibular complete denture. MATERIALS AND METHODS. Patients were selected and treatment was carried out with all the three different concepts i.e, immediate denture constructed with conventional (Group A), tooth-supported (Group B) and Implant-supported (Group C) immediate mandibular complete dentures. Parameters of evaluation and comparison were occlusal vertical dimension measured by radiograph (at three different time intervals), Masseter muscle electromyographic (EMG) measurement by EMG analysis (at three different positions of jaws) and bite force measured by force transducer (at two different time intervals). The obtained data were statistically analyzed by using ANOVA-F test at 5% level of significance. If the F test was significant, Least Significant Difference test was performed to test further significant differences between variables. RESULTS. Comparison between mean differences in occlusal vertical dimension for tested groups showed that it was only statistically significant at 1 year after immediate dentures insertion. Comparison between mean differences in wavelet packet coefficients of the electromyographic signals of masseter muscles for tested groups was not significant at rest position, but significant at initial contact position and maximum voluntary clench position. Comparison between mean differences in maximum biting force for tested groups was not statistically significant at 5% level of significance. CONCLUSION. Immediate complete overdentures whether tooth or implant supported prosthesis is recommended than totally mucosal supported prosthesis.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.2
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• pp.41-52
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• 2016

PURPOSE: This study was conducted to compare the levels of usage of the superficial neck muscles during head rotation in forward head posture and in multimodal postures for improvement of cervical rotation movement impairment. METHODS: To acquire electromyography (EMG) signals from the sternocleidomastoid (SCM-M), upper trapezius (UPT-M), and the splenius capitis (SPC-M) muscles, 11 subjects practiced right rotation of the head in forward head postures (FHP), upright sitting postures (USP), upright sitting postures with supported arms (SUP), standing postures with the arms leaning against the wall (WSP), and four feet postures (FFP), respectively. RESULTS: The left SCM-M was used significantly more in the FFP compared to the FHP, but not in other postures (p<0.01). The left UPT-M was used significantly more in all postures other than the FHP. The right SPC-M was used significantly more in the FFP (p<0.001) and significantly less (p<0.05) in the SUP compared to the FHP. CONCLUSION: During the rotation of the head, although the usage of the SPC-M significantly decreased in SUP compared to FHP but the usage of the SCM-M and UPT-M did not decrease significantly in other postures compared to FHP. Further research is necessary to prove the hypothesis that special postures may reduce the activity of the superficial neck muscles during head rotation.

• Physical Therapy Korea
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• v.23 no.4
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• pp.9-15
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• 2016

Background: Squatting is one of the best functional exercises to strengthen the quadriceps muscle in independent gait and activities of daily living. Although the use of a gym ball during squat exercise is the most common way of strengthening the vastus medialis oblique (VMO) muscle, published data on this subject are limited. Objects: The purpose of this study was to compare the sequential muscle activation of the VMO and vastus lateralis (VL) muscles during squat exercise using a gym ball at different knee flexion angles. Methods: Forty healthy adults were randomly divided into experimental (squat exercise using a gym ball) and control (squat exercise alone) groups, in which squats were performed at $45^{\circ}$ and $90^{\circ}$ knee flexion. Electromyographic (EMG) activity data were collected over 10 seconds under the 2 angles of knee flexion ($45^{\circ}$ and $90^{\circ}$). Results: There was significant group and time interaction effect for VMO and VL muscle activation at $45^{\circ}$ knee flexion. This was similarly demonstrated at $90^{\circ}$ knee flexion. No significant group main effect and time main effect for VMO and VL muscle activation were noted at $45^{\circ}$ knee flexion, respectively. In contrast, there was significant group main effect and time main effect for VMO and VL muscle activation at $90^{\circ}$ knee flexion. These significant differences were demonstrated through two-way analysis of variance over repeated measurements, suggesting that the EMG activity of the VMO muscle during squatting with a gym ball showed remarkable improvement compared to that of the VL muscle. Conclusion: This research suggests that squat exercise using a gym ball may be more beneficial in improving the activity of VMO than of the VL muscle at both $45^{\circ}$ and $90^{\circ}$ of knee flexion, respectively. We highly recommend squat exercises with a gym ball for selective strengthening of the VMO muscle in knee rehabilitation.

• Physical Therapy Korea
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• v.24 no.4
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• pp.77-83
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• 2017

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. Although the side-lying wiper exercise (SWE) is the most effective shoulder external rotation exercise to maximize infraspinatus activity, the effect of adduction force on the infraspinatus and posterior deltoid has not been demonstrated. Objects: This study was conducted to investigate whether horizontal adduction force increases infraspinatus activity and decreases posterior deltoid activity. Methods: Twenty-eight healthy subjects (male: 21, female: 7; $age=23.5{\pm}1.8years$; $height=170.1{\pm}7.4cm$; $weight=69.4{\pm}9.6kg$) were recruited. Subjects were asked to perform the SWE under two conditions: (1) general SWE and (2) SWE with adduction force using pressure biofeedback. Surface electromyography (EMG) signals of the infraspinatus and posterior deltoid were recorded during SWE. Paired t-tests were used to compare the EMG activity of the infraspinatus and posterior deltoid between the two conditions. Results: Posterior deltoid muscle activity was significantly decreased following SWE with adduction force ($7.53{\pm}4.52%$) relative to general SWE ($11.68{\pm}8.42%$) (p<.05). However, there was no significant difference in the infraspinatus muscle activity between the SWE with adduction force ($28.33{\pm}12.16%$) and the general SWE ($26.54{\pm}13.69%$) (p>.05). Conclusion: Horizontal adduction force while performing SWE is effective at decreasing posterior deltoid activity.

