• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.394-399
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• 2020

Purpose: The aim of this study was to determine the effects of lower rib cage lateral expansion limitation on the maximal inspiratory and expiratory pressures and on abdominal muscle activity during maximal respiratory breathing in healthy subjects. Methods: Fifteen healthy male subjects voluntarily participated in this cross-sectional study. During maximal breathing, maximal inspiratory and expiratory pressures were measured, and abdominal muscle activity was determined with using surface electromyography. Also, the measurement was repeated with using a non-elastic belt to the lower rib cage for limiting of lateral expansion. A Wilcoxon signed-rank test was performed for obtaining the statistical difference with a significance level of 0.05. Results: The findings of this study are as follows: 1) There were no significant differences in maximal inspiratory and expiratory pressure with and without lower rib cage lateral expansion (p>0.05), 2) There was no significant difference in abdominal muscle activity during the maximal inspiratory phase (p>0.05). However, right external oblique muscle activity decreased significantly during maximum exhalation with lower rib expansion limitation (p<0.05). Conclusion: The results of the current study indicate that a non-elastic belt was effective in decreasing right external oblique muscle activity during forced expiratory breathing in healthy subjects.

• PNF and Movement
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• v.13 no.1
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• pp.25-30
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• 2015

Purpose: The aim of this study was to examine the effects of abdominal muscle contraction thickness using real-time ultrasound imaging while applying an abdominal draw-in maneuver (ADIM) and pelvic floor muscle contraction (PFC) to low back pain patients and healthy subjects. Methods: The subjects were 21 young adults; a group of 10 low back pain patients and a control group of 11 healthy subjects. Measurements were made with the subjects on a pillow in a supine position, with the knee joints flexed at 60 degrees. While the two groups conducted ADIM and PFC, their transverse abdominal muscle (TrA), internal abdominal oblique muscle (IO), and external abdominal oblique muscle (EO) thicknesses were measured using an ultrasound imaging system. Result: The TrA muscle contraction thickness ratio during PFC and ADIM was significantly lower in the low back pain group than in the healthy group (p<0.05). The EO muscle contraction thickness ratio during ADIM was also significantly lower in the low back pain group than in the healthy group. The healthy group's muscle contraction thickness ratio was significantly lower during PFC than during ADIM in the TrA, IO, and EO (p<0.05). The low back pain group's muscle contraction thickness ratio was lower during PFC than during ADIM in the TrA, IO, and EO, but the difference was not statistically significant. Conclusion: The results of this study indicate that oral direction during ADIM induced an appropriate contraction of the TrA. Therefore, the procedure reported here may be applied during rehabilitation for appropriate contraction of the TrA.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.319-327
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• 2012

Purpose : This study aimed to identify the asymmetry observed in the rehabilitative ultrasound imaging of lateral abdominal muscle thickness and performance between the affected and unaffected side during the abdominal drawing-in maneuver (ADIM), an exercise used to facilitate activation of selectively TrA to stabilize the trunk prior to limb movement. Methods : The Participants were twenty one patients with post-stroke hemiplegia in this study. Ultrasound imaging was used to measure amount of changes in thickness of the external oblique (EO), internal oblique (IO), transversus abdominis (TrA). A Paired t-test was used to compare relaxed muscle thickness to contracted muscle thickness of all 3 muscles between the affected and unaffected sides. Results : The outcome measures included side to side differences of absolute thickness, contraction ratio among the lateral abdominal muscles. There was no significantly difference in between the affected and unaffected side at rest. But, there was a significantly difference in absolute muscle thickness between the affected and unaffected side of only TrA muscle. Also contraction ratio was a significantly difference between the affected and unaffected TrA muscle. Conclusion : These findings support the asymmetrical activation of TrA muscle during abdominal muscle contraction in patients with post-stroke hemiplegia. Further studies are warranted for confirming this outcome.

