Search

Background: The peroneus longus (PL) and peroneus brevis (PB) function as the primary muscles of eversion, a movement closely associated with tibial external rotation for ankle mor-tise stability. Ankle motion and tibial rotation vary based on different ankle and knee positions. Objects: This study aimed to investigate the PL, PB, and biceps femoris (BF) muscle activation and eversion strength during side-lying isometric eversion exercise based on different ankle positions (neutral [N] and plantarflexion [PF]) and knee positions (90° flexion [KF] and exten-sion [KE]). Methods: Thirty healthy adults with an Ankle Joint Functional Assessment Tool score of ≥ 22 were recruited (mean age = 24.8 ± 3.1 years). Maximal isometric eversion strength and submaximal muscle activation of the PL, PB and BF were measured during isometric eversion exercise in side-lying. A 2 × 2 repeated measures analysis of variance was performed to inves-tigate differences in muscle activation and strength. Results: The PL and PB muscle activation showed significant main effects with the knee and ankle positions (p < 0.05); activation was greater in the KE and PF positions than in the KF and N positions. The BF muscle activation showed a significant interaction effect with knee and ankle positions, which was greater in knee extension and ankle plantarflexed (KEPF) posi-tion than in knee flexion and ankle plantarflexed (KFPF) position (p < 0.05). Eversion strength showed a significant main effect only in ankle position (p < 0.05) and was greater in the N position than in the PF position. Conclusion: The results of this study indicate that the KEPF position can be recommended to facilitate contraction of the PL and PB during side-lying eversion exercise. Furthermore, the effects of the knee-ankle positions should be considered for measuring ankle eversion strength and implementing the isometric submaximal side-lying eversion exercise.

Background: In Taekwondo athletes, ankle sprain is the most common risk factor for injury. Repeated ankle injuries lead to weakness and imbalance of the ankle muscles, resulting in chronic ankle instability (CAI). Both the ankle and toe muscles contribute to the inversion and eversion of the foot at the subtalar joint. Therefore, it is necessary to consider the ankle and toe joint positions when measuring ankle invertor and evertor strength. Objects: This study aimed to compare the muscle strength and ratio differences of the ankle invertor and evertor muscles in both the toe and ankle positions between the CAI and unin-jured sides in Taekwondo athletes. Methods: Fifteen Taekwondo athletes participated in this study. The isometric strengths of both the ankle invertor and evertor were determined in different ankle and toe positions (dor-siflexion with toe extension, dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion). Paired t-tests were used to determine the differences be-tween the ankle invertor and evertor in strength and ratio according to toe and ankle positions between the ankle CAI side and the uninjured side. Results: The results demonstrated that ankle evertor strength significantly decreased in all ankle and toe positions on the CAI side (p < 0.05). In addition, significant differences were observed in the ratios of the ankle invertor and evertor strengths in the dorsiflexion with toe flexion, plantarflexion with toe extension, and plantarflexion with toe flexion positions (p < 0.05). Conclusion: The findings of this study suggest that athletes, trainers, and clinicians should consider ankle and toe positions when measuring invertor and evertor strength and develop ankle rehabilitation protocols for Taekwondo athletes with CAI.

Background: Stress urinary incontinence (SUI) impacts the social, physical, and psychologi-cal well-being and quality of life of the patient. Several techniques exist for its management, including transcutaneous electrical stimulation (TES). Objects: We aimed to demonstrate the effects of TES on ultrasonographic variables and quality of life in women with SUI. Methods: This prospective study recruited 21 women who had been diagnosed with grade 1 or 2 SUI between July 2018 and March 2019. The exclusion criteria were pregnancy and a history of urogenital surgery. All participants were assessed at baseline and 8 weeks after intervention initiation. The bladder neck position (BNP), length of the urethra (LU), funneling index (FI), and rhabdosphincter thickness (RT) were measured. The Incontinence-Quality of Life (I-QOL) was used to assess incontinence-specific quality of life. Statistical significance level was set at p < 0.05. Results: Twenty-one patients with SUI used TES for 8 weeks. BNP and FI significantly de-creased after intervention (p < 0.05). LU, anterior and posterior RT (indicators of external sphincter hypertrophy) significantly increased post-intervention (p < 0.05). The total I-QOL score increased from 64.81 to 71.86 after the intervention (p < 0.05). Conclusion: This intervention improved BNP, LU, FI, RT, and subjective indicators such as quality of life in women with SUI. Therefore, TES can be an effective non-surgical treatment method for improving SUI symptoms and quality of life in these patients.

Abstract Objectives The traditional understanding of craniocervical alignment emphasizes specific anatomical landmarks. However, recent research has challenged the reliance on forward head posture as the primary diagnostic criterion for neck pain. An advanced relationship exists between neck pain and craniocervical alignment, which requires a deeper exploration of diverse postures and movement patterns using advanced techniques, such as clustering analysis. We aimed to explore the complex relationship between craniocervical alignment, and neck pain and to categorize alignment patterns in individuals with nonspecific neck pain using the K-means algorithm. Methods This study included 229 office workers with nonspecific neck pain who applied unsupervised machine learning techniques. The craniocervical angles (CCA) during rest, protraction, and retraction were measured using two-dimensional video analysis, and neck pain severity was assessed using the Northwick Park Neck Pain Questionnaire (NPQ). CCA during sitting upright in a comfortable position was assessed to evaluate the resting CCA. The average of midpoints between repeated protraction and retraction measures was considered as the midpoint CCA. The K-means algorithm helped categorize participants into alignment clusters based on age, sex and CCA data. Results We found no significant correlation between NPQ scores and CCA data, challenging the traditional understanding of neck pain and alignment. We observed a significant difference in age (F = 140.14, p

Background: Lateral instability of the ankle is one of the most common causes of musculoskeletal ankle injuries. The peroneus longus (PL) and peroneus brevis (PB) contribute to ankle stability. In early rehabilitation, isometric exercises have been selected for improvement of ankle stability. To effectively train the peroneal muscles during eversion, it is important to consider ankle and body posture. Objects: This study aimed to compare activation of the PL, PB, and biceps femoris (BF) muscles during eversion in different ankle postures (neutral [N], plantarflexed [PF]) and body postures (sitting and side-lying). Methods: Thirty healthy individuals with no history of lateral ankle sprains within the last 6 months were included in the study. Maximal isometric strength of eversion and muscle activation were measured simultaneously. Muscle activation at submaximal eversion was divided by the highest value obtained from maximal isometric eversion among the four postures (percent maximal voluntary isometric contraction [%MVIC]). To examine the differences in muscle activation depending on posture, a 2 × 2 repeated measures analysis of variance (ANOVA) was conducted. Results: There were significant interaction effects of ankle and body postures on PL muscle activation and evertor strength (p < 0.05). The PL muscle activation showed a significantly greater difference in the side-lying and PF conditions than in the sitting and N conditions (p < 0.05). Evertor strength was greater in the N compared to the PF condition regardless of body posture (p < 0.05). In the case of PB and BF muscle activation, only the main effects of ankle and body posture were observed (p < 0.05). Conclusion: Among the four postures, the side-lying-PF posture produced the highest muscle activation. The side-lying-PF posture may be preferred for effective peroneal muscle exercises, even when considering the BF muscle.

