Ho-Jin Shin’s research while affiliated with Gachon University and other places

Background and Objectives: Chronic low back pain is a widespread condition, particularly in older populations, contributing to physical, mental, and social burdens. Traditional treatments, such as medications and surgery, carry long-term risks, including dependency, side-effects, and complications from invasive procedures. Additionally, healthcare accessibility is limited due to high costs, long waiting times, and geographic disparities in healthcare services, particularly in rural areas. For these reasons, non-pharmacological approaches that address both physical and psychological aspects are increasingly recognized as effective. This study aimed to evaluate the effectiveness of a marine resource-based healing program in Taean, South Korea, in improving pain, physical function, and mental health in patients with non-specific chronic low back pain. Materials and Methods: This randomized controlled trial involved 46 participants with non-specific chronic low back pain (mean age, 68.7 ± 5.1 years), randomly allocated to either an experimental group (marine healing program) or a control group (core exercises). The experimental group participated in a 4-night, 5-day intervention comprising heated peat pack therapy, mindfulness meditation, core exercises, and local tourism. The control group performed core exercises without additional interventions. Key outcomes included pain, muscle properties, functional disability, lower extremity function, balance, gait, and depression. Results: The experimental group demonstrated significant reductions in resting pain (p < 0.001), improved pressure pain threshold at L3 (p < 0.001), decreased L3 muscle tone (p = 0.015), and improved functional disability scores (p < 0.001). Functional gains were observed in lower extremity function scores (p < 0.001), balance (sway area: p = 0.046), gait velocity (p < 0.001), and depression levels (p < 0.001). Conclusions: The marine healing program significantly improved pain, functional abilities, and mental well-being in patients with non-specific chronic low back pain, highlighting its potential as an integrative approach to chronic low back pain management. Further studies are recommended to explore long-term and generalized effects.

Objectives Mild cognitive impairment (MCI) is characterized by a mild decline in cognitive function and represents a risk stage for dementia in community‐dwelling older adults. Exercise and dual‐task training have been used to improve physical health, psychosocial health, and cognitive and learning functions in various subjects. However, the optimal time for these interventions has yet to be clearly identified. This study investigated the effects of cognitively loaded physical exercise (CLPE) on cognitive function and physical health in community‐dwelling older adults with mild cognitive impairment and compared the differences according to exercise time. Methods Fifty‐one community‐dwelling aged 60 years or older with MCI were randomly assigned to 30‐min CLPE (30CLPE, n = 17), 60‐min CLPE (60CLPE, n = 17), and control ( n = 17) groups. The CLPE program consisted of a twice‐weekly exercise program for 8 weeks. During the exercise, a dual task was performed to assess cognitive load. The control group performed a typical exercise program at a dementia center during the same period. The Korean version of the Montreal Cognitive Assessment was used to evaluate cognitive function, and various physical health factors were assessed using the handgrip dynamometer and pinch gauge, Senior Fitness Test, dynamic and static balance abilities, and gait variables. Results After the intervention, both the 30CLPE and 60CLPE groups showed significant improvements in cognitive function, upper limb strength, senior fitness, balance, and gait ( p < 0.05), while the control group showed no significant changes in any of the variables ( p > 0.05). In between‐group comparisons, both CLPE groups showed significantly improved cognitive and physical functions compared to the control group ( p < 0.05). However, there was no significant difference between the 30 CLPE and 60 CLPE groups ( p > 0.05). Conclusions The results of this study demonstrate that cognitively loaded physical exercise is effective in improving cognitive and physical function in individuals with MCI. Both the 30‐min and 60‐min sessions resulted in significant improvements, with no statistically significant differences observed between the two durations. This suggests that persistence and consistency of exercise may be more important than the duration of individual sessions. Trial Registration Clinical Trials.gov: KCT0009053

This study was conducted to determine the effect of muscle energy technique (MET) on pelvic alignment, leg length, pain, and fatigue in chronic low back pain (CLBP) patients with leg length discrepancy (LLD). Forty-two CLBP patients with LLD volunteered to participate and were randomly assigned to the MET group (n = 21) and placebo group (n = 21). The intervention group performed three METs with 5 s of isometric contraction and 30 s of rest once, and the placebo group performed three times the placebo-MET, maintaining the same posture as the MET group without muscle isometric contraction. X-ray equipment, tape measure, and visual analog scale were used to evaluate pelvic alignment, leg length, pain, and fatigue before and after each intervention. In comparison pre- and postintervention, only the MET group showed significant changes in pelvic alignment, leg length, pain, and fatigue (p < 0.05). In comparison between groups, there were significant differences in all variables (pelvic alignment, leg length, pain, fatigue) (p < 0.05). The results of this study confirmed the therapeutic effect of MET for improving pelvic alignment, functional LLD, pain, and fatigue in CLBP patients with functional LLD. Future research is needed to evaluate the long-term effect on more chronic low back pain patients.

