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BACKGROUND: The cranio-cervical flexion exercise and sub-occipital muscle inhibition technique have been used to improve a forward head posture among neck pain patients with straight leg raise (SLR) limitation. However, little is known about the cranio-vertebral angle (CVA) and cervical spine range of motion (CROM) after applying stretching methods to the hamstring muscle. OBJECTIVE: To compare the immediate effects of static stretching and proprioceptive neuromuscular facilitation stretching on SLR, CVA, and CROM in neck pain patients with hamstring tightness. METHODS: 64 subjects were randomly allocated to the static stretching (n1= 32) or proprioceptive neuromuscular facilitation (n2= 32) stretching group. The SLR test was performed to measure the hamstring muscle’s flexibility and tightness between the two groups, with CROM and CVA also being measured. The paired t-test was used to compare all the variables within each group before and after the intervention. The independent t-test was used to compare the two groups before and after the stretching exercise. RESULTS: There were no between-group effects for any outcome variables (P> 0.05). However, all SLR, CVA, and CROM outcome variables were significantly improved within-group (P< 0.05). CONCLUSIONS: There were no between-group effects for any outcome variable; however, SLR, CVA, and CROM significantly improved within-group after the one-session intervention in neck pain patients with hamstring tightness.

Background Older adults have higher prefrontal cortex (PFC) activation and lower dual-task performance than younger adults because of age-related physical and cognitive functional impairments. Objective To investigate the effect of treadmill walking on PFC activation and dual-task performance in older adults. Methods A total of 20 older adults (mean age, 64.35 ± 2.74 years) and 20 younger adults (mean age, 30.00 ± 3.15 years) performed single- and dual-task walking in overground and treadmill conditions. A wearable functional near-infrared spectroscopy device and gait analyzer were used to analyze PFC activation and dual-task cost (DTC). Results In both groups, treadmill walking demonstrated reduced PFC activation while dual-task walking and reduced DTC compared to overground walking. Furthermore, despite a higher DTC in gait variability, correct response, total response, response index and a higher error score in older adults than in younger adults during overground walking, there was no difference in treadmill walking. The difference in PFC activation between single and dual tasks was also observed only in overground walking. There was no difference in PFC activation between the two age groups. Conclusions Older adults can maintain the similar level of dual-task performance as younger adults in treadmill walking, with PFC activation reduced. However, although older adults recruit PFC level similar to that in younger adults in overground walking, older adults show lower dual-task performance than younger adults due to inefficient use of PFC with aging. This indicates that treadmill and overground walking do not share similar activation patterns during dual-task walking.

BACKGROUND Taekkyon, a Korean form of martial arts, has been trained for a long period. However, it is not yet known whether the Taekkyon exercise has better effects on functional mobility or balance in older adults than other types of well-investigated exercise programs such as Tai Chi (TC). OBJECTIVE This study aimed to compare the effects of TC and Taekkyon exercise programs on the lower-extremity strength, balance, and gait ability of community-dwelling older women as a fall prevention method. METHODS Community-dwelling older women were randomly allocated into the TC group (n1= 23) and the Taekkyon group (n2= 23). Both groups completed 1 h of either TC or Taekkyon exercises twice weekly for 12 consecutive weeks (24 sessions in total). We measured the Timed Up and Go test (TUG), Functional Reach test (FR), one-leg standing test (OLS), Five Times Sit-to-Stand test (5 × STS), 30 Second Sit-to-Stand test (30 s STS), and spatiotemporal gait parameters (gait velocity, step length, step width, stride time, and cadence) before and after the intervention. RESULTS Both groups similarly showed statistically significant improvements in balance (TUG, FR, and OLS), lower-extremity strength (5 × STS and 30 s STS), and spatiotemporal gait parameters except for step width (P< 0.05). Moreover, the TC group showed greater improvement in the OLS test than the Taekkyon group (P< 0.05). CONCLUSIONS The results from this study support the efficacy of the TC and Taekkyon exercise programs at improving mobility in this population of older women. However, this study did not clarify which exercise program is more effective as general balance and mobility training program for older women.

