Pelvic floor muscles positively affect not only urinary incontinence but also lumbar stabilization by generating intra-abdominal pressure through interaction with muscles around the trunk. Especially, contracting pelvic floor muscles consistently and gently at low intensity is one of the most effective methods to separate and contract transverse abdominis which plays an important role in lumbar stabilization. The purpose of this study was to reexamine the importance of pelvic floor muscles which had not been used much in the treatment of lumbago and to introduce pelvic floor muscle exercises that can be utilized in the treatment of lumbago by examining literature on the relationship between pelvic floor muscles and lumbar stabilization. It is expected that this study will help apply lumbar stabilization exercise to patients with lumbago more variously and effectively.
Obejectives : Slow-motion strengthening trainings build up muscles better than any other type of training, these exercises focus on balancing and strengthening the muscles in the anatomical center of the body - the core - which includes the back, hip and abdominal muscles. Methods : We had a concept of 'core', and compared core muscles with 12 meridian tendino-musculature based on Thomas Myers' myofascial meridian. Results : It has been suggested that the core muscles correspond to meridians of foot- three Yin and foot- three Yang. The study of core muscles strengthening exercise and movement therapy is requred.
Active straight-leg raise (ASLR) is a physical evaluation procedure to test lumbar spine stability. Several previous studies have reported various methods to control the activation of abdominal muscles during ASLR. We investigated the effects of three different hip positions in frontal plane on abdominal muscles to increase or decrease the difficulty level of lumbar spine stability exercise during ASLR in pain free subjects. Eleven young and healthy subjects voluntarily participated in this study (6 men, 5 women; mean age=$24.0{\pm}1.2$ years, height=$160.0{\pm}7.3cm$, weight=$55.0{\pm}10.6kg$, body mass index=$21.5{\pm}2.3kg/m^2$). The subjects had three trials on each ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction. Separate repeated-measures analysis of variance (ANOVA) and the post hoc Bonferroni tests (with ${\alpha}$=.05/3=.017) were performed for each muscle among the three different hip positions in frontal plane (ASLR with hip $10^{\circ}$ adduction, neutral hip, and hip $30^{\circ}$ abduction). The ipsilateral external oblique (EO), contralateral EO, ipsilateral internal oblique/transverse abdominis (IO/TrA), and contralateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with hip $10^{\circ}$ adduction. Also, the ipsilateral EO, contralateral EO, and ipsilateral IO/TrA were significantly greater in ASLR with hip $30^{\circ}$ abduction compared with ASLR with neutral hip. These results suggest that ASLR with hip $30^{\circ}$ abduction and neutral would be useful method to strengthen the EO and IO/TrA. And, ASLR with hip $10^{\circ}$ adduction would be effective in early stages of lumbar stabilization program due to low activation of EO and IO/TrA during maintaining of ASLR position with low load.
The purpose of this study was to examine the effects of graded low back exercise program with patient education about low back pain care on abdominal strength, endurance and flexibility of waist of chronic low back pain patents. For this study 13 patients aged 40 to 60 were selected as subjects, who suffered from low back pain and got diagnosed by physician. The exercise program and the education were executed for total 6 weeks, posture education were executed with physical exercises over first 1 to 4 weeks period and over 5 to 6 weeks the exercises were executed. The effect of the exercises and the education were evaluated through weights, WHR, fat(%), flexibility by sit-and-reach and trunk extension test, strength by sit-up test and back sit-up test. Weights were, decreased after physical exercise and education, but there was no statistical significance. Wasit hip ratio(WHR) and fat(%) were decreased after physical exercise and education, but there were no statistical significances. Sit-and-reach was significantly increased from $13.68{\pm}5.59cm$ to $19.45{\pm}3.81cm$ after education and physical exercise(P<0.05). Trunk extension was significantly increased from $30.31{\pm}11.34cm$ to $40.88{\pm}6.16cm$ after education and physical exercise(P<0.05). Sit-up and Back sit-up were increased after physical exercise and education, but there were no statistical significances. These results suggest that graded low back exercise program with patient education about low back pain care increase the abdominal strength, endurance and the flexibility of waist in low back pain patients.
