Purpose : Robot-assisted training (RAT) is increasingly used in lower-limb rehabilitation to deliver high-intensity, repetitive, and task-specific practice. Despite growing clinical adoption, its effectiveness across heterogeneous patient populations remains unclear. This systematic review and meta-analysis aimed to evaluate the clinical effectiveness of RAT across diagnostic categories and to compare its outcomes with those of conventional rehabilitation therapy. Methods : A PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020-compliant systematic review and meta-analysis was conducted. PubMed, Scopus, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for randomized controlled trials published between January 1990 and December 2024. Eligible studies included participants with lower-limb impairments of any etiology, employed exoskeleton- or end-effector-based RAT, and reported gait-related functional outcomes. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Random-effects models were applied to calculate standardized mean differences (SMDs) with 95 % confidence intervals (CIs). Results : Eight randomized controlled trials involving 299 participants met the inclusion criteria. Intervention durations ranged from 4 to 8 weeks, with training sessions conducted 3-5 times per week for 30~50 minutes. Primary outcomes included walking speed, 6-minute walk test distance, gait endurance, and functional independence. Pooled analyses demonstrated significantly greater improvements with RAT compared with conventional therapy (SMD= 0.63, 95 % CI 0.40~0.86; I²= 45 %), indicating a moderate treatment effect. Both exoskeleton and end-effector systems were associated with functional gains, with exoskeleton-based interventions showing slightly larger effect sizes in subgroup analyses. Conclusion : Robot-assisted training provides moderate and clinically meaningful improvements in gait performance and walking endurance across diverse patient populations. Incorporating RAT as an adjunct to conventional rehabilitation may enhance functional recovery. However, future trials should establish optimal training protocols, long-term effectiveness, and cost-effectiveness to better inform clinical decision-making.

Purpose : This study aimed to compare the effects of quadruped backward rocking (QBR) and sitting hip flexion (SHF) exercises on trunk and hip muscle activity in individuals with lumbar flexion type. Methods : Sixteen individuals classified as lumbar flexion type were randomly assigned to either a QBR (n= 8) or a SHF (n= 8) group. QBR was performed in a quadruped position maintaining neutral spinal alignment while rocking backward beyond 90 ° of hip flexion, pushing a gym ball between the hips and wall. SHF was performed seated, lifting the leg beyond 90 ° of hip flexion while minimizing compensatory lumbar flexion through transversus abdominis contraction. Each group performed a 30-minute exercise intervention. Muscle activity of the rectus femoris (RF), rectus abdominis (RA), erector spinae (ES), and gluteus maximus (GM) was measured using surface electromyography during a standing hip flexion task before and after the intervention. Results : A mixed ANOVA revealed significant main effects of time for the RF, RA, and GM (p<.05), whereas no significant group effects or group×time interactions were observed for any muscle. Within-group analyses showed that both QBR and SHF groups demonstrated increased activity of the RF and ES and decreased activity of the RA and GM following the intervention. In the QBR group, activity of the RF and ES significantly increased, while that of the RA significantly decreased. In the SHF group, the RA and GM significantly decreased, whereas changes in the RF and ES were not statistically significant. Conclusion : Both QBR and SHF produced similar overall patterns of muscle activity changes, with increased RF and ES and decreased RA and GM activity after the intervention. No significant differences were found between the two exercises, although muscle-specific responses varied in magnitude and statistical significance.

Purpose : Pedestrian collision avoidance is an anticipatory perception-action process shaped by spatial geometry, social context, and sensory-attentional constraints. However, evidence on avoidance strategy and timing initiation remains dispersed across paradigms. Methods : Following PRISMA 2020 guidelines, we synthesized 14 empirical studies (2005-2025) including controlled laboratory, virtual reality, and ecological settings that reported quantitative or qualitative outcomes on avoidance strategy and/or initiation timing during human walking. Results : Two mechanismsdominated: directional adjustment (steering) and speed modulation. Steering was the default response indyadic and oblique encounters, while speed modulation occurred preferentially for yielding roles, acute angles, or constrained spaces;combined responses arose when residual risk persisted. Initiation was anticipatory, typically occurring when the minimum predicted distance (MPD) dropped below threshold (<1 m). MPD trajectories exhibited observation, reaction, and regulation phases, indicating proactive rather than reflexive control. In multi-agent contexts, pedestrians typically resolved conflicts sequentially, though certain formations invited simultaneous co-adaptation, as revealed by joint analysis of MPD and dynamic gap affordances. Under path constraints, pedestrians recruited body rotation, which scaled with corridor width became critical for safe passage in narrow spaces. Ecological data demonstrated role asymmetries: individuals bore greater avoidance effort, higher dyadic interaction, weakened dyad responsiveness, and deviation magnitude scaled with social interaction level even at comparable risk. Conclusions : Evidence converged on a context-strategy-timing framework: low MPD triggers avoidance; context (geometry, role, social engagement, constraint) selects steering and speed control combinations; and postural freedom (rotation) engages as space tightens. This synthesis provides mechanistic targets for predictive pedestrian models, human-robot navigation policies, and rehabilitation programs training timely steering first, with speed and rotation layered under elevated risk or constraint.