BACKGROUND: Fibromyalgia is accompanied by symptoms of fatigue, depression, sleep disorders, and physical and mental stress [1]. It is a difficult-to-treat disorder because its exact causes are unknown. OBJECTIVE: This study aimed to examine the effect of progressive muscle relaxation therapy (PMRT) on pain, fatigue, and stress in patients with fibromyalgia syndrome. METHODS: Thirty-seven patients with fibromyalgia syndrome (age: 20–65 years) were randomly allocated to the PMRT group (n1= 18, 2 men and 16 women) or non-PMRT group (n2= 19, 2 men and 17 women). The PMRT group received PMRT twice a week for 8 weeks and the non-PMRT group received conventional physical therapies such as electro-stimulation and heat therapies during this period. The outcome was evaluated before and after 8 week sofintervention using the Visual Analogue Scale, Multidimensional Assessment of Fatigue, Perceived Stress Scale, and measurement of the blood pressure and pulse rate. RESULTS: Pain and fatigue significantly decreased in the PMRT group compared with the non-PMRT group (both P< 0.001). In addition, perceived stress (P< 0.001), systolic blood pressure (P< 0.001), diastolic blood pressure (P< 0.05), and pulse rate (P< 0.001) significantly decreased in the PMRT group compared with the non-PMRT group. CONCLUSIONS: The findings indicate that progressive muscle relaxation therapy is a viable rehabilitative therapy for pain, fatigue, and stress symptoms in patients with fibromyalgia syndrome.

[Purpose] The purpose of this study was to examine the effects of Taekkyon training on balance control during stair descent in community-dwelling older adults. [Participants and Methods] Participants were randomly assigned to either the Taekkyon group or wellness education group. The participants in the Taekkyon group received Taekkyon training 2 times a week for 12 weeks. The participants in the wellness education group participated in a health education program 1 hour weekly for 12 weeks. Subjects stood in a predetermined position on the top of the custom-built 3-step staircase and then descended the stairs at a self-paced speed. The changes in the translation of the center of pressure before and after Taekkyon training were measured. [Results] The Taekkyon group showed a greater increase in the displacement of the center of pressure in the anteroposterior and mediolateral directions as well as the average velocity of the center of pressure in posttesting than the wellness education group. The Taekkyon group also showed a significant increase in all measures after Taekkyon training. However, little change was found in all measures in the wellness education group. [Conclusion] These findings support the use of Taekkyon training as an effective fall-preventive rehabilitation program to reduce falling in older adults.

Background: Limited data are available on the effect of stretching exercise in patients with patellofemoral pain (PFP) who have inflexible quadriceps, which is one of the various causes of PFP syndrome. This study compares quadriceps flexibility, strength, muscle activation time, and patient-reported outcomes after static and dynamic quadriceps stretching exercises in patients with PFP who had inflexible quadriceps. Hypothesis: Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes would improve with dynamic quadriceps stretching as compared with static quadriceps stretching exercises. Study Design: Randomized controlled trial. Level of Evidence: Level 2. Methods: Of the 44 patients included in the study, 20 performed static stretching and 24 performed dynamic stretching. Quadriceps flexibility was assessed by measuring the knee flexion angle during knee flexion in the prone position (the Ely test). Muscle strength and muscle activation time were measured using an isokinetic device. The patient-reported outcomes were evaluated using the visual analogue scale for pain and anterior knee pain scale. Results: No significant differences in quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in the involved knees were found between the 2 groups ( P values > 0.05). Conclusion: Quadriceps flexibility and strength, muscle activation time, and patient-reported outcomes in patients with PFP who had inflexible quadriceps showed no significant differences between the static and dynamic quadriceps stretching exercise groups. Clinical Relevance: Both static and dynamic stretching exercises may be effective for improving pain and function in patients with PFP who have inflexible quadriceps.

Background: Patellofemoral pain (PFP) syndrome is closely associated with muscle tightness. However, studies regarding the effects of stretching exercises on PFP patients with inflexible hamstrings are scarce. The aim of the study was to compare the effects between static and dynamic hamstring stretching in patients with PFP who have inflexible hamstrings. Hypothesis: Compared with static hamstring stretching, dynamic hamstring stretching will improve the parameters of hamstring flexibility, knee muscle strength, muscle activation time, and clinical outcomes in this patient population. Study Design: Prospective randomized controlled trial. Level of Evidence: Level 2. Methods: A total of 46 patients (25, static stretching; 21, dynamic stretching) participated. Hamstring flexibility was assessed according to the popliteal angle during active knee extension. Muscle strength and muscle activation time were measured using an isokinetic device. Clinical outcomes were evaluated using the visual analog scale (VAS) for pain and the anterior knee pain scale (AKPS). Results: There were no differences in hamstring flexibility and knee muscle strength of the affected knees between the groups ( P > 0.05). Significantly improved muscle activation time and clinical outcomes of the affected knees were observed in the dynamic stretching group compared with the static stretching group (all Ps < 0.01 for hamstring, quadriceps, VAS, and AKPS). Conclusion: In patients with PFP who have inflexible hamstrings, dynamic hamstring stretching with strengthening exercises was superior for improving muscle activation time and clinical outcomes compared with static hamstring stretching with strengthening exercises. Clinical Relevance: Clinicians and therapists could implement dynamic hamstring stretching to improve function and reduce pain in patients with PFP who have inflexible hamstrings.