Background: Single-leg squat (SLS)s are commonly used as assessment tool and closed kinetic exercises are useful for assessing performance of the lower extremities. Pronated feet are associated with foot pressure distribution (FPD) during daily activities. Objects: To compare the FPD during SLSs between groups with pronated and normal feet. Methods: This cross-sectional study included 30 participants (15 each in the pronated foot and control groups) are recruited in this study. The foot posture index was used to distinguish between the pronated foot and control groups. The Zebris FDM (Zebris Medical GmbH) stance analysis system was used to measure the FPD on the dominant side during a SLS, which was divided into three phases. A two-way mixed-model ANOVA was used to identify significant differences in FPD between and within the two groups. Results: In the hallux, the results of the two-way mixed-model ANOVAs revealed a significant difference between the group and across different phases (p < 0.05). The hallux, and central forefoot were significantly different between the group (p < 0.05). Moreover, significant differences across different phases were observed in the hallux, medial forefoot, central forefoot, lateral forefoot, and rearfoot (p < 0.05). The post hoc t-tests were conducted for the hallux and forefoot central regions. In participants with pronated foot, the mean pressure was significantly greater in hallux and significantly lower, in the central forefoot during the descent and holding phases. Conclusion: SLSs are widely used as screening tests and exercises. These findings suggest that individuals with pronated feet should be cautious to avoid excessive pressure on the hallux during the descent-to-hold phase of a SLS.

Background: Limitations of shoulder range of motion (ROM), particularly shoulder internal rotation (SIR), are commonly associated with musculoskeletal disorders in both the general population and athletes. The limitation can result in connective tissue lesions such as superior labrum tears and symptoms such as rotator cuff tears and shoulder impingement syndrome. Maintaining the center of rotation of the glenohumeral joint during SIR can be challenging due to the compensatory scapulothoracic movement and anterior displacement of the humeral head. Therefore, observing the path of the instantaneous center of rotation (PICR) using the olecranon as a marker during SIR may provide valuable insights into understanding the dynamics of the shoulder joint. Objects: The aim of the study was to compare the displacement of the olecranon to measure the rotation control of the humeral head during SIR in individuals with and without restricted SIR ROM. Methods: Twenty-four participants with and without restricted SIR ROM participated in this study. The displacement of olecranon was measured during the shoulder internal rotation control test (SIRCT) using a Kinovea (ver. 0.8.15, Kinovea), the 2-dimensional marker tracking analysis system. An independent t-test was used to compare the horizontal and vertical displacement of the olecranon marker between individuals with and without restricted SIR ROM. The statistical significance was set at p < 0.05. Results: Vertical displacement of the olecranon was significantly greater in the restricted SIR group than in the control group (p < 0.05). However, no significant difference was observed in the horizontal displacement of the olecranon (p > 0.05). Conclusion: The findings of this study indicated that individuals with restricted SIR ROM had significantly greater vertical displacement of the olecranon. The results suggest that the limitation of SIR ROM may lead to difficulty in rotation control of the humeral head.

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

Background: The serratus anterior (SA) is a muscle that performs protraction of the scapulothoracic joint and plays a role in stabilizing the scapula. Imbalances or weaknesses in SA activation are associated with a variety of shoulder dysfunctions, making selective SA strengthening important for rehabilitation. Objects: We aimed to compare the muscle activation of the pectoralis major (PM), SA, external oblique (EO), and internal oblique (IO) during the push-up plus (PUP) exercise with isometric hip adduction (HA) and abdominal drawing-in maneuver (ADIM). Methods: Nineteen healthy male participants performed three PUP exercises: standard PUP, PUP with ADIM, and PUP with HA. Surface electromyography was used to measure and analyze the muscle activity for PM, SA, EO, and IO. Results: PUP with HA showed the lowest PM activity and highest SA activity, and no significant difference was observed between PUP and PUP with ADIM. PUP with ADIM showed significantly the highest EO and IO activity, followed by PUP with HA and PUP. Additionally, PUP with HA showed the lowest PM/SA ratio, and no significant difference was noted between PUP and PUP with ADIM. Conclusion: PUP with HA was able to show high SA muscle activity while reducing PM muscle activity. In addition, PUP with HA can lead to higher EO and IO muscle activity than standard PUP. This exercise could be used as a practical exercise method to selectively strengthen SA and improve scapular muscle stability during early shoulder rehabilitation.

This study aimed to evaluate the effectiveness of our newly developed virtual reality head-mounted display (VR-HMD) “walker avoidance” game in reducing step-aside reaction time (SART) and enhancing agility in collision avoidance. Fifteen young adults in experimental group (EG) engaged in the “walker avoidance” game, while another 15 young adults in the control group (CG) played the “first touch” tutorial. The results showed the EG had significant decreases (p < 0.01) in both SART-standing and SART-walking when compared with pre-intervention measurements. Compared with the CG, the EG SART-standing exhibited significant decreases in both the first (p = 0.001) and second (p < 0.001) measurements post-intervention; the EG SART-walking demonstrated significant decreases in all (p < 0.05) measurements, except for pre-intervention measurement. One-dimensional statistical parametric mapping (spm1d) also demonstrated significant differences in most of the electromyography and forefoot/hindfoot ground reaction force results because the step-aside movement became quicker in the EG following training. After pushing the leg-heel contact, the EG participants made a toe-off sooner than the CG participants. Following two sessions of our newly developed “walker avoidance” game, conducted 1 week apart, the EG exhibited less collisions with virtual pedestrians and reduced reaction times to unpredictable directional change measurements compared with the CG. This study demonstrated the effectiveness of this targeted VR training program in improving motor function, which introduced a novel approach to rehabilitation as a digital therapy. It offers innovative perspectives and an approach for clinical rehabilitation, while also providing new ideas for the VR content development industry.

In this study, we evaluated the antiphotoaging properties of Actinidia chinensis Planch (ACP) and the molecular mechanisms underlying its ability to prevent UVB-mediated photoaging. Administration of the ethanolic extract of ACP (EEACP) to the dorsal area of hairless mice effectively ameliorated UVB-mediated wrinkle formation, epidermal thickening, and loss of lipid droplets in the epidermis. Additionally, the UVB-induced loss of collagen content in the epidermis was significantly attenuated in mouse skin treated with EEACP. The expression of procollagen type 1 and metalloproteinase-1a, which are related to collagen content in the epidermis, was restored by EEACP treatment in UVB-irradiated mice and NIH-3T3 mouse skin fibroblast cells. Interestingly, EEACP effectively ameliorated UVB-induced reactive oxygen species overproduction. Furthermore, the activation/phosphorylation of AKT, rather than mitogen-activated protein kinases, has been identified as a major target of EEACP in preventing UVB-mediated photoaging. Additionally, N-(1 deoxy-1-fructosyl) valine and phenethylamine glucuronide were identified as analytical indicators of EEACP using high-performance liquid chromatography/mass spectrometry. These results suggest that EEACP can be developed as a functional natural agent capable of preventing photoaging by attenuating UVB-induced activation of the reactive oxygen species/AKT pathway.

