• Journal of International Academy of Physical Therapy Research
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• v.11 no.3
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• pp.2113-2118
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• 2020

Background: Patients with stroke have core muscle weakness and limited rib cage movement, resulting in restrictive lung disease. Objectives: To examine the comparison of effects of rib cage joint mobilization combined with diaphragmatic breathing exercise and diaphragmatic breathing exercise on the pulmonary function and chest circumference in patients with stroke. Design: A cluster randomized controlled trial. Methods: Twenty-four patients were randomly assigned to an experimental group (rib cage joint mobilization combined with diaphragmatic breathing exercise group) and control group (diaphragmatic breathing exercise group). Patients in the experimental group underwent rib cage joint mobilization for 15 min and diaphragmatic breathing exercise for 15 min. The control group underwent diaphragmatic breathing exercise for 30 min. Both groups underwent exercise thrice a week for 4 weeks. The pulmonary function and chest circumference were measured using the MicroLab spirometer and a tape measure, respectively. Results: After the intervention, the pulmonary function and chest circumference significantly improved in both groups. These improvements were significantly higher in the experimental group than those in the control group. Conclusion: Rib cage joint mobilization combined with diaphragmatic breathing exercise improves pulmonary function and chest circumference in patients with stroke.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2004.10a
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• pp.1154-1159
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• 2004

Unexpected postoperative changes, such as growth in rib hump, has been occasionally reported after corrective surgery for scoliosis. However there has been experimental data for explanation of these changes, nor the suggestion of optimal correction method. This numerical study was designed to investigate the main correlating elements in operative kinematics with post-operative changes of vertebral rotation and rib cage deformation in the corrective surgery of scoliosis. To develop a scoliotic spine model automatically, a special program for converting normal spine model to scoliotic spine model was developed. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. The skeletal deformity of scoliosis was reconstructed, by mapping the X-ray images of a scoliosis into this three dimensional normal spine and rib cage model. The geometric mapping was performed by translating and rotating the spinal colume with the amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• PNF and Movement
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• v.12 no.2
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• pp.115-121
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• 2014

Purpose: The study aimed to examine the influence of PNF direct and indirect breathing treatments for patients with cervical spinal cord injuries who had breathing problems. Methods: For each cervical spinal cord patient, force vital capacity (FVC), peak expiratory flow, maximum phonation time (MPT), rib cage width, and VAS were measured pre-intervention and four weeks after post-intervention. The indirect method and the direct method were used for interventions. We treated patients with the indirect method using scapular anterior depression pattern, bilateral extensor pattern with rhythmic initiation, and a combination of isotonic. We treated patients with the direct method, applying pressure on the sternum and using rhythmic initiation (hold relax and stretch reflex) for the rib cage. Training occurred for 50 minutes a day and three days per week for four weeks. Results: FVC, MPT, peak expiratory flow, and rib cage width were increased and decreased at the VAS point for rolling after treatment. Conclusion: Patients with cervical spinal cord injuries who had breathing problems felt uncomfortable when they had conversations on a couch. We found that PNF direct and indirect treatments improved rib cage width and breathing functions of patients with cervical spinal cord injuries.

• The Journal of Korean Physical Therapy
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• v.32 no.6
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• pp.394-399
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• 2020

Purpose: The aim of this study was to determine the effects of lower rib cage lateral expansion limitation on the maximal inspiratory and expiratory pressures and on abdominal muscle activity during maximal respiratory breathing in healthy subjects. Methods: Fifteen healthy male subjects voluntarily participated in this cross-sectional study. During maximal breathing, maximal inspiratory and expiratory pressures were measured, and abdominal muscle activity was determined with using surface electromyography. Also, the measurement was repeated with using a non-elastic belt to the lower rib cage for limiting of lateral expansion. A Wilcoxon signed-rank test was performed for obtaining the statistical difference with a significance level of 0.05. Results: The findings of this study are as follows: 1) There were no significant differences in maximal inspiratory and expiratory pressure with and without lower rib cage lateral expansion (p>0.05), 2) There was no significant difference in abdominal muscle activity during the maximal inspiratory phase (p>0.05). However, right external oblique muscle activity decreased significantly during maximum exhalation with lower rib expansion limitation (p<0.05). Conclusion: The results of the current study indicate that a non-elastic belt was effective in decreasing right external oblique muscle activity during forced expiratory breathing in healthy subjects.

• Journal of the Korean Society of Physical Medicine
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• v.17 no.2
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• pp.95-100
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• 2022

PURPOSE: The purpose of this study was to compare the effect of depending on the location of applying chest expansion resistance exercise on the respiratory muscle strength stroke patients, and to suggest more effective interventions to improve respiratory function in stroke patients in clinical practice. METHODS: A total of 30 subjects were selected and divided into two groups, and chest cage extension resistance exercise was applied to the sternum and rib cage, respectively, and performed for 4 weeks, 3 times a week, for 20 minutes. In order to compare the general characteristics of the study subjects and the homogeneity of the group, the pre-experimental values were analyzed using the independent sample t-test. Paired-sample t-test was used for pre-post value comparison of maximum inspiratory pressure and maximum expiratory pressure in each group. Statistical significance was set to .05. RESULTS: Both the sternum application group and the rib cage application group showed a significant difference in the maximum inspiratory pressure according to the intervention. Also, there was a statistically significant difference in the maximum expiratory pressure in the sternum application group. CONCLUSION: As breathing exercise is important for stroke patients, based on the results of this study, if therapists perform sternal extension resistance exercise or rib extension resistance exercise according to the patient's condition and environment, it can help the breathing function of stroke patients.