OBJECTIVE The aims of the study were to investigate the kinetic effects of sit-to-stand training in various foot positions on the coronal plane in patients with strokes and to suggest appropriate exercises. DESIGN Thirty-six poststroke subjects participated in this study. The subjects performed three sit-to-stand trials in the following foot positions: (a) symmetric foot positioning (symmetric), (b) affected foot placed to the side (asymmetric 1), and (c) and less affected foot placed to the side (asymmetric 2). They were asked to perform sit-to-stand training at a spontaneous velocity and remain standing for 5 secs, whereas the vertical ground reaction force was measured using force platforms. The activation of lower limb muscles was evaluated using surface electromyography, and the peak and mean vertical ground reaction force and weight-bearing symmetry ratio were evaluated using force platforms. RESULTS Our results showed significant increases in the muscle activation, peak and mean vertical ground reaction force, and weight-bearing symmetry ratio of the lower limbs using the asymmetric 2 strategy (P < 0.05). CONCLUSIONS Our results suggest that sit-to-stand training with the less affected foot placed to the side by the width of the subject's foot may be the most beneficial in the rehabilitation of patients with hemiparetic stroke.

In the present study, a new technique for analyzing dynamic strain aging (DSA), which causes the Portevin-Le Chatelier (PLC) band and type A serrations in a tensile curve, was proposed. The analytical technique is based on the thermoelectric phenomenon known as the Seebeck effect. The variation of the voltage of the gauge part was monitored by the four-wire voltage measurement method during tensile tests. The voltage was additionally changed by a thermo-electromotive force induced by the local deformation heat of the PLC band, i.e. the Seebeck effect. The voltage change led to serrations in the voltage vs. strain (or time) curve. The voltage serrations more clearly exhibited the nucleation and propagation of the PLC band and a critical strain for DSA, which is crucial for investigation of the DSA mechanism, compared to stress serrations in tensile flow curves.

BACKGROUND Cervical spinal instability often leads to neck pain and forward head posture (FHP). To improve neck pain and FHP, both the suboccipital muscle inhibition (SMI) technique and cranio-cervical flexion exercise (CCFE) have been used. However, little is known regarding the validity of hamstring flexibility in neck pain subjects after CCFE as a treatment index, and comparison between the SMI technique and CCFE for neck pain treatment. OBJECTIVE This study aimed to determine the short-term effects of SMI technique and CCFE, which represent passive and active exercise programs, respectively, and whether these improve the straight leg raise (SLR) test results, popliteal angle (PA), cranio-vertebral angle (CVA), and cervical range of motion (CROM) and are equally effective in immediate enhancement of such measures in neck pain subjects. METHODS Twenty subjects with neck pain were randomly allocated to the SMI and CCFE groups (n= 10 each). The outcomes were evaluated via clinical evaluation and SLR, PA, CVA, and CROM measurement before and after intervention. RESULTS SLR test results, PA, CVA (sitting and standing), and CROM (flexion, extension, lateral flexion, and right and left rotations) after both interventions were significantly higher than those before the interventions (P< 0.05). The SLR test results (left), PA, and CVA (standing) after the SMI technique improved to levels similar to those observed after CCFE. CONCLUSIONS Both the SMI technique and CCFE improve SLR test results, PA, CVA, and CROM and are equally effective in immediate enhancement of the hamstring flexibility, CVA, and CROM in subjects with neck pain.

This study was conducted to investigate the effects of the degree of dual-task (DT) interference on gait, dual-task cost (DTC), cognitive ability, balance, and fall efficacy in people with stroke. In this cross-sectional study, people with chronic stroke (N = 36) performed a DT gait assessment (gait and cognitive task). During the evaluation, DT interference in motor and cognition was evaluated simultaneously. Thus, the group with severe interference in both tasks (mutual interference) was compared with the group with mild interference in either. The main effects for the degree of motor interference were observed on gait performance, DTC in motor, time up and go, and trail-making test B. In the cognitive interference, the main effects were observed on correct response rate, DTC in cognition, time up and go, and trail-making test B. An interaction effect was observed in the trail-making test B. The degree of motor interference affected gait, balance ability, and executive function (EF), and the degree of cognitive interference influenced the correct response rate in the DT condition, balance ability, and EF. Furthermore, mutual interference led to a significant reduction in EF in people with stroke.

