• The Journal of Korean Physical Therapy
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• v.22 no.5
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• pp.39-47
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• 2010

Purpose: The purpose of this study was to characterize changes in back muscles in patients with chronic back pain. Accordingly, we studied 154 patients with chronic low back pain with regard to area, aspect and triggering position of the pain. We also determined muscle atrophy in painful areas. Methods: Subjects were questioned about pain and a pain provoking test was done. On Magnetic Resonance Imaging (MRI), we measured cross sections of the multifidus, erector spinae, iliopsoas and quadratus lumborum muscles at each spinal level. Results: Muscles in painful regions (multifidus and erector spinae muscles) decreased in area significantly more than nonpainful regions, and showed a significant difference (p<0.05) at levels L3, L4, and L5. Painful regions of the iliopsoas and quadratus lumborum did not change significantly more than non-painful regionsexcept at L5 (p<0.05). The group that had unilateral low back pain showed a significant decrease in cross section compared to the group that had central or bilateral pain (p<0.05). Conclusion: Chronic low back pain causes variable decreases in cross-sectional areas of some but not all back muscles, and at some but not all spinal levels.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.3
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• pp.1818-1822
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• 2019

Background: Ipsilateral pelvic elevation has been reported as a common compensatory movement during side-lying hip abduction. It has been reported that pelvic elevation inhibits sufficient contraction of gluteus medius. However, few studies have identified the effects of controlled pelvic elevation on the trunk and hip muscles. Objective: To examine the effects of controlled pelvic elevation using visual biofeedback on the muscle activity of the trunk and hip muscles. Design: Crossover study. Methods: Twelve healthy males performed side-lying hip abduction exercises with and without visual biofeedback for pelvic elevation. Electromyography (EMG) activities of the gluteus medius, quadratus lumborum, and multifidus were analyzed using a wireless EMG system while the ipsilateral pelvic elevation angle was measured using a motion sensor during side-lying hip abduction exercises. Results: EMG activities of the gluteus medius (p = .002), quadratus lumborum (p = .022), and multifidus (p = .020) were significantly increased and ipsilateral pelvic elevation was significantly decreased (p = .001) during side-lying hip abduction with visual biofeedback compared to without visual biofeedback. Conclusions: The results of this study suggest that the application of biofeedback for pelvic motion could improve the trunk and hip muscle activation pattern and decrease compensatory pelvic motion during side-lying hip abduction exercise.

• Physical Therapy Korea
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• v.18 no.1
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• pp.37-46
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• 2011

The purpose of this study was to investigate intra-rater reliability and determine the validity of electromyography (EMG) measurements to represent muscle activity and ultrasonography (US) to represent muscle thickness during manual muscle testing (MMT) to external abdominal oblique (EO) and lumbar multifidus (MF). Twenty healthy subjects were recruited for this study and asked to perform MMT at differing levels. The subjects' muscle activity using EMG was measured by a ratio to maximum voluntary contraction (MVC) and root mean square (RMS) methods. The subjects' muscle thickness using US was measured by raw muscle thickness and change ratio of thickness to maximum (MVC) or resting condition. In three trials, measurements were performed on each subject by one examiner. The intra-rater reliability of measurements of EMG and US to EO and MF was calculated using intra-class coefficients. The intra-rater reliability of all measurements was excellent (ICC=.75~.98) in EMG and US. The conduct validity was calculated by one-way ANOVA with repeated measurements to compare whether the EMG and US measurements were different between MMT at different levels. There was only a significant difference between all grades at %MVC thickness measurement of US. These results suggest that a %MVC thickness measurement of US was a more sensitive and discriminate in all manual muscle testing grades. This information will be useful for the selection of US measurement and analysis methods in clinics.