• Physical Therapy Korea
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• v.18 no.3
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• pp.8-15
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• 2011

Abdominal muscle plays a crucial role in postural control and respiration control. However, thickness of abdominal muscle in the paretic side of a hemiplegic patient has not been reported in previous studies. The purpose of this research was to compare lateral abdominal muscle thickness between the nonparetic and paretic side in patients with chronic stroke using rehabilitative ultrasound imaging. Twenty two patients with chronic stroke participated in this study. Absolute thickness of transversus abdominis (TrA), internal oblique (IO) and external oblique (EO) was measured at the end of inspiration and expiration during quiet breathing, and relative thickness was calculated (thickness of each muscle as a percentage of total muscle thickness). Ultrasound imaging was recorded three times and the average value was determined for statistical analysis. Differences in absolute and relative lateral abdominal muscle thickness between the nonparetic and paretic side were assessed with paired t-tests. Absolute muscle thickness of the paretic side TrA was thinner than that of the nonparetic side at the end of inspiration and expiration during quiet breathing. Relative muscle thickness of the paretic side TrA was thinner than the paretic side only at the end of expiration during quiet breathing (p>.05). Therefore, it is necessary to strength TrA in patients with chronic stroke during physical therapy intervention. Further study is needed whether physical therapy intervension will induce TrA thickness in patients with chronic stroke in prospective study design.

• PNF and Movement
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• v.12 no.1
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• pp.39-43
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• 2014

Purpose: This study was to examine lateral abdominal muscle activation during maximum expiration exercise between healthy and chronic low back pain(CLBP) patients. Methods: The subjects were 16 CLBP patients and 16 healthy people between the ages of 22 and 53. The thickness of the abdominal muscles was measured using ultrasonography(LOGIQ Book XP, GE, USA). We instructed the subjects how to perform the exercises and measured changes in thickness of the transversus abdominis(TrA) and internal oblique(IO) muscles during the maximum expiration. The main outcome variables were the ratios of the TrA and IO thickness during the exercise versus in the relaxed position(TrA and IO activation ratios). Results: There were significant differences between CLBP patients and healthy subjects for TrA in the relaxed position. However there was no difference in the ratio of change in the muscle activity(TrA, IO). Conclusion: These findings, CLBP patients exhibited atrophy of the TrA muscle, but voluntary TrA muscle activation was similar to that of the normal subjects. Therefore, this exercise could be used during core strengthening in CLBP patients.

• PNF and Movement
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• v.17 no.1
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• pp.1-9
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• 2019

Purpose: This study investigates the effects of task-oriented training for a left trunk flexion pattern using real-time ultrasound imaging in a stroke patient with unilateral neglect symptoms. Methods: This study used the ABA experimental design, which is a single-subject research method among individual case research methods. For the ABA experimental design, changes in the degree of unilateral neglect, balance ability, and the thickness of the lateral abdominal muscle were visually analyzed during the baseline process, in the intervention period, and after the intervention. The experiments were performed 24 times in total for 8 times in each of the 3 periods. The unilateral neglect was measured using the Albert test, balance ability was measured using the Berg balance test, and the thickness of the lateral abdominal muscle was measured using ultrasound imaging. The subject was a 50-year-old male patient with unilateral neglect caused by right cerebral hemorrhage. He performed task-oriented training for a voluntary left trunk flexion pattern using real-time ultrasound imaging during the intervention period. Results: The result of comparing the data collected during the intervention period with the data point average of the baseline process showed that balance ability improved and the tendency line was above the baseline. The tendency line of unilateral neglect was below the baseline and showed a decreasing tendency. The thickness of the lateral abdominal muscle showed an increasing trend and the tendency line was above the baseline. Conclusion: The results of this study suggest that the task-oriented training for left trunk flexion pattern using real-time ultrasound imaging has a beneficial effect on balance ability, the degree of unilateral neglect, and the strength of the lateral abdominal muscle in unilateral neglect patients.