[Purpose] To investigate the effects of a pelvic compression belt (PCB) and chair height on the kinematics and kinetics of the lower extremity during sit-to-stand (STS) maneuvers in healthy people. [Subjects and Methods] Twenty-two people participated in this study. They were required to perform STS maneuvers under four conditions. Hip joint moment and angular displacement of the hip, knee, and ankle were measured. A PCB was also applied below the anterior superior iliac spine. [Results] The angular displacement of the ankle joint increased while performing STS maneuvers from a normal chair with a PCB in phase 1, and decreased during phase 2 when performing STS maneuvers from a high chair. The overall angular displacement in phase 3 was decreased while rising from a chair with a PCB and rising from a high chair. When performed STS maneuvers from a high chair, the angular displacement of the hip, knee, and ankle joint decreased considerably in phase 3. This decreased lower extremity motion in phase 3 indicated that participants required less momentum to complete the maneuver. [Conclusion] The results of this study suggest that a PCB might be appropriate for patients with pelvic girdle pain and lower back pain related to pregnancy.

Phosphatidylcholine (PPC) formula has been therapeutically used to reduce areas of localized fat. However, no single research has been carried out on its effect on a variety of cells in adipose and muscle tissues. Herein, the current study aimed to explore the activity of PPC on different cells in adipose and muscle tissues and to investigate the molecular mechanisms contributing to the effects of PPC on lipolysis and apoptosis. mRNA expression levels of various genes were measured by quantitative real-time PCR. Protein expression levels were observed through Western blotting and cell viability was measured by MTT assay. Lipolysis and caspase 3 activity assay were performed using commercial kits. PPC induces lipolysis and apoptosis in adipocytes (3T3-L1), but not in the other tested cells, including skeletal muscle cells (C2C12 myocytes), endothelial cells (HUVEC), and fibroblasts (BJ). The possible role of TNFα and IL-1β-mediated pathways on the effects of PPC was also revealed. We confirmed that treatment with PPC caused lipolysis and apoptosis in a dose-dependent manner (only in 3T3-L1 adipocytes). The effect of PPC observed in 3T3-L1 adipocytes was not evident in C2C12 myocytes, HUVEC, and fibroblasts. PPC also increased TNFα and IL-1β expression and release in 3T3-L1 adipocytes in a dose-dependent fashion, but not in C2C12 myocytes, HUVEC, and BJ. Suppression of TNFα or IL-1β reversed PPC-induced lipolysis and apoptosis in 3T3-L1 adipocytes, suggesting that PPC could promote adipocyte-specific lipolysis and apoptosis through TNFα and IL-1β-mediated signaling. We conclude that the specific activity of PPC on adipocyte in adipose without other tissue damages can be an effective approach for melting lipid.

In this work, the antibacterial activity of silver nanoparticles (AgNPs) synthesized using Areca catechu extracts against three species of antibiotic-susceptible and three species of resistant bacteria was investigated. The effects of this plant were more promising when compared with other medicinal plants tested. The hydrothermal extract of Areca catechu was mixed with silver nitrate to synthesize AgNPs. The synthesized particle characteristics were analyzed by UV&ndash, Vis spectrophotometry, scanning electron microscopy (SEM), dynamic light scattering (DLS), and Fourier-transform infrared spectroscopy (FT-IR). Minimum inhibitory concentration and minimum bactericidal concentration tests were conducted to confirm antibacterial activity and the results showed that AgNPs synthesized using Areca catechu extracts effectively inhibited the growth of bacterial species. Moreover, the SEM images of the bacterial species treated with AgNPs synthesized with Areca catechu extracts showed that clusters of AgNPs were attached to the surface of the bacterial cell wall, which could induce destruction of the cell membranes. The results suggest that AgNPs synthesized with Areca catechu extracts have the potential to treat antibiotic-resistant bacteria known as the major cause of nosocomial infections.

To investigate the effects of respiratory muscle training (RMT) combined with the abdominal drawing-in maneuver (ADIM) on the pulmonary function in patients with chronic spinal cord injury (SCI).Thirty-seven subjects with SCI (level of injury: C4-T6, time since injury: 4-5 years) were randomly allocated to three groups; the integrated training group (ITG), the RMT group (RMTG), and the control group (CG). The ITG performed RMT using an incentive respiratory spirometer (IRS) and the ADIM using a stabilizer. The RMTG received only RMT using an IRS. Subjects in the CG received alternative and routine physical therapy or usual care. The interventions were conducted over an eight-week period. Pulmonary function was evaluated using spirometry to measure the forced vital capacity (FVC) and forced expiratory volume in 1 second (FEVThe differences between the pre- and post-test values for FVC (0.47 ± 0.05 versus 0.15 ± 0.06 versus -0.03 ± 0.01) and FEVThese findings suggest positive evidence that RMT with additional ADIM training can improve pulmonary function in SCI pulmonary rehabilitation.

