• Journal of the Korean Society of Physical Medicine
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• v.5 no.4
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• pp.615-621
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• 2010

Purpose : The purpose of this study was to compare chronic LBP patients and asymptomatic subjects on measures of multifidus size (cross-sectional area;CSA, thickness) and symmetry (proportional difference of relatively larger side to smaller side). Methods : Data were obtained from 12 asymptomatic subjects without a prior history of LBP (8 females, 4 males), and a retrospective audit was undertaken of records from 12 chronic low back pain patients (8 females, 4 males). CSA and Thickness of the lumbar multifidus muscles was measured from axial T1-weighted magnetic resonance images(MRI). Results : The results of the analysis showed that chronic LBP patients had significantly smaller multifidus CSA and thickness than asymptomatic subjects at L4-5 vertebral levels(p<.05). The asymmetry between sides was seen at L4- L5 vertebral level in patients with chronic low back pain presentations(p<.05). Conclusions : MRI provided a quantitative measure of change between asymptomatic subjects and chronic low back pain patients of multifidus muscle. MRI identified significant differences in cross-sectional area and thickness and helps to evaluate clinically and plan the treatment modalities of LBP.

• The Korean Journal of Pain
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• v.19 no.1
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• pp.119-122
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• 2006

Upper thoracic back pain can be musculoskeletal in origin or it could be visceral referred pain, which may be indicative of a serious medical condition. We experienced a case of a 55-years-old female patient who complained of upper thoracic back pain for 1 month, which started 10 days after a traffic accident. She described the pain as being a dull, constant nagging sensation with an intensity of 4/10 on the visual analogue scale. Her pain did not subside after trigger point injection of the rhomboid and trapezius muscles. She reported intermittent palpitation, which indicated that the cardiovascular or pulmonary systems were involved. She was diagnosed with pulmonary thromboembolism by the imaging studies. Refractory upper thoracic back pain should be investigated to rule out this treatable, but potentially fatal condition.

• Journal of International Academy of Physical Therapy Research
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• v.1 no.2
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• pp.162-168
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• 2010

Low back pain is a common phenomenon among the golfers. In an attempt to understand low back pain, the kinematic changes and golf swing motion analysis has been performed to focus on lumbar spine in pro. golfers. According to the swing pattern, significant variations of the lumbar joint forces and loads has related with muscles activities so the motion analysis of lumbar spine were discussed. The purpose of this study was to analyze motion of lumbar spine and it was to compare joint force during golf swing in pro. golfers. The swing motion of the subjects was tracked using a 3D motion analysis system by Motion Analysis Ltd. and SIMM software. The angle changes of lumbar spine rapidly in vx direction during the top back swing and the finish and in vy direction during the follow through and in vz direction during the down swing and the impact(Subject A). The angle changes of lumbar spine rapidly in vx direction during the top back swing and in vy direction during the down swing, the impact and the follow through and in vz direction during the down swing(Subject B). In conclusion, subject A and B both show sudden angle changes between 1st-3rd lumbar spine and 4th-5th lumbar spine during the stage from address to top back swing which caused by over upper body twisting.

• Korean Journal of Applied Biomechanics
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• v.15 no.4
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• pp.67-74
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• 2005

The purpose of this study is to compare and analyze the muscle activations between the professional golfers without low back pain symptom and the professional golfers with low back pain symptom, and so identify the stress related to golf swings, and provide the basic data to minimize the low back pain and the injury risk. Using surface electrode electromyography, we evaluated muscle activity in 6 male professional golfers during the golf drive swing. Surface electrodes were used to record the level of muscle activity in the Abdominal Oblique, Elector Spinae, Rectus Abdominis, Gluteus Maximus muscles during the golfer's swing. These signals were compared with %RVC(Reference voluntary contraction) which was normalized by IEMG(Integrated EMG). The golf swing was divided into five phases: take away, forward swing, acceleration, early follow through, late follow through. we observed patterns of trunk muscle activity throughout five phases of the golf swing. The results can be summarized as follows: RES(Right Elector Spinae) had statistically significant difference in take away phase, LGM(Left Gluteus Maximus), LRA(Left Rectus Abdominis), LOA(Left Oblique Abdominal) had statistically significant difference in forward swing phase, RES(Right Elector Spinae), RGM(Right Gluteus Maximus), ROA(Right Oblique Abdominal) had statistically significant difference in acceleration phase, RES(Right Elector Spinae), RGM(Right Gluteus Maximus) had statistically significant difference in early follow-through phase, LES(Left Elector Spinae), RGM(Right Gluteus Maximus) had statistically significant difference in late follow through phase.

