Publications by authors named "Hwi-Young Cho"

62 Publications

Therapeutic Effect of BDNF-Overexpressing Human Neural Stem Cells (F3.BDNF) in a Contusion Model of Spinal Cord Injury in Rats.

Int J Mol Sci 2021 Jun 28;22(13). Epub 2021 Jun 28.

Department of Biomedical Science, CHA Stem Cell Institute, CHA University, 335 Pangyo-ro, Bundang-gu, Seongnam-si 13488, Gyeonggi-do, Korea.

The most common type of spinal cord injury is the contusion of the spinal cord, which causes progressive secondary tissue degeneration. In this study, we applied genetically modified human neural stem cells overexpressing BDNF (brain-derived neurotrophic factor) (F3.BDNF) to determine whether they can promote functional recovery in the spinal cord injury (SCI) model in rats. We transplanted F3.BDNF cells via intrathecal catheter delivery after a contusion of the thoracic spinal cord and found that they were migrated toward the injured spinal cord area by MR imaging. Transplanted F3.BDNF cells expressed neural lineage markers, such as NeuN, MBP, and GFAP and were functionally connected to the host neurons. The F3.BDNF-transplanted rats exhibited significantly improved locomotor functions compared with the sham group. This functional recovery was accompanied by an increased volume of spared myelination and decreased area of cystic cavity in the F3.BDNF group. We also observed that the F3.BDNF-transplanted rats showed reduced numbers of Iba1- and iNOS-positive inflammatory cells as well as GFAP-positive astrocytes. These results strongly suggest the transplantation of F3.BDNF cells can modulate inflammatory cells and glia activation and also improve the hyperalgesia following SCI.
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http://dx.doi.org/10.3390/ijms22136970DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8269438PMC
June 2021

Development of a novel model of intervertebral disc degeneration by the intradiscal application of monosodium iodoacetate (MIA) in rat.

Spine J 2021 Jun 9. Epub 2021 Jun 9.

Department of Physiology, Korea University, Seoul, Republic of Korea. Electronic address:

Background Context: Low back pain is one of the most common musculoskeletal disorders. Although, the pathology of intervertebral disc (IVD) degeneration has been modeled using various biological methods, these models are inadequate for simulating similar pathologic states in humans.

Purpose: This study investigated whether monosodium iodoacetate (MIA) injection into the IVD of rats could generate a reliable model of IVD degeneration.

Study Design/settings: In vivo animal study.

Methods: MIA was injected into two-disc spaces (L4-5 and L5-6) of Sprague-Dawley rats. Their behaviors were examined by measuring weight load shifts from hind to forefoot, rearing, and von Frey tests. We examined the inhibition of pain behavior through intraperitoneal morphine injection and measured cyclooxygenase-2 (COX-2) and transcription factor nuclear factor-kappa B (NF-κB) levels in the IVD and dorsal root ganglion (DRG) by Western blot. Bone alterations were assessed by microfocus computed tomography (micro-CT), and IVD and/or cartilage changes were evaluated by hematoxylin and eosin and safranin-O staining and inducible nitric oxide synthase (iNOS) immunohistochemistry. The other authors declare no conflicts of interest. This project funded by the Memorial Fund and the National Research Foundation of Korea (NRF).

Results: We observed increased weight load shifts to the forefoot and decreased rearing. Morphine-injected rats showed reduced pain. NF-κB and COX-2 expression increased in the IVD and left and/or right DRG. Micro-CT analyses suggested progressive bone deformation. Histologic examination showed decreased IVD width and nucleus pulposus area. Cartilaginous changes indicated epiphyseal growth plate loss. Finally, iNOS expression was increased in the subchondral endplate.

Conclusions: These results suggest that low back pain (LBP) models can be developed by MIA injection into the IVDs of rats and that an animal model is useful for exploring degenerative alterations in the affected discs. Therefore, MIA injection may be a useful model for the study of changes in the IVD to elucidate the mechanisms underlying clinical symptoms, such as LBP, in patients with IVD degeneration.

Clinical Significance: This model in which MIA was injected into the disc better represented the human histologic and behavioral characteristics than the existing puncture model.
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http://dx.doi.org/10.1016/j.spinee.2021.06.008DOI Listing
June 2021

Effect of Sit-to-Stand Training Combined with Taping on Spasticity, Strength, Gait Speed and Quality of Life in Patients with Stroke: A Randomized Controlled Trial.

Life (Basel) 2021 May 31;11(6). Epub 2021 May 31.

Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea.

Background And Objectives: Spasticity is one of the factors that make it more difficult to control posture in stroke patients. Taping has been used to manage muscle stiffness in various musculoskeletal disorders. Recently, it has been used to decrease spasticity in stroke patients, but the effect of taping combined with therapeutic exercise is still unclear. The purpose of the present study was to determine whether the sit-to-stand (STS) training combined with taping improves the ankle spasticity, muscle strength, gait speed, and quality of life in stroke patients.

Material And Methods: The study recruited 40 stroke patients, who were randomly divided into two groups: the taping and STS training (TSTS) group (n = 20) and the STS group (n = 20). The subjects in the TSTS group underwent STS training with Kinesio taping on the tibialis anterior, calf and ankle joint, whereas the subjects in the STS group underwent only STS training. All participants underwent 30 sessions of STS training (30 minutes, 5 days per week for 6 weeks). The present study evaluated the spasticity of ankle plantar flexors by the mean of the composite spasticity score; the muscle strength and gait speed were evaluated using the handheld dynamometer and the 10-meter walk test, respectively, and the quality of life was assessed using the stroke-specific quality of life scale.

