• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.231-238
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• 2021

Background: Extensor muscle strengthening exercises with counterforce braces (EX) is a conventional conservative treatment for lateral epicondylitis (LE) of the elbow. In addition, polydeoxyribonucleotide (PDRN) or extracorporeal shockwave therapy (ESWT) has been recently used for LE. Methods: Sixty-three patients with chronic LE participated in this study and randomly allocated in three groups (G1: EX, G2: EX+PDRN injection, and G3: EX+ESWT). All of the three groups were taught to perform EX at the first out-patient department (OPD) visit. Group 2 was injected with 3 mL PDRN (5.625 mg/3 mL), while group 3 received ESWT at the first OPD visit. Visual analog scale pain score, Mayo elbow performance score (MEPS), and ultrasonographic examination were checked before, 6 weeks, and 12 weeks after the treatments. Results: Overall functional scores and ultrasonographic findings in all three groups improved after treatment. The mean MEPS in group 2 improved more than groups 1 and 3 at 6 weeks (G1, 56.9>62.4; G2, 54.3>65.0; G3, 55.7>62.6), and more than group 1 at 12 weeks (G1, 56.9>67.9; G2, 54.3>73.6). The mean common extensor tendon depth (CETD) on ultrasonography in group 2 increased more than groups 1 and 3 at 6 and 12 weeks (6 weeks: G1, 0.385>0.386; G2, 0.332>0.392; G3, 0.334>0.357; 12 weeks: G1, 0.385>0.409; G2, 0.332>0.438; G3, 0.334>0.405 [cm]). Conclusions: PDRN injections combined with EX exhibited a greater improvement in mean MEPS and mean CETD compared to EX only or EX combined with ESWT for LE within the 12 weeks follow-up.

• Journal of Biomedical Engineering Research
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• v.30 no.3
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• pp.221-225
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• 2009

The purpose of this study was to investigate the biomechanical effects of an application of whole body vibration during strengthening exercise. Every participant performed four weeks exercise program using general leg-press versus vibrating leg-press. Participants did legpress exercise three sets of 25 repetitions with the load of 25 percent of 1RM during first week, three sets of 20 repetitions with 40 percent of 1RM during second week, three sets of 15 repetitions with 60 percents of 1RM during third week, and three sets of 15 repetitions with 80 percent of 1RM during last fourth week. The vibration(25Hz, 5mm) was applied only to the vibration exercise group. A three dimensional virtual lower extremity model for one of subject and virtual leg-press model were generated. The knee extensor muscle forces were analyzed using the virtual model and the knee joint torque(maximum extension torque) was measured using an isokinetic device. Calculated muscle forces were smaller in vibrating leg-press exercise than in general leg-press exercise. An increase of the maximum knee extension joint torque was 2.14 times larger approximately after the four week vibration leg-press exercise program was performed.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.8 no.2
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• pp.57-71
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• 2002

Cervical pain is a rapid increase that is owing to a flexion-extension whiplash injury, unappropriated posture, chronical repetition injury from abdominal position of head and neck, excessive repeating work, chronical deficiency of excercise. Because of that is bring about muscle unbalance, tightness of cervical extensor muscle, weakness of cervical deep flexor muscles, instability of cervical region and reduction of proprioceptive sensor. Recent the role of muscle is more emphasized for preservation of sine stabilization. And cognition of integrated muscular system, importance for the operation and relation is increased to maintain stability of the motor system and pertinent function. Therefore we are going to introduce the sling exercise and stabilization exercise method for advanced efficient of cervical and upper limb and for the muscle strengthening to importance cervical stabilization through neurological program as control the reaction of cervical stabilization. Sling exercise therapy(SET) concept consists of a system of diagnosis and treatment. The system of diagnosis involves testing the muscle's tolerance through progressive loading in open and close kinetic chains. The SET system contains elements such as relaxation, increasing the range of movement, traction, training the stabilizing musculature, sensory-motor exercises, training in open and close kinetic chains, dynamic training of the mobilizing musculature, cardiovascular exercise, group exercise, personal exercise at home Sensory-motor training is an essential element of the SET concept. The emphasis is on closed kinetic chain exercise on an unstable surface, there by achieving optimum stimulation of the sensory-motor apparatus.