• Physical Therapy Korea
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• v.14 no.4
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• pp.21-27
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• 2007

The purposes of this study were to compare core muscle activities with and without the use of Pilates resistive equipment during bridging exercises and to investigate the efficacy of a Pilates device. Fourteen healthy individuals (6 males, 8 females) between 20 to 26 years of age were examined. They were engaged in a bridging exercise with and without a magic circle. Three consecutive repetitions of each exercise were performed. Surface electromyography (sEMG) was used to measure the electrical activities of the right side internal oblique, the adductor longus, the multifidus, and the gluteus maximus muscles. Normalized EMG activities were compared using a paired t-test and the level of significance was set at =.05. The results showed that the EMG activities of the internal oblique (p=.0078), the adductor longus (p=.0007), and the gluteus maximus (p=.0001) muscles were significantly higher when using the magic circle during the Pilates bridging exercise. Also, statistically significant change existed in the multifidus muscle (p=.0106). The bridging exercise, combined with hip adduction using the magic circle, may enhance core stabilization. Therefore, using a magic circle during hip adduction combined with bridging exercise may be recommended usefully for individuals wanting to strength the core muscles. Further research is needed to access the nature of motor control of the Pilates mat exercises and to deliver exercise intervention for lower back pain patients.

• Journal of the Korean Society of Physical Medicine
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• v.14 no.3
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• pp.39-45
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• 2019

PURPOSE: We investigated the most effective way to activate the posterior oblique sling muscles by performing prone hip extension exercises. METHODS: An electromyography system was used to measure the activation of the posterior oblique sling muscles (latissimus dorsi, gluteus maximus, multifidus, and biceps femoris) in three different prone hip extension exercises of in 12 healthy individuals (6 men and 6 women): 1) prone hip extension, 2) prone hip extension with internal rotation and extension of the arm, and 3) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell. RESULTS: The overall muscular activation of the posterior oblique sling muscles was more increased when performing 1) prone hip extension with internal rotation and 2) prone hip extension with internal rotation and extension of the arm with a 1-Ib dumbbell as compared with that during prone hip extension except for the biceps femoris activation. There was a statistically significant difference in the activities of the contralateral multifidi among all three exercises; of the ipsilateral multifidi in PHE1) prone hip extension alone, PHE2) prone hip extension with internal rotation and extension of the arm and PHE3) prone hip extension with internal rotation and extension of the arm with 1-Ib dumbbell; and of the ipsilateral gluteus maximus among all the prone hip extension exercises. There was no significant difference in the activity of the biceps femoris among the three exercises. CONCLUSION: Prone hip extension with internal rotation and with internal rotation and extension of the arm with 1-Ib dumbbell can activate the posterior oblique sling muscles and so prevent back pain in healthy people.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.1-9
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• 2018

PURPOSE: The purpose of this study was to determine the effect of exercise therapy on low back pain (LBP), the function of paraspinal and abdominis muscles, and the sacrohorizontal angle as seen on the radiographs of the lumbar spine in a young female golf player with LBP. METHODS: This case report describes an 11-year-old female golfer who presented with LBP. The exercise therapy program comprised lumbar joint mobilization, lumbar spine flexion distraction, abdominal bridge, plank, side plank, and single-leg extensions from a 4-point kneeling position for 40 min/day; this was done twice a week for 8-weeks. LBP [visual analog scale (VAS) and Oswestry disability index (ODI)] and function of paraspinal and abdominis muscles [Ito test, curl-up test, $90^{\circ}$ stop test, squat test, opened eye one leg stance test (OEOL), and closed eye one leg stance test (CEOL)] were measured before and after 4 and 8 weeks of exercise therapy. The radiographs were analyzed for the lumbar Cobb's angle and sacrohorizontal angle before and after 8 weeks of exercise therapy. RESULTS: After 4 and/or 8 weeks of exercise therapy, VAS and ODI scores decreased; results for the Ito test, curl-up test, $90^{\circ}$ stop test, squat test, and OEOL and CEOL of muscle function improved; and the lumbar Cobb's angle and sacrohorizontal angle improved. CONCLUSION: These results suggest that exercise therapy improves LBP, muscle function, and radiographic parameters associated with LBP in young golf players. These findings have clinical implications for exercise therapy in young female golf players who have LBP.