Purpose : This systematic review aimed to synthesize current evidence from randomized controlled trials (RCTs) examining the effects of functional training interventions on physical, functional, and psychological outcomes in athletes with chronic ankle instability (CAI). Methods : A comprehensive literature search was performed in seven databases (PubMed, Cochrane Library, Embase, CINAHL, Scopus, KISS, RISS) covering January 2015 to September 2025. Only RCTs including athletes diagnosed with CAI and receiving functional, neuromuscular, proprioceptive, balance, or performance oriented training were selected. Three independent reviewers screened and extracted data using predefined criteria, with inter-rater agreement confirmed by Fleiss' kappa (K= 0.638). Outcomes included balance, strength, proprioception, neuromuscular activation, pain, agility, hop performance, and patient-reported measures. Risk of bias was assessed using the Cochrane RoB 1.0 tool. Results : Twenty RCTs (N= 749; 18~54 participants per trial) met the inclusion criteria. Intervention duration ranged from 4 to 12 weeks. Improvements were frequently reported in dynamic balance (e.g., star excursion balance test/Y balance test), postural control, proprioception, ankle strength, neuromuscular activation, and patient-reported outcomes (e.g., Cumberland ankle instability tool/foot ankle ability measure), with multicomponent neuromuscular/balance/stabilization or hop-based programs showing the most consistent gains. Technology-assisted approaches (e.g., virtual reality/exergaming/transcranial direct current stimulation) showed additional benefits in selected measures, but evidence for superiority over conventional training was limited. Overall risk of bias was low to moderate, and blinding was commonly unclear. Conclusion : Functional training interventions are effective for improving neuromuscular control, proprioception, balance, and sport specific functional performance in athletes with CAI. Multimodal and sensorimotor focused programs appear particularly beneficial, while technology based interventions offer complementary advantages in cognitive motor and perceptual domains. These findings support a progressive, sport specific rehabilitation framework tailored to the unique demands of athletic CAI. Further high quality RCTs with standardized protocols and long term follow up are needed.

Purpose : Ankle sprain is one of the most prevalent musculoskeletal injuries in sports, and recurrent sprains may lead to chronic ankle instability (CAI). Proprioceptive and strengthening exercises are considered core components of CAI rehabilitation; however, their independent effects remain insufficiently explored. This study aimed to compare the effects of proprioceptive training and strengthening exercise on ankle muscle activation and balance in adults with CAI. Methods : Twenty adults with a Cumberland ankle instability tool (CAIT) score of ≤24 were recruited from D University in Busan, Korea, and randomly assigned to a proprioceptive training group (n= 10) or a strengthening exercise group (n= 10). The proprioceptive group performed single-leg balance and functional training using a Bosu ball, while the strengthening group performed resistance exercises using elastic bands and weight-bearing activities. Both groups trained three times per week for three weeks. Muscle activation of the tibialis anterior, lateral gastrocnemius, medial gastrocnemius, and peroneus longus was assessed using surface electromyography and normalized to %MVIC. Static and dynamic balance were evaluated using the Biorescue system. Results : Only the proprioceptive training group showed a significant decrease in medial gastrocnemius muscle activation, and a significant between-group difference was observed for this muscle. No significant changes were found in the peroneus longus, tibialis anterior, or lateral gastrocnemius. For balance, a significant reduction in sway area was observed in the proprioceptive group during eyes-closed static balance, while the strengthening group showed significant decreases in total path length and mean velocity during eyes-open static balance. Both groups demonstrated significant improvements in dynamic balance, indicated by an increased total limit of stability area, with no significant between-group differences. Conclusion : Proprioceptive training primarily influenced neuromuscular activation patterns, whereas strengthening exercise mainly improved balance performance. Both interventions effectively enhanced dynamic balance and may serve as complementary rehabilitation strategies for individuals with CAI. Clinicians may select or combine these interventions based on patient-specific functional needs and rehabilitation goals.

Purpose : This study examined the effects of combined thoracic mobility and scapular stabilization exercises on cervical posture and range of motion in patients with mechanical neck pain, with a focus on postural alignment and functional cervical movement control. Methods : Thirty patients with mechanical neck pain were randomly assigned to an experimental group (n= 15) or a control group (n= 15). Both groups performed cervical stabilization exercises twice weekly for four weeks. The experimental group additionally performed thoracic mobility and scapular stabilization exercises. The intervention targeted the interdependence of the cervical, thoracic, and scapular regions within the kinetic chain. Primary outcomes were cervical range of motion (CROM) and the craniovertebral angle (CVA). Data were analyzed using paired and independent t-tests. Effect sizes (Cohen's d) and 95 % confidence intervals were calculated to assess the extent of intervention effects. Results : After four weeks, the experimental group showed significant improvements in all CROM directions (flexion, extension, and rotation) and in CVA compared with the control group (p<.05). The control group showed limited improvements that were not clinically significant in several measures. These findings indicate that enhancing thoracic mobility and scapular stability improves cervical alignment and movement control in patients with mechanical neck pain, suggesting enhanced neuromuscular coordination across adjacent segments. Conclusion : Combined thoracic mobility and scapular stabilization exercises effectively improved cervical posture and range of motion in patients with mechanical neck pain. These results suggest that a kinetic-chain-based rehabilitation approach targeting the thoracic and scapular regions may be more effective than isolated cervical exercises in restoring functional alignment, reducing compensatory movement patterns, and optimizing cervical spine function.

