• 한국전문물리치료학회지
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• 제12권1호
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• pp.1-10
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• 2005

The purpose of this study was to verify the most effective spinal stabilization exercises program by comparing the activities of muscles contributing to spinal stabilization during four types of exercises using a sling and a mat. Twenty healthy males were recruited and each subjects performed four types of exercises. Exercise 1 was performed in a quadruped position with the subjects lifting the left arm and the opposite leg on the mat. Exercise 2 was performed in a prone position while holding a sling with the right hand and the left knee was fully extended while lifting the left arm and right leg. Exercise 3 was performed in quadruped position while holding a sling with one the right hand and lifting the opposite arm and leg. In exercise 4, subjects were instructed to maintain a balance push-up position while holding slings with both hands in 10 cm forward reaching with extended elbows. Electromyographic(EMG) activities were recorded from the multifidus, external oblique, internal oblique, abdominal rectus, and erector spinalis muscles during the exercises. The EMG amplitude of each muscle was normalized to the amplitude in the maximal voluntary isometric contraction (MVIC) of each muscle. Repeated ANOVA and Bonferroni's tests were used to compare the differences in the muscle activity according to the types of exercise. The EMG amplitudes of all the muscles were significantly different according to the types of exercises (p<.05). The highest EMG activities of each muscle was as follow; multifidus was 73.38%MVIC in exercise 3, the erector spinalis was 40.03%MVIC in exercise 3, the external oblique was 135.88%MVIC in exercise 4, the internal oblique was 128.60%MVIC in exercise 4, and the rectus abdominalis was 95.24%MVIC in Exercise 4. The types of exercises showed a significant difference in composition rate of EMG amplitudes of each muscle (p<.05). EMG composition rate of the multifidus was high in exercise 1 and 3. However, EMG composition rates of the external oblique, internal oblique, and the rectus abdominals were high in exercise 2 and 4. These results showed differences in EMG activities of muscles contributing to trunk stabilization during different therapeutic exercises. Therefore, the type of exercise should be carefully selected to effectively strengthen a specific trunk stabilizer.

• 대한통합의학회지
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• 제6권4호
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• pp.39-45
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• 2018

Purpose : The purpose of this study is to investigate the effect of core motion pattern on abdominal muscle thickness on unstable support surface using sling suspension system and to provide an effective exercise program for therapeutic rehabilitation in clinical practice. Methods : In this study, we used the flank exercise using a sling. It was intended for 21 healthy men and 9 healthy women. Before and after the exercise of the subjects, abdominal muscles (EO, IO, TrA the thickness of the muscle) was determined using a diagnostic ultrasonic apparatus. The period of exercise was 3 times a week for 6 weeks. The exercise for each group started with 3 sets per week and 1 set per week was added. A description of the method and attitude of each exercise is as follows. First, the push-up flank 's exercise position is to put both feet on the sling and hold the floor with both hands. Second, the side flank's exercise postures take the side flanks, while the two legs hang on the sling and one arm supports the body with an articulated bend (about $90^{\circ}$). Third, the elbow flank's exercise position is to put the two legs on the sling, and take a flank posture with the arms bent and joint bending (about $90^{\circ}$). Results : There was a significant difference in the thickness of the muscle in the three flank movements after the exercise (p<.05). The most significant difference was in the change of the muscle thickness in the abdominal muscle, the outer muscle, and the stomach in the elbow flank exercise after exercise. There was a significant difference between the mean thickness of the abdominal muscles according to the flank type after exercise (p<.05). Conclusion : In flank exercise for core stabilization using sling, it is considered effective to strengthen the abdominal muscles by considering the support surface, difficulty level, change of movement pattern.

