Effects of the Three-Direction Movement Control Focus Complex Pain Program and Neurodynamic Focus Complex Pain Program on Pain, Mechanosensitivity, and Body Function in Taekwondo Athletes with Non-Specific Low Back Pain: A Preliminary Study.

We aimed to determine the effects of three-direction movement control focus complex pain program (3D-MCE) and neurodynamic focus complex pain program (NDT) on pain, mechanosensitivity, and body function in Taekwondo athletes with non-specific low back pain. This study used a two-group pretest-posttest design and was conducted at a university physiotherapy lab and training center. It included 21 Taekwondo athletes with non-specific low back pain from a Taekwondo studio and a University in Busan. Participants were divided into a 3D-MCE group (n = 10) and an NDT group (n = 10). The numerical rating pain scale (NRPS), pain pressure threshold (PPT), movement analysis, and Oswestry Disability Index (ODI) were measured before and after the intervention. The intervention was performed for 45 min twice a week for 4 weeks. Each group performed movement control exercises and neurodynamic techniques. The NRPS, motion analysis, and ODI were significantly changed after the intervention in the 3-DMCE group. The NRPS, PPT, and ODI changed significantly after the intervention in the NDT group. Moreover, the PPT and motion analysis showed significant differences between the two groups. For Taekwondo athletes with non-specific low back pain, 3D-MCE improved the stability control ability of the lumbar spine. It was confirmed that neurodynamic techniques reduce muscle and nerve mechanosensitivity.

Effects of Complex Pain Control Programs on Taekwondo Athletes with Recurrent Low Back Pain: A Case Study.

Background and Objectives: Practitioners of martial arts such as Taekwondo are likelier to experience back pain during training or competition. As the back pain of taekwondo athletes shows various symptoms depending on the athlete's characteristics, such as technique and movement, a case study was conducted to verify the intervention effect suitable for individual traits. We examined the effects of a complex pain control program on pain, mechanosensitivity, and physical function in a Taekwondo athlete with recurrent low back pain (LBP). Materials and Methods: A Taekwondo athlete with LBP was recruited from D University, Busan. The intervention program was performed for 45 min twice a week for 3 weeks, and the patient was followed up with after 2 weeks. The numerical rating pain scale (NRPS), pain pressure threshold, mechanosensitivity, and Oswestry Disability Index (ODI) scores were measured before and after the intervention. Therapeutic massage and nerve stimulation therapy were performed. Lumbar flexion, extension, and rotation were performed in the movement control exercise group, whereas the sliding technique, a neurodynamic technique of the tibial nerve, was applied in the neurodynamic technique group. This effect was verified by comparing the average measured values before and after the intervention. Results: Pain (NRPS) and mechanosensitivity reduced, range of motion and tactile discrimination abilities improved, and physical function (ODI) improved. The effect of the improved intervention lasted 2 weeks. Conclusions: These results indicate that application of complex pain control programs considering the four aspects of pain mechanisms for 3 weeks can be an effective intervention in Taekwondo athletes with recurrent LBP.

Impact of Movement Control Training Using a Laser Device on the Neck Pain and Movement of Patients with Cervicogenic Headache: A Pilot Study.

This study verified the effect of movement control training using a laser device on the neck pain and movement of patients with cervicogenic headache. A total of twenty outpatients recruited from two Busan hospitals were equally divided into two groups. The experimental group underwent movement control training with visual biofeedback, while the control group performed self-stretching. Both groups received therapeutic massage and upper cervical spine mobilization. A four-week intervention program was also conducted. Measurement tools including the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, pressure pain threshold, range of motion, sensory discrimination, and Neck Disability Index helped assess the participating patients before and after the intervention. Additionally, the Wilcoxon signed-rank test and the Mann-Whitney U test helped determine inter and intra-group variations, respectively, before and after the intervention. Most of the measurement regions revealed significant changes post-intervention within the experimental group, while only the cervical flexion-rotation test, visual analog scale, Headache Impact Test-6, and Neck Disability Index indicated significant changes post-intervention within the control group. There were also considerable inter-group differences. Thus, movement control training using a laser device more effectively improves neck pain and movement of patients with cervicogenic headache.