Background: Falls are a common and serious problem in the elderly population. Muscle strength and balance are important factors in the prevention of falls. The Y-balance test (YBT) is used to assess dynamic postural control and shows excellent test-retest reliability. However, no studies have examined the relationship between lower-limb strength and YBT scores in elderly women. Objects: This study aimed to examine the relationship between lower-limb strength and YBT scores in elderly women. Methods: Thirty community-dwelling elderly women participated in the study. Lower-limb strength including hip flexor, hip extensor, hip abductor (HAB), hip adductor (HAD), knee flexor, knee extensor, ankle dorsiflexor, and ankle plantar flexor (PF) muscles was examined using a smart KEMA strength sensor (KOREATECH Inc.), and the YBT was used to assess dynamic balance. Relationship between lower-limb strength and YBT was demonstrated using a Pearson’s correlation coefficient. Results: HAB strength (r = 0.388, p < 0.05), HAD strength (r = 0.362, p < 0.05), and ankle PF strength (r = 0.391, p < 0.05) positively correlated with the YBT-anterior direction distance. Ankle PF strength was positively correlated with the YBT-posteromedial direction distance (r = 0.396, p < 0.05) and composite score (r = 0.376, p < 0.05). Conclusion: The results of this study suggest that HAB, HAD, and ankle PF strengths should be considered for dynamic postural control in elderly women.

Background: The elderly population is increasing rapidly worldwide. Muscle mass, usual walking speed (UWS), knee extension strength (KES), hand grip strength (HGS), peak expiratory flow (PEF), and depression is used for sarcopenia diagnosis. All four of these factors (KES, HGS, PEF, and depression) correlated with UWS and also to muscle mass. But, many studies have suggested that no correlation exists between muscle mass and UWS. Objects: This study aimed: 1) to investigate whether muscle mass reduction affected UWS, as mediated by KES, HGS, PEF and depression, and 2) to explored whether significant changes in these mediators varied by the body segment in which muscle mass evaluated in elderly female aged 65–80 years. Methods: A total of 100 female aged 65–80 years were surveyed. Muscle mass was measured by body segment (upper and lower segment), and KES, HGS, PEF, depression, and UWS were also assessed. Median analyses were progressed in IBM SPSS software (ver. 23.0, IBM Co.) using a downloaded INDIRECT macro. Results: The direct effect of the KES and PEF were significant, and the indirect effect of KES and PEF were not significant. Thus, KES and PEF served as full mediators of the effect of muscle mass on UWS. Regardless of bodily region, KES and PEF combined with muscle mass were significant mediators of UWS, with similar indirect effect sizes. Conclusion: KES and PEF are the only mediators regardless of body part. Therefore, mediating the KES and PEF may prevent sarcopenia progression in elderly female. Also, sarcopenia can be readily assessed by evaluating either the upper or lower body; it is not necessary to measure total muscle mass.

Background: Various functional tests such as upper quarter Y-balance test (UQYBT) are used to evaluate shoulder stability and mobility in clinical or sports fields. Previous studies have been conducted to determine the correlation between the scapular or trunk muscle and UQYBT. However, the correlation between UQYBT and hip flexor, which can be considered as a core muscle, has not been confirmed. Objects: To verify the relationship between the UQYBT and scapular muscle (scapular protractor and lower trapezius [LT]), trunk muscle, and hip flexor strengths in healthy male participants. Methods: A total of 37 healthy male participants were recruited and underwent UQYBT in the push-up posture. The isometric strength of the scapular protractor, LT, trunk flexor and extensor, and hip flexors were measured using a smart KEMA strength sensor (KOREATECH Inc.). Results: The superolateral direction of the UQYBT was moderately to strongly related to trunk extensor (r = 0.443, p < 0.01), scapular protractor (r = 0.412, p < 0.05), LT (r = 0.436, p < 0.01), and both sides of the hip flexors (supporting-side: r = 0.669, p < 0.01; non-supporting- side: r = 0.641, p < 0.01). The inferolateral direction of the UQYBT was moderately related to the scapular protractor (r = 0.429, p < 0.01), LT (r = 0.511, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.481, p < 0.01; non-supporting-side: r = 0.521, p < 0.01). The medial direction of the UQYBT was moderately to strongly related with the scapular protractor (r = 0.522, p < 0.01), LT (r = 0.541, p < 0.01), and both sides of hip flexors (supporting-side: r = 0.605, p < 0.01; non-supporting-side: r = 0.561, p < 0.01). Conclusion: This study showed that the strength of the scapular muscles, trunk muscles, and hip flexor muscles correlated to the UQYBT. Therefore, the strength of not only the scapular and trunk muscles but also the hip flexor muscles should be considered to improve the UQYBT.

Objective Ankle injuries in delivery workers (DWs) are often caused by trips, and high recurrence rates of ankle sprains are related to chronic ankle instability (CAI). Heel rise requires joint angles and moments similar to those of the terminal stance phase of walking that the foot supinates. Thus, our study aimed to develop, determine, and compare the predictive performance of statistical machine learning models to classify DWs with and without CAI using ankle kinematics during heel rise. Methods In total, 203 DWs were screened for eligibility. Seven predictors were included in our study (age, work duration, body mass index, calcaneal stance position angle [CSPA] in the initial and terminal positions during heel rise, calcaneal movement during heel rise [CM HR ], and plantar flexion angle during heel rise). Six machine learning algorithms, including logistic regression, decision tree, AdaBoost, Extreme Gradient boosting machines, random forest, and support vector machine, were trained. Results The random forest model (area under the curve [AUC], 0.967 [excellent]; F1, 0.889; accuracy, 0.925) confirmed the best predictive performance in the test datasets among the six machine learning models. For Shapley Additive Explanations, old age, low CMHR, high CSPA in the initial position, high PFA, long work duration, low CSPA in the terminal position, and high body mass index were the most important predictors of CAI in the random forest model. Conclusion Ankle kinematics during heel rise can be considered in the classification of DWs with and without CAI.

Background: The gluteus medius (Gmed) plays a critical role in maintaining frontal plane stability of the pelvis during functional activities, such as one-leg lifting. Side-lying hip abduction (SHA) has been used as a dynamic test to evaluate Gmed function. However, the abduction force of the lower leg against the floor is not controlled during SHA. Therefore, hip abduction performance with contralateral adduction in the side-lying position (HAPCA) can be proposed as an alternative method to assess performance of hip abduction. If the number of HAPCA is related to the lateral pelvic shift distance, a new quantitative measurement for hip abductor function may be presented. Objects: This study aimed to investigate the relationship between the number of successful HAPCA and the lateral pelvic shift distance during one-leg lifting. Methods: Thirty healthy participants were recruited, and lateral pelvic shift distance was measured during one-leg lifting test using two-dimensional analysis. The number of successful HAPCA was counted when participants touched both target bars at the beat of a metronome. Results: There was a negative correlation between the number of HAPCA and lateral pelvic shift distance during one-leg lifting (r = –0.630, p < 0.05). The number of HAPCA accounted for 39.7% of the variance in the lateral pelvic shift distance during one-leg lifting (F = 18.454, p < 0.001). Conclusion: The number of successful HAPCA is significantly correlated with lateral pelvic shift distance during one-leg lifting. This finding suggests that HAPCA can be proposed as a new measurement for hip abductor performance and more research is needed on its relationship with hip abductor strength.

