• Journal of the Korean Society of Physical Medicine
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• v.8 no.1
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• pp.29-39
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• 2013

PURPOSE: The purpose of this study was to determine if the program focusing on gluteal muscle exercise combined lumbar stabilization had an effects on pain, functional disability and lumbar instability in chronic low back pain patients who had lumbar instability. METHODS: Thirty four patients were recruited in this study. The participants were randomly allocated stabilization exercise group (SEG) (n=17) and gluteal muscle exercise group (GEG) (n=17). The gluteal muscle exercise group conducted gluteal muscle exercises combined lumbar stabilization and stabilization exercise group did only lumbar stabilization exercise for 30 minutes three times a week for six weeks. Pre-exercise assessment tools, visual analogue scale (VAS) and Korean version Oswestry Disability Index level (KODI) were used for pain and functional disability each. Also, these were scored by the tool of lumbar instability. The pain, functional disability levels, and lumbar instability after six weeks with this exercise were re-evaluated. RESULTS: First, SEG showed a significant decrease in the lumbar pain, functional disability levels and lumbar instability. Second, GEG showed a significant decrease in the lumbar pain, functional disability levels and lumbar instability. The third, GEG showed even more significant decrease in the lumbar pain levels, functional disability levels and lumbar instability than SEG. CONCLUSION: Gluteal muscle exercises combined lumbar stabilization are more effective than only lumbar stabilization exercise in the pain levels, functional disability levels and lumbar instability for the chronic low back pain patients with lumbar instability.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.26 no.2
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• pp.55-61
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• 2020

Background: This study demonstrate the effect of bridge exercise using sling device on the improvement of gluteal maximus and elector Spine EMG (electromyogram) in college student. Methods: 30 college students participated in this experiment and received bridge exercise using sling device for 30 minutes a day for four weeks. Results: The effects of bridge exercise using sling device were evaluated by measuring the muscle activation on gluteal maximus and elector spine. The differences between pre-test and post-test in G-max (p<.05) and right elector spine (p<.05) were significant. The difference between in G-max left and right side was not significant both before (p<.05) and after (p<.05) bridge exercise using sling. The difference between in elector spine left and right side was not significant before bridge exercise using sling (p<.05) but after bridge exercise using sling (p<.05). Conclusion: The results indicated that bridge exercise using sling device improved gluteal maximus and elector spine EMG. This study demonstrated the effectiveness of this new approach and provided a good guide to improve gluteal maximus and elector spine EMG.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.3
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• pp.31-42
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• 2023

Background: This study aimed to investigate the effects of combining the lumbar stabilization exercise with the gluteal muscle strength exercise on pain, the dysfunction index, and postnatal depression in women experiencing chronic low back pain after a cesarean section. Methods: The study used a randomized design with two groups: one group (n=15) performed the lumbar stabilization exercise along with the gluteal muscle strength exercise, while the other group (n=15) only did the lumbar stabilization exercise. The intervention consisted of 30 minute exercise sessions, twice a week, for 6 weeks. The pain was assessed using the visual analog scale (VAS), the dysfunction index with the Oswestry disability index (ODI), and postnatal depression using the edinburgh postnatal depression scale-Korean version (EPDS-K). Results: Both groups showed significant improvements in their VAS, ODI, and EPDS-K scores within their respective groups (p<.05). Additionally, the between-group analysis revealed significant differences in post-test results (p<.05). Conclusion: The combination of the lumbar stabilization exercise and the gluteal muscle strength exercise proved to be more effective in reducing pain, improving the dysfunction index, and alleviating postnatal depression in women with chronic low back pain after a cesarean section. Therefore, incorporating these exercises could be beneficial as an intervention program for women experiencing chronic low back pain after a cesarean section.

