• Physical Therapy Korea
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• v.22 no.1
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• pp.37-48
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• 2015

This study aimed to investigate the effect of the abdominal drawing-in maneuver (ADIM) and abdominal expansion maneuver (AEM) on trunk stabilization, as well as trunk muscle activities and differences in quadruple visual analogue scale, Korean Oswestry Disability Index, and Fear Avoidance Beliefs Questionnaire scores, in patients with chronic low back pain and lumbar spine instability. To increase intra-abdominal pressure during the trunk stabilization exercise, the technique of pushing the abdomen out using diaphragmatic abdominal breathing suggested by Pavel Koral was used, which we termed the AEM. Fifty patients who tested positive on more than three of the five lumbar spine instability tests were separated from 138 patients with chronic low back pain of these patients, 16 were placed in the control group (trunk stabilization exercise), 17 were placed in the ADIM group (trunk stabilization exercise with ADIM), and 17 were placed in the AEM group (trunk stabilization exercise with AEM). Each group participated in the study for 30 minutes three times weekly for 4 weeks. Surface electromyography was used to measure the trunk muscle activities during the kneeling forward and supine bridging positions, and one-way repeated analysis of variance was used to determine the statistical significance of the trunk muscle activities in the rectus abdominis, internal oblique (IO), erector spinae, and multifidus (MF) muscles. The ADIM and AEM groups showed relatively larger improvements in psychosocial and functional disability level than control group. There were significant changes among the three groups, those from the measured values of the AEM group was significantly higher than the other two groups in changes in IO and MF trunk muscle activities (p<.05). This finding demonstrates that trunk stabilization exercises with AEM is more effective than ADIM for increasing trunk deep muscle activity of chronic low back pain patients with lumbar spine instability.

• Physical Therapy Korea
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• v.21 no.2
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• pp.1-7
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• 2014

Lumbopelvic stabilization exercise has become the most popular treatment method in lumbar rehabilitation since its effectiveness was shown in some aspects of pain and disability. The abdominal drawing-in maneuver (ADIM) has been extensively implemented to promote lumbopelvic stability. However, performing ADIM correctly is difficult even for healthy subjects, and it is time consuming to train people in ADIM. Thus, the purpose of this study was to compare abdominal muscle [rectus abdominalis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO)] activity during lumbopelvic stabilization exercises (ADIM only, ADIM with a ball, maximum exhalation only, and maximum exhalation with a ball) performed in a supine position with feet against a wall. Fifteen healthy subjects were recruited for this study. Surface electromyography was used to measure abdominal muscle activity during lumbopelvic stabilization exercises. A one-way repeated-measures analysis of variance was used to determine the statistical significance of RA, EO, and TrA/IO muscle activity during four lumbopelvic stabilization exercises. Both-side TrA/IO muscle activity was significantly greater with maximum exhalation with a ball than with ADIM only or ADIM with a ball (p<.008). The results of this study suggest that maximum exhalation with a ball can be used as an effective lumbopelvic stabilization exercise to increase TrA/IO muscle activity in healthy subjects.

• 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.

• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.17-23
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• 2010

Purpose: The purpose of this study was to compare the effects, in elderly women, of (a) physical therapy with (b) individual and group lumbar muscle exercise Methods: Forty-two elderly women took part in this study. Their average age was 52.59 years. All subjects participated in the study for 8 weeks, doing exercises 3 days per week. All participants were assessed on the Oswestry disability index (ODI), Gaitview. The data were analyzed using paired t-tests. Results: Foot pressure and ODI scores showed statistically significant pre- to post-exercise differences for both groups. We also found significant differences between group therapy and individual therapy. There were changes in mean ODI scores, but these were not significant. Conclusion: Eight weeks participation in an was found to be effective in improving the health of older women. Individual therapy with a physical therapist is more effective than group therapy in creating harmonious movement of the lower extremity and lumbar stability. The results of our study suggests the benefit of an exercise program with a physical therapist.

