The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.
PURPOSE: Femur and tibia alignment in the knee joint is important to the biomechanics of lower limb movement. The purpose of this study was to compare vastus medialis oblique (VMO) and vastus lateralis electromyographic muscle activities according to tibial rotation taping methods. METHODS: Twenty-nine healthy subjects (13 males and 16 females) in the 20s, without knee joint-related diseases or disorders, participated in our study. After identifying each subject's dominant foot, the maximal voluntary isometric contraction (MVIC) was determined using a manual muscle tester. The activity of each target muscle was measured at 50% MVIC in isometric muscle contraction and at a $30^{\circ}$ knee flexion position before and after applying internal and external rotation taping by the Mulligan concept and in the neutral position. Non-elastic tape was used to stabilize the tibia rotation position. RESULTS: In the males, VMO muscle activity was significantly increased in the tibia internal rotation position ($47.2{\pm}14.6$, $mean{\pm}SD$) than in the neutral position ($39.3{\pm}14.9$) (p<.05). CONCLUSION: The results of this study indicate that when applying tibia internal rotation taping in healthy males, VMO muscle activity significantly increases during isometric extension of the knee. Therefore, this study provides a basis for selecting the appropriate taping method, in consideration of the available treatments in clinical practice for patients with knee problems.
Objective: The purpose of this study was to compare the activities of the abdominal muscles according to trunk stabilization exercises using Swiss ball in normal individuals. Design: Cross-sectional study. Methods: Ten healthy university students participated in this study. The subjects were required to complete the following three exercise positions: Exercise position 1, sitting on a Swiss ball and lifting the legs; Exercise position 2, pushing to a plank position from an ending position; and Exercise position 3, push-up posture with the legs on a Swiss ball. Changes in the trunk muscle activities were estimated using Biometric electromyography (EMG). Activities of the dominant side internal oblique muscle (IOM) and external oblique muscle (EOM) were estimated in all participants. The maximal voluntary isometric contraction (MVIC %) was measured to standardize the EMG signals for the IOM and EOM during maximum resistance when sitting up with each shoulder pointing towards the contralateral pelvis with knees bent and both arms crossed on the chest for 5 seconds. Results: There was a significant difference in the activity of the internal and external oblique muscles between Exercises 1 and 2 and Exercises 1 and 3 (p<0.05). Furthermore, the IOM/EOM activity ratio was the greatest during Exercise 3 and the smallest during Exercise 1. IOM and EOM activities were the greatest during Exercise 2 with greater EOM activity. Conclusions: In future studies, it will be necessary to investigate muscle activities by supplementing the above-mentioned limitations during the stabilization exercise. The results of this study may be used as a basis for controlling the intensity and frequency of exercise while prescribing trunk stabilization exercises.
본 연구는 Thoracic cage Rando Phantom을 이용하여 가슴우리 구성하는 뼈중에서 복장의 선예한 영상을 얻고자 영상의 검사방법을 연구하였다. 엑스선관 초점에서 팬톰거리는 80Cm에서 엑스선관 각도에는 수직으로 팬톰의 자세는 우측 및 좌측의 후전사방향과 우측 및 좌측 전후 사방향 자세로 20°, 25°, 30° 변경하여 검사하였다. 획득한 영상을 방사선사가 주관적으로 영상평가 하였으며, 평가 데이터를 SPSS ver. 3.0으로 분석하였다. ImageJ Program을 이용하여 신호대잡음비(SNR)를 계산하였다. 그 결과 Cronbach Alpha 값이 0.789로 유의하게 높았다. 신호대잡음비(SNR)의 결과는 갈비과 정확한 복장뼈의 영상을 얻고자 할 때는 엎드린 자세에서는 검사 시 우측 후전사방향 20°에서 6.038으로 높았으며 바로누운자세에서는 좌측 전후사 방향 25° 검사 시 에서 7.860으로 높았다. 결론으로 복장뼈의 선예한 영상을 얻고자 엑스선 촬영기법으로 엎드려서 촬영할 경우에는 환자자세를 우측후전사방향 20°에서 또한 바로누운자세에서 촬영 할 경우에는 좌측전후사방향 25°에서 촬영기법을 이용한다면 선예한 영상을 얻을 수 있으리라 사료된다.
