• The Journal of Korean Physical Therapy
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• v.31 no.2
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• pp.122-128
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• 2019

Purpose: This study examined the effects of sagittal spinopelvic alignment on the clinical parameters, motor symptoms, and respiratory function in patients with mild to moderate Parkinson's disease (PD). Methods: This study was a prospective assessment of treated patients (n=28, Hoehn and Yahr (H&Y) stage 2-3) in a PD center. Twenty-eight subjects ($68.5{\pm}5.7yrs$) participated in this study. The clinical and demographic parameters, including age, sex, symptoms duration, treatment duration, and H&Y stage, were collected. Kinematic analysis was conducted in the upright standing posture with a motion capture system. A pulmonary function test (PFT) was performed in the sitting position using a spirometer. The motor symptoms were assessed on part III of the movement disorder society sponsored version of the unified Parkinson's disease rating scale (MDS-UPDRS). SPSS 18.0 was used to analyze the collected data. Results: The exceeding 12 degrees group of the lower trunk showed significantly higher on the clinical parameters than the below 12 degrees group. In addition, the exceeding 12 degrees group of the lower trunk showed a significantly lower forced expiratory volume at one second (FEV1) / forced vital capacity (FVC) (%) and 25-75% forced mid-expiratory flow (FEF) (L/s) than in the below group. On the other hand, there was no difference in the upper trunk and the cervical pelvis between the groups. Conclusion: These findings suggest that the sagittal balance in the lower trunk is related to the clinical parameters and respiratory function, but not the motor symptoms in patients with mild to moderate PD.

• PNF and Movement
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• v.14 no.3
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• pp.237-244
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• 2016

Purpose: This case report examines the influence of proprioceptive neuromuscular facilitation (PNF) combined with a dynamic neuromuscular stabilization approach on balance in patients with cerebellar atrophy. Methods: The target subject of this case report was a 34-year-old woman who was informed of the purpose of this research and voluntarily agreed to participate in it. The case report conformed to research ethics based on the Helsinki Declaration. The target subject was confirmed to have cerebellar atrophy from an unknown cause in 2009 and was diagnosed with slight ataxia. At that time, she could carry out daily activities without physical therapy. On May 19, 2015, she suffered both a subdural hemorrhage (SDH) and subarachnoid hemorrhage (SAH) in a traffic accident. She was urgently moved to the emergency room and managed by nonsurgical treatment, and then, the cerebellar atrophy and ataxia gradually deteriorated. To evaluate the patient's balance capacity before and after intervention, the trunk impairment scale (TIS), trunk impairment scale (OLST) during eye-closing/opening, timed up and go test (TUG), and visual analogue scale (VAS) were conducted. The PNF intervention program was executed for 30 min, four times a week, for three weeks. Results: The TIS and OLST during eye-closing/opening were improved by as much as a point, by 8.15 s and 6.21 s, respectively, after applying the PNF program. TUG and VAS decreased by 1.33 s and 3 points, respectively, after intervention. According to the result, the OLST during eye-closing/opening and VAS improved remarkably in comparison with those before intervention. Conclusion: As the final result of the case report, PNF intervention combined with DNSA more effectively improved the static balance capacity, such as the OLST during eye-closing/opening and VAS, compared to the dynamic balance capacity. In addition, the intervention duration and period of the exercise program are recommended to be more than 1 h a day for four weeks considering the learning ability of a patient with cerebellar atrophy.

• The Journal of Korean Academy of Sensory Integration
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• v.17 no.1
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• pp.9-18
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• 2019

Objective : This study investigated the effect of intensive weight shift training (IWST) on the ability to balance in a sitting posture of children with spastic cerebral palsy (SCP). Methods : One child with spastic diplegia participated in this study for a total of 8 weeks using the ABA experimental design. For the pre-intervention period (A1), general physical therapy (GPT) for children with SCP was performed. The intervention period (B1 and B2), GPT and IWST were conducted for children with SCP, and GPT was conducted again for the post-intervention period (A'1 and A'2). Trunk control capacity was measured using the Korean Trunk Control Measurement Scale (TCMS-K) and Biorescue (RM Ingenierie, France). Results : All TCMS-K variables increased from A1 to B2, and decreased from B2 to A'2. The total area with limit of stability (LOS) increased from A1 to B2, and decreased from B2 to A'2. The ratio of the left/right (Lt/Rt) and anterior/posterior (Ant/Post) LOS area was closer to 1, meaning symmetry, in B2 than in A1. The ratio of the Lt/Rt LOS area decreased further from 1 in A'2 than in B2. The ratio of the Ant/Post LOS area was closer to 1 in A'2 than in B2. Conclusion : IWST had a positive effect on the improvement of balance in the sitting posture of a child with SCP. The results suggest that IWST might help to improve the balance abilities of children with SCP for independent sitting, postural control, and activities of daily living.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.152-156
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• 2020