Various sensory feedback methods are considered important for motor learning, but the effect of each sensory feedback method on effective squat learning still needs to be clarified. This study aimed to investigate the effect of sensory feedback types on the acquisition and retention of a squat. A double‐blinded, randomized controlled trial was carried out. Thirty‐healthy people were recruited and randomly assigned to the visual feedback group (VFG = 10), tactile feedback group (TFG = 10), and control group (CG = 10). VFG received visual feedback through video data of the participant performing squats, and TFG received tactile feedback through manual contact with a physical therapist. Both groups received feedback on the movements that needed correction after each set was completed. CG maintained rest without receiving any feedback. The retro‐reflexive marker, force plate, and electromyography were used to measure body angle, foot center of pressure (COP), and muscle activity. All assessments were measured to confirm a squat acquisition. VFG and TFG showed significant differences in neutral knee position (NKP), trunk forward lean (TFL), anterior knee displacement (AKD), and anteroposterior (AP) foot COP (p < 0.050). In addition, the acquisition was retained until 3 days later for NKP and a week later for TFL, AKD, and AP foot COP in VFG (p < 0.050), while the acquisition was not retained in TFG (p > 0.050). There was no statistically significant change in CG (p > 0.050). This study demonstrated that visual feedback positively affects the acquisition and retention of squats. Therefore, we recommend the use of visual feedback for squat acquisition and retention in exercise novices.

This study aimed to investigate the effect of the load and bar position on trunk and lower extremity muscle activity during squat exercise. High bar back squats (HBBS) and low bar back squats (LBBS) were performed in random order at 50%, 60%, and 70% loads of one repetition maximum by 28 experienced healthy adult men who had been performing squats for at least one year. Before the experiment, the maximal voluntary contraction of the vastus medialis, vastus lateralis, rectus femoris, biceps femoris, rectus abdominis, transverse abdominis, external oblique, and erector spinae muscles was measured by means of surface electromyography. In addition, eccentric and concentric exercises were performed for 3 s each to measure the muscle activity. There was a significant difference in muscle activity according to the load for all muscles in the eccentric and concentric phases (p < 0.05), indicating that muscle activity increased as the load increased. In addition, in the comparison between HBBS and LBBS, significant differences were shown in all lower extremity muscles and all trunk muscles except for the external oblique in the concentric phase according to the bar position (p < 0.05). HBBS showed a higher muscle activity of the lower extremity in the eccentric and concentric phases than in LBBS, while LBBS showed a higher muscle activity of the trunk muscle in the eccentric and concentric phases than in HBBS (p < 0.05). HBBS requires more force in the lower extremity than LBBS and is particularly advantageous in strengthening the muscular strength of the quadriceps. In contrast, LBBS requires more muscle activity in the trunk than HBBS and is more effective in carrying heavier loads because of the advantage of body stability. This study suggests that rehabilitation experts apply the bar position and load as important variables affecting the intensity and method of training for target muscle strengthening of the lower extremities and trunk.

Background: Center of pressure (COP) is a useful measure for dynamic balance, which directly represents the ability of weight shift and control of the foot, however, there is no study analyzing COP during whole stance phase in the elderly with acute stroke.Methods: A total of 30 acute ischemic stroke patients (mean age±standard deviation [SD], 75.0±5.6 years; 11 females) and 30 propensity score matched controls (mean age±SD, 72.8±5.9 years; 17 females) using age, sex, and Korean version of Mini-Mental State Examination score were finally included. Participants performed barefoot walking trials on a pressure-sensitive mat until 20 footfalls in each limb were corrected. To evaluate gait function based on COP, mean and coefficient of variance as variability were calculated for 3 types of variables as followings: (1) durations of sub-phases in stance phase, (2) mean locations and displacement ranges of COP, and (3) velocities.Results: Significant difference was observed in many of both mean and variability variables. Especially, stroke patients had an increased duration, posterior location of COP, wide range of mediolateral and anteroposterior displacement range, and slow velocity in foot flat phase belonging to the double limb stance. In variability variables, stroke patients had significantly larger variabilities of COP velocities in all sub-phases except in foot flat phase and late propulsive phase were stood out.Conclusions: The elderly with acute ischemic stroke had inefficiency during double limb stance and reduced functional balance in single limb stance in both sides, implying impaired gait ability on COP excursion in these patients.