Investigation on changes in the usage patterns of Seoul Bike usage patterns owing to COVID-19 according to pass type.

Human mobility has been significantly impacted by varying degrees of social distancing and stay-at-home directives that have been implemented in many countries to prevent the spread of COVID-19; this effect was observed regardless of the mode of transportation. Several studies have indicated that bike-sharing is a relatively safe option in terms of COVID-19 infection, and more resilient than public transportation. However, previous studies on the effects of COVID-19 on bike-sharing, rarely considered the type of pass in their investigation of the pandemic-induced changes in usage patterns of shared bikes. To overcome this limitation, this study used trip records obtained from Seoul Bike to investigate the changes in usage patterns of shared bikes during the COVID-19 pandemic. The spatiotemporal usage patterns were characterized in this study based on the type of pass. Additionally, using t-tests and k-means clustering, we discovered significant factors that influenced changes in one-day pass usage rates and temporal usage patterns at the station level. Finally, we constructed spatial regression models to estimate changes in bike rentals caused by COVID-19 based on pass type. The findings provided a comprehensive understanding of how bike-sharing usage varies depending on pass type, which is closely related to shared bikes trip purposes.

Effect of Incorporating Short-Foot Exercises in the Balance Rehabilitation of Flat Foot: A Randomized Controlled Trial.

Effective balance rehabilitation is essential to address flat foot (pes planus) which is closely associated with reduced postural stability. Although sensorimotor training (SMT) and short-foot exercise (SFE) have been effective for improving postural stability, the combined effects of SMT with SFE have not been evaluated in previous studies. The aim of this study was to compare the lone versus combined effects of SMT with SFE on postural stability among participants with flat foot. This was a single-blinded, randomized controlled trial. A total of 32 flat-footed participants were included in the study (14 males and 18 females) and assigned to the SMT combined with SFE group and SMT alone group. All participants underwent 18 sessions of the SMT program three times a week for six weeks. Static balance, dynamic balance, and the Hmax/Mmax ratio were compared before and after the interventions. Static and dynamic balance significantly increased in the SMT combined with SFE group compared with the SMT alone group. However, the Hmax/Mmax ratio was not significantly different between the two groups. Therefore, this study confirms that the combination of SMT and SFE is superior to SMT alone to improve postural balance control in flat-footed patients in clinical settings.

Changes in training posture induce changes in the chest wall movement and respiratory muscle activation during respiratory muscle training.

Postural changes induce changes in chest wall kinematics and eventually pulmonary function, and affect chest wall shape and chest motion. This study aimed to examine the effects of postural change on changes in the chest wall during respiratory muscle training. Using a repeated measures design, this study followed 13 healthy adults (13 men; mean age, 23.73 years). All participants performed four postures (neutral, full trunk rotation, half-range trunk rotation, and lateral ribcage shift postures) during respiratory muscle training. The chest wall movement during the four postures was measured using a three-dimensional motion-analysis system during respiratory muscle training. Surface electromyography data were collected from the diaphragm and sternocleidomastoid muscles, and the asymmetric ratio of muscle activation was calculated based on the collected data. The chest wall movements of the upper costal and middle costal region were greater in the neutral posture than in the full rotation, half rotation, and lateral ribcage shift postures (P<0.05). The respiratory muscle activation on diaphragm of left was greater in the full rotation posture than in the neutral posture, half rotation, and lateral ribcage shift postures (P<0.05). The asymmetric ratio of muscle activation was greater in the full rotation posture than in the neutral posture, half rotation, and lateral ribcage shift postures (P<0.05). This study verified that postural change during respiratory muscle training may affect chest wall movement and muscle activation. Thus, this study recommends respiratory muscle training to be performed in neutral posture.

The correlation between diaphragm thickness, diaphragmatic excursion, and pulmonary function in patients with chronic stroke.

