• Physical Therapy Rehabilitation Science
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• v.5 no.3
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• pp.113-119
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• 2016

Objective: The effect of abdominal expansion maneuver (AEM) and abdominal draw-in maneuver (ADIM) on postural control in an unsupported position in stroke patients. Design: Randomized controlled trial. Methods: A total of 36 persons with hemiplegic stroke participated in this study. The subjects were randomly divided into an AEM experimental group (n=12), an experimental ADIM group (n=12), and a control group (n=12). We collected the general characteristics of all subjects and the pre-test results before the intervention and after 4 weeks of the intervention. The trunk stabilization training of the ADIM and AEM group were performed 15 minutes a day, 3 times a week for 4 weeks, and general physical therapy was performed 2 times a day, 30 minutes per session, 5 times a week for all three groups. The control group received joint mobilizations, muscle strengthening, endurance strengthening, and gait exercises along with treatment of the central nervous system, such as neuro-developmental treatment, mat, and gait training. The AEM is an inspiratory phase of tidal breathing expanding the lateral lower ribcage in a lateral direction with minimal superior movements of the chest. Then the lower abdomen expands and the navel moves in an anterior-caudal direction. The ADIM is a repeated contraction and relaxation of the anal sphincter during inspiration. The navel pulls the lower abdomen to the direction of the spine without the movement of the trunk and pelvis. Results: Before and after the interventions, medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area 95% was a statistically significant change in all three groups (p<0.05). The post-hoc test showed a significant improvement in medial-lateral axis movement distance, anterior-posterior axis movement distance, sway mean velocity, and sway area in the AEM group compared with the control group, and in the ADIM group compared with the control group (p<0.05). Conclusions: In conclusion, both AEM training and ADIM training are necessary interventions to maintain the independent sitting position according to the characteristics of the patient.

• 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.

• Journal of Korean Physical Therapy Science
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• v.26 no.1
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• pp.15-21
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• 2019

Background: The purpose of this study was to the effects of stretching on lumbar flexibility after lumbar and lower muscle strengthening exercise. Design: Randomized Controlled Trial. Methods: 24 subjects without back pain in their twenties were divided into 12 experimental groups and 12 control groups. The experimental group performed a stretching program after muscle strength exercise. In the control group, only muscle strength exercise was performed, and total exercise was performed 24 times a week for 8 weeks to compare and analyze before and after experiment. Results: The results of this study are as follows: 1) There was no statistically significant difference in both before and after weight of experimental group and control group. 2) There was no statistically significant difference in both before and after skeletal muscle levels of experimental group and control group. 3) There was no statistically significant difference in both before and after fat mass of experimental group and control group. 4) There was a statistically significant difference in both before and after trunk forward flexion of experimental group and control group. Conclusion: This research showed a positive affect on increasing flexibility, which is expected to have a great effect on improvement of flexibility in the future.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.4
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• pp.647-653
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• 2013

PURPOSE: The purpose of this study was to compare the lower extremities muscle activation between squatting exercise with gym ball and wall for improving muscle strengthening in lower extremities. METHODS: Participants were 21 university students (males 10, females 11) who didn't have any problem with orthopedic surgery. Participants performed squatting exercise with gym ball and wall. Squatting exercise with gym ball were performed using by gym ball behind back, and the gym ball were fixed in back and wall. We asked participants to push back the gym ball slightly to prevent fall of ball. Wall squatting exercise, we ask participants to contact their back in wall slightly in order to prevent trunk flexion during performed squatting exercise. Each squatting exercise had performed until knee joint were flexed at 60 degree, and maintained five seconds. We collected data from E.M.G of Biceps femoris, Gastrocnemius, Vastus medialis and lateralis, Tibialis anterior of lower extremity in isometric phase of knee joint angle 60 degree of each squatting exercise. We analysed data using by ANOVA and independent t-test of SPSS PC ver.20.0 in order to compare the muscle activation between squatting exercise with gym ball and wall. RESULT: All of lower extremities muscle activation showed more higher value in squatting exercise with gym ball than squatting exercise with wall, especially there was significantly difference of muscle activation in vastus medialis, tibialis anterior between squatting exercise with gymball and with wall. CONCLUSION: On comprehensively considering the results of the present study, we suggested that squatting exercise with gym ball was more effective method improving lower extremity muscle strengthening.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.24 no.2
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• pp.17-27
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• 2018

