• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.1
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• pp.53-67
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• 2023

Background: This study comparatively evaluated the effects of equipment-based pilates exercises (EPE) and lumbar stability exercises (LSE) in patients with chronic low back pain in terms of their Visual Analogue Scale(VAS), Oswestry Disability Index(ODI), and abdominal muscle thickness. Methods: A total of 30 participants were recruited and randomly assigned to either the EPE or the LSE. The VAS, ODI, and abdominal muscle thicknesses of the participants were measured before and after the intervention. Results: The EPE were more effective in terms of the duration of a sustained reduction in VAS scores. post hoc test revealed that EPE were more efficacious in terms of a sustained improvement in ODI scores. With respect to changes in abdominal muscle thickness, there was a significant difference in the thickness of internal oblique muscles(IO) and the external oblique muscles(EO) between the two groups. Conclusion: In this study, both types of exercise interventions resulted in improvements in the VAS, ODI scores, and abdominal muscle thickness in patients with chronic low back pain. However, EPE were found to be more effective than LPE in terms of longer sustained improvements in VAS and ODI scores. Also, with respect to abdominal muscle thickness, the thickness of EO and IO improved only in the EPE group.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.2
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• pp.91-101
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• 2017

PURPOSE: The aim of this study was to verify the effect of trunk strengthening exercise using oscillation by comparing trunk muscle thickness, as well as balance of healthy adults during exercises performed with an oscillatory device and non-oscillatory device. METHODS: Twenty-two participants were randomly assigned to one of two groups: the trunk strengthening exercise using oscillation (TSEO) group (n=11) or the trunk strengthening exercise using non-oscillation (TSEN) group (n=11). Subjects in all groups performed the exercises three days per week for 6 weeks. All subjects performed four types of exercises: pull over, seated twist, power push, and diagonal power plank. Trunk muscle thickness of the rectus abdominis (RA), internal oblique (IO), external oblique (EO), transverse abdominis (TrA), and multifidus (MT) were measured with an ultrasonography. The balance ability were evaluated using the Romberg test with eyes open, eyes closed, one-leg standing test (OLST), and limits of stability (LOS). All tests were performed before the intervention, as well as after 6 weeks and 8 weeks of exercises. RESULTS: There was a significant difference of RA, IO, TrA, and MT according to the main effect of the time (p<.05). There was a significant difference of IO and LOS according to interaction effect between the time and group (p<.05). CONCLUSION: As intended, the cyclic forces induced by the oscillating device did increase trunk muscle thickness. However, the effect was limited and significant only for the IO muscle. Combining trunk strengthening exercise with oscillation appears to be more effective in improving dynamic balance.

• The Journal of Korean Physical Therapy
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• v.30 no.5
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• pp.166-172
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• 2018

Purpose: This study compared the different sling and resistance exercises on pelvic rotation during active straight leg raises (ASLR) and on pain in patients with chronic low back pain (CLBP). Methods: Twenty subjects were divided randomly into a sling group (SG) and a resistance exercise group (REG). Internal oblique (IO), external oblique (EO), rectus abdominis (RA), and rectus femoris (RF) muscle activity; pelvic rotation angle during ASLR; and visual analogue scale, pressure pain threshold were measured. Sling and resistance exercises were then performed for 30 minutes and the measurements taken again. Results: Both groups showed significantly lower RF muscle activity and significantly higher EO and IO muscle activity (p<0.05). The RA muscle activity decreased significantly in the SG, but increased significantly in the REG (p<0.05). The pelvic rotation angle was significantly lower in the SG (p<0.05). The pain press threshold increased significantly in both groups (p<0.05). The visual analogue scale decreased significantly in the SG (p<0.05). Conclusion: Both exercises appear to be beneficial for modifying the muscle activity and pain control in the intervention of CLBP. On the other hand, the sling was more effective in increasing the pressure threshold than resistance exercise, and the pelvic rotation angle was reduced. Therefore, both exercises can help patients with CLBP change their muscle activity and control pain. CLBP patients should use a sling for short periods of time to learn to reduce the pain and control pelvic rotation.