[Purpose] This study aimed to investigate the correlation between the diaphragm thickness and diaphragm excursion, and pulmonary function in individuals with stroke. [Subjects and Methods] One hundred fourteen patients who were clinically diagnosed with ischemic or hemorrhagic stroke were included. The diaphragm thickness and excursion were assessed using ultrasonography, and the diaphragm thickening ratio was standardized using a formula. To analyze pulmonary function, we measured the forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. [Results] A statistically significant correlation was found between the diaphragm thickness, thickness ratio, and diaphragm excursion; and the forced vital capacity, forced expiratory volume in one second, and peak expiratory flow. [Conclusion] This study demonstrated that there is a relationship between respiratory function and diaphragm thickness and diaphragm excursion, especially in the paretic side of the diaphragm. Therefore, the role of the respiratory muscles of the paretic side is important in rehabilitation programs to improve the respiratory function of stroke patients.

The effect of resistance exercise direction for hip joint stabilization on lateral abdominal muscle thickness.

The aim of this study was to determine the effects of resistance direction in hip joint stabilization exercise on change in lateral abdominal muscle thickness in healthy adults. Twenty-six healthy adults were randomly allocated to either a hip stabilization exercise by hip straight resistance group (n=12) or a hip diagonal resistance group (n=14). The outcome measures included contraction thickness ratio in transversus abdominis (TrA), internal oblique (IO) and external oblique, and TrA lateral slide were assessed during the abdominal drawing-in maneuver by b-mode ultrasound. The researcher measured the abdominal muscle thickness of each participant before the therapist began the intervention and at the moment intervention was applied. There was a significant difference in lateral abdominal muscle thickness between the straight resistance exercise of hip joint group and the diagonal resistance exercise of hip joint group. Significant differences were found between the two groups in the percentage of change of muscle thickness of the TrA (P=0.018) and in the thickness ratio of the TrA (P=0.018). Stability exercise accompanied by diagonal resistance on the hip joint that was applied in this study can induce automatic contraction of the IO and TrA, which provides stability to the lumbar spine.

Relative activity of respiratory muscles during prescribed inspiratory muscle training in healthy people.

[Purpose] This study aimed to determine the effects of different intensities of inspiratory muscle training on the relative respiratory muscle activity in healthy adults. [Subjects and Methods] Thirteen healthy male volunteers were instructed to perform inspiratory muscle training (0%, 40%, 60%, and 80% maximal inspiratory pressure) on the basis of their individual intensities. The inspiratory muscle training was performed in random order of intensities. Surface electromyography data were collected from the right-side diaphragm, external intercostal, and sternocleidomastoid, and pulmonary functions (forced expiratory volume in 1 s, forced vital capacity, and their ratio; peak expiratory flow; and maximal inspiratory pressure) were measured. [Results] Comparison of the relative activity of the diaphragm showed significant differences between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. Furthermore, significant differences were found in sternocleidomastoid relative activity between the 60% and 80% maximal inspiratory pressure intensities and baseline during inspiratory muscle training. [Conclusion] During inspiratory muscle training in the clinic, the patients were assisted (verbally or through feedback) by therapists to avoid overactivation of their accessory muscles (sternocleidomastoid). This study recommends that inspiratory muscle training be performed at an accurate and appropriate intensity through the practice of proper deep breathing.

The effect of progressive high-intensity inspiratory muscle training and fixed high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients.

[Purpose] This study investigated the effects of progressive load and fixed load high-intensity inspiratory muscle training on the asymmetry of diaphragm thickness in stroke patients. [Subjects] Twenty-one stroke patients were assigned to one of three groups: progressive load high-intensity inspiratory muscle training (n = 8), fixed load high-intensity inspiratory muscle training (n = 6), and controls (n = 7). [Methods] The progressive load and fixed load high-intensity inspiratory muscle training participants undertook an exercise program for 20 minutes, three times weekly, for 6 weeks. After each session, diaphragm thickness was measured using ultrasonography. The diaphragm asymmetry ratio and diaphragm thickening ratio were standardized using a formula. [Results] After intervention, the diaphragm asymmetry ratio significantly differed among the three groups, and the diaphragm asymmetry ratio significantly increased in the control group. A significant increase was identified in the diaphragm thickening ratio within the progressive load and fixed load high-intensity inspiratory muscle training groups. [Conclusion] Progressive load and fixed load high-intensity inspiratory muscle training decreased the asymmetry of diaphragm thickness in stroke patients; this effect, in turn, increased the diaphragm thickening ratio in stroke patients. The two interventions examined here should be selectively applied to individuals in the clinical field.