• Annals of Rehabilitation Medicine
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• v.42 no.6
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• pp.804-813
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• 2018

Objective To elucidate the effect of a 12-week horizontal vibration exercise (HVE) in chronic low back pain (CLBP) patients as compared to vertical vibration exercise (VVE). Methods Twenty-eight CLBP patients were randomly assigned to either the HVE or VVE group. All participants performed the exercise for 30 minutes each day, three times a week, for a total of 12 weeks. Altered pain and functional ability were evaluated using the visual analog scale (VAS) and Oswestry Disability Index (ODI), respectively. Changes in lumbar muscle strength, transverse abdominis (TrA) and multifidus muscle thicknesses, and standing balance were measured using an isokinetic dynamometer, ultrasonography, and balance parameters, respectively. These assessments were evaluated prior to treatment, 6 weeks and 12 weeks after the first treatment, and 4 weeks after the end of treatment (that is, 16 weeks after the first treatment). Results According to the repeated-measures analysis of variance, there were significant improvements with time on VAS, ODI, standing balance score, lumbar flexor, and extensor muscle strength (all p<0.001 in both groups) without any significant changes in TrA (p=0.153 in HVE, p=0.561 in VVE group) or multifidus (p=0.737 in HVE, p=0.380 in VVE group) muscle thickness. Further, there were no significant differences between groups according to time in any of the assessments. No adverse events were noticed during treatment in either group. Conclusion HVE is as effective as VVE in reducing pain, strengthening the lumbar muscle, and improving the balance and functional abilities of CLBP patients. Vibrational exercise increases muscle strength without inducing muscle hypertrophy.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.11 no.1
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• pp.37-48
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• 2005

Objects: This study is designed to analysis improvement and maintaince of trunk stability targeting patients who need post operative rehabilitation exercise after undergoing opened microscopic laser discectomy(OMLD) due to HNP. Method: Between March 2004 and February 2005 a total sixty patients who underwent OMLD due to $L_4/L_5$, $L_5/S_1$ HNP and who agreed to the experiment were subject for this study. Experimental group consisted of 18 subjects, and they underwent 45 minutes dynamic lumbar stabilization exercise And control group consisted of 18 subjects who conducted conservative physical therapy based on the use of physical modality for 45 minutes except to exercise. Results: Experimental group that was lumbar extensor's isometric peak torque, weight distribution of both leg, trunk muscle balance and Oswestry LBP disability index increased during 12 weeks in a statistically significant manner compared to before exercise (p<.05). When re-test was tried, isometric peak torque (p>.05) and Oswestry LBP disability index(p<.05) maintained 12th week level or improved. Weight distribution rate of both leg and trunk muscle balance maintained the level of 8th week of exercise execution(p<.05). Control group that was lumbar extensor's isometric peak torque, weight distribution rate of both leg and trunk muscle balance aggravated during 12 weeks compared to pre-test(p>.05) But, Oswestry LBP disability index increased in a statistically significant level compared to pre-test(p<.05). When re-test was tried, isometric peak torque increased slightly compared to pre-test, but decreased when at least $60^{\circ}$ flexion angle(p>.05). Weight distribution rate of both leg and trunk muscle balance also aggravated compared to pre-test(p>.05), and Oswestry LBP disability index was similar to the 4th week of physical therapy execution(p>.05). Conclusion: Successive postoperative Especially, Application of dynamic lumbar stabilization exercise program is important than traditional lumbar strengthening exercise program in the maintaince of spinal stability.

