• PNF and Movement
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• v.10 no.2
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• pp.25-31
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• 2012

Purpose : The purpose of this study is to figure out the effects of Open Laser Microdiscectomy(OLM) on deep muscles by comparing multifidus and longissimus muscle size (cross section area; CSA) of pre and post operation. Methods : The subjects consisted of forty patients who had OLM. The data were analyzed with paired t-test comparing left and right deep muscle CSA of pre and post-operation, and both the deep muscle CSA of pre and post-operation, using SPSS ver. 15.0 program. Results : The results of this study showed a significant difference in deep muscle size (CSA) between pre and post operation (p<.05). Although there was not a meaningful difference between right and left deep muscle size (CSA) in pre operation (p>.05), there was a significant difference between both of them in post operation (p<.05). Conclusion : Therefore we made the conclusion that the operation causes decrease of muscle tone in deep muscles and muscle imbalance by causing muscle atrophy in the lumbar deep muscle after the operation.

• Physical Therapy Korea
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• v.11 no.4
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• pp.19-29
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• 2004

Many muscles of the trunk and hip are capable of contributing to the stabilization and protection of the lumbar spine. To have optimal effectiveness, a training program should include dynamic back/stomach/hip exercises. This study was designed to assess the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscle activities during various low back stabilization exercises. Participants were 26 healthy adults (13 males, 13 Females), aged 21 to 28 years. The surface electromyography (EMG) was recorded from the L5 level paraspinal, external abdominal oblique, and gluteus maximus muscles. The recorded signal was averaged and normalized to the maximal electromyographic amplitude obtained during the maximal voluntary contraction. The measurements were taken during 3 low back stabilization exercises. One-way analysis of variance with repeated measures was used to examine the difference, and a post hoc test was performed with least significant difference. A level of significance was set at p<.05. The significance of difference between men and women, and between the electromyographic recording sites was evaluated by an independent t-test. The EMG activity for the externus oblique and gluteus maximus muscles had significant differences among 3 exercises (p<.05). In males, the EMG activity for the external abdominal oblique muscle had significantly increased differences during exercises 1 and exercise 2 (p<.05). The gluteus maximus muscle had significantly increased differences during exercise 2 and exercise 3 (p<.05). In females, the multifidus muscle had significantly increased difference during exercise 3 (p<.05), the external abdominal oblique muscle had significantly increased difference during exercise 1 (p<.05). and the gluteus maximus muscle had significantly decreased difference during exercise 3 (p<.05). The results were that the external abdominal oblique muscle was apparently activated during the curl-up exercise in females and males, and the multifidus muscle was apparently activated during the bridging exercise in females and during the sling exercise in males and females.1)In comparison of the %MVC between males and females, exercise 2 and exercise 3 apparently activated of the multifidus and gluteus maximus muscles in both males and females (p<.05). The EMG activity of the gluteus maximus muscle of the males significantly increased during exercise 2 and exercise 3 (p<.05). The EMG activity the multifidus muscle of the females was significantly increased during exercise 2 and exercise 3 (p<.05). More research is needed to understand the nature of motor control problems in the deep muscles in patients with low back pain.

• Korean Security Journal
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• no.20
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• pp.71-93
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• 2009

The purpose of this study was to evaluate the effects of using spinal stabilization exercise for the improvement of atrophy of the multifidus and psoas major, of pain and disability with chronic low back pain in private guard and security. For 42 patients diagnosed with CLBP, and divided into spinal stabilization exercise group(SSEG) and general spinal strengthening exercise group(GSSEG). Each exercise was conducted for 10 weeks. Pain and disability were measured before and after exercise using the Visual analogue scale(VAS) and the Oswestry disability index(ODI). Cross section area(CSA) of both the left and right multifidus and the psoas major at the upper end plate of L4 were measured before and after exercise using computed tomography(CT). After 10 weeks of exercise, the both group's pain and lumbar disability were significantly decreased(p<0.01). Also there was significant difference in both group(p<0.05). In addition, the CSA of the left and right multifidus and posas major were significantly increased as compared to the pre-exercise in both group(p<0.01). But SSEG's cross sectional areas of multifidus was more significantly increase than GSSEG(p<0.05). In summary, Spinal stabilization exercise is more effective in improving atrophy in private guard and security patients, in reducing patients' pain and disability. It is an effective treatment to aid rehabilitation in these cases.