Result: The TSTS group and the STS group showed significant improvements in spasticity, muscle strength, walking speed, and quality of life after the intervention (p < 0.05). The level of improvement in the TSTS group was significantly higher in spasticity, muscle strength, and walking speed compared to the STS group (p < 0.05).

Conclusions: The present study demonstrated that STS training is effective for decreasing spasticity in stroke patients and suggested that additional taping intervention further improved this effect. In addition, improvement of muscle strength and gait function was observed with a significant decrease of ankle spasticity.
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http://dx.doi.org/10.3390/life11060511DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8226448PMC
May 2021

Effect of Posterior Pelvic Tilt Taping on Pelvic Inclination, Muscle Strength, and Gait Ability in Stroke Patients: A Randomized Controlled Study.

J Clin Med 2021 May 28;10(11). Epub 2021 May 28.

Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea.

Objective: Pelvic alignment asymmetry in stroke patients negatively affects postural control ability. This study aimed to investigate the effect of posterior pelvic tilt taping on pelvic inclination, muscle strength, and gait ability in stroke patients.

Methods: Forty stroke patients were recruited and randomly divided into the following two groups: the posterior pelvic tilt taping (PPTT) group ( = 20) and the control group ( = 20). All participants underwent sitting-to-standing, indoor walking, and stair walking training (30 min per day, 5 days per week, for 6 weeks). The PPTT group applied posterior pelvic tilt taping during the training period, while the control group did not receive a tape intervention. Pelvic inclination was measured using a palpation meter (PALM). A hand-held dynamometer and the 10-meter walk test were used to measure muscle strength and gait ability.

Results: Significantly greater improvements in the pelvic anterior tilt were observed in the PPTT group than in the control group ( < 0.05). Muscle strength in the PPTT group was significantly increased compared to the control group ( < 0.05). Significantly greater improvements in gait speed were observed in the PPTT group than the control group.

Conclusions: According to our results, posterior pelvic tilt taping may be used to improve the anterior pelvic inclination, muscle strength, and gait ability in stroke patients.
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http://dx.doi.org/10.3390/jcm10112381DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198939PMC
May 2021

The Effects of Taping Combined with Wrist Stabilization Exercise on Pain, Disability, and Quality of Life in Postpartum Women with Wrist Pain: A Randomized Controlled Pilot Study.

Int J Environ Res Public Health 2021 03 30;18(7). Epub 2021 Mar 30.

Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea.

The purpose of this study was to evaluate the effects of wrist stabilization exercise combined with taping on wrist pain, disability, and quality of life in postpartum women with wrist pain. Forty-five patients with wrist pain were recruited and randomly divided into three groups: wrist stabilization exercise + taping therapy (WSE + TT) group (n = 15), wrist stabilization exercise (WSE) group (n = 15), and control group (n = 15). The WSE + TT and WSE groups performed wrist stabilization exercises for 40 min (once a day, five times a week for eight weeks), and the control group performed passive range of motion (P-ROM) exercise for the same amount of time. Additionally, the WSE + TT group attached taping to the wrist and forearm during the training period. The visual analogue scale (VAS) was used to assess pain level of the wrist. The Disabilities of the Arm, Shoulder and Hand (DASH) and the Short Form-36 (SF-36) were used to evaluate the degree of wrist disability and quality of life, respectively. The WSE + TT group showed a significant decrease in wrist pain and functional disability compared to two groups ( < 0.05). Significant improvement in the SF-36 score was observed in the WSE + TT and WSE groups compared to that in the control group ( < 0.05). However, there was no significant difference between the WSE + TT and WSE groups in the SF-36. Our findings indicate that wrist stabilization exercise combined with taping is beneficial and effective in managing wrist pain and disability in postpartum women with wrist pain.
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http://dx.doi.org/10.3390/ijerph18073564DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8037921PMC
March 2021

Effects of Prolonged Sitting with Slumped Posture on Trunk Muscular Fatigue in Adolescents with and without Chronic Lower Back Pain.

Medicina (Kaunas) 2020 Dec 23;57(1). Epub 2020 Dec 23.

Department of Physical Therapy, Gachon University, Incheon 21936, Korea.

This study investigated the effects of prolonged sitting on trunk muscular fatigue and discomfort in participants with and without chronic lower back pain (LBP). This study included 15 patients with LBP and 15 healthy controls. All participants were instructed to sit on a height-adjustable chair with their knee and hip joints bent at 90° for 30 min, in slumped sitting postures. Surface electromyography was used to assess the median frequency of the internal obliques (IO)/transversus abdominis (TrA) and multifidus (MF) muscles. Perceived discomfort was measured using a Borg category ratio-scale. Median frequency of the trunk muscles and perceived discomfort after 30 min of sitting were compared with baseline. There were no significant differences within the group and between both groups in the median frequency of bilateral IO and MF muscles. The LBP group showed significantly greater perceived discomfort after prolonged sitting, as compared to the control group. Prolonged sitting with slumped posture could increase the risk of experiencing lower back discomfort.
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http://dx.doi.org/10.3390/medicina57010003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822118PMC
December 2020

Effectiveness of Heel-Raise-Lower Exercise after Transcutaneous Electrical Nerve Stimulation in Patients with Stroke: A Randomized Controlled Study.

J Clin Med 2020 Oct 31;9(11). Epub 2020 Oct 31.

Department of Physical Therapy, Gachon University, Incheon 21936, Korea.

Objective: This study was conducted to investigate the effect of the heel-raise-lower exercise on spasticity, strength, and gait speed after the application of 30 min of transcutaneous electrical nerve stimulation (TENS) in patients with stroke.

Methods: The participants were randomly divided into the TENS group and the placebo group, with 20 participants assigned to each group. In the TENS group, heel-raise-lower exercise was performed after applying TENS for six weeks. The placebo group was trained in the same manner for the same amount of time but without electrical stimulation. The spasticity of the ankle plantar flexors was measured using the composite spasticity score. A handheld dynamometer and a 10-m walk test were used to evaluate muscle strength and gait speed, respectively.