• Physical Therapy Rehabilitation Science
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• v.6 no.2
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• pp.96-104
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• 2017

Objective: The purpose of this study was to investigate the effect of the hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on the clinical symptoms and the treatment effects in balance, sit to stand, and gait abilities in patients with TBI. Design: A single case study. Methods: A 13-year-old adolescent with quadriplegia and hip joint control impairment participated in this four-week training intervention. The patient, diagnosed with TBI, wastreated with hip joint strengthening exercises using PNF. In the first week, we focused on strengthening the body, relaxing the hip flexors and activating the hip extensor muscles in order to solve the patient's physical function and body structure. From the 2nd and 4th week, we improved the motivation through the task-oriented method, and then weight-bearing training of the right lower extremity was proceeded by kicking a soccor ball with the left lower extremity. The exercises were performed for 4 weeks, 5 days a week, for 60 minutes with the exercise intensity gradually increased according to the subject's physical abilities. Results: As a result of the study, the patient demonstrated improvements in the physical examination, which were evaluated before and after intervention and included the manual muscle test, modified Ashworth scale, sensory assessment, coordination assessment, Berg balance scale, 5-time sit to stand test, and the 10 meters walk test. Conclusions: The results of this case suggest that a hip joint strengthening exercise program using PNF may improve hip control ability, balance, sit to stand and gait ability in a patient with TBI.

• Physical Therapy Rehabilitation Science
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• v.3 no.2
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• pp.112-118
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• 2014

Objective: The purpose of this study was to investigate the effects of an exercise with and without neuromuscular electrical stimulation (NMES) of the quadriceps femoris muscle, on strength, pain, and weight distribution in patients with knee instability post surgery. Design: Randomized controlled trial. Methods: Twenty patients in the early stage of rehabilitation after knee surgery were recruited as subjects and were randomly divided into either experimental group (exercise combined with NMES) (n=10) or control group (n=10). Both groups received strength training of the lower limb for 20 min/day, 5 days/week for 4 weeks. The experimental group used NMES for unilateral quadriceps femoris training with incremental increases in the intensity of isometric contraction over 4 weeks. Outcome measurements were assessed using the digital manual muscle testing, 30-chair stand test (30CST), numeric pain rating scale (NPRS) and weight distribution using the foot analyzer before and after 4 weeks of training. Results: After the 4-week intervention, knee extensor strength increased significantly in the experimental group post intervention (p<0.05), and there was a significant improvement in the experimental group compared with the control group (p<0.05). The 30CST and NPRS scores improved significantly in the experimental group compared to the control group (p<0.05), and there was a significant difference between the two groups (p<0.05). Weight distribution was significantly improved in the experimental group compared with the control group, (p<0.05), but there was no significant difference in improvement between the two groups. Conclusions: This study showed that NMES combined with strengthening exercises of the lower limbs is effective in improving lower limb pain and strength in patients with instability after knee surgery.

• PNF and Movement
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• v.19 no.2
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• pp.183-193
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• 2021

Purpose: The purpose of this research was to investigate the effects of performing Pilates exercises for eight weeks on the isokinetic trunk strength and balance of female middle school students with lumbago. Methods: Twenty-four female students who met the test requirements were recruited and randomly divided into a control group (CG, n = 16) and a Pilates exercise group (Pilates group; PG, n = 8). The PG performed a Pilates program, which consisted of lumbar muscle strengthening exercises, for 60 minutes three times a week for eight weeks. Data analysis was conducted by two-way repeated ANOVA, and a Bonferroni test was carried out when significant differences appeared. The alpha level was set at 0.05. Results: Following the experimental treatment, the PG showed an increased trunk flexion peak torque of 17% and 13% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased about 31% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Following the experimental treatment, the PG showed an increased trunk extensor peak torque of approximately 29% and 21% at angular velocities of 180°/sec and 300°/sec, respectively. The intergroup comparison showed no significant difference at pre-measurement, while the PG increased approximately 27% (180°/sec) and 15% (300°/sec) higher than the control group at post-measurement. Both the CG and the PG showed a 20% and 50% decrease in pain index after the experimental treatment, respectively. After the experimental treatment, the PG had about 50% lower pain than the CG. The average error rate of static balance in the PG reduced by 19% from 3.28±0.45 to 2.65±0.36, confirming a significant improvement. Conclusion: Regular Pilates exercise for eight weeks improved the isokinetic trunk muscle strength of female middle school students with lumbago and relieved their pain. Pilates was also shown to be effective in improving balance.

