• Journal of the Korean Society of Physical Medicine
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• v.10 no.4
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• pp.39-48
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• 2015

PURPOSE: This study aimed to compare the degree of lumbopelvic rotation during the active straight leg raise (ASLR) test in chronic low back pain with and without lumbar segmental instability. METHODS: A total of 71 patients with chronic low back pain were recruited for this study. The subjects who tested positive for more than three of the five lumbar segmental instability tests (prone lumbar instability, lumbar passive extension test, anterior posterior mobility test, passive straight leg raise, age) were categorized into the lumbar segmental instability positive group. Patients who tested positive for less than three of the five tests were categorized into the lumbar segmental instability negative group. The lumbopelvic rotation was measured three times during ASLR and a mean was determined. Subjective heaviness during the ASLR was measured on 6 point scale. RESULTS: There was a statistically significant difference in the lumbopelvic rotation angle between the groups with and without lumbar segmental instability (p<.01). There was no significant difference in the subjective heaviness during ASLR. The mean lumbopelvic rotation angle during ASLR was $13.54{\pm}2.86^{\circ}$, and $8.81{\pm}2.47^{\circ}$ in the positive and negative groups, respectively (p<.01). The cut-off value of the lumbopelvic rotation during was $10.5^{\circ}$, the sensitivity was 82.9%, and the specificity was 80.6%. CONCLUSION: These results suggest that lumbopelvic rotation is more prevalent in patients without lumbar segmental instability. Clinically, this important when diagnosing chronic low back pain with lumbar segmental instability, as the lumbopelvic rotation angle during the ASLR test can be used to aid in diagnosis.

• Physical Therapy Korea
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• v.23 no.1
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• pp.80-86
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• 2016

Background: Prone hip extension (PHE) can be performed to measure the lumbopelvic motor patterns and motions. Imbalances in lumbopelvic muscle activity and muscle weakness can result in instability including pain in lumbopelvic region. The posterior oblique sling (POS) muscles contribute to dynamic lumbopelvic stability. In addition, POS are anatomically aligned with the trapezius muscle group according to shoulder positions. Objects: This study compared the electromyography (EMG) activity of POS and pelvic compensations during PHE with and without pre-activation of lower trapezius muscle (lowT). Methods: Sixteen healthy males were recruited. PHE was performed in randomized order: PHE with and without lowT pre-activation. Surface EMG signals were recorded for biceps femoris (BF), gluteus maximus (GM) (ipsilateral), lumbar multifidus (MF) (bilateral), and the lowT (contralateral). An electromagnetic tracking motion analysis was used to measure the angle of pelvic rotation and anterior tilting. Results: The ipsilateral GM and bilateral MF EMG amplitudes were greater during PHE with lowT pre-activation compared to PHE without lowT pre-activation (p<.05). The BF amplitude during PHE without lowT pre-activation was significantly greater than that during PHE with lowT pre-activation (p<.05). The angles of pelvic rotation and anterior tilting during PHE with lowT pre-activation were significantly smaller compared to PHE without lowT pre-activation (p<.05). Conclusion: PHE with lowT pre-activation, which is aligned with the POS, showed more increased MF and GM muscular activity with smaller lumbopelvic compensations in rotation and anterior tilting compared to PHE without lowT pre-activation.

• Physical Therapy Korea
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• v.31 no.1
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• pp.79-88
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• 2024

Background: The abdominal drawing-in maneuver (ADIM), a method of lumbar stabilization training, is an effective neuromuscular intervention for lumbar instability associated with low back pain (LBP). Objects: The purpose of this study was to compare the effect of a 2-week period of the ADIM and tensor fasciae latae-iliotibial band (TFL-ITB) self-stretching on lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity during active prone hip lateral rotation. Methods: Twenty-two subjects with lumbar extension rotation syndrome accompanying shortened TFL-ITB (16 males and 6 females) were recruited for this study. The subjects were instructed how to perform ADIM training or ADIM training plus TFL-ITB self-stretching program at home for a 2-week period. A 3-dimensional ultrasonic motion analysis system was used to measure the lumbopelvic rotation angle and lumbopelvic rotation movement onset. An independent t-test was used to determine between-group differences for each outcome measure (lumbopelvic rotation angle, lumbopelvic rotation movement onset, TFL-ITB length, and pain intensity). Results: The results showed that ADIM training plus TFL-ITB self-stretching decreased the lumbopelvic rotation angle, delayed the lumbopelvic rotation movement onset, and elongated the TFL-ITB significantly more than did ADIM training alone. Pain intensity was lower in the ADIM training plus TFL-ITB self-stretching group than the ADIM training alone group; however, the difference was not significant. Conclusion: ADIM training plus TFL-ITB self-stretching performed for a 2-week period at home may be an effective treatment for modifying lumbopelvic motion and reducing LBP.

• Journal of the Korean Society of Physical Medicine
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• v.12 no.3
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• pp.1-10
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• 2017

PURPOSE: This study assessed the effect of the pelvic compression belt on the electromyographic activity of erector spinae (ES), internal oblique (IO), rectus femoris (RF), and biceps femoris (BF) after bridge exercise with pelvic belt compression in subjects with lumbar instability. METHODS: Forty subjects with lumbar instability volunteered for this study. We asked them to perform the bridge exercise while wearing a pelvic belt compression for 30 minutes five times weekly over a six week period. The pelvic compression belt was adjusted just below the anterior superior iliac spines with stabilizing pressure using elastic compression bands during bridge position. Surface electromyographic data were collected from the erector spinae (ES), internal oblique (IO), rectus femoris (RF) and biceps femoris (BF). RESULTS: After the six week intervention, the experimental group improved significantly. Muscle activation significantly decreased in the erector spinae, rectus femoris, and biceps femoris, and increased in the internal oblique muscle in bridge position while wearing a PCB (P <.01). CONCLUSION: Our findings suggest that the bridge exercise with pelvic belt compression is helpful to reduce activation in superficial muscles and lower extremity muscles such as erector spinae (ES), rectus femoris (RF), biceps femoris (BF) and increase activation in deep trunk muscle such as the internal oblique (IO).

• Physical Therapy Korea
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• v.26 no.4
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• pp.1-9
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• 2019

Background: Cervical dysfunction is a common pathomechanical marker in individuals with forward head posture (FHP). To overcome the limitations of the isometric chin-tuck (ICT) exercise, dynamic neuromuscular stabilization (DNS), which emphasizes an entire spinal chain exercise, has recently shown promising clinical results. Objects: Purpose of this study was to compare the immediate effects between ICT and DNS techniques. Methods: 43 young subjects (mean age, $24.0{\pm}5.0$ years) were recruited. Group of subjects with FHP were measured under baseline, ICT, and DNS conditions. Outcome measures included sitting height, longus colli (LC) and sternocleidomastoid (SCM) muscle thickness and LC/SCM thickness ratio. One-way repeated measures ANOVA was used to compare the continuous dependent variables among FHP, ICT, and DNS conditions at p<.016. Results: Both ICT and DNS exercise conditions yielded significantly increased LC muscle thickness, LC/SCM thickness ratio and sitting height than did FHP condition (p<.0001, respectively). Sitting height was significantly greater in DNS exercise than in the ICT exercise (p<.0001). Conclusion: The present results demonstrated that sitting height was greater in the DNS exercise than in the ICT exercise, as well as both corrective postural training exercises were effective on LC/SCM muscle balance ratio when compared with the baseline FHP condition. Therefore, it is considered that DNS exercise can be the recommended exercise for people with FHP.