Purpose : The prolonged use of face masks has become a daily norm, increasing airflow resistance and potentially inducing dysfunctional breathing patterns such as rapid shallow breathing. While respiratory muscle training (RMT) using elastic resistance is known to enhance lung function via proprioceptive feedback, the comparative efficacy of specific breathing strategies under masked conditions remains underexplored. This study aimed to investigate and compare the effects of thoracic expansion exercise (TEE) and abdominal expansion exercise (AEE) using Theraband on respiratory mechanics and pulmonary function in young females wearing face masks. Methods : Thirty healthy female university students with no history of respiratory disease were recruited and randomly assigned to either the thoracic expansion exercise group (TEEG, n= 15) or the abdominal expansion exercise group (AEEG, n= 15). Both groups performed breathing exercises while wearing KF94 masks for 30 minutes, three times a week for 4 weeks. Theraband was applied to the lower rib cage for the TEEG and the umbilical region for the AEEG to provide consistent resistance. Participants followed a specific breathing rhythm of 4-second inhalation, 2-second hold, and 6-second exhalation. Pulmonary functions (FVC, FEV1, FEV1/FVC, PEF) were measured at baseline, 2 weeks, and 4 weeks. Data were analyzed using repeated measures ANOVA with Bonferroni post-hoc tests. Results : Both groups demonstrated significant improvements in FVC, FEV1, and PEF over the intervention period (p<.001). However, a statistically significant Group×Time interaction was observed. The AEEG showed significantly greater improvements in FVC (p<.05), FEV1 (p<.05), and PEF (p<.01) compared to the TEEG at the 4-week post-test. Notably, the PEF values in the AEEG increased markedly, indicating that active abdominal contraction effectively enhanced expiratory power against mask resistance. No significant interaction was found for the FEV1/FVC ratio. Conclusion : These findings provide empirical evidence that while both exercises are beneficial, AEE focusing on diaphragmatic activation is biomechanically more efficient than TEE for improving lung capacity and expiratory flow rate under masked conditions. Therefore, clinicians should prioritize abdominal resistance breathing training to restore pulmonary function and prevent respiratory fatigue in individuals required to wear face masks for prolonged periods.

Purpose : This study aimed to investigate the effects of a 6-week lumbar stabilization exercise program on balance and fear of falling in older women with a history of falls. Fall-experienced older adults often exhibit decreased trunk stability, impaired balance, and heightened fear of falling. Thus, this study examined whether lumbar stabilization training would yield greater benefits than lower limb stabilization exercise. Methods : Eighteen women aged 65-80 years with prior fall experience were randomly assigned to either a lumbar stabilization group (BSG, n=9) or lower limb stabilization group (LSG, n=9). Both groups participated in supervised exercise sessions thrice a week for 6 weeks. The lumbar program consisted of bridge, dead bug, and bird-dog exercise, whereas the lower limb program included squats, lunges, and walking lunges. Balance was assessed using the one-leg standing test and timed up and go test (TUG). Fear of falling was measured using the survey of activities and fear of falling in the elderly (SAFE) questionnaire. Pre- and post-intervention measures were analyzed using paired t-tests, and between group differences using independent t-tests with a significance level of p<.05. Results : Both groups showed significant improvements in all balance measures and fear of falling after the 6-week intervention (p<.05). However, the BSG demonstrated significantly greater improvements compared to the LSG. In particular, the BSG showed larger increases in one-leg standing time and more pronounced reduction in TUG duration (mean improvement: 2.7 s). Fear of falling scores decreased more substantially in the BSG (p<.05), indicating superior psychological and functional benefits. Conclusion : A 6-week lumbar stabilization exercise program effectively enhanced balance and reduced fear of falling in older women with prior fall experience, producing greater benefits than lower limb stabilization exercise. These suggest that lumbar stabilization should be considered a primary component in fall-prevention and rehabilitation programs for high-risk older adults.

Purpose : The purpose of this study is to establish a safe user interface by identifying advantages and disadvantages, improvements, potentially harmful errors in use, design defects, and scope of use during the development of the user interface. In addition, the purpose of this study is to analyze and evaluate whether the user inten3ded to use the evaluation product according to the intention under the generally expected usage conditions, without any errors or difficulties, and whether user requirements are met. Methods : The subjects of this study were conducted in a usability laboratory at the MediBio international certification center of K university, and five experts in observation and recording conducted the test, and cognitive inspection and usability testing methods were used in parallel in the usability formation evaluation. Representative users of expert groups, including usability experts, and representative users of real user groups performed user tasks within predefined test scenarios and without prior training on the product. Prior to the test session, pre-session interviews were conducted to investigate more accurate user circumstances, and immediately after the test session, post-session interviews were conducted to investigate user information on usability problems that occurred during the test and satisfaction, including overall opinions on the product. Results : The evaluation revealed major usability issues, including design flaws and misuse risks, and suggested clear directions for improvement. Conclusion : For electric wheelchair users, this study evaluated the usability of the interface by dividing it into five categories: product stability, product suitability, self-technicality, expectation conformity, and ease of learning. As a result of the 5-point Likert scale-based survey, high satisfaction was generally found in all items, suggesting that the interface conforms to user-centered design principles and has functionality and intuition suitable for actual use.

