• Journal of The Korean Society of Integrative Medicine
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• v.3 no.4
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• pp.43-51
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• 2015

Purpose : This study examines the effect of trunk stabilization program on the body balance, lung capacity, and muscular activity of the rectus abdominis and external oblique of healthy adults. Method : A survey was conducted for 20 students of K University located in the city of Y in Gyeongsangbuk-do Province of Korea. The trunk stabilization program consisted of a hollowing exercise, curl-up, bridging exercise, and birddog exercise. This was performed 14 times in total (7 times a week for two weeks). For analysis, good balance was used to measure both static and dynamic balancing ability. A peak flow meter was used to measure the maximum expiratory flow, and MP150 was used to measure muscular activity of the rectus abdominis and external oblique. Result : After the trunk stabilization program, the participants showed a difference in score and time taken to achieve static and dynamic balance, and muscular activity of the rectus abdominis and external oblique at a statistically significant level (p<0.05). However, no significant difference was observed in the left-to-right distance and front-to-back distance in a dynamic balance, and the lung capacity (p>0.05). Conclusion : The results showed that the trunk stabilization program was effective in enhancing both static and dynamic balancing ability and muscular activity. It also increased the lung capacity although the change was not at a statistically significant level.

• Archives of Reconstructive Microsurgery
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• v.24 no.1
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• pp.7-12
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• 2015

Purpose: The rectus abdominis musculocutaneous (RAM) flap has contributed to the efficient reconstruction of soft tissue defects. The flap has the advantage of easy dissection, minimal donor site morbidity, and the constant vascular anatomy with long pedicle. Authors used the free RAM flap to reconstruct multi-located soft tissue defects while still considering functionality and aesthetics. We present the long-term outcomes and versatility of free RAM flaps. Materials and Methods: From 1994 to 2004, all patients who underwent soft tissue reconstruction with free RAM flap were reviewed retrospectively. The site of the reconstruction, vessels of anastomosis, type of RAM flap, and outcomes, including flap success rate, hospital stay after flap transfer, conduction of secondary procedure, flap complications, and donor-site complications were analyzed. Results: Twenty-one patients underwent 24 free RAM flaps in site of breast, face, upper extremity and lower extremity. Mean follow-up period was 36.1 months (range, 3~156 months). The overall success rate was 92% with only a loss of 2 flaps. Minor complications related to transferred flaps were necrosis of 2 partial flaps, hematoma formation in 3 cases, and a wound infection in 1 case. Donor site morbidity was not observed. Debulking surgery was performed in 4 patients, and scar revision was performed in 3 patients. Conclusion: Free RAM flap is a workhorse flap for general soft-tissue reconstruction with minimal donor site morbidity with aesthetically good results. Thus, the free RAM flaps are versatile, and sturdy for any sites of soft-tissue where reconstruction could be performed.

• Physical Therapy Korea
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• v.16 no.1
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• pp.18-24
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• 2009

The purpose of this study was to assess the effect of bridging stabilization exercises on trunk muscles activity on and off a Swiss ball. 20 healthy university students volunteered to participate in this study. Subjects were required to complete following four exercises: exercise 1, single bridging exercise; exercise 2, feet on ball bridging exercise; exercise 3, calf on ball bridging exercise; exercise 4, back on ball bridging exercise. Surface electromyography from selected trunk muscles was normalized to maximum voluntary isometric contraction. A repeated measures of ANOVA with post-hoc Bonferroni's correction was used to determine the influence of exercise type on muscle activity for each muscle and descriptive statistics was used to determine local/global muscle ratios. The rectus abdominis of exercise 4 showed significantly higher muscle activity than rectus abdominis of exercise 1, 2, 3 (p<.05). The external oblique of exercise 2, 4 showed significantly higher muscle activity than external oblique of exercise 1 (p<.05). The internal oblique of exercise 2, 4 showed significantly higher muscle activity than internal oblique of exercise 1 (p<.05). The erector spinae of exercise 2, 3, 4 showed significantly higher muscle activity than erector spinae of exercise 1 (p<.05). Median of internal oblique/rectus abdominis ratio of exercise 1 was 1.16, exercise 2 was 2.43, exercise 3 was 2.45, exercise and 4 was 1.27. Median of internal oblique/external oblique ratio of exercise 1 was 1.01, exercise 2 was .91, exercise 3 was .99, and exercise 4 was .93. 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.

