Independent walking is an important goal of clinical and community-based rehabilitation for children with cerebral palsy (CP). Virtual reality-based rehabilitation therapy is effective in motivating children with CP. This study investigated the effects of treadmill training with virtual reality on gait, balance, muscular strength, and gross motor function in children with CP. Eighteen children with spastic CP were randomly divided into the virtual reality treadmill training (VRTT) group (9 subjects, mean age, 10.2 years) and treadmill training (TT) group (9 subjects, mean age, 9.4 years). The groups performed their respective programs as well as conventional physical therapy 3 times/week for 8 weeks. Muscle strength was assessed using a digitalized manual muscle tester. Gross motor function was assessed using the Gross Motor Functional Measure (GMFM). Balance was assessed using the Pediatric Balance Scale (PBS). Gait speed was assessed using the 10-meter walk test (10MWT), and gait endurance was assessed using the 2-minute walk test (2MWT). After training, gait and balance was improved in the VRTT compared to the TT group (P < 0.05). Muscular strength was significantly greater in the VRTT group than the TT group, except for right hamstring strength. The improvements in GMFM (standing) and PBS scores were greater in the VRTT group than the TT group (P < 0.05). Furthermore, the VRTT group showed the higher values of 10MWT and 2MWT compared to the TT group (P < 0.05). In conclusion, VRTT programs are effective for improving gait, balance, muscular strength, and gross motor function in children with CP.

Background: Early diagnosis as well as treatment is important in management of congenital muscular torticollis (CMT). The purpose of this study was to find an effective physical therapy modality to improve the sternocleidomastoid (SCM) muscle thickness, the ratio of the SCM muscle thickness on the affected side to that on the non-affected side (A/N ratio), and head rotation in infant under 3 months of age diagnosed with CMT.Methods and analysis: A single-blind, randomized clinical trial was conducted. Participants were assigned in one of the 3 study groups through randomization. The treatment was performed 3 times a week for 30 minutes until the head tilt was 5 degrees. Group 1 was treated by handling for active or active-assist movement, group 2 was treated with passive stretching, and group 3 was treated with thermotherapy. For general characteristics, a x 2 test and 1-way analysis of variance were used. Intragroup differences were analyzed using a paired t test, and intergroup differences were analyzed using an age-adjusted analysis of covariance.Results: After the intervention, there was no significant difference between groups in terms of SCM thickness on the affected side and A/N ratio (P > .05). Degree of head rotation on the affected side showed significant differences between groups (P < .05), with Group 2 showing significantly better results than group 1 and group 3 (P < .05, both). Conclusion:Passive stretching treatment was more effective than other treatments of this study for improvement in degree of head rotation in CMT infants under 3 months of age.Trial registration: The trial is registered at the Institutional Review Board of Sahmyook University (IRB number, 2-7001793-AB-N-012019103HR) and the Clinical Research Information Service (CRiS; registry number, KCT0004862) Abbreviations: A/N ratio = ratio of the thickness on the affected side to that on the non-affected side, CMT = congenital muscular torticollis, ROM = range of motion, SCM = sternocleidomastoid muscle.

Objective: Congenital muscular torticollis (CMT) is a disease with abnormal head and neck posture in infants. It affects the child's movement and development and can lead to complications. Therefore, this study aims to find out what factors influence the rehabilitation treatment duration of infants with CMT. Design: Cross-sectional study. Methods: The subjects were 63 infants under 90 days of age who were diagnosed with CMT. Age, thickness of the sternocleidomastoid muscle (SCM) on the affected and non-affected side, head tilt angle, and head rotation angle of the affected head in infants were collected. The ratio of muscle thickness was calculated from the thickness of the affected SCM and the thickness of the non-affected SCM (A/N ratio). All subjects underwent conservative physical therapy twice a week for 30 minutes, and the end of the treatment was when the angle of head tilt was normal or less than 5 degrees, and the treatment duration was calculated. Results: Age, thickness of affected SCM, and head tilt were significantly correlated with treatment duration (p<0.05). The thickness of the non-affected SCM, A/N ratio, and head rotation angle did not show any correlation with treatment duration. The factors affecting the treatment duration were head tilt and age, showing 21% explanatory power of adjusted R 2. Conclusions: The main factors affecting the treatment duration of infants with CMT are head tilt and age. Therefore, more attention should be directed to the infant's head tilt and age for effective physical therapy of infants with CMT.

