• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.45-53
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• 2018

Purpose: The purpose of this study was to investigate the effects of muscle activity and muscle strength according to verbal command volume during isokinetic and isometric quadricep exercises. Methods: To measure muscle activity and muscle strength, surface electrodes were attached to the participants, as they sat on a Biodex chair. The isometric exercise was performed three times, with maximum exercise at $30^{\circ}$ bending angle, based on a maximum extension state of the knee at $0^{\circ}$. The average holding time was unified to three seconds. In addition, the isokinetic exercise was performed three times, at $60^{\circ}/sec$. The verbal command ranged between 0∾60 dB and 0∾75 dB. Muscle activity was measured using surface electromyography (4D-MT, Relive, Gimhae, Korea). The Biodex System 4 was used to measure the isometric and isokinetic strength of the nodal line, and 4D-MT was used to measure muscle activity. Results: There were significant improvements in the maximal and relative muscle strengths, when the 0∾ 60 dB and 0∾75 dB verbal commands were applied with isokinetic extension/flexion (p<.05). The isokinetic exercise (0∾75 dB) group showed a significant difference in the vastus medialis oblique muscle activity change (p<.05), while the isometric exercise (0∾75 dB) group showed a significant difference in the rectus femoris muscle activity change (p<.05). Conclusions: Our results reveal that verbal commands effectively improve muscle activity and muscle strength during isokinetic and isometric quadricep exercises.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.4
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• pp.2253-2260
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• 2020

Background: Patients with low back pain (LBP) experience misalignments in the center of pressure (COP) and muscle imbalances due to frequent onesided posture adjustments to avoid pain. Objectives: To identify the effects of Squat Exercises with Vertical Whole-Body Vibration on the Center of Pressure and Trunk Muscle Activity. Design: Randomized controlled trial. Methods: Thirty LBP patients with an imbalance in the COP were sampled and randomly assigned to an experimental group of 15 patients who under went an intervention involving squat exercises with vertical WBV and a control group of 15 patients who were treated via a walking intervention. As pretests before the interventions, the subjects' COP was identified by measuring their stability index (ST), and erector spinae, rectus abdominis, transverse abdominis, gluteus medius muscle activity was analyzed by determining the % reference voluntary contraction (%RVC) value using surface electromyography while sit to stand. After four weeks, a post test was conducted to remeasure the same variables using the same methods. Results: Statistically significant differences were found in the ST (P<.01) and trunk muscle (P<.05, P<.001) in the experimental group before and after the intervention. In terms of the differences between the left- and right-side (RL) muscle activity, only the transverse abdominis (TrA) and gluteus medius (GM) exhibited statistically significant increase (P<.05). A comparison of the groups showed statistically significant differences in the TrA with respect to muscle activity (P<.05) and in the RLTrA and RLGM in terms ofthe difference between left- and right-side muscle activity (P<.01). Conclusion: Squat exercises with vertical WBV produced effective changes in the COP of patients with LBP by reducing muscle imbalances through the delivery of a uniform force. In particular, strengthening the TrA and reducing an imbalance in the GM were determined to be important factors in improving the COP.

• PNF and Movement
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• v.18 no.3
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• pp.375-382
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• 2020

Purpose: The purpose of this study was to investigate the muscle contraction onset time characteristics of the gluteus maximus, semitendinosus, and biceps femoris muscles at different knee flexion angles in individuals with shortened or over-lengthened hamstrings performing prone hip extension. Methods: Twenty-six participants were divided into a hamstring shortened group (n = 12) and hamstring lengthened group (n = 14). Wireless surface electromyography was used to verify the muscle onset time of the gluteus maximus, semitendinosus, and biceps femoris when performing prone hip extension at different knee flexion angles. Results: There were significant differences in the muscle onset times of the semitendinosus and biceps femoris between the hamstring shortened group and hamstring lengthened group (p < 0.05). In addition, there was a significant difference in the muscle contraction onset times among of the gluteus maximus, semitendinosus, and biceps femoris muscles when performing prone hip extension at a knee flexion of 90° in the hamstring shortened group (p < 0.05) and a knee flexion angle of 0° in the hamstring lengthened group (p < 0.05). Conclusion: In all groups, there was no effect on the onset time of the gluteus maximus muscle according based on the knee angle. In addition, the knee flexion angles affected the onset time of the muscle contraction of the gluteus maximus muscle in the hamstring shortened group and hamstring lengthened group with an abnormal length of the hamstring muscle.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.1
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• pp.133-140
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• 2021