Results: Spasticity was significantly more improved in the TENS group (mean change -2.0 ± 1.1) than in the placebo group (mean change -0.4 ± 0.9) ( < 0.05). Similarly, muscle strength was significantly more improved in the TENS group (6.4 ± 3.3 kg) than in the placebo group (4.5 ± 1.6 kg) ( < 0.05). Moreover, participants assigned to the TENS group showed a significant greater improvement in gait speed than those in the placebo group (mean change -5.3 ± 1.4 s vs. -2.7 ± 1.2 s).

Conclusions: These findings show the benefits of heel-raise-lower exercise after TENS for functional recovery in patients with stroke.
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http://dx.doi.org/10.3390/jcm9113532DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7692363PMC
October 2020

A Novel Method for Gait Analysis on Center of Pressure Excursion Based on a Pressure-Sensitive Mat.

Int J Environ Res Public Health 2020 10 26;17(21). Epub 2020 Oct 26.

Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea.

Center of pressure (COP) during gait is a useful measure for assessing gait ability and has been investigated using platform or insole systems. However, these systems have inherent restrictions in repeated measure design or in obtaining true vertical force. This study proposes a novel method based on a pressure-sensitive mat system for COP measurement and presents normal reference values for the system. To explore repeatability, this work also investigated relative and absolute intra-rater reliabilities and determined the number of footfalls required to obtain a reliable measurement. Ninety healthy young adults participated and performed barefoot walking on a force-sensitive mat at a comfortable and fast pace. The time points and subphase duration of the stance phase, displacement ranges, and mean locations of COP and velocity of COP excursion were parameterized. The results showed acceptable and consistent variabilities of the parameters. Seven footfalls were determined as the threshold for most parameters to show a good to reasonable level of reliability. In conclusion, the presented method can be used as a reliable measurement for COP excursion, and it is recommended that more than seven footfalls be collected to ensure a high level of reliability.
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http://dx.doi.org/10.3390/ijerph17217845DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7663129PMC
October 2020

The impact of smartphone use on gait in young adults: Cognitive load vs posture of texting.

PLoS One 2020 12;15(10):e0240118. Epub 2020 Oct 12.

Department of Physical Therapy, Gachon University, Incheon, Republic of Korea.

Many researches have reported that the use of smartphones has a negative impact on gait variability and speed of pedestrians by dispersion of cognition, but the influence of factors other than cognitive function on gait is still unclear. The purpose of this study was to investigate the impact of smartphone use on spatiotemporal gait parameters in healthy young people while walking. 42 healthy young adults were recruited and instructed to walk in four conditions (walking without using a smartphone, typing on a smartphone with both hands, typing on a smartphone with one hand, and texting posture with non-task). All spatiotemporal gait parameters were measured using the GAITRite walkway. Compared to walking without using a smartphone, the subjects walked with a slower cadence and velocity and changed stride length and gait cycle and spent more time in contact with the ground when using a smartphone (p < 0.05). In addition, even if a texting posture was taken without performing a task, a similar change was observed when using a smartphone (p < 0.05). This study found that a cautious gait pattern occurred due to smartphone use, and that a change in gait appeared just by taking a posture without using smartphone.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0240118PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7549775PMC
December 2020

A Comparison of the Transient Effect of Complex and Core Stability Exercises on Static Balance Ability and Muscle Activation during Static Standing in Healthy Male Adults.

Healthcare (Basel) 2020 Oct 1;8(4). Epub 2020 Oct 1.

Department of Physical Therapy, Gachon University, Incheon 21936, Korea.

Balance ability is a necessary exercise factor required for the activities of daily living. This study investigated the effects of short-term complex exercise (CE) and core stability exercise (CSE) on balance ability and trunk and lower-extremity muscle activation on healthy male adults. Twenty-nine healthy male adults were included. All performed CE and CSE for 1 min each; the exercise order was randomized. The primary and secondary outcomes were balance ability and muscle activation, respectively. In balance ability, CE showed a significant difference in all variables in both eye-opened and eye-closed conditions compared with the baseline ( < 0.05). In comparisons among exercises, the path length and average velocity variables showed a significant decrease in the eye-opened condition, and the path length variable showed a significant decrease in the eye-closed condition ( < 0.05). In muscle activation, CE showed a significant increase in the gluteus medius (Gmed) and decrease in the rectus femoris (RF), tibialis anterior (TA), and RF/biceps femoris (BF) ratio in the eye-opened condition compared to the baseline and a significant decrease in RF and RF/BF ratio in the eye-closed condition ( < 0.05). Both CE and CSE improved the static balance ability. Furthermore, muscle activation significantly increases in Gmed and decreases in the RF, TA, and RF/BF ratio. Therefore, we recommend including CE in an exercise program that has the purpose of improving static balance ability.
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http://dx.doi.org/10.3390/healthcare8040375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7711515PMC
October 2020

The Effectiveness of Trunk Stabilization Exercise Combined with Vibration for Adolescent Patients with Nonspecific Low Back Pain.

Int J Environ Res Public Health 2020 09 25;17(19). Epub 2020 Sep 25.

Department of Physical Therapy, College of Health Science, Gachon University, Incheon 21936, Korea.