Background: Delivery workers repeatedly get in and out of trucks and walk or run to deliver packages during work. Iliotibial band syndrome (ITBS) is a well-known non-traumatic overuse injury of the lateral side of the knee caused by frequent knee flexion and extension. Hip muscle strength is among the factors that prevent lower extremity injuries. Although many studies have examined the relationship between ITBS and hip muscle strengths, there was no study comparing hip muscle strength and ratio between delivery workers with and without ITBS. Objects: This study aimed to compare hip muscle strength and hip internal/external rotator and adductor/abductor strength ratios between delivery workers with and without ITBS. Methods: Fourteen delivery workers with ITBS matched inclusion criteria in the present study among 20 participants. Because total sample size was required 28 subjects by G*power program (ver. 3.1.9.4; University of Trier), 14 delivery workers without ITBS were recruited. Hip muscle strengths were measured in a side-lying position using a Smart KEMA pulling sensor (KOREATECH Co. Ltd.). An independent t-test was used to compare hip muscle strengths and hip internal/external rotator and hip adductor/abductor strength ratios between delivery workers with and without ITBS. Results: The adductor/abductor strength ratio was significantly greater in delivery workers without ITBS than in those with ITBS (p < 0.05). The strengths of the hip abductor, hip adductor, hip internal rotator, hip external rotator, and the ratio of internal/external rotator strengths were not significantly different between the delivery workers with and without ITBS (p > 0.05). Conclusion: This study’s findings showed that delivery workers with ITBS had significantly lesser adductor/abductor strength ratio, while the strengths of the hip abductor and adductor muscles did not differ significantly. These results suggest that adductor/abductor strength ratio should be considered when evaluating and treating ITBS in delivery workers.

Background: Posterior capsule tightness (PCT), commonly seen in overhead athletes, is a soft tissue adaptation that is also noted in non-throwers. PCT is associated with scapular and humeral kinematic alterations, significant restriction of shoulder internal rotation (IR) range of motion (ROM), and significant scapular anterior tilting. Sleeper and cross-body stretches (CBS) are suggested for PCT and IR deficits, and have been modified since introduction. A novel modified sleeper stretch (NMSS) was designed in this study to prevent the risk of anterior translation of the humeral head. Though the effects of posterior shoulder stretching exercise have been widely studies, to the best of our knowledge, no previous studies have investigated the effectiveness of posterior shoulder exercises in decreasing scapular anterior tilting. Objects: To compare the immediate effects of two posterior shoulder stretching exercises (NMSS and CBS) on scapular anterior tilting and shoulder IR ROM. Methods: Thirty-two subjects with anteriorly tilted scapula and IR deficits [mean age: 24.3 ± 2.5 years; 15 males and 17 females] participated in this study. Subjects were randomly assigned to either the NMSS or CBS groups. Scapular anterior tilting (at rest and at shoulder 60° active IR) and shoulder IR ROM were measured before and immediately after intervention. Results: Scapular anterior tilting significantly decreased, while the shoulder IR ROM significantly increased in both groups. However, there was no significant group-by-time interaction effect or significant difference between the groups. Conclusion: Both stretching exercises were effective in restoring shoulder IR ROM and decreasing scapular anterior tilting.

Abstract Background Upper trapezius (UT) pain with myofascial trigger points (MTrPs) can affect movement at the glenohumeral joint as well as at the scapulothoracic joint. The investigation of muscle recruitment patterns can discern motor control strategies. The purpose of this study was to compare shoulder muscle recruitment patterns and muscle activity according to various loads between individuals with and without chronic UT pain. Methods In this cross-sectional study, twenty-four participants that had UT pain with MTrPs and sex, age, body weight matched 24 controls with no UT pain were recruited. Surface EMG electrodes were attached to the UT, the serratus anterior (SA), the lower trapezius (LT) and the middle deltoid (MD). All participants performed isometric shoulder abduction with a load of 25%, 50%, or 75% of the maximum strength at 60° of shoulder abduction. The EMG activity, the activity ratio (SA/UT, LT/UT, MD/UT), and the relative contribution of each muscle activity were calculated. Results MD activity was significantly decreased in the UT pain group compared to that in the control group (p

Background: The lateral step down (LSD) is a form of stair negotiation used by the elderly because it requires less movement of the lower extremity. Although it is necessary to study the amount of pelvic drop and the strength of a hip abductor during LSD for intervention, limited studies have investigated the relationship between the amount of pelvic drop and strength of a hip abductor during LSD in elderly people.Objects: This study aimed to determine the relationship between the amount of pelvic drop on an unsupported leg and the strength of the hip abductor during LSD in the elderly.Methods: Thirty elderly people (male: 17, female: 13) were recruited. Subjects performed the LSD task, and the evaluator measured and the amount of pelvic drop on an unsupported side. Also, the isometric strength of the hip abductor was measured in a supine position.Results: We found significant relationships between the strength of the hip abductor and the amount of pelvic drop (r = –0.386). The average hip abductor strength normalized by body weight was 1.06 N/kg (max: 1.99, min: 0.52) and the average contralateral pelvic drop (CPD) angle was 4.16° (max: 15.3, min: 0).Conclusion: Our results indicated that the strength of the hip abductor had a moderate cor-relation with the CPD during a LSD in the elderly. Hip abductor weakness could translate into altered movement of the pelvis.

Background: Pronated foot posture (PFP) contributes to excessive dynamic knee valgus (DKV). Although foot orthoses such as medial arch support (MAS) are widely and easily used in clinical practice and sports, few studies have investigated the effect of MAS on the improve-ment of DKV during stair descent in individuals with a PFP. Moreover, no studies reported the degree of improvement in DKV according to the severity of PFP when MAS was applied.Objects: This study aimed to examine the immediate effect of MAS on DKV during stair descent and determine the correlation between navicular drop distance and changes in DKV when MAS is applied.Methods: Twenty individuals with a PFP (15 males and five females) participated in this study. The navicular drop test was used to measure PFP severity. The frontal plane projection angle (FPPA) was calculated under two conditions, with and without MAS application, using 2-dimensional video analysis.Results: During stair descent, the FPPA with MAS (173.1° ± 4.7°) was significantly greater than that without MAS (164.8° ± 5.8°) (p < 0.05). There was also a significant correlation between the navicular drop distance and improvement in the FPPA when MAS was applied (r = 0.453, p = 0.045).Conclusion: MAS application can affect the decrease in DKV during stair descent. In addi-tion, MAS application should be considered to improve the knee alignment for individuals with greater navicular drop distance.

