• The Journal of Korean Physical Therapy
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• 제32권6호
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• pp.372-377
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• 2020

Purpose: The purpose of this study was to verify the effect of applying clam exercise on improving trunk control and balance ability in stroke patients. Based on this, we tried to provide clinical information. Methods: In this study, 18 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a clam exercise group (9 patients) and a control group (9 patients). After 30 minutes of neuro-development therapy, they performed clam exercise or bridge exercise for 3 weeks, 5 times a week for 30 minutes. A trunk impairment scale (TIS) and a postural assessment scale for stroke patients-trunk control (PASS-TC) were performed to evaluate the subjects' ability to control trunk before and after intervention. Balance ability was measured by Balancia before and after intervention. Results: After the training periods, area 95% COP and weight distribution of the affected side were significantly different from the clam exercise group compared to the control group (p<0.05). Conclusion: Based on the results of this study, in can be seen that the clam exercise is effective in improving the balance ability compared to the bridge exercise. Maintaining the standing posture requires muscle strength of the hip abduction and extension, which is the result of the clam exercise selectively strengthening these muscles. Therefore, if you want to provide intervention to improve the balance of stroke patients, it is recommended to perform a clam exercise.

• Physical Therapy Rehabilitation Science
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• 제10권2호
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• pp.90-97
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• 2021

Objective: The purpose of this study was to find out how the back instability during clam exercise (CE) causes changes in pelvic rotation and hip joint abductor muscle activity, and to find out the effects with different methods of application of pressure biofeedback. Design: Comparative study using repeated measures. Methods: Each subjects performed the clam exercise (CE) without pressure biofeedback, the clam exercise with pressure biofeedback applied to the back (CE-PBU to back), and the clam exercise with pressure biofeedback applied to the side (CE-PBU to side). The amount of pelvic rotation was measured using myomotion. And the muscle activity of the muscle gluteus medius and the tensor fasciae latae was measured using EMG device. One-way repeated measures ANOVA followed by the Bonferroni post test were used to compare the EMG activity in each muscle and pelvic rotation angle during the CE, CE-PBU to back, CE-PBU to side. Results: The amounts of pelvic rotation was the lowest in CE-PBU to back (p< 0.05) and the ratio of muscle activity of the muscle gluteus / tensor fasciae latae was the highest in CE-PBU to back (p< 0.05). Conclusions: It is thought that, in order to stabilize the waist-pelvis and increase hip joint muscle strength in subjects with back instability, applying clam exercise with pressure biofeedback applied to the lower back is effective in improving waist-pelvic movements and selectively strengthening the muscle gluteus medius.

• 대한물리치료과학회지
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• 제28권1호
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• pp.23-32
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• 2021

Background: The purpose of this study was to find out how the lumbar instability during clam exercise causes changes in pelvic rotation and hip joint abductor muscle activity. Design: Case-control study. Methods: Twenty male participated in this study. The amount of pelvic rotation was measured using myomotion during the clam exercise in a normal group and a group of patients with low lumbar instability, and the muscle activity of the muscle gluteus medius and the tensor fasciae latae using an EMG device. Results: The amount of pelvic rotation that occurred during the clam exercise was statistically significantly greater in the lumbar instability group than in the normal group (p<.05), and the ratio of muscle activity of the muscle gluteus medius/the tensor fasciae latae was statistically significantly higher in the normal group than in the lumbar instability group (p<.05). Conclusion: In order to stabilize the lumbo-pelvic and strengthen the strength of the hip joints, it is believed that it is necessary to apply exercise while controlling the lumbo-pelvic movement during clam exercises, and various studies will be needed.

• PNF and Movement
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• 제20권3호
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• pp.341-349
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• 2022

Purpose: The purpose of this study is to compare the muscle activity of the hip abductors and the ratio between the hip abductor muscle group according to the range of hip abduction during the clam exercise. Methods: This study was conducted on 18 healthy men in their aged 20 to 29 who had not been diagnosed with spine-related diseases. The subjects performed a clam exercise without rotation of the pelvis in a state of 60° hip flexion and 90° knee joint flexion in the side-lying position. Using Myomotion equipment and EMG, the muscle activity of the hip abductor muscles and the activity ratio between the hip abductor muscle group were measured during the clam exercise by dividing the range into initial, mid-range, and terminal sections. Repeated measures analysis of variants was employed to compare the activity and use of hip abductor muscles according to range of motion during the clam exercise. Results: Gluteus medius muscle activation was significantly increased in the comparison of muscle activity in the initial, mid-range, and terminal sections of hip abduction. Tensor fasciae latae muscle activation was significantly increased in the comparison of muscle activity in all range of motion sections as well. The gluteus medius-tensor fasciae latae muscle activation ratio was significantly increased in the terminal section compared to the initial section. Conclusion: The gluteus medius and tensor fasciae latae had higher muscle activities as they approached the terminal section during the clam exercise, and the hip abduction activity ratio of the gluteus medius and tensor fasciae latae was higher as the range of motion approached the terminal section.