There are many adolescent patients complaining of low back pain, but research on it is lacking. The purpose of this study was to investigate the effects of trunk stabilization exercise combined with vibration on the pain, proprioception, and kinematics of the lumbar spine (LS) during sit to stand (STS) in adolescent patients with nonspecific low back pain (LBP). Fifty LBP patients were recruited and were randomly divided into two groups: Vibration group ( = 25) and placebo group ( = 25). All participants underwent 36-sessions of training consisting of six exercises. The Vibration group provided vibration stimulation during exercise, but the placebo group did not. The Numeric Pain Rating Scale (NPRS) and digital dual inclinometer were used to measure pain intensity and proprioception. The kinematics of the lumbar spine during STS were measured by motion capture system. After training, the pain and proprioception in the vibration group improved significantly greater than the placebo group ( < 0.05). The mobility of LS (maximum range of motion, angular velocity, lumbar to hip movement ratios) and lumbar-hip coordination during STS in the vibration group were significantly improved compared to the placebo group ( < 0.05). Thus, trunk stabilization exercise combined with vibration may be used to improve the pain, proprioception, and kinematic of the lumbar spine during sit to stand in adolescent patients with LBP.
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http://dx.doi.org/10.3390/ijerph17197024DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579292PMC
September 2020

Thermotherapy Plus Neck Stabilization Exercise for Chronic Nonspecific Neck Pain in Elderly: A Single-Blinded Randomized Controlled Trial.

Int J Environ Res Public Health 2020 08 1;17(15). Epub 2020 Aug 1.

Department of Health Science, Gachon University Graduate School, Incheon 21936, Korea.

Neck pain is a serious problem for public health. This study aimed to compare the effects of thermotherapy plus neck stabilization exercise versus neck stabilization exercise alone on pain, neck disability, muscle properties, and alignment of the neck and shoulder in the elderly with chronic nonspecific neck pain. This study is a single-blinded randomized controlled trial. Thirty-five individuals with chronic nonspecific neck pain were randomly allocated to intervention ( = 18) or control ( = 17) groups. The intervention group received thermotherapy with a salt-pack for 30 min and performed a neck stabilization exercise for 40 min twice a day for 5 days (10 sessions). The control group performed a neck stabilization exercise at the same time points. Pain intensity, pain pressure threshold (PPT), neck disability index, muscle properties, and alignment of the neck and shoulder were evaluated before and after the intervention. Significant time and group interactions were observed for pain at rest ( < 0.001) and during movement ( < 0.001), and for PPT at the upper-trapezius ( < 0.001), levator-scapula ( = 0.003), and splenius-capitis ( = 0.001). The disability caused by neck pain also significantly changed between groups over time ( = 0.005). In comparison with the control group, the intervention group showed significant improvements in muscle properties for the upper-trapezius (tone, = 0.021; stiffness, = 0.017), levator-scapula (stiffness, = 0.025; elasticity, = 0.035), and splenius-capitis (stiffness, = 0.012), and alignment of the neck ( = 0.016) and shoulder ( < 0.001) over time. These results recommend the clinical use of salt pack thermotherapy in addition to neck stabilization exercise as a complementary intervention for chronic nonspecific neck pain control.
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http://dx.doi.org/10.3390/ijerph17155572DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7432917PMC
August 2020

Manipulative Therapy Plus Ankle Therapeutic Exercises for Adolescent Baseball Players with Chronic Ankle Instability: A Single-Blinded Randomized Controlled Trial.

Int J Environ Res Public Health 2020 07 11;17(14). Epub 2020 Jul 11.

Graduate School of Integrative Medicine, CHA University, Seongnam 13488, Korea.

Manipulative therapies and exercises are commonly used for the management of chronic ankle instability (CAI), but there is no evidence regarding the efficacy of high-velocity low-amplitude manipulation (HVLA) in addition to ankle therapeutic exercise to improve CAI in adolescent baseball players (ABP). To compare the effects of HVLA plus ankle therapeutic exercise and ankle therapeutic exercise alone on ankle status, pain intensity, pain pressure threshold (PPT), range of motion (ROM) of the ankle joint, and balance ability in ABP with CAI, a single-blinded randomized controlled trial was conducted. A total of 31 ABP with CAI were randomly allocated to the intervention (n = 16) or control (n = 15) groups. The intervention group received HVLA plus resistance exercise twice a week for 4 weeks, while the control group received resistance exercise alone. Ankle status, pain intensity, PPT, ROM, and balance ability were assessed before and after the intervention. The American Orthopedic Foot and Ankle Society scores showed significant group and time interactions (total, = 0.002; pain, < 0.001; alignment, = 0.001). There were significant group and time interactions in pain intensity (resting pain, = 0.008; movement pain, < 0.001). For ROM, there were significant group and time interactions on dorsiflexion ( = 0.006) and eversion ( = 0.026). The unipedal stance of the balance ability showed significant group and time interactions in path length ( = 0.006) and velocity ( = 0.006). Adding HVLA to resistance exercises may be synergistically effective in improving the ankle status, pain intensity, ROM, and balance ability in ABP with CAI.
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http://dx.doi.org/10.3390/ijerph17144997DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7399978PMC
July 2020

Brain activity during a working memory task in different postures: an EEG study.

Ergonomics 2020 Nov 1;63(11):1359-1370. Epub 2020 Jul 1.

Department of Health Science, Gachon University Graduate School, Incheon, Republic of Korea.