Background: Trunk movements are an important factor in activities of daily living; however, these movements can be impaired by stroke. It is difficult to quantify and measure the active range of motion (AROM) of the trunk in patients with stroke.Objects: To determine the reliability and validity of measurements using a digital goniometer (DG) and smart phone (SP) applications for trunk rotation and lateral flexion in stroke patients.Methods: This is an observational study, in which twenty participants were clinically diag-nosed with stroke. Trunk rotation and lateral flexion AROM were assessed using the DG and SP applications (Compass and Clinometer). Intrarater reliability was determined using intraclass correlation coefficients (ICCs) with 95% confidence intervals. Pearson correlation coefficient was used to determine the validity of the DG and SP in AROM measurement. The level of agreement between the two instruments was shown by Bland–Altman plot and 95% limit of agreement (LoA) was calculated.Results: The intrarater reliability (rotation with DG: 0.96–0.98, SP: 0.98; lateral flexion with DG: 0.97–0.98, SP: 0.96) was excellent. A strong and significant correlation was found be-tween DG and SP (rotation hemiplegic side: r = 0.95; non-hemiplegic side: r = 0.90; lateral flexion hemiplegic side: r = 0.88; non-hemiplegic side: r = 0.78). The level of agreement between the two instruments was rotation (hemiplegic side: 23.02° [LoA 17.41°, –5.61°]; non-hemiplegic side: 31.68° [LoA 23.87°, –7.81°]) and lateral flexion (hemiplegic side: 20.94° [LoA 17.48°, –3.46°]; non-hemiplegic side: 27.12° [LoA 18.44°, –8.68°]).Conclusion: Both DG and SP applications can be used as reliable methods for measuring trunk rotation and lateral flexion in patients with stroke. Although, considering the level of clinical agreement, DG and SP could not be used interchangeably for measurements.

Background: The craniocervical flexion test (CCFT) was developed for the activation and en-durance of deep cervical flexors. However, the muscle thickness and muscle thickness chang-ing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported.Objects: To determine the difference in thickness of the SCM and DCF muscles and the differ-ence in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP.Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maxi-mum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonog-raphy was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP.Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

Background: The superimposed technique (ST) involves the application of electrical muscle stimulation (EMS) during voluntary muscle action. The physiological effects attributed to each stimulus may be accumulated by the ST. Although various EMS devices for the quadriceps muscle are being marketed to the general public, there is still a lack of research on whether ST training can provide significant advantages for improving quadriceps muscle strength or thickness compared with EMS alone.Objective: To compare the effects of eight weeks of ST and EMS on the thicknesses of the rectus femoris (RF) and vastus intermedius (VI) muscles and knee extension strength.Methods: Thirty healthy subjects were recruited and randomly assigned to either the ST or EMS groups. The participants underwent ST or EMS training for eight weeks. In all partici-pants, the thicknesses of the RF and VI muscles were measured before and after the 8-week intervention by ultrasonography, and quadriceps muscle strength was measured using the Smart KEMA tension sensor (KOREATECH Co., Ltd.).Results: There were significant differences in the pre- and post-intervention thicknesses of the RF and VI muscles as well as the quadriceps muscle strength in both groups (p < 0.05). RF thickness was significantly greater in the ST group (F = 4.294, p = 0.048), but there was no significant difference in VI thickness (F = 0.234, p = 0.632) or knee extension strength (F = 0.775, p = 0.386).Conclusion: EMS can be used to improve quadriceps muscle strength and RF and VI muscle thickness, and ST can be used to improve RF thickness in the context of athletic training and fitness.

Background: The serratus anterior (SA) muscle prevents scapular winging (SW) by stabilizing the medial border of the scapula during arm movement. The upper trapezius (UT) and lower trapezius (LT) muscles may compensate for the weak SA muscle in individuals with SW during shoulder flexion. However, there is no study to examine whether compensation by UT and LT occurs in individuals with SW.Objects: This study compared the muscle activities of UT, LT, and SA as well as the SA/UT activity ratio between individuals with and without SW during shoulder flexion with load.Methods: This study recruited 27 participants with SW (n = 14) and without SW (n = 13). Electromyography data of the SA, UT, and LT muscles and SA/UT activity ratio were recorded and analyzed during shoulder flexion with 25% load of the maximal shoulder flexion force. Independent t-test was used to compare the UT, LT, and SA muscle activities and SA/UT ratio between the groups with and without SW; statistical significance was set at α of 0.05.Results: SA activity was significantly lesser in the group with SW than in the group without SW. However, there were no significant differences in the UT and LT activities and SA/UT activ-ity ratio between the two groups.Conclusion: The SA activity was lesser in the group with SW than in the group without SW with 25% load of the maximal shoulder flexion force, but there was no compensatory muscle activity of the UT and LT observed. Therefore, further studies are warranted to clarify the compensatory strategy of scapular stabilization in individuals with SW during shoulder flexion under other heavy load conditions.

Background: Considering the kinetic chain of the lower extremity, a pronated foot position (PFP) can affect malalignment of the lower extremity, such as a dynamic knee valgus (DKV). Although the DKV during several single-leg movement tests has been investigated, no studies have compared the differences in DKV during a single-leg step down (SLSD) between subjects with and without PFP. Objects: The purpose of this study was to compare the DKV during SLSD between subjects with and without PFP. Methods: Twelve subjects with PFP (9 men, 3 women) and 15 subjects without PFP (12 men, 3 women) participated in this study. To calculate the DKV, frontal plane projection angle (FPPA), knee-in distance (KID), and hip-out distance (HOD) during SLSD were analyzed by twodimensional video analysis software (Kinovea). Results: The FPPA was significantly lower in PFP group, compared with control group (166.4° ± 7.5° and 174.5° ± 5.5°, p < 0.05). Also, the KID was significantly greater in PFP group, compared with control group (12.7 ± 3.9 cm and 7.3 ± 2.4 cm, p < 0.05). However, the HOD not significantly differed between two groups (12.7 ± 1.7 cm and 11.4 ± 2.5 cm, p > 0.05). Conclusion: The PFP is associated with lower FPPA and greater KID. When assess the DKV during SLSD, the PFP should be considered as a crucial factor for occurrence of DKV.

Background: The CKCUES test evaluates the functional performance of the shoulder joint. The CKCUES test scores CKC exercises of the upper limbs to examine shoulder stability. Although the CKCUES test provides quantitative data on functional ability and performance, no study has determined the relationship between CKCUES scores and SA and TB muscle strength. Objects: The objective of this study is to determine the relationship between the CKCUES test scores and the strength of the SA and TB muscles in the CKCUES and unilateral CKCUES tests. Methods: Sixty-six healthy male volunteers participated in the study. A Smart KEMA strength sensor measured SA and TB muscle strength. Two parallel lines on the floor indicated the initial hand placement to start CKCUES tests. For 15 seconds, the subject raises one hand and reaches over to touch the supporting hand, then returns to the starting position. Results: The correlation between the CKCUES test scores and the strength of the SA was strong (r = 0.650, p < 0.001), and the TB was moderate (r = 0.438, p < 0.001). The correlation between the unilateral CKCUES test and the strength of the SA of the supporting side was strong (r = 0.605, p < 0.001), and swing side was strong (r = 0.681, p < 0.001). The correlation between the unilateral CKCUES test and the strength of the TB of the supporting side was moderate (r = 0.409, p < 0.001), and swing side was moderate (r = 0.482, p < 0.001). Conclusion: Our study showed that the CKCUES test had a strong association with isometric strength of SA and moderate association with that of TB. These findings suggest that the CKCUES test can evaluate the function of the SA. Moreover, the unilateral CKCUES test can evaluate unilateral shoulder function.

