• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.29 no.2
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• pp.23-29
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• 2023

Background: There is still controversy as to whether hip external rotation and dorsiflexion selectively activate the vastus medialis obliquus (VMO) during straight leg raise exercise. Due to the anatomical characteristics, hip adduction must be preceded to activate the VMO. In this study, the activities of the rectus femoris (RF), vastus lateralis (VL), VMO were measured by adding the hip adduction movement to the straight leg raise exercise with hip 45° external rotation and straight leg raise exercise with hip 45° external rotation and dorsiflexion. Through this, we want to find out whether the VMO is selectively activated. Methods: Thirteen healthy participants performed straight leg raise exercise with hip 45° external rotation, straight leg raise exercise with hip 45° external rotation and dorsiflexion, straight leg raise exercise with hip 45° external rotation and adduction, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion was randomly performed. Through this, EMG data of the RF, VL, VMO were collected. Results: During the straight leg raise exercise, hip adduction increased the activity of the VMO and VL, no significant difference was found(p>.05). However, in the VMO/VL ratio, straight leg raise exercise with hip 45° external rotation and adduction and dorsiflexion activated the VMO and the VL at a ratio of about 1:1, It showed a significantly higher rate than straight leg raise exercise with hip 45° external rotation(p<.05). Conclusion: During the straight leg raise exercise, hip adduction is considered to be an important movement that can selectively induce the activity of the VMO. Therefore, follow-up studies on this should be conducted.

• PNF and Movement
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• v.11 no.2
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• pp.87-93
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• 2013

Purpose : The purpose of this study was to investigate the effects of closed chain breathing exercise on thorax circumference increase and ROM of shoulder rotation for cervical vertebral cord injury patient's. Methods : 12 cervical vertebral cord injury patients volunteer to participate in this study. closed chain breathing exercise group of 4 subjects performed exercise three time a week. The deep breathing exercise group and general exercise group of 4 subjects performed exercise three time a week. We analyaed the descriptive statistics and $3{\times}2$ repeated measures ANOVA by SPSS 12.0 for window. Results : In comparison of rotation of shoulder ROM between pre and post value, the increase of rotation ROM of shoulder was significant in the closed chain breathing exercise group(p<.05). Conclusion : The closed chain breathing exercise helped to increased rotation ROM of shoulder.

• Physical Therapy Korea
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• v.29 no.2
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• pp.106-116
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• 2022

Background: Shoulder external rotation exercises are commonly used to improve the stabilizing ability of the infraspinatus. However, during exercise, excessive activation of the posterior deltoid compared to the infraspinatus causes the humeral head to move anteriorly in an abnormal position. Many researchers have emphasized selective activation of the infraspinatus during shoulder external rotation exercise. Objects: This study aims to delineate the optimal exercise method for selective activation of infraspinatus by investigating the muscle activities of the infraspinatus and posterior deltoid according to the four shoulder exercise methods and two forearm positions. Methods: Thirty healthy individuals participated in this study. The participants were instructed to perform shoulder external rotation exercises following four exercise methods: sitting external rotation (SIER); standing external rotation at 90° abduction (STER); prone external rotation at 90° abduction (PRER); side-lying external rotation (SLER), and two forearm positions (neutral, supinated). The electromyography (EMG) signal amplitude was measured during each exercise. Surface EMG signals were recorded from the posterior deltoid, infraspinatus, and biceps brachii. Results: EMG results of the infraspinatus and posterior deltoid in PRER, were significantly higher than that of the other exercises (p < 0.01). The EMG ratio (infraspinatus/posterior deltoid) in SIER was significantly higher than that of the other exercises. EMG activation of the posterior deltoid in SIER, PRER, and SLER was significantly higher in neutral than in supinated (p < 0.01). Furthermore, the EMG of the infraspinatus in SIER was significantly higher in neutral than in supinated (p < 0.01). The EMG ratio (infraspinatus/ posterior deltoid) in SIER was significantly higher in neutral than in supinated (p < 0.05.) Contrarily EMG ratios in PRER and SLER were significantly higher in supinated than in neutral (p < 0.05). Conclusion: The results show that clinicians should consider these exercise methods and forearm positions when planning shoulder external rotation exercises for optimal shoulder rehabilitation.