While working is more comfortable in a supine position and healthier in a standing, most people work in a sitting. However, it is unclear whether there are differences in brain activity efficiency in different postures. Here, we, therefore, compared changes in brain activity across three different postures to determine the optimal posture for performing working memory tasks. Their effect on brain activity was examined using EEG signals together with the information of accuracy and reaction times during 2-back task in 24 subjects. Substantial differences in brain waves were observed at sitting and standing positions compared to the supine, especially in delta waves and frontal lobe, where is known to improve the modulation of brain activity efficiently. Brain efficiency was higher during standing and sitting than in a supine. These findings show that postural changes may affect the efficiency of brain activity during working memory tasks. Differences in brain efficiency between different postures during working memory tasks have not been explored. This study suggests that efficiency in several brain areas is higher during sitting and standing than in a supine position. This finding has important implications regarding workplace environments. Furthermore, this result would be useful to improve accomplishment and reduce negative effects of work posture. EEG: electroencephalogram; PSQI: Pittsburgh sleep quality index; KSS: Karolinska sleepiness scale; FFT: fast fourier transform; ROI: region of interest; ANS: autonomic nervous system; Fp: prefrontal; AF: anterior frontal; frontal; Fz: midline frontal; temporal; central; Cz: midline central; P: parietal; Pz: midline parietal; O: occipital; Oz: midline occipital.
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http://dx.doi.org/10.1080/00140139.2020.1784467DOI Listing
November 2020

Mud Therapy Combined with Core Exercise for Chronic Nonspecific Low Back Pain: A Pilot, Single-Blind, Randomized Controlled Trial.

Evid Based Complement Alternat Med 2020 3;2020:7547452. Epub 2020 Apr 3.

Department of Physical Therapy, Gachon University, Incheon, Republic of Korea.

Background: Low back pain (LBP) is common in the elderly and an appropriate intervention for LBP management should be investigated. The aim of this study is to investigate the potential of mud-heat intervention combined with core exercise as an alternative intervention for relieving pain and improving motor function in individuals with nonspecific chronic LBP.

Methods: Thirty-one individuals with chronic nonspecific LBP were randomly allocated to either the intervention group ( = 16) or the control group ( = 15). The intervention group used a mud pack for 30 min and performed a core-exercise program for 50 min twice a day for 4 days (8 sessions). The control group performed the core-exercise program only, at the same time point as the intervention group. Pain intensity was assessed using a 100 mm visual analog scale and a pain pressure threshold (PPT) as the primary outcomes. The secondary outcome measures included functional disability by LBP (Oswestry Disability Index), muscle properties, and static/dynamic balance.

Results: There was a significant group difference in pain intensity at rest (=0.048) and in the PPT at the two sites assessed (2 cm lateral to L3 spinous process, =0.045; 2 cm lateral to L5 spinous process, =0.015). No group differences were found in terms of muscle properties. Compared to core exercise only, moor-heat therapy and core exercise showed a significant improvement in static balance (=0.026) and dynamic balance (=0.019).

Conclusion: Mud therapy combined with core exercise is effective in relieving pain and improving motor function in patients with chronic nonspecific LBP. Further research is needed to underpin these preliminary results.
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http://dx.doi.org/10.1155/2020/7547452DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7157804PMC
April 2020

Gait training with auditory feedback improves trunk control, muscle activation and dynamic balance in patients with hemiparetic stroke: A randomized controlled pilot study.

J Back Musculoskelet Rehabil 2020 ;33(1):1-6

Department of Physical Therapy, Gachon University, Incheon, Korea.

Background: Auditory feedback enables an individual to identify and modify the differences between actual and intended movement during the motor learning process.

Objective: We investigated the effects of gait training with auditory feedback on trunk control, muscle activation, and dynamic balance in patients with hemiparetic stroke.

Methods: Twenty participants with hemiparetic stroke were recruited in this study and randomly assigned to the experimental (n= 10) or control (n= 10) group. The subjects in the experimental group participated in gait training with auditory feedback for 30 minutes, 5 times a week, for 4 weeks, whereas those in the control group received conventional gait training for 30 minutes, 5 times a week, for 4 weeks. During auditory feedback training, a beeping sound is produced every time a patient loaded weight that was higher than the preset threshold on the cane. Activation of the erector spinae muscle was measured using surface electromyography, and trunk control was evaluated using the Trunk Impairment Scale (TIS). Dynamic balance was measured using the Timed Up and Go (TUG) test.

Results: Muscle activation was significantly higher in the experimental group than in the control group (6.6 ± 9.2% vs 1.4 ± 5.4% nonparetic peak activity). No significant difference was found in the TIS score between the experimental and control groups. Based on the TUG test, a significant improvement was observed in the experimental group compared to the control group (12.1 ± 11.4 vs 3.8 ± 4.7 s).

Conclusion: Our findings indicate that gait training with auditory feedback was beneficial for improving trunk control and muscle activation in patients with hemiparetic stroke.
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http://dx.doi.org/10.3233/BMR-170852DOI Listing
August 2020

Effects of Light Touch on Balance in Patients with Stroke.

Open Med (Wars) 2019 9;14:259-263. Epub 2019 Apr 9.

Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea, 191 Hambangmoe-ro, Yeonsu-gu, Inchon, 406-799, Republic of Korea.

Light touch is the combination of cutaneous and kinesthetic inputs. The literature suggests that light touch compensates for a reduced amount of center of pressure information in older peoples, blind subjects and patients with neurological disorder. This study investigated the effects of light touch applied to an external bar, on the postural sway in individuals with hemiparetic stroke. We used a cross sectional study, fifteen individuals with stroke and 15 healthy age-matched adults stood as still as possible on a force plate. Experimental trials (duration, 30 s) included two visual conditions (open eyes and closed eyes), two somatosensory conditions (no touch and light touch) and two support surface conditions (firm and foam surfaces). The area of center of pressure (COP) and the mean velocity of COP in the medio-lateral and anterior-posterior directions were assessed. For both groups, COP velocity and area decreased with light touch regardless of the visual or surface conditions. The effects of light touch were similar in both groups. In addition, results show that the effectiveness of light touch in reducing postural sway was greater on a foam surface than on a firm surface. Our findings indicate that light touch could be beneficial in postural control for individuals with hemi-paretic stroke.
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http://dx.doi.org/10.1515/med-2019-0021DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6463820PMC
April 2019

Effects of therapeutic exercise on sea sand on pain, fatigue, and balance in patients with chronic ankle instability: a feasibility study.

