• The Journal of Korean Physical Therapy
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• v.33 no.1
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• pp.47-52
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• 2021

Purpose: Biofeedback using various ways has helped correct the sitting posture. This study compared the multifidus muscle activity, pelvic and 2nd sacrum tilting angle during typing in nonspecific lower back pain (NCLBP) subjects with and without visual biofeedback. Methods: Thirty subjects with NCLBP were enrolled in this study. An electromyography device was used to measure the multifidus muscle activity. An electromagnetic tracking motion device was used to measure the pelvic and 2nd sacrum tilting angle. The multifidus muscle activity, pelvic, and 2nd sacrum tilting angle were measured before and after typing for 30 minutes in the sitting position. An independent t-test was used to compare the changing values for 30 minutes between the group with and without visual biofeedback. Results: The changing values of the multifidus muscle activity, pelvic, and 2nd sacrum tilting angle were significantly smaller in the group with visual biofeedback than the group without visual biofeedback (p<0.05). Conclusions: In subjects with NCLBP, the visual biofeedback can be recommended to maintain the multifidus muscle activity, pelvic, and 2nd sacrum tilting angle during typing for 30 minutes.

• The Journal of Korean Physical Therapy
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• v.23 no.6
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• pp.9-14
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• 2011

Purpose: The pelvic tilting exercise is a well recognized rehabilitation maneuver. However, little information is available on the changes of lumbar segmental motion during pelvic tilting. This study was conducted to measure the kinematics of the pelvic tilting exercise on the supine and prone positions via fluoroscopy. Methods: A total of 10 female subjects were enrolled. During anterior, neutral, and posterior pelvic tilting, radiographs were taken in each exercise via fluoroscopy (ARCADIS Orbic, Siemens, USA). Images were sent to the picture archiving communication system (PACS), and the digitized images were analyzed using LabVIEW software (National Instruments, USA). Lumbosacral lordosis and the intervertebral body angle, intervertebral disc angle, and intervertebral displacement were analyzed. Results: The results of lumbar kinematic analysis during three tilting postures in the supine and prone positions demonstrated that lumbosacral lordosis and the intervertebral body angle and intervertebral disc angle were significantly higher when the pelvis was tilted anteriorly (p>0.05). However, there was no significant difference between anterior and neutral tilting in the intervertebral disc angle at the L3/4 level in the prone position (p>0.05), and there was no significant difference among tilting positions in intervertebral body displacement in the prone position (p>0.05). Conclusion: This study provides scientific evidence about the pelvic tilting exercise in lumbosacral segmental motion. Depending on the pelvic tilting exercise, kinematic changes were demonstrated in both positions, especially in the supine position. It is suggested that the supine position is effective for mobility, but it should be used carefully for the LBP (Low back pain) patient with hypermobility.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.259-268
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• 2022

Objective: The purpose of this study was to measure the immediate effect of hip hinge exercise stretching on hamstring flexibility, pelvic tilting angle, proprioception, and dynamic balance in individual with tightness of the hamstring. Design: A randomized controlled trial. Methods: A total of 35 healthy young adults (27 males, 8 females) volunteered for this study and randomly divided into three groups (Hip hinge exercise stretching group, passive stretching group, and PNF stretching group). The hamstring flexibility, pelvic tilting angle, knee joint proprioception, dynamic balance was conducted for 3 times. In order to evaluate the hamstring flexibility, the active knee extension test was performed. Forward bending test was performed to examine pelvic tilting angle.The proprioception was tested by the joint position sense test and dynamic balance was evaluated by Y balance test. Results: The hamstring flexibility, pelvic tilting angle and dynamic balance were significantly improved between three groups before and after intervention (p<0.05). Dynamic balance was significantly difference between the three groups in the posterolateral direction (p<0.05). Conclusions: This study result showed that hip hinge exercise stretching was the most effective method for increasing hamstring flexibility, pelvic tilting angle and dynamic balance. In addition, it is necessary to study whether hamstring stretching is effective in low back pain patient with hamstrings tightness.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.35-39
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• 2019

Purpose: The purpose of this study was to assess the intra-rater and inter-rater reliability and validity of pelvic tilting angle measurements using a smart phone-based inclinometer (Clino) compared to a palpation meter (PALM) in the standing and sitting position. This study used an interchangeable method with Clino to measure the pelvic tilting angle in the standing and sitting positions. Methods: Twenty healthy subjects were recruited. Measurements of the pelvic tilting angle in the standing and sitting positions were obtained by two examiners using the Clino and PALM. A resting session was conducted 10 minutes later to assess the intra and inter rater reliability. To assess validity of the measurement using Clino, a PALM was used as the gold standard. The intra-class correlation coefficient (ICC) was used to determine the intra and inter rater reliability of Clino and a PALM. To assess the validity, the Pearson correlation coefficients were used for two measurement techniques to measure the pelvic tilting angle in the standing and sitting positions. The statistical significance was set to ${\alpha}=0.05$. Results: Measurements of the pelvic tilt had high inter-rater reliability in the standing (ICC=0.82) and sitting (ICC=0.88) positions using Clino and intra-rater reliability in the standing (ICC=0.87) and sitting (ICC=0.91) positions using Clino. Measurements of the pelvic tilt had high validity by a comparison of PALM and Clino in the standing (r=0.83) and sitting (r=0.89) positions (p<0.05). Conclusion: The use of Clino can be recommended as a tool to replace the PALM and measure the pelvic tilt angle in the standing and sitting positions while maintaining the clinical reliability and validity.