• Journal of the Korean Society for Precision Engineering
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• v.23 no.3 s.180
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• pp.187-194
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• 2006

Unexpected postoperative changes, such as growth in rib hump and shoulder unbalance, have been occasionally reported after corrective surgery for scoliosis. However there has been neither experimental data fer explanation of these changes, nor the suggestion of optimal correction method. Therefore, the numerical study was designed to investigate the post-operative changes of vertebral rotation and rib cage deformation after the corrective surgery of scoliosis. A mathematical finite element model of normal spine including rib cage, sternum, both clavicles, and pelvis was developed with anatomical details. In this study, we also developed a special program which could convert a normal spine model to a desired scoliotic spine model automatically. A personalized skeletal deformity of scoliosis model was reconstructed with X-ray images of a scoliosis patient from the normal spine structures and rib cage model. The geometric mapping was performed by translating and rotating the spinal column with an amount analyzed from the digitized 12 built-in coordinate axes in each vertebral image. By utilizing this program, problems generated in mapping procedure such as facet joint overlapping, vertebral body deformity could be automatically resolved.

• Physical Therapy Korea
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• v.16 no.3
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• pp.9-15
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• 2009

The purpose of this study was to examine contraction of abdominal muscles on surface electromyographic (EMG) activity of superficial cervical flexors, rib cage elevation and angle of craniocervical flexion during deep cervical flexion exercise in supine position. Fifteen healthy subjects were participated for this study. All subjects performed deer cervical flexion exercise with two methods. The positions of two methods were no volitional contraction of abdominal muscles in hook-lying position with 45 degree hip flexion (method 1) and 90 degrees hip and knee flexion with feet off floor for inducing abdominal muscle contraction (method 2). Surface EMG activities were recorded from five muscles (sternocleidmastoid, anterior scaleneus, recuts abdominis, external oblique, internal oblique). And distance of rib cage elevation and angle of craniocervical flexion were measured using a three dimensional motion analysis system. The EMG activity of each muscle was normalized to the value of reference voluntary contraction (%RVC). The EMG activities, distance of rib cage elevation. and angle of craniocervical were compared using a paired t-test between two methods. The results showed that the EMG activities of sternocleidmastoid and anterior scaleneus during deep cervical flexion exercise in method 2 were significantly decreased compared to method 1 (p<.05). Distance of rib cage elevation and angle of craniocervical flexion were significantly decreased in method 2 (p<.05). The findings of this study indicated that deep cervical flexion exercise with contraction of abdominal muscles could be an effective method to prevent substitute motion for rib cage elevation and contraction of superficial neck flexor muscles.

• The Korean Journal of Pain
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• v.29 no.3
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• pp.185-188
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• 2016

The $12^{th}$ rib syndrome is a disease that causes pain between the upper abdomen and the lower chest. It is assumed that the impinging on the nerves between the ribs causes pain in the lower chest, upper abdomen, and flank. A 74-year-old female patient visited a pain clinic complaining of pain in her back, and left chest wall at a 7 on the 0-10 Numeric Rating scale (NRS). She had a lateral fixation at T12-L2, 6 years earlier. After the operation, she had multiple osteoporotic compression fractures. When the spine was bent, the patient complained about a sharp pain in the left mid-axillary line and radiating pain toward the abdomen. On physical examination, the $10^{th}$ rib was not felt, and an image of the rib-cage confirmed that the left $10^{th}$ rib was severed. When applying pressure from the legs to the $9^{th}$ rib of the patient, pain was reproduced. Therefore, the patient was diagnosed with $9^{th}$ rib syndrome, and ultrasound-guided $9^{th}$ and $10^{th}$ intercostal nerve blocks were performed around the tips of the severed $10^{th}$ rib. In addition, local anesthetics with triamcinolone were administered into the muscles beneath the $9^{th}$ rib at the point of the greatest tenderness. The patient's pain was reduced to NRS 2 point. In this case, it is suspected that the patient had a partial resection of the left $10^{th}$ rib in the past, and subsequent compression fractures at T8 and T9 led to the deformation of the rib cage, causing the tip of the remaining $10^{th}$ rib to impinge on the $9^{th}$ intercostal nerves, causing pain.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2008.11a
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• pp.201-202
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• 2008

• Therapeutic Science for Rehabilitation
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• v.12 no.2
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• pp.99-107
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• 2023

Objective : To investigate the effects of thorax mobility exercises on thorax mobility, breathing pattern, and respiratory capacity in subjects with restricted thorax mobility. Methods : Thirteen subjects with restricted thorax mobility participated in this study. Measurement of thorax circumference using a tape measure (difference between inhalation and exhalation), breathing pattern (distance of rib cage elevation during breathing), and respiratory capacity was performed. Paired t-test was used to compare the thorax mobility, breathing pattern, and respiratory capacity between before and after thorax mobility excercise. Statiscal significance was set at .05. Results : There were significant differences in thorax mobility and breathing pattern, but no significant difference in respiratory capacity (p < .05). Conclusion : Based on the results of this study, thorax mobility exercise using the rib mobilization technique is considered to be a method that can improve thorax mobility and normalize abnormal breathing patterns that cause rib cage elevation.