PURPOSE: The purpose of this study was to investigate the effects of a supplementary Ki-hap technique and verbal encouragement on the activation of abdominal muscles during performance of crunch exercise in healthy subjects. METHODS: 93 subjects were randomly allocated to three group, crunch exercise group (CG), crunch exercise with Ki-hap group (CKG), and crunch exercise with Ki-hap and verbal encouragement group (CKVG), with 31 subjects in each group, respectively. The interventions were conducted over three trials in each group, and measurements were performed on each subject by one examiner in three trials. The activation of rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were evaluated using electromyography (EMG) during performance of crunch exercise with non-Ki-hap, Ki-hap and Ki-hap combined with verbal encouragement. RESULTS: Our results showed a significantly greater increase in the EMG patterns of all muscles during performance of crunch exercise in the CKG (p

Jeong-Hyeon Kang, Hye-Rim Suh, Chang-Yong Kim, Hyeong-Dong Kim, Hyungkun Kim Department of Health Science, Graduate School, Korea University; Department of Physiology, College of Medicine and Neuroscience Research Institute, Korea University; The Biomechanics and Movement Rehabilitation Laboratory, Health and Sciences Institute, Korea University; Department of Physical Therapy, College of Health Science, Korea University; Department of Health Science, Graduate School, Korea University, Seoul, Korea

Regular exercise can delay age-related risk factors and can maintain or improve physical health and activity in older adults leading to a decrease in fall risk. The purpose of this study was to compare 2 different interventions for fall prevention, tai chi (TC) and Otago, by examining lower extremity strength, balance, and spatiotemporal gait parameters in community-dwelling older women.We performed a randomized trial in which subjects were assigned to 1 of 2 groups: the TC group (n = 21; age, 72.8 ± 4.7 years, range: 65-83 years), which participated in a modified Sun-style TC exercise program; and the Otago group (n = 24; age, 71.5 ± 3.6 years, range: 65-79 years), which participated in the Otago exercise program. The Timed Up and Go (TUG) test, functional reach (FR) test, one-leg standing (OLS) test, 5 times sit-to-stand test (5×STS), 30-second sit-to-stand (30s STS) test, and gait parameters (gait velocity, step length, step width, stride time, and cadence) were measured before and after the intervention.Both groups showed statistically significant improvements in balance (TUG and OLS tests), lower extremity strength (5×STS and 30s STS tests), and spatiotemporal gait parameters, except for step width and step length (P.05). The Otago group showed a significantly improved FR, whereas the TC group showed a significantly improved step length after the intervention (P.05). Furthermore, the Otago group exhibited greater improvements in the TUG (P.001), FR (P.001), 5×CST (P.01), and 30-second CST (P.01) tests: a faster cadence (P.001) and shorter stride time (P.001) when compared with the TC group. The TC group showed greater improvements in the OLS test, step length, and step width (P.01) and faster gait velocity (P.05) than the Otago group.The findings from this study support the efficacy of the TC and Otago exercise programs in improving mobility in this sample of subjects. Furthermore, the Otago group showed greater improvement in lower extremity strength, whereas the TC group showed greater improvement in balance (OLS test). Also, the TC group showed a greater improvement in gait velocity after TC training program compared with the Otago exercise program. However, this study does not elucidate which exercise program is a more effective intervention method with older women for fall prevention.

Objective To determine the effect of crossed-education, using task-related training on a tilt table, on upper extremity function and grip strength in subjects with post-stroke hemiplegia. Design Double-blind, randomized controlled, pilot study. Patients A total of 45 patients between 6 and 12 months post-stroke. Methods Subjects were randomly allocated to the control group, or experimental group I or II. All subjects received conventional upper limb training for 30 min, 3 times a week for 6 weeks, and training on 3 different tilt table applications for 20 min a day. The outcome was evaluated using the Fugl-Meyer scale, Wolf Motor Function Test, and measurements of grip strength using a hydraulic hand dynamometer, prior to and 6 weeks post-intervention. Results There was a significantly greater increase, post-test, in the Fugl-Meyer scale (p = 0.003), maximal grip strength of the affected hand (p = 0.04), and grip strength, compared with the less-affected hand (p = 0.03), in subjects who underwent supplementary task-oriented training on a tilt table compared with those in the control group. There was also a significantly greater increase in Wolf Motor Function score (p = 0.001), post-test, in subjects who underwent task-oriented training on a tilt table compared with those in the 2 experimental groups. Conclusion Compared with tilt table or conventional training alone, crossed-education using task-oriented training on a tilt table may result in improvements in arm function and maximal grip strength in persons with chronic hemiplegia post-stroke.