Background: The serratus posterior inferior (SPI) muscle originates from the spinous process of T11-L2 and inserts at the lower border of the 9–12th ribs. This muscle is involved in thoracolumbar rotation and stability. Several positions can be used to improve trunk stability; the quadruped position is a good position for easily maintaining a neutral spine. In particular, during one arm lifting, various muscles act to maintain a neutral trunk position, and the SPI is one of these muscles. If trunk stability is weakened, uncontrolled trunk rotation may occur at this time. Tape can be used to increase trunk stability. There have been no studies on the effect of taping applied to the SPI muscle on thoracolumbar junction (TLJ) stability. Objects: This study compared the TLJ rotation angle between three different conditions (without taping, transverse taping, and SPI muscle direction taping). Methods: Thirty subjects were recruited to the study (18 males and 12 females). The TLJ rotation angle was measured during one arm lifting in a quadruped position (ALQP). Two taping methods (transverse and SPI muscle direction taping) were applied, and the TLJ rotation angle was measured in the same movement. Results: SPI muscle direction taping significantly reduced TLJ rotation compared to that without taping (p < 0.001) and with transverse taping (p < 0.001). There was a significant difference in the TLJ rotation angle between transverse taping and SPI muscle direction taping (p < 0.017). Conclusion: SPI muscle direction taping reduces the TLJ rotation angle during ALQP. Therefore, SPI muscle direction taping is one method to improve TLJ stability and reduce uncontrolled TLJ rotation during ALQP.

Background: Whole-body vibration (WBV) has been used to alleviate proprioceptive damage by musculoskeletal and neurological conditions. However, no study has determined whether wearing shoes while applying WBV can affect proprioception precision of the knee joint. Objects: This study aimed to determine the differences in the proprioceptive precision of the knee joint before and after WBV and to compare the proprioceptive precision of the knee joint between barefoot and shoe-wearing conditions. Methods: This study recruited 33 healthy participants. A passive-to-active angle reproduction test was used to measure the proprioception precision of the knee joint using an electrogoniometer, and the target angle was set to a knee flexion of 30°. Proprioception precision was calculated using the error angle (angular difference from 30°). Proprioceptive precision was measured in weight-bearing and non-weight-bearing positions before and after applying WBV for 20 minutes at 12 Hz in barefoot and shoe-wearing conditions. Mixed repeated analysis of variance was used to determine the differences in changes in the proprioceptive precision of the knee joint according to foot conditions. Results: There were significant improvements in the weight-bearing (p = 0.002) and nonweight- bearing (p < 0.001) proprioceptive precision of the knee joint after applying WBV. However, there was no significant difference in the change in proprioceptive precision of the knee joint after applying WBV between the barefoot and shoe-wearing conditions. Conclusion: WBV stimulation had an immediate effect on improving the proprioceptive precision of the knee joint. However, foot conditions (barefoot or shoe-wearing) during WBV application did not influence the proprioceptive precision of the knee joint.

Background: Forward head posture (FHP) causes various posture imbalances associated with the head and neck. Myofascial release is an effective treatment method used for relaxing muscles and reducing muscle hyperactivity, but no studies have been conducted on suboccipital and neck muscles related to FHP. Objects: The purpose of this study was to investigate the immediate effect of roller massages on the cranio-cervical flexion (CCF) range of motion (ROM) and CCF strength applied to suboccipital and neck muscles in subject with forward head posture. Methods: Twenty-four FHP subjects (male: 13, female: 11) were recruited for this study. All subjects were recruited with a craniovertebral angle (CVA) of 53 degrees or less and a head tilt angle (HTA) of 20.66 degrees or higher. CCF strength was measured using Pressure biofeedback unit (PBU) in the supine posture and CCF ROM was measured using smartphone-based inclinometer. Roller massage (RM) was applied to suboccipital and neck muscles for 2 minutes and CCF ROM and strength were remeasured. Results: These results of this study showed that CCF ROM was a significant difference in CCF ROM before and after RM (p < 0.05). CCF strength also showed a significant difference before and after RM (p < 0.05). Conclusion: RM method might be recommended to increase the immediate ROM and strength of CCF in subjects with forward head posture.

Background: Anterior cruciate ligament reconstruction (ACLR) causes a reduction in the balance of the lower extremities. Static and dynamic balance were evaluated separately to confirm the decrease in balance in patients underwent ACLR. The commonly used methods include the Biodex Balance System (BBS) for static balance and the Y balance test (YBT) for dynamic balance. No study has evaluated whether the static and dynamic balance of the involved side recovers as much as the uninvolved side one year after ACLR. Objects: The purpose of this study was to investigate the recovery of static and dynamic balance between the involved and the uninvolved sides. Methods: The BBS (overall, anteroposterior index, and mediolateral index) and YBT (anterior, posterolateral, and posteromedial) of 58 patients underwent ACLR were measured one year postoperation. Both sides of the BBS and the YBT were compared using the paired t-test. Results: All the index of the BBS showed no difference between the involved and the uninvolved sides, while all the scores of the YBT showed a significant difference in both sides. The YBT anterior result was 54.64 ± 5.62 cm in the involved side and 56.90 ± 5.41 cm in the uninvolved side (p = 0.001). The YBT posterolateral results were 90.12 ± 10.51 cm and 92.34 ± 9.85 cm (p = 0.013). The YBT posteromedial results were 93.72 ± 8.84 cm and 96.14 ± 9.37 cm (p = 0.002). Conclusion: A year after ACLR, the static balance showed no difference, while the dynamic balance showed a significant difference in the involved and the uninvolved sides. The static balance of the involved side recovered as much as the uninvolved side, but the dynamic balance did not. Therefore, dynamic balance training should be considered in the rehabilitation program for patients underwent ACLR.

Background: Prolonged standing during work causes a lower extremity pain and disorders. Patellofemoral pain syndrome (PFPS) is one of the common diagnoses of the knee pain. Although the etiology of PFPS is not completely understood, it is considered to be multifactorial. Objects: The purpose of this study was to investigate difference in strength of knee muscles, quadriceps:hamstring muscles strength ratio (Q:H ratio), asymmetry ratio of knee muscles strength and dorsiflexion range of motion (ROM) between standing workers with and without PFPS. Methods: Twenty-eight standing workers with PFPS and 26 age-, height-, and weightmatched standing workers without PFPS participated in this study. A tension sensor measured knee muscle strength, and motion sensor measured dorsiflexion ROM. The asymmetry ratio of knee muscles was calculated by a specific formula using the knee muscles strength of the dominant side and the sound side. An independent t-test was used to identify significant differences in the strength, ROM, Q:H ratio, and asymmetry ratio between the PFPS and normal groups. Results: The standing worker with PFPS have significantly lower dorsiflexion ROM (p < 0.000) and higher asymmetry ratio of the hamstring muscles strength (p < 0.000) compare to the standing worker without PFPS. No significant differences were seen in the strength of quadriceps muscle and hamstring muscles, Q:H ratio, and asymmetry ratio of quadriceps muscle strength. Conclusion: There was a significant difference in the asymmetry ratio of the isometric hamstring muscle strength. This finding suggests that the asymmetry ratio of isometric hamstring muscle strength may be more important than measuring only the hamstring muscle strength of the PFPS side. Furthermore, the results of this study showed a significant difference in dorsiflexion ROM between the standing industrial workers with and without PFPS. Dorsiflexion ROM and isometric hamstring muscle strength should be considered when evaluating the subjects with PFPS.

