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Abstract Background Traditional Korean Medicine (TKM) is highly integrated with the modern health care system of South Korea and is actively used in the public health field. Since 2014, the Ministry of Health and Welfare of South Korea has supported the development of standard models for TKM-based health promotion programs. This study aimed to develop and evaluate a standard TKM-based health promotion program for disadvantaged children. Methods Using convenience sampling, we recruited 16 Community Children’s Centers (CCCs) located in Busan and Yangsan, South Korea, which are welfare daytime facilities for children from socially disadvantaged families. The CCCs were divided into two groups of eight CCCs—intervention CCCs and control CCCs—through random allocation, and children in each group were selected as subjects for the study. For 12 weeks, the TKM-based health promotion program developed in this study along with the basic services of CCCs were applied to children in the intervention group, and only the basic services of CCCs were provided to children in the control group. Data were obtained through pre- and post-surveys with the legal representatives of the children prior to implementing the program and after the 12-week program, respectively. The outcome variables—the number of outpatient visits, absences, lateness/early leaves, infectious symptoms, and EuroQol-5D and EQ-visual analog scale scores–were measured and statistically compared between the groups by descriptive analysis, chi-square test, t-test, and difference-in-differences model with regression analysis. Results At baseline, there were 156 children in the intervention group and 153 children in the control group, among which 155 and 147 children, respectively, were included in the analysis. Results indicated that the number of outpatient visits was significantly lower (by 65%) in the intervention group than in the control group (p = 0.03), and this was similar in the sensitivity analysis. Regarding other outcome variables, the effects were not consistently significant. Conclusions A standard TKM-based health promotion program has the potential to improve the health of disadvantaged children. In the future, studies with long-term interventions and a larger sample are needed to enhance the applicability of these programs in communities.

The present study aimed to analyze the developmental trajectories of English achievement and exposure time through private education, utilizing univariate and multivariate latent growth curve analysis. This study used a subset of the Gyeonggi Education Panel Study data from 2012 to 2017. The results indicated consistent disparities in the growth of English achievement, depending on the student's proficiency levels at the starting point. In particular, the early exposure to private tutoring was significantly and closely related to the initial status and the growth trajectory of English achievement. When the sample was classified by urbanicity, the findings suggested that the gap in English achievement was likely to increase over time across the two regions, with a stronger correlation with private tutoring found in urban areas. These results underscore the need for educational intervention for students in less advantageous conditions, and they provide valuable pedagogical implications for teaching English in the Korean EFL context.

Background Tibial stress fracture (TSF) is a common injury in basketball players. This condition has been associated with high tibial shock and impact loading, which can be affected by running speed, footwear condition, and footstrike pattern. However, these relationships were established in runners but not in basketball players, with very little research done on impact loading and speed. Hence, this study compared tibial shock, impact loading, and foot strike pattern in basketball players running at different speeds with different shoe cushioning properties/performances. Methods Eighteen male collegiate basketball players performed straight running trials with different shoe cushioning (regular-, better-, and best-cushioning) and running speed conditions (3.0 m/s vs. 6.0 m/s) on a flat instrumented runway. Tri-axial accelerometer, force plate and motion capture system were used to determine tibial accelerations, vertical ground reaction forces and footstrike patterns in each condition, respectively. Comfort perception was indicated on a 150 mm Visual Analogue Scale. A 2 (speed) × 3 (footwear) repeated measures ANOVA was used to examine the main effects of shoe cushioning and running speeds. Results Greater tibial shock (P < 0.001; η2 = 0.80) and impact loading (P < 0.001; η2 = 0.73–0.87) were experienced at faster running speeds. Interestingly, shoes with regular-cushioning or best-cushioning resulted in greater tibial shock (P = 0.03; η2 = 0.39) and impact loading (P = 0.03; η2 = 0.38–0.68) than shoes with better-cushioning. Basketball players continued using a rearfoot strike during running, regardless of running speed and footwear cushioning conditions (P > 0.14; η2 = 0.13). Discussion There may be an optimal band of shoe cushioning for better protection against TSF. These findings may provide insights to formulate rehabilitation protocols for basketball players who are recovering from TSF.

