• Journal of the Korean Society of Physical Medicine
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• v.17 no.3
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• pp.1-10
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• 2022

PURPOSE: This study examined the effects of the resistance levels on the muscle activities around the hip and spine during bridge exercise with hip abduction resistance in patients with chronic back pain. METHODS: A cross-over study design was used. Twenty subjects with low back pain were enrolled in this study. The subjects performed bridge exercises with hip abduction resistances (20 mmHg, 40 mmHg, and 60 mmHg). A Narrow Sling was used to provide resistance. Surface electromyography was used to measure the activity of the erector spinae, biceps femoris, gluteus maximus, and gluteus medius. RESULTS: The muscle activity of the gluteus maximus and gluteus medius increased significantly with increasing resistance levels. There was a significant difference in the muscle activity of the biceps femoris with a resistance level between 20 mmHg and 40 mmHg, but there was no significant difference in the other resistance levels. There was no significant difference according to resistance level in the erector spinae. The muscle activity ratios of the gluteus medius/erector spinae and gluteus maximus/erector spinae increased significantly with increasing resistance strength. CONCLUSION: The different levels of abduction resistance for hip abduction during bridge exercise will help activate the gluteus maximus selectively in patients with chronic back pain.

• The Journal of Korean Physical Therapy
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• v.31 no.1
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• pp.62-66
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• 2019

Purpose: This study examined the most efficient exercise position to activate the gluteus medius (GM) and tensor fascia latae (TFL) in hip abduction in side-lying (HA-SL), clam in side-lying (CL-SL), and sling bridging in side-lying (SB-SL), which are the most representative GM exercises. Methods: Twenty-four healthy male adults aged from 20 to 40 years, whose body mass index was under 25, participated in this experiment. While all participants conducted three different positions with a counterbalanced manner, such as in AB, CL, and BR, activation of the GM and TFL was measured using 8-channel wireless EMG. Exercise was performed for 10 seconds three times in total with a five minute-break session. Results: Significant differences in GM and TFL activation were observed among the three positions (p<0.05). The highest activation of 60.69 was observed in BR followed in order by 46.03 and 12.92 in HA-SL and CL, respectively. TFL activation in HA-SL was 42.01, followed in order by 35.98 and 14.01 in BR and CL, respectively. On the other hand, there was no significant difference in TFL muscle activation between BR and HA-SL. Conclusion: These findings suggest that both BR and HA-SL in GM can be done selectively. CL has remarkably low muscle activation in GM and TFL, which makes it less valuable in GM and TFL exercise. In conclusion, selective BR and HA-SL exercise should be applied to maximally and effectively activate the GM.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.28 no.2
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• pp.67-75
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• 2022

Background: Scapular winging is a rare disorder that is commonly caused by nerve damage of the dorsal scapular nerve, spinal accessory nerve, or the long thoracic nerve. This affects the scapulohumeral rhythm which may cause abnormal kinetic motion of the shoulder. The purpose of this case report is to describe a self-exercise oriented management incorporating shoulder strengthening to reduce symptoms in a shoulder pain patient with winging scapular. Methods: A 45 year old male patient complained of pain in his both shoulders without any trauma. Shoulders were treated with steroid injections for supraspinatus tendonitis, but although pain improved to some extent, pain and disability continued for 3 months. Both shoulders had pain, decreased active range of motions, muscles weakness, and scapular winging. The patient underwent 9 interventional sessions over 3 months and was managed mainly by self-exercise. The intervention method involved push up plus, sling, muscle strengthening, and stabilization exercises. Loads were increased as symptoms improved. Results: Clinical outcomes were measured at every session. Pain in both shoulders reduced to 0 on a numerical pain rate scale by the 4th session, and the active range of motion was fully recovered. During the 9th session, the strength of the serratus anterior had improved from grade P to G on the right side and grade G to N grade on the left. Conclusion: In this case study, the self-exercise program was effective in reducing pain, increasing active range of motion, and improving muscle strength in subjects with scapular winging.