Purpose : This study investigated the impact of providing physical therapy services outside hospital settings on the financial burden of the Korean national health insurance (NHI) system and on patient accessibility and satisfaction. We examined whether community- and home-based models of physical therapy could reduce unnecessary physician visits and improve public benefits. Methods : A cross-sectional survey was conducted with 266 participants (197 patients and 69 caregivers) receiving physical therapy at hospitals or clinics nationwide. The questionnaire covered demographics, current physical therapy use, frequency of physician consultations, travel time, satisfaction with care, and attitudes toward community-based services. To estimate potential reductions in NHI expenditure, we modeled a scenario in which physician consultations related to physical therapy were standardized to twice per month, applying the 2024 outpatient re-consultation fee of 12,590 KRW. Descriptive and multiple regression analyses were performed. Results : Most respondents regularly received physical therapy at hospital-based facilities, and over 80 % reported being satisfied with current services. However, 83.0 % answered that accessibility would improve if physical therapy were available in community centers or near the home, and 87.6 % agreed that community-based physical therapy should be covered by NHI. Factor analysis showed that perceived appropriateness of physical therapy was the strongest predictor of overall satisfaction (𝛽 = 0.318, p<.001), followed by service convenience (𝛽 = 0.144, p= .013). When physician consultations for patients currently visiting daily or weekly were reduced to twice monthly, the estimated reduction in NHI expenditure for the survey sample was approximately 287 million KRW per year. Conclusion : These findings suggest that introducing community-based and home-based physical therapy within the Korean health-care system could enhance accessibility and satisfaction while reducing avoidable physician consultations and related NHI costs.

Purpose : Reconstruction is often performed for anterior cruciate ligament rupture, to restore knee stability and maximize functional ability to return to the pre-injury level. Prehabilitation can be performed to improve physical function pre- and postoperatively through exercise intervention, to prevent symptoms from worsening by connecting the preoperative period, which can be long, and maximize rehabilitation outcomes. Prehabilitation before anterior cruciate ligament reconstruction can help prepare patients physically and mentally for surgery and postoperative treatment and is an effective strategy to improve patient outcomes. Therefore, this study aimed to investigate the effectiveness of prehabilitation before anterior cruciate ligament reconstruction and to provide clinical assistance in implementing a prehabilitation program before anterior cruciate ligament reconstruction. Methods : The study was conducted between February 28, 2025 and March 29, 2025, using PubMed, Physiotherapy Evidence Database, and Cochrane Central Register of Controlled Trials to identify and analyze recent studies on the effects of prehabilitation before anterior cruciate ligament reconstruction. The keywords were "anterior cruciate ligament," "ACL," "prehabilitation," "preoperative rehabilitation," "preoperative physiotherapy," and "preoperative exercise." Studies performed in the past five years were enrolled, and three out of 403 studies identified, were finally included. Results : According to the three studies that met the inclusion criteria for this literature review, it was found that prehabilitation before anterior cruciate ligament reconstruction showed positive results for knee function, range of motion, and quadriceps peak force. Conclusion : Therefore, applying an appropriate prehabilitation program according to the patient's condition before anterior cruciate ligament reconstruction may have a positive impact on the patient's prognosis. Furthermore, these results may contribute to a better understanding of the potential clinical applicability of prehabilitation programs prior to anterior cruciate ligament reconstruction. Further research should confirm and analyze the effectiveness of prehabilitation before anterior cruciate ligament reconstruction through systematic reviews and meta-analyses.

Purpose : The purpose of this study was to investigate the POS (posterior oblique sling) muscles activity according to contraction of lower trapezius and latissimus dorsi, and with and without knee flexion in mild pelvic asymmetry male subjects. Methods : This study included 21 male participants with mild pelvic asymmetry. The subjects were selected with a difference of the both pelvic height between 2° and less than 4°. The EMG activity of POS were compared among different postures; prone hip extension and knee extension with lower trapezius (LT), prone hip extension and knee flexion with lower trapezius (LT), prone hip extension and knee extension with latissimus dorsi (LD), and prone hip extension and knee flexion with latissimus dorsi (LD). This study was based on the gluteus maximus (GM) on the elevated side of the pelvis, and the muscle activity was measured on the ipsilateral biceps femoris (BF), ipsilateral and contralateral erector spinae (ES), and contralateral lower trapezius and latissimus dorsi. Results : The GM activity was significantly higher in the two positions at knee flexion with LT contraction, and knee flexion with LD contraction (p<.001). Whereas, the BF activity was significantly higher in the two positions at knee extension with LT contraction, and knee extension with LD contraction, and significantly higher in the position with LD contraction compared to LT contraction (p<.001). The ipsilateral ES was significantly lower at knee extension with LD contraction (p<.05). And, contralateral ES was significantly higher at knee extension and knee flexion with LT contraction (p<.001). Conclusion : The POS muscles activity is affected by the contraction of other POS muscles of upper and lower extremities. This indicates that the POS muscles are functionally connected, which may be clinically useful when applying exercise program of POS muscles.

Purpose : This study explored the effects of dynamic tape application on the erector spinae muscles of competitive yacht athletes, focusing on changes in muscle mechanical properties and their influence on functional movement performance. Although dynamic taping is widely used in sports and rehabilitation, evidence describing its direct impact on spinal muscle behavior and movement efficiency remains limited. Methods : Ten yacht athletes in their early twenties participated voluntarily. All subjects reported no medication use within the past month and demonstrated full, pain-free range of motion without musculoskeletal issues. A quasi-experimental one-group pretest-posttest design was employed. Baseline assessments included muscle oscillation frequency, muscle tone, decrement, relaxation time, and viscoelasticity of the erector spinae using a noninvasive myotonometer. Functional movement ability was evaluated through the seven standardized Functional Movement Screen (FMS) tasks, each performed three times with mean scores recorded. Dynamic tape was then applied bilaterally along the erector spinae following established taping procedures, after which all variables were reassessed under identical conditions. Results : Following taping, significant increases were observed in muscle oscillation frequency and stiffness, while relaxation time and viscoelasticity showed significant decreases (p<.05). Decrement, reflecting fatigue resistance, did not differ significantly from baseline. FMS outcomes indicated enhanced trunk extension control, particularly during the inline lunge, suggesting improved spinal stability with taping. Conclusion : Dynamic taping appeared to provide effective mechanical support to the erector spinae muscles, contributing to improved postural alignment and neuromuscular control during functional tasks. These findings suggest that, when applied appropriately, dynamic tape may serve as a supportive intervention that enhances muscle efficiency and spinal stability in athletic populations. Further research with larger samples and controlled designs is recommended to clarify the mechanisms through which dynamic taping influences spinal biomechanics and functional performance.