• The Journal of Korean Physical Therapy
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• v.22 no.3
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• pp.9-15
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• 2010

Purpose: To evaluate, in patients with degenerative disc disease (DDD), the efficacy of using spinal stabilizing exercises for the reversal? of atrophy of the multifidus and psoas major, reductions in pain and disability, and for increases in paraspinal muscle strength. Methods: Nineteen patients diagnosed with DDD participated for 10 weeks in a spinal stabilization exercise program. Pain and disability were measured before and after exercise using, respectively, a visual analogue scale (VAS) and the Oswestry Disability Index (ODI). Paraspinal muscular strength in four directions was evaluated using CENTAUR. Both before and after exercise we used computed tomography (CT) too measure cross-sectional areas (CSAs) of both the left and right multifidus and the psoas major at the upper & lower endplate of L4. Results: After 10 weeks of a spinal stabilization exercise program, pain was significantly decreased from $5.7{\pm}0.9$ to $2.5{\pm}0.9$ (p<0.01); the ODI score decreased from $16.7{\pm}4.9$ to $7.3{\pm}3.1$. Paraspinal muscle strength was significantly increased (p<0.01) and the CSAs of the left and right multifidus and psoas major muscles were significantly increased (p<0.01). Conclusion: Spinal stabilization exercise is effective in reversing atrophy in DDD patients, in reducing pain and disability, and in increasing paraspinal muscle strength. It is an effective treatment foro aiding rehabilitation in these cases.

• Journal of Korean Physical Therapy Science
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• v.14 no.1_4
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• pp.1-10
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• 2007

The purpose of this study was to find the effects of the lumbar stabilizing exercise on the isometric lumbar extension strength and the range of motion of lumbar extension. 16 healthy subjects were recruited (9 males, 7 females, mean age 25${\pm}$3.2). They performed 5 types of exercises 5 times per week for 4 weeks. We evaluated isometric trunk extension strength (0, 12, 24, 36, 48, 60, $72^{\circ}$) by MedX(Ocala, FL) and measured range of motion of lumbar extension. All measurements were measured at pre-exercise and 4 weeks post-exercise. The results of this study were summarized as follows; After 4 weeks of exercise, isometric lumbar extension strength was generally increased but there were only significant differences at $12^{\circ},\;24^{\circ},\;48^{\circ}$. The range of motion of lumbar extension was increased (p<.05). The isometric lumbar extension strength correlated with the range of motion of lumbar extension. In conclusion, our results have shown that lumbar stabilizing exercise influenced both lumbar extension strength and range of motion of lumbar extension.

• Journal of Korean Physical Therapy Science
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• v.7 no.2
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• pp.415-425
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• 2000

It is well known that the lifetime incidence of low back pain is extraordinarily high, but those who incur the majority of the cost, both personally and financially, are the chronic pain. Stabilization programmers attracted our interest, with their aims of using the muscle system to protect spinal joint structures from further repetitive microtrauma, recurrent pain and degerative change. In overviewing the stabilizing role of the trunk and back mucles our attention became focused on muscles which controlled the lumbar and lumbosacral joints rather than on muscles which span the spine from the thorax to pelvis. It was considered that muscles such as the lumbar multifidus, transversus abdominis, and possibly also parts of the obliquus internus abdominis, would most likely function to stabilize the segments of the lumbar spine. In order to check if these muscles were functioning in low back pain patients, it was necessary to devise specific muscle tests. The new concept involves exercises using only relatively low activity levels in the muscles. More emphasis is placed on a motor skill which has to be relearned, practised and then gradully incorporated back into functional movement.