The purpose of this study was to assess the loading distributing characteristics of implant prosthesis according to position and direction of load, under vertical and inclined loading using FEA analysis. The finite element model was designed according to standard fixture (4.1mm restorative component x 11.5mm length). The crown for mandibular first molar was made using UCLA abutment. Each three-dimensional finite element model was created with the physical properties of the implant and surrounding bone. This study simulated loads of 200N at the central fossa in a vertical direction (loading condition A), 200N at the outside point of the central fossa with resin filling into screw hole in a vertical direction (loading condition B), 200N at the centric usp in a $15^{\circ}$ inward oblique direction (loading condition C), 200N at the in a $30^{\circ}$ inward oblique direction (loading condition D) or 200N at the centric cusp in a $30^{\circ}$ outward oblique direction (loading condition E) individually. Von Mises stresses were recorded and compared in the supporting bone, fixture, and abutment screw. The following results have been made based on this study: 1. Stresses were concentrated mainly at the ridge crest around implant in both vertical and oblique loading but stresses in the cancellous bone were low in both vertical and oblique loading. 2. Bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. The magnitude of the stress was greater with the oblique loading than with the vertical loading. 3. An offset of the vertical occlusal force in the buccolingual direction relative to the implant axis gave rise to increased bending of the implant. 4. The relative positions of the resultant line of force from occlusal contact and the center of rotation seems to be more important. 5. The magnitude of the stress in the supporting bone, fixture and abutment screw was greater with the outward oblique loading than with the inward oblique loading and was the greatest under loading at the centric cusp in a $30^{\circ}$ outward oblique direction. Conclusively, this study provides evidence that bending moments resulting from non-axial loading of dental implants caused stress concentrations on cortical bone. But it seems to be more important that how long is the distance from center of rotation of the implant itself to the resultant line of force from occlusal contact(leverage). The goal of improving implants should be to avoid bending of the implant.
Objective: To compare, in terms of their demonstration of tears of the anterior glenoid labrum, oblique axial MR arthrography obtained with the patient's shoulder in the abduction and external rotation (ABER) position, with conventional axial MR arthrography obtained with the patient's arm in the neutral position. Materials and Methods: MR arthrography of the shoulder, including additional oblique axial sequences with the patient in the ABER position, was performed in 30 patients with a clinical history of recurrent anterior shoulder dislocation. The degree of anterior glenoid labral tear or defect was evaluated in both the conventional axial and the ABER position by two radiologists. Decisions were reached by consensus, and a three-point scale was used: grade 1=normal; grade 2=probable tear, diagnosed when subtle increased signal intensity in the labrum was apparent; grade 3=definite tear/defect, when a contrast material-filled gap between the labrum and the glenoid rim or deficient labrum was present. The scores for each imaging sequence were averaged and to compare conventional axial and ABER position scans, Student's t test was performed. Results: In 21 (70%) of 30 patients, the same degree of anterior instability was revealed by both imaging sequences. Eight (27%) had a lower grade in the axial position than in the ABER position, while one (3%) had a higher grade in the axial position. Three whose axial scan was grade 1 showed only equivocal evidence of tearing, but their ABER-position scan, in which a contrast material-filled gap between the labrum and the glenoid rim was present, was grade 3. The average grade was 2.5 (SD=0.73) for axial scans and 2.8 (SD=0.46) for the ABER position. The difference between axial and ABER-position scans was statistically significant (p<0.05). Conclusion: MR arthrography with the patient's shoulder in the ABER position is more efficient than conventional axial scanning in revealing the degree of tear or defect of the anterior glenoid labrum. When equivocal features are seen at conventional axial MR arthrography, oblique axial imaging in the ABER position is helpful.
Purpose. To examine the effects of body position and time after feeding on gastric residuals in low birth weight infants(LBW). Methods. A repeated measures design was conducted. Twenty LBW infants being fed via indwelling nasogastric tubes were randomly assigned to one of 5 different position orderings. In each position, gastric residuals were measured at 30, 60, 90, 120, 150, and 180 minutes after feeding. Results. In comparisons of gastric residuals with position and time, the main effects of position and time were statistically significant (F=5.038, p=0.001; F=429.763, p < 0.001, respectively), but the interaction between position and time was found not to be significant. In pairwise comparisons, the gastric residuals were more reduced in the right anterior oblique and prone positions compared with the left lateral position (p < 0.05) and the differences across time periods were significant (p < 0.001). Conclusions. The body position after feeding has a significant affect on gastric residuals over time in LBW infants. The right anterior oblique or prone position is recommended rather than left lateral position after feeding. Knowledge of the proper position and the pattern of gastric emptying over time after feeding may lead to the development of evidence-based nursing care.