Purpose: This study aimed to compare the relative muscle activity on the erector spinae, gluteus maximus, and hamstring, using a non-visual feedback bridge exercise and a visual feedback bridge exercise with a tension sensor and clinometer. Methods: Twenty-two healthy subjects participated in this study. The study subjects performed bridge exercises without visual feedback, bridge exercises using a tension sensor, and bridge exercises using an inclinometer in the supine position, and the muscle activity of the left and right erector spinae, gluteus maximus, and hamstring muscles was measured while maintaining isometric contraction during the bridge movement. Muscle activity was measured by using surface an electromyography equipment. To standardize the measured action potential of each muscle, the maximum voluntary isometric contraction was measured. The bridge exercise was repeated 3 times for 5s each. Using repeated analysis of variance, we compared the significant difference in EMG activity for each muscle between the three experiments, and all statistical processing was performed using SPSS version 26. The statistical significance level was set at α = 0.05. Results: During bridging exercises, the asymmetry of the muscle activity of the erector spinae and gluteus maximus during visual feedback guiding was lower than that during no visual feedback. However, there was no significant difference. Moreover, the asymmetry of the muscle activity of the hamstring muscles was significantly lower during tension sensor visual feedback than that during no visual feedback (p<0.05). Conclusion: These findings suggest that bridge exercise with visual feedback using a tension sensor and an inclinometer is effective in inducing symmetrical movement. When it is necessary to symmetrically adjust the weight load of both feet during the bridge exercise, it is effective to apply visual feedback using a tension sensor.

• The Korean Journal of Pain
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• v.34 no.2
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• pp.217-228
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• 2021

Background: The purpose of this study was to assess the effectiveness of transcutaneous electrical nerve stimulation (TENS) in chronic low back pain and neuropathic pain. Methods: Seventy-four patients aged 18-65 with chronic low back pain were included in the study. Baseline measurements were performed, and patients were randomized into three groups. The first group received burst TENS (bTENS), the second group conventional TENS (cTENS), and the third group placebo TENS (pTENS), all over 15 sessions. Patients' visual analogue scale (VAS) scores were evaluated before treatment (preT), immediately after treatment (postT), and in the third month after treatment (postT3). Douleur Neuropathique 4 Questions (DN4), the Modified Oswestry Low Back Pain Disability Questionnaire (MOS), the Beck Depression Inventory (BDI), and sympathetic skin response (SSR) values were also evaluated preT and postT3. Results: A statistically significant improvement was observed in mean VAS scores postT compared to preT in all three groups. Intergroup comparison revealed a significant difference between preT and postT values, that difference being assessed in favor of bTENS at multiple comparison analysis. Although significant improvement was determined in neuropathic pain DN4 scores measured at postT3 compared to preT in all groups, there was no significant difference between the groups. No statistically significant difference was also observed between the groups in terms of MOS, BDI, or SSR values at postT3 (P > 0.05). Conclusions: bTENS therapy in patients with low back pain is an effective and safe method that can be employed in short-term pain control.

• Physical Therapy Korea
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• v.28 no.3
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• pp.194-199
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• 2021

Background: The scapulo-thoracic musculatures including serratus anterior (SA), upper trapezius and lower trapezius can provide shoulder stability and functional shoulder movement. Objects: The muscle activities of upper and lower SA were compared during three different scapular protraction exercises in healthy individuals in sitting position. Methods: Twenty-five healthy subjects were participated. Electromyography device was used to measure muscle activity of upper and lower SA and trapezius muscles. Each subject was asked to perform three different scapular protraction exercises (scapular protraction [SP], SP with self-resistance [SPSR], SPSR with hand-exerciser [SPSRH]) in random order. One-way repeated measures analysis of the variance and a Bonferroni post hoc test were used. Results: The muscle activity of lower SA muscle was significantly different among three conditions (SP vs. SPSR vs. SPSRH) (p < 0.01). The lower SA muscle activity was significantly greater during SPSRH compared to SP and SPSR, which required joint stability more than SP and SPSR (p < 0.01). Conclusion: SPSRH exercise can be recommended to facilitate the muscle activity of lower SA. In addition, the intramuscular variation in the upper and lower SA during scapular protraction exercise is required to consider the effective rehabilitation.

• PNF and Movement
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• v.19 no.2
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• pp.269-278
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• 2021

Purpose: This study aimed to investigate effective cueing methods for selective muscle activation of the serratus anterior. Methods: Based on the inclusion criteria, 26 healthy adults, both males and females, were recruited for the measurement of muscle activation of the upper trapezius and serratus anterior muscles while performing basic movements in knee push-up plus (KPP) and dynamic hug (DH) positions using five different cueing methods. An electromyogram was used to measure muscle activation, and both muscle activation and muscle ratio (serratus anterior/upper trapezius) were compared during the basic movements and different cueing methods. The cueing methods were trapezius verbal cueing, trapezius verbal cueing + trapezius tactile cueing, emphasis verbal cueing, serratus anterior tactile cueing, and trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing. Results: The results of the study showed that there was a significant difference in the muscles for the two exercises (p < 0.05). There was also a significant difference between the cueing methods (p < 0.05). The correlative effect between the muscles and cueing methods was also significant (p < 0.05). The muscle ratio in trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing during KPP and DH was higher than in basic movements and other cueing methods. This confirms that trapezius verbal cueing + trapezius tactile cueing + serratus anterior tactile cueing is an effective cueing method for selective activation of the serratus anterior during KPP and DH. This study also demonstrated that cueing by a therapist may both increase and decrease selective muscle activation. Conclusion: Through this study, an effective cueing method to selectively activate the serratus anterior may be suggested, and the results of this study may provide basic information regarding future studies and clinical practice.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.27 no.3
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• pp.37-46
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• 2021