• Journal of Korea Society of Industrial Information Systems
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• v.6 no.3
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• pp.79-86
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• 2001

The CTD(Cumulative Trauma Disorder) as a new kind of occupational disease occurs mainly to workers on handling line under the highly-specialized industrial environments. This study took into account their exposure to Cumulative Trauma Disorders(CTD) by the utilization of EMG system, with respect to worker's muscle fatigue test according to fulfillment of iterative and simple task. The findings of this study were as follows : From the result of AEMG test analysis, worker's fatigue extent according to elapsed time of task was inclined to be increased continually. On the other hand, after its task ending, their fatigue extent was inclined to be decreased than before-circumstance of refractory brick lifting. The transference of MF(Median Frequency) and MPF(Mean Power Frequency) had highly significant difference between muscle fatigue and the elapsed time of work. Especially, their fatigue extent to erectorspinae and multifidus to lift firebrick was increased in the mean time. The transference of ZCR(Zero Crossing Rate) had considerable significant difference between muscle fatigue and the elapsed time of work. In short, as the work went of the muscle fatigue extent increased gradually. Thus, it can be concluded that the fatigue of erectorspinae and multifidus extent according to fulfillment of iterative and simple task is gradually being increased.

• Physical Therapy Korea
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• v.22 no.1
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• pp.93-102
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• 2015

Prolonged sitting can contribute to low back pain. The lumbar taping can be applied to correct the sitting posture. This study aimed to investigate the effect of lumbar taping on lumbar kinematics and the muscle activities of multifidus (MF) and internal oblique in the individuals with nonspecific chronic low back pain (NSCLBP) as they type for 30 minutes. Nineteen subjects with NSCLBP (9 people in non taping group and 10 people in taping group) were recruited. Lumbar taping was applied to the taping group before typing. Both groups started typing in a neutral sitting position with their feet on the floor. The change of posture and S2 posterior tilting (S2P) were measured to investigate kinematic data. Three sensors were attached on T12, L3, and S2 to identify the change of posture. Surface electromyography was used to measure the muscle activities. Palpation meter was used to standardize the angle of pelvic tilt in sagittal plane before typing. All instruments were used to measure each data before and after typing. Independent t-test was used to compare the changing values of lumbar kinematics and muscle activities before and after typing between both groups. The changing values of S2P and change of posture of L3 and S2 were significantly smaller in the taping group compared to the non taping group (p<.05). The changing value of muscle activities of MF between before and after typing was significantly smaller in the taping group compared to the non taping group (p<.05). In conclusion, the lumbar taping during the 30-minute typing task can be applied to maintain correct sitting posture in the lumbar and pelvis and to maintain activation of MF.

• Safety and Health at Work
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• v.7 no.1
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• pp.49-54
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• 2016

Background: Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods: Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results: Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values ($t_{(9)}=-11.97$ to -2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion: Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury.

• Journal of Korean Biological Nursing Science
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• v.24 no.1
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• pp.17-25
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• 2022

Purpose: To determine the prognostic role of muscle area and muscle radiation attenuation in the erector spinae (ES) and multifidus (MF) muscles in patients undergoing gastrectomy. Methods: Patients with stage I-III gastric cancer undergoing gastrectomy were retrospectively enrolled in this study. Clinicopathologic characteristics were collected and analyzed. Both paraspinal muscle index of ES/MF muscles (PMI_EM) and paraspinal muscle radiation attenuation in the same muscles (PMRA_EM) were analyzed at the 3rd lumbar level using axial computed tomographic images. Cox regression analysis was applied to estimate overall survival (OS) and disease-free survival (DFS). Results: There was only a weak correlation between PMI_EM and PMRA_EM (r= 0.28). Multivariate Cox regression revealed that PMRA_EM, but not PMI_EM, was an important determinant of survival. PMRA_EM along with age, tumor-node-metastasis (TNM) stage, perineural invasion, and serum albumin level were significant determinants of both OS and DFS that constituted Model 1. Harrell's concordance index and integrated area under receiver operating characteristic curve were greater for Model 1 than for Model 2 (consisting of the same covariates as Model 1 except PMRA_EM) or Model 3 (consisting of only TNM stage). Conclusion: PMRA_EM, but not PMIEM, was an important determinant of survival. Because there was only a weak correlation between PMI_EM and PMRA_EM in this study, it was presumed that they were mutually exclusive. Model 1 consisting of age, TNM stage, perineural invasion, serum albumin level, and PMRA_EM was greater than nested models (i.e., Model 2 or Model 3) in predicting survival outcomes.