• Journal of Korean Academy of Nursing
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• v.33 no.5
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• pp.591-600
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• 2003

Purpose: The purpose of this study was to investigate the effects of exercise training using biofeedback and constraint-induced movement on the upper extremity function of hemiplegic patients. Method: A non-equivalent pretest-posttest design was used. Study subjects were a conveniently selected group of 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who have been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours in a day over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of the VIE motor ability(hand function, grip power, pinch power, U/E ROMs), and motor activity(amount, quality). Result: 1. After 2 weeks of treatment, the motor abilities of affected U/E(hand function, grip power, pinch power, ROMs of wrist flexion, elbow flexion and shoulder flexion/extension) were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. However, there was no significant difference in wrist extension between experimental or control group. 2. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group with no decrement at 4-week follow-up. Conclusion: The above results state that exercise training using biofeedback and constraint-induced movement could be an effective intervention for improving U/E function of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

• Journal of the Korean Society of Physical Medicine
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• v.2 no.1
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• pp.41-47
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• 2007

Purpose : This study was to find the effects of conservative therapy and sling therapy program of strength exercise and Gymnic Ball therapy program of stabilizer exercise and to find the effects of pain relieve through visual analogue scale(VAS) in chronic low back pain patients (male; 18, female;22). Methods : The measurement of pain was performed to both group by VAS from pre treatment to one to seven weeks. Results : 1. By the result of one-way ANOVA, Both group was the statistical significance in VAS during seven weeks(p<.05). 2. By the result of paired t-test, Both group was not statistical significance between the values of pre treatment and treatment after six and seven weeks but was statistical significance one week to seven weeks(p<.05). Conclusion : It was concluded that low back pain would be relieved by the progressive exercise and education for low back pain, and that the interventions would be helpful to prevent additional injuries by increasing the flexibility and muscular endurance.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.115-125
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• 2016

PURPOSE: This study aimed to compare the effects of lumbar stabilization exercise with those of the neurodynamic technique on low back pain in patients with lumbar instability. METHODS: The subjects included those with more than three tests with positive results for lumbar instability and those with a positive sign during the neurodynamic test, all of whom had low back pain. For the lumbar stabilization exercise group (n=15), lumbar stabilization exercise was performed using a sling system, while the neurodynamic technique group (n=15) performed the neurodynamic technique. The intervention was performed 5 days a week for 4 weeks. All measurement of each subject were measure at pre-intervention and post-intervention (after 4 weeks). SPSS/PC ver. 18.0 program was used to compile results. RESULTS: There was no significant difference in general characteristics of subjects between both groups (p>.05). Assessed items included the visual analog scale score (VAS), Korean version of the Oswestry Disability Index (KODI), lumbar instability test positive response counter (LIC) and Fear-Avoidance Beliefs Questionnaire score (FABQ), and a significant reduction was observed post-intervention compared to pre-intervention values in both groups (p<.01). Other assessed items such as trunk flexibility and lumbar extensor endurance and lumbar flexor endurance were significantly increased post-intervention in both groups compared to pre-intervention values (p<.01). There was no significant difference in all parameters between both groups (p>.05). CONCLUSION: Our results indicate that the neurodynamic technique may be useful for improving low back pain in patients with lumbar instability.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.37-42
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• 2015

Background: This study investigates the impact of the cervical musculoskeletal intervention on post-traumatic stress disorder patient's cervical pain levels and depression factor. Methods: Thrty neck pain patients diagnosed with post-traumatic stress disorder were enrolled. Neck exercise training using a sling system was applied to the experimental group and self-neck movement exercise, modification of the McKenzie exercise, was applied to the control group. Both groups were checked every week whether they performed or not. Both groups performed their exercise for 35 minutes for a time and 3 times per week. Total period of the intervention was 6 weeks. To compare the effects of interventions, threshold of cervical tenderness and depression level were measured before and after the each intervention and also measured at follow-up. Results: Painthreshold of left trapezius showed a significant difference between two groups at three points. It increased 19.71% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 20.06% in the experimental group. Pain threshold of right trapezius showed a significant difference at three points. It increased 18.35% in the experimental group after the intervention compared to before the intervention. At follow-up it also increased 15.93% in the experimental group. According to the result interaction between groups and measurement time in both side of trapezius was valid. Depression level showed significant difference in the experimental group between three points. It decreased 18.07% after the intervention compared to before the intervention and decreased 15.21% at follow-up. According to the result interaction between groups and measurement time in depression level was valid. Conclusions: This study has important implications as the therapeutic strategy, high potent of improving symptoms, shows effect to a subject who has psychological problem such as posttraumatic stress disorder (PTSD).

