• The Journal of Korean Physical Therapy
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• v.30 no.2
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• pp.63-66
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• 2018

Purpose: The purpose of the current study was to examine the effects of exercise-induced fatigue of the plantar flexor muscle in the dominant ankle on the plantar flexor strength and postural control function of the contra-lateral side. Methods: Twenty-one young adults (male: 10, female: 11) volunteered to participate in this study. An exercise-induced fatigue protocol to induce fatigue was performed in the plantar flexor of the dominant ankle. For the fatigue protocol, the participants were instructed to raise their heels as high as possible in the position with one leg stance of the dominant lower limb, and the heel was then downed after holding for 1 second. The muscle strength of the contra-lateral plantar flexor was measured using a digital muscle strength test device, and the static and dynamic postural control were tested by acquiring the center of gravity velocity while performing one leg standing. A paired t-test was used to identify the differences between the pre- and post, and the data were analyzed using SPSS 12.0 software. Results: Comparison of the pre- and post-test data revealed a significant difference in the plantar flexor strength and dynamic postural control after exercise-induced muscle fatigue in the dominant side. On the other hand, there was no significant difference in the static postural control. Conclusion: These findings have practical implications, suggesting that unilateral muscle fatigue affects the ankle muscle strength and postural ability of the contralateral side.

• 재활복지
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• v.14 no.3
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• pp.225-256
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• 2010

This study aims to provide the basic data of the rehabilitation program for the schoolchild with intellectual disability by designing new framework of the features of postural control for the schoolchild with intellectual disability. For this, the study investigated what sensations the schoolchild are using to maintain posture by selectively or synthetically applying vision, vestibular sensation and somato-sensation, and how the coordinative sensory system of the schoolchild is responding to any sway referenced sensory stimulus. The study intended to prove the limitation of motor system in estimating the postural stability by providing the cognitive motor task, and provided the features of postural control of the schoolchild with intellectual disability by measuring the onset times and orders of muscle contraction of neuron-muscle when there is a postural control taking place due to the exterior disturbance. Furthermore, by comparatively analyzing the difference between the normal schoolchild and the intellectually disabled schoolchild, this study provided an optimal direction for treatment planning when the rehabilitation program is applied in the postural control ability training program for the schoolchild with intellectual disability. Taking gender and age into consideration, 52 schoolchild including 26 normal schoolchild and 26 intellectually disabled schoolchild were selected. To measure the features of postural control, CTSIB test, and postural control strategy test were conducted. The result of experiment is as followed. First, the schoolchild with intellectual disability showed different feature in using sensory system to control posture. The normal schoolchild tended to depend on somato-sensory or vision, and showed a stable postural control toward a sway referenced stimulus on somato-sensory system. The schoolchild with intellectual disability tended to use somato-sensory or vision, and showed a very instable postural control toward a sway referenced vision or a sway referenced stimulus on somato-sensory system. In sensory analysis, the schoolchild with intellectual disability showed lower level of proficiency in somato-sensation percentile, vision percentile and vestibular sensation percentile compare to the normal schoolchild. Second, as for the onset times and orders of muscle contraction for strategies of postural control when there is an exterior physical stimulus, the schoolchild with intellectual disability showed a relatively delayed onset time of muscle control, and it was specially greater when the perturbation is from backward. As for the onset orders of muscle contraction, it started from muscles near coax then moved to the muscles near ankle joint, and the numbers and kinds of muscles involved were greater than the normal schoolchild. The normal schoolchild showed a fast muscle contracting reaction from every direction after the perturbation stimulus, and the contraction started from the muscles near the ankle joint and expanded to the muscles near coax. From the results of the experiments, the special feature of the postural control of the schoolchild with intellectual disability is that they have a higher dependence on vision in sensory system, and there was no appropriate integration of swayed sensation observed in upper level of central nerve system. In the motor system, the onset time of muscle contraction for postural control was delayed, and it proceeded in reversed order of the normal schoolchild. Therefore, when use the clinical physical therapy to improve the postural control ability, various sensations should be provided and should train the schoolchild to efficiently use the provided sensations and use the sensory experience recorded in upper level of central nerve system to improve postural control ability. At the same time, a treatment program that can improve the processing ability of central nerve system through meaningful activities with organizing and planning adapting reaction should be provided. Also, a proprioceptive motor control training program that can induce faster muscle contraction reaction and more efficient onset orders from muscularskeletal system is need to be provided as well.

