• Physical Therapy Korea
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• v.28 no.1
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• pp.18-26
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• 2021

Previous studies have reported that deep neck flexor (DNF) exercise can improve neck problems, including neck pain, forward head posture, and headache, by targeting the deep and superficial muscles of the neck. Despite the prevailing opinion across studies, the benefits of DNF can vary according to the type of neck problems and the outcome measures adopted, ranging from positive outcomes to non-significant benefits. A meta-analysis was conducted in this study to assess conclusive evidence of the impact of DNF exercise on individuals with neck problems. We used PUBMED, MEDLINE, NDSL, EMBASE, and Web of Science to search for primary studies and the key terms used in these searches were "forward head posture (FHP)," "biofeedback," "pressure biofeedback unit," "stabilizer," "headache," and "neck pain." Twenty-four eligible studies were included in this meta-analysis and were coded according to the type of neck problems and outcome measures described, such as pain, endurance, involvement of neck muscle, craniovertebral angle (CVA), neck disability index (NDI), cervical range of motion (CROM), radiographs of the neck, posture, strength, endurance, and headache disability index. The overall effect size of the DNF exercise was 0.489. The effect sizes of the neck problems were 0.556 (neck pain), -1.278 (FHP), 0.176 (headache), and 1.850 (mix). The effect sizes of outcome measures were 1.045 (pain), 0.966 (endurance), 0.894 (deep neck flexor), 0.608 (superficial neck flexor), 0.487 (CVA), 0.409 (NDI), and 0.252 (CROM). According to the results of this study, DNF exercise can effectively reduce neck pain. Thus, DNF exercise is highly recommend as an effective exercise method for individuals suffering from neck pain.

• Journal of the Ergonomics Society of Korea
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• v.34 no.3
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• pp.199-215
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• 2015

Objective: The purpose of this study is to find the level of physical relaxation of individual subject by monitoring psychophysiological biofeedback to different types of mattresses. And, the study also aims to find a protocol to make a selection of the best mattress based on the measured information. Background: In Korea, there are an increasing number of people using western style bed. However, they are often fastidious in choosing the right mattress for them. In fact, people use their past experience with their old mattress as well as the spontaneous experience they encounter in a show room to finally decide to buy a bed. Method: Total five mattresses were tested in this study. After measuring the elasticity of the mattresses, they were sorted into five different classes. Physiological and psychological variables including Electromyography (EMG), heart rates (HR), oxygen saturations (SaO2) were used. In addition, the peak body pressure concentration rate was used to find uncomfortably pressured body part. Finally, the personal factors and subjective satisfaction were also examined. A protocol was made to select the best mattress for individual subject. The selection rule for the protocol considered all the variables tested in this study. Results: The result revealing psychological comfort range of 0.68 to 0.95, dermal comfort range of 3.15 to 6.07, back muscle relaxation range of 0.25 to 1.64 and personal habit range of 2.0 to 3.4 was drawn in this study. Also a regression model was developed to predict biofeedback with the minimal use of biofeedback devices. Moreover results from the proposed protocol with the regression equation and subjective satisfaction were compared with each other for validation. Ten out of twenty subjects recorded the same level of relaxation, and eight subjects showed one-level difference while two subjects showed two-levels difference. Conclusion: The psychophysiological variables and suitability selection process used in this study seem to be used for selecting and assessing ergonomic products mechanically or emotionally. Application: This regression model can be applied to the mattress industry to estimate back muscle relaxation using dermal, psychophysiology and personal habit values.

• Physical Therapy Korea
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• v.17 no.4
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• pp.1-7
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• 2010

The aim of this study was to investigate the effects of lumbar stabilization on both trunk and lower limb muscle activity and center of pressure (COP) in single leg standing. Surface electromyography (EMG) was used to collect muscle activity data, the mean velocity of COP was measured using a force plate, and a pressure biofeedback unit was used for lumbar stabilization training. The findings of this study are summarized as follows: 1) The EMG activity of the erector spinae decreased significantly and the activity of the rectus abdominis, internal oblique, external oblique, gluteus maximus, and gluteus medius increased significantly with lumbar stabilization single leg standing. 2) No differences in activity in the tibialis anterior, medial gastrocnemius, rectus femoris, and medial hamstrings were found with single leg standing. 3) The mean velocity of COP in the antero-posterior and medio-lateral directions in the lumbar stabilization single leg standing decreased significantly compared with the preferred single leg standing. The findings of this study therefore indicate that lumbar stabilization can facilitate the co-activation of deep stabilization and global muscles that improve postural control capability during single leg standing.

