• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.51-58
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• 2018

Backdround: Using RUSI (Rehabilitation Ultra Sound Imiging) method, which showed high reliability in soft tissue measurements, we compared the muscle relax and contraction, sex, and physical characteristics of the activity of the multifidus muscle in patients with chronic low back pain and normal subjects. Methods: In this study, 16 patients (male: 8, female: 8) with chronic low back pain and 16 healthy adult (male: 8, female: 8) were participated. Subjects lied prone posture on the table with elbow flexed $90^{\circ}$ and shoulder abducted $120^{\circ}$ (starting position). Test was applied two types that muscle relax position and muscle contraction position. Muscle relax position is equal to starting position and muscle contraction position is that upper extremity lift up about 5cm from the table. We measured the thickness of the multifidus muscle in each position by ultrasound. Results: There was a statistically significant difference between the two groups in deviation of Both Side Difference of Activated resting-Arm Lifting Ratio according to posture change between the chronic low back pain patient group and the normal group. Conclusion: The result of this study support previous study showing that there is an imbalance in the activity of multifidus in patients with chronic low back pain.

• The Journal of the Korea Contents Association
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• v.11 no.6
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• pp.270-278
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• 2011

The purpose of this study was to compare acute and chronic LBP patient in twenties and forties, respectively by size measure paraspinal muscle (cross-sectional area; CSA). CSA of paraspinal muscle (psoas, multifidus, erector muscle) size was measured by free-handling technique of the picture archiving and communication system(PACS) using MRI at the level(lower end-plate of L4) in twenties(9 males, 10 females) and forties(9 males, 8 females) in acute and chronic LBP patient. The results of this study showed no significantly difference between acute and chronic LBP (p>0.05) in twenties patients. However, there was significant difference between acute and chronic LBP (p<0.05) in forties patients. Also, there was significant difference in paraspinal muscle CSA between chronic LBP patients in twenties and chronic LBP patients in forties (p<0.05). This study showed that paraspinal muscle atrophy was observed in forties with various cause, but Not chronic LBP patients in twenties. Accordingly it is required for chronic LBP patients in forties to minimize trunk muscle atrophy through immediate back muscle dynamic exercise and early functional activity.

• The Journal of the Korea Contents Association
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• v.11 no.4
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• pp.235-243
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• 2011

The purpose of the study was to examine the thickness of the trunk muscles ie. external obliques (EO), transversus abdominis (TrA), and multifidus and the trunk endurance strength in order to determine any relationship between the presence or absence of low back pain (LBP) and the size of trunk muscles. Data were obtained from 50 subjects, aged between 19-29 years. Participants had no experience of spinal problems that had resulted in a restriction of normal activity or time-off work and no current spinal symptoms. Measurements of muscle thickness of the trunk muscles were collected at rest, contraction and 15 seconds of post contraction during endurance strength tests. Background information was obtained followed all physical measures. Subjects were divided into two groups based on their experience of LBP. In draw-in maneuver, increasing the thickness of TrA was observed in all participants while EO was decreased at contraction in group 1 and increase in group 2. Only subjects in the group 2 had TrA increased during the flexion endurance test. In the side-bridge endurance test, the thickness of the right TrA was also observed differently between groups. Therefore, the results of the study may suggest that a function of specific muscle should be addressed for training persons with LBP.

• The Journal of the Korea Contents Association
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• v.12 no.3
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• pp.233-243
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• 2012

The purpose of this study was to examine the effects of lumbar stabilization exercise using the PNF techniques on the lumbar deep muscles thickness and functional activity in chronic low back pain patient. Group I(n=10): general physical therapy group; Group II(n=10): general lumbar stabilization exercise group; Group III(n=10): lumbar stabilization exercise using PNF techniques(stabilizing reversal, rhythmic stabilization, combination of isotonic) group. Change of pain was measured with visual analog scale(VAS). To observe muscle thickness changes, we measured transverse abdominis(TrA), external oblique(EO), multifidus with real time ultrasound scanning. The functional activity were measured with Oswestry Disability Questionnaire(ODQ) and Roland & Morris Disability Questionnaire(RMDQ). In VAS test, group III had more significantly decreased than before exercise. In muscle thickness test, group III had more significantly increased than before exercise in right/left TrA, EO, multifidus. In ODQ & RMDQ test, group III had more significantly decreased than before exercise. This study show that the PNF techniques is effective in improving the lumbar stability and functional activity in chronic low back pain patients.

• Physical Therapy Korea
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• v.19 no.2
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• pp.20-28
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• 2012

The lumbar multifidus muscle, which can be separated into deep fascicles (DM) and superficial fascicles (SM), is important for lumbar segmental stability. However, no previous studies have investigated the effect of lumbar stabilization exercises on the thickness of DM and SM. Thus, the purpose of this study was to assess DM thickness after three different lumbar segmental stabilization exercises. In total, 30 healthy male participants were recruited and randomly assigned to one of three exercise groups: hollowing in the quadruped position (H-Quad), contralateral arm and leg lift (CALL), and bilateral arm and leg lift (BALL). Each lumbar segmental stabilization exercise was conducted over 4 weeks. Ultrasonography was used to compare the DM and SM thickness before and after the 4 weeks of exercise. A mixed-model analysis of variance using Scheffe's post-hoc test was used for statistical analysis. The results showed a significant effect for the measurement time (before vs. after 4 weeks of exercise) in the DM (F=31.26, p<.05) and SM (F=4.56, p<.05). At the end of the 4 weeks, the DM thickness had increased significantly in the H-Quad exercise group, and the SM thickness had increased significantly in the CALL and BALL exercise groups. Also in the BALL exercise group, the SM thickness was greater compared with that in the H-Quad exercise group. These findings suggest that the thickness of the DM and SM were increased by different types of lumbar segmental stability exercise after 4 weeks.