• Transactions of the Korean Society of Mechanical Engineers A
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• v.33 no.1
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• pp.27-33
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• 2009

Human postural responses appeared to have stereotyped modality, such as ankle mode, knee mode and hip mode in response to various perturbations. We examined whether human postural control gain of full-state feedback could be decoupled along with the eigenvector. To verify the model, postural responses subjected to fast backward perturbation were used. Upright posture was modeled as 3-segment inverted pendulum incorporated with feedback control, and joint torques were calculated using inverse dynamics. Postural modalities such as ankle, knee and hip mode were obtained from eigenvectors of biomechanical model. As oppose to the full-state feedback control, independent eigenvector control assumes that modal control input is determined by the linear combination of corresponding modality. We used optimization method to obtain and compare the feedback gains for both independent eigenvector control and full-state feedback control. As a result, we found that simulation result of eigenvector feedback was not competitive in comparison with that of full-state feedback control. This implies that the CNS would make use of full-state body information to generate compensative joint torques.

• Journal of Biomedical Engineering Research
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• v.30 no.6
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• pp.495-502
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• 2009

This paper investigated the effects of dynamic postural control for maintaining upright standing on a support surface during continuous sinusoidal horizontal translation in anterior-posterior direction. 15 healthy young subjects participated in this experiment. The analysis of body movement was analyzed using Ariel Performance Analysis System. Motion pattern was analyzed by seven markers on subject's body. Position of markers were head, chest, hip, right knee, left knee, right ankle and left ankle. Seven different frequencies of support surface were employed ; 0.1, 0.25, 0.5, 0.75, 1, 1.5 and 2Hz at 2cm of moving path of motionbase. The experiments were performed dynamic postural reponses at the condition of eye open. The results showed that median frequency of the knee, ankle were increased in all frequency bands. Following the frequency of perturbation increased, postural control strategy was changed from ankle strategy to combined strategy. The experiment results could be applied to the dynamic postural training for the elderly and the rehabilitation training for the patients to improving the ability of postural control.

• Physical Therapy Korea
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• v.16 no.4
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• pp.23-30
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• 2009

Core stability exercises for patients with hemiplegia have become increasingly important and a variety of exercises have been developed over the years to give the hemiplegic patients more stable postural control. This study examined the therapeutic effects of the core stability exercises on the ability of static and dynamic postural control. Fifteen hemiplegic patients (7 males, 8 females, age ranging from 46 to 76 years) hospitalized in a Daejoen rehabilitation hospital were enrolled in this study. Nine and 6 patients had a cerebral infarction and cerebral hemorrhage, respectively. The subjects participated in a core stability exercise program consisting of a total of 12 sessions 3 times each week over a 4-week period with each exercise lasting approximately 15 minutes. The ability of static and dynamic postural control by Berg Balance Scale (BBS) and Timed Up and Go (TUG), respectively, were measured before and after the core stability exercise. A Wilcoxon signed ranks test was used to compare the effects of the ability of static and dynamic postural control before and after core stability exercise in patients with hemiplegia. The ${\alpha}$=.05 level of significance was used for the statistical tests. Core stability exercises were effective in improving the ability of static postural control; BBS (p<.05). Core stability exercises were also effective in improving the ability of dynamic postural control; TUG (p<.05). Overall, core stability exercise is believed to be an important therapeutic method in rehabilitation programs for hemiplegic patients.

• Physical Therapy Korea
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• v.19 no.3
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• pp.40-50
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• 2012

The purpose of this study was to investigate the effect of visual feedback on the postural control of stroke patients, by systematically varying conditions of visual feedback [eye-open condition (EO) vs. eye-closed condition (EC)], and base-support (both-side support, affected-side support, and unaffected-side support). In this study, we allocated 41 stroke patients with no damage in the cerebellum and visual cortex who can walk at least 10 meters independently, and 35 normal adults who have no experience of stroke to the control group. Both groups were asked to perform a "sit-to-stand" task three to five times, and their postural control ability was measured and compared in terms of asymmetric dependence (AD) instead of the traditional symmetric index (SI) in the literature. The results showed that although both subject groups maintained better postural control in the EO condition than in the EC condition, the patient group appeared to be more stable in EC than in EO when they were required to perform the task of the support condition given on the affected side. These results implied that visual feedback can impair stroke patients' postural control when it is combined with a specific support condition.