• Physical Therapy Korea
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• v.18 no.1
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• pp.9-17
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• 2011

The purpose of this study was to assess visual biofeedback's influence on trunk muscles' (EMG) activity and endurance holding time for correct position during whole-body tilt exercise. For the study, we recruited 14 volunteers who showed no symptom of lumbar disease during medical tests. We measured the EMG activity of their rectus abdominis, external abdominal oblique, internal abdominal oblique and erector spinae muscles, and their endurance holding time for correct position during $40^{\circ}$ anterior and posterior whole-body tilt under two conditions: whole-body tilt with and without visual biofeedback. Resistance with gravitational force on the trunk during whole-body tilt was applied by using a device that had a monitor on which the subjects could check their alignment and that sounded an alarm if a subject's alignment collapsed. The study showed an increase in the EMG activity of external abdominal oblique, internal abdominal oblique/rectus abdominis ratio and endurance holding time for correct position during both $40^{\circ}$ anterior and posterior whole-body tilt with visual biofeedback compared with without visual biofeedback (p<.05). We suggest that the whole-body tilt exercise with visual biofeedback could be a beneficial strategy for selectively strengthening the internal abdominal oblique muscle and minimizing the rectus abdominis muscle's activity while maintaining correct alignment during whole-body tilt exercise.

• Physical Therapy Korea
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• v.14 no.2
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• pp.21-28
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• 2007

The purpose of this study was to compare the onset times of muscle activities and the order of muscle firing in erector spinae, multifidus, rectus abdominis and biceps brachii during perturbation between subjects with and without work-related chronic low back pain (LBP). Twenty-nine subjects, 14 with and 15 without LBP, participated in this study. The muscle responses were measured by surface EMG (electromyography) during perturbation in eye opened and eye closed conditions. The EMG onset times of the erector spinae, multifidus, rectus abdominis and biceps brachii were similar between groups in eye closed condition. But the onset times of the erector spinae, multifidus, rectus abdominis were significantly delayed in subjects with LBP in eye opened condition. The results provide an evidence for impaired feed-forward control of the trunk muscles in subjects with LBP. Further studies are needed to identify whether the impaired feed-forward control of the trunk muscles is the contributing factor to LBP.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.531-534
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• 2011

Purpose: The rectus abdominis myocutaneous flap is currently the most commonly used donor site of immediate and delayed breast reconstruction surgery, for its versatility and ease of handling, as well as sufficient blood supply. Despite many advantages of rectus abdominis flap, morbidity of donor site is considered as inevitable shortcoming. The authors recently faced a devastating complication, small bowel obstruction that led to strangulation, after delayed breast reconstruction with free transverses rectus abdominis myocutaneous (TRAM) flap. And we would like to report it, because abdominal pain after TRAM flap is a common symptom and can be overlooked easily. Methods: A 56-year-old female patient who had history of receiving total abdominal hysterectomy 20 years ago underwent delayed breast reconstruction with TRAM flap transfer. She complained abdominal discomfort and pain from third postoperative day, postoperative small bowel obstruction that arose from strangulated bowel and prompt emergency operation was done. Results: After resection of the strangulated bowel and reanastomosis, quickly her symptoms were relieved, and there were no further problems during her hospital stay. 7 days after her emergency operation she was discharged. Conclusion: In patients with previous abdominal surgical history, prolonged ileus can lead to bowel strangulation, so surgeons should always consider the possibility, and must be aware of abdominal symptoms in patients who receive free TRAM flap operations.

• PNF and Movement
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• v.13 no.2
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• pp.81-88
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• 2015

Purpose: The purpose of this study was to analyze the effect of normal timing according to angular motion in PNF patterns on electromyography (EMG) activity in rectus abdominis, internal oblique abdominal muscle, external oblique abdominal muscle, and erector spinae. Methods: Ten healthy adults volunteered to participate in this study. The participants were required to complete following two PNF extremity patterns; upper extremity extension- adduction-internal rotation pattern with $180^{\circ}$, $90^{\circ}$, $30^{\circ}$ and lower extremity flexion- adduction-external rotation pattern with $0^{\circ}$, $60^{\circ}$, $90^{\circ}$. A paired t-test was used to determine the influence of the two PNF patterns on muscle activity in each muscle. Descriptive statistics were used to determine the ratio of local muscle activity to global muscle activity. Results: In terms of their effect on applied normal timing, the upper and lower extremity pattern significantly affected the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). The upper extremity pattern (at an extension angle of $30^{\circ}$) and the lower extremity pattern ((at a flexion angle of $90^{\circ}$) influenced the rectus abdominis, internal oblique, external oblique, and erector spinae (p < .05). Conclusion: The effect of the upper and lower extremity patterns on applied normal timing was significant in that these patterns increased trunk muscle activation. The upper extremity pattern (at an extension angle of $30^{\circ}$) and the lower extremity pattern (at a flexion angle of $90^{\circ}$) increased trunk muscle activation. Normal timing is required to increase trunk muscle strength and extremity movement.