Background: This study investigated the effects of pelvic floor stabilization exercise of pain, disfunction, psychosocial, electromyography (EMG) activity on the lower back pain with postpartum. Methods: The study included 20 postpartum women who were randomly assigned to a sling exercise group (SEG, n=10) or a general physical therapy group (GPTG, n=10). Outcomes were assessed using to lower back pain with postpartum the quadruple visual analogue scale (QVAS), the Korean version of the Oswestry disability index (KODI), the fear avoidance belief questionnaire (FABQ), the inventory of functional status after childbirth (IFSAC), the edinburgh postnatal depression scale-Korean (EPDS-K), and trunk muscle activity before and after a 4-week exercise intervention. Statistical analysis were performed using a mean, standard deviation, crosstab test, paired t-test, independent t-test. Kolmogorove-Smirnov test was used for test of normality. Results: Compared to the GPTG, the SEG showed significant improvement in the QVAS, KODI, FABQ, IFSAC, and EPDK-K scores (p<.05) after 4 weeks. Conclusion: Postpartum pelvic strengthening exercise proved to have a positive effect.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.39-47
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• 2018

PURPOSE: The purpose of this investigation was to conduct a systemic review of studies that examine the effects of strengthening exercise on gait ability and GMFM in children with cerebral palsy and propose a standard for cerebral palsy therapy based on a meta-analysis of the studies. METHODS: An extensive literature search was conducted using databases including the KISS (Korean studies Information Service System), RISS, DBpia, PubMed and ScienceDirect, with the following search terms: 'Strengthening Exercise,' 'Resistance Exercise,' 'Gait ability,' 'GMFM' or 'cerebral palsy'. RESULTS: Eleven studies were included in this review and the duration of the intervention varied from 5 to 24 weeks. The number of application per week was mostly 2-3 times, while 5 intervention per week was adopted in a few cases. The total number of intervention applied varied from 18 to 36 and the respective effect sizes of GMFM on crawling and sitting were very high (1.075 and .881) while those of GMFM on standing and walking were very low(.206 and .125). The effect size was for gait speed was only .221. CONCLUSION: Trunk exercise and lower limb exercise effectively improved GMFM in children with cerebral palsy, resulting in improved outcomes in sitting and crawling. The results of this study will be useful for designing evidencebased cerebral palsy therapy programs.

• Journal of the Korean Society of Physical Medicine
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• v.9 no.3
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• pp.249-253
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• 2014

PURPOSE: This study intends to examine the effects of change of anatomical position of the ankle joint in open kinematic chain, an appropriate position for selective muscle training, on vastus lateralis obliques, rectus femoris, vastus medilais obliques, and rectus abdominalis muscle activation and to present an effective method of muscle training for patients and normal people. METHODS: The participants of this study were Korean healthy adult in their 20s. The 8 channel surface electromyography was used to measure muscle activation while the subjects raised their legs under each condition. Under each condition, while the subjects raised the leg to hip joint flexion at $60^{\circ}$ along the arch. RESULTS: The analysis result of muscle activation by each section and position during leg rising. There were significant differences. CONCLUSION: For independent strengthening of each muscle, muscle activation was measured according to leg raising angles and the result differed according to each section and position. If this study result is applied to muscle training for patients who need selective muscle training, more effective muscle strengthening will be made possible.