The effect of thoracic region self-mobilization on chest expansion and pulmonary function.

[Purpose] The aim of this study was to determine the effects of thoracic region self-mobilization on chest expansion and pulmonary function in healthy adults. [Subjects] Nineteen healthy adults were randomly allocated to either an intervention group (n = 8) or a control group (n = 11). [Methods] Subjects in the intervention group performed self-mobilization of the thoracic region 3 times per week for 6 weeks (18 sessions). The outcome measures included chest expansion when breathing, pulmonary function, and predicted pulmonary function. [Results] There was a significant difference in chest expansion between the intervention group and the control group. However, there was no significant difference in pulmonary function between the intervention group and the control group. [Conclusion] Thoracic region self-mobilization may be beneficial for increasing chest expansion in healthy adults.

The effects of plantar flexor static stretching and dynamic stretching using an aero-step on foot pressure during gait in healthy adults: a preliminary study.

[Purpose] The aim of this study was to examine whether plantar flexor static stretching and dynamic stretching using an Aero-Step results in changes in foot pressure during gait in healthy adults. [Subjects] Eighteen normal adults were randomly allocated to either a dynamic stretching using an Aero-Step group (DSUAS) group (n = 8) or a static stretching (SS) group (n = 10). [Methods] The DSUAS and SS participants took part in an exercise program for 15 minutes. Outcome measures were foot plantar pressure, which was measured during the subject's gait stance phase; the asymmetric ratio of foot pressure for both feet; and the visual analogue scale (VAS) measured during the interventions. [Results] There were significant differences in the asymmetric ratio of foot pressure for both feet and VAS between the two groups after intervention. However, there were no significant differences in foot plantar pressure during the gait stance phase within both groups. [Conclusion] DSUSAS is an effective stretching method, as pain during it is lower than that with SS, which can minimize the asymmetric ratio of foot pressure for both feet during gait due to asymmetric postural alignment.

Effects of Abdominal Stimulation during Inspiratory Muscle Training on Respiratory Function of Chronic Stroke Patients.

[Purpose] The purpose of the present study was to verify a new method for improving respiratory functions by applying both abdominal stimulation and inspiratory muscle training (IMT) to train the inspiratory muscle and the expiratory muscle simultaneously, to improve the efficiency of IMT of chronic stroke patients. [Subjects] Eighteen stroke patients were randomly assigned to an experimental group (n = 9) and a control group (n = 9). [Methods] The experimental group was administered IMT with abdominal stimulation, and the control group was administered only IMT. During the intervention period, the experimental group and control group received training 20 min/day, 3 times/wk, for 4 weeks. To examine the lung functions of the subjects, FVC, FEV1, PEF, and FEF25-75 were measured using an electronic spirometer. The diaphragm thickness ratio was calculated from measurements made with a 7.5-MHz linear probe ultrasonic imaging system. [Result] The experimental group and the control group showed significant increases in diaphragm thickness ratio on the paretic side, but not on the non-paretic side. With regard to lung function, the experimental group showed significant increases in FEV1, PEF, and FEF25-75. The changes between before and after the intervention in the two groups were compared with each other, and the results showed significant differences in FEV1 and PEF. [Conclusion] The present study identified that IMT accompanied by abdominal stimulation improved the pulmonary function of chronic stroke patients.

An Analysis of Muscle Activities of Healthy Women during Pilates Exercises in a Prone Position.

[Purpose] This study analyzed the activities of the back and hip muscles during Pilates exercises conducted in a prone position. [Subjects] The subjects were 18 healthy women volunteers who had practiced at a Pilates center for more than three months. [Methods] The subjects performed three Pilates exercises. To examine muscle activity during the exercises, 8-channel surface electromyography (Noraxon USA, Inc., Scottsdale, AZ) was used. The surface electrodes were attached to the bilateral latissimus dorsi muscle, multifidus muscle, gluteus maximus, and semitendinous muscle. Three Pilates back exercises were compared: (1) double leg kick (DLK), (2) swimming (SW), and (3) leg beat (LB). Electrical muscle activation was normalized to maximal voluntary isometric contraction. Repeated measures analysis of variance was performed to assess the differences in activation levels among the exercises. [Results] The activity of the multifidus muscle was significantly high for the SW (52.3±11.0, 50.9±9.8) and LB exercises(51.8±12.8, 48.3±13.9) and the activity of the semitendinosus muscle was higher for the LB exercise (49.2±8.7, 52.9±9.3) than for the DLK and SW exercises. [Conclusion] These results may provide basic material for when Pilates exercises are performed in a prone position and may be useful information on clinical Pilates for rehabilitation programs.