• Journal of the Korean Society for Precision Engineering
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• v.24 no.6
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• pp.121-130
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• 2007

In this paper, we present the development of a new training system for equilibrium sense and postural control. This system consists of an unstable platform, a force plate, a computer, and training programs. The unstable platform provides 360 degrees of movement allowing for training in all directions. To evaluate the effects of the training system, we performed various experiments to train the ability of equilibrium sense and postural control of fifteen young healthy subjects. We measured the time a subject maintains his or her center of pressure on a target, the time a subject moves his or her center of pressure to a target, and the mean absolute deviation of the trace before and after the training. We analyzed these parameters obtained before and after the training using paried-sample T-test. The result shows that the subjects experienced distinctive enhancement in their ability of postural control through the training using our system.

• Journal of the Korean Society of Physical Medicine
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• v.15 no.2
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• pp.49-56
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• 2020

PURPOSE: This study examined the difference in muscle activity of the trunk and legs during flat walking with or without an abdominal drawing-in maneuver. METHODS: This study was conducted on 15 healthy males and eight females who were attending D University in Busan. This experiment was conducted after 15 minutes of abdominal drawing-in training using a pressure biofeedback unit before the experiment, and the difference in the muscle activity of the trunk and legs during flat walking with or without an abdominal drawing-in technique was investigated. Surface electromyography was used, and the electrode attachment site was the right sternocleidomastoid muscle, splenius capitis muscle, rectus abdominis muscle, external abdominal oblique muscle, transverse abdominis muscle, erector spinae muscle, vastus medialis muscle, and vastus lateralis muscle (TM DTS, Noraxon, USA). The data were analyzed statistically using a paired t-test on SPSS version 18.0 (IBM). RESULTS: The muscle activity of the rectus abdominis muscle, external abdominal oblique muscle, transverse abdominis muscle, vastus medialis muscle were increased significantly and maintained more than walking without maintaining an abdominal drawing-in maneuver (p < .05). Moreover, muscle activity of the erector spinae muscle was decreased significantly and maintained more than walking without maintaining an abdominal drawing-in maneuver (p < .05). CONCLUSION: Maintaining an abdominal drawing-in maneuver during flat walking is more effective during walking training.

• PNF and Movement
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• v.18 no.1
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• pp.35-44
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• 2020

Purpose: The purpose of this study was to investigate the effect of the simultaneous abdominal drawing-in maneuver (ADIM) on the muscle activity of the ipsilateral trunk and leg during proprioceptive neuromuscular facilitation (PNF) leg flexion, adduction, and external rotation with knee flexion (D1) patterns. Methods: The participants were 20 healthy adult males and females (18 males and 2 females). The maneuvers were performed by a physical therapist who fully understands the PNF leg patterns (D1) and their application in clinical practice. The participants were trained and allowed to practice for 15 minutes prior to applying ADIM, to ensure adequate learning as evidenced by the pressure biofeedback unit. In this study, we measured the muscle activity of the trunk and leg when the PNF leg pattern (D1) was performed by the physical therapist either sustaining or releasing the ADIM. Muscle activity was measured on the right transverse abdominis muscle (TRA), the external abdominal oblique muscle (EO), the internal abdominal oblique muscle (IO), the erector spinae muscle (ES), the vastus medialis oblique muscle (VMO), the vastus lateralis oblique muscle (VLO), and the tibialis anterior muscle (TA) and compared using the mean values from averaging three repeated measurements. Results: The muscle activity of the transversus abdominis, the external abdominal oblique, the internal abdominal oblique, the vastus medialis oblique, and the vastus lateralis oblique was significantly greater (p < 0.05), and the muscle activity of the erector spinae was significantly less (p < 0.05) during PNF leg pattern (D1) when the ADIM contraction was sustained compared to when it was not. Conclusion: These results suggest that sustaining ADIM during PNF leg pattern (D1) training increases the trunk and leg muscle activity, resulting in more effective training.

• PNF and Movement
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• v.18 no.3
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• pp.403-414
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• 2020

Purpose: This study examined how performing chin tuck exercises in supine, sitting, and standing positions affects changes in the muscle activity of the neck and shoulder. Methods: Seventeen men and three women with forward head posture participated in the study. The subjects performed the chin tuck exercise using a pressure biofeedback unit. After determining the ideal order for performing the chin tuck exercise in supine, sitting, and standing positions through randomized controlled trials, muscle activity was measured in the dominant-side sternocleidomastoid, scalenus anterior, upper trapezius, and levator scapulae. Muscle activity was measured three times in each muscle for each position, and the average of the three measurements was used for analysis. Results: In this study, the chin tuck exercise performed in a supine position reduced muscle activity of the sternocleidomastoid, scalenus anterior, upper trapezius, and levator scapulae significantly more than performing the exercise in either sitting or standing positions (p < 0.05). No significant difference in muscle activity was observed when the exercise was performed in a sitting position versus a standing position (p < 0.05). Conclusion: Performing a chin tuck exercise in a supine position is more effective for stabilizing the neck and shoulder than performing it in a sitting or standing position, as it reduces excessive tension and fatigue in the neck and shoulder.