Objective: Hip abductors play a role in providing stability and movement to the lower limbs. The purpose of this study was to examine the effects of hip abductor fatigue on static balance and gait in the general population. Design: One group pre-test post-test design. Methods: Thirteen university students in their twenties volunteered for the study and had underwent a functional assessment. To induce fatigue, the subjects were instructed to raise their dominant lower extremity up against a load of 50% of 1 repetition maximum while producing hip abduction in a side-lying position. Subjects were instructed to maintain an abduction speed of 30 repetitions per minute to induce fatigue. Muscle fatigue was considered to be established when subjects were unable to perform hip abduction three consecutive times along with the metronome. A post-test of balance and gait was performed immediately in order to prevent fatigue recovery. The center of pressure (COP) distance area was measured using the Zebris FDM-S Multifunction Force measuring plate. Gait performance was analyzed using the GAITRite. Results: The COP distance was increased after fatigue was induced. There was a significant increase in the standard deviation of the medio-lateral and antero-posteror distance (p<0.05). Although there was no significant difference in gait parameters, there was a significant decrease in single support time after fatigue was induced (p<0.05). Conclusions:There was an increase in static balance instability and a significant decrease in single support time during gait due to hip abductor muscle fatigue.

[Purpose] This study aimed to examine the relationship between maximal lateral reaching distance on the affected side and weight shifting using the Multi-directional Reach Test in persons with stoke. [Subjects] Fifty-one chronic stroke participants were recruited from two rehabilitation hospitals. This study administered the Berg Balance Scale, Timed Up-and-Go, Trunk Impairment Scale, Modified Barthel Index and measured different maximal reaching distances. [Results] The maximal lateral reaching distance on the affected side was correlated with the BBS (r=0.571), TUG (r=−0.478), TIS (r=0.561), and MBI scores (r=0.499), the lateral reaching distance in all directions on the non-affected side (r=0.785), the maximal backward reaching distance (r=0.723), and the maximal forward reaching distance (r=0.673). The maximal reaching distance on the affected side was also affected by that on the non-affected side, in addition to the maximal backward reaching distance and MBI score. The final step model of stepwise multiple regression was explained 69.5%. [Conclusion] Maximal lateral reaching distance on the affected side as determined by the Multi-directional Reach Test is a good method of assessing functional performance in stroke patients. Data regarding maximal reaching distance on the non-affected side can be used to measure functional impairment on the affected side in clinical settings.

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Abstract.[Purpose] The study purpose was to investigate the test-retest reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0-Korean version (QUEST-K) for individuals with traumatic spinal cord injury. [Subjects and Methods] Seventy participants with spinal cord injury were enrolled in this study. The participants were assessed using the QUEST-K in two sessions conducted 3 days apart. This study also utilized the spinal cord independence measure III and modified Barthel index for determining their validity concurrently with the QUEST-K.[Results] The test-retest reliability (intraclass correlation coefficient 0.855) of the QUEST-K was high, indicating a good agreement. The results of the QUEST-K testing were not substantially positively correlated with those of the spinal cord independence measure III (r = −0.075) and Modified Barthel Index (r=−0.138).[Conclusion] The test-retest reliability of the QUEST-K was high in individuals with spinal cord injury. The QUEST-K could be a reliable measure for evaluating the satisfaction with assistive technology during functional performance in patients with spinal cord injury. The ability of the QUEST-K to detect actual changes is acceptable for research and clinical settings.

Objective: Clinical measures that quantify upper extremity function are needed for the accurate evaluation of patients and to plan an intervention strategy. The purpose of this study was to examine the relationship between the Unified Parkinson's Disease Rating Scale (UPDRS)-Motor Exam and upper extremity performance as a quantifying clinical tool of upper extremity function in persons with Parkinson's disease. Design: Cross-sectional study. Methods: Thirty-two idiopathic Parkinson's Disease persons participated in this study. To investigate the relationship between the UPDRS-motor exam, Box and Block test (BBT), and Action Research Arm Test (ARAT) by two physical therapists. The examination took up to 1 hour, and the participants were invited to rest between each clinical measure in order to minimize the effects of fatigue. Clinical measures were assessed while the subjects were in the "on" phase of their medication cycle, generally 1-3 hour after taking their anti-Parkinson's medications. Results: In more affected side, the UPDRS-motor exam was significantly negative correlated with the BBT (p<0.05) but it was not significantly correlated with the ARAT. In less affected side, only positively correlation was significantly shown between BBT and ARAT (p<0.05). On the other hand, between BBT and ARAT were not significantly correlated with the UPDRS-motor exam. Conclusions:The UPDRS-motor exam is effective tool which was significantly correlated with manual dexterity in more affected upper extremity. But The UPDRS-motor exam is not effective tool in less affected upper extremity.