• The Korean Journal of Rehabilitation Nursing
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• v.5 no.2
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• pp.134-144
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• 2002

Purpose: The purpose of this study was to investigate the effects of upper extremity exercise training on the motor activity, the ADL and the health related quality of life. Method: A non-equivalent pretest-posttest design was used. Study subjects were conveniently selected 40 hemiplegic patients(20 experimental subjects, 20 control subjects) who had been enrolled in two community health centers. After biofeedback training the subjects of experimental group were given constraint-induced movement, involving restraint of unaffected U/E in a sling for about 6 hours over a period of two weeks, while at the same time intensively training the affected U/E. Outcomes were evaluated on the basis of motor activity(amount, quality) of plegic side, ADL(ADL, IADL) and health related QOL(SF-36). Results: 1. After 2 weeks of treatment, the amount of use and the quality of motor activity of affected U/E were significantly higher in subjects who participated in exercise training than in subjects in the control group. 2. There were no significant differences in ADL and IADL between experimental and control groups. 3. After 2 weeks of treatment, the health related QOL was significantly higher in subjects who participated in exercise training than in subjects in the control group. Conclusion: The above results state that the U/E exercise training could be an effective intervention for improving the motor activity and the health related QOL of chronic hemiplegic patients. Long-term studies are needed to determine the lasting effects of constraint-induced movement.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.4
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• pp.1914-1920
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• 2019

Background: Mobilization and cranio-cervical flexion exercise has been reported in reducing pain from cervical part and improving its motor function; also, has been represented that alleviate of neck pain and recover of neck muscles improve the normal gait performance. However, few studies have identified the effects of mobilization and exercise on pain and gait parameters with preceding issues. Objective: To examine the effects or changes of pressure pain threshold (PPT) and gait parameters in patients with chronic neck pain. Design: Cross-Sectional Clinical Trials Methods: Twenty patients with the history of neck pain (>3 months) performed the cervical mobilization and cranio-cervical flexion exercise. Gait parameters were assessed with wireless device and collected data were transmitted to the personal computer via Bluetooth. The PPT was measured posteroanterior direction at the prone position and the mean of subsequent three PPT measurements was used for the final analysis. Results: Both cervical central posteroanterior mobilization (CCPAM) (p<.000) and sling-based cranio-cervical flexion exercise (SBCCFE) (p<.000) group showed a significant increase in the PPT and the gait parameters, cadence (p<.023), was significantly increased in the CCPAM group, however slightly increased in the SBCCFE group. The comparison between the CCPAM and the SBCCFE groups after treatment did not show significant differences for the score on the PPT and gait parameters. Conclusions: This study suggests that CCPAM and SBCCFE increase PPT, cadence, and gait speed.

• Archives of Orthopedic and Sports Physical Therapy
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• v.14 no.2
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• pp.33-44
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• 2018

Purpose: The primary purpose of this study was to investigate the effects of cervical stabilization exercise (CSE) on hamstring flexibility in patients with neck pain. A secondary purpose of this study was to investigate the effects of cervical range of motion (CROM) and craniovertebral angle (CVA). Methods: This study was a single-blind, randomized, comparative trial. Twenty patients were allocated into either the cranio-cervical flexion exercise (CCFE) group or the CSE group. Before and after the intervention, we measured straight leg raise (SLR), popliteal angle (PA), CROM, and CVA in the sitting and standing positions. Fisher's exact test, the Mann-Whitney test, and Wilcoxon's signed-rank test were used to analyze our data. Results: Both groups showed significant improvements in the value of SLR, PA, cervical extension, cervical rotation, and CVA in the standing position (both, p<.05) after intervention. However, only the CSE group showed significant improvements in cervical right lateral flexion (z=-2.209; p<.01) and cervical left lateral flexion (z=-2.537; p<.05) after intervention. The CSF group showed more significant improvements in SLR, PA, both cervical lateral flexions, and both cervical rotations than the CCFE group. Conclusions: The results of this study will guide future research in identifying the effectiveness of CSE. In conclusion, it can be inferred that CSE has a positive effect on SLR, PA, CROM, and CVA in the standing position in patients with chronic neck pain.