• Physical Therapy Korea
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• v.14 no.4
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• pp.50-57
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• 2007

The purpose of this study was to investigate the relationship between delays in initiation and termination of tibialis anterior contraction through surface electromyographic (sEMG) analysis in adults with hemiplegia and healthy subjects and clinical assessment of lower-limb mobility. EMG activity of 6 long-term survivors of stroke and 5 healthy subjects was recorded during maximal isometric ankle dorsiflexion in 3 seconds beeper signals. It must be done as fast and forcefully as possible. Lower limb mobility was assessed with Modified Emory Functional Ambulation Profile (mEFAP). Delay in initiation and termination of muscle contraction was significantly prolonged in the affected lower limb relative to the unaffected limb. Termination of muscle contraction in the hemiplegic lower limb was significantly delayed than the initiation on the affected sides. Delay in initiation and termination of muscle contraction correlated significantly with a few range of mEFAP. Abnormally delayed initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in hemiparetic patients. Consequently, this study showed that abnormal delay of initiation and termination of muscle contraction may contribute to hemiparetic lower limb mobility in adults with hemiplegia. Further studies are needed to demonstrate a treatment effect.

• The Journal of Korean Physical Therapy
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• v.21 no.1
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• pp.1-7
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• 2009

Purpose: The aim of this study was to determine the effect of proprioceptive neuromuscular facilitation (PNF) leg patterns on muscle activation of paretic and nonparetic arm in post-stroke hemiparetic subjects. Methods: Eighteen hemiparetic patients participated in this study. Each subject was asked to perform four PNF leg patterns against maximal manual resistance on nonparetic leg. EMG data were collected from biceps and triceps on the paretic and nonparetic side. The measured EMG data was digitized and processed to root mean square (RMS) and expressed as percentage maximal voluntary isometric contraction (％MVIC). The data were analyzed using paired t-test and one-way analysis of variance (ANOVA) with repeated measures to determine the statistical significance. Results: The results of this study were summarized as follows: Firstly, during four PNF patterns application, all of the ％MVIC values of biceps and triceps in paretic and nonparetic arms increased significantly compared with resting condition (p<0.05). Secondly, there was a significant difference in ％MVIC of paretic biceps between PNF leg pattern 1 and 4 (p<0.05). Conclusion: In conclusion, regardless of the kinematic components of PNF leg patterns, all of the muscle activation of biceps and triceps in paretic and nonparetic arm was significantly increased. The finding of this study indicates that irradiation effect caused by PNF leg patterns is beneficial for increased muscle activation of both paretic and nonparetic arms in post-stroke patients.

• The Journal of Korean Physical Therapy
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• v.29 no.3
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• pp.128-134
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• 2017

Purpose: The purpose of this study is to investigate the effects of healthy persons performing a plank exercise with hip abduction and use of sling on trunk muscle activity. Methods: Twenty-three subjects participated in this study. Muscle activities of the multifidus, rectus abdominis, external oblique and internal oblique were assessed with electromyography (EMG) while the subjects performed 6 various types of plank exercises in random order. Results: There was a significant difference in multifidus and internal oblique on the supported side and the multifidus, external oblique, and internal oblique on the elevated side (p<0.05), and differences in plank methods were significantly higher in the multifidus, rectus abdominis, external oblique, internal oblique of the supported side and the rectus abdominis, external oblique and internal oblique on the elevated side (p<0.05). In addition, post-hoc analysis of the various plank methods showed that muscle activity was significantly higher during the general plank exercise compared with the knee-supported-in-sling plank exercises (p<0.05), and was significantly higher with the ankle-supported-in-sling plank exercises compared with the general plank exercise. Conclusion: There was greater trunk muscle activity with plank exercises performed with the ankle-supported-in-sling and hip abduction plank exercises compared with the general or knee-supported-in-sling plank exercises. Through this study, various plank exercises have been discovered that can be selected at different intensities for core muscle training purposes based on trunk muscle strength.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.17-24
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• 2009

Purpose: The purpose of this study was to investigate the effects of a combination of isotonic (CI) technique on the balance, muscle fatigue and muscle activities of the quadriceps muscle in the paretic leg of hemiplegic patients. Method: All the subjects received a combined isotonic technique of proprioceptive neuromuscular facilitation (PNF) for about 30 minutes 3 times per week for 6 weeks. The root mean square (RMS) and mid frequency (MF) were recorded by surface electromyography (EMG)(EMG/EP system, OXFORD Medelec, UK) during maximal voluntary isometric contractions (MVIC). The balance ability was measured by a balance system (BIODEX, USA). Result: The RMS of the quadriceps muscle at post-treatment was significantly increased compared to that at pretreatment (p<0.05). Yet there was no significant difference among the three muscles. There were no significant difference in the MF of the vastus lateralis and rectus femoris between pre- and post-treatment, but the MF of the vastus medialis was significantly decreased (p<0.05). There was a significant difference in the vastus medialis and lateralis between pre- and post-treatment (p<0.05). Moreover, the overall stability index at post-treatment was significantly decreased compared to that at pre-treatment (p<0.05). But there was no significant difference between the anterior/posterior and medial/lateral stability indexes. Conclusion: The results of this study indicated that a CI technique of PNF had an effect to improve the balance and muscle activity in hemiplegic patients.