Abstract.[Purpose] The purpose of this study was to determine the reliability, validity, and responsiveness of the Fugl-Meyer Assessment (FMA) for hemiplegic patients.[Subjects] For the reliability and validity study, 50 patients with stroke (26 males, 24 females) were recruited. For the responsiveness study, 16 hemiplegic patients (8 males, 8 females) participated.[Methods] Two physical therapists and one occupational therapist rated 50 video recordings of hemiplegic patients using the FMA to test the inter-rater reliability, and one physical therapist (rater A) rated each of the 50 video clips on two occasions, two weeks apart, to evaluate the test-retest reliability. Responsiveness was calculated three months after the baseline assessment. Reliability was calculated using the intraclass correlation coefficient (ICC), standard error of measurement (SEM), and smallest real difference (SRD). Concurrent validity was examined using Pearson's correlation coefficient and responsiveness was calculated using the effect size (ES) and standardized response mean (SRM).[Results] Assessment using the FMA showed high relative reliability, and the absolute reliability was satisfactory for the inter-rater and test-retest reliabilities. The correlations between motor function of the FMA and the Jebsen-Taylor hand function, grip power, motor assessment scale (MAS), and the Berg balance scale (BBS) were moderate to good, and were highly significant (p<0.05), while responsiveness was moderate to large. [Conclusion] The results indicate that the FMA is a reasonable assessment of the function of the upper and lower extremities of patient with stroke.

The aim of this study was to determine the effects of motor dual-task training (MDT), cognitive dual-task training (CDT), and motor and cognitive dual-task training (MCDT) on balance and daily living abilities of stroke patients. In addition, the relationships among assessment tools such as center of pressure (COP), Korean version of Berg Balance Scale (K-BBS), and the Functional Independence Measure (FIM) were investigated. [Subjects and Method] Thirty-eight stroke patients were randomly allocated to a MDT group, a CDT group, and a MCDT group, and training was performed three times a week for six weeks. The patients' balance was assessed with the mean area of COP movement and K-BBS, and the daily living abilities were evaluated with FIM before and after the training. [Results] Post-training, a significant difference in COP was found in each of the three groups, and between the CDT group and the MCDT group. K-BBS and FIM also showed a significant difference in each of the three groups, and comparison among the three groups showed that the improvement in the MCDT group was significantly better than those of the other two groups. Highly negative correlations were found between COP and K-BBS and between COP and FIM (r=-0.960,-0.874, respectively), and a highly positive correlation was found between K-BBS and FIM (r=0.870). [Conclusion] For effective training of balance and daily living abilities for stroke patients, it is more effective to implement both motor and cognitive dual-tasks than motor or cognitive dualtasks alone.

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Abstract.[Purpose] To determine inter-rater and intra-rater reliability using video recordings, and the concurrent validity of the Gross Motor Function Classification System (GMFCS).[Subjects] The subjects who were assessed were 71 children with cerebral palsy (CP; 46 boys, 25 girls) who were divided into three age groups according to the GMFCS guidelines; 0-2 years, 2-4 years, and 4-6 years.[Methods] Eleven pediatric physical therapists rated 71 video recordings of children with CP to test inter-rater reliability. Two of them rescored the same video recordings to test intra-rater reliability at an interval of one month. Concurrent validity was evaluated by comparing GMFCS levels with the subscale of the Pediatric Evaluation of Disability Inventory (PEDI) such as self-care, mobility, and social ability.[Results] By age group, inter-rater reliability was high (ICC = 0.994, 0.993, and 0.996 respectively). Intra-rater reliability was also high (ICC = 0.972-0.996), and correlation was higher between GMFCS level and the mobility domain of PEDI than between GMFCS level and non-motor domains of PEDI. [Conclusion] This study confirmed the reliability and validity of the GMFCS, supporting its use in clinical practice and research.