• Physical Therapy Rehabilitation Science
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• v.9 no.3
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• pp.184-190
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• 2020

Objective: Patients with low back pain can possibly have impaired core muscle function, which is the common cause of low back pain. Spinal stabilization exercises are recommended for prevention and reinforcement. This study aimed to compare the effects of different types of feedback on abdominal and lumbar multifidus (LM) muscle recruitment during spinal stabilization exercises. Design: Cross-sectional study. Methods: Fifty-seven healthy subjects (sex=male 21/female 36, age=21.28±1.60 years) were divided into three different groups: the control group (n=19), the auditory feedback (AF) group (n=19), and the visual and auditory feedback (VAF) group (n=19). The control group received no feedback, whereas the AF group only received AF during exercises and the VAF group received the AF and visual feedback through the real-time ultrasound images. The main outcome measure was the assessment of the thickness of the abdominal muscles and LM measured by a dual ultrasound. Results: When VAF was applied, the thickness of the transverse abdominis significantly increased rather than when feedback was not applied or with AF only (p<0.05). The VAF group showed significant differences in both the control group and the AF group in the post-hoc test (p<0.05), and there was no significant difference between the control group and the AF group. Conclusions: With spinal stabilization exercises, VAF should be applied in standing posture for healthy adults to further promote the production of effective contractions.

• The Journal of the Korea Contents Association
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• v.20 no.9
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• pp.486-493
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• 2020

The purpose of this study was to identify the effects of an exercise program for lumbar stabilization on static and dynamic balancing and gait of stroke patients. The subjects were 27 stroke patients, who were divided into an experimental group(n=14) and a control group(n=13). The exercise was conducted for 30 minutes a day, four times a week, and for six weeks. The variables included static and dynamic standing balance and gait, which were verified before and after the lumbar stabilization exercise. Using the IBM SPSS(19.0 version), data were analyzed with t-test and two-way ANOVA to validate the differences before and after the experiment and between the groups. The significance level was set at α = .05 and the results of this study are as follows. First, statistically significant differences were found in the static standing balance after the exercise (P< .05). Second, there were statistically significant differences in the dynamic standing balance after the exercise (P< .05). Third, statistically significant differences were found in the gait of the patients after the exercise (P< .05). In addition, the interactions between the two groups showed significant differences. These results suggest that stroke patients need a variety of lumbar exercises and that the lumbar stabilization exercise can improve physical treatment and health of the patients, having positive effects on their quality of life. Further studies are necessary to explore the applications of various lumber exercises.

• Physical Therapy Korea
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• v.25 no.1
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• pp.1-11
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• 2018

Background: The continuous co-contraction of the trunk muscles through trunk stabilization exercises is important to patients with lumbar spinal stenosis (LSS). However, intentional abdominal muscle contraction (IAMC) for trunk stabilization has been used only for specific training in the treatment room. Objects: The purpose of this study was to provide feedback to adults with LSS to enable IAMC during activities of daily living (ADLs). Methods: The participants with spinal stenosis were divided into an experimental group of 15 adults and a control group of 16 adults. Electromyographic signals were measured while the subjects kept their both hands held up at $90^{\circ}$. The measured muscles were the rectus abdominis (RA), external oblique (EO), internal oblique (IO), and erector spinae (ES). Pelvic tilt was measured using a digital pelvic inclinometer. The degree of pain was measured using the visual analogue scale (VAS) and functional capacity was measured using the Korean version of the Oswestry disability index (KODI). Results: While the experimental group showed statistically significantly higher activities in the RA, EO, and IO after the intervention compared with the control group. Pelvic tilt was significantly decreased only in the experimental group. Both the experimental and control groups exhibited statistically significant declines in the VAS and KODI (p<.01). In terms of the levels of changes, the experimental group exhibited a statistically significant larger decline only in the VAS and the pelvic tilt when compared with the control group (p<.05). Conclusions: The subjects could stabilize their trunks, and relieve their pain and dysfunctions and reduce pelvic tilt by learning abdominal muscle contraction during ADLs. The combination of therapeutic exercises and IAMC may have greater effects on patients with LSS.