• 한국체육학회지인문사회과학편
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• v.54 no.1
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• pp.505-514
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• 2015

The purpose of this study was to examine the muscle activation in trunk and low-limbs muscle during squat exercise on various instability surface. 10 subject performed squat with 75% of 1 repetition maximum (1RM) on a stable floor, stability blue, stability black and BOSU. Electromyographic (EMG) activity was measured trunk muscle such as rectus abdomina (RA), external obliques (EO), internal obliques (IO), multifidus (MF), and low-limbs muscle such as gluteus maximus (GMA), gluteus medius (GME), biceps femoris (BF), rectus femoris (RF), vastus medialis oblique (VMO), vastus lateral oblique (VLO), medialis gastrocnemius (MG), lateral gastrocnemius (LG), soleus (SOL) and anterior tibia (AT) when ascending and descending squat phase. One-way ANOVA repeated measure with Sheffe used to compare the muscle activity on the stable and unstable surface. Squat with BOSU ball induces higher muscle activity of IO, MF, GMA and GME compared with stability and stability blue and blackduring descending motion. Squat with BOSU ball induces higher muscle activity of GMA compared with stability and stability blue and blackduring ascending motion. This results suggested that BOSU ball in the squat could be effective increasing of trunk stability and gluteal muscle activity. However, there was no difference of squat on low-limb muscle with or without instability.

• Journal of the Korean Orthopaedic Association
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• v.56 no.3
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• pp.208-214
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• 2021

Purpose: Verifying a reliable predictor of the progression of vertebral deformity in patients with acute osteoporotic fractures of the lumbar spine may be useful. A qualitative analysis of the muscle near the spine was performed using magnetic resonance imaging (MRI), and its correlation with a spinal deformity was determined under the hypothesis that the causes of the kyphotic deformity are associated with muscle reduction in the multifidus and erector spinae. Materials and Methods: The study was performed in a retrospective manner using the electronic medical records of patients who presented to the author's institution between January 2007 and March 2018, and were diagnosed with an acute lumbar fracture. The fat infiltration rates of the multifidus and erector spinae were measured using MRI taken at the time of injury, and the mean value was defined as the total fat infiltration rate (TFI). Based on lateral radiographs of the lumbar spine at the one-year follow-up, the loss of height of the vertebral body, the kyphotic angle and the wedge angle were measured. The statistical significance was confirmed by calculating the Pearson correlation coefficient. Results: One hundred twenty-nine patients, of which 30 were male and 99 were female, were examined. The mean age was 71.28 years. The mean T-score was -3.53±0.79 g/cm², and the mean fat infiltration was 15.20%±11.99%. TFI was positively correlated with age (R=0.373, p<0.001), compression rate (R=0.369, p<0.001), and Cobb's angle (R=0.386, p<0.001) after a one year follow-up, but negatively correlated with the BMD score (R=-0.252, p=0.004). As the fracture progressed to the lower lumbar level, the compression rate (R=-0191, p=0.030) and wedge angle (R=-0.428, p<0.001) at the time of injury tended to decrease. Conclusion: In patients with osteoporotic vertebral fractures, the fat infiltration rate may be an important predictor of conservative treatment. The prognosis of patients with a high-fat infiltration rate should be explained during patient education, and the patients must be monitored closely through short-term outpatient follow-up.

• Journal of the Korean Orthopaedic Association
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• v.55 no.4
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• pp.318-323
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• 2020

Purpose: To examine the relationship between total fat infiltration (TFI) rate, which quantifies the reduction of muscles around the spine and is an important factor for sarcopenia, and the factors affecting osteoporotic vertebral compression fracture. Materials and Methods: Patients treated for osteoporotic compression fractures of the lumber spine from January 2012 to December 2016 were analyzed retrospectively. Among them, this study included ninety-eight patients who were 1) diagnosed with osteoporosis with a bone mineral density (BMD) T score of less than 2.5 g/cm², 2) received vertebroplasty or kyphoplasty for lumbar fractures, 3) involved one segment of the lumbar spine, and 4) were followed-up for more than one year. The TFI rate confirmed by analyzing magnetic resonance imagings with the Image J program was studied. Based on this, the relationship between the TFI of the multifidus and erector spinae muscles and the factors of osteoporosis were analyzed. Results: The mean TFI of the multifidus and erector spinae was 14.66±10.16. The spine BMD showed a positive correlation with the hip BMD, but a negative correlation with the TFI. A positive correlation was observed between the hip BMD and body mass index. In addition, vitamin D was positively correlated with both the hip and spine BMD but negatively correlated with the TFI rate. Conclusion: Muscle growth helps treat osteoporosis, and can prevent fractures that occur frequently in osteoporosis patients. Increasing the vitamin intake can also slow the progression of muscle atrophy.