J Sports Med Phys Fitness 2019 Jul 12;59(7):1200-1205. Epub 2019 Feb 12.

Department of Physical Therapy, Gachon University, Incheon, South Korea -

Background: Chronic ankle instability (CAI) is a common disease following ankle sprain and appears balance and gait problems, pain, and fatigue. This study aimed to examine the effect of therapeutic exercise performed on sea sand on pain, fatigue, and balance ability in patients with CAI.

Methods: This study was designed as a randomized controlled trial. Subjects with a Cumberland Ankle Instability Tool (CAIT) score of less than 27 were selected. 22 subjects were randomly assigned to the sea sand (SS) group (N.=11) or the self-management (SM) group (N.=11). The SS group performed the therapeutic exercise on sea sand and the SM group conducted the exercises on a firm surface at home 5 times over the course of a week. To measure static balance, center of pressure (COP) of one-leg standing on the force plate was assessed. Visual Analog Scale (VAS) was used to measure pain and fatigue.

Results: The SS group showed statistically significant improvements in all static balance outcomes (COP-area, COP-average velocity, minor-axis, major-axis) after the intervention (P<0.05), while the SM group did not show a significant change in all static balance parameters (P>0.05). Also, the SS group showed statistically significant improvements in pain and fatigue (P<0.05). All outcomes except major axis showed statistically significant differences between SS group and SM group at change value (P<0.05).

Conclusions: Therapeutic exercise on sea sand effectively improved balance and decreased pain and fatigue. Thus, it can be considered a rehabilitation method for CAI patients.
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http://dx.doi.org/10.23736/S0022-4707.19.09405-2DOI Listing
July 2019

Apoptotic changes in a full-lengthened immobilization model of rat soleus muscle.

Muscle Nerve 2019 02 18;59(2):263-269. Epub 2018 Dec 18.

Department of Physiology, College of Medicine and Neuroscience Research Institute, Korea University, Seoul, 136-705, South Korea.

Introduction: Lengthened immobilization may prevent muscle shortening, and help maintain normal muscle length. However, its apoptotic effects remain unclear. We evaluated the effects of long-term immobilization on apoptotic proteins.

Methods: Rat soleus muscles were immobilized by casting in a neutral (NEUT) or lengthened (LENG) position for 21 days. We evaluated dynamic weight load and muscle atrophy following the 21-day period using hematoxylin and eosin staining. We measured Bax (pro-apoptotic Bcl-2 family member), MyoD (myogenic differentiation factor D), MYH (myosin heavy chain), and cleaved poly(ADP-ribose)polymerase levels and examined apoptotic nucleus expression.

Results: Decreased dynamic weight load and muscle atrophy changes were observed in LENG. Both NEUT and LENG showed significantly reduced levels of MYH. LENG showed a significant increase in Bax and MyoD expression as well as in the number of apoptotic nuclei.

Conclusions: Long-term lengthened immobilization may increase apoptotic changes and decrease muscle formation proteins in muscle. Muscle Nerve 59:263-269, 2019.
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http://dx.doi.org/10.1002/mus.26359DOI Listing
February 2019

Effect of a cervical support pillow on sternocleidomastoid activity and satisfaction in asymptomatic participants.

J Phys Ther Sci 2018 Jun 12;30(6):840-842. Epub 2018 Jun 12.

Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea.

[Purpose] The aim of this study was to examine the changes in sternocleidomastoid muscle (SCM) activity when using a cervical support pillow (CSP) and to determine the pillow's effect on satisfaction in asymptomatic participants. [Subjects and Methods] This study followed a cross-over design and the order of the measurements was counterbalanced. Twenty asymptomatic participants were positioned supine for 5 minutes by using either a CSP or a general pillow (GP) while the activity of the SCM was measured using surface electromyography. [Results] The CSP significantly decreased the activity of the SCM compared with the GP, and satisfaction after use of the CSP was significantly greater than that after use of the GP. [Conclusion] This study suggests that the CSP may be effective in preventing unnecessary neck muscle activation during sleep in asymptomatic people.
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http://dx.doi.org/10.1589/jpts.30.844DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6016307PMC
June 2018

Whole-body vibration improves ankle spasticity, balance, and walking ability in individuals with incomplete cervical spinal cord injury.

NeuroRehabilitation 2018 ;42(4):491-497

Department of Physical Therapy, College of Health Science, Gachon University, Incheon, Republic of Korea.

Objectives: This study aimed to investigate the effects of whole-body vibration (WBV) training on ankle spasticity, balance, and walking ability in patients with incomplete spinal cord injury (iSCI) at cervical level.

Methods: Twenty-eight patients with cervical iSCI were randomly assigned to WBV (n = 14) or control group (n = 14). WBV group received WBV training, while control group was treated with placebo-treatment. All interventions were given for 20-min, twice a day, 5-days a week for 8-weeks. The spasticity of ankle plantar-flexors was assessed by estimating passive resistive force using a hand-held dynamometer. Balance was analyzed based on postural sway length (PSL) using a force plate. Timed-Up and Go test (TUG) and 10 m-Walk Test (10MWT) were used to assess walking ability.

Results: Both groups showed significant improvements in spasticity, balance and walking ability. Also, the significant differences between two groups were demonstrated in the outcomes of spasticity (3.0±1.7 vs 0.9±1.2), PSL (6.4±1.2 vs 3.2±0.9 with eyes-open, and 15.1±10.9 vs 7.4±4.3 with eyes-closed), TUG (2.3±1.3 vs 1.0±1.0), and 10MWT (3.5±2.3 vs 1.3±1.4).