• The Journal of Korean Physical Therapy
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• v.15 no.3
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• pp.45-64
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• 2003

The purpose of this study was to examine the effects of the pelvic tilting exercise, pelvic tilting exercises with floor walking training, pelvic tilting exercises with treadmill walking training on quantitative gait function in patients with hemiplegia. Thirty patients with hemiplegia due to cerebrovascular disease participated in this study. Subjects were randomly assigned to one of pelvic tilting exercise group, pelvic tilting exercise with floor walking training group and pelvic tilting exercises with treadmill walking training group. The effects of each therapeutic method were evaluated by measurements of gait velocity, cadence, stride length, step length, base of support and foot angle using ink-foot prints. Data were analyzed statistically using paired t-test and one-way ANOVA. The results of this research are as followings : 1. After treatment, it turned out that pelvic tilting exercises with treadmill walking training has the most effect on gait velocity, cadence, stride length, step length and foot angle, which has significant difference in statistics (p<0.05). 2. Quantification of the gait velocity, cadence, both stride length and step length demonstrated a significant increase (p<0.05) after treatment in all groups when compared with values measured before treatment. The base of support and foot angle in affected side decreased significantly (p<0.05) after treatment in all groups when compared with values measured before treatment. 3. The lumbosacral angle noted a significant increase (p<0.05) after treatment in all groups, however, an ANOVA analysis did not reveal any differences between groups.

• Physical Therapy Korea
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• v.20 no.4
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• pp.16-21
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• 2013

The purpose of this study was to determine the effect of contralateral hip adduction (CHA) on the muscle activity of lumbar stabilizers and the angle of pelvic lateral tilting during hip abduction in side lying. Twenty healthy male subjects with no medical history of lower extremity or lumbar spine disorders were recruited for the study. Subjects randomly performed preferred hip abduction (PHA) and hip abduction with contralateral hip adduction in side lying. The muscle activities of the dominant side rectus abdominis, external oblique, internal oblique, quadratus lumborum, gluteus medius, and non-dominant side hip adductor longus were measured during PHA and CHA by using a surface electromyography (EMG) system. Pelvic lateral tilting motion was measured by using a three-dimensional motion analysis system. Data on EMG and pelvic motion were collected at the same time during PHA and CHA. A paired t-test was used to compare EMG activity and the angle of pelvic lateral tilting in the two exercises. The study found that the EMG activities of all muscles were more increased significantly in CHA than PHA condition. The angle of pelvic lateral tilting was more decreased significantly in CHA than PHA condition. These findings suggest that CHA could be recommended as a hip abduction exercise for activating lumbar stabilizers and decreasing compensatory pelvic lateral tilting motion.

• Physical Therapy Korea
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• v.21 no.1
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• pp.37-46
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• 2014

Asymmetric sitting posture may cause asymmetric buttock pressure and unilateral low back pain (LBP). The purpose of this study was to compare the differences of buttock pressure between both sides, and pelvic angle (sagittal and coronal planes) during typing in a sitting position on a pressure mat (Baltube) in individuals with and without unilateral LBP. Ten subjects with unilateral LBP and ten subjects without unilateral LBP were recruited for this study. Buttock pressure was measured using a pressure mat and pelvic angles were measured using a palpation meter. The subjects performed typing in a sitting posture for 30 minutes. Pressure data were collected and averaged at initial term (from start to first minutes) and final term (last minutes of 30 minutes). Angles of pelvic tilting were measured after 30 minutes typing. Pressure asymmetry values (difference in pressure between both sides) were calculated at the initial and final terms. A two-way analysis of variance was used to compare the differences between the initial and final pressure asymmetry values in subjects with and without unilateral LBP. An independent t-test was applied to compare the pelvic tilt angles between the two groups. To compare the change of pressure from the initial term to the final term between the symptomatic and asymptomatic sides in the unilateral LBP group, a paired t-test was applied. In the unilateral LBP group, the pressure asymmetric value at the final term was significantly greater than that of the initial term (p<.05). The angle of pelvic tilting in coronal plane was significantly greater in the unilateral back pain group compared to the without unilateral LBP group (p<.05), however, there was no significant difference in the angle of pelvic tilting in the sagittal plane between the two groups (p>.05). In the unilateral LBP group, the change of pressure from the initial term to the final term was significantly less in the symptomatic side (-6.90 mmHg) than the asymptomatic side (5.10 mmHg). This asymmetric sitting posture may contribute to unilateral LBP in the sitting position. Further studies are needed to determine if asymmetric weight bearing in sitting causes unilateral LBP or if unilateral back pain causes asymmetric weight bearing, and if the correction of asymmetric weight bearing in sitting can reduce unilateral LBP.