Kim, Ji-hyun;Yoon, Hyeo-bin;Park, Joo-hee;Jeon, Hye-seon
Physical Therapy Korea
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v.24
no.4
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pp.60-67
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2017
Background: Scapular downward rotation syndrome (SDRS) is a common scapular alignment impairment that causes insufficient upward rotation and muscle imbalance, shortened levator scapulae (LS) and rhomboid, and lengthened serratus anterior (SA) and trapezius. A modified shrug exercise (MSE), performing a shrug exercise with the shoulders at $150^{\circ}$ abduction, is known as an effective exercise to increase scapular stabilizer muscle activation. Previous studies revealed that scapular exercise are more effective when combined with trunk stabilization exercises in decreasing scapular winging and increasing scapular stabilizer muscle activation. Objects: The purpose of our study was to clarify the effect of MSE with or without trunk stabilization exercises in subjects with SDRS. Methods: Eighteen volunteer subjects (male=10, female=8) with SDRS were recruited for this experiment. All subjects performed MSE under 3 different conditions: (1) MSE, (2) MSE with an abdominal draw-in maneuver (ADIM), and (3) MSE with an abdominal expansion maneuver (AEM). The muscle thickness of the lower trapezius (LT) and the SA were measured using an ultrasonography in each condition. Electromyography (EMG) data were collected from the LT, LS, SA, and upper trapezius (UT) muscle activities. Data were statistically analysed using one-way repeated analysis of variance at a significance level of .05. Results: The muscle thickness of the LT and the SA were the significant different in the MSE, MSE with ADIM (MSE+ADIM) and MSE with AEM (MSE+AEM) conditions (p<.05) In both LT and SA, the order of thick muscle thickness was MSE+AEM, MSE+ADIM, and MSE alone. No significant differences were found in the EMG activities of the SA, UT, LS, and LT in all condition. Conclusion: In conclusion, MSE is more beneficial to people with SDRS when combined with trunk stabilization exercises by increased thickness of scapular stabilizer muscles.
Purpose: This study investigated the effects of visual feedback during abdominal hollowing (AH) in four point kneeling position, using real-time ultrasound imaging through measurement of the changes in the thickness of transversus abdominis (TrA), internal abdominal oblique (IO), and external abdominal oblique (EO). Methods: The subjects of this study were 32 healthy males who were divided intothe experimental group of 16 subjects and the control group of 16 subjects. The real-time ultrasound feedback was applied to the experimental group while they were educated on the AH exercise in four point kneeling whereas only general education and training were given to the control group. After the training, the changes in the thickness of abdominal muscles during AH in four point kneeling were compared between the experimental group and the control group. Results: The differences of the changes in the thickness of TrA and EO between the two groups were statistically significant. Conclusion: The experimental group experienced a higher increase in the thickness of TrA than the control group while the thickness of IO and EO of the experimental.
Park, Chan-bum;Ahn, Jin-young;Kim, Ho-young;Lee, Jong-ha;Jeon, Hye-seon
Physical Therapy Korea
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v.24
no.1
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pp.71-78
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2017
Background: Muscle weakness and impaired trunk muscle control are common in stroke patients. The bridging exercise (BE) is generally used for trunk stabilization and improving the overall function of stroke patients. The effectiveness of the BE with hip adductor contraction (BEHA) in facilitating trunk muscle activation has been well studied in healthy adults. However, the impact of BEHA in sub-acute stroke patients has not yet been investigated. Objects: The purpose of this study was to determine the effects of BEHA on the electromyography (EMG) activities and the asymmetry of the rectus abdominis (RA), external oblique (EO) and internal oblique (IO) abdominal muscles. Methods: Twenty participants with sub-acute stroke (11 males and 9 females) were recruited. Each participant was asked to perform bridging exercises for five seconds under three different conditions: BE in a neutral position (BEN), BEHA with a large ball (BEHAL) and BEHA with a small ball (BEHAS). The EMG amplitudes of the bilateral RA, EO and IO and the asymmetry of the EMG activity between the sound and affected sides were compared among the conditions. The significance level was set at ${\alpha}=.05$. Results: The EMG activities of RA, EO and IO were significantly greater during BEHAL and BEHAS than during BEN (p<.05); the asymmetry of the RA, EO and IO decreased significantly during BEHAL and BEHAS compared to BEN (p<.05). However, no measured variables showed any significant differences between BEHAL and BEHAS (p>.05). Conclusion: This study compared the EMG activities of the RA, EO and IO on both sides and the asymmetry of the RA, EO and IO during BEN, BEHAL and BEHAS. Our findings suggest that BEHA was more effective for individuals with hemiplegic stroke at facilitating and normalizing abdominal muscle control than BEN.