• Journal of The Korean Society of Integrative Medicine
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• v.5 no.2
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• pp.25-32
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• 2017

Purpose : The purpose of this study was to determine the effect of ribcage stabilization using a belt in the supine position during double leg lowering (DLL) by investigating the electromyographic (EMG) activities of the abdominal muscles. Methods : Twenty-two subjects with lumbar extension syndrome were recruited. EMG activity was recorded from rectus abdominalis (RA) and internal oblique abdominalis (IO), external oblique abdominalis (EO) muscles while subjects performed three double leg lowering exercises: double leg lowering (DLL), double leg lowering with abdominal draw-in maneuver (DLL-ADIM), and double leg lowering with ribcage stabilization using a belt (DLL-belt). RA, IO, and EO EMG activity were analyzed via one-way repeated-measures analysis of variance (ANOVA). Bonferroni correction was performed where significant differences were identified (p<.017, .05/3). Results : RA, IO, and EO EMG activity differed significantly among the three exercises (p<.05). The use of post hoc pair-wise comparison with Bonferroni correction showed that RA muscle activity significantly differed among the three exercises (p<.017), and IO muscle activity in the DLL exercise was significantly decreased compared to the DLL-ADIM and DLL-belt exercises (p<.017). There was no significant difference between IO muscle activity for DLL-ADIM and DLL-belt exercises (p>.017). EO muscle activity in the DLL-belt exercise was significantly increased compared to both DLL and DLL-ADIM exercises (p<.017), but there was no significant difference between EO muscle activity for DLL and DLL-ADIM exercises (p>.017). Conclusion : DLL-belt is a more effective exercise for activating the abdominal muscles than DLL-ADIM exercise. Therefore, we recommend DLL-belt exercises for strengthening the abdominal muscles.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.4
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• pp.171-181
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• 2020

Purpose : The purpose of this study was to investigate the effects of curl-up and proprioceptive neuromuscular facilitation (PNF) neck flexion exercises on stroke patients' trunk muscle activity, ability to control the trunk, and balance by comparing two exercise methods. Methods : The study involved patients who had been diagnosed with stroke based on the results of computerized tomography or magnetic resonance imaging at O Hospital in Daegu, South Korea, between January and July 2020. In total, 30 subjects were selected and by flipping a coin, randomly assigned to an experimental group (n=15) that performed PNF neck flexion exercises and a control group (n=15) that performed curl-up exercises. Both groups received traditional rehabilitation therapy for 30 minutes a day five times a week for a six-week period. In addition, the experimental group performed PNF neck flexion exercises and the control group curl-up exercises for 15 minutes a day five times a week over the same period. The subjects' muscle activity in the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) were measured before and after the experiment. The subjects' trunk impairment scale (TIS) and Berg balance scale (BBS) scores were also assessed. Paired t test was performed to measure the amount of statistical change before and after intervention in both groups. An independent sample T test was performed to measure the amount of statistical change between the two groups. Results : Both groups experienced statistically significant increases in their RA, IO and EO muscle activity, total TIS scores, and total BBS scores after the intervention. No statistically significant differences in the changes before and after the intervention were found for any of the resulting values between the two groups. Conclusion : A comprehensive review of the study's results suggested that neck flexion exercises using the PNF irradiation concept and curl-up exercise are effective in increasing stroke patients' abdominal muscle activity and improving trunk control ability and balance in chronic stroke patients.

• Journal of The Korean Society of Integrative Medicine
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• v.10 no.1
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• pp.81-89
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• 2022