Conclusions: WBV may be a safe and effective intervention to improve spasticity, balance and walking ability in individuals with cervical iSCI. Thus, WBV may be used to improve these symptoms in clinics.
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http://dx.doi.org/10.3233/NRE-172333DOI Listing
October 2018

The effects of tongue pressure strength and accuracy training on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia: a preliminary randomized clinical trial.

Int J Rehabil Res 2018 Sep;41(3):204-210

Physical Therapy, Gachon University, Incheon.

Tongue pressure strength and accuracy training (TPSAT) has been proposed as an intervention to improve dysphagia. However, the effects of TPSAT on dysphagia in subacute stroke patients remain unclear. The aim of this study was to investigate the effects of TPSAT on tongue pressure strength, swallowing function, and quality of life in subacute stroke patients with dysphagia. Sixteen subacute stroke patients were assigned randomly to two groups: the TPSAT group (n=8) or the control group (n=8). In the former, both TPSAT and traditional dysphagia therapies were performed for 30 min each per day; in the latter, only traditional dysphagia therapy was performed for 30 min twice a day. Both groups performed each daily intervention five times per week for 8 weeks. To assess the tongue pressure strength, maximum isometric tongue pressures (MIPs) of the anterior and posterior tongue using the Iowa Oral Performance Instrument were measured before and after the intervention. Mann Assessment of Swallowing Ability (MASA) and Swallowing-Quality of Life (SWAL-QOL) were also used to assess the swallowing function and quality of life, respectively. TPSAT with traditional dysphagia therapy significantly improved MASA, SWAL-QOL, and MIPs both anteriorly and posteriorly, and traditional dysphagia therapy significantly increased MASA, SWAL-QOL, and MIPs anteriorly (P<0.05). The TPSAT group showed a significant improvement in anterior and posterior MIPs and tongue movement score in MASA compared with the control group (P<0.05). Our findings suggest that TPSAT may significantly improve dysphagia management in subacute stroke patients.
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http://dx.doi.org/10.1097/MRR.0000000000000282DOI Listing
September 2018

Effects of lumbar lordosis assistive support on craniovertebral angle and mechanical properties of the upper trapezius muscle in subjects with forward head posture.

J Phys Ther Sci 2018 Mar 2;30(3):457-460. Epub 2018 Mar 2.

Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea.

[Purpose] The aim of this study was to investigate the effect of lumbar lordosis assistive support (LLAS) on craniovertebral angle (CVA) and mechanical properties of the upper trapezius (UT) muscle in subjects with forward head posture (FHP). [Subjects and Methods] This study recruited 20 subjects with FHP. CVA and muscle tone, viscoelasticity, and stiffness of the UT were measured using Myoton in all subjects in a sitting position with LLAS and in a neutral sitting position. The order of measurements was randomized and the mean values were calculated twice. [Results] The sitting position with LLAS showed a significantly greater improvement than the neutral sitting position with regard to CVA and muscle tone, viscoelasticity, and stiffness of the UT. [Conclusion] We suggest that the sitting position using LLAS induces the maintenance of normal neck posture and a reduction in the muscle tone of the UT in the subjects with FHP.
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http://dx.doi.org/10.1589/jpts.30.457DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857458PMC
March 2018

Effects of chin tuck exercise using neckline slimmer device on suprahyoid and sternocleidomastoid muscle activation in healthy adults.

J Phys Ther Sci 2018 Mar 2;30(3):454-456. Epub 2018 Mar 2.

Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 21936, Republic of Korea.

[Purpose] This study investigated the effect of chin tuck exercise (CTE) using a neckline slimmer device on suprahyoid (SH) and sternocleidomastoid (SCM) muscle activation in healthy adults. [Subjects and Methods] We measured activation of the SH and SCM muscles using surface electromyography in 20 healthy adults during head lift exercise (HLE) and CTE using a neckline slimmer device. The order of exercises was randomized and the mean and peak values of each muscle's activation were assessed. [Results] During the CTE using a neckline slimmer device, SH activation was significantly greater and SCM activation was significantly lower than during the HLE. [Conclusion] This study suggest that chin-tuck exercise using a neckline slimmer device may be more helpful than HLE for swallowing training.
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http://dx.doi.org/10.1589/jpts.30.454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5857457PMC
March 2018

The reliability and validity of the Korean version of the lower limb functional index.

J Phys Ther Sci 2018 Jan 27;30(1):50-52. Epub 2018 Jan 27.

Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea.

[Purpose] The purpose of this study was to establish the reliability and validity of the Korean-translated version of the Lower Limb Functional Index (LLFI) in the assessment of patients with lower-limb disorders. [Subjects and Methods] Fifty-six subjects with lower-limb disorders, 24 men and 32 women, participated in this study. Reliability was determined by using the intra-class correlation coefficient and Cronbach's α for internal consistency. Validity was examined by correlating the LLFI scores with the Lower Extremity Functional Scale (LEFS) and Short Form 36 (SF-36) scores. [Results] The test-retest reliability was 0.95. The criterion-related validity was established through a comparison with the Korean versions of the LEFS and SF-36. [Conclusion] The Korean version of the LLFI was shown to be a reliable and valid instrument for assessing lower-limb complaints.
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http://dx.doi.org/10.1589/jpts.30.50DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5788774PMC
January 2018

The effects of task-oriented training on hand dexterity and strength in children with spastic hemiplegic cerebral palsy: a preliminary study.

J Phys Ther Sci 2017 Oct 21;29(10):1800-1802. Epub 2017 Oct 21.

Department of Physical Therapy, Gachon University: 191 Hambangmoe-ro, Yeonsu-gu, Incheon 406-799, Republic of Korea.