An effective and standardized method for applying a tilt table as a supplementary treatment in the early rehabilitation of stroke patients is still missing. The aim of this study was to determine the influence of progressive task-oriented training on the tilt table on the improvement in lower extremity (LE) muscle activation and clinical function in subjects with hemiplegia due to stroke. Thirty-nine subjects with acute stroke were randomly allocated to three groups; control group, tilt table group, and task-oriented training group on the tilt table, with 13 patients, respectively. All of the subjects received the routine therapy for half an hour, and subjects in the experimental groups additionally received training on two different tilt table applications for 20min a day, five times a week for three weeks. The effect of tilt table applications was assessed using the surface electromyography (EMG) analysis during stepping-like movements on the tilt table for LE muscle activation and clinical scores for function. Our results showed that there was a significantly greater increase in the EMG patterns of the extensors and flexors of the affected leg muscles during flexion and extension movements of both legs and clinical scores in patients undergoing the progressive task-oriented training on the tilt table compared to the other groups. These findings suggest that progressive task-oriented training on the tilt table can improve LE muscle activation and clinical scores of functional performance for early rehabilitation of subjects with acute stroke.

Shikonin, a natural flavonoid found in the roots of Lithospermum erythrorhizon, has been shown to possess many biological functions. The present study was undertaken to investigate the influence of shikonin on vascular smooth muscle contractility and to determine the mechanism involved. Denuded aortic rings from male rats were used and isometric contractions were recorded and combined with molecular experiments. Shikonin significantly relaxed fluoride-, thromboxane A2- or phorbol ester-induced vascular contraction suggesting as a possible anti-hypertensive on the agonist-induced vascular contraction regardless of endothelial nitric oxide synthesis. Furthermore, shikonin significantly inhibited fluoride-induced increases in pMYPT1 levels and phorbol ester-induced increases in pERK1/2 levels suggesting the mechanism involving the inhibition of Rho-kinase activity and the subsequent phosphorylation of MYPT1 and the inhibition of MEK activity and the subsequent phosphorylation of ERK1/2. This study provides evidence regarding the mechanism underlying the relaxation effect of shikonin on agonist-induced vascular contraction regardless of endothelial function.

Purpose: No study has examined the effects of the combination of respiratory muscle training (RMT) and abdominal drawing-in maneuver (ADIM) on respiratory muscle activity and function in stroke patients during early pulmonary rehabilitation. The purpose of this study was to investigate the effects of RMT combined with ADIM on decreased respiratory muscle activity and function in patients with post-stroke hemiplegia. Methods: Thirty-seven subjects with post-stroke hemiplegia were randomly allocated to three groups; integrated training group (ITG), respiratory muscle training group (RMTG), and control group (CG). All of the subjects received routine therapy for stroke rehabilitation for 1 hour, five times a week for 6 weeks. Especially, the ITG received RMT using an incentive respiratory spirometer and ADIM using a Stabilizer, and the RMTG only received RMT using incentive respiratory spirometer for 15 minutes a day, five times a week for 6 weeks. Pulmonary function was evaluated using spirometry for measuring the forced vital capacity (FVC) and force expiratory volume in 1 second (FEV1). Additional surface electromyography (sEMG) analysis was included by measuring the respiratory muscle activity. Results: Our results showed that changes between the pre- and post-test values of FVC (F512?50, P50?02) and FEV1 (F512?81, P50?01) (Pv0?05) in the ITG were significantly (Pv0?05) greater. Changes in EMG activation of the diaphragm (F513?75, P50?003) and external intercostal (F514?33, P50?002) (Pv0?01) muscles of patients in the ITG during maximal static inspiratory efforts were significantly (Pv0?05) greater than those in patients of the RMTG and the CG at post-test. Conclusions: Our findings suggested that RMT combined with ADIM could improve pulmonary function in patients with post-stroke hemiplegia.