Purpose: The subjective visual vertical (SVV) test is used to evaluate the otolith function in the inner ear. This study compared the different balance ability according to the results of the SVV in healthy adults. Methods: This study recruited 30 normal healthy subjects who did not have neurological and musculoskeletal disorders. The subjects were divided into experimental and control groups based on the results of SVV: experimental group, >2°; control group, <2°. The static balance ability was evaluated using the Fourier Index, which could evaluate the balance capacity objectively and quantitatively. Results: The mean angle of the SVV in the experimental and control groups was 4.44° and 0.59°, respectively. In the result of the Fourier series, the F1 frequency band in the experimental group showed a significantly higher value under one condition compared to the control group (p<0.05). In the F2-4 and F5-6 frequency bands, the experimental group showed a significant increase in the Fourier series value under the four conditions compared to the control group (p<0.05). In the F7-8 frequency band, significantly higher values of the Fourier series were observed in the experimental group under the three different conditions (p<0.05). Conclusion: These results showed increased trunk sway while maintaining static balance in the experimental group who showed a larger SVV angle compared to the control group. The SVV can be applied to evaluate the vestibular system and balance ability in normal adults.

• Korean Journal of Applied Biomechanics
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• v.30 no.1
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• pp.73-81
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• 2020

Objective: The purpose of this study is to analyze the effects of aquatic walking exercise on gait and balance parameters of elderly women. Method: 15 elderly people were recruited for this study (age: 73.20±5.19 yrs, height: 153.87±3.36 cm, mass: 60.33±5.73 kg). All variables were measured using Gaitview AFA-50. The variables were the heel contact time ratio, gait angle, and M/P change ratio for gait patterns and ENV, REC, RMS, Total Length, TLC, Sway velocity, and Length/ENV for balance abilities. A paired t-test and the Wilcoxon signed-rank test were carried out to verify the differences in the test scores after participating in the water walking program. The significance level for all statistical analyses was set to α=.05. Results: As for the changes in their walking function after the exercise, heel contact time ratio (p<.01) showed a statistical significance, while gait angle and M/P change ratio did not reveal statistically significant differences. In the test of balance ability on both feet and with eyes opened, statistical significance was found in ENV, REC, RMS, TLC (p<.01), and sway velocity (p<.05), while the test with eyes closed showed statistical significance in length/ENV as well as ENV, REC, RMS, sway velocity (p<.01) TLC, and total length (p<.05). As for the single-leg stance balance ability, ENV and REC revealed statistically significant differences. Conclusion: These results show that water walking is effective for improving the function of the ankle flexor muscles, providing stability to the ankle joint during walking and helping efficient walk. In addition, it is also expected to help prevent falls due to loss of balance by improving the stability of lower extremity muscles and trunk.

• PNF and Movement
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• v.13 no.2
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• pp.73-80
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• 2015

Purpose: The purpose of this study was to determine the effect of symmetrical-reciprocal pattern of scapula and pelvis exercises using proprioceptive neuromuscular facilitation (PNF) on gait speed and balance in patients with hemiplegia. Methods: Among the adult patients with hemiplegia that were hospitalized at Michuhol Rehabilitation Center after being diagnosed with stroke, 10 that were capable of independent walking for more than five minutes and that understood and cooperated with the therapy and test methods of this research, were selected as subjects. The therapy was implemented based on the concept of PNF, and it was performed on a low mat and a height-adjustable mat, as proscribed by the fundamental procedure for PNF. Symmetrical-reciprocal pattern of scapula and pelvis exercises were applied to the patients in the decubitus position. The therapy scheme included stabilizing reversals, rhythmic stabilization, and a combination of isotonics, rhythmic initiation, and dynamic reversals. To investigate gait speed and body trunk mobility before and after the symmetrical-reciprocal pattern of scapula and pelvis exercises were applied, walking speed for a distance of 10 m was measured and balance was tested based on the Berg-Balance scale test table. The Berg-Balance scale test was performed by one therapist to minimize any error that could occur from the subjective evaluation method used by therapists. Results: Gait speed increased by 8.97 seconds after applying the symmetrical-reciprocal pattern of scapula and pelvis exercises using the concept of PNF, showing a significant difference (p<0.01). However, balance showed no significant difference after the therapy (p>0.14). Conclusion: Exercise therapy that uses the symmetrical-reciprocal pattern of scapula and pelvis with the concept of PNF can be said to be a useful therapeutic technique that can enhance the walking speed of patients with hemiplegia.