[Purpose] The purpose of this study was to investigate the effects of task-oriented training (TOT) on hand dexterity and strength in children with spastic hemiplegic cerebral palsy. [Subjects and Methods] Twelve children with spastic hemiplegic cerebral palsy were randomly assigned to either the TOT group (n=6) or the control group (n=6). In both groups, conventional occupational therapy was performed 40-min/day, 2 times a week, for 4 weeks. In the TOT group, TOT was additionally performed for 20 min, and the control group received usual care. The box and block test (BBT) was performed to assess hand dexterity. Hand strength was also assessed using hand dynamometer. [Results] After intervention, the TOT group showed a significant improvement of hand dexterity. In the control group, BBT and grip strength were not significantly improved after intervention. [Conclusion] In clinical settings, we suggest that TOT may be used as an intervention to improve hand dexterity in children with spastic hemiplegic cerebral palsy.
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http://dx.doi.org/10.1589/jpts.29.1800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5684012PMC
October 2017

The effects of spinal support device on pain and extensibility of the hamstrings in patients with non-specific low back pain.

J Phys Ther Sci 2017 Aug 10;29(8):1301-1304. Epub 2017 Aug 10.

Department of Physical Therapy, College of Health Science, Gachon University, Republic of Korea.

[Purpose] The objective of this study was to investigate the effects of spinal support device (SSD) on pain and hamstring extensibility in patients with non-specific low back pain (NSLBP). [Subjects and Methods] 20 patients with NSLBP were recruited and randomly assigned to either the SSD group or the control group. In the SSD group, SSD was applied; in the control group, bed rest in supine position was performed. Both groups underwent treatment 20 min/day, 3 times a week, for a duration of 4 weeks. To assess the hamstring extensibility, sit and reach test (SRT) was performed. To assess pain pressure threshold (PPT) of the sacroiliac joint, a pressure algometer was used. Visual analog scale (VAS) was used to quantify pain. [Results] The SSD group showed a significant improvement in sacroiliac joint pain with increased VAS, and the control group showed a significantly increased VAS after intervention. In the SSD group, VAS was significantly increased, but SRT was not changed compared with the control group. [Conclusion] These results demonstrated that an application of SSD effectively attenuates low back pain. Therefore, SSD may be a suitable intervention for pain control in patients with NSLBP.
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http://dx.doi.org/10.1589/jpts.29.1301DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5574329PMC
August 2017

Effects of lingual strength training on lingual strength and articulator function in stroke patients with dysarthria.

J Phys Ther Sci 2017 Jul 15;29(7):1201-1204. Epub 2017 Jul 15.

Department of Physical Therapy, College of Health Science, Gachon University, Republic of Korea.

[Purpose] This study investigated the effects of lingual strength training (LST) on lingual strength and articulator function in stroke patients with dysarthria. [Subjects and Methods] 16 stroke patients with dysarthria were randomly assigned into two groups: the experimental group (n=8) or the control group (n=8). Both groups received the conventional rehabilitation therapy at 30 min/day, 5 times for week, and during 4 weeks, and the experimental group received an additional 30 min of LST using the Iowa Oral Performance Instrument (IOPI). The Maximum Isometric Tongue Pressures (MIPs) was used to assess the lingual strength and the Alternating-Motion Rate (AMR) and Sequential-Motion Rate (SMR) were used to measure the articulator function. [Results] After the intervention, the experimental group showed a significant improvement in MIPs and AMR (/tə/) than the control group. [Conclusion] Findings of this study suggest that LST provides positive effects on lingual strength and articulator function, and thus can be used as an interventional method in stroke patients with dysarthria.
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http://dx.doi.org/10.1589/jpts.29.1201DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5509591PMC
July 2017

The reliability and validity of the Korean version of the Upper Limb Functional Index.

J Phys Ther Sci 2017 Jun 7;29(6):1062-1065. Epub 2017 Jun 7.

Department of Physical Therapy, College of Health Science, Gachon University, Republic of Korea.

[Purpose] The purpose of this study was to establish the reliability and validity of Upper Limb Functional Index (ULFI), which has been translated into Korean, in treating patients with upper limb complaints. [Subjects and Methods] Fourty-nine subjects with upper limb disorder, 20 males and 29 females, participated in this study. Reliability was determined by using the intra class correlation coefficient and Cronbach's alpha for internal consistency. Validity was examined by correlating ULFI scores with Disability of Arm, Shoulder and Hand (DASH). [Results] Test-retest reliability was 0.90. The criterion-related validity was established by a comparison with the Korean version of DASH. [Conclusion] The Korean version of ULFI was shown to be a reliable and valid instrument for assessing upper limb complaints.
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http://dx.doi.org/10.1589/jpts.29.1062DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5468200PMC
June 2017

Effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia.

J Phys Ther Sci 2017 Apr 20;29(4):609-612. Epub 2017 Apr 20.

Department of Physical Therapy, Uiduk University, Republic of Korea.

[Purpose] This study was conducted to identify the effects of expiratory muscle strength training on swallowing function in acute stroke patients with dysphagia. [Subjects and Methods] A total of 18 stroke patients with dysphagia were enrolled in the study. All participants were randomly assigned to either an experimental group (n=9) or a control group (n=9). All participants performed traditional-swallowing rehabilitation therapy in 30-minute sessions five times a week for four weeks; however, only the experimental group received expiratory muscle strength training. [Results] Both groups showed significant improvements after mediation. When compared with the control group, the functional dysphagia scale, vallecular residue, and penetration-aspiration scale were significantly improved in the experimental group. [Conclusion] Expiratory muscle strength training is an effective intervention for impaired swallowing function in acute strike patients with dysphagia.
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http://dx.doi.org/10.1589/jpts.29.609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5430257PMC
April 2017