Background: The hip muscle plays various roles. Several types of functional performance tests are used for the assessment of patients with various lower extremity injuries. Hip muscle functions are important to test the performance of maintaining the spine, pelvic, and leg during bridging exercise. We designed a novel functional performance test tool, which we named close kinetic chain dynamic lower extremity stability (CKCLE) test to assess hip muscle functions. Objects: The purpose of this study was to determine the relationship between CKCLE test and hip extensor, external rotator, and abductor strengths. Methods: Twenty-two subjects were recruited in the present study (13 males and 9 females). The hip extensor, external rotator, and abductor muscle strengths were measured using a Smart KEMA strength sensor. When the examiner said “Go”, the subject performed the CKCLE test by moving one leg from the floor and touching the opposite knee and then return to the floor while maintaining the bridging position. The subjects attempted as many “touches” as possible in the allotted time (20 seconds) during the maximal tests. The correlation between the hip muscle (extensor, external rotator, and abductor) strength of the supporting leg and the number of CKCLE tests performed in 20 seconds was determined using the Pearson correlation. Results: Hip extensor (r = 0.626, p < 0.05), hip external rotator (r = 0.616, p < 0.05), and hip abductor muscle strengths (r = 0.475, p < 0.05) positively correlated with the number of CKCLE tests performed. Conclusion: We designed a CKCLE test and found that performance in the test correlated with hip extensor, external rotator, and abductor muscle strengths. The result suggests that the CKCLE test can be applied as a performance test to assess the functions of the hip extensor, external rotator, and hip abductor muscles.

Background: Forward head posture (FHP) is common postural malalignment. FHP is described relatively extension to upper cervical and lower cervical is relatively flexion. Although several researchers mentioned the lower cervical flexion posture in FHP, most of the studies related to FHP is focused on the deep cervical flexor function. Objects: The purposes of present study is to compare the cervical strength (upper cervical extension [UCE], lower cervical extension [LCE], upper cervical flexion [UCF], lower cervical flexion [LCF]) between individuals with and without FHP. Methods: Fifty-one participants are recruited. Participants who have the craniovertebral angle (CVA) less than 48 degree were classified to the FHP group (n = 24) and the others were included in without FHP group (n = 27). The cervical strength (UCE, LCE, UCF, LCF) were measured using Smart KEMA strength sensor and the strength data was normalized by body weight. All strength measurement conducted at head and neck neutral position in sitting. Independent t-test was used to compare the cervical strength between individuals with and without FHP. Results: The mean value of CVA was greater in without FHP group than with FHP group (p < 0.000). The strength value of UCF (p < 0.002) and LCE (p < 0.001) was significant less in FHP group than without FHP group. But no significant differences were seen in the LCF and UCE strength between two groups. Conclusion: UCF and LCE weakness in FHP group should be considered to evaluate and manage the individuals with FHP.

Background: Scapular winging (SW) could be caused by tightness or weakness of the periscapular muscles. Although data mining techniques are useful in classifying or predicting risk of musculoskeletal disorder, predictive models for risk of musculoskeletal disorder using the results of clinical test or quantitative data are scarce. Objects: This study aimed to (1) investigate the difference between young women with and without SW, (2) establish a predictive model for presence of SW, and (3) determine the cutoff value of each variable for predicting the risk of SW using the decision tree method. Methods: Fifty young female subjects participated in this study. To classify the presence of SW as the outcome variable, scapular protractor strength, elbow flexor strength, shoulder internal rotation, and whether the scapula is in the dominant or nondominant side were determined. Results: The classification tree selected scapular protractor strength, shoulder internal rotation range of motion, and whether the scapula is in the dominant or nondominant side as predictor variables. The classification tree model correctly classified 78.79% (p = 0.02) of the training data set. The accuracy obtained by the classification tree on the test data set was 82.35% (p = 0.04). Conclusion: The classification tree showed acceptable accuracy (82.35%) and high specificity (95.65%) but low sensitivity (54.55%). Based on the predictive model in this study, we suggested that 20% of body weight in scapular protractor strength is a meaningful cutoff value for presence of SW.

ObjectiveDysfunction of the pelvic floor muscles (PFM) is associated with sexual dysfunction in women with stress urinary incontinence (SUI). The EasyK7 device was developed to stimulate the PFM by surface electrical stimulation during sitting (SESdS). We investigated the effects of SESdS on PFM function and sexual function in women with SUI.MethodsWomen with SUI were randomized into the SESdS and control groups. PFM function and sexual function were assessed using a perineometer and the pelvic organ prolapse–urinary incontinence sexual function questionnaire (PISQ), respectively. After 8 weeks, the groups were compared using either analysis of covariance with the baseline values as covariates or the paired Student's t-test.ResultsThe final analysis included 16 subjects from each group. There were significant differences between the SESdS and control groups after the intervention, as well as within the SESdS group between the pre- and post-intervention measurements. The P-values for the differences in PFM measurements between the groups, and between the pre- and post- intervention measurements within the SESdS group, were 0.001 and 0.004 for power, 0.015 and 0.011 for strength, and 0.012 and 0.034 for endurance, respectively. In addition, in the PISQ, there were significant differences between the groups and between the pre- and post-intervention measurements within the SESdS group in the partner-related domain (between groups: P=0.003; within SESdS group: P=0.024) and total score (between groups: P

This work, for the first time to our best knowledge, presents a W-band multi-channel frequency-modulated continuous-wave (FMCW) radar system on low-cost FR-4 substrates. A center-fed patch array antenna on an FR-4 substrate can achieve a maximum gain of 10.8 dBi. It is enabled by aperture coupled feeding using an on-chip feeder implemented on a CMOS radar transmitter (Tx) and receiver (Rx). The proposed radar system consists of one Tx and four Rx channels placed in the back cavity of a microstrip array antenna like an active array antenna system. Additionally, Tx and Rx chipsets include a wideband frequency multiplier with high multiplication ratio of 63, making it easy to distribute reference FMCW waveform synthesized at a very low frequency about 1.25 GHz for 79 GHz output using direct digital synthesis (DDS). Extending the number of channels and implementing various waveforms can be easily accomplished with very good phase noise. The functionality of the proposed radar system on low-cost substrates is confirmed by distance and angle measurements.