• The Korean Journal of Pain
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• v.35 no.1
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• pp.86-96
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• 2022

Background: To explore the association between low back pain (LBP) and pelvic pain (PP) and rectus abdominis diastasis (RAD) in postpartum women and identify the characteristics and risk factors. Methods: Women diagnosed with RAD and a history of labor and delivery, between 2009 and 2018, were identified from six hospitals within the Partners Healthcare System. Univariate and multivariable binary logistic regression analyses were used to identify the risk factors associated with pain. Results: Age at onset of RAD in the non-cesarean delivery group was earlier than those in cesarean delivery (CD) group (P = 0.017). Women who underwent CD demonstrated 4.5 times greater risk of RAD than those who had no CD exposure. The cumulative composition ratio of LBP at every age stage of the period from 8 years pre-first delivery to 8 years post-first delivery was significantly higher than the other five conditions (RAD, umbilical hernia, PP, depressive disorder [DD], and strain of muscle, fascia, and tendon [SMFT]) (P for trend < 0.001). Women with DD, SMFT, and PP were more likely to have LBP (odds ratio [OR] = 1.91, 95% confidence interval [CI] 1.06 to 3.47, P = 0.032; OR = 4.50, 95% CI 1.64 to 12.36, P = 0.003; OR = 2.14, 95% CI 1.17 to 3.89, P = 0.013; respectively). Conclusions: In postpartum women with RAD, DD, SMFT, and PP were found to be risk factors contributing to the development of LBP. Race and LBP also played roles in the development of PP.

• Physical Therapy Rehabilitation Science
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• v.11 no.2
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• pp.245-252
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• 2022

Objective: This study aimed to investigate the abdominal muscle activity difference while performing the abdominal bracing technique focusing on inspiration (abdominal bracing group), the general abdominal bracing technique (general bracing group), and the abdominal hollowing technique (abdominal hallowing group) Design: A cross-sectional study design. Methods: Thirty-three healthy participants were recruited for this study. The participants were allocated to 3 different groups; Abdominal bracing group, general bracing group, and abdominal hallowing group. The surface electromyography was placed over the rectus abdominis, external oblique, and internal oblique muscles to collect the activation of abdominal muscles during the trial. Results: The muscle activity of the abdominal bracing group and general bracing groups was significantly higher in all abdominal muscles than in the abdominal hollowing group (p<0.05) Both rectus abdominis and external oblique muscles showed higher muscle activations in the abdominal bracing group over the general bracing group (p<0.05). However, the ratio of bilateral external obliques and rectus abdominis to bilateral internal obliques was highest when the hollowing technique was applied (p<0.05). Conclusions: The results of study showed the abdominal bracing technique that emphasized inhalation rather than the abdominal hollowing technique or general abdominal bracing technique increased the activity of the abdominal muscles. Therefore, this study is considered to be a data for effective training if the abdominal bracing technique that emphasizes inhalation is applied as a method to increase the activation of the abdominal muscles.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.9 no.3
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• pp.215-222
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• 2015

The purpose of this study was to investigate abdominal local muscle activity during modified bridge exercise. 17 subjects participated in this study. Abdominal muscles measured. External oblique abdominis (EO), internal oblique abdominis (IO), transvers abdominis (TrA), and rectus abdominis (RA) during general bridge exercise and modified bridge exercise, respectively. Electromyogram (EMG) and real-time ultrasound were used to verify alteration of muscles. Activation of RA and EO muscles of non-dominant foot was significantly difference in general bridge exercise group, not modifiedl bridge exercise group. In the modified bridge exercise group, thickness of IO and TrA muscle of non-dominant foot was significantly difference in modified bridge exercise group than general bridge exercise group. Therefore, modified bridge exercise may be apply as more effective exercise for local muscle activity than global muscle.