• Journal of The Korean Society of Integrative Medicine
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• v.6 no.4
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• pp.15-27
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• 2018

Purpose : This study aims to present a rehabilitation exercise and physical education program (REPEP) for local community stroke patients by examining an exercise program provided from traditional physical therapeutic perspectives. Methods : The subjects were 40 stroke patients residing in a local community and managed by a public health center (the group-exercise group: 20, the individual-exercise group: 20). In the case of the group-exercise group (GEG), the subjects were divided into small groups composed of five members each to participate in the program. The individual-exercise group (IEG) took part in the program individually. The subjects received a REPEP that included a warm-up exercise, an elastic band exercise, a leg exercise, a balance and gait exercise, an arm and trunk exercise, and a cool-down exercise twice per week for 20 weeks. They had their gait function, balance index, and muscle strength in the bilateral knee joints tested before and after the experiment. Results : Compared to before the experiment, both groups' gait function, balance index, and muscle strength in the knee joints increased after the experiment. After the experiment, the GEG experienced more improvement in their gait function, balance index, and muscle strength in the bilateral knee joints, excluding their gait velocity and $300^{\circ}/sec$ flexion and extension, than the IEG (p<.05). Conclusion : An exercise program provided from the traditional physical therapeutic perspectives may be applied to stroke patients as their REPEP. In addition, a REPEP was more effective in improving their gait function, balance index, and muscle strength in the knee joints when the subjects formed a group and took part in the program than when they partook in it individually.

• Korean Journal of Applied Biomechanics
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• v.17 no.2
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• pp.207-216
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• 2007

The purpose of this study was to biomechanical analysis Judo's Kuzushi throwing motion in order to increase the effectiveness of Nage-waja(throwing technique). The Tori was a Judo player with 18 years experience(4th degree) while the Uke was a player with 2 years experience(1st degree). The kinematic data was captured using the Vicon motion system (7 cameras) and the kinetics were recorded by force plates(2 AMTI). The following were the results; While leaning to the front the subject's trunk's angle was $14.5^{\circ}$, the lower limbs angle was $23.8^{\circ}$, knee angle was $179.6^{\circ}$ and the vertical reaction of the left leg was 325.42N(BW 0.34) and the right leg was 233.7N(BW 0.47). While leaning back the subject's trunk's angle was $11.3^{\circ}$, the lower limbs angle was $4.1^{\circ}$, knee angle was $1761^{\circ}$ and the vertical reaction of the left leg was 299.53N(BW 0.43) and the right leg was 441.7N(BW 0.64). While leaning to the left the subject's trunk's angle was $30.8^{\circ}$, the lower limbs angle was $2.7^{\circ}$, knee angle was $175.2^{\circ}$ and the vertical reaction of the left leg was 711N(BW 1.03) and the right leg was 9.2N(BW 0.01). While leaning to the right the subject's trunk's angle was $36.5^{\circ}$, the lower limbs angle was $10.4^{\circ}$, knee angle was $175.2^{\circ}$ and the vertical reaction of the left leg was 13.2N(BW 0.02) and the right leg was 694.7N(BW 1.01). While leaning to the left front corner the subject's trunk's angle was $19.8^{\circ}$ (front) and $15.1^{\circ}$ (left), the lower limbs angle was $17.8^{\circ}$ (front) and $2.4^{\circ}$ (left), knee angle was $177.8^{\circ}$ (front) and $173.9^{\circ}$(left), and the vertical reaction of the left leg was 547.4N(BW 0.8) and the right leg was 117.8N(BW 0.17). While leaning to the right front corner the subject's trunk's angle was $15.4^{\circ}$ (front) and $17.7^{\circ}$ (right), the lower limbs angle was $21.1^{\circ}$, (front) and $5.7^{\circ}$ (right), knee angle was $175.5^{\circ}$ (front) and $178.9^{\circ}$(right), and the vertical reaction of the left leg was 53N(BW 0.08) and the right leg was 622.4N(BW 09). While leaning to the left rear corner the subject's trunk's angle was $9.2^{\circ}$ (back) and $13.8^{\circ}$ (left), the lower limbs angle was $2^{\circ}$, (back) and $5.7^{\circ}$ (left), knee angle was $175.5^{\circ}$ (back) and $172.8^{\circ}$(left), and the vertical reaction of the left leg was 698.2N(BW 1.02) and the right leg was 49.6N(BW 0.07). While leaning to the right rear corner the subject's trunk's angle was $8.9^{\circ}$ (back) and $19.6^{\circ}$ (right), the lower limbs angle was ${0.6^{\circ}}_"$ (back) and $3.1^{\circ}$ (right), knee angle was $174.6^{\circ}$ (back) and $175.6^{\circ}$(right), and the vertical reaction of the left leg was 7.2N(BW 0.01) and the right leg was 749.4N(BW 1.09). It was observed that during the Judo motion Kuzushii the range of the COM varied from $26.5{\sim}39.9cm$. It was concluded that the upper body leaned further than the lower body as there was knee extension. There was high left leg reaction forces while leaning to the left and likewise for the right side. It was therefore deduced that the Kuzushi was a more effective throwing technique for the left side.