Kaempferide (KFD) is a naturally occurring flavonoid that exists in various medicinal plants. The pharmaceutical properties of KFD, including its anti-cancer, antioxidant and anti-diabetic effects, have been noted, but the effects of KFD on photoaging and their underlying molecular mechanism have yet to be elucidated. In this study, we investigated the effects of KFD on Ultraviolet-B (UVB)-mediated photoaging processes using in vitro and in vivo photoaging model systems. The topical administration of KFD on mouse dorsal areas suppressed UVB-mediated wrinkle formation and epidermal thickening. In addition, the UVB-mediated reduction of dermal collagen content, which was estimated by Masson’s trichrome staining, was recovered through KFD treatments. Furthermore, we found that UVB-induced abnormal values of procollagen type-1 (COL1A1), metalloproteinases (MMP-1a and MMP-3) and proinflammatory cytokines (IL-8, MCP-3 and IL-6) on mouse skin tissue as well as NIH-3T3 cells was recovered through KFD treatment. The administration of KFD to NIH-3T3 cells suppressed the UVB-mediated upregulation of reactive oxygen species (ROS), mitogen-activated protein kinases (MAPKs) and AKT phosphorylation. Furthermore, the treatment of ROS inhibitor restored the UVB-induced MAPKs and AKT phosphorylation as well as the abnormal expression of photoaging related genes. These findings indicate that KFD can attenuate UVB-induced ROS elevation to elicit anti-photoaging activity. Taken together, our data suggest that KFD could be developed as a potential natural anti-photoaging agent.

Neuroinflammation is one of the critical causes of neuronal loss and cognitive impairment. We aimed to evaluate the anti-neuroinflammatory properties of Ishige okamuae using mice intracerebroventricularly injected with lipopolysaccharides (LPS) and LPS-treated C6 glioma cells. We found that the short- and long-term memory deficits of LPS-injected mice were improved by oral administration of Ishige okamurae extracts (IOE). LPS-induced neuronal loss, increase in amyloid-β plaque, and expression of COX-2 and iNOS were restored by IOE. In addition, LPS-induced activation of Toll-like receptor-4 (TLR-4) and its downstream molecules, such as MyD88, NFκB, and mitogen-activated protein kinases (MAPKs), were significantly attenuated in the brains of mice fed with IOE. We found that pretreatment of IOE to C6 glioma cells ameliorated LPS-induced expression of TLR-4 and its inflammatory cascades, such as MyD88 expression, reactive oxygen species production, MAPKs phosphorylation, and NFκB phosphorylation with consequent downregulation of COX-2, iNOS, proinflammatory cytokines, and nitric oxide expression. Furthermore, IOE (0.2 µg/mL) was found to have equivalent efficacy with 10 μM of MyD88 inhibitor in preventing LPS-induced inflammatory responses in C6 glioma cells. Taken together, these results strongly suggest that IOE could be developed as a promising anti-neuroinflammatory agent which is able to control the TLR-4/MyD88-dependent signaling pathways.

Abstract Background Previous studies suggested that patients with symptomatic intervertebral disc degeneration (IDD) of lumbar spine have reduced cross-sectional area (CSA) and functions of core muscles. However, reduced CSA and functions of core muscles have been observed not only in patients with symptomatic IDD but also in patients with other subgroups of low back pain (LBP). Thus, it is uncertain whether reduced CSA and functions of core muscles lead to IDD and LBP, or pain leads to reduced CSA and functions of core muscles in patients with symptomatic IDD. Therefore, this study aimed to compare the CSA and functions of core muscles between asymptomatic participants with and without IDD in magnetic resonance imaging (MRI). Methods Twenty asymptomatic participants (12 men and 8 women) participated in this study. Ten participants had asymptomatic IDD at L4–5. The others were healthy controls (without IDD at all levels of lumbar spine). The CSA of core muscles was measured using MRI. Maximal isometric trunk flexor strength and side bridge strength were measured by a Smart KEMA strength sensor. Trunk flexor endurance test, side bridge endurance test and plank endurance test were used to measure core endurance. Double legs loading test was used to measure core stability. Mann-Whitney U test was used to compare the differences between two groups. Results There were no significant differences in core muscle functions between the two groups (p > 0.05). Moreover, there was no significant difference in CSA between the two groups (p > 0.05). Conclusions There was no significant difference in CSA and core muscle functions between asymptomatic participants with and without IDD. These findings indicate that a degenerative or bulging disc in asymptomatic individuals has little effect on CSA and functions of core muscles, especially in young age. Therefore, the general core endurance test or strength test could not differentiate asymptomatic people with and without IDD of lumbar spine. Trial registration number Clinical Research information Service. KCT0004061. Registered 13 June 2019. retrospectively registered.

Silicon carbide (SiC) was prepared by carbothermal reduction of a crystalline-layered sodium silicate (δ-Na2Si2O5)/carbon nanocomposite (LCN), which contained a stacked carbon film embedded with cobalt between the silicate layers. Subsequent sintering of this mixture for 3 h at 1000–1350°C resulted in the formation of graphitic carbon and SiC. Meanwhile, sintering without a cobalt catalyst resulted in the formation of graphitic carbon, regardless of the temperature. The use of a cobalt catalyst allowed the formation of a pure SiC phase at 1350°C. The formed SiC had an irregular worm-like morphology, with a particle size of ~5 µm. The Brunauer-Emmett-Teller surface areas of graphitic carbon and SiC were 28–150 and ~7.0 m2/g, respectively. We concluded that graphite and SiC were produced at this low sintering temperature because of the cobalt catalyst, which facilitated nanomixing of carbon and SiO2 by sandwiching the carbon films between the silicate layers.

This paper presents 77-GHz CMOS radar transmitter and receiver chips equipped with monopole feeders for use in frequency-modulated continuous-wave radar systems. The on-chip monopole feeder can feed not only the aperture of waveguides but also the slots on planar circuits by simply attaching the chips to a printed circuit board using a low-cost non-conductive epoxy. With the aid of a high ratio multiplier and the proposed on-chip feeder, a radar system can easily be integrated without needing to use precise and expensive millimeter-wave packaging technologies. In order to experimentally confirm this, the chips integrated with waveguides are first measured and a full radar system integrated on the planar circuit is evaluated using the microstrip patch antennas. Finally, with the benefit of compact integration technology, the design of a five-channel 3-D environmental sensing radar for small-unmanned aerial vehicles is presented.

Purpose: To determine the agreement among the items of the Korean physical therapist licensing examination, learning objectives of class subjects, and physical therapists’ job descriptions. Methods: The main tasks of physical therapists were classified, and university courses related to the main tasks were also classified. Frequency analysis was used to determine the proportions of credits for the classified courses out of the total credits of major subjects, exam items related to the classified courses out of the total number of exam items, and universities that offer courses related to the Korean physical therapist licensing examination among the surveyed universities. Results: The proportions of credits for clinical decision making and physical therapy diagnosis-related courses out of the total number credits for major subjects at universities were relatively low (2.06% and 2.58%, respectively). Although the main tasks of physical therapists are related to diagnosis and evaluation, the proportion of physiotherapy intervention-related items (35%) was higher than that of examination and evaluation-related items (25%) on the Korean physical therapist licensing examination. The percentages of universities that offer physical therapy diagnosis and clinical decision making-related courses were 58.62% and 68.97%, respectively. Conclusion: Both the proportion of physiotherapy diagnosis and evaluation-related items on the Korean physical therapist licensing examination, and the number of subjects related to clinical decision making and physical therapy diagnosis in the physical therapy curriculum, should be increased to ensure that the examination items and physical therapy curriculum reflect the practical tasks of physical therapists.