• Physical Therapy Korea
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• v.19 no.2
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• pp.29-38
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• 2012

This study aimed to identify the asymmetry observed in the electromyography (EMG) activity patterns of selected trunk and thigh muscles between the affected and unaffected sides during the sit-to-stand movement in ambulatory patients with post-stroke hemiparesis. This study included 20 patients with post-stroke hemiparesis. The differences between stroke fast walkers (${\geq}8m/s$, 11 subjects) and stroke slow walkers (<8 m/s, 9 subjects) were compared. The activation magnitude and onset time of the multifidus, lumbar erector spinae, hamstrings, and quadriceps during the sit-to-stand movement were recorded through surface EMG. Moreover, the EMG activation magnitude and onset time ratios of each bilateral corresponding muscle from the trunk and leg were measured by dividing the relevant values of the unaffected side by those of the affected side. In all the subjects, the activation magnitudes of the multifidus, hamstring, and quadriceps on the affected side significantly decreased compared to those on the unaffected side (p<.05). The onset time of muscle activity in the affected side was markedly delayed for the multifidus and quadriceps during the task (p<.05). The activation magnitude ratios of the quadriceps were markedly decreased in the stroke slow walkers as compared to those in the stroke fast walkers. These findings indicate that the asymmetry in the multifidus, hamstring, and quadriceps muscle activation patterns in patients with post-stroke hemiparesis may be due to the excessive muscle activation in the unaffected side to compensate for the weakened muscle activity in the affected side. Our findings may provide researchers and clinicians with information that can be useful in rehabilitation therapy.

• Journal of Korean Medicine Rehabilitation
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• v.32 no.1
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• pp.51-62
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• 2022

Objectives Objective of this study is to investigate the role of paraspinal muscles by examining the correlation between slip percentage (SP) of spondylolisthesis and fatty infiltration of lumbar paraspinal muscle. Methods Retrospective analysis was performed on 45 patients diagnosed with spondylolisthesis based on medical records. Using T2-weighted axial magnetic resonance imaging, cross-sectional areas (CSAs) of psoas major (PM), multifidus (MU) and erector spinae (ES) were calculated and divided by CSA of lower level vertebral body (VB). SP was measured using sagittal T2-weighted images. Correlation of SP with muscle relative cross-sectional area (RCSA) and muscle fatty infiltration by Goutallier classification was respectively analyzed using Spearman correlation. Statistic assessment conducted by Wilcoxon signed rank test and paired t-test using program GraphPad prism 5 (GraphPad Software, Inc., San Diego, CA, USA). Results Spondylolisthesis forward slip percentage by Taillard's method was negatively associated with both side MU RCSAs. No significant correlation was found between PM RCSA, ES RCSA and SP. Forward slippage was significantly correlated with fatty infiltration of lumbar paraspinal muscle measured by Goutallier classification. Conclusions This study is to understand the role of paraspinal muscle affecting spinal instability by investigating correlation between statistical deviation of lumbar muscle characters (RCSA, fatty infiltration of lumbar muscle) and SP. We found that spondylolisthesis SP is positively related to fatty infiltration of lumbar paraspinal muscle. and is negatively associated with both side MU RCSAs.