• The Journal of Korean Physical Therapy
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• v.16 no.4
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• pp.38-58
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• 2004

The regain of independent ambulatory ability is a important goal in the rehabilitation program of hemiplegic patient. Not only the function of lower extremity muscles, but also trunk muscles which stabilize extremities and pelvis, are important factors in normal gait. Therefor, it is necessary to develop an effective program which can improve muscle strength and symmetric activity of trunk muscles. The purpose of this study was to evaluate the influence of trunk muscle strengthening by forceful respiratory exercise on the gait asymmetry ratio in hemiplegic patient. 45 Hemiplegic patients due to stroke was randomized in 3 groups, forceful expiratory training(FET), forceful inspiratory training(FIT) and control group. In the experimental groups, ordinary physical therapy with forceful expiratory training and forceful inspiratory training for 20 minutes duration 3 times per week for 6 weeks were respectively performed. In the control group, only ordinary physical therapy was done. Before and after experiments, temporal-spatial gait parameters was measured in all patients. The data of 28 patients who carried out the whole experimental course were statistically analysed. The results of these experiment are as follows : 1. In comparison of difference of single support time asymmetry ratio among 3 groups, the FET group was significantly decreased than the control group (p<.05). 2. In comparison of difference of step length asymmetry ratio among 3 groups, the FIT group was significantly decreased than the control group (p<.05). Based on these results, it is concluded that the forced respiratory exercise program for 6 weeks can be improve the gait asymmetry ratio in hemiplegic patients. Therefore, the forced respiratory exercise is useful to improve the walking ability in hemiplegic patients. Since this study dealt only with the patients who could walk more than 3 meters in distance on floor independently, the further study for evaluating the influence of the forceful respiratory exercise on patients with acute stage stroke and also the development in various methods of use are expected.

• The Journal of Korean Physical Therapy
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• v.25 no.2
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• pp.103-109
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• 2013

Purpose: This study was conducted in order to suggest an effective method of daily life movement training for stroke patients by comparison and analysis of the biomechanic characteristics of sitting up from a lying posture in stroke patients and healthy elderly participants. Methods: Fifteen stroke patients and 15 age-matched elderly participants were included in the study. The movement of sitting up from a lying posture was divided into three stages, and the differences in muscle activity in the sternocleidomastoid (SCM), rectus abdominis (RA), external oblique (EO), and rectus femoris (RF) during the movement were analyzed. Results: Subjects in the experimental group showed slower speed than those in the control group. In the neck joint, the change of angle in movement showed a larger decrease at all stages in the experimental group than in the control group; the movement also decreased in stages I and II in the upper trunk joint. The movement also showed a statistically significant decrease in stage II in the lower trunk, pelvic, and hip joints. The SCM showed higher activity in the control group than in the experimental group, showing a statistically significant difference; the RA showed high activity in the experimental group. The RF showed higher activity in the control group than in the experimental group, showing a statistically significant difference. Conclusion: From the results obtained above, increasing movements in the neck, pelvic, and hip joints and strengthening of lower body muscles are required in order to improve the ability for getting up from a lying posture in stroke patients.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.205-211
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• 2021

Objective: This study aimed to identify the effects of assuming different knee angles and hip abduction during bridge exercise and hip thrust exercise on lower body muscle activity. Design: Cross-sectional study Methods: Thirty-three healthy adults (18 men and 15 women) were instructed to perform the bridge and hip thrust exercises while randomly assuming 120°, 90° and 60° of knee flexion and 0° and 30° of hip abduction. EMG data (%maximum voluntary isometric contraction) were recorded three times from the erector spinae (ES), gluteus maximus (GM) and biceps femoris (BF) muscles of participant's dominant side and the mean values were analyzed. Results: The results showed that, during the hip thrust compared to the bridge exercise, there was significantly greater gluteus maximus muscle activity in all hip conditions while the biceps femoris activity was significantly less, and the erector spinae muscle activity was significantly greater with 30° of hip abduction (p<0.05). With all exercises, the erector spinae and the biceps femoris exhibited significantly greater muscle activity with 60° of knee flexion compared to 90° and 120° of knee flexion (p<0.05), and significantly greater muscle activity with 90° compared to 120° of knee flexion (p<0.05). In the case of the gluteus maximus, greater muscle activity was exhibited with 120° compared to 60° of knee flexion with all hip abduction conditions (p<0.05). Conclusions: It was effective for muscle activation of main agonists such as the gluteus maximus and erector spinae during thrust exercise, and the change in knee flexion angle was effective for muscle activation of the gluteus maximus. Therefore, it is considered that this study can be used as a selective indicator of the target movement angle during hip strengthening exercise for specific muscles.