Purpose : The purpose of this study was to assess the effect of bridging stabilization exercises of trunk muscles activity on a Swiss ball according to change of position. Methods:30 healthy university students volunteered to participate in this study. Subjects were required to complete following three exercise positions. Exercise position 1; Supine bridge with Swiss ball, Exercise position 2; Side bridge with Swiss ball, Exercise position 3; Prone bridge with Swiss ball. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. Results : A repeated measures of ANOVA with Duncan's correction was used to determine the influence of exercise type on muscle activity for rectus abdominis, external oblique, erector spinae. The erector spinae of exercise position 1 showed significantly higher muscle activity than exercise position 2, 3(p<.05). The external oblique of exercise position 2, 3 showed significantly higher muscle activity than exercise position 1(p<.05). The rectus abdominis of exercise position 3 showed significantly higher muscle activity than exercise position 1, 2(p<.05) Conclusion: These results indicate that muscle activity can be influenced by addition of a Swiss ball in bridging exercises. It is recommend to use a Swiss ball for trunk stabilization exercise.
Purpose: This study aimed to compare the contraction ratios of the abdominal muscles and the preferential activation ratios of the transversus abdominis muscle (TrA) during the abdominal drawing-in maneuver (ADIM) in the hook-lying, sitting, and standing positions. Methods: This study included 30 healthy participants. The thicknesses of the TrA, internal oblique muscle (IO), and external oblique muscle (EO) were measured at rest and during the ADIM in the hook-lying, sitting, and standing positions using B-mode ultrasound imaging. The contraction ratios of these muscles and the preferential activation ratios of the TrA were calculated for each position. Results: The contraction ratio of the TrA and preferential activation ratio of the TrA during the ADIM in the hook-lying position were significantly higher than those in the sitting and standing positions (p < 0.05). The contraction ratio of the TrA during the ADIM in the sitting position was significantly higher than that in the standing position (p < 0.05). Conclusion: The hook-lying position tended to facilitate TrA activity better than the sitting position. Furthermore, the sitting position tended to facilitate TrA activity better than the standing position. These findings suggest that the ADIM in the hook-lying position should be implemented before that in the sitting position and that the ADIM in the sitting position should be implemented before that in the standing position.
In this study, the purpose is to present the foot inclination angle for realizing an image similar to that of the existing examination method and to present the clinical usefulness of the new examination method through comparison between the existing examination method and the newly designed standing foot oblique projection. A foot phantom was used, and the magnification of the image according to the angle was quantitatively evaluated by attaching a nut to the position of the cuboid of the phantom. The internal oblique image acquired using a 30° wedge was set as the standard image. And that image was compared with the images acquired by changing the angle of the foot from 20° to 65° at intervals of 5°. Image evaluation was performed by 3 radiological technologists, and qualitative evaluation using a Likert 5-point scale for evaluation items of true oblique view and quantitative evaluation of the value obtained by measuring the diameter of a nut in each image were performed as image evaluation. For data analysis, reliability analysis between the measure and comparative analysis of the average value for each angle were performed. The qualitative evaluation score for each image was 4.5 to 5 points for most questions in the case of the standard image. And 4 points or less for most questions in the images with a foot angle of 45° or less, and an evaluation score close to the standard image was obtained in the image of 50° or more. And in the quantitative evaluation, the diameter of the nut was measured to be 9.28~9.56 mm. The qualitative evaluation showed a reliability of 0.95~1.0 and the quantitative evaluation was 0.62. As a result of comparing and analyzing the average of the quantitative and qualitative average values for each angle image, the group with the average value most similar to the standard image was images obtained at 55° and 60°, and in the post-analysis, the images of both groups were the same group as the standard image(p<0.01). As a result of this study, it was found that the angle of inclination of the foot for realizing the image most similar to the existing image in the standing foot oblique projection is 55°~60°. In addition, if this test method is applied to the clinic, it is believed that it will help prevent safety accidents such as falls during the test and improve test efficiency by minimizing the movement of patients for the test.
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