This study examined the effects of smart phone use while young adults negotiated an obstacle (2 cm high). Seventy-four young adults (mean age: 23.76±3.17 years, age range: 20-27 years) participated in the study. They were allocated randomly into two groups; smart phone group and no smart phone group. The smart phone group negotiated an obstacle while simultaneously using a smart phone at a self-paced speed whereas the no smart phone group negotiated an obstacle with no special option. A motion analysis system were used to measure the gait parameters, such as toe clearance, cadence, step length, step width, stride length, and walking velocity in two groups. The toe clearance, and step-width, cadence, and step-length were significantly greater for the smart phone group than the no smart phone group (p

[Purpose] This study investigated the effects of accuracy constraints (targets) placed on the stepping-limb heel-strike (HS) on the electromyogram (EMG) and ground reaction forces (GRFs) during gait initiation. [Subjects and Methods] Twenty healthy subjects (29.2 ± 2.9 years) were asked to begin walking or stepping over a 10-cm-high obstacle at a fast speed. A 3-cm-diameter target was placed on the ground to dictate the position and accuracy of the stepping-limb HS. [Results] The results showed that the initiation velocity increase in the no-target conditions was due to modulation of the stance- and stepping-limb GRFs and a corresponding increase in the tibialis anterior (TA) activities of both limbs before stepping-limb toe-off. This was achieved by significantly increasing the stepping- and stance-limb TAEMG1 (determined between the onset of movement and time to peak anteroposterior (A-P) GRF of the stepping- and stance- limb) for the no-target conditions. It seems, therefore, that TAEMG1 and the slope to stepping-limb peak A-P GRF contributed to the intended velocity of initiation. [Conclusion] These data indicate that gait initiation and/or stepping over an obstacle may prove to be tasks by which motor control can be measured. The present study provides insight into the working mechanisms of the stepping and stance limbs and shows a clear need to further investigate whether the intact or affected limb should be used to initiate gait during rehabilitation and prosthetic training.

The aim of this study was to investigate the comparison between a Ki-hap, defined as a psyching-up technique, and verbal encouragement, defined as a verbal command by a third party, on abdominal muscle activation during performance of the crunch exercise in healthy participants. Ninety participants were randomly allocated to the following three groups: crunch only exercise group (CG, n1 = 30), crunch exercise with Ki-hap group (CKG, n2 = 30), and crunch exercise with Ki-hap and verbal encouragement group (CKVG, n3 = 30). The interventions were conducted over three trials with each group, and measurements involving each participant, were performed by a single examiner. The activation of the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were evaluated using electromyography (EMG) during performance of the crunch exercise by the CG, CKG, and CKVG. Our results showed a significantly greater increase in the EMG patterns of all muscles during performance of the crunch exercise in the CKG (p < 0.05) compared to those in the CG and CKVG. The results also showed that there was a significantly greater increase in the activation of the EO and IO muscles in the CKVG (p < 0.05) compared with that in the CG. These findings demonstrated that the addition of the Ki-hap technique and verbal encouragement, during performance of the crunch exercise, improves activation of the abdominal muscles.

This commentary regards the inferences of the findings related to the effect of crossed-education using the progressive task-oriented approach on a tilt table in stroke patients. The findings from these studies recommend that crossed-education using the task-oriented training on the tilt table was very helpful for the function and rehabilitation of lower limb and clinical scores in acute and chronic hemiplegic stroke patients. Since these publications, a novel neurorehabilitation strategy using the crossed-education approach has been reported instead of rehabilitation treatment method concentrated on the affected-side. This has not been used in any study with acute and chronic stroke subjects. Furthermore, follow-up study also obtained that the use of crossed-education using task-oriented training on a tilt table has more aids on the betterment of maximal grip strength and arm function in a sub-acute stage of post-stroke hemiplegia subjects. Therefore, our proposed therapeutic approach could be a novel neuro-rehabilitation strategy for patients with various upper and lower limb severities.

Because two types of side-channel attacks, namely passive information leakages and active fault injections, are considered separate implementation threats to cryptographic modules, most countermeasures against these attacks have been independently developed. However, Amiel et al. demonstrated that a fault injection combined with a simple power analysis SPA can break such a classical Rivest, Shamir, and Adelman RSA system implementation. In this paper, we show that this combined attack CA can be applied to the Boscher, Naciri, and Prouff algorithm, which is an SPA/fault attack FA-resistant exponentiation method for RSA implementation. Furthermore, this paper proposes a novel exponentiation algorithm resistant to power analysis and an FA as well as to the CA. The proposed exponentiation algorithm can be employed for secure Chinese remainder theorem-RSA implementation. In addition, the paper presents some experimental results of an SPA under the assumption of a successful fault injection.

