• Physical Therapy Korea
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• v.28 no.3
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• pp.186-193
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• 2021

Background: While the formal test has been used to provide a quantitative measurement of core stability, studies have reported inconsistent results regarding its test-retest and intraobserver reliabilities. Furthermore, the validity of the formal test has never been established. Objects: This study aimed to establish the concurrent validity and test-retest reliability of the formal test. Methods: Twenty-two young adults with and without core instability (23.1 ± 2.0 years) were recruited. Concurrent validity was determined by comparing the muscle thickness changes of the external oblique, internal oblique, and transverse abdominal muscle to changes in core stability pressure during the formal test using ultrasound (US) imaging and pressure biofeedback, respectively. For the test-retest reliability, muscle thickness and pressure changes were repeatedly measured approximately 24 hours apart. Electromyography (EMG) was used to monitor trunk muscle activity during the formal test. Results: The Pearson's correlation analysis showed an excellent correlation between transverse abdominal thickness and pressure biofeedback unit (PBU) pressure as well as internal oblique thickness and PBU pressure, ranging from r = 0.856-0.980, p < 0.05. The test-retest reliability was good, intraclass correlation coefficient (ICC1,2) = 0.876 for the core stability pressure measure and ICC1,2 = 0.939 to 0.989 for the abdominal muscle thickness measure. Conclusion: Our results provide clinical evidence that the formal test is valid and reliable, when concurrently incorporated into EMG and US measurements.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.244-250
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• 2021

Objective: The purpose of this study was to investigate the effect of sprinter pattern bridging exercise using theraband on activation of lower extremity and abdominal muscle and to find out postures that can effectively improve abdominal and lower extremity muscle strength and increase abdominal stability. Methods: This study was designed as a cross-sectional study. The following research was done with applicants attending S university in Seoul to compare the difference in muscle activity between one-leg-Support bridging exercise and sprinter-pattern bridging exercise using theraband. For 48 study participants, we first measured their MVC. Then, we applied one-leg-support bridging exercise and sprinter-pattern bridging exercise at random order. These data were expressed as the percentage of maximal voluntary contraction (%MVC).Electromyography analysis was performed by measuring the external obliques, internal obliques, biceps femoris, and gluteus maximus. Results: There was a statistically significant increment of muscle activity in external and internal oblique muscle(p<0.001)by sprinter-pattern bridging exercise using theraband. On the lower body, statistically significant increment of muscle activity in biceps femoris and gluteus maximus was found(p<0.05). On the other hand, on erector spinae, there was statistically significant decrease in muscle activity(p<0.05). Conclusions: Efficient treatment is expected when sprinter-pattern bridging exercise using theraband is applied clinically.For patients with chronic knee and ankle pain who have difficulty bearing weight, including low back pain and internal rotation of the femur, starting with a low weight bearing, we think it will be helpful in planning systematic training aimed at progressively strengthening the lower extremities.

• Physical Therapy Korea
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• v.29 no.1
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• pp.79-86
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• 2022

Background: Bird dog exercise (BDE) is one of the lumbar stabilization exercises that rehabilitate low back pain by co-contraction of the local and global muscles. Previous studies have reported the effect of various type of BDEs (for example, practicing the exercises on various surfaces and changing the limb movement) for muscle co-contraction. Objects: This study aimed to investigate the effect of knee joint flexion position of the raised lower limb on abdominal and back muscle activity during BDE in patients with chronic low back pain (CLBP). Methods: Thirteen males participated in this study (age: 32.54 ± 4.48 years, height: 177.38 ± 7.17 cm). Surface electromyographic (SEMG) data of the internal abdominal oblique (IO), external abdominal oblique (EO), lumbar multifidus (MF), and thoracic part of the iliocostalis lumborum (ICLT) were collected in two knee joint flexion positions (90° flexion versus 0° flexion) during BDE. The SEMG data were expressed as a percentage of root mean square mean values obtained in the maximal voluntary isometric contraction. Results: Greater muscle activity of the IO (p = 0.001), MF (p = 0.009), and ICLT (p = 0.021) of the raised lower limb side and the EO (p = 0.001) and MF (p = 0.009) of the contralateral side were demonstrated in the knee joint flexion position compared to the knee joint extension position. Greater local/global activity ratios of the abdominal muscle (i.e., IO and EO) of the raised lower limb (p = 0.002) and the back muscle (i.e., MF and ICLT) of the contralateral side (p = 0.028) were also noted in the knee joint flexion position. Conclusion: BDE with a knee joint flexion position might be recommended as an alternative lumbar stabilization exercise to enhance muscle activity in both the raised lower limb and the contralateral sides of the trunk for individuals with CLBP.