• Physical Therapy Rehabilitation Science
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• v.5 no.2
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• pp.70-77
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• 2016

Objective: The purpose of this study was to compare the activation of trunk and gluteal muscles during bridge exercises with a sling (BS), single-legged bridge exercise with a sling (SBS), single-legged bridge exercise (SB), and general bridge exercise (GB). Design: Cross-sectional study. Methods: Twenty-five healthy participants (19 males and 6 females, aged 27.8 [4.78]) voluntarily participated in this study. In the bridging exercise, each subject lifted their pelvis with their legs and feet in contact with the sling or normal surface. The electrical activities of the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO) muscles during the bridging exercises on the 2 surfaces were measured using surface electromyography. Subjects practiced each of the four bridge condition three times in random order and average values were obtained. Results: On the ipsilateral side, activities of the IO, EO, and ES during SBS was significantly higher than those during BS, SB, and GB (p<0.05). Activities of the IO and EO during SB was significantly higher than those during BS and GB (p<0.05). On the contralateral side, activities of the GM and EO during SB and SBS was significantly higher than that during BS and GB (p<0.05). These results verify the theory that the use of sling and single leg lift increases the activation trunk and gluteal muscles during bridging exercises. Conclusions: The single-legged bridge exercise with a sling can be recommended as an effective method to facilitate trunk and gluteal muscle activities.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.23 no.2
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• pp.33-44
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• 2017

Background: Lumbar stabilization exercise and gluteal muscle strengthening exercises are widely used to treat for lower back pain patient. The present study aimed to compare the effects of lumbar stabilization exercise and gluteal muscle strengthening exercises on chronic lower back pain with lumbar spine instability, with regard to pain intensity, disability, and psychosocial factors. Methods: Among 53 patients with chronic lower back pain, those with spine instability were selected using 5 examination tests. The selected 28 patients were randomly assigned to lumbar stabilization exercise group (LSE, n=15) and gluteal strengthening exercise group (GSE, n=13). Each group performed the corresponding exercise for 40 minutes, twice a week for 4 weeks. To analyze and compare the effects, pain intensity, the level of low back disability, and psychosocial factors were assessed before and after intervention. Results: There was significant difference in lower back pain intensity between the two groups before and after intervention. The change in low back disability was significant in the GSE group alone following intervention (p<.05), but no other significant difference was found between the groups. Among psychosocial factors, the changes in the fear-avoidance beliefs questionnaire (FABQ)-physical activity and FABQ-total were significant in the LSE group alone following intervention (p<.05). However, no significant difference were found in these factors between the two groups before and after intervention. Conclusions: LSE and GSE for lower back pain with lumbar spine instability showed no significant difference for pain intensity, physical disability, or psychosocial functioning.

• Physical Therapy Korea
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• v.23 no.3
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• pp.57-67
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• 2016

Background: Many previous studies recommended the side-lying hip abduction (SHA) exercise for targeting the gluteus medius (Gmed) and gluteus maximus (Gmax) muscle activity while the decreasing tensor fasciae latae (TFL) activation. Mischoice of hip position and angle in SHA may increase the risk of lower extremity injuries and undesirable muscle activation. However, information is limited on the effect of composite hip flexion angles and hip rotation on the gluteal muscle activity during SHA. Objects: This study aimed to compare muscle activity (Gmed, TFL, and Gmax) and activity ratios (Gmed/TFL, Gmax/TFL, and Gmed/Gmax) using surface electromyography (EMG) during SHA exercise at three different hip flexion angles either with or without internal rotation (IR) in subjects with Gmed weakness. We hypothesized that applying hip flexion and IR during SHA would increase gluteal muscle activity and decrease TFL activity. Methods: Muscle activity and activity ratios in 20 volunteers with Gmed weakness during 6 different SHA were investigated with surface EMG. One-way repeated-measures analysis of variance was used to determine the statistical significance. Results: Significant differences were found among the six different exercises for Gmed ($F_{2,41}=11.817$, p<.001) and Gmax ($F_{3,52}=5.513$, p=.003) muscle activity, and Gmed/TFL ($F_{3,54}=8.735$, p<.001) and Gmax/TFL ($F_{2,37}=4.019$, p=.028) activity ratios. Conclusion: Applying hip flexion is an effective method for increasing gluteal activity, and it elicits great Gmed/TFL and Gmax/TFL activity ratios during SHA in subjects with Gmed weakness.