Purpose: The purpose of this study was to assess the effects of breathing techniques on trunk muscle activity and balance during Pilates reformer footwork exercises, comparing results both within and between groups before and after the intervention. Methods: Thirty-one adult women over the age of 20 were selected as subjects for this study. They were divided into a Pilates breathing group (n = 15) and a general breathing group (n = 16) using a randomized control group study design. A surface electromyogram was used to measure muscle activity within and between the groups before and after the reformer footwork exercise. Static balance measurements were taken while standing on two legs, and dynamic balance measurements were taken while standing on one leg. All measurements were taken three times, and the average values were used for analysis. Results: The results of the study showed that muscle activity increased with significant differences in the external oblique and transverse abdominal muscles after exercise in the pre-post comparison within the Pilates breathing group (p < 0.05). In the between-group comparison, there was a significant difference in the increase in muscle activity of the external oblique and transverse abdominal muscles in the Pilates breathing group (p < 0.05). In the pre-post comparison of static and dynamic balance within the Pilates breathing group, there was a significant increase (p < 0.05) after exercise. The Pilates breathing group also showed a significant increase even in the between-group comparison (p < 0.05). Conclusion: This study confirmed that reformer footwork exercise accompanied by Pilates breathing has positive effects on muscle activity and static balance ability of trunk muscles in adult women. Therefore, reformer footwork exercise accompanied by Pilates breathing can be presented as an effective exercise method to increase trunk stability and balance ability through the simultaneous activity of the trunk muscles.
Journal of the Korean Society of Physical Medicine
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v.18
no.2
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pp.71-82
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2023
PURPOSE: This study examined the effect of training using video content on abdominal muscle thickness, Oswestry disability index (ODI), and pain in college students with chronic back pain. METHODS: Twenty-nine college students with chronic back pain participated in this study. The subjects were assigned randomly to 15 experimental groups who trained using video content and 14 control groups who exercised voluntarily using back exercise leaflets. The video used for the intervention was obtained from YouTube, and the difficulty level of the video was classified into six levels. Both groups participated in the intervention for 40 minutes/day, three times a week for six weeks, and the variables of abdominal muscle thickness, ODI, and pain were compared before and after the intervention. RESULTS: In the experimental group, there were statistically significant changes in the thickness of the internal oblique and transverse abdominis muscles, ODI, and pain after the intervention, except for the external oblique muscle (p < .05). In the control group, there was no statistically significant difference in all variables after the intervention (p > .05). A statistically significant difference in all variables was observed between the experimental group and the control group after the intervention except for the external oblique muscle (p < .05). CONCLUSION: Treatment of chronic low back pain using video content is a possible alternative treatment if quality images are selected and the difficulty levels are adjusted.
Objective: The purpose of this study was to investigate the conditions for the application of various plank exercises to people who require trunk stabilization by comparing trunk muscle activity according to the degree of hip abduction in the plank exercise. Design: Cross-sectional study. Methods: Twenty healthy participants voluntarily participated in this study and the plank exercise was performed under 5 conditions (two-legged support plank [TSP] with hip abduction, TSP with hip abduction of 15 degrees, TSP with hip abduction of 30, one-legged support plank [OSP] with hip abduction of 15 degrees, OSP with hip abduction of 30 degrees). In order to measure the trunk muscle activity according to the 5 conditions, surface electromyography was used. The electrical activities of the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were measured during the 5 plank exercises. Subjects practiced each of the 5 conditions three times in random order and the average values were obtained. Results: In the OSP condition with 15/30 degrees of hip abduction, activities of the RA, EO, and IO were significantly greater than during the TSP (p<0.05). In the OSP with 30 degrees of hip abduction condition, activities of the left EO, IO were significantly greater than other plank exercise conditions (p<0.05). Conclusions: The plank exercise with hip abduction of 30 degrees and the OSP exercise can be suggested as an effective method to enhance the activity of the trunk oblique muscles.
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