Female caregivers of people with disabilities are burdened physically and mentally. To improve these symptoms, an intervention that is easy to apply and has fewer side effects, such as natural healing, has been proposed, but the effect of healing using marine resources is unclear until now. The purpose of this study is to investigate the effect of meditation accompanied with stabilization exercise in the marine region on the improvement of pain, tactile sense, muscle characteristics, muscle strength, balance, quality of life, and depression in female caregivers of people with severe physical disabilities. Twenty-four female family caregivers were recruited and were randomly assigned to the marine therapy group (MTG, n = 12) and the control group (CG, n = 12). Both groups performed the same meditation (35 min) and stabilization exercise (25 min) twice a day for 3 nights and 4 days per session (total 8 sessions). The MTG performed these in the marine region, whereas the CG performed the interventions in the urban region. Pain (pain intensity and pain pressure threshold), tactile sense (tactile spatial acuity), muscle characteristics (stiffness, elasticity), muscle strength (hand and pinch grip strength), balance, quality of life, and depression were measured before and after the intervention and 4 weeks after the intervention. Both groups showed significant improvements in pain intensity (resting pain: f(2) = 72.719, p < 0.001; movement pain: f(2) = 24.952, p < 0.001), muscle strength (right pinch grip: f(2) = 15.265, p < 0.001), and depression (f(2) = 13.312, p < 0.001), while tactile spatial acuity (TSA) (upper part: f(2) = 14.460, p < 0.001; lower part: f(2) = 7.672, p = 0.002), dynamic balance (f(2) = 4.196, p = 0.024), and quality of life (overall quality of life & general health: f(2) = 5.443, p = 0.009; physical health: f(2) = 13.991, p < 0.001; psychological: f(2) = 9.946, p < 0.001; environmental: f(2) = 20.004, p < 0.001; total: f(2) = 11.958, p < 0.001) were significantly improved only in MTG. There was no significant change in pain pressure threshold (upper trapezius (UT): f(2) = 0.765, p = 0.473; levator scapula (LS): f(2) = 0.213, p = 0.809; splenius capitis (SC): f(2) = 0.186, p = 0.831) and muscle characteristics (UT stiffness: f(2) = 1.486, p = 0.241; UT elasticity: f(2) = 0.358, p = 0.702; LS stiffness: f(2) = 2.440, p = 0.102; LS elasticity: f(2) = 0.544, p = 0.585) in both groups. In comparison between groups, the MTG showed a significant difference in sensory function compared to the CG (resting pain: f(2) = 10.487, p = 0.005; lower part: f(2) = 5.341, p = 0.034 in TSA). Our findings suggest that meditation combined with stabilization exercise improved pain, muscle strength, and depression of female caregivers. In particular, greater benefits on tactile sense, balance, and quality of life were found in performing these in the marine region compared to the urban region.

This study aimed to determine the effect of a forest healing anti-aging program on psychological, physiological, and physical health in older people with mild cognitive impairment (MCI). Twenty-two older people with MCI living in the city participated in a forest healing anti-aging program. Psychological indicators included the mini-mental state examination (MMSE), Beck depression inventory (BDI), profile of mood states (POMS), World Health Organization Quality of Life instrument (WHOQOL), and the Pittsburgh sleep quality index (PSQI). Physiological indicators included vital signs, body composition, and blood analysis. Physical indicators included the senior fitness test (SFT), muscle strength, spatiotemporal parameter of gait, static balance, and dynamic balance. Psychological, physiological, and physical indicators were evaluated at first and second pre-measurement, post-measurement, and one-month follow-up. MMSE, BDI, POMS, WHOQOL, body composition, blood analysis, SFT, muscle strength, spatiotemporal parameter of gait, and dynamic balance were significantly different between pre- and post-measurement. Beck depression inventory, POMS, WHOQOL, PSQI, SFT, muscle strength (elbow flexor muscle, knee extensor muscle), spatiotemporal parameter of gait significantly improved continually until the one-month follow-up. In conclusion, the forest healing program had a positive effect on the psychological, physiological, and physical health of older people with MCI.

Recent studies have suggested that breathing type may affect balance ability. However, most of these studies were conducted on the elderly and patients with musculoskeletal or neurological disorders. Therefore, the effect of voluntary breathing, such as thoracic and abdominal breathing, on the balance ability of people in various age groups is not clearly understood. The purpose of this study was to investigate the differences in balance ability according to the type of breathing in healthy young adults. This study included 78 healthy, young adults. All subjects were assessed for balance ability in neutral breathing, thoracic breathing, and abdominal breathing through a crossover design. Balance ability was assessed during static standing using a force plate. Participants were trained in voluntary breathing, evaluated using electromyography. During voluntary breathing, sway velocity, anterior-posterior difference, and anterior-posterior standard deviation increased while anterior-posterior sample entropy decreased compared to neutral breathing (p < 0.05). Compared with thoracic breathing, abdominal breathing increased sway velocity and variability, and reduced complexity (p < 0.05). These findings show that balance ability is affected by breathing, even in healthy young adults.