BACKGROUND:The previous studies on basketball landing have not shown a systematic agreement between landing impacts and midsole densities. One plausible reason is that the midsole densities alone used to represent the cushioning capability of a shoe seems over simplified. The aim of this study is to examine the effects of different landing heights and shoes of different cushioning performance on tibial shock, impact loading and knee kinematics of basketball players. METHODS:Nineteen university team basketball players performed drop landings from different height conditions (0.45m vs. 0.61m) as well as with different shoe cushioning properties (regular, better vs. best-cushioned). For each condition, tibial acceleration, vertical ground reaction force and knee kinematics were measured with a tri-axial accelerometer, force plate and motion capture system, respectively. Heel comfort perception was indicated on the 150-mm Visual Analogue Scale. A 2 (height) x 3 (footwear) ANOVA with repeated measures was performed to determine the effects of different landing heights and shoe cushioning on the measured parameters. RESULTS:We did not find significant interactions between landing height and shoe conditions on tibial shock, impact peak, mean loading rate, maximum knee flexion angle and total ankle range of motion. However, greater tibial shock, impact peak, mean loading rates and total ankle range of motion were determined at a higher landing height (P < 0.01). Regular-cushioned shoes demonstrated significantly greater tibial shock and mean loading rate compared with better- and best-cushioned shoes (P < 0.05). The correlation analysis indicated that the heel comfort perception was fairly associated with impact peak and mean loading rate regardless of heights (P < 0.05), but not associated with tibial shock. CONCLUSIONS:Determination of shoe cushioning performance, regardless of shoe midsole materials and constructions, would be capable in order to identify optimal shoe models for better protection against tibial stress fracture. Subjective comfort rating could estimate the level of impact loading in non-laboratory based situations.

BACKGROUND:The rapid and repetitive badminton lunges would produce strenuous impact loading on the lower extremities of players and these loading are thought to be the contributing factors of chronic knee injuries. This study examined the impact loading characteristics in various groups of badminton athletes performing extreme lunges. METHODS:Fifty-two participants classified into male skilled, female skilled, male unskilled, and female unskilled groups performed badminton lunge with their maximum-effort. Shoe-ground kinematics, ground reaction forces, and knee moments were measured by using synchronised force platform and motion analysis system. A 2 (gender) x 2 (skill-level) factorial ANOVA was performed to determine the effects of different gender and different playing levels, as well as the interaction of two factors on all variables. RESULTS:Male athletes had faster approaching speed (male 3.87 and female 1.08 m/s), longer maximum lunge distance (male 1.47 and female 1.16 m), larger maximum (male 215.7 and female 121.65 BW/s) and mean loading rate (male 178.43 and female 81.77 BW/s) and larger peak knee flexion moment (male 0.75 and female 0.69) compared with female athletes (P < 0.001). Unskilled athletes exhibited smaller footstrike angle (skilled 45.78 and unskilled 32.35°), longer contact time (skilled 0.69 and unskilled 0.75 s), larger peak horizontal GRF (skilled 1.61 and unskilled 2.40 BW), smaller mean loading rate (skilled 150.15 and unskilled 110.05 BW/s) and larger peak knee flexion moment (P < .05; skilled 0.69 and unskilled 0.75 Nm/BW) than the skilled athletes. In addition, the interaction indicated greater peak GRF impact in female unskilled athletes compared with female skilled athletes (P < 0.001; female skilled 2.01 and female unskilled 2.95 BW), while there was no difference between male participants (P > 0.05; male skilled 2.19 and male unskilled 2.49 BW). CONCLUSIONS:These data suggested that male athletes and/or unskilled athletes experience greater impact loading rates and peak knee flexion moment during lunge compared with female and skilled athletes, respectively. This may expose them to higher risk of overuse injuries. Furthermore, female unskilled athletes seemed to be more vulnerable to lower extremity injuries.

BACKGROUND:Lunge is one frequently executed movement in badminton and involves a unique sagittal footstrike angle of more than 40 degrees at initial ground contact compared with other manoeuvres. This study examined if the shoe heel curvature design of a badminton shoe would influence shoe-ground kinematics, ground reaction forces, and knee moments during lunge. METHODS:Eleven elite and fifteen intermediate players performed five left-forward maximum lunge trials with Rounded Heel Shoe (RHS), Flattened Heel Shoe (FHS), and Standard Heel Shoes (SHS). Shoe-ground kinematics, ground reaction forces, and knee moments were measured by using synchronized force platform and motion analysis system. A 2 (Group) x 3 (Shoe) ANOVA with repeated measures was performed to determine the effects of different shoes and different playing levels, as well as the interaction of two factors on all variables. RESULTS:Shoe effect indicated that players demonstrated lower maximum vertical loading rate in RHS than the other two shoes (P < 0.05). Group effect revealed that elite players exhibited larger footstrike angle, faster approaching speed, lower peak horizontal force and horizontal loading rates but higher vertical loading rates and larger peak knee flexion and extension moments (P < 0.05). Analysis of Interactions of Group x Shoe for maximum and mean vertical loading rates (P < 0.05) indicated that elite players exhibited lower left maximum and mean vertical loading rates in RHS compared to FHS (P < 0.01), while the intermediate group did not show any Shoe effect on vertical loading rates. CONCLUSIONS:These findings indicate that shoe heel curvature would play some role in altering ground reaction force impact during badminton lunge. The differences in impact loads and knee moments between elite and intermediate players may be useful in optimizing footwear design and training strategy to minimize the potential risks for impact related injuries in badminton.