[Purpose] The purpose of this study was to examine the effects of Tai Chi (TC)-based exercise on dynamic postural control during obstacle negotiation by subjects with mild or moderate Parkinson's disease (PD). [Subjects] Twelve subjects (mean age, 65.3±6.1 years) diagnosed with idiopathic PD were enrolled for this study. [Methods] All the subjects were tested a week before and 12 weeks after the initiation of the TC exercise. In the test, they were instructed to negotiate an obstacle from the position of quiet stance at a normal speed. They were trained with TC exercise that emphasized multidirectional shift in weight bearing from bilateral to unilateral support, challenging the postural stability, three times per week for 12 weeks. Center of pressure (COP) trajectory variables before and after TC exercise were measured using two force plates. [Results] A comparison of the results between pre- and post-intervention showed a statistically significant improvement in anteroposterior and mediolateral displacement of COP. [Conclusion] Twelve weeks of TC exercise may be an effective and safe form of stand-alone behavioral intervention for improving the dynamic postural stability of patients with PD. Language: en

10 young adults (6 males/4 females, 24.6±1.9 years, age range: 22.0-26.9) and 10 older adults (1 male/9 females, 76.9±5.1 years, age range: 65.2-81.2) participated in the study. Both groups crossed an obstacle, which is 10% of leg length, and COM was measured using motion analysis system. Independent t-test was used to find significant differences between two groups.

The purposes of the present study were to compare the effects of backward and lateral walking training and to identify whether additional backward or lateral walking training would be more effective in increasing the walking function of poststroke patients.Fifty-one subjects with hemiplegic stroke were randomly allocated to 3 groups, each containing 17 subjects: the control group, the backward walking training group, and the lateral walking training group. The walking abilities of each group were assessed using a 10-m walk test and the GAITRite system for spatiotemporal gait.The results show that there were significantly greater posttest increases in gait velocity (F = -12.09, P = 0.02) and stride length (F = -11.50, P = 0.02), decreases in the values of the 10-m walk test (F = -7.10, P = 0.03) (P0.05) and double-limb support period (F = 40.15, P = 0.000), and improvements in gait asymmetry (F = 13.88, P = 0.002) (P0.01) in subjects in the lateral walking training group compared with those in the other 2 groups.These findings demonstrate that asymmetric gait patterns in poststroke patients could be improved by receiving additional lateral walking training therapy rather than backward walking training.Complete the self-assessment activity and evaluation online at http://www.physiatry.org/JournalCME CME OBJECTIVES: Upon completion of this article, the reader should be able to: (1) understand the potential benefits of backward walking (BW) and lateral walking (LW) training on improving muscle strength and gait; (2) appreciate the potential value of backward and lateral walking gait training in the treatment of hemiplegic stroke patients; and (3) appropriately incorporate backward and lateral walking gait training into the treatment plan of hemiplegic stroke patients.Advanced ACCREDITATION: The Association of Academic Physiatrists is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.The Association of Academic Physiatrists designates this activity for a maximum of 1.5 AMA PRA Category 1 Credit(s)™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

The aim of this study was to determine the effect of whole-body vibration training combined with task-related training on arm function, spasticity, and grip strength in subjects with poststroke hemiplegia.Forty-five subjects with poststroke were randomly allocated to 3 groups, each with 15 subjects as follows: control group, whole-body vibration group, and whole-body vibration plus task-related training group. Outcome was evaluated by clinical evaluation and measurements of the grip strength before and 4 weeks after intervention.Our results show that there was a significantly greater increase in the Fugl-Meyer scale, maximal grip strength of the affected hand, and grip strength normalized to the less affected hand in subjects undergoing the whole-body vibration training compared with the control group after the test. Furthermore, there was a significantly greater increase in the Wolf motor function test and a decrease in the modified Ashworth spasticity total scores in subjects who underwent whole-body vibration plus task-related training compared with those in the other 2 groups after the test.The findings indicate that the use of whole-body vibration training combined with task-related training has more benefits on the improvement of arm function, spasticity, and maximal grip strength than conventional upper limb training alone or with whole-body vibration in people with poststroke hemiplegia.

PURPOSE: The object of the present study is to investigate the effects of the insole supporting medial longitudinal arch while walking in spastic cerebral palsy with pes planus. METHODS: Ten spastic bilateral cerebral palsy children with pes planus participated in this study. The insole were custom-made for the individual child. Muscle activity was measured by surface EMGs attached on tibialis anterior (TA), gastrocnemius (GA), vastus medialis oblique (VMO), biceps femoris long head (BF). temporal-spatial parameters such as velocity, step length, stride length, stance time, toe angle were collected while the subjects walked on the GAITRite system. RESULTS: The results of the present study were summarized as follows: 1. Muscle activities in mean EMGs while walking: Left VMO, Right TA, Left BF and GA revealed significant reductions after applying insole. 2. Muscle activities in peak EMGs while walking: Left TA and BF demonstrated reductions significantly after applying insole. 3. There were improvements in temporal-spatial gait parameters with insole: velocity, both step length, Right stride length and Right toe angle were increased(p