• Physical Therapy Korea
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• v.18 no.3
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• pp.49-58
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• 2011

The purpose of this study was to evaluate the effects of bridging stabilization exercise on balance ability and gait performance in elderly women. The subjects of this study were thirty-one elderly women over 65 years old in HongSung-Gun Senior Citizen Welfare Hall. The subjects were randomly assigned into one of three groups (trunk stabilization exercise on the mat, whole body vibration, and Swiss ball) and participated in each exercise program three times a week for 4 weeks. Each exercise began in the bridging position. The dynamic balance and gait were measured by limit of stability area using force plate, Berg Balance Scale (BBS), and Timed Up and Go Test (TUG). The results were as follows: 1) The limit of stability in three groups increased significantly in anterior-posterior and medial-lateral lean after 4-weeks intervention (p<.05). 2) There were no significant differences in the limit of stability among three groups after 4-weeks intervention (p>.05). 3) The BBS and TUG in three groups increased significantly after 4-weeks intervention (p<.05). 4) There were significant differences among three groups in BBS. Post-hoc test showed that Swiss ball exercise group was significantly higher than the mat and whole body vibration groups. 5) There were no significant differences TUG among three groups after 4-weeks intervention (p>.05). In conclusion, this study suggested that 4 weeks of the bridging stabilization exercises were effective on balance and gait in all three groups. Particularly Swiss ball exercise group showed higher improvement than two other exercise groups (mat, whole body vibration group).

• Korean Journal of Applied Biomechanics
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• v.30 no.1
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• pp.121-129
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• 2020

Objective: This study was conducted with the aim of verifying the effectiveness of the duocock exercise, which is being utilized at the newly developed site to promote balance maintenance, basic physical strength and muscle strength among various age groups, in order to prevent fall and successfully age. Method: In this study, we conducted the duocock Exercise Program for 12 weeks (twice a week for an hour) for 10 senior citizens aged 65 or older (68.8±4.76 yrs, height: 15±6.00 cm) using Western-based health institutions in Daejeon, and compared the pre- and post- effects on basic physical strength and posture balance. All the data obtained from this study were used in statistical program SPSS 24 to perform paired t-test. The significance level for all statistical analyses was set at the level of p<0.05. Results: The 12 week duocock program showed statistically significant improvements in lower extremity muscle strength, equilibrium, agility, balance, and coordination in the basic fitness factors underlying successful aging (p<0.05). In addition, the trunk imbalance, which acts as a factor of falls and body balance, was statistically significant (p<0.05) and the posture balance of the sagittal plane also showed the effect of proper body adjustment. Conclusion: Based on the results of this study, duocock provides a new exercise program in the form of a sustainable sport as a two-handed exercise, and is very effective for the elderly to improve their basic physical strength as well as to control postural imbalances, strengthen and increase muscle strength.