• Journal of the Korea Society of Computer and Information
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• v.16 no.2
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• pp.55-60
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• 2011

In this paper, we propose a new method for extracting muscles from lumbar images. The proposed method sets areas without distortions with field expert's assistance as areas of measuring interest and removing noises from initial ultrasonic videos. Then, the method emphasizes the brightness contrast with Ends-in search stretching algorithm and separate thoracic vertebra from subcutaneous fat area using morphological characteristics. 4-directions contour tracing algorithm is applied to extract the bottom of subcutaneous fat area. Extracting thoracic vertebra area requires noise removal and morphological characteristics as well among candidate areas obtained by controlling min-max brightness. The thickness of muscles is then defined as the length between subcutaneous fat area and extracted thoracic vertebra. The experiment which consists of 368 image analysis verifies that the proposed method is more effective in measuring the thickness of muscles than before.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.1
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• pp.35-49
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• 2014

Purpose : The purpose of this study was to find the effects of the lumbar stabilization exercise and strength exercise on pain, ROM, strength, muscle thickness of low back pain(LBP) patients. Method : The subjects were consisted of twelve patients who had nonspecific LBP. All subjects randomly assigned to lumbar stabilization exercise group(N=6) and strength exercise group(N=6). We measured muscular strength, ROM by using Tergumed-extension, rotation and muscle thickness by using ultrasonography and pain score by using Visual analog scale(VAS). The lumbar stabilization exercise group received TOGU exercise, strength exercise group received Tergumed exercise. The data analyzed by repeated measure of Independent t-test, paired t-test, reliability test. Result : The results were as follows. The result which measured of the change of pain score was a significant decrease. The result which measured of the change of ROM and strength was a significant increase. The result which measured of the change of the Internal abdominal oblique, External abdominal oblique on muscle thickness was a significant increase. Stabilization exercise group and Strength exercise group showed the significant difference in muscle thickness on Transversus abdominis, Multifidus. Stabilization exercise group was more increased in muscle thickness. Conclusion : Therefore, we suggest that stabilization exercise is effective for non-specific low back pain.

• 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.

• Proceedings of the Korea Multimedia Society Conference
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• 2012.05a
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• pp.1-3
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• 2012

본 논문에서는 요부 초음파 영상에서 다열근의 두께를 자동으로 측정하는 방법을 제안한다. 기존의 방법에서는 Valley Search 알고리즘을 적용하여 측정 기준 객체를 추출하고 다열근의 두께를 측정하였으나, 다열근의 형태학적 위치 정보를 반영하지 않았기 때문에 잘못된 측정 기준 객체를 추출하는 단점이 있다. 따라서 본 논문에서는 중앙 객체 탐색 알고리즘을 적용하여 측정 기준 객체를 추출하고 다열근의 두께를 자동으로 측정하는 방법을 제안한다. 제안된 방법을 획득한 요부 초음파 영상을 대상으로 실험한 결과, 기존의 방법보다 효율적으로 측정 기준 객체를 추출하고 다열근의 두께를 기존의 방법보다 정확히 측정하는 것을 확인할 수 있었다.

• Proceedings of the Korean Society of Computer Information Conference
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• 2010.07a
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• pp.413-416
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• 2010

본 논문에서는 요부 영상에서 근육을 추출하는 방법을 제안한다. 제안된 방법은 초음파 영상에서 왜곡이 존재하지 않는 영역을 측정 할 근육 영역을 설정한 후, 초기 초음파 영상에서 불필요한 잡음을 제거하고 Ends-in Search Stretching 기법을 적용하여 근육 영역의 명암 대비를 강조한다. 그리고 형태학적 특징을 이용하여 등뼈 영역과 피하지방을 분리한 후, 4 방향 윤곽선 추적 알고리즘을 적용하여 피하지방의 하단 부분을 추출한다. 또한 최대 및 최소 명암도를 조정하여 얻어진 등뼈의 후보 영역에서 형태학적 특징을 이용하여 잡음을 제거하고 최종적으로 등뼈 영역을 추출한다. 추출된 등뼈 영역에 대해 피하지방층과 등뼈 사이를 근육의 두께로 측정한다. 본 연구에서 제안된 방법을 요부의 초음파 영상에 적용하여 근육 영역을 추출한 결과, 제안된 방법이 초음파 영상에서 근육 영역들의 두께를 측정하는데 기존의 근육 측정 방법보다 효과적인 것을 확인 할 수 있었다.