• Physical Therapy Korea
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• v.21 no.4
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• pp.49-55
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• 2014

Excessive lumbar flexion during sit-to-stand (STS) is a risk factor for lower back pain. Postural taping can prevent unwanted flexion of the lumbar spine. This study aimed to demonstrate the effect of taping the lower back on the lumbopelvic region and hip joint kinematics during STS. Sixteen healthy subjects participated. All subjects performed the STS with and without taping of the lower back. A three-dimensional motion analysis system was used to measure the kinematics of the lumbar spine, pelvis, and hip joint during STS. The angle of the peak lumbar flexion, pelvic anterior tilting, and hip flexion and angular displacement of the lumbar spine between starting position and maximal lumbar flexion were collected. Paired t-tests, or Wilcoxon's rank-sum test for non-parametric distribution, were used to assess differences in the measurements with and without taping. A p-value <.05 was taken to indicate a significant difference. Significant differences were observed in the angle of the peak lumbar flexion, pelvic anterior tilting, hip flexion and angular displacement of the lumbar spine (p<.05). Taping was associated with a significant decrease in the angle of peak lumbar flexion and angular displacement of the lumbar spine between the starting position and maximal lumbar spine flexion. In addition, the peak angle of pelvic anterior tilting and hip flexion were significantly increased with taping. The findings of this study suggest that taping the lower back can decrease excessive lumbar flexion, and increase the pelvic anterior tilting and hip flexion motion during STS.

• Physical Therapy Korea
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• v.5 no.2
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• pp.23-38
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• 1998

The objective of this study was to identify the effects of pelvic tilting exercise on gait patterns of hemiplegic patients. The subjects of this study were 31 hemiplegic in- and out-patients of the Rehabilitation Hospital, Yonsei University Medical Center, from September 24, 1997 through November 5, 1997. Pre- and post-treatment change in gait patterns were measured using a ink foot-print. The data were analyzed by the paired t-test, one-way ANOVA, and independent t-test. The findings were as follows: The difference in gait patterns between pre- and post-treatment was statistically significant, with an increase in gait velocity to 7.98 cm/sec post-treatment; an increase in cadence to 7.29 steps/min; a narrowing of the base of support to 1.33 cm; an increase in step length of 3.92 cm on the less affected side and 3.73 cm on the more affected side; an increase in stride length of 5.82 cm on the less affected side and 5.92 cm on the more affected side(statistically not significant in foot angle). In relation to sex, age, cause of stroke, and laterality of paralysis, the difference in gait patterns between pre- and post-treatment was not statistically significant. Where there was no significant difference of the effects of pelvic exercise regarding the degree of spasticity, the presence of a decrease in proprioception, and the duration of treatment. In conclusion, hemiplegic pelvic tilting exercise was found to have transmitting positive effect in improving gait patterns.

• The Journal of Korean Physical Therapy
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• v.30 no.1
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• pp.23-28
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• 2018

Purpose: This study examined the effectiveness of iliopsoas self-stretching on the hip extension angle, gluteus maximus (GM) activity, and pelvic compensated angle during prone hip extension (PHE) in subjects with iliopsoas shortness. Methods: Twenty-healthy subjects with iliopsoas shortness were recruited. Electromyography (EMG) was used to examine erector spinae (ES), multifidus (MF), GM, and biceps femoris (BF) while performing PHE. An electromagnetic tracking motion analysis device was used to measure the pelvic compensations. The pelvic compensations while performing PHE were considered to be anterior tilting and rotation. A modified Thomas test was used to monitor the hip extension angle before and after iliopsoas self-stretching. A paired t-test was used to investigate the significant difference after iliopsoas self-stretching during PHE. The level of statistical significance was set to ${\alpha}=0.05$. Results: Muscle activity of GM and hip extension angle were significantly greater after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). BF and pelvic rotation angle were significantly lower after iliopsoas self-stretching compared to that before iliopsoas self-stretching during PHE (p<0.05). The muscle activity of ES was not significantly different between PHE before and after iliopsoas self-stretching (p>0.05). Conclusion: Iliopsoas self-stretching can be effective in selectively strengthening the GM muscles with minimized pelvic compensation in subjects with iliopsoas shortness.