• The Journal of the Korea Contents Association
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• v.9 no.1
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• pp.323-330
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• 2009

Objectives: There are many reasons to restrict extension of knee. Unless we can find any structural deformities from patients, we don't have any clue of helping this condition except give them some instruction of exercise of strengthening anterior thigh muscles and releasing extensor muscle group of lower extremities. In this study, the author reports new case, using technique of releasing restriction of knee movement based on Sacro Occipital Technique. Method: From the day of notifying 14yrs. old patient's extension restriction of knee, it had have 7 trials of having S.O.T category Ⅰ. technique procedure. Result: The patient can stand without extension restriction of knee. Conclusion: In many case, muscle soft tissue work helps releasing hamstring tension so that we can make patient stand with straightly extended knee position but if this method is not working then S.O.T category Ⅰ. technique procedure may be considerable to improve this condition.

• Women's Health Nursing
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• v.7 no.2
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• pp.169-187
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• 2001

This study was performed to probe the effect of exercise program on muscle strength, endurance, flexibility, pain, disability level and life satisfaction in female teachers of elementary school who complain of low back pain. For this study, 44 female teachers aged 30-50 years with mechanical low back pain of 6 months' duration, who had the structural normalities in the lumbar spine, were recruited from April 1 to July 10 1999. Twenty three out of them were assigned to the experimental group and twenty one to the control group. The exercise program consisted of education on right postures, the etiology and diagnosis of low back pain, and exercise intervention such as muscle relaxation, elongation and strengthening. With 8 weeks program, the subjects received two sessions of education and six sessions of group exercise in the 1st week, while three sessions of group exercise and four sessions of individual exercise weekly and two sessions of education during the later 7 weeks. The muscle strength and endurance were measured by Cybex 770, the flexibility by flexibility measurement machine, the intensity of pain by Visual Analogue Scale (VAS), the level of disability by Oswestry low back pain disability scale, depression by Beck depression inventory (BDI), and life satisfaction by Life satisfaction index-Z. Study measurements were taken before and after 8 weeks exercise program. Data were analyzed using paired t-test, t-test, and ANCOVA. The results were as follows ; 1. The flexors and extensors peak torque and flexors peak torque per body weight of experimental group were significantly increased at test velocities $30^{\circ}$/sec, $60^{\circ}$/sec compared with those of control group. There was no significant difference in extensors peak torque per flexors peak torque at $30^{\circ}/sec$, $60^{\circ}/sec$ between experimental and control group. 2. The flexors and extensors total work and flexors total work per body weight of experimental group were significantly increased at $120^{\circ}/sec$, compared with those of control group. 3.The flexibility of lumbar spine in experimental group was significantly increased compared with that of control group. The pains in anterior, posterior, left lateral and right lateral bending and in rotation of experimental group were significantly increased compared with those of control group. 4. The Oswestry disability scores of experimental and control group were significantly decreased, and there was no difference in the Oswestry disability score change between experimental and control group. 5. The scores of BDI of experimental group were significantly decreased compared with those of control group. Life satisfaction index-Z scores of experimental group were not changed, but those of control group were significantly decreased. There was no difference in the score change of Life satisfaction index-Z between experimental and control group. 6. ANCOVA analysis for the data variables of inhomogeneous baseline represented that there was no significant difference in extensors peak torque and extensors total work at $120^{\circ}/sec$ and extensor total work per body weight at $120^{\circ}/sec$ change between experimental group and control group. These findings indicate that the exercise program could be effective in increasing the muscle strength, endurance, flexibility and decreasing pain, improving depression in female teachers of elementary school with chronic low back pain. It is suggested that the exercise program could be an essential factor for the effective nursing intervention to the patients suffered from chronic low back pain.