• Clinics in Shoulder and Elbow
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• 제25권4호
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• pp.282-287
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• 2022

Background: Muscular forces drive proximal humeral fracture deformity, yet it is unknown if arm position can help mitigate such forces. Our hypothesis was that glenohumeral abduction and humeral internal rotation decrease the pull of the supraspinatus and subscapularis muscles, minimizing varus fracture deformity. Methods: A medial wedge osteotomy was performed in eight cadaveric shoulders to simulate a two-part fracture. The specimens were tested on a custom shoulder testing system. Humeral head varus was measured following physiologic muscle loading at neutral and 20° humeral internal rotation at both 0° and 20° glenohumeral abduction. Results: There was a significant decrease in varus deformity caused by the subscapularis (p<0.05) at 20° abduction. Significantly increasing humeral internal rotation decreased varus deformity caused by the subscapularis (p<0.05) at both abduction angles and that caused by the supraspinatus (p<0.05) and infraspinatus (p<0.05) at 0° abduction only. Conclusions: Postoperative shoulder abduction and internal rotation can be protective against varus failure following proximal humeral fracture fixation as these positions decrease tension on the supraspinatus and subscapularis muscles. Use of a resting sling that places the shoulder in this position should be considered.

• 대한물리의학회지
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• 제2권2호
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• pp.243-250
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• 2007

Purpose : Shoulder subluxation is a very common problem in patients with hemiplegia with stroke. Prevention of the low tone subluxed shoulder has been an issue for physical therapists working with neurological patients for many years. Methods : This study reviewed the literature to definite the management and a cause of shoulder subluxation with hemiplegia patients after stroke. Various modalities have been suggested for realigning the glenohumeral joint, but their use is controversial. The purpose of this paper is to review critically the evidence base in order to inform the clinical decision-making process for physiotherapists working in neurology. Results : Literature has identified supports, strapping and functional electrical stimulation(FES) in the management of low tone shoulders. Following review of this evidence it is suggested that there is a lack of reliable and valid research evidence on which to base conclusions. The modalities with the best supporting evidence for realigning the low tone subluxed glenohumeral joint are the triangular sling, Harris hemi sling and the Rolyan humeral cuff used in a standing position and the lap board and arm trough while the patient is sitting. However, due to soft tissue adaptation with associated lack of movement, over-correction and the need for careful patient positioning these supports need to be evaluated for each patient and should be used only in appropriate situations. Conclusion : Similarly, there is a lack of evidence on the effects of long-term use to this equipment. Electrical stimulation is also thought to have potential in the treatment to subluxed low tone shoulders but additional research is required to clarify the parameters for use and the long-term effects of these forms of management.

• 대한정형도수물리치료학회지
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• 제13권1호
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• pp.67-72
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• 2007

Anatomy: The rotator cuff comprises four muscles-the subscapularis, the supraspinatus, the infraspinatus and the teres minor-and their musculotendinous attachments. The subscapularis muscle is innervated by the subscapular nerve and originates on the scapula. It inserts on the lesser tuberosity of the humerus. The supraspinatus and infraspinatus are both innervated by the suprascapular nerve, originate in the scapula and insert on the greater tuberosity. The teres minor is innervated by the axillary nerve, originates on the scapula and inserts on the greater tuberosity. The subacromial space lies underneath the acromion, the coracoid process, the acromioclavicular joint and the coracoacromial ligament. A bursa in the subacromial space provides lubrication for the rotator cuff. Etiology: The space between the undersurface of the acromion and the superior aspect of the humeral head is called the impingement interval. This space is normally narrow and is maximally narrow when the arm is abducted. Any condition that further narrows this space can cause impingement. Impingement can result from extrinsic compression or from loss of competency of the rotator cuff. Syndrome: Neer divided impingement syndrome into three stages. Stage I involves edema and/or hemorrhage. This stage generally occurs in patients less than 25 years of age and is frequently associated with an overuse injury. Generally, at this stage the syndrome is reversible. Stage II is more advanced and tends to occur in patients 25 to 40 years of age. The pathologic changes that are now evident show fibrosis as well as irreversible tendon changes. Stage III generally occurs in patients over 50 years of age and frequently involves a tendon rupture or tear. Stage III is largely a process of attrition and the culmination of fibrosis and tendinosis that have been present for many years. Treatment: In patients with stage I impingement, conservative treatment is often sufficient. Conservative treatment involves resting and stopping the offending activity. It may also involve prolonged physical therapy. Sport and job modifications may be beneficial. Nonsteroidal anti - inflammatory drugs(NSAIDS) and ice treatments can relieve pain. Ice packs applied for 20 minutes three times a day may help. A sling is never used, because adhesive capsulitis can result from immobilization.