• Physical Therapy Rehabilitation Science
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• v.4 no.1
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• pp.11-16
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• 2015

Objective: Prone bridge exercise is one of the core strengthening exercise for improving abdominal, lower and upper extremity muscles. In addition, coactivation of the trunk muscles and extremities is important for treatment of low back pain. This study aimed to investigate the correlation between the thickness, cross-sectional area of the target muscle, and endurance during prone bridge exercise. Our hypothesis was that an increase in muscle thickness is positively related to the hold time for the static prone bridge exercise. Design: Cross-sectional study. Methods: Fourteen healthy university students (8 men and 6 women) voluntarily participated in the study at Sahmyook University. Hold time for the prone bridge with one and both legs was measured. The resting and contracted thickness of the lateral abdominal, rectus femoris, and triceps muscles was measured using rehabilitative ultrasound imaging. The correlation between muscle thickness and endurance for maintenance time was evaluated. Results: The prone bridge with both legs and the contraction thickness of the triceps muscle showed a positive correlation (r=0.692, p<0.05); the prone bridge with one leg and the contraction thickness of the internal oblique and transversus abdominis muscles showed a positive correlation (r=0.545, 0.574, p<0.05, 0.05, respectively). Conclusions: Endurance for the prone bridge exercise with a stable support surface is correlated with the contraction thickness of arm muscles; the prone bridge exercise with an unstable support surface is correlated with the contraction thickness of the deep abdominal muscles.

• PNF and Movement
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• v.16 no.2
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• pp.301-306
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• 2018

Purpose: This study aimed to describe and identify the relationship between gait and contracted ratios of the transverse abdominal (TrA), internal oblique (IO), and external oblique (EO) muscles. Methods: This study was conducted on 50 elderly people. The contracted ratios of the lateral abdominal muscles (LAM) were measured using the abdominal drawing-in maneuver (ADIM) and ultrasonographic imaging. Gait was measured using the timed up and go test and the 10 m walk test. Results: The contracted ratios of the TrA and IO muscles significantly increased after ADIM. Those of the TrA muscles showed a significant correlation with gait in the limited community ambulatory group. The contracted ratios of the IO and EO muscles showed a significant correlation with gait in the community ambulatory group. Conclusion: Our findings suggest a specific training on the relationship between gait speed and the activation of the LAM in elderly people.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.229-236
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• 2007

Purpose: Breast reconstruction with deep inferior epigastric perforator(DIEP) free flap is known to be the most advanced method of utilizing autologous tissue. The DIEP free flap method saves most of the rectus abdominis muscle as well as anterior rectus sheath. Therefore, the morbidity of the donor site is minimized and the risk of hernia is markedly decreased. Methods: We chose the internal mammary artery and its venae comitantes as recipient vessels, and deep inferior epigastric vessels as donor vessels. The number and location of the perforators derived from medial or lateral branch of deep inferior epigastric artery(DIEA) in 23 DIEP flaps were identified. Ten patients underwent evaluation of their abdominal wall function preoperatively and 6 months postoperatively by using Lacote's muscle grading system. Results: Of the 23 patients, a patient with one perforator from lateral branch of DIEA experienced partial necrosis of flap. Total flap loss occurred in one patient. Mild abdominal bulging was reported in one patient 4 months postoperatively probably because of early vigorous rehabilitational therapy for her frozen shoulder. Postoperative abdominal wall function tests in 10 patients showed almost complete recovery of muscle function upto their preoperative level of upper and lower rectus abdominis and external oblique muscle function at 6 months postoperatively. All patients have been able to resume their daily activities. Conclusion: The breast reconstruction with DIEP free flap is reliable and valuable method which provide ample soft tissue from abdomen without compromising the integrity of abdominal wall. Selection of reliable perforators is important and including more than two perforators may decrease fat necrosis and partial necrosis of flap.

• Journal of Yeungnam Medical Science
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• v.31 no.2
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• pp.139-143
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• 2014

Spontaneous intramuscular hematoma of the abdominal wall is a rare condition characterized by acute abdominal pain. It is often misdiagnosed as a surgical condition. It used to be associated with risk factors such as coughing, pregnancy, and anticoagulant therapy. Most cases of abdominal wall hematomas were rectus sheath hematomas caused by the rupture of either the superior or inferior epigastric artery, but spontaneous internal oblique hematoma was extremely rare. In this report, we present a case of spontaneous internal oblique hematoma in a 69-year-old man with non-dialysis chronic kidney disease who was taking cilostazol. The patient complained of abrupt abdominal pain with a painful palpable lateral abdominal mass while sleeping. The abdominal computed tomography showed an 8 cm-sized mass in the patient's left internal oblique muscle. The administration of cilostazol was immediately stopped, and the intramuscular hematoma of the lateral oblique muscle disappeared with conservative management.