Purpose : Forward head posture (FHP) is a common musculoskeletal problem among university students, largely due to prolonged use of smartphones and computers. It is associated with neck pain, reduced cervical mobility, and impaired muscular endurance, which can negatively affect daily activities and academic performance. Recently, telerehabilitation using mobile platforms has emerged as a cost-effective and accessible alternative to traditional face-to-face interventions, yet its clinical effectiveness remains under debate. Therefore, this study aimed to compare the effects of a smartphone-based telerehabilitation exercise program with a conventional face-to-face rehabilitation program on posture, mobility, endurance, and pain in students with FHP. Methods : Thirty university students diagnosed with FHP based on craniovertebral angle (CVA) and pain intensity were randomly assigned to either a telerehabilitation group (n=15) or a face-to-face group (n=15). Both groups participated in a standardized six-week neck rehabilitation program, performed three times per week, consisting of stretching, deep cervical flexor training, scapular stabilization, and cervical stretching. Assessments were conducted before and after the intervention and included CVA, cervical range of motion (ROM) measured with a CROM device, isometric muscular endurance of cervical flexors and pain intensity measured with a visual analog scale (VAS). Results : The telerehabilitation group demonstrated significant improvements in all measured variables, including CVA, cervical ROM, muscular endurance, and pain reduction (p < 0.05). The face-to-face group also showed significant improvements in CVA and pain but did not achieve a statistically significant increase in muscular endurance. Between-group comparisons revealed no significant differences across outcomes. Conclusion: These findings suggest that a smartphone-based telerehabilitation exercise program is as effective as conventional face-to-face rehabilitation in improving cervical posture, mobility, and pain among university students with FHP. Telerehabilitation may thus be considered a practical alternative for musculoskeletal management in populations with limited access to in-person therapy.

Purpose : This study aimed to comprehensively investigate the comparative effects of three distinct types of tongue cleaners on the oral environments and levels of user satisfaction of university students residing in Busan. By systematically analyzing these students' specific salivary components alongside subjective satisfaction metrics, this work sought to generate objective, evidence-based data to facilitate the development of more effective oral hygiene management protocols. Methods : The study population was comprised of 31 university students categorized into three experimental groups based on which tongue cleaner design they had been assigned: Group A (spoon type), Group B (brush type), and Group C (scraper type). The students' salivary components-specifically markers indicating tooth health, gingival status, and overall oral cleanliness-were quantitatively measured using the Sill-Ha LH-4912 testing system to evaluate physiological changes. Measurements were obtained at baseline and once more after the three-week intervention period. Additionally, subjective parameters, including user satisfaction and perception of oral health, were assessed using a structured questionnaire. Statistical significance was analyzed using paired t-tests and one-way ANOVA. Results : Significant improvements in salivary acidity, buffer capacity, and key gingival health indicators, including protein, leukocytes, and occult blood (p<.05), were observed following the three-week intervention period,. Notably, Group A, which used spoon-type cleaners, exhibited the most substantial efficacy, demonstrating a statistically significant reduction in cariogenic bacteria (p<.001) and occult blood levels (p= .019). Group A also received the highest ratings for perceived plaque removal efficiency, a subjective evaluation. Conversely, Group B recorded the highest scores for grip comfort and the sensation of freshness. Conclusion : Regularly applyingtongue cleaners significantly enhances one'soral environment by mitigating acidity and reducing inflammatory markers. Although brush-type cleaners arefavored for their subjective freshness, spoon-typecleaners are superior in terms of objective bacterial control. Consequently, professionals should recommend devices by balance clinical efficacy with user preferences, thereby optimizing long-term oral health.

Purpose : This study aimed to examine the relationships among subjective health perception, tongue strength, and oral frailty in older adults residing in selected areas of Busan.By identifying the interrelationship between self-perceived health, oral functional decline, and physiological indicators, this study sought to provide foundational data for developing oral frailty prevention and management programs for the elderly Methods : A total of 63 older adults (18 men, 45 women) participated in this cross-sectional study. Data were collected through structured questionnaires assessing subjective health, oral and gingival health perception, and oral frailty, along with objective measurements of tongue strength using a tongue pressure device. Statistical analyses, including t-tests, one-way ANOVA, and Pearson's correlation coefficients, were performed to identify differences and relationships among variables. Results : Oral frailty levels showed significant differences according to sex, age, swallowing discomfort, and choking experience (p<.05). Tongue strength was significantly higher in males, participants living with family, and those with a history of diabetes (p<.05). Higher oral frailty scores were associated with lower subjective health and oral health perception levels as well as reduced tongue strength. Significant correlations were found between subjective health perception and tongue strength (r= 0.364, p<.001) and between oral frailty and tongue strength (r= -0.419, p<.001). Conclusion : These findings indicate that oral frailty is closely related to both subjective health perception and physiological oral function. Declines in tongue strength may contribute to lower self-rated health, suggesting that tongue strength measurement can serve as a practical screening tool for early detection of oral frailty. Furthermore, an integrated community-based health management approach-including oral care, nutrition, and social participation-may be essential for promoting healthy aging and improving quality of life among older adults.