• Journal of Korean Physical Therapy Science
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• v.28 no.3
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• pp.42-52
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• 2021

Background: The purpose of this study was to investigate the effects of the severity and direction of lumbar disc herniation (LDH) on the facet joints and paraspinal muscles. Design: Cross-sectional design. Methods: The subjects were divided according to the diagnosis for severity of unilateral herniation of L4-L5 disc. The groups consisted of disc protrusion group (n=15), disc extrusion group (n=15), and no disc herniation group (n=15). The asymmetry and angle of facet joints and the cross-sectional area of paraspinal muscles were analyzed and compared using magnetic resonance imaging (MRI). Results: The results showed that the angle of facet tropism was larger in disc extrusion group than the disc protrusion group and the difference was found to be significant difference (p<0.01). In addition, when both left and right angles of patients with unilateral disc herniation were measured, the results showed larger facet joint angle in the herniated area of the disc extrusion group than in the disc protrusion group. When paraspinal muscles were measured according to the severity of disc herniation and the degree of facet joint asymmetry, there was no difference in paraspinal muscles between the disc protrusion and disc extrusion groups. Meanwhile, the multifidus muscle was smaller in the group with facet tropism than the group without facet tropism (p<0.03), while there were no significant differences in the erector spinae and psoas muscles. Conclusion: Progression of disc herniation resulted in increased facet joint tropism, increased angle of the facet joints in the direction of disc herniation, and decreased size of the multifidus muscle.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.9 no.2
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• pp.31-38
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• 2011

Purpose : The purpose of this study was to compare the effects of different supporting surfaces on trunk muscle activities during core stabilization exercises. Methods : A total of 20 healthy college students participated in this study for 6 weeks. In this study, we divided participants into a stable surface exercise group and an unstable surface exercise group. Each group performed core stabilization exercises of Curl-ups, Bridges, and Quadrupedal position. Core stabilization exercises were performed 3 times a week for 30 minutes during 6 weeks. The stable surface exercise group used a yoga mat while the unstable surface exercise group used AERO step. This study was designed using pre-test and post-test measurements. We used Surface Electromyograpy (sEMG) to measure for the rectus abdominis, external abdominal oblique, and multifidus muscle of trunk muscle activities. Data was processed using a paired sample t-test on SPSS 18.0. Results : For the stable surface exercise group there was a meaningful improvement in left rectus abdominis, left external abdominal oblique, and right multifidus (p<0.05). For the unstable surface exercise group, a meaningful improvement was seen in the left external abdominal oblique and right multifidus. Conclusion : From the experiment, we concluded that differences in surface can make various degrees of improvement in muscles activities, which suggests patients can choose a better option under their own conditions when planning to have a core stability exercise.

• Journal of The Korean Society of Integrative Medicine
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• v.1 no.2
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• pp.67-80
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• 2013

Purpose : This study was to investigate effects of closed kinetic chain and open kinetic chain exercise on the lumbar stabilizarion. Methods : A total of 30 healthy over 20 years old college students(men = 14, women = 16) who were participated in this. We selected randomly people of CKC, OKC, and control group. For the past four weeks, CKC and OKC group worked out 3 times per week and then we compared within group and between groups on muscle width. Results : 1. The width of internal oblique, transverse abdominis, and multifidus were all significantly increased after four weeks exercise in the CKC group(P<.05). 2. The width of internal oblique, transverse abdominis, and multifidus were all increased after four weeks exercise in the OKC group but transverse abdominis musule only showed significant difference. 3. Difference values between pre-exercise and post-exercise of transverse abdominis and multifidus in the CKC group was significantly high and difference among the groups were significant. Conclusion : Accordingly, lumbar stabilizing exercise was more effective to increase a width of abdominal deep muscles through CKC exercise.