• Journal of the Korean Society of Physical Medicine
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• v.4 no.3
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• pp.193-200
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• 2009

Purpose：In this study is to verify the effects postural control training based on Bobath approach for body schema and visual perception on Middle Cerebral Artery(MCA) Infarcts. Methods：The subject was a 46 years old man with MCA infaction, lives in B city. An AB design for a single-subject research was used for this study. The procedures consisted of 1 time of baseline phase(A), 20 times of treatment phase(B). We applied the Bobath approach at the subject. Treatments included to facilitate trunk alignment and stability, and to train weight bearing and shifting, to facilitate pelvis movement, and to train walk especially stance phase and assist up-down stairs locomotion in environment similar to actual daily life. Results：With this treatment, the majority of body schema and visual perception and postural control was improved in treatment phase compared with in baseline phase. Therefore, this study supported the effectiveness of postural control training based on Bobath approach for body sechma and visual perception of hemiplegia. Conculusion：This study is integrated postural control training with Bobath approach that are widespread for hemiplegia and measured outcomes based on individualized therapy goals. Consequently the study is suggested the meaning of quality effectiveness of Bobath approach.

• Journal of Korean Physical Therapy Science
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• v.9 no.3
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• pp.97-106
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• 2002

Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

• The korean journal of orthodontics
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• v.21 no.3
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• pp.521-541
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• 1991

The purpose of this study was to investigate the growth changes of the mandible and associated structure in response to postural hyperpropulsion and changes after removal of postural hyperpropulsor. The experimental animals were four-week-old Sprague-Dawley males rats. The animals were worn the postural hyperpropulsor diurnally for 10 hours per day. The animals were sacrified after 1-week, 2-week, 4-week postural hyperpropulsion and 4-week postural hyperpropulsion 4-week removal period. The growth changes of rat mandible and associated structures following postural hyperpropulsion on the growing rat mandible were observed biometrically, radiographically and histologically. The finding were as follows. 1. The angle between the chief axis of the bone trabeculae in the condyle and the mandibular plane of rats observed for 4 weeks after worn the hyperpropulsor for 4 weeks was directed posteriorly as compared with that of control rats. 2. The ratio of mandibular length to maxillary length of experimental rats was higher than that of control rats. 3. The tooth axis of mandibular first molar of rats worn the postural hyperpropulsor for 4 weeks was mesially inclined as compared with control rats. 4. Histologically, the cartilage layer at the superior region of the condyle of rats worn the postural hyperpropulsor for 2 weeks appeared thicker than that of same aged normal rats, and generalized increase of the cartilage layer was shown on the condyle of rats worn the postural hyperpropulsor for 4 weeks. 5. There was no significant histologic difference between rats observed for 4 weeks after worn the postural hyperpropulsor for 4 weeks (8 week experimental rats) and same aged normal rats. 6. The newly formed bone at anterior region of articular fossa of rats worn the postural hyperpropulsor for 2 weeks and 4 weeks was thicker than that of same aged normal rats.

• Physical Therapy Korea
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• v.26 no.3
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• pp.57-66
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• 2019

Background: Visual and somatosensory integration processing is needed to reduce pusher behavior (PB) and improve postural control in hemiplegic patients with acute stroke. Objects: This study aimed to investigate the effects of game-based postural vertical training (GPVT) on PB, postural control, and activity daily living (ADL) in acute stroke patients. Methods: Fourteen participants with acute stroke (<2 months post-stroke) who had PB according to the Burke lateropulsion scale (BLS) (score>2) were randomly divided into the GPVT group ($n_1=7$) and conventional postural vertical training (CPVT) group ($n_2=7$). The GPVT group performed game-based postural vertical training using a whole-body tilt apparatus. while the CPVT group performed conventional postural vertical training to reduce PB (30 minutes/session, 2 times/day, 5 days/week for 3 consecutive weeks). The BLS was evaluated to assess the severity of PB. And each subject's postural control ability and ADL level were assessed using the postural assessment scale for stroke (PASS), balance posture ratio (BPR), and Korean-modified Barthel index (K-MBI). Outcomes were measured pre- and post-intervention. Results: Comparison of the pre- and post-intervention assessment results showed that both interventions led to the following significant changes: decreased severity of PB scores and increased PASS, BPR, and K-MBI scores (p<.05). In particular, statistical analysis between the two groups, the BLS score was significantly decreased in the GPVT group (p<.05). And PASS, BPR, and K-MBI scores were significantly improved in the GPVT group than in the CPVT group (p<.01, respectively). Conclusion: This study demonstrated that GPVT lessened PB severity and improved postural control ability and ADL levels in acute stroke patients.