Purpose : Kegel exercises reported that it is effective in managing stress-related or complex urinary incontinence through contraction and relaxation of the pelvic floor muscles. In many previous studies, it was confirmed that Kegel exercise is involved in respiration as well as urinary system diseases. However, there is a lack of research on the effect of pelvic setting when performing Kegel exercises. Therefore, this study was conducted to investigate the effect on maximum voluntary ventilation (MVV) and abdominal muscle thickness through Kegel exercise after lumbar-pelvic motor control using pressure biofeedback unit (PBU). Methods : The subjects of this study were 10 healthy female students in their 20s. Subjects measured MVV with a spirometer. In hooklying, external oblique, internal oblique, and transverse abdominis of the dominant hand were measured using ultrasound. The measured value was an average of three times. After one week of intervention, measurements were made in the same manner. Before Kegel exercise, pelvic setting training was performed using PBU. In hooklying, PBU was placed in the waist and set to 40 mmHg, and it was adjusted to 60 mmHg through pelvic muscle contraction. For Kegel exercise, the pelvis was first set using PBU, and then the pelvic floor muscles were contracted for 8 seconds and relaxed for 8 seconds, 10 times, 1 set, and 3 sets. Results : In MVV, a significant difference was confirmed after exercise than before exercise (p<.05). There was also a significant difference in abdominal muscle thickness before and after exercise (p<.05). Conclusion : Based on the results of this study, Kegel exercise using PBU had an effect on MVV and abdominal muscle thickness. However, since this study was conducted without a control group as a preliminary study, additional research should be conducted to supplement this.

• 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 Rehabilitation Science
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• v.8 no.3
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• pp.162-169
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• 2019

Objective: The purpose of this study was to investigate the conditions for the application of various plank exercises to people who require trunk stabilization by comparing trunk muscle activity according to the degree of hip abduction in the plank exercise. Design: Cross-sectional study. Methods: Twenty healthy participants voluntarily participated in this study and the plank exercise was performed under 5 conditions (two-legged support plank [TSP] with hip abduction, TSP with hip abduction of 15 degrees, TSP with hip abduction of 30, one-legged support plank [OSP] with hip abduction of 15 degrees, OSP with hip abduction of 30 degrees). In order to measure the trunk muscle activity according to the 5 conditions, surface electromyography was used. The electrical activities of the rectus abdominis (RA), external oblique (EO), and internal oblique (IO) muscles were measured during the 5 plank exercises. Subjects practiced each of the 5 conditions three times in random order and the average values were obtained. Results: In the OSP condition with 15/30 degrees of hip abduction, activities of the RA, EO, and IO were significantly greater than during the TSP (p<0.05). In the OSP with 30 degrees of hip abduction condition, activities of the left EO, IO were significantly greater than other plank exercise conditions (p<0.05). Conclusions: The plank exercise with hip abduction of 30 degrees and the OSP exercise can be suggested as an effective method to enhance the activity of the trunk oblique muscles.

• Physical Therapy Rehabilitation Science
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• v.4 no.1
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• pp.44-48
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• 2015

Objective: The purpose of this study was to investigate the relationship between anticipatory postural adjustment (APA), single task, dual tasks and physical performances. The trunk muscles of APA consist of bilateral erector spinae (ES) and bilateral internal oblique (IO) adnominal muscles, during rapid stepping with the affected or unaffected leg in a sitting posture. Design: Cross-sectional study. Methods: In patients with chronic stroke, electrodes of surface electromyography (EMG) were attached on the bilateral erector spinae (ES), bilateral internal oblique adnominal (IO), and bilateral rectus femoris (RF) muscles. RF acts as the prime mover. The stroke patients performed hip flexion until $20^{\circ}$ as fast as possible at each leg in a sitting posture according to a visual cue. The visual cue unexpectedly appeared on monitor in front of the stroke patient. The single task was the Timed Up and Go (TUG) test. The dual tasks were the TUGconitive, which increased cognitive capacity, and the TUGmanual task, which had an external focus. Results: All EMG data showed earlier onset latency before the prime mover. In affected leg raising, the onset time of unaffected ES muscle of the stroke patients was correlated with the single and dual tasks (p<0.05). In unaffected leg raising, the onset time of the affected IO muscle was related to all the tasks (p<0.05). Gait speed showed a relationship with the unaffected ES muscle only. Conclusions: The trunk muscles of the bilateral ES and bilateral IO play an important role in APA. The single and dual tasks using TUG test were correlated with the APA s of ES and IO muscles. Dual task by the TUG test is a good measuring tool for reflecting the real life in patients with chronic stroke.