• The Journal of Korean Physical Therapy
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• v.28 no.3
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• pp.205-211
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• 2016

Purpose: This study investigated the influence of muscle activity of the trunk and lower limb during a bridge exercise using a unstable surface and during one-legged bridge hip abduction in healthy adults. Methods: Nineteen healthy participated in this study (12 males and 7 females, aged $29.0{\pm}5.0$). The participants were instructed to perform the bridge exercises under six different conditions. Trunk and lower limb muscle activation, such as the erector spinae (ES), gluteus maximus (GM), external oblique (EO), and internal oblique (IO), was measured using surface electromyography. The six different bridge exercise conditions were conducted randomly. Data analysis was performed by using the mean scores after three trials of each condition. Results: On the ipsilateral side, muscle activity of the IO, EO, and ES during the hip abduction condition (Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction, Bridge with use of a sling and single-leg hip abduction) was significantly higher than those during Unstable surface (Bridge with use of a ball, Bridge with use of a sling) and General bridging exercise (p<0.05). In the contralateral side, activities of the GM and EO during Single-legged hip abduction bridge, Bridge with use of a ball and single-leg hip abduction and Bridge with use of a sling and single-leg hip abduction was significantly higher than that during Bridge with use of a ball, Bridge with use of a sling and General bridging exercise (p<0.05). Conclusion: This study demonstrated that performing a bridge exercise with use of a sling and single-leg hip abduction had an effect on trunk and gluteal muscle activation. The findings of this study suggest that this training method can be clinically effective for unilateral training and for patients with hemiplegia.

• Physical Therapy Rehabilitation Science
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• v.12 no.2
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• pp.149-154
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• 2023

Objective: This study is designed to investigate the effect of ankle joint position on hip extensor muscle activity when bridging exercise in sagittal plane. Design: Cross-sectional study Methods: The subjects were recruited from 20 healthy adult men. The subjects performed three types of bridging exercises (normal bridging, ankle dorsiflexion bridging, ankle plantar flexion bridging) three times for five seconds with a rest of 15 seconds between measurements and two minutes of rest between each motion. The target muscles were the gluteus maximus, biceps femoris, soleus, and tibialis anterior. A surface electromyography was used to measure the muscle activity of these muscles. Results: The results show there was no statistically significant difference between the three types of exercise in the gluteus maximus muscle activity. However, the biceps femoris showed a significant difference between the three types of exercises (p<0.05). Conclusions: In conclusion, when the three different bridging exercises were performed by adding ankle motion to normal bridging exercise, there was a significant difference in the muscle activity of the gluteus maximus relative to the biceps femoris muscle activity in the order of the ankle dorsiflexion bridging, normal bridging, and ankle plantar flexion bridging exercise. Therefore, this could be an effective option for a bridging exercise if applied to patients with a weak gluteal muscle and shortening of the hamstring muscle in further studies.

• Journal of the Korean Society of Physical Medicine
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• v.19 no.2
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• pp.17-28
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• 2024

PURPOSE: This study was conducted to investigate the effect of gluteal muscle strengthening exercises (GMSE) with ankle joint pumping exercises (AJPE) on thigh swelling, gait ability, and pain level in patients who underwent total hip arthroplasty. METHODS: A total of 38 patients who had undergone total hip replacement surgery >1 week prior participated in this study. Participants were randomly assigned to a group that performed only GMSE (CG; n = 19) and a group that performed GMSE and AJPE (EG; n = 19). The CG group performed GMSE for 30 min, and the EG group performed GMSE for 30 min followed by AJPE for 15 min. Exercises were performed five times a week, for a total of 20 times over 4 weeks in both groups. Thigh swelling (thigh size), 10 m walking test (10MWT) and timed up and go test (TUG) results, pain level (visual analogue scale, VAS) scores, Short Form 36 health survey (SF-36), and hip outcome scale (HOS) scores were evaluated before and after the intervention. RESULTS: After 4 weeks of intervention, significant differences were observed in the thigh size, 10MWT, TUG, VAS, SF-36, HOS before and after intervention in both groups (p < . 05). However, only thigh size showed a significant interaction between group and measurement time (p < . 05). CONCLUSION: GMSE combined with AJPE might be effective in improving the gait ability and pain level in patients with total hip arthroplasty, and GMSE may be more effective in improving thigh swelling and gait ability than GMSE without AJPE.

• Physical Therapy Korea
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• v.26 no.3
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• pp.91-98
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• 2019

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.