• The Journal of Advanced Prosthodontics
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• v.12 no.4
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• pp.204-209
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• 2020

PURPOSE. Prevention of xerostomia and stress is important to prolong healthy life expectancy and improve the quality of life. We aimed to investigate the effects of tongue rotation exercise for increasing salivary secretions and stabilizing salivary stress hormone levels. MATERIALS AND METHODS. Twenty four participants without subjective oral dryness were enrolled. The exercises comprised tongue rotation exercise and empty chewing. The salivary stress hormone level was measured using a Salivary Amylase Monitor. Unstimulated whole saliva volume and salivary amylase activity were measured before tongue rotation exercise or empty chewing and subsequently 5, 10, and 15 minutes after these exercises. Differences in the rates of change of unstimulated whole saliva volume and salivary amylase activity were analyzed by repeated measure analysis of variance. RESULTS. Statistically significant differences among the rates of change were not observed after empty chewing for unstimulated whole saliva volume and salivary amylase activity at the four measurement times. However, the rate of change of unstimulated whole saliva volume and salivary amylase activity were statistically significantly different among the four time points: before the tongue rotation exercise and 5, 10, and 15 minutes post-exercise (P<.05 and P<.01, respectively). CONCLUSION. Tongue rotation is effective in increasing saliva secretion, reducing stress, improving oral function, and extending healthy life expectancy.

• PNF and Movement
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• v.9 no.4
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• pp.49-55
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• 2011

Purpose : The aim of this study was to identify of bilateral trunk rotation(BTR) exercise and PNF exercise on gait in the individuals with malalignment syndrome. Methods : Subjects were 32 that were divided 2 groups in 20's generation. Interventions were trunk ratation exercise and PNF exercise. We used Medex for trunk rotation exercise. BTR group received exercise for three-sets (10min/set) along with stretching exercise ten-minutes, 3 times per week. PNF group took turns the D1 pattern in upper extremity and the D1 pattern in the opposite side of lower extremity for three-sets (10min/set). The measurement were force metatarsal 1 (FM 1), impulse metatarsal 1 (IM 1), force heel lat (FHL), impulse heel lat (IHL) by using footscan (RS scan). Statistical method was repeated measurement of ANOVA and p value was 0.05. Results : BTR and PNF group were significantly different in time(FM 1, IM 1, FHL, IHL). As different of right/left, BTR and PNF exercise were significantly different in FM 1, IM 1, FHL. Conclusion : BTR exercise was good exercise for malalignment but needs expensive equipment, for example, Medex. PNF exercise doesn't need expensive equipment but good method in malalignment syndrome person for gait ability. If PNF exercise is more experiment, PNF exercise could use variety for more patients.

• Physical Therapy Rehabilitation Science
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• v.10 no.2
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• pp.90-97
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• 2021

Objective: The purpose of this study was to find out how the back instability during clam exercise (CE) causes changes in pelvic rotation and hip joint abductor muscle activity, and to find out the effects with different methods of application of pressure biofeedback. Design: Comparative study using repeated measures. Methods: Each subjects performed the clam exercise (CE) without pressure biofeedback, the clam exercise with pressure biofeedback applied to the back (CE-PBU to back), and the clam exercise with pressure biofeedback applied to the side (CE-PBU to side). The amount of pelvic rotation was measured using myomotion. And the muscle activity of the muscle gluteus medius and the tensor fasciae latae was measured using EMG device. One-way repeated measures ANOVA followed by the Bonferroni post test were used to compare the EMG activity in each muscle and pelvic rotation angle during the CE, CE-PBU to back, CE-PBU to side. Results: The amounts of pelvic rotation was the lowest in CE-PBU to back (p< 0.05) and the ratio of muscle activity of the muscle gluteus / tensor fasciae latae was the highest in CE-PBU to back (p< 0.05). Conclusions: It is thought that, in order to stabilize the waist-pelvis and increase hip joint muscle strength in subjects with back instability, applying clam exercise with pressure biofeedback applied to the lower back is effective in improving waist-pelvic movements and selectively strengthening the muscle gluteus medius.