Comparative analysis of acromiohumeral distances according to the locations of the arms and humeral rotation.

[Purpose] The purpose of this study was to compare the potential effects of resistance exercise according to the positions of the arms and the rotation of the humerus on the subhumeral acromial space. [Subjects] The study subjects were 34 subjects without shoulder pain. [Methods] Ultrasonographic measurements of the acromiohumeral distance of the subjects were made at three shoulder positions: 90° flexion, scaption at 90° abduction, and 90° abduction in an upright sitting position. The subjects were instructed to vertically push against a table to the maximum level with the humerus in internal, neutral, and external rotation. The measurements were made three times in each position. [Results] There was a significant difference in acromiohuneral distance between neutral and internal rotation of the humerus, and between external rotation and internal rotation of the humerus. In the scaption position, there was a significant difference between neutral and internal rotation of the humerus, and between external rotation and internal rotation of the humerus. In the 90° flexion position, there was a significant difference between neutral and internal rotation, and between neutral and external rotation. There was a significant difference between the flexion position and the abduction position, and between the flexion position and the scaption position. In terms of the internal rotation of the humerus, there was a significant difference between 90° flexion and 90° abduction. [Conclusion] These findings can be applied in exercises prescribed to increase the acromiohumeral distance and to aid the treatment and evaluation of shoulder dysfunctions.

An Analysis of the Thickness of Abdominal Muscles during Forceful Expiration and Pulmonary Function in Teenage Smokers and Nonsmokers.

[Purpose] The purpose of this study was to examine the effects of smoking on teenagers' internal oblique (IO) and transverses abdominis (TrA) expiratory muscles and their pulmonary function. [Subjects] A total of 30 healthy teenagers (15 smokers; 15 nonsmokers) voluntarily participated in the study. [Methods] The subjects were instructed to maintain an upright standing posture with their scapulars against the wall. Measurements were then taken to determine the thickness of their right IO and their right TrA while they were at rest and in a state of forced expiration using a 7.5 MHz linear probe of an ultrasonic imaging system. The measured thickness was converted into the percentage of change in muscle thickness (PCMT) and the relative contribution ratio (RCR) using a calculation formula, and then the data were analyzed. [Results] No significant differences were found between the two groups in the thickness, PCMT, and RCR of both the IO and TrA muscles, while there were significant differences in the forced expiratory volume at one second (FEV1) and the peak expiratory flow (PEF). [Conclusion] This study examined teenage smokers whose duration of smoking was relatively short. The two groups did not show significant differences in the thickness of both the IO and TrA muscles. However, based on the forced expiratory volume at one second (FEV1) and PEF measurements, the smokers showed greater decreases in pulmonary function than the nonsmokers.

Comparison of the Effects of Walking with and without Nordic Pole on Upper Extremity and Lower Extremity Muscle Activation.

[Purpose] The aim of this study was to assess the effect of Nordic pole walking on the electromyographic activities of upper extremity and lower extremity muscles. [Subjects and Methods] The subjects were randomly divided into two groups as follows: without Nordic pole walking group (n=13) and with Nordic pole walking group (n=13). The EMG data were collected by measurement while the subjects walking on a treadmill for 30 minutes by measuring from one heel strike to the next. [Results] Both the average values and maximum values of the muscle activity of the upper extremity increased in both the group that used Nordic poles and the group that did not use Nordic poles, and the values showed statistically significant differences. There was an increase in the average value for muscle activity of the latissimus dorsi, but the difference was not statistically significant, although there was a statistically significant increase in its maximum value. The average and maximum values for muscle activity of the lower extremity did not show large differences in either group, and the values did not show any statistically significant differences. [Conclusion] The use of Nordic poles by increased muscle activity of the upper extremity compared with regular walking but did not affect the lower extremity.