Purpose : Given the increasing complexity of ethical issues in contemporary healthcare-such as end-of-life decision-making, reproductive technologies, and patient autonomy-nursing students are required to develop a sound ethical foundation before entering clinical practice. This descriptive survey study aimed to identify factors influencing biomedical ethics awareness among nursing students and to examine the effects of moral sensitivity, ethical values, and ethical decision-making confidence on biomedical ethics awareness in order to provide evidence for nursing ethics education interventions. Methods : A cross-sectional descriptive design was used. Participants were 149 nursing students enrolled at K university in South Korea who voluntarily agreed to participate. Data were collected using structured self-report questionnaires measuring moral sensitivity, ethical values, ethical decision-making confidence, and biomedical ethics awareness. Statistical analyses were conducted using IBM SPSS Statistics (version 27.0) (IBM Corp., Armonk, USA), including descriptive statistics, independent t-tests, Pearson's correlation analysis, and multiple regression analysis. Results : The mean scores were 3.81 for moral sensitivity, 3.77 for ethical values, 3.85 for ethical decision-making confidence, and 2.78 for biomedical ethics awareness. Biomedical ethics awareness showed significant positive correlations with moral sensitivity (r= 0.44, p<.01), ethical values (r= 0.44, p<.001), and ethical decision-making confidence (r= 0.55, p<.05). Ethical decision-making confidence differed significantly according to completion of ethics education and level of major satisfaction. Multiple regression analysis revealed that ethical values (β= 0.24, p<.01) significantly influenced biomedical ethics awareness, whereas moral sensitivity and ethical decision-making confidence were not significant predictors. Conclusion : These findings suggest that nursing ethics education should emphasize the development and internalization of ethical values through reflective and experience-based learning approaches to effectively enhance biomedical ethics awareness. Nursing ethics education should therefore prioritize the cultivation and internalization of ethical values through reflective, discussion-based, and experiential learning strategies rather than focusing solely on knowledge acquisition or ethical reasoning skills.

Purpose : This study aimed to explore the mediating role of positive psychological capital in the relationship between self-efficacy and career satisfaction among undergraduate social welfare students. Specifically, the study examined how students mobilize key psychological resources, including resilience, optimism, hope, and emotional regulation, when confronting academic demands, field practice challenges, and career-related uncertainties, and how these processes contribute to the development of professional identity and career satisfaction. Methods : A qualitative phenomenological approach was employed to gain an in-depth understanding of students' lived experiences. Fifteen undergraduate social welfare students (7 males and 8 females; mean age= 21.80 years) from C University voluntarily participated in focus group interviews. Semi-structured interview questions guided participants to reflect on their academic learning experiences, field practice, perceptions of the social welfare profession, career concerns, and strategies for coping with stress and uncertainty. All interviews were audio-recorded with informed consent, transcribed verbatim, and analyzed using Colaizzi's phenomenological method. The analytical process included extracting significant statements, formulating meanings, organizing theme clusters, and integrating these into overarching categories to ensure methodological rigor and credibility. Results : The findings indicated that successfully overcoming academic and field-related challenges strengthened students' self-efficacy and fostered positive psychological capital. Emotional regulation, perseverance, and the capacity to recover from setbacks emerged as central mechanisms supporting this process. Intrinsic motivation was enhanced through self-directed learning, reflective practice, and the establishment of long-term career goals aligned with personal values. In addition, supportive relationships with peers, professors, and field supervisors promoted a sense of belonging and professional identity, which contributed to higher levels of perceived career satisfaction. Conclusion : The results suggest that self-efficacy and positive psychological capital are critical factors influencing career satisfaction among social welfare students. Educational and counseling interventions that systematically enhance these psychological resources and strengthen social support systems may promote students' well-being, motivation, and sustainable professional development.

Purpose : This study aimed to examine the mediating role of communication competence in the relationship between problem-solving ability and emotional intelligence among undergraduate students majoring in occupational therapy. Methods : An online survey was conducted among 177 undergraduate occupational therapy students between May and September 2025. The instruments used included the problem-solving inventory (PSI), the Korean version of the Wong and Law emotional intelligence scale (K-WLEIS), and the global interpersonal communication competence scale (GICCS). Data were analyzed using descriptive statistics, Pearson correlation analyses, mediation analyses, and the Sobel test. Results : Among the dimensions of problem-solving, participants demonstrated the highest level of problem-solving confidence and the lowest level of personal control. Emotional intelligence was characterized by the highest scores in self-emotional appraisal and the lowest scores in emotional utilization. Communication competence showed strong positive correlations with both the total problem-solving score (r= 0.705) and the total emotional intelligence score (r= 0.751). The total problem-solving score exhibited moderate correlations with the total emotional intelligence score and with all emotional intelligence subdomains (r= 0.441~0.687). In addition, the total emotional intelligence score demonstrated moderate correlations with problem-solving subcomponents, specifically problem-solving confidence (r= 0.661) and approach-avoidance style (r= 0.582). Mediation analysis indicated that problem-solving significantly influenced communication competence (49.6 %) and emotional intelligence (47.2 %). Communication competence partially mediated the relationship between problem-solving and emotional intelligence (61.4 %), indicating that it plays a key explanatory role in the interaction among these variables. These findings suggest that students with higher problem-solving abilities exhibit more effective communication competence, which subsequently contributes to enhanced emotional intelligence. Conclusion : The findings suggest that undergraduate occupational therapy students may benefit from educational approaches that simultaneously strengthen problem-solving ability and communication competence. Accordingly, future university curricula should consider the development of integrated programs designed to foster these core competencies.