• Physical Therapy Korea
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• v.26 no.3
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• pp.91-98
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• 2019

Background: The bridge exercise targets the gluteus maximus (Gmax) and gluteus medius (Gmed). However, there is also a risk of dominant hamstring (HAM) and erector spinae (ES) muscles. Objects: To analyze the muscle activity the of Gmax, Gmed, HAM and ES during the bridge exercise with and without hip external rotation in different degrees of knee flexion. Methods: Twenty-three subjects were participated. The electormyography (EMG) activity of the Gmax, Gmed, HAM and ES muscles was recorded during the exercise. The subjects performed the bridge exercise under four different conditions: (a) with $90^{\circ}$ knee flexion, without hip external rotation (b) with $90^{\circ}$ knee flexion, with hip external rotation (c) with $135^{\circ}$ knee flexion, without hip external rotation (d) with $135^{\circ}$ knee flexion, with hip external rotation. Results: There was no significant interaction effect between the degree of knee flexion and hip external rotation. There was a significant main effect for degree of knee flexion in Gmax, HAM muscles activity. Gmax muscle activity was significantly greater in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). While HAM muscle activity was significantly less in $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p<.001). ES muscle activity was significantly less in the $135^{\circ}$ knee flexion position than in the $90^{\circ}$ knee flexion position (p=.002). The activity of both the Gmax and Gmed muscles was significantly greater with hip external rotation (p<.001 and p=.005, respectively). Conclusion: For patients performing the bridge exercise, positioning the knee in $135^{\circ}$ of flexion with hip external rotation is effective for improving Gmax and Gmed muscle activity while decreasing HAM, and ES muscle activity.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.219-229
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• 2013

PURPOSE: The purpose of the study was to investigate a influence in Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise of shoulder adhesive capsulitis. METHODS: The methods of the study was to investigate a change in range of motion (ROM), an increase in ROM, visual analogue scale (VAS) and disability questionnaire by Proprioceptive Neuromuscular Facilitation, and self-assisted ROM exercise on 32 patients who were diagnosed with shoulder adhesive capsulitis. RESULTS: There was no significant difference between the two groups who were treated in the Proprioceptive Neuromuscular Facilitation and self-assistive ROM exercise group for flexion, extension, internal rotation, external rotation, VAS and disability questionnaire. Both group's flexion, extension, internal ratation, and external rotation levels were significantly different before and after the treatment. And significant statistical decrease in VAS and disability was seen. The extension of the shoulder joint was closely related to external rotation (r=0.84). There was a close relationship between internal rotation and external rotation at the shoulder joint. There was no increased range of extension through the exercise method. However, flexion, extension, internal rotation, external rotation, VAS, and disability questionnaire of Proprioceptive Neuromuscular Facilitation groups were obviously higher than in the self-assisted ROM exercise group. CONCLUSION: Our study suggest that considering Proprioceptive Neuromuscular Facilitation for the patient who has shoulder adhesive capsulitis in clinic.

• PNF and Movement
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• v.12 no.1
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• pp.33-37
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• 2014

Purpose: In this research, the properties of the shoulder joint were measured through eccentric resistive exercise with the patients who have rotator cuff tear of shoulder joints as the targets. Methods: 23 patients who have pain due to the rupture of rotator cuff on shoulder joints were selected and divided into Exercise group (12) and Control group (11). Two groups executed exercise for 30 minutes 3 days a week. Exercise group had executed eccentric resistive exercise, and the Control group executed Complex exercise. Results: In external rotation $180^{\circ}/s$, $240^{\circ}/s$, the Exercise group showed to be an average of 8% higher than the Control group. For Internal rotation $90^{\circ}/s$, $180^{\circ}/s$, $240^{\circ}/s$ the Exercise group showed to be an average of 30% higher that the Control group. Conclusion: To lessen the rupture of rotator cuff on shoulder joints, muscles strengthening is very important across various methods of eccentric exercise programs which are external/internal rotators of the shoulder joint needed for throwing. This is effective in preventing injury and improving rotation.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.6 no.1
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• pp.69-79
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• 2008

In this paper, the effects of the external-rotation exercise on the gait of hemiplegia was investigated. 26 patients with hemiplegia due to cerebrovascular accident participated in this study. Subjects were randomly assigned to experimental group(n=12) and control one(n=14). 12 subjects of the experimental group were received the external rotation reducing exercise on the mat with seating and supine posture after the general therapeutic exercise for hemiplegia. 14 subjects of the control group were received only general therapeutic exercise. The effects of external rotation reducing exercise were evaluated by measurements of gait velocity, cadence, stride length, step length and foot angle using ink-foot prints. The collected data were analyzed statistically based on Wilcoxon, Mann-Whitney and correlation analysis. After treatment of three weeks, it turned out that external rotation reducing exercise has the significant effect on foot angle(p<0.01). However the exercise has no statistically significant direct effect on the gait velocity, cadence, stride length and step length.