• Journal of Korean Physical Therapy Science
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• v.9 no.3
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• pp.97-106
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• 2002

Purpose. This study was tried to compare the effect of the change in postural deviation caused by the pain side Subjects and Methods. Inpatients and outpatients (n=71) were selected from I hospital who have a musculoskeletal low back pain and shoulder pain without any history of the central nervous system (CNS) lesions, orthopaedic problems of the both lower extremities, or the vestibular and the visual default. For the control group, normal and healthy subjects (n=30) were selected without any history of weight bearing disorders. the weight bearing was rated by the computerized force plate. Results. 1) Postural deviation was not significant difference between patients and control group(p<0.01). But postural deviation in patients was more pronounced than control group. 2) There was significant difference of postural deviation between in patients according to the pain side(p<0.01). When the pain side was on the left side, postural deviation tended to the right. When the pain side was on the right side and vertebral body, postural deviation tended to the left. 3) There was no significant difference of postural deviation between regional pain in shoulder and regional pain in low back(p<0.01). Discussions and Conclusion. As a result, the pain, for sure, affected the good posture and its keeping process directly or/and indirectly. Therefore, as the postural deviation increases, the additional energy consumption increased by the works of the muscles to keep the good posture. Preponderated postural deviation, furthermore, could load too much to the musculoskeletal system, leading to increase the pain. The postural deviation, a result of the pain, can cause a secondary deformity of the distal area as a compensatory reaction, and this compensation actually become a cause of the musculoskeletal symptom back in a cycle. Therefore, the appropriate treatment of the musculoskeletal problem and the education of the posture correction should be given to decrease the pain, preventing the secondary deformities, and increasing muscle energy efficiency of the posture remaining muscles.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.1
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• pp.1-10
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• 2005

Objectives: To compare the efficacy of two types specific exercise intervention (deep and superficial abdominal muscle exercises) in the treatment of patients with chronic low back pain (CLBP). Design: A randomized, comparative, repeated-measures. Subjects: Twenty-four patients with CLBP (at least for 3 months), mean $age{\pm}SD=51.58{\pm}16.21$ (yrs). Methods: Twenty-four patients with this condition were assigned randomly to two treatment groups. Both first and second group underwent 3 weeks specific exercise treatment program. The first group specific trained for the deep abdominal muscles. The second group specific trained for the superficial abdominal muscles. Results: After intervention, the first group showed a statistically significant reduction in pain intensity and functional disability levels (p<.05). The second group showed no significant change in these parameters after intervention (p>.05). Conclusions: According to results, a "deep abdominal muscle exercises" treatment approach appears more effective than a "superficial abdominal muscle exercises" treatment in patients with CLBP.

• Physical Therapy Korea
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• v.14 no.2
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• pp.21-28
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• 2007

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in erector spinae, multifidus, rectus abdominis and biceps brachii during perturbation between subjects with and without work-related chronic low back pain (LBP). Twenty-nine subjects, 14 with and 15 without LBP, participated in this study. The muscle responses were measured by surface EMG (electromyography) during perturbation in eye opened and eye closed conditions. The EMG onset times of the erector spinae, multifidus, rectus abdominis and biceps brachii were similar between groups in eye closed condition. But the onset times of the erector spinae, multifidus, rectus abdominis were significantly delayed in subjects with LBP in eye opened condition. The results provide an evidence for impaired feed-forward control of the trunk muscles in subjects with LBP. Further studies are needed to identify whether the impaired feed-forward control of the trunk muscles is the contributing factor to LBP.