Purpose : This study aims to investigate dental hygienists' perceptions of Artificial Intelligence (AI) and their intention to use AI, and to analyze the effects of these factors on job engagement. Methods : This survey was conducted among 120 dental hygienists using an online Google form from May 1 to May 31, 2025. After excluding three unreliable responses, data from 117 participants were analyzed. Descriptive statistics, independent t-tests, one-way analysis of variance (one-way ANOVA), correlation analysis, and linear regression analysis were performed. The questionnaire consisted of 11 items measuring AI perception, 3 items measuring intention to use AI, and 10 items measuring job engagement. Results : Regarding dental-related characteristics, job engagement was significantly higher among participants working in larger clinics, holding higher job positions, receiving incentives, and having longer career durations. Among the AI perception items, "positive impact on the medical field" showed the highest mean score(4.12±0.71). For intention to use AI, "prediction of AI use" showed the highest mean score (4.23±0.67). Dental hygienists' intention to use AI was positively correlated with AI perception (𝛾 = 0.56) and job engagement (𝛾 = 0.30, p<.01). While AI perception did not have a significant effect on job engagement (p>.05), a one-unit increase in intention to use AI was associated with a 0.78-point increasein job engagement after controlling for covariates (B = 0.78, p<.01). Conclusion : The findings indicate that dental hygienists' perception of AI was not significantly associated with job engagement; however, the intention to actively use AI in practice was a significant factor in enhancing it. Therefore, promoting AI use among dental hygienists requires moving beyond basic technical training toward the systematic development of practice-oriented education programs tailored to clinical tasks. Strengthening dental hygienists' practical AI application skills as clinical professionals may enhance job engagement and ultimately contribute to improving the quality of dental healthcare services.

Purpose : This study aimed to analyze the factors associated with experiences of periodontal treatment among Korean adults and to examine temporal changes over the past decade. By comparing data from two nationally representative surveys, this study sought to identify evolving demographic, behavioral, and systemic health patterns related to periodontal care, thereby providing evidence for long-term oral health policy and preventive strategies. Methods : Raw data from the 6th Korea national health and nutrition examination survey (KNHANES, 2013) and the 9th KNHANES (2023) were utilized. A total of 2,469 participants in 2013 and 3,422 participants in 2023 were included in the final analysis. Statistical analyses were performed using IBM SPSS Statistics version 21.0. Complex sample cross-tabulation was conducted to examine variations in the distribution of independent variables associated with periodontal treatment experience, and complex sample logistic regression analysis was performed to identify determinants of treatment experience across survey years. Statistical significance was set at p<.05. Results : In 2013, periodontal treatment experience was significantly higher among adults in their 20s, males, former smokers, those reporting chewing or speaking discomfort, and individuals diagnosed with hypertension, dyslipidemia, or diabetes, as well as those without allergic rhinitis (p<.05). In 2023, treatment experience was more prevalent among adults in their 60s, males, daily smokers, and individuals reporting masticatory difficulty, speech discomfort, and chronic diseases such as hypertension, dyslipidemia, or diabetes (p<.05). Conclusion : Periodontal treatment experience was closely associated with both oral symptoms-such as toothache, chewing, and pronunciation difficulties-and systemic health and behavioral factors, including smoking, alcohol intake, hypertension, dyslipidemia, and diabetes. These findings emphasize that adult periodontal care is influenced by multidimensional health determinants, underscoring the need for comprehensive, lifestyle-oriented oral health programs and integrated disease management policies.

Purpose : The objective of this study is to develop highly efficient and environmentally sustainable cultivation strategies for two consumer-preferred tomato varieties-Daejeo tomatoes and premium cherry tomatoes-under increasing climate-change pressures, including prolonged heat waves. Given the global importance, economic value, and nutritional benefits of tomatoes, we further evaluated the health-promoting potential of these varieties by analyzing bioactive compounds, mineral content, and dietary fiber. Methods : A formulation derived from agrofishery by-products and combined with six effective microorganisms (EM)-Bacillus subtilis, Bacillus velezensis (GH-13), Lactobacillus plantarum, Rhodobacter sphaeroides (GT), Chlorella sp., and Bacillus thuringiensis (BT)-was applied to Daejeo tomatoes and premium cherry tomatoes for 10 weeks as an alternative to chemical fertilizers. Crop yield was determined by measuring fruit weight, while bioactive constituents, inorganic compounds, and total soluble solids (°Brix) were analyzed to evaluate the potential health implications of tomato consumption. Results : The application of nutrient-enhanced EM powder significantly improved fruit number, fruit weight, total soluble solids (°Brix), and freshness-related indicators in both tomato varieties. In premium cherry tomatoes, the number of fruit increased by 43 % compared with the control, while Daejeo tomatoes exhibited a 14 % increase in fruit weight. Total soluble solids (°Brix) increased by approximately 59 % in Daejeo tomatoes. Mineral content was highest in EM-treated Daejeo tomatoes, while total polyphenol content was highest in EM-treated premium cherry tomatoes. These findings indicate that nutrient-enhanced EM powder application positively influenced the accumulation of nutritional and functional components in both tomato varieties. Conclusion : These findings suggest that nutrient-enhanced EM powder application significantly enhances the overall nutritional and functional quality of both tomato varieties, supporting its potential application in sustainable organic farming systems. The bioactive compounds identified could potentially confer additional benefits to human health.