• 대한물리의학회지
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• 제14권2호
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• pp.9-19
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• 2019

PURPOSE: This study compared the effects of three different clamshell exercises (CLAM) on the gluteus medius (GMED), quadratus lumborum (QL), anterior hip flexor (AHF), gluteus medius/quadratus lumborum ratio, and gluteus medius/anterior hip flexor ratio by studying the activities of participants with GMED weakness. METHODS: Eleven subjects with weak GMED participated in this study. Subjects performed CLAM under three different conditions (standard, and modified 1 and 2). Surface electromyography was then used to measure the muscle activity and one-way repeated-measures analysis of variance was used to assess the statistical significance of the measured variables. RESULTS: GMED and the QL muscle activities did not differ significantly between the standard CLAM and the modified CLAM with the 2 different foot positions (F=4.74, P=.02; F=4.57, P=.02, respectively). AHF activity was significantly different in the two different foot positions when compared to the standard CLAM (F=11.17, P=.00). However, there was no significant difference between the AHF activities for the two different foot positions (P=.09). Finally, GMED/QL and GMED/AHF ratios were not significantly different between the three different CLAM exercises (F=.63, P=.55; F=.82, P=.45, respectively). CONCLUSION: Modified CLAM can be recommended as a good method to minimize AHF activity while maintaining GMED activity in subjects with weak GMED.

• The Journal of Korean Physical Therapy
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• 제25권5호
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• pp.337-342
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• 2013

Purpose: This study was conducted in order to determine the effect of visual and tactile feedback on muscle activity of the gluteus maximus (Gmax) and abdominal muscles and the motion of pelvic rotation during performance of clam exercise (CE). Methods: Thirteen subjects without low back pain were recruited for this study. Each subject was instructed to perform the CE without and with feedback. The subjects were instructed to keep pelvic from rotating backwards by palpating the ASIS and monitoring the pelvic movement by themselves during performance of CE with feedback. The electromyographic (EMG) activities of Gmax and abdominal muscles were collected using surface EMG. Angles of pelvic rotation were measured using a 3-dimensional motion-analysis system. Paired t-tests were used for comparison of EMG activities in each muscle and the angle of pelvic rotation. Results: The EMG activities of all abdominal muscles were not significant between CM without and CM with feedback (p>0.05). The EMG activity of Gmax was significantly greater in CM with feedback compared with CM without feedback (without vs. with feedback; 14.2% vs. 20.7%MVIC) (p<0.05). The angle of pelvic rotation was significantly less in CM with feedback compared with CM without feedback (without vs. with feedback; $15.3^{\circ}$ vs. $10.8^{\circ}$ ) (p<0.05). Conclusion: Therefore, these findings suggest that CM with the visual and tactile feedback is effective in activation of the Gmax and correcting of the uncontrolled lumbopelvic rotation during CE.

• The Journal of Korean Physical Therapy
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• 제31권1호
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• pp.62-66
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• 2019

Purpose: This study examined the most efficient exercise position to activate the gluteus medius (GM) and tensor fascia latae (TFL) in hip abduction in side-lying (HA-SL), clam in side-lying (CL-SL), and sling bridging in side-lying (SB-SL), which are the most representative GM exercises. Methods: Twenty-four healthy male adults aged from 20 to 40 years, whose body mass index was under 25, participated in this experiment. While all participants conducted three different positions with a counterbalanced manner, such as in AB, CL, and BR, activation of the GM and TFL was measured using 8-channel wireless EMG. Exercise was performed for 10 seconds three times in total with a five minute-break session. Results: Significant differences in GM and TFL activation were observed among the three positions (p<0.05). The highest activation of 60.69 was observed in BR followed in order by 46.03 and 12.92 in HA-SL and CL, respectively. TFL activation in HA-SL was 42.01, followed in order by 35.98 and 14.01 in BR and CL, respectively. On the other hand, there was no significant difference in TFL muscle activation between BR and HA-SL. Conclusion: These findings suggest that both BR and HA-SL in GM can be done selectively. CL has remarkably low muscle activation in GM and TFL, which makes it less valuable in GM and TFL exercise. In conclusion, selective BR and HA-SL exercise should be applied to maximally and effectively activate the GM.