Background: Tibial stress fracture (TSF) is a common injury in basketball players. This condition has been associated with high tibial shock and impact loading, which can be affected by running speed, footwear condition, and footstrike pattern. However, these relationships were established in runners but not in basketball players, with very little research done on impact loading and speed. Hence, this study compared tibial shock, impact loading, and foot strike pattern in basketball players running at different speeds with different shoe cushioning properties/performances. Methods: Eighteen male collegiate basketball players performed straight running trials with different shoe cushioning (regular-, better-, and best-cushioning) and running speed conditions (3.0 m/s vs. 6.0 m/s) on a flat instrumented runway. Tri-axial accelerometer, force plate and motion capture system were used to determine tibial accelerations, vertical ground reaction forces and footstrike patterns in each condition, respectively. Comfort perception was indicated on a 150 mm Visual Analogue Scale. A 2 (speed) × 3 (footwear) repeated measures ANOVA was used to examine the main effects of shoe cushioning and running speeds. Results: Greater tibial shock (P < 0.001; η² = 0.80) and impact loading (P < 0.001; η² = 0.73–0.87) were experienced at faster running speeds. Interestingly, shoes with regular-cushioning or best-cushioning resulted in greater tibial shock (P = 0.03; η² = 0.39) and impact loading (P = 0.03; η² = 0.38–0.68) than shoes with better-cushioning. Basketball players continued using a rearfoot strike during running, regardless of running speed and footwear cushioning conditions (P > 0.14; η² = 0.13). Discussion: There may be an optimal band of shoe cushioning for better protection against TSF. These findings may provide insights to formulate rehabilitation protocols for basketball players who are recovering from TSF. [ABSTRACT FROM AUTHOR]

Unique dual medical system in Korea has resulted in the emergence of dual-licensed medical doctors (DLMDs) who have both traditional Korean medicine (KM) and Western medicine (WM) licenses. There have been few studies on DLMDs in spite of their growing number and importance within the medical system. We surveyed the current status and attitudes of DLMD to assess their role in integrative medicine. Questionnaires were administered to the members of the association of DLMD. Data from 103 DLMD were collected and statistically analyzed. 41.4% of DLMD were copracticing both WM and KM at a single clinic, preferring the WM approach for physical examinations, laboratory tests, and education for patients -- and the KM approach for treatment and prescription. Musculoskeletal, gastroenterologic, and allergic diseases were considered to be effectively treated with co-practice. DLMD highly agreed on the efficiency of copractice for disease control and patients' satisfaction. On the other hand, they regarded the lack of health insurance coverage for copractice and increased medical expenditure as major problems in providing co-practice. To expand the role of DLMD as mediators of integration in primary health care, the effectiveness of their co-practice should be evaluated and a corresponding health insurance reimbursement system should be established. [ABSTRACT FROM AUTHOR]

Maintaining balance while performing "Hakdariseogi" in Taekwondo, which involves standing on one leg, is a critical aspect of the Poomsae competition. The purpose of this study was to investigate the effect of proprioceptive training and lower-limb muscular strength training on the balance of Taekwondo Poomsae athletes over a 6-week period. Thirty Taekwondo Poomsae athletes were randomly assigned to three groups, namely, a proprioception training group, a lower-limb muscular strength training group, and a control group. Biomechanics data were collected using eight infrared cameras (Qualysis, Sweden) at 200 Hz and a force plate (Kistler, Switzerland) at 2,000 Hz while the participants performed "Hakdariseogi" before and after the 6-week intervention. Balance and stability variables were calculated using customized MATLAB R2014b software (Mathworks, Inc., USA). The medio-lateral (M/L) center of pressure (CoP) range, M/L CoP mean velocity, antero-posterior (A/P) CoP range, A/P CoP mean velocity, and the vertical ground reaction torque after the training were reduced at P1 in the PG groups (p < 0.05). A decrease in the A/P CoP range, A/P CoP mean velocity, and vertical ground reaction torque after the training were observed at P2 in the PG and SG groups (p < 0.05). The PG exhibited a smaller A/P CoP range and A/P CoP mean velocity, in comparison to CG (p < 0.05). The A/P CoP position at P1 was negatively correlated with the vertical ground reaction torque, A/P CoP range, and A/P CoP mean velocity at P2(r = -0.438, r = -0.626, r = -0.638). Based on the above results, this study determined that both proprioception training and lower-extremity muscle strength training resulted in an improvement of athletic performance. It was also desirable to move the CoP position through conscious effort forward at P2 in order to maintain the crane stance without sway. [ABSTRACT FROM AUTHOR]