• Physical Therapy Korea
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• v.29 no.3
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• pp.180-186
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• 2022

Background: The craniocervical flexion test (CCFT) was developed for the activation and endurance of deep cervical flexors. However, the muscle thickness and muscle thickness changing ratio of the sternocleidomastoid (SCM) and deep cervical flexor (DCF) muscles in subjects with and without forward head posture (FHP) have not been reported. Objects: To determine the difference in thickness of the SCM and DCF muscles and the difference in the muscle thickness changing ratio between SCM, DCF, and DCF/SCM 20 mmHg and DCF/SCM 30 mmHg between subjects with and without FHP. Methods: Thirty subjects with and without FHP were enrolled. The muscle thickness of the SCM and DCF was measured when maintained at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg using a pressure biofeedback unit during the CCFT. Ultrasonography was used to capture images of SCM and DCF muscle thickness during the CCFT, which was calculated using the picture archiving and communication system (PACS). Results: We observed a significant difference within the pressure main effect between SCM and DCF at a baseline pressure of 20 mmHg and a maximum pressure of 30 mmHg (p < 0.05). However, there was no significant difference in the muscle thickness and muscle thickness changing ratio for SCM and DCF during CCFT between subjects with and without FHP. Conclusion: There was no significant difference in the muscle thickness recruitment pattern during CCFT in posture changes between subjects with and without FHP.

• Women's Health Nursing
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• v.8 no.3
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• pp.412-423
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• 2002

This study was designed to evaluate the effect of pelvic floor muscle exercise using biofeedback and electrical stimulation after normal vaginal delivery. The data were collected from November 1999 to April 2000 at a university hospital located in Seoul, Korea. Out of 49 women with normal vaginal delivery, 25 of experimental group(with exercise) and 24 of control group(without exercise) were questioned about lower urinary symptoms, discomfort during sexual intercourse and daily life. The maximum pressure of pelvic floor muscle contraction(MPPFMC) and duration of pelvic floor muscle contraction(DPFMC) were measured at pre-treatment, the end of treatment and 8 weeks after a treatment program. The pelvic floor muscle exercise program(using biofeedback and electrical stimulation) was applied to the experimental group twice a week for 4 weeks at the incontinence clinic and the pelvic floor muscle exercise at home for that time and more 8 weeks. Data were analyzed by t-test, $x^2$-test, Fisher's exact test and the repeated measures ANOVA. The results were as follows; 1) MPPFMC(p=0.000) and DPFMC(p=0.021) were significantly increased in the experimental group. 2) In the lower urinary symptoms, daily frequency(p=0.001), nocturia(p=0.002), incontinence episode(p=0.016), stress incontinence(p=0.012), quantity of incontinence(p=0.026), straining(p=0.041), and strength of stream(p=0.009) were significantly decreased in the experimental group. 3) Discomfort during sexual intercourse had not a significant difference between the two groups, which was not significantly decreased as time passed. 4) In the discomfort during daily life, activity restriction(p=0.042), exercise restriction (p=0.008), interpersonal relationship restriction(p=0.046), and discomfort of general life(p=0.027) showed a significant difference between the two groups, which were not significantly decreased as time passed. In conclusion, it is suggested that the pelvic floor muscle exercise using biofeedback and electrical stimulation might be a safer and more effective program for the improvement of postpartum pelvic muscle contraction.

• Journal of the Ergonomics Society of Korea
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• v.31 no.2
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• pp.337-343
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• 2012

Objective: The aim of this study was to determine the effect of abdominal-compression belt in one leg standing on balance in normal adult. Background: With the effects of increased intra-abdominal pressure, the abdominal-compression belt is contributing to a static balance control. However, specific study is still insufficient. Method: Forty subjects were randomly allocated to two groups: control(n=20) and experimental group(n=20), respectively. The experimental group used an abdominal-compression belt, whereas the control group did not that. All subjects were educated using pressure biofeedback unit and ultrasound imaging for exact application by abdominal-compression belt. Main outcome measurement was used a general stability index, fourier harmony index, weight distribution index, and fall index in tetrax balance system. Results: Experimental group improved significantly on general stability, only 2 factors(eyes closed with head turned forward and eyes closed with head turned backward) among fourier harmony index, and fall index, However, weight distribution index did not revealed significant difference. Conclusion: The findings suggest that application of abdominal-compression belt could be effective on improving balance ability in one leg standing of normal adults. Application: The results of the abdominal-compression belt might help to control balance in workers.