• Physical Therapy Korea
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• v.21 no.2
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.1
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• pp.1-8
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• 2017

PURPOSE: This study was to determine the changes of abdominal muscles activation according to the heel contact methods of stair ascent in healthy young adults. METHODS: 33 healthy young subjects (mean age: $26.37{\pm}9.72$ years, age range: 20-32 years) volunteered under two conditions. They were performed stair ascent with heel contact and without heel contact. The effects of heel contact methods were assessed using the surface electromyography (sEMG) analysis during stair ascent for activation of abdominal muscles (internal oblique; IO, transverse abdominis; TrA, external oblique; EO rectus abdominis; RA). The interventions were conducted over three trials in each method, and measurements were performed on each subject by one examiner in three trials. RESULTS: Our results revealed that there were significantly greater increase in the EMG activation of IO and TrA muscles in the performance of stair ascent with heel contact (p<.05) compared to those of stair ascent without heel contact. The results also showed that there were greater decrease in the ratio of abdominal muscle activation in those of stair ascent with heel contact compared with stair ascent without heel contact. CONCLUSION: These findings demonstrated that the method of stair ascent with heel contact would suggest positive evidence for improving activation of abdominal muscles.

• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.311-327
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• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• Physical Therapy Korea
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• v.16 no.1
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• pp.1-9
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• 2009

An abdominal drawing-in maneuver (ADIM) with a pressure biofeedback unit can be used to prevent excessive lumbar lordosis during bridging exercise. Therefore, in this research, the effects of an ADIM on lumbar lordosis and lower extremity muscle activity during bridging exercise were investigated in thirty healthy adults. Surface electromyography (EMG) and VICON system were used to collect kinematic data and muscle activity, respectively. A paired t-test was used to determine a statistical significance. The results showed as follows: (1) When performing bridging exercise with an ADIM, the height of the anterior superior iliac spine and greater trochanter decreased significantly (p<.05). (2) When performing bridging exercise with an ADIM, the trunk extension angle and pelvic angle increased significantly (p<.05). (3) When performing bridging exercise with an ADIM, the EMG signal amplitude increased significantly in the rectus abdominis, internal oblique abdominis, external oblique abdominis, medial hamstring, and lateral hamstring (p<.05). (4) When performing bridging exercise with an ADIM, the EMG signal amplitude decreased significantly in the erector spinae (p<.05). From the result of this research, an ADIM trained with pressure biofeedback unit during bridging exercise is effective to prevent excessive contraction of erector spinae, to limit excessive motion of pelvis from sagittal plane and to increase muscle activity of abdominal muscles and hamstring muscle.

• Physical Therapy Korea
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• v.19 no.2
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• pp.80-86
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• 2012

The purpose of this study was to compare the muscle activity of the abdominal and lumbar multifidus during unilateral prone hip extension on the floor and on a round foam roll. Fifteen healthy participants were recruited. They were instructed to perform a unilateral hip extension on the floor and on a round foam roll in the prone position. Surface electromyography (EMG) signals were recorded from bilateral lumbar multifidus (LM), external oblique (EO), and internal oblique (IO) muscles. A paired t-test was used to compare muscle activity, with the level of significance set at ${\alpha}$=.05. The results showed that bilateral LM, EO, IO EMG activity during right-hip extension on a round foam roll was greater than that on the floor, and EMG activity of bilateral LM, right EO, and left IO during left-hip extension on a round foam roll was greater than that on the floor (p<.05). These findings suggest that the unilateral hip-extension exercise on a round foam roll can be used to activate the lumbar multifidus and abdominal oblique muscles and causes a different increasing pattern between the two lifting sides.

• Physical Therapy Korea
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• v.18 no.1
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• pp.37-46
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• 2011

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

• Journal of Korean Medicine Rehabilitation
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• v.18 no.4
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• pp.203-215
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• 2008

Objectives : The purpose of this study was to investigate abdominal muscles in chronic low back pain patients by meridian-electromyograph. Methods : Sample group of 11 with from low back pain during three months and control group of 10 subjects without low back pain have been recruited. Outcomes were assessed using meridian-electromyograph, visual analogue scale, and oswestry disability index. Results : Contraction power of external oblique abdominalis in control group was significantly higher than sample group, but there was no significant difference in muscle fatigue. Conclusions : According to above results, there are correlations between abdominal muscles and low back pain.