Purpose : This study analyzed publications in the field of integrative and complementary medicine from the United States and South Korea between 2015 and 2024, focusing on overall publication patterns, structural characteristics of research trends, and citation trends, with the aim of identifying leading research topics and core themes over time. Methods : Bibliographic data of the final set of articles were collected from the Web of Science (WoS) database in accordance with predefined inclusion criteria. The selected articles were analyzed using R (version 4.3.1; R Foundation for Statistical Computing, Vienna, Austria) for bibliometric analysis of integrative and complementary medicine research in the United States and South Korea. Results : Research conducted in the United States encompassed a wide range of non-pharmacological interventions, including acupuncture, yoga, meditation, and chiropractic care, and tended to address comprehensive health topics extending beyond pain and cancer management to mental health. In contrast, research in South Korea has primarily focused on mechanistic investigations of inflammation, immunity, and apoptosis, targeting traditional Korean medicine-based interventions and natural compounds, such as red ginseng and ginseng. Thematic map analysis showed that research in the United States has expanded from an initial focus on complementary medicine and anti-inflammatory topics to areas including the mental health of veterans, metabolic disorders, gut microbiota, and natural product-based interventions. South Korean research has shifted from early themes centered on acupuncture, inflammation, and Parkinson's disease to mechanism-oriented topics related to cancer, immunity, and neuroinflammation. Conclusion : This study systematically compared integrative and complementary medicine research over an extended period using a bibliometric method, thereby providing a comprehensive overview of national differences in core research areas and shifts in research directions. Future studies should expand the range of countries analyzed to enable a more detailed examination of global research trends.

Purpose : This study aimed to examine the effects of a 12-week resistance training program combined with 𝛽-glucan supplementation on body composition and isokinetic muscle function in older adults. Given the age-related decline in skeletal muscle strength and neuromuscular function, identifying effective nutritional strategies that may enhance exercise-induced adaptations is of clinical and functional importance. 𝛽-glucan, a bioactive polysaccharide, has been suggested to exert immunomodulatory and metabolic effects; however, its potential role in improving muscle function when combined with resistance training in older adults remains unclear. Methods : Eighteen community-dwelling older adults aged 60~70 years voluntarily participated in this randomized controlled trial. Participants were randomly assigned to either an exercise plus 𝛽-glucan supplementation group (EX-BG, n= 10) or an exercise plus placebo group (EX-PLA, n= 10). Both groups completed a gymstick-based moderate-intensity resistance training program for 50 minutes per session, three times per week, over a 12-week intervention period. The EX-BG group consumed 0.5 g of 𝛽-glucan powder derived from Aureobasidium pullulans SM2001 once daily, while the EX-PLA group ingested a sucralose-based placebo (SPLENDA^®, USA). Body composition variables, including body weight, body fat percentage, bone mineral content, lean body mass, and muscle mass, were assessed using bioelectrical impedance analysis (InBody 720). Isokinetic muscle function of the knee extensors and flexors at angular velocities of 60 °/s and 180 °/s was measured using a Biodex System 3.0 dynamometer. Data were analyzed using repeated-measures analysis of variance. Results : No significant main effects of time, group, or group-by-time interaction were observed for any body composition variables (p>.05). However, significant improvements were found in left knee flexor strength at both 60 °/s and 180 °/s in the EX-BG group compared with the EX-PLA group (p<.05). These findings indicate that 𝛽-glucan supplementation may selectively enhance neuromuscular performance when combined with resistance training. Conclusion : A 12-week resistance training program combined with 𝛽-glucan supplementation improved isokinetic knee flexor function in older adults, despite the absence of measurable changes in body composition. These results suggest that 𝛽-glucan may contribute to functional muscle adaptations beyond exercise alone, highlighting its potential as a supportive nutritional strategy for improving neuromuscular function in aging populations.

Purpose : This study aims to identify the correlation between the levels of role stress, job performance, and job attitude among occupational therapists working at the metropolitan dementia center and the dementia care center, as well as to determine the influencing factors for each of these elements. Methods : The questionnaire consisted of 50 items, including general characteristics, role stress (role conflict, role ambiguity, and role overload), job performance, and job attitude (job satisfaction, organizational commitment, and turnover intention). Results : The score of role stress was 2.88, and its sub-factors, role conflict, 3.02, role ambiguity, 2.47, and role excess, 3.15. The score of job performance was 3.82. The score of job attitude was 3.08, and its sub-factors, job satisfaction, 3.37, organizational commitment, 3.21, and turnover intention, 3.24. It was confirmed that role stress and job performance affected job attitude. It was confirmed that role stress had a negative effect on organizational commitment and a positive effect on turnover intention. On the other hand, it was confirmed that job performance had a positive effect on organizational commitment. Conclusion : The dementia care center provides programs and services for dementia patients, those with mild cognitive impairment, and normal elderly people. Therefore, a multidisciplinary approach by experts is necessary, and since the roles of team members are crucial, measures are needed to enable workers to demonstrate their work ability and secure long-term employment. Reducing role stress-such as role conflict, role ambiguity, and role overload-can enhance workers' performance. This improvement in performance leads to a better work attitude, resulting in increased job satisfaction and organizational commitment, while also lowering turnover intention. Furthermore, when employment stability and fair compensation are offered together, workers can deliver consistent services, ensuring ongoing management and care for dementia patients.