Background: The increase in the activity of the upper trapezius (UT) muscle and decrease in the activity of the serratus anterior (SA) and lower trapezius (LT) muscle produce an abnormal scapulohumeral rhythem. Therefore, the SA is the focus of therapeutic exercise protocols for the rehabilitation. This study aimed to compare the activity of the muscles according to resistance levels during protraction exercise. Methods: Thirteen healthy 20 to 30 years old male and female subjected participated in the study. All subjects performed the scapular protraction exercise with the weights of 0, 5, and 10kg, combined with horizontal shoulder abduction and adduction. The electromyography data of the SA, UT, and pectoralis major (PM) during the exercise were recorded using surface electrodes. The ratios of PM/SA and UT/SA were calculated. Repeated one-way ANOVA was used to determine the statistical significance. Results: There was a significant difference in the muscle activity of the SA and PM (p<.05). Specifically, SA had the highest activity and PM had the lowest activity at an abduction resistance 10kg (p<.01). There was a significant difference in the ratios of UT/SA and PM/SA (p<.05). The ratio of PM/SA was the lowest at the abduction resistance of 10kg (p<.01). Conclusion: According to this study, for the selective activation of the serratus anterior, protraction exercises should be applied as a method of adding resistance to protraction and horizontal abduction.

• Journal of the Korean Society of Physical Medicine
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• v.16 no.4
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• pp.117-124
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• 2021

PURPOSE: This study examined the effect of muscle thickness of the deep cervical flexor muscle, muscle tonicity, and muscle fatigue of the superficial cervical flexor muscle by applying a functional latex pillow to patients with chronic cervical pain. METHODS: An experimental group using a functional latex pillow and a control group using a general pillow were assigned randomly to 30 people. Each pillow was applied in a comfortable lying position in the experimental group and control group. The deep cervical flexor muscle thickness was measured in the longus colli and longus capitus using ultrasonography. The muscle tonicity and muscle fatigue of the superficial cervical flexor muscle were measured separately in the sternocleidomastoid muscle using a myotonometer and electromyography. RESULTS: In the experimental group(functional latex pillow), the muscle tonicity of the superficial cervical flexor muscle like the sternocleidomastoid muscle was significantly lower than that of the control group (general pillow)(p < .01). CONCLUSION: This study suggests that the functional latex pillow may effectively reduce the muscle tonicity of the sternocleidomastoid muscle, which is the superficial cervical muscle, in patients with chronic cervical pain. On the other hand, it was not effective on the muscle thickness of the deep cervical flexor muscle and muscle fatigue of the superficial cervical flexor muscles.

• Korean Journal of Applied Biomechanics
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• v.32 no.1
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• pp.31-36
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• 2022

Objective: The purpose of this study was to investigate muscle activation according to the four strap lengths in the TRX plank exercise to provide scientific and accurate data on effective training methods. Method: Twenty healthy men who had at least 6 months of weight training experience and could fully adjusted plank exercise, were participate in this study (age: 25.2 ± 3.7 yrs., height: 174.2 ± 3.9 cm., weight: 71.2 ± 9 kg). To pursue the study purpose, surface electrodes were attached to trunk muscles (pectoralis major, rectus abdominis, external oblique, internal oblique, erector spinae, latissimus dorsi) and lower extramity muscles (gluteus maximus, rectus femoris, gastrocnemius), and the muscle activity was measured using 11-channel electromyography equipment. In order to verify the muscle activation according to the four strap lengths during TRX plank exercise, an one-way ANOVA with repeated measure was used with statistical significance level set at as α=.05. Results: First, there were statistically significant differences in pectoralis major, rectus abdominis, external oblique, internal oblique, and erector spinae among TRX strap lengths. Second, there were statistically significant differences in gluteus maximus, rectus femoris, and gastrocnemius among TRX strap lengths. Third, even though no statistically significant difference found in latissimus dorsi, but increased muscle activation tendency was showed as the length of the strap increased. Conclusion: From the results of this study, it may be possible that TRX exercise prevent injuries and improve lower extremity muscle as well as trunk muscles by setting appropriate length of strap.