• The Journal of Korean Physical Therapy
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• 제35권4호
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• pp.89-94
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• 2023

Purpose: This study investigates the impact of self-myofascial release using a foam roller on the quadriceps femoris for pelvic stability. We further compare the effects of a GRID surface Foam Roller (GFR), a Non-Vibration Foam Roller (NVFR), and a Vibration Foam Roller (VFR). Methods: Thirty healthy adults (15 males, 15 females) participated in this study and were randomly assigned to one of three conditions: GFR, NVFR, or VFR. Participants walked at self-selected speeds with an arm sling before and after foam roller stretching. The analyzed gait parameters included pelvic tilt, pelvic obliquity, and pelvic rotation. Results: In the NVFR and VFR groups, there was a Significant differences were obtained in the pelvic tilt between pre-test and post-test values (p<0.05) in the NVFR and VFR groups, but no significant difference was observed in the GFR group (p>0.05). Comparing the amount of change between the three groups exhibited a significant decrease in pelvic tilt in the NVFR and VFR groups compared to the GFR group (p<0.017). No significant differences were found in pelvic obliquity and pelvic rotation (p>0.05) in all groups. Conclusion: While walking, the use of a VFR for self-myofascial release results in pelvic alteration by reducing the anterior pelvic tilt. We propose that a foam roller can be utilized to enhance pelvic stability during gait.

• 대한정형도수물리치료학회지
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• 제12권1호
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• pp.37-43
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• 2006

PURPOSE: Previous studies have documented the lack of ultrasound's non-thermal effects on nerve conduction using frequencies of 1 MHz and 870 kHz. The purpose of this study was to determine the biophysical effects of continuous ultrasound on median local forearm temperature and motor nerve conduction velocities using frequencies of 3.0 MHz. SUBJECTS: Twelve healthy subjects (6 males, 6 females, age $22.30{\pm}2.41$ yrs, weight $61.33{\pm}10.16$ kg, height $167.58{\pm}8.04$ cm) without a history of neurological or musculoskeletal injury to their dominant arm volunteered for this study. METHODS AND MATERIALS: Each subject received a total of five treatments, one each at .0, 0.5, 1.0, 1.5, 2.0 W/$cm^2$ of 3 MHz continuous ultrasound on the anterior surface of the middle area of dominant forearm for 10 minutes. Dependent measures for forearm local temperature and median motor nerve conduction velocity (MNCV) were taken pretreatment and immediately post-treatment. One-way ANOVA were used for each dependent measure. RESULTS: The posttreatment forearm local temperature were differed significantly (p<0.001) between intensities of ultrasound. The posttreatment forearm local temperature of the ultrasound treated with 1.0 w/$cm^2$, 1.5 w/$cm^2$ and 2.0 w/$cm^2$ were significantly higher than 0.5 w/$cm^2$ and 0.0 w/$cm^2$ of ultrasound (p<0.05). The posttreatment median MNCV were differed significantly from the respective pretreatment velocities (p<0.001). The MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were significantly (p<0.05) slower than that observed pretreatment, while the three ultrasound intensities produced significantly increased posttreatment MNCV: 1.0 w/$cm^2$ and 1.5 w/$cm^2$ and 2.0 W/$cm^2$. The posttreatment MNCV at 2.0 w/$cm^2$ and 1.5 w/$cm^2$ was significantly faster than that at 0 w/$cm^2$, 0.5 w/$cm^2$ and 1.0 w/$cm^2$ (p<0.05), the MNCV at 1.0 w/$cm^2$ was significantly faster than that associated with 0 w/$cm^2$ and 0.5 w/$cm^2$ of ultrasound (p<0.05). CONCLUSIONS: The decreased median motor forearm local temperature and MNCV of the ultrasound treated with 0.0 w/$cm^2$ and 0.5 w/$cm^2$ were attributed to the cooling effect by ultrasound transmission gel. Local forearm temperature and nerve conduction velocity were directly related to the intensity of ultrasound. Alterations in MNCV from ultrasound on healthy nerves appeared to be related to temperature changes induced by thermal effects of ultrasound.