Objective: This study aims to analyze and evaluate fatigue in upper trapezius muscles of adults when inputting text on a smart phone, thereby examining the risk of cumulative trauma disorders in the musculoskeletal system of the upper extremity. Method: Forty-five healthy adults were divided equally into three groups: a smartphone group, a notebook group, and a desktop group. A surface electromyogram was placed on the upper trapezius muscle of each participant, after which they inputted text for ten minutes within an ergonomic setting; their side posture was recorded on video and analyzed. Results: The spectral edge frequency values for the smartphone group, as recorded from the upper right trapezius muscles on the surface electromyogram, showed a significant decrease(p<.05). Regarding the RULA, all three groups had results indicating "action level 2". Conclusion: All three groups had results indicating "action level 2" according to the RULA, which means that additional research on the posture of the participants while performing tasks is necessary, and their posture needs to be corrected. In particular, the smartphone group has the highest levels of fatigue in the upper trapezius muscles, suggesting that the task of inputting text on a smartphone is a high risk for causing cumulative trauma disorders.

[Purpose] This study investigated the effects of stretching and joint stabilization exercises applied to spastic shoulder joints on improving shoulder dysfunction in hemiplegic patients. [Subjects and Methods] Hemiplegic patients were classified into three groups: one group received 30 min of traditional exercise therapy for the spastic shoulder joint; one group received 30 min stretching; and one group received 15 min of stretching and 15 min of joint stabilization exercises. The exercises were performed once a day, five times per week for eight weeks. Changes in the pathologic thickness of tendons and recovery of shoulder function were compared among the three groups. Differences among the three groups before the experiment, at four weeks, and at eight weeks were analyzed using repeated measures ANOVA. [Results] The stretching and joint stabilization exercise therapy group showed greater improvement in shoulder function than the traditional exercise therapy group and the stretching only group. This group also showed greater decreases in the pathologic thickness of tendons, than the other groups. [Conclusion] This study demonstrated that an exercise therapy program that combined stretching and joint stabilization exercise was more effective than other exercises for improvement of spastic shoulder joint dysfunction in hemiplegic patients.

ObjectiveTo investigate associations between angiotensin-converting enzyme (ACE) polymorphisms and muscle fatigability in 65-year-old Koreans.MethodThe study participants were 49 Koreans aged 65 years. ACE insertion/deletion (I/D) polymorphisms were determined by polymerase chain reaction and serum ACE activity, by spectrophotometry. Body mass index (BMI), body fat mass (BFM), and lean body mass (LBM) were determined. To evaluate muscle fatigability, dynamic Electromyography was used to measure maximum voluntary isometric contractions (MVICs) of ankle plantar flexor muscles. Patients were seated with their hips flexed at 90°, knees fully extended, and ankles at 0°. Continuous submaximal VICs (40% MVIC) were then performed, and contraction duration and EMG frequency changes during the initial 2 min were measured. A self-reported physical activity questionnaire was used to evaluate effects of ACE activity levels on muscle fatigability.ResultsAmong the 49 volunteers, 15 showed II genotype; 22, ID genotype; and 12, DD genotype. Serum ACE activity levels were significantly higher in DD genotype subjects than in II genotype subjects (p<0.05). Furthermore, the duration of submaximal isometric contractions was longer in II and ID genotype subjects than in DD genotype subjects (p<0.05). Dynamic EMG showed significantly lower mean frequency changes in II genotype subjects than in DD genotype subjects (p<0.05). However, LBM, BFM, and BMI were independent of ACE genotypes.ConclusionACE II genotype subjects showed significantly higher resistant to muscle fatigue than that by DD genotype subjects. However, body composition and BMI showed no correlations with ACE I/D polymorphisms.

The axe kick, in Olympic style taekwondo, has been identified as the most popular scoring technique aimed to the head during full contact competition. The first purpose of this study was to identify and investigate design issues with the current World Taekwondo Federation approved chest protector. A secondary purpose was to develop a novel chest protector addressing the identified design issues and to conduct a biomechanical analysis. Fifteen male elite Taekwondo players were selected to perform three different styles of the axe kick, i.e., front, in-out, and out-in axe kick five times each for a total of 45 kicks. Two-way repeated measures ANOVA showed significant differences between the novel and existing chest protector conditions for vertical height of the toe, downward kicking foot speed, hip flexion angle and ipsilateral shoulder flexion extension range of motion (ROM) (p < 0.05). There were no significant differences between the control condition (no chest protector) and the novel chest protector condition for these variables (p > 0.05). These results indicate that the novel chest protector interferes less with both the lower and upper limbs